[Clinical and procedural characteristics of patients with acute coronary syndrome during the COVID-19 pandemic 2020 compared to a control group from 2019]. / Klinische und prozedurale Charakteristika von Patienten mit akutem Koronarsyndrom während der COVID-19-Pandemie 2020 im Vergleich zu einer Kontrollgruppe aus 2019.

BACKGROUND: During the COVID-19 pandemic medical treatments including emergencies were often delayed, in part because of fear of an infection with Sars-CoV-2. Even patients with an acute coronary syndrome (ACS) were affected by these circumstances. In the present study we provide a systematic comparison of patients with ACS during the COVID-19 pandemic compared to a control group. METHODS: This is a retrospective cross-sectional study including all patients admitted with an ACS (STEMI, NSTEMI, unstable angina) undergoing coronary angiography between March 2019 and June 2019 (group A) and between March 2020 and June 2020 (group B). Demographic factors, cardiovascular risk factors and procedural data (extent of coronary disease, clinical diagnose, revascularisation strategy and outcome, use of mechanical support devices, door-to-needle time and in-hospital mortality) were compared. RESULTS: 469 patients were included in the present study (239 patients in group A and 230 in group B, mean age 69 years, 71% male). Compared to group A there were fewer patients with STEMI and unstable angina (p=0,033) but more patients with NSTEMI (p=0,047) in group B. Patients in group B had less often single vessel disease (p=0,001) but in contrast more often triple vessel disease compared to group A (p=0,052). CONCLUSION: Despite overall comparable numbers of ACS patients those admitted during the COVID-19 pandemic were more frequently diagnosed with NSTEMI and had a larger extent of coronary disease compared to a control group.

Usefulness of wearable electrocardiography devices in patients experiencing paroxysmal cardiac-related symptoms: A case series of the "CardioSecur" system.

Background: Electrocardiograms (ECGs) recorded with wearable devices and additional smartphone apps play an increasing role in cardiology. Case summaries: We present two cases in which it was possible to record an ECG during cardiac-related symptoms using the patients' smartphones. Previous standard resting and 24-hour ECGs had revealed no pathologies. In one case, AV nodal reentry tachycardia was detected and treated accordingly. In the second case, ischemic ECG changes were recorded in a young woman without cardiovascular risk factors during a chest pain episode. Suspecting a coronary vasomotion disorder, an invasive diagnostic procedure was performed. The acetylcholine spasm provocation test revealed coronary microvascular spasm and appropriate therapy was initiated. Discussion: Smartphone-based ECG systems which can be used by the patient independently while experiencing cardiac-related symptoms are a modern diagnostic tool. Considering the use of these systems is beneficial for early diagnosis and appropriate treatment for paroxysmal arrhythmias and coronary vasomotion disorders.

Colonization of Different Grapevine Tissues by Plasmopara viticola-A Histological Study.

Plasmopara viticola, the downy mildew pathogen, is one of the most important pathogens in European viticulture. This oomycete infects grapevine leaves via zoospores that encyst at stomata. A primary germ tube then enters the substomatal cavity and develops a tubular network of hyphae that proliferate intercellularly and parasitize the leaf mesophyll cells by haustoria. Leaf infections have thus been the primary object of multiple studies concerning the physiology of the pathogen and defense reactions of grapevines. Besides leaves, this oomycete pathogen is able to spread throughout the plant tissue. As shown here by microscopy, it colonizes leaf petioles, shoots, berries and seeds. Evidence is provided showing that this process is facilitated by formation of special fan-shaped hyphae that seem to be necessary to overcome physical barriers in plant tissues. Physical obstacles are mainly constituted by vascular tissue in leaf veins, leaf petioles and shoots. In grapevine shoots, the mycelium seems to extend along the cambial layer between xylem and phloem tissue. Infected young berries are completely colonized on the inside. Older infected "leather berries" show glossy appositions of the fan-shaped hyphae at the inner side of the berry skin. The seeds from that stage of infestation are devoid of endosperm and embryo and biologically dysfunctional. Furthermore, a classification system for P. viticola infection based on the degree of infections in petioles and shoot tips is presented. This study contributes to a better understanding of downy mildew pathogenesis in grapevine, a prerequisite for efficient control measures.