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1.
Med Microbiol Immunol ; 205(3): 263-8, 2016 Jun.
Article in English | MEDLINE | ID: mdl-26666643

ABSTRACT

An accurate quantification of low viremic HCV RNA plasma samples has gained importance since the approval of direct acting antivirals and since only one single measurement predicts the necessity of a prolonged or shortened therapy. As reported previously, HCV quantification assays such as Abbott RealTime HCV and Roche COBAS AmpliPrep/COBAS TaqMan HCV version 2 (CTM v2) may vary in sensitivity and precision particularly in low-level viremia. Importantly, substantial variations were previously demonstrated between some of these assays compared to the Roche High Pure System/COBAS TaqMan assay (HPS) reference assay, which was used to establish the clinical decision points in clinical studies. In this study, the reproducibility of assay performances across several laboratories was assessed by analysing quantification results generated by six independent laboratories (3× RealTime, 3× CTM v2) in comparison with one HPS reference laboratory. The 4th WHO Standard was diluted to 100, 25 and 10 IU/ml, and aliquots were tested in triplicates in 5 independent runs by each assay in the different laboratories to assess assay precision and detection rates. In a second approach, 2 clinical samples (GT 1a & GT 1b) were diluted to 100 and 25 IU/ml and tested as described above. While the result range for WHO 100 IU/ml replicates across all laboratories was similar in this analysis, the CVs of each laboratory ranged from 19.3 to 25.6 % for RealTime laboratories and were lower than CVs of CTM v2 laboratories with a range of 26.1-47.3 %, respectively, and also in comparison with the CV of the HPS reference laboratory (34.9 %). At WHO standard dilution of 25 IU/ml, 24 replicates were quantified by RealTime compared to 8 replicates with CTM v2. Results of clinical samples again revealed a higher variation of CTM v2 results as compared to RealTime values. (CVs at 100 IU/ml: RealTime: 13.1-21.0 % and CTM v2: 15.0-32.3 %; CVs at 25 IU/ml: RealTime 17.6-34.9 % and CTM v2 28.2-54.9 %). These findings confirm the superior precision of RealTime versus CTM v2 at low-level viremia even across different laboratories including the new clinical decision point at 25 IU/ml. A highly precise monitoring of HCV viral load during therapy will remain crucial for patient management with regard to futility rules, therapy efficacy and SVR.


Subject(s)
Drug Monitoring/methods , Hepacivirus/isolation & purification , Hepatitis C, Chronic/drug therapy , Hepatitis C, Chronic/virology , Viral Load/methods , Antiviral Agents/therapeutic use , Humans , RNA, Viral/blood , Reproducibility of Results
2.
Open Forum Infect Dis ; 2(2): ofv077, 2015 Apr.
Article in English | MEDLINE | ID: mdl-26180827

ABSTRACT

Condomless sex is a key driver of sexually transmitted diseases. In this study, we assess the long-term changes (2000-2013) of the occurrence of condomless sex among human immunodeficiency virus (HIV)-infected individuals enrolled in the Swiss HIV Cohort study. The frequencies with which HIV-infected individuals reported condomless sex were either stable or only weakly increasing for 2000-2008. For 2008-2013, these rates increased significantly for stable relationships among heterosexuals and men who have sex with men (MSM) and for occasional relationships among MSM. Our results highlight the increasing public health challenge posed by condomless sex and show that condomless sex has been increasing even in the most recent years.

3.
Open Forum Infect Dis ; 1(2): ofu040, 2014 Sep.
Article in English | MEDLINE | ID: mdl-25734114

ABSTRACT

BACKGROUND: The factors that contribute to increasing obesity rates in human immunodeficiency virus (HIV)-positive persons and to body mass index (BMI) increase that typically occurs after starting antiretroviral therapy (ART) are incompletely characterized. METHODS: We describe BMI trends in the entire Swiss HIV Cohort Study (SHCS) population and investigate the effects of demographics, HIV-related factors, and ART on BMI change in participants with data available before and 4 years after first starting ART. RESULTS: In the SHCS, overweight/obesity prevalence increased from 13% in 1990 (n = 1641) to 38% in 2012 (n = 8150). In the participants starting ART (n = 1601), mean BMI increase was 0.92 kg/m(2) per year (95% confidence interval, .83-1.0) during year 0-1 and 0.31 kg/m(2) per year (0.29-0.34) during years 1-4. In multivariable analyses, annualized BMI change during year 0-1 was associated with older age (0.15 [0.06-0.24] kg/m(2)) and CD4 nadir <199 cells/µL compared to nadir >350 (P < .001). Annualized BMI change during years 1-4 was associated with CD4 nadir <100 cells/µL compared to nadir >350 (P = .001) and black compared to white ethnicity (0.28 [0.16-0.37] kg/m(2)). Individual ART combinations differed little in their contribution to BMI change. CONCLUSIONS: Increasing obesity rates in the SHCS over time occurred at the same time as aging of the SHCS population, demographic changes, earlier ART start, and increasingly widespread ART coverage. Body mass index increase after ART start was typically biphasic, the BMI increase in year 0-1 being as large as the increase in years 1-4 combined. The effect of ART regimen on BMI change was limited.

4.
Immunol Invest ; 38(1): 67-75, 2009.
Article in English | MEDLINE | ID: mdl-19172486

ABSTRACT

Lymphocyte transformation tests (LTT) are time-consuming radioactive assays used in the clinic for the determination of allergic drug reactions and extensively in basic immunological research. In the present study we propose an alternative method in the monitoring of T-cell responses by isothermal microcalorimetric (IMC) measurements of overall cellular heat production as a function of time. For mitogen-induced lymphocyte proliferation, we analyzed a concentration dependent effect of phytohemaglutinin (PHA) and both tests showed a good correlation. This was also the case for specific antigenic stimulation with Varidase(R) or tetanus toxoid. On the other hand, antigen-induced lymphocyte proliferation analyzed by pre and post influenza vaccine (Inflexal(R) V) samples, showed no such correlation. Our study suggests that IMC measurements, despite the advantages of simplicity, on-line recording of metabolic activity and no use of radioactivity, may be limited to monitoring mitogen-induced lymphocyte proliferation.


Subject(s)
Calorimetry/methods , Cell Proliferation , Lymphocyte Activation/immunology , T-Lymphocytes/cytology , Autoradiography/methods , Humans , Influenza Vaccines/immunology , Phytohemagglutinins/immunology , Sensitivity and Specificity , Streptodornase and Streptokinase/immunology , T-Lymphocytes/metabolism , Temperature , Tetanus Toxoid/immunology , Thymidine , Tritium , Vaccines, Virosome/immunology
5.
Clin Exp Rheumatol ; 26(3): 453-6, 2008.
Article in English | MEDLINE | ID: mdl-18578968

ABSTRACT

BACKGROUND: Early differentiation between septic and non-septic arthritis is difficult. A previous study showed promising diagnostic accuracy of serum Procalcitonin (PCT) in septic arthritis, limited by a low sensitive PCT test kit. OBJECTIVE: To investigate the diagnostic value of PCT in patients with septic and non-septic arthritis using a novel test with low detection limit. METHODS: Forty-two patients, 28 with non-septic and 14 with septic arthritis were prospectively included. For each patient, gram stain, culture and polarization microscopy of synovial fluid was done and PCT, C-reactive protein (CRP), white blood cell count, uric acid and blood cultures were taken. Patients with septic arthritis, patients with non-septic arthritis with and without concomitant infection were compared. RESULTS: Patients with septic arthritis had a significant higher PCT concentration than patients with non-septic arthritis (p<0.0001). At a cut-off of 0.1 (0.25) ng/ml, sensitivity for septic arthritis was 100(93)% and specificity 46(75)%. Specificity rose to 93% after exclusion of patients with non-septic arthritis and concomitant infection. Both sensitivity and specificity for the diagnosis of septic arthritis were higher for PCT than CRP. CONCLUSIONS: Our data suggest that PCT seems to be a highly sensitive and specific marker for septic arthritis, depending on the clinical setting. Further studies are warranted.


Subject(s)
Arthritis, Infectious/blood , Arthritis, Infectious/diagnosis , Arthritis/blood , Arthritis/diagnosis , Calcitonin/blood , Protein Precursors/blood , Adult , Aged , Aged, 80 and over , Arthritis, Infectious/microbiology , Biomarkers/blood , C-Reactive Protein/metabolism , Calcitonin Gene-Related Peptide , Case-Control Studies , Diagnosis, Differential , Female , Humans , Listeria monocytogenes/pathogenicity , Male , Middle Aged , Prospective Studies , Sensitivity and Specificity , Staphylococcus aureus/pathogenicity , Streptococcus agalactiae/pathogenicity , Uric Acid/metabolism
7.
Circ Res ; 79(3): 524-31, 1996 Sep.
Article in English | MEDLINE | ID: mdl-8781485

ABSTRACT

Migration of smooth muscle cells from media to intima is critical for the development of neointimal thickening after balloon catheter injury of the rat carotid artery. The present experiments were designed to identify molecules expressed by smooth muscle cells migrating in vivo in the injured artery. Cell migration was maximized by infusing recombinant platelet-derived growth factor-BB (PDGF-BB) after a minimal filament denudation of the rat carotid artery, whereas cell proliferation was minimized by injecting an antibody against basic fibroblast growth factor (bFGF). This treatment caused an eightfold increase in smooth muscle cell migration into the intima but only a twofold increase in intimal smooth muscle cell replication rates. Differential display screening was used to isolate cDNAs that were overexpressed in the injured PDGF-BB-treated versus unmanipulated rat carotids. One of the clones isolated hybridized to a 4.2-kb mRNA species and shared 90% sequence homology to mouse alpha 1 type VIII collagen. Northern and Western blots confirmed overexpression of type VIII collagen in the injured PDGF-BB-treated vessels. In a separate series of experiments, we performed filament denudation injury and administered antibodies to inhibit the actions of endogenous bFGF and PDGF-BB, thereby decreasing smooth muscle cell migration, and found that type VIII collagen mRNA expression varied with migration. Using a different arterial injury model (balloon catheter injury), we showed that expression of type VIII collagen was maximal 2 to 4 days after injury, in coincidence with cell migration from the media to the intima. This molecule constitutes an important component of smooth muscle cell response to vessel injury and may play an important functional role in mediating migration.


Subject(s)
Carotid Arteries/metabolism , Carotid Artery Injuries , Collagen/metabolism , Platelet-Derived Growth Factor/pharmacology , Animals , Base Sequence , Becaplermin , Blotting, Northern , Blotting, Western , Catheterization , Cloning, Molecular , Collagen/genetics , DNA, Complementary/genetics , Male , Mice , Molecular Sequence Data , Proto-Oncogene Proteins c-sis , RNA, Messenger/metabolism , Rats , Rats, Sprague-Dawley , Recombinant Proteins
8.
J Vasc Res ; 31(3): 163-72, 1994.
Article in English | MEDLINE | ID: mdl-8148467

ABSTRACT

Laminin, a major structural glycoprotein complex of basement membranes has been found to be modulated by angiotensin II in vitro and in vivo. In cultures of aortic organoids and vascular smooth muscle cells, expression of laminin was stimulated by exogenous vasoconstrictor peptide. Stimulation of laminin protein and mRNA expression was observed for both laminin B1/B2-chains and an unknown laminin heavy chain. Compared with PYS-2 cells, a mouse teratocarcinoma cell line which constitutively expresses a 10-kb mRNA transcript for 'classical' laminin A-chain, cultured vascular smooth muscle cells (VSMC) did not express a corresponding mRNA. However, cultured VSMC were found to express laminin A-chain-related mRNAs of approximately 1.8 kb and approximately 3.8 kb, respectively. The 1.8-kb species of transcript was expressed in a constitutive manner, whereas the 3.8-kb mRNA was found to be regulated by angiotensin II. Laminin complexes secreted by cultured cells contained a approximately 300 kD heavy chain which did not immunoreact with immunoreagents raised against either the classical laminin complex secreted by EHS tumor cells or the merosin heavy chain. The putative A-chain analogue possibly represents a new form of a tissue-specific laminin heavy chain, distinct from the A- and M-chains thus far described. Translation products encoded by the A-chain-related transcripts of cultured smooth muscle cells could not be specified using currently available antibodies. The putative protein(s) is speculated to contain the biological features of the N-terminus of the laminin A-chain, namely self-assembly and association with collagen type IV.


Subject(s)
Gene Expression Regulation , Laminin/biosynthesis , Muscle, Smooth, Vascular/metabolism , RNA, Messenger/biosynthesis , Animals , Aorta/drug effects , Aorta/metabolism , Blotting, Northern , Blotting, Western , Cells, Cultured , DNA Probes , Dose-Response Relationship, Drug , Endothelium, Vascular/drug effects , Endothelium, Vascular/metabolism , Immunohistochemistry , Laminin/genetics , Male , Mice , Muscle, Smooth, Vascular/drug effects , Organoids/drug effects , Organoids/metabolism , Precipitin Tests , Protein Biosynthesis , Rats , Rats, Inbred SHR , Teratocarcinoma/metabolism , Transcription, Genetic , Tumor Cells, Cultured
9.
J Biol Chem ; 269(14): 10524-8, 1994 Apr 08.
Article in English | MEDLINE | ID: mdl-8144638

ABSTRACT

Among all the receptor-linked protein-tyrosine-phosphatase RPTP alpha clones described from mammalian tissues, one differed in that it encoded a 9-amino-acid insert 3 residues upstream from the transmembrane segment (Kaplan, R., Morse, B., Huebner, K., Croce, C., Howk, R. Ravera, M., Ricca, G., Jaye, M., and Schlessinger, J. (1990) Proc. Natl. Acad. Sci. U. S. A. 87, 7000-7004). Using the polymerase chain reaction technique, simultaneous expression of both isoforms was demonstrated in human T-cell and vascular smooth muscle libraries, as well as in the A431 human epidermal cancer cell line. Following transient expression in COS-1 cells, each isoform gave rise to two proteins of 100 and 130 kDa, respectively. Endoglycosidase treatment showed that the 100-kDa species corresponded to a molecule exclusively glycosylated on N-residues, whereas the 130-kDa species contained both, N- and O-linked carbohydrates. Pulse-chase experiments demonstrated that the smaller RPTP alpha protein is a precursor of the larger one. A high affinity antibody was generated that recognizes the immature protein only; however, both proteins can be detected by Western blot analysis after a simple chemical hydrolysis. Following Superose 12 chromatography, the 100- and 130-kDa species of RPTP alpha emerged as 200- and 340-kDa proteins, respectively. Both species exhibited similar enzymatic activities as determined with a peptide substrate in immunoprecipitates.


Subject(s)
Isoenzymes/metabolism , Protein Tyrosine Phosphatases/metabolism , Receptors, Cell Surface/metabolism , Amino Acid Sequence , Base Sequence , Cell Line , DNA, Complementary , Enzyme Precursors/genetics , Enzyme Precursors/metabolism , Glycosylation , Humans , Isoenzymes/genetics , Molecular Sequence Data , Molecular Weight , Protein Tyrosine Phosphatases/genetics , Receptor-Like Protein Tyrosine Phosphatases, Class 4 , Receptors, Cell Surface/genetics , Tumor Cells, Cultured
10.
J Vasc Res ; 30(4): 192-201, 1993.
Article in English | MEDLINE | ID: mdl-8357950

ABSTRACT

Endothelin-1 (ET-1), a vasoconstrictor peptide produced by endothelial and vascular smooth muscle cells (VSMC) might play a role in vascular remodelling. To investigate the proposed 'mitogenic' potential of ET-1, we examined the effects of chronic exposure of VSMC to ET-1 on cell cycle, growth/proliferation and differentiation under essentially mitogen-free culture conditions. Bulk cultures of thoracic aortic VSMC of spontaneously hypertensive (SHR) and normotensive Wistar Kyoto (WKY) rats, although exhibiting genetically determined differences in growth/proliferation (due to shortened G1 and G2 phases in SHR VSMC), respond in a similar manner to ET-1 exposure: long-term exposure (12-15 days) of VSMC from both sources to ET-1 in nonmitogenic medium did not promote cycling of cells. On the contrary, ET-1 attenuated the cycling of VSMC which had already cycled beyond the S phase. For cells which had not cycled beyond the S phase, ET-1 interrupted progression through the cell cycle at the late G1/early S phase. The specific ability of SHR VSMC to grow in mitogen-free medium was abolished by ET-1, most likely via down-regulation of platelet-derived growth factor (PDGF)-alpha receptors. Subsequent to ET-1 exposure, VSMC expressed increased levels of mRNA and protein for smooth-muscle-specific alpha-actin. However, expression of smooth muscle alpha-actin did not predominate over beta-actin as observed for adult contractile VSMC in vivo. The ET-1-induced expression of smooth-muscle-specific alpha-actin mRNA was dose dependent (EC50 approx. 2 x 10(-9) M), and alpha-actin protein expressed was associated with organized actin fibers.


Subject(s)
Endothelins/pharmacology , Muscle, Smooth, Vascular/cytology , Actins/metabolism , Animals , Aorta/cytology , Aorta/drug effects , Cell Cycle/drug effects , Cell Division/drug effects , Immunohistochemistry , Muscle, Smooth, Vascular/drug effects , Muscle, Smooth, Vascular/metabolism , Osmolar Concentration , Rats , Rats, Inbred SHR , Rats, Inbred WKY
11.
Biochem Biophys Res Commun ; 192(1): 189-97, 1993 Apr 15.
Article in English | MEDLINE | ID: mdl-8476421

ABSTRACT

This study has investigated the influence of the vasoconstrictor peptides angiotensin II (Ang II) and endothelin-1 (ET-1) on fibronectin expression by vascular smooth muscle cells (VSMC). In confluent, quiescent cultures of VSMC, Ang II and ET-1 elevated fibronectin mRNA levels in a time- and dose-dependent fashion. ET-1 and Ang II also induced a time-dependent expression of immunoreactive fibronectin in cultures of aortic organoids, and for both peptides the fibronectin immunoreactivity was most prominent within those medial smooth muscle cell layers close to the vessel lumen. Immunoprecipitation of biosynthetically labelled fibronectin elaborated by cultured VSMC revealed a predominant expression of soluble fibronectin in response to Ang II, whereas for ET-1 the newly synthesized fibronectin was predominantly incorporated into the extracellular matrix deposit of the cells. These findings indicate that Ang II and ET-1 may exert disparate effects on smooth muscle cell phenotype and migration.


Subject(s)
Angiotensin II/physiology , Aorta/metabolism , Endothelins/physiology , Fibronectins/biosynthesis , Animals , Cells, Cultured , Extracellular Matrix/metabolism , Fibronectins/genetics , Gene Expression , Male , Muscle, Smooth, Vascular/metabolism , RNA, Messenger/metabolism , Rats , Rats, Inbred SHR
12.
Am J Pathol ; 141(2): 377-88, 1992 Aug.
Article in English | MEDLINE | ID: mdl-1379781

ABSTRACT

The extracellular matrix glycoprotein tenascin is associated with remodeling events in many embryonic and pathologic tissues. The expression of tenascin has been investigated by immunohistochemistry in blood vessels of Wistar-Kyoto (normotensive) and spontaneously hypertensive rats. Weak tenascin staining was present throughout the tunica media of large and small arteries from normotensive animals; strong staining was only detectable at branching sites. In arteries from hypertensive animals, foci of strong tenascin staining were scattered throughout the tunica media. The expression of tenascin mRNA and protein by rat aortic smooth muscle cells cultured in serum-free medium was induced by the vasoconstrictor peptide angiotensin II. Transforming growth factor-beta and platelet-derived growth factor also stimulated tenascin mRNA expression. Vascular smooth muscle cells attached specifically to a substratum of tenascin, but remained rounded. Thus, increased focal tenascin expression by vascular smooth muscle cells is associated with hypertension, and may mediate angiotensin II-induced changes in vascular structure in hypertension.


Subject(s)
Angiotensin II/pharmacology , Cell Adhesion Molecules, Neuronal/metabolism , Extracellular Matrix Proteins/metabolism , Hypertension/metabolism , Muscle, Smooth, Vascular/metabolism , Animals , Arteries/metabolism , Cell Adhesion/physiology , Cells, Cultured , Hypertension/pathology , Immunohistochemistry , Male , Muscle, Smooth, Vascular/pathology , Rats , Rats, Inbred SHR , Rats, Inbred WKY , Reference Values , Tenascin
13.
Thromb Res Suppl ; 12: 11-21, 1990.
Article in English | MEDLINE | ID: mdl-2082483

ABSTRACT

The effects of 50 mg aspirin combined with 400 mg dipyridamole were compared with those of standard anticoagulant therapy, in the prevention of aortocoronary vein bypass graft occlusion. Early graft occlusion in 249 patients, with 749 distal vein graft anastomoses, were angiographically assessed 11.5 +/- 2 days after surgery and were almost equal in both treatment groups. In half of the patients in each group, active treatment was replaced by placebo after 3 months. Repeat angiography after 1 year (360 +/- 24 days) showed that more new late graft occlusions occurred in patients with only 3 months active medication (either regimen). The incidence of major complications was significantly higher in patients treated with anticoagulants, with minor side-effects more common in the antiplatelet group. Thus, this antiplatelet drug regimen was as effective as standard anticoagulant therapy in the prevention of early and late bypass graft occlusion, but carried a significantly lower risk of severe complications. In addition, as replacement of active treatment by placebo after 3 months resulted in significantly more graft occlusions, antithrombotic treatment should be continued for at least one year after coronary artery bypass graft surgery.


Subject(s)
Anticoagulants/therapeutic use , Aspirin/therapeutic use , Coronary Artery Bypass , Dipyridamole/therapeutic use , Graft Occlusion, Vascular/prevention & control , Adult , Aged , Anticoagulants/adverse effects , Aspirin/adverse effects , Dipyridamole/adverse effects , Double-Blind Method , Drug Therapy, Combination , Female , Humans , Male , Middle Aged , Time Factors
14.
Schweiz Med Wochenschr ; 119(43): 1518-20, 1989 Oct 28.
Article in German | MEDLINE | ID: mdl-2692145

ABSTRACT

In a prospective randomized trial the effect of prolonged antithrombotic treatment with anticoagulants or antiplatelet drugs (50 mg aspirin + 400 mg dipyridamole daily) on late bypass-graft occlusion was studied. After 3 months active treatment was replaced by placebo in half of the patients. Between the angiographic checkups 2 weeks and 12 months postoperatively, 28/330 (8%) new graft occlusions had occurred on continued therapy, versus 44/319 (14%) on placebo (p = 0.03). This difference was most pronounced in individual grafts (6% vs 12%, p = 0.01), so that fewer patients with 12 months' active therapy had at least one occluded graft (22% versus 32%, p = 0.08). These findings suggest that antithrombotic treatment should not be halted 3 months after CABG surgery but should be continued for at least one year and possibly longer.


Subject(s)
4-Hydroxycoumarins/therapeutic use , Aspirin/therapeutic use , Coronary Artery Bypass , Dipyridamole/therapeutic use , Phenprocoumon/therapeutic use , Adult , Aged , Coronary Angiography , Female , Humans , Male , Middle Aged , Prospective Studies , Randomized Controlled Trials as Topic , Vascular Patency
15.
Lancet ; 2(8653): 1-7, 1989 Jul 01.
Article in English | MEDLINE | ID: mdl-2567792

ABSTRACT

In a prospective randomised trial, 249 patients who had aortocoronary vein bypass surgery were assigned either to a platelet inhibitory drug regimen or to standard anticoagulant therapy. Treatment was replaced by placebo in half of the patients in each group after 3 months. The platelet inhibitory drug regimen--very low-dose aspirin combined with dipyridamole--was as effective as standard anticoagulant therapy to prevent early and late graft occlusion. Death, myocardial infarction, and severe bleeding occurred significantly more often in patients receiving anticoagulants, whereas mild drug-related gastrointestinal and cerebral side-effects were more common in patients taking platelet inhibitory drugs. Antithrombotic treatment should be continued for at least 1 year after coronary artery bypass graft surgery.


Subject(s)
4-Hydroxycoumarins/administration & dosage , Aspirin/administration & dosage , Coronary Artery Bypass , Coronary Disease/prevention & control , Coronary Thrombosis/prevention & control , Dipyridamole/administration & dosage , Graft Occlusion, Vascular/prevention & control , Phenprocoumon/administration & dosage , Platelet Aggregation Inhibitors/therapeutic use , Postoperative Complications/prevention & control , Premedication , Adult , Aged , Aspirin/adverse effects , Aspirin/therapeutic use , Clinical Trials as Topic , Dipyridamole/adverse effects , Dipyridamole/therapeutic use , Double-Blind Method , Drug Administration Schedule , Drug Evaluation , Drug Therapy, Combination , Female , Follow-Up Studies , Humans , Male , Middle Aged , Phenprocoumon/adverse effects , Phenprocoumon/therapeutic use , Platelet Aggregation/drug effects , Prospective Studies , Random Allocation , Saphenous Vein/transplantation
16.
Eur Heart J ; 9 Suppl N: 98-103, 1988 Dec.
Article in English | MEDLINE | ID: mdl-3246266

ABSTRACT

Demonstration of ischaemic left ventricular dysfunction in the absence of chest pain should provide important confirmation of silent myocardial ischaemia in patients with asymptomatic ST segment changes. For this purpose, a new portable scintillation probe (VEST) similar to a miniaturized nuclear stethoscope combined with a Holter ECG was evaluated. After standard equilibrium radionuclide angiocardiography with technetium-99m labelled red blood cells, the VEST was positioned under gamma-camera control and data were recorded from 1-12 h in 61 unselected patients. Ejection fraction (LVEF), relative changes in volumes, heart rate and ST segment changes were determined. Reproducibility of LVEF at rest (r = 0.91; variability 3.8 +/- 3%, N = 19) and during exercise (r = 0.98; variability 3.2 +/- 2%, N = 19) was good. In 15 asymptomatic exercise tests four different patterns of LVEF and ST segment responses were identified: (1) decrease in LVEF followed by significant ST depression (five times); (2) ST depression followed by decrease in LVEF (three times); (3) decrease in LVEF without significant ST changes (three times); and (4) ST depression without significant LVEF change (four times). In this still small series, patterns (1) to (3) corresponded to patients with documented coronary artery disease, which was not the case for pattern (4). For detection of silent ischaemia at rest, a decrease in LVEF of greater than 5% lasting for greater than 1 min was defined as ischaemic LV dysfunction. Using this definition, four spontaneous episodes of silent LV dysfunction could be demonstrated in two of three CCU patients with unstable angina during 160-680 min of data recordings without simultaneous ST changes.(ABSTRACT TRUNCATED AT 250 WORDS)


Subject(s)
Coronary Disease/diagnostic imaging , Heart/physiopathology , Monitoring, Physiologic/methods , Aged , Angiocardiography , Electrocardiography , Exercise Test , Heart Rate , Humans , Middle Aged , Radionuclide Imaging
17.
Schweiz Med Wochenschr ; 118(46): 1719-23, 1988 Nov 19.
Article in German | MEDLINE | ID: mdl-3212424

ABSTRACT

To validate a new portable scintillation probe (VEST) for determination of LV function, 68 patients were studied after standard radionuclide angiography (RNA). Reproducibility of VEST LV-ejection fraction was good (rest r = 0.93; exercise r = 0.96) with unchanged probe position, somewhat less good after probe repositioning (r = 0.84) and correlated with RNA (rest r = 0.79; exercise r = 0.83). Long term measurements in 7 patients showed valid data for up to 12 hours. Combined with simultaneous two lead ECG recording VEST seems suitable for detection of transient changes of LV function such as occur during ischemia or due to drug treatment.


Subject(s)
Heart Ventricles/diagnostic imaging , Radionuclide Imaging/methods , Stroke Volume , Exercise Test , Female , Humans , Male , Middle Aged , Radionuclide Imaging/instrumentation , Technetium , Ventricular Function
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