Vascular events during follow-up in patients with aortic arch atherosclerosis.

BACKGROUND AND PURPOSE: An association between aortic arch atherosclerosis and vascular events has been demonstrated. However, few data exist regarding follow-up evaluation of this disease. METHODS: In this study, 183 patients with the diagnosis of aortic arch atherosclerosis were prospectively followed up. This diagnosis was made during an echocardiographic cross-sectional study. In 136 patients, raised plaques with thickness < 5 mm had been shown to exist, and in 47 patients complex plaques with thickness > or = 5 mm or plaques with mobile components had been demonstrated on the initial transesophageal echocardiography. RESULTS: During a mean follow-up period of 16 +/- 7 months, vascular events with a presumed embolic origin occurred in 15 patients. The incidence was 4.1 per 100 person-years in patients with raised plaques compared with 13.7 per 100 person-years in the group with complex plaques. The Kaplan-Meier survival analysis revealed a significantly higher rate of vascular events in patients who were found to have complex plaques (P < .01). In the Cox proportional hazards analysis, the finding of complex plaques (relative risk [RR], 4.3; 95% confidence interval [CI], 1.5 to 12.0; P = .006), coronary artery disease (RR, 4.0; 95% CI, 1.2 to 13.1; P = .02), and a history of previous embolism (RR, 4.0; 95% CI, 1.1 to 14.4; P = .03) were independent predictors of vascular events. CONCLUSIONS: Patients with the finding of protruding plaques or plaques with mobile components have a high risk of subsequent vascular events.

[Noninvasive diagnosis of coronary heart disease with cardiokymography: use of signal averaging technique]. / Nichtinvasive Diagnostik der koronaren Herzerkrankung mit Kardiokymographie: Einsatz der Signalmittelungstechnik.

Regional wall motion abnormality is the best indicator for coronary ischemia. Myocardial wall motion is registrated by cardiokymography (CKG), a mechanocardiographic method. Because of the high incidence of artefacts, echocardiography and nuclear imaging technique have been preferred. Computer-assisted signal averaging CKG improves practicability and allows measurements during exercise testing. Exercise testing was performed in 54 patients with suspected ischemic heart disease without mitral or aortic valve dysfunction, myocardial infarction or prior cardiac surgery. The results of simultaneously recorded ECG and CKG were compared with coronary angiographic results. CKG sensitivity and specificity were higher than that of ECG (76 and 80% vs 71 and 52%). If diagnosis was based on pathological or nonpathological results of both CKG and ECG, sensitivity and negative predictive value increased to 87 and 83%, respectively. Sensitivity reached 93% when only one pathological result was required. CKG combined with signal-averaging techniques has advanced to become a specific and sensitive tool in the non-invasive diagnostic approach to ischemic heart disease.

[Activities and properties of adenosine triphosphatase (ATPase) in homogenates of renal cortex, liver, myocardium and small-intestine mucosa in sheep]. / Untersuchungen über die Aktivität und die Eigenschaften der Adenosintriphosphatase (ATPase) in Homogenaten der Nierenrinde, des Gehirns, der Leber, des Herzmuskels und der Dünndarmschleimhaut von Schafen

Studies conducted into the activity of adenosine triphosphatase (ATPase) in homogenate of several tissues of sheep and against the background of pH 7.5 (tris-HCl buffer) have shown highest enzyme activity to develop in renal cortex and cerebral cortex followed, in declining order of quotation, by liver, myocardium, and mucous membrane of small intestine. ATPase activities were studied also in the presence of pH-values between 7.2 and 8.95 (tris-HCl buffer) and between 8.6 and 11 (piperazine buffer), with the pH optimum of ATPase in the above tissues having been found to lie at approximately 9.0. Different concentrations of Mg ions were added, and maximum ATPase activity of 2 mMol ATP was obtained by adding 2 mMol Mg. Decline in ATPase activity should be expected in the case of hypomagnesaemia. Addition of different concentrations of sodium and potassium ions gave in most of the tissues tested maximum activity in response to 10 mMol potassium and 68 mMol sodium. Na-K ATPase could be inhibited by oubain particularly in cerebral and renal cortex.