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Biomedical subjects

G Breithardt

Publications and source records attributed to G Breithardt.

566 records · Page 32Linked to original sources
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Microembolic load in asymptomatic patients with cardiac aneurysm, severe ventricular dysfunction, and atrial fibrillation. Clinical and hemorheological correlates.

Transcranial Doppler sonography has become a widely used method for detecting cerebral circulating microemboli (ME) arising from the carotid arteries or the heart. Yet, studies on subgroups of patients with distinct cardiac sources of embolism are still limited. The same holds true for investigation on the relationship between microembolization and hemorheological parameters. A total of 142 patients suffering from left ventricular aneurysm (LVA, n = 52), severe left ventricular dysfunction (LVD, n = 43), or chronic atrial fibrillation (AF, n = 47) were enrolled in this study. All patients had been neurologically asymptomatic for at least 1 month. Further relevant embolic disorders of the carotid arteries and the heart had been excluded. Unilateral monitoring for ME over the middle cerebral artery was performed for 30 min. Blood was drawn after each monitoring for determination of plasmatic coagulation parameters, as well as plasma viscosity, and platelet reactivity. The overall prevalence of ME was 31%, with a slightly higher prevalence in patients with LVA (37%) compared to patients suffering from AF (30%) or LVD (26%). With single-factor analysis, a trend towards higher ME prevalences was found with (a) a history of remote embolic events, (b) ineffective anticoagulation, (c) increased platelet aggregation, or (d) increased plasma viscosity (all p > 0.1). The combination of ineffective anticoagulation in conjunction with increased platelet aggregation, however, was significantly associated with higher ME rates even after adjustment for other factors by logistic regression analysis. Our results demonstrate a low ongoing microembolic activity in asymptomatic patients suffering from LVA, LVD and AF. An activated plasmatic coagulation system together with increased platelet aggregation contributes to ME generation.

Adult↗
PubMedDate not supplied

Abundance of microembolic signals detected by transcranial doppler ultrasound in a patient with Eisenmenger's syndrome.

BACKGROUND: Clinically silent circulating microemboli can be detected by transcranial Doppler sonography. CASE DESCRIPTION: We report the case of a 45-year-old man with congenital cyanotic heart disease, elevated haematocrit, low platelet count and decreased protein C and protein S activity. Before and following several haemodilutions, we performed 5 1-hour transcranial Doppler recordings from one or both middle cerebral arteries (MCAs) on different days. The number of microembolic signals per hour varied from 54 to 134. During the bilateral recording, the microemboli occurred on both sides (55 in the right and 45 in the left MCA, respectively). There was no relation to red blood cell count, platelet count, the spontaneously lowered prothrombin time or the spontaneously prolonged activated partial thromboplastin time. CONCLUSIONS: The origin of the large number of microembolic signals found in this patient remains unclear, but may be presumed in the intra-abdominal or crural venous system.

Eisenmenger Complex↗
PubMedDate not supplied

Reduced beat-to-beat changes of heart rate: an important risk factor after acute myocardial infarction.

The prognostic significance of heart rate variability derived from 24-hour electrocardiographic recordings was investigated in 250 patients with acute myocardial infarction. During a follow-up of 6 months 15 patients experienced a serious arrhythmic event. These patients showed a significantly reduced beat to beat variability (p = 0.006), a slightly reduced 5-min variability (p = 0.04) and no significant differences in the 24-hour variability compared to the patients free of arrhythmic events. Based on Cox proportional hazard analysis, beat to beat variability remained an independent risk factor (p = 0.0036) in addition to the presence or absence of ventricular late potentials (p = 0.0004) and history of previous infarction (p = 0.04).

Aged↗