Ernst Wellnhofer - Academia.edu (original) (raw)

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Papers by Ernst Wellnhofer

Critical Care Medicine, 2004

Ein Kompendium für Mediziner, Informatiker, Qualitätsmanager und Epidemiologen, 2015

Background-Invasive screenings at predefined time intervals for acute rejection and transplant co... more Background-Invasive screenings at predefined time intervals for acute rejection and transplant coronary artery disease (TxCAD) are standard procedures. However, cardiac biopsies and catheterizations are distressing and risky for the patients and are also costly. We assessed the reliability of pulsed-wave tissue Doppler imaging (PW-TDI) for the timing of invasive examinations in heart recipients in an attempt to avoid unnecessary endomyocardial biopsies (EMBs) and catheterizations. Methods and Results-PW-TDI obtained at the basal left ventricular posterior wall before 408 EMBs and 293 catheterizations was tested for its diagnostic value regarding rejection and TxCAD with the use of International Society of Heart and Lung Transplantation biopsy grading, coronary angiography, and intravascular ultrasound as standards.

European Heart Journal Cardiovascular Imaging, Dec 1, 2003

Zusammenfassung Die Transplantatvaskulopathie (TVP) stellt einen der größten limitierenden Fakt... more Zusammenfassung Die Transplantatvaskulopathie (TVP) stellt einen der größten limitierenden Faktoren für das Langzeitüberleben nach Herztransplantation (HTx) dar. Neben dem diagnostischen Instrument der Angiographie werden derzeit auch der intravaskuläre Ultraschall und andere nichtinvasive Methoden für die Diagnosestellung genutzt. Die frühe Diagnose einer TVP mit mikrovaskulärer Beteiligung ist mit den obigen Verfahren nur bedingt möglich, obwohl sie erhebliche Bedeutung für Prognose und

J Endovascular Therapy, 2001

To report the increased efficacy of oversized, overlapping stents to treat an internal carotid ar... more To report the increased efficacy of oversized, overlapping stents to treat an internal carotid artery (ICA) dissecting aneurysm. A 55-year-old woman presented with reduced consciousness, aphasia, and right-sided hemiplegia owing to an infarction of the left middle cerebral artery territory documented by computed tomography. Digital subtraction angiography disclosed an extracranial dissection of the left ICA with a pseudoaneurysm. Two self-expanding Wallstents were placed, bridging the dissected segment and overlapping at the level of the aneurysm neck. Immediate arteriography showed remarkably reduced filling of the pseudoaneurysm. Serial arteriograms performed 6 days and 9 and 20 months after stenting documented the disappearance of the pseudoaneurysm without appreciable intimal hyperplasia of the vessel w all. Reducing stent porosity by overlapping the devices causes significant hemodynamic changes inside the aneurysm sac, accelerating intra-aneurysmal thrombosis.

Circulation, Nov 22, 2011

The purpose of this study was to determine whether steady-state free precession (SSFP) could impr... more The purpose of this study was to determine whether steady-state free precession (SSFP) could improve accuracy of geometric models for evaluation of left ventricular (LV) function in comparison to turbo gradient echo (TGrE) and thereby reduce the acquisition and post-processing times, which are commonly long by use of the Simpson's Rule. In 25 subjects, cine loops of the complete heart in short and horizontal long-axis planes were acquired using TGrE (TR/TE/flip ¼ 5.0/1.9/25) compared with SSFP (TR/TE/flip ¼ 3.2/1.2/60). LV volumes and EF were measured with various geometric models for TGrE and SSFP. With three-dimensional data, the LV volumes were higher and the resulting EF lower for SSFP in contrast to TGrE (51^15% vs. 57^15%, p , 0:001). With SSFP, various geometric models yielded good to excellent correlations for LV volumes and LVEF compared to volumetric data (r ¼ 0:94 2 0:98; mean relative difference 7.0 -11.4%). In contrast, correlations were low using biplane or single-plane ellipsoid models in TGrE (r ¼ 0:71 2 0:75; mean relative difference 15.9-30.2%). A new combined 327 geometric model, taking all three dimensions into account, yielded the highest accuracy for SSFP in comparison to volumetric data (r ¼ 0:99; mean relative difference 4.7%). Geometric models for assessment of LV volumes and EF yield higher accuracy and reproducibility by use of the SSFP sequence than by standard TGrE. This may increase clinical utility of magnetic resonance by shorter acquisition and processing times.

European Heart Journal Supplements, 2004

Background Mortality in severe congestive heart failure rises with the incidence of an inter-and ... more Background Mortality in severe congestive heart failure rises with the incidence of an inter-and intraventricular conduction delay and doubles if atrial fibrillation (AF) occurs. Electrical cardioversion (CV) is frequently regarded as less promising in these patients. Encouraged by first conversions during defibrillation threshold (DFT) testing we consecutively attempted electrical cardioversion in 30 patients selected for cardiac resynchronization therapy (CRT). Methods After successful CV an additional atrial electrode was placed during implantation of a CRT device (ICD or pacemaker) to ensure AV sequential biventricular pacing. Regular clinical follow-up examinations up to 2 years were performed. Results In 23 (75%) of 30 patients (onset of AF at least 6 months earlier), sinus rhythm (SR) could successfully be restored. Under antiarrhythmic medication in 21 patients SR was still present after 333±142 days. Furthermore, a significant increase of EF from 22% to 31% (P < 0:05) with an accompanying significant increase of the VO 2max from 12.9 to 16.1 ml/kg/min (P < 0:05) was measured. Conclusion In CRT candidates with supposed permanent AF more vigorous external or internal cardioversion attempts are justified. In the majority of patients SR can be established and persists for at least 1 year with a superproportional improvement in functional capacity.

Eur J Echocardiogr, 2003

The publisher regrets that this was an accidental duplication of an article that has already been... more The publisher regrets that this was an accidental duplication of an article that has already been published in Eur. J. Echocardiogr., 4 (2003) 162-168, . The duplicate article has therefore been withdrawn.

Journal of the American Society of Echocardiography, Jun 1, 2002

J Heart Lung Transplant, 2007

Purpose: Endothelial cells and intimal lesions play a central role in the etiopathogenesis of epi... more Purpose: Endothelial cells and intimal lesions play a central role in the etiopathogenesis of epicardial vasculopathy after heart transplantation (HTx). But, their role in the development of microvasculopathy remain unclear. Methods and Materials: We studied 72 patients (64 males, mean age 50 yrs), who underwent prospective analyses at 4 weeks (FU1ϭ72) and 1 year (FU2ϭ48) after HTx. Microvascular endothelial cells and non-stenotic (mild) and stenotic medial alterations (ϭstenotic microvasculopathy, MVP) were studied in right ventricular biopsies using routine H & E stainings and immunohistochemical methods, identifying smooth muscle cells (alpha-actin) endothelial cells (CD31) and proliferating cells (PCNA). Results: Endothelial alterations were exclusively non-stenotic and affected almost half of the patients . The prevalence of non-stenotic medial alterations decreased from FU1 (36%) to FU2 (28%), while stenotic MVP was more prevalent at FU2 (50%) than at FU1 (39%).