@article{HeldHesseGoettetal.2014,
  author    = {Held, Matthias and Hesse, Alexander and G{\"o}tt, Franziska and Holl, Regina and H{\"u}bner, Gudrun and Kolb, Philipp and Langen, Heinz Jakob and Romen, Tobias and Walter, Franziska and Sch{\"a}fers, Hans Joachim and Wilkens, Heinrike and Jany, Berthold},
  title     = {A symptom-related monitoring program following pulmonary embolism for the early detection of CTEPH: a prospective observational registry study},
  series = {BMC Pulmonary Medicine},
  volume    = {14},
  journal   = {BMC Pulmonary Medicine},
  doi       = {10.1186/1471-2466-14-141},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-119281},
  pages     = {141},
  year      = {2014},
  abstract  = {Background Chronic thromboembolic pulmonary hypertension (CTEPH) is a long-term complication following an acute pulmonary embolism (PE). It is frequently diagnosed at advanced stages which is concerning as delayed treatment has important implications for favourable clinical outcome. Performing a follow-up examination of patients diagnosed with acute PE regardless of persisting symptoms and using all available technical procedures would be both cost-intensive and possibly ineffective. Focusing diagnostic procedures therefore on only symptomatic patients may be a practical approach for detecting relevant CTEPH. This study aimed to evaluate if a follow-up program for patients with acute PE based on telephone monitoring of symptoms and further examination of only symptomatic patients could detect CTEPH. In addition, we investigated the role of cardiopulmonary exercise testing (CPET) as a diagnostic tool. Methods In a prospective cohort study all consecutive patients with newly diagnosed PE (n=170, 76 males, 94 females within 26 months) were recruited according to the inclusion and exclusion criteria. Patients were contacted via telephone and asked to answer standardized questions relating to symptoms. At the time of the final analysis 130 patients had been contacted. Symptomatic patients underwent a structured evaluation with echocardiography, CPET and complete work-up for CTEPH. Results 37.7\%, 25.5\% and 29.3\% of the patients reported symptoms after three, six, and twelve months respectively. Subsequent clinical evaluation of these symptomatic patients saw 20.4\%, 11.5\% and 18.8\% of patients at the respective three, six and twelve months time points having an echocardiography suggesting pulmonary hypertension (PH). CTEPH with pathological imaging and a mean pulmonary artery pressure (mPAP) ≥ 25 mm Hg at rest was confirmed in eight subjects. Three subjects with mismatch perfusion defects showed an exercise induced increase of PAP without increasing pulmonary artery occlusion pressure (PAOP). Two subjects with pulmonary hypertension at rest and one with an exercise induced increase of mPAP with normal PAOP showed perfusion defects without echocardiographic signs of PH but a suspicious CPET. Conclusion A follow-up program based on telephone monitoring of symptoms and further structured evaluation of symptomatic subjects can detect patients with CTEPH. CPET may serve as a complementary diagnostic tool.},
  language  = {en}
}
@phdthesis{Walter2009,
  author    = {Walter, Franziska},
  title     = {Pharmakologische Postkonditionierung mit dem Sphingosin-1-Phosphat-Rezeptoragonisten FTY 720 nach myokardialer Isch{\"a}mie/Reperfusion},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-46402},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2009},
  abstract  = {Einleitung: Mehrere ex vivo Studien zeigten zuletzt, dass Sphingosin-1-phosphate Schutz gegen myokardiale Isch{\"a}mie/ Reperfusionsschaden verleihen [19], [20]. Der synthetische Sphingosin-1-phosphat-Rezeptoragonist FTY 720 war ebenso in der Lage, Entz{\"u}ndungsreaktionen in verschiedenen Krankheitsmodellen zu verringern [8]. Deshalb wollten wir die Hypothese pr{\"u}fen, dass eine Behandlung mit FTY 720 zu einer Infarktgr{\"o}ßenreduktion nach myokardialer Isch{\"a}mie/ Reperfusion in vivo f{\"u}hrt. Methode: In m{\"a}nnlichen Wistar Ratten wurde myokardiale Isch{\"a}mie dadurch induziert, dass wir die linke Koronararterie f{\"u}r 45 min mittels Fadenligatur verschlossen. Nach 24 h wurde die Infarktgr{\"o}ße bestimmt und die Granulozyteninfiltration im Infarktgebiet festgestellt. Caspase 3 Aktivit{\"a}t und TNF- alpha Konzentration im Myokardgewebe wurden durch ELISA ermittelt. FTY 720 wurde vor Beginn der Reperfusion i. p. appliziert oder 24 h vor Reperfusionsbeginn und nochmals direkt vor Reperfusionsbeginn. Ergebnisse: Die einmalige Gabe von 0,5 mg/kg FTY 720 vor Reperfusion oder die zus{\"a}tzliche Vorbehandlung der Tiere 24 Stunden vor der operativen Infarzierung reduzierte signifikant die periphere Lymphozytenanzahl. Sie nahm keinen Einfluss auf die Granulozytenanzahl im Blut. FTY 720 reduzierte die Granulozyteninfiltration und die TNF- alpha Konzentration der Borderzone. Es hatte aber keinen Effekt auf die myokardiale Caspase 3 Aktivit{\"a}t. Beide Behandlungsformen, weder die FTY 720- Gabe vor Reperfusionsbeginn noch die zweimalige FTY 720- Gabe waren in der Lage, Infarktgr{\"o}ße am Rattenherz zu reduzieren. FTY 720 erh{\"o}hte jedoch die Sterblichkeit der Ratten, wenn es einmalig vor Reperfusionsbeginn gegeben wurde, da es fatale myokardiale Arrhythmien induzierte. Zusammenfassung: Trotz seines antiinflammatorischen Effektes bei einmaliger Gabe von FTY 720 wurde die Sterblichkeit der Tiere durch Arrhythmieinduktion erh{\"o}ht. Beide Behandlungsregimes konnten die Infarktgr{\"o}ße nicht reduzieren.},
  subject      = {FTY 720},
  language  = {de}
}