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Hans-Peter Dübel

Publications and source records attributed to Hans-Peter Dübel.

7 recordsLinked to original sources
PubMed2007

Multislice computed tomography: angiographic emulation versus standard assessment for detection of coronary stenoses.

The present study investigated angiographic emulation of multislice computed tomography (MSCT) (catheter-like visualization) as an alternative approach of analyzing and visualizing findings in comparison with standard assessment. Thirty patients (120 coronary arteries) were randomly selected from 90 prospectively investigated patients with suspected coronary artery disease who underwent MSCT (16-slice scanner, 0.5 mm collimation, 400 ms rotation time) prior to conventional coronary angiography for comparison of both approaches. Sensitivity and specificity of angiographic emulation [81% (26/32) and 93% (82/88)] were not significantly different from those of standard assessment [88% (28/32) and 99% (87/88)], while the per-case analysis time was significantly shorter for angiographic emulation than for standard assessment (3.4 +/- 1.5 vs 7.0 +/- 2.5 min, P < 0.001). Both interventional and referring cardiologists preferred angiographic emulation over standard curved multiplanar reformations of MSCT coronary angiography for illustration, mainly because of improved overall lucidity and depiction of sidebranches (P < 0.001). In conclusion, angiographic emulation of MSCT reduces analysis time, yields a diagnostic accuracy comparable to that of standard assessment, and is preferred by cardiologists for visualization of results.

Aged↗
PubMed2006

Head-to-head comparison of multislice computed tomography and exercise electrocardiography for diagnosis of coronary artery disease.

AIMS: To prospectively compare multislice computed tomography (MSCT) and exercise electrocardiography (ex-ECG) for diagnosis of coronary artery disease (CAD) with conventional coronary angiography as the reference standard. METHODS AND RESULTS: A consecutive cohort of 80 patients with suspected CAD was examined with MSCT using 16 x 0.5 mm detector collimation, ex-ECG, and conventional coronary angiography according to standard protocols. Results were compared using the paired McNemar's test, the chi(2) test, and 95%CIs. Both the sensitivity and specificity of MSCT [91% (40 of 44 patients, 95%CI 78-97%) and 83% (30 of 36 patients, 95%CI 67-94%)] were significantly higher (P = 0.039 and P < 0.001) than those for ex-ECG [73% (32 of 44 patients, 95%CI 57-85%) and 31% (11 of 36 patients, 95%CI 16-48%)]. The pairwise McNemar's test showed significant differences between MSCT and ex-ECG in the overall diagnosis in patients with suspected CAD (P = 0.036). The rate of non-diagnostic examinations was not significantly (P = 0.078) different between MSCT and ex-ECG [8% (6 of 80 patients, 95%CI 3-16%) vs. 19% (15 of 80 patients, 95%CI 11-29%)]. CONCLUSION: In this consecutive cohort of patients scheduled to undergo conventional coronary angiography, the performance of MSCT for diagnosis of CAD was superior to that of ex-ECG.

Aged↗
PubMed2004

Atypical vessels as an early sign of intracardiac myxoma?

We report on a woman with previously unknown left atrial myxoma, who underwent percutaneous coronary intervention. 45 months after the initial coronary angiography, echocardiography demonstrated a large atrial myxoma, which was not seen echocardiographically before. The retrospective analysis of the pre-intervention coronary angiography revealed atypical vessels in the atrial septum, which are interpreted as early signs of myxoma.

Chest Pain↗
PubMed2002

[Standards in interventional therapy of coronary artery disease].

This review provides an overview of current percutaneous coronary interventional techniques (PCI) in patients with acute and chronic coronary artery disease. The indications for PCI have expanded during the past two decades, and no absolute contraindications remain. The chief limitations to event free survival following balloon angioplasty have been abrupt vessel closure in the short term and restenosis in the long term. The therapeutic effect of arterial vessel enlargement through PCI is accompanied by various degrees of arterial injury with exposure of thrombogenic components. Depending on the degree of activation of the coagulation cascade, as well as platelet adhesion and aggregation, this may result in intracoronary thrombus formation and subsequent ischemic sequelae. Therefore, inhibition of platelets and the coagulation system has always been central to interventional investigations. Restenosis has been the most important long-term limitation of PCI. Coronary artery stents have become an important adjunct to conventional balloon angioplasty owing to their dual function of reducing acute complications and the long term risk of restenosis. Although coronary artery stents serve as antirestenosis devices and reduce target vessel revascularisation requirements compared with balloon angioplasty, they themselves become a source of restenosis. In-stent restenosis is a major challenge for the interventionalist. None of the available interventional modalities provides optimal acute results, and long-term results are even poorer. This is especially true for diffuse in-stent restenosis lesions which have high recurrence rates. Thus, mechanical treatment modalities for evolved in-stent restenosis can only be one step in a comprehensive strategy for prevention and treatment. Brachytherapy as an adjunct seems to be especially promising, but late thrombosis, delayed restenosis and the potential for very late fibrosis are matters of concern. As attention has turned towards the prevention of in-stent restenosis new techniques such as drug delivering stents and gene therapy to inhibit the biological reaction of the vessel wall are likely to obtain greater importance.

Angioplasty, Balloon, Coronary↗