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Biomedical subjects

U Süthoff

Publications and source records attributed to U Süthoff.

6 recordsLinked to original sources
PubMed1986

Noninvasive monitoring of cardiac allograft rejection by intramyocardial electrogram recordings.

Rejection after cardiac transplantation was monitored in nine patients by control of intramyocardial electrogram (IMEG) recordings transmitted by an implanted telemetric pacemaker. Under immunosuppression with cyclosporin A and prednisolone, 33 out of a total of 119 endomyocardial biopsy specimens showed moderate rejection (infiltrate with myocytolysis). Twenty-nine of these rejection episodes could be correctly predicted from IMEG recordings with a voltage drop above 15% used as a criterion (sensitivity 87.9%). Eighty-three of 86 negative biopsy results corresponded to negative IMEG results (specificity 96.5%). In this group of patients, amplitude of body surface electrocardiograms was not useful for the diagnosis of rejection because of the broad range of spontaneous variation. Control of IMEG voltage amplitude appears to be more accurate than body surface electrocardiogram amplitude in the detection of rejection episodes. Thus the onset of rejection during biopsy intervals is more readily detected and treatment is instituted earlier. The method is suitable for ambulatory patient monitoring by the patient's local physician.

Biopsy↗
PubMed1985

[Heart transplantation in cardiomyopathy].

Within the spectrum of presently accepted candidates for heart transplantation, end-stage heart failure in dilated cardiomyopathy has become the principle indication. Although several indicators of poor prognosis have been specified, the decision for heart transplantation is primarily made on clinical grounds. Expected long-term survival after transplantation is 60 to 80% at one year and more than 50% at five years. Since July, 1983, 50 patients underwent orthotopic heart transplantation, 38 of whom had been suffering from dilated cardiomyopathy. Ages ranged from nine to 54 years with a mean of 40 years. At present, 38 patients are alive, 34 are discharged from hospital, 14 have returned to work or school. Physical capacity and cardiac function are normal. There was no difference between the cardiomyopathy patients and the coronary artery disease patients with respect to rate and severity of rejection episodes, infection and long-term findings. Heart transplantation is considered a promising routine treatment for end-stage heart failure in particular in younger patients with dilated cardiomyopathy.

Adolescent↗
PubMed1985

Heart transplantation--a two-year experience.

In July 1983, a heart transplant program was initiated. Up to September 1985, 72 orthotopic transplants in 69 patients (62 men, 7 women, age 9 to 55 years, mean 40.1 years) have been performed. All patients suffered from end-stage heart failure, which was due to coronary artery disease in 15 patients, congestive cardiomyopathy in 53 patients and endocardial fibrosis in one woman. All patients survived the operation, but there were 6 deaths within the first 30 postoperative days. Eight more patients died subsequently. Causes of death were rejection in 6, infection in 3, cerebral hemorrhage in 2, sudden death in 2 and pulmonary embolism in one patient. Actuarial survival at one and two years was calculated at 75%. The detection of allograft rejection was the major postoperative problem. This was achieved by serial endomyocardial biopsy and myocardial voltage monitoring via a telemetry pacemaker system. The lowest rate of organ toxicity, rejection and infection was achieved using a triple immunosuppressive regime including Azathioprine, Cyclosporine A and steroids with initial doses of antithymocyte globulin. It is concluded that heart transplantation can be regarded as a routine procedure for patients with intractable heart failure. The operative risk is limited, and an elaborate immunosuppressive regimen makes long-term survival possible without obvious allograft deterioration. Cardiac transplantation should be seriously considered in patients under 55 years, who suffer from life-threatening heart failure not amenable to other modes of therapy.

Adolescent↗