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  1. Article: Wichtige Stadieneinteilungen und Scores in der Kardiologie.

    Bonetti, Piero O

    Therapeutische Umschau. Revue therapeutique

    2013  Volume 70, Issue 10, Page(s) 581–588

    Abstract: Classifications and scores play a fundamental role in clinical cardiology. While classification systems may help to quantify symptoms and stages of disease, specific scores enable risk stratification and may facilitate decision-making in various cardiac ... ...

    Title translation Important classifications and scores in cardiology.
    Abstract Classifications and scores play a fundamental role in clinical cardiology. While classification systems may help to quantify symptoms and stages of disease, specific scores enable risk stratification and may facilitate decision-making in various cardiac disorders. The present article reviews some of the most frequently used cardiologic classifications and scores. Frequently used classification systems are the NYHA classification for staging patients with cardiac diseases according to their symptoms and functional capacity, and the CCS classification for grading the severity of symptoms in patients with stable angina pectoris. The Killip classification represents a simple clinical tool to estimate mortality risk in patients with acute coronary syndromes. While there is no controversy about the acute management of patients with STEMI - i. e. reperfusion therapy by fibrinolysis or, preferably, primary percutaneous coronary intervention - the diagnostic and therapeutic strategy in patients with NSTE-ACS depends on their individual risk. Various scores have been developed for early risk stratification in patients with NSTE-ACS. Of these, the TIMI risk score and the GRACE score are the most frequently used. Prevention of thromboembolic events represents a primary therapeutic goal in patients with atrial fibrillation. In affected patients, scores such as the CHA2DS2-VASc-Score and the HAS-BLED score are helpful in assessing individual risk of thromboembolic and bleeding complications. Herewith, these scores aid in decision-making for anticoagulation and, thereby, improve prognosis of patients with atrial fibrillation.
    MeSH term(s) Adult ; Aged ; Cardiovascular Diseases/classification ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/mortality ; Cardiovascular Diseases/therapy ; Decision Support Techniques ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Risk Assessment ; Severity of Illness Index ; Survival Analysis
    Language German
    Publishing date 2013-10
    Publishing country Switzerland
    Document type English Abstract ; Journal Article ; Review
    ZDB-ID 82044-1
    ISSN 1664-2864 ; 0040-5930
    ISSN (online) 1664-2864
    ISSN 0040-5930
    DOI 10.1024/0040-5930/a000451
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Wichtige Stadieneinteilungen und Scores in der Kardiologie

    Bonetti, Piero O.

    Therapeutische Umschau

    2013  Volume 70, Issue 10, Page(s) 581–588

    Abstract: In der Kardiologie werden diverse Einteilungen zur Quantifizierung von Symptomen und zur Gradierung von Krankheitsstadien eingesetzt. Ebenso spielen spezielle Scores bei der Risikoabschätzung verschiedenster kardiologischer Krankheitsbilder eine große ... ...

    Abstract In der Kardiologie werden diverse Einteilungen zur Quantifizierung von Symptomen und zur Gradierung von Krankheitsstadien eingesetzt. Ebenso spielen spezielle Scores bei der Risikoabschätzung verschiedenster kardiologischer Krankheitsbilder eine große Rolle und stellen in vielen Fällen einen entscheidenden Faktor bei der therapeutischen Entscheidungsfindung dar. Im Folgenden soll auf einige der im klinischen Alltag am häufigsten verwendeten, kardiologischen Stadieneinteilungen und Scores näher eingegangen werden. Die NYHA-Klassifikation zur Gradierung des Schweregrades der Symptomatik von Patienten mit Herzerkrankungen ist wohl eine der bekanntesten medizinischen Stadieneinteilungen überhaupt. Ebenfalls häufig angewendet wird die CCS-Klassifikation, die der Einteilung des Schweregrades pektanginöser Beschwerden bei Patienten mit stabiler koronarer Herzkrankheit dient. Etwas in Vergessenheit geraten ist die Killip-Klassifikation, welche ein einfaches, klinisches Instrument zur Abschätzung des Mortalitätsrisikos von Patienten mit akutem Koronarsyndrom darstellt. Während bei Patienten mit akutem ST-Hebungsinfarkt (STEMI) das therapeutische Vorgehen – d. h. die notfallmäßige Koronarreperfusion mittels Thrombolyse oder besser mittels primärer perkutaner Koronarintervention – in der Regel unbestritten ist, richtet sich das diagnostische und therapeutische Vorgehen bei Patienten mit akutem Koronarsyndrom ohne ST-Hebung (NSTE-ACS) nach deren individuellem Risiko. Um das Risiko von Patienten mit NSTE-ACS möglichst frühzeitig abschätzen zu können, stehen diverse Scores zur Verfügung, wobei der TIMI risk score und der GRACE score die derzeit am gebräuchlichsten sind. Bei Patienten mit Vorhofflimmern – der häufigsten klinisch relevanten Rhythmusstörung – kommt der Prävention thromboembolischer Ereignisse besondere Bedeutung zu. Auch hier helfen Scores wie der CHA2DS2-VASc-Score und der HAS-BLED-Score bei der Beurteilung des Thromboembolierisikos resp. bei der Abschätzung des unter einer Antikoagulation zu erwartenden Blutungsrisikos, was eine optimale Indikationsstellung zur Einleitung einer Antikoagulation erlaubt und so zur Verbesserung der Prognose betroffener Patienten beiträgt.
    Keywords Kardiologie ; Klassifikationssystem
    Language German
    Document type Article
    ZDB-ID 82044-1
    ISSN 1664-2864 ; 0040-5930
    ISSN (online) 1664-2864
    ISSN 0040-5930
    Database bibnet.org

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  3. Article: Watching football on TV may potentially be life-threatening.

    Bonetti, Piero O / Hunziker, Patrick R

    Swiss medical weekly

    2006  Volume 136, Issue 13-14, Page(s) 228

    MeSH term(s) Coronary Artery Disease/physiopathology ; Coronary Artery Disease/therapy ; Defibrillators, Implantable ; Electrocardiography ; Humans ; Male ; Middle Aged ; Monitoring, Physiologic ; Myocardial Ischemia/physiopathology ; Soccer ; Stress, Psychological/physiopathology ; Stroke Volume/physiology ; Television
    Language English
    Publishing date 2006-04-01
    Publishing country Switzerland
    Document type Case Reports ; Letter
    ZDB-ID 2036179-8
    ISSN 1424-3997 ; 1424-7860
    ISSN (online) 1424-3997
    ISSN 1424-7860
    DOI 10.4414/smw.2006.11429
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Right coronary artery to coronary sinus fistula.

    Laske, Andreas / Ritter, Manfred / Bonetti, Piero O

    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

    2009  Volume 36, Issue 6, Page(s) 1079–1080

    MeSH term(s) Aged ; Arteriovenous Fistula/diagnosis ; Arteriovenous Fistula/surgery ; Coronary Angiography ; Coronary Artery Disease/diagnosis ; Coronary Artery Disease/surgery ; Coronary Sinus/surgery ; Echocardiography, Transesophageal ; Humans ; Male ; Mitral Valve Prolapse/diagnostic imaging ; Mitral Valve Prolapse/surgery
    Language English
    Publishing date 2009-12
    Publishing country Germany
    Document type Case Reports ; Journal Article
    ZDB-ID 639293-3
    ISSN 1873-734X ; 1010-7940 ; 1567-4258
    ISSN (online) 1873-734X
    ISSN 1010-7940 ; 1567-4258
    DOI 10.1016/j.ejcts.2009.06.049
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Watching football on TV may potentially be life-threatening

    Bonetti, Piero O. / Hunziker, Patrick R.

    Swiss medical weekly

    2006  Volume 136, Issue 13-14, Page(s) 228

    Language German
    Document type Article
    ZDB-ID 2036179-8
    ISSN 1424-7860
    Database Current Contents Medicine

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  6. Article: Endothelial function and cerebrovascular disease: implications for diagnosis and treatment.

    Elesber, Ahmad A / Bonetti, Piero O / Lerman, Amir

    Current treatment options in cardiovascular medicine

    2006  Volume 8, Issue 3, Page(s) 213–219

    Abstract: Cerebrovascular disease remains one of the most common causes of morbidity and mortality in the United States. There is strong evidence to implicate endothelial dysfunction in the initiation and progression of atherosclerosis and its complications. It is ...

    Abstract Cerebrovascular disease remains one of the most common causes of morbidity and mortality in the United States. There is strong evidence to implicate endothelial dysfunction in the initiation and progression of atherosclerosis and its complications. It is now well known that endothelial dysfunction represents a systemic syndrome involving multiple vascular beds, including the cerebral vasculature. Currently, no gold standard treatment for endothelial dysfunction exists. Nonetheless, several treatment strategies have been found to be helpful in improving endothelial function. A few of these strategies have been implicated in stroke risk reduction as well, adding another line of evidence to the relationship between endothelial function and cerebrovascular disease.
    Language English
    Publishing date 2006-04-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2057337-6
    ISSN 1534-3189 ; 1092-8464
    ISSN (online) 1534-3189
    ISSN 1092-8464
    DOI 10.1007/s11936-006-0014-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Incidence and time frame of life-threatening arrhythmias in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.

    Cricri, Patrizia / Trachsel, Lukas D / Müller, Peter / Wäckerlin, Adrian / Reinhart, Walter H / Bonetti, Piero O

    Swiss medical weekly

    2012  Volume 142, Page(s) w13604

    Abstract: Background: Life-threatening arrhythmias may complicate the hospital course of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). The optimal duration of electrocardiographic ... ...

    Abstract Background: Life-threatening arrhythmias may complicate the hospital course of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). The optimal duration of electrocardiographic monitoring in such patients is not well established. We aimed to determine the incidence and the time of occurrence of life-threatening arrhythmias in STEMI patients undergoing PPCI.
    Methods: Data of 382 consecutive patients with STEMI undergoing PPCI were analysed regarding the occurrence of ventricular fibrillation (VF), sustained ventricular tachycardia (sVT) or bradycardia necessitating temporary or permanent pacing.
    Results: Of these patients, 55% had inferior STEMI, 41% anterior and 4% lateral STEMI. The infarct-related arteries were the right in 41%, the left anterior descending in 41%, the left circumflex in 16%, the left main stem in 1% and a vein graft in <1%. During hospitalisation, 27 (7.0%) patients developed 29 life-threatening arrhythmias (incidence 7.6%): 19 episodes occurred during PPCI (VF n = 11, bradycardia n = 8), 9 episodes during the first 24 hours after PPCI (VF n = 7, sVT n = 2), and 1 sVT episode in a hypokalemic patient on the 4th post-procedural day. A total of 17 patients (4.5%) died within the first 30 days, and 3 of these died during the PPCI procedure.
    Conclusions: Life-threatening arrhythmias occur in a considerable proportion of STEMI patients undergoing PPCI during hospitalisation. Most of these arrhythmias occur during the PPCI procedure. Post-procedural life-threatening arrhythmias are virtually limited to the first 24 hours after PPCI. Thus, routine electrocardiographic monitoring beyond the first 24 hours after PPCI might not be required in most patients with uncomplicated STEMI.
    MeSH term(s) Adult ; Aged ; Angioplasty, Balloon, Coronary/adverse effects ; Angioplasty, Balloon, Coronary/mortality ; Arrhythmias, Cardiac/etiology ; Electrocardiography ; Female ; Humans ; Incidence ; Intraoperative Complications ; Male ; Middle Aged ; Myocardial Infarction/complications ; Myocardial Infarction/therapy ; Postoperative Complications ; Time Factors ; Treatment Outcome
    Language English
    Publishing date 2012
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2036179-8
    ISSN 1424-3997 ; 1424-7860
    ISSN (online) 1424-3997
    ISSN 1424-7860
    DOI 10.4414/smw.2012.13604
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Complement inhibition to treat myocardial infarction?

    Gerber, Bernhard / Kyburz, Tatiana / Reinhart, Walter H / Bonetti, Piero O / Stussi, Georg

    BMJ case reports

    2011  Volume 2011

    Abstract: The authors describe the case of a middle-aged women who presented with an acute myocardial infarction due to thrombotic occlusion of angiographically normal coronary arteries. Coronary thrombosis was caused by a hypercoagulable state related to a ... ...

    Abstract The authors describe the case of a middle-aged women who presented with an acute myocardial infarction due to thrombotic occlusion of angiographically normal coronary arteries. Coronary thrombosis was caused by a hypercoagulable state related to a haemolytic crisis of paroxysmal nocturnal haemoglobinuria and the patient was treated conservatively with antithrombotic agents. The clinical course was complicated by both severe bleeding and thrombotic complications and the patient eventually died of a massive intracerebral haemorrhage. The rapid occurrence of complications inhibited a timely administration of a specific treatment for complement-mediated haemolysis (eculizumab).
    MeSH term(s) Aged ; Antibodies, Monoclonal, Humanized/therapeutic use ; Complement Inactivating Agents/therapeutic use ; Coronary Angiography ; Echocardiography ; Fatal Outcome ; Female ; Hemoglobinuria, Paroxysmal/complications ; Hemoglobinuria, Paroxysmal/drug therapy ; Humans ; Myocardial Infarction/diagnosis ; Myocardial Infarction/etiology
    Chemical Substances Antibodies, Monoclonal, Humanized ; Complement Inactivating Agents ; eculizumab (A3ULP0F556)
    Language English
    Publishing date 2011-04-26
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr.01.2011.3701
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Simvastatin preserves diastolic function in experimental hypercholesterolemia independently of its lipid lowering effect.

    Mannheim, Dallit / Herrmann, Joerg / Bonetti, Piero O / Lavi, Ronit / Lerman, Lilach O / Lerman, Amir

    Atherosclerosis

    2011  Volume 216, Issue 2, Page(s) 283–291

    Abstract: Objective: Isolated diastolic dysfunction is present in 40% of heart failure patients. It has been attributed to myocardial fibrosis and related to cardiovascular risk factor exposure. We hypothesized that simvastatin will improve these dynamics in ... ...

    Abstract Objective: Isolated diastolic dysfunction is present in 40% of heart failure patients. It has been attributed to myocardial fibrosis and related to cardiovascular risk factor exposure. We hypothesized that simvastatin will improve these dynamics in experimental hypercholesterolemia (HC).
    Methods: Three groups of pigs were studied after 12 weeks of normal (N) diet, HC diet, or HC diet with simvastatin (80 mg/day) treatment. Cardiac function was assessed by electron beam computed tomography (EBCT) and percentage of myocardium occupied by microvessels (myocardial vascular fraction) was calculated by micro-CT. Collagen content was determined by Sirius red staining and confirmed by a quantitative, hydroxyoproline-based assay.
    Results: Compared with N, LDL serum concentration was higher in HC and HC+simvastatin (1.0±0.1 vs. 7.9±1.7 and 9.6±1.2 mmol/L, p<0.05 for both). Cardiac early diastolic filling was reduced in HC compared with N (102.4±11.3 vs. 151.1±12.1 mL/s; p<0.05) but restored in HC+simvastatin (176.8±21.3 mL/s, p<0.05 vs. HC). Compared with N, myocardial vascular fraction was higher in HC but not in HC+simvastatin (1.98±0.84 vs. 4.48±0.31 and 2.95±0.95%; p<0.05 for HC vs. N). Myocardial collagen content was higher in HC than in HC+simvastatin and N (4.72±1.03 vs. 1.62±0.12 and 1.21±0.24% area staining; p<0.05 for HC vs. N), which was attributable mainly to an increase in collagen III (2.90±0.48 vs. 1.62±0.12 and 1.21±0.24% area staining; p<0.05 for HC vs. N).
    Conclusions: Simvastatin is able to prevent diastolic dysfunction in experimental HC independent of its lipid lowering effect. This beneficial effect is, at least partially, due to a decrease in myocardial fibrosis and angiogenesis.
    MeSH term(s) Animals ; Diastole/drug effects ; Disease Models, Animal ; Female ; Heart Failure/blood ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Hydroxyproline/blood ; Hypercholesterolemia/drug therapy ; Lipids/chemistry ; Microcirculation ; Microvessels ; Myocardium/pathology ; Simvastatin/therapeutic use ; Swine ; Tomography, X-Ray Computed/methods ; X-Ray Microtomography/methods
    Chemical Substances Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Lipids ; Simvastatin (AGG2FN16EV) ; Hydroxyproline (RMB44WO89X)
    Language English
    Publishing date 2011-02-24
    Publishing country Ireland
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 80061-2
    ISSN 1879-1484 ; 0021-9150
    ISSN (online) 1879-1484
    ISSN 0021-9150
    DOI 10.1016/j.atherosclerosis.2011.02.036
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Effect of brief secondhand smoke exposure on endothelial function and circulating markers of inflammation.

    Bonetti, Piero O / Lardi, Elena / Geissmann, Christa / Kuhn, Max U / Brüesch, Hermann / Reinhart, Walter H

    Atherosclerosis

    2011  Volume 215, Issue 1, Page(s) 218–222

    Abstract: Objective: In contrast to the well defined detrimental consequences of long-term secondhand smoke (SHS) exposure, little is known about the acute effects of passive smoking on endothelial function and inflammation. The aim of the present study was to ... ...

    Abstract Objective: In contrast to the well defined detrimental consequences of long-term secondhand smoke (SHS) exposure, little is known about the acute effects of passive smoking on endothelial function and inflammation. The aim of the present study was to assess the acute effects of short-term SHS exposure on endothelial function and circulating markers of inflammation.
    Methods: Peripheral microvascular endothelial function assessed by reactive hyperemia peripheral arterial tonometry (RH-PAT) index, circulating markers of endothelial function (von Willebrand factor antigen, Thrombomodulin, E-selectin) and circulating inflammatory markers (high sensitivity C-reactive protein (hsCRP), Interleukin-6 (IL-6)) were measured in eighteen male, non-smoking volunteers before and 12h after a 1-h SHS exposure.
    Results: Twelve hours after passive smoking, average RH-PAT index was significantly lower than before SHS exposure (1.54±0.49 vs 2.01±0.55 (mean±SD), p=0.01) indicating deterioration of peripheral microvascular endothelial function. von Willebrand factor antigen as a marker of endothelial activation was significantly increased after SHS exposure (93.0±25.5% vs 78.4±17.9%, p=0.03). Levels of Thrombomodulin, E-selectin, hsCRP, and IL-6 were unaffected by SHS exposure.
    Conclusion: Short-term SHS exposure leads to a measurable disturbance of endothelial function. However, 1h of passive smoking appears to be too short to elicit a significant inflammatory response.
    MeSH term(s) Adult ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/physiopathology ; E-Selectin/blood ; Endothelium, Vascular/physiopathology ; Humans ; Hyperemia/etiology ; Inflammation ; Male ; Thrombomodulin/blood ; Tobacco Smoke Pollution/adverse effects ; von Willebrand Factor/immunology ; von Willebrand Factor/metabolism
    Chemical Substances E-Selectin ; Thrombomodulin ; Tobacco Smoke Pollution ; Von Willebrand antigen ; von Willebrand Factor
    Language English
    Publishing date 2011-03
    Publishing country Ireland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80061-2
    ISSN 1879-1484 ; 0021-9150
    ISSN (online) 1879-1484
    ISSN 0021-9150
    DOI 10.1016/j.atherosclerosis.2010.12.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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