Skip to main content
Erschienen in: Pediatric Cardiology 5/2006

01.10.2006

Metabolic Alterations and Neurodevelopmental Outcome of Infants with Transposition of the Great Arteries

verfasst von: I. Sook Park, S. Young Yoon, J. Yeon Min, Y. Hwue Kim, J. Kok Ko, K. Soo Kim, D. Man Seo, J. Hee Lee

Erschienen in: Pediatric Cardiology | Ausgabe 5/2006

Einloggen, um Zugang zu erhalten

Abstract

Abnormal neurodevelopment has been reported for infants who were born with transposition of the great arteries (TGA) and underwent arterial switch operation (ASO). This study evaluates the cerebral metabolism of TGA infants at birth and before ASO and neurodevelopment 1 year after ASO. Proton magnetic resonance spectroscopy (1H-MRS) was performed on 16 full-term TGA brains before ASO within 3–6 days after birth. The brain metabolite ratios of [NAA/Cr], [Cho/Cr], and [mI/Cr] evaluated measured. Ten infants were evaluated at 1 year using the Bayley Scales of Infants Development II (BSED II). Cerebral metabolism of infants with TGA was altered in parietal white matter (PWM) and occipital gray matter (OGM) at birth before ASO. One year after ASO, [Cho/Cr] in PWM remained altered, but all metabolic ratios in OGM were normal. The results of BSID II at 1 year showed delayed mental and psychomotor development. This delayed neurodevelopmental outcome may reflect consequences of the altered cerebral metabolism in PWM measured by 1H-MRS. It is speculated that the abnormal hemodynamics due to TGA in utero may be responsible for the impaired cerebral metabolism and the subsequent neurodevelopmental deficit.
Literatur
1.
Zurück zum Zitat Ashwal S, Holshouser BA, Hinshaw DB Jr, Schell RM, Bailey L (1996) Proton magnetic resonance spectroscopy in the evaluation of children with congenital heart disease and acute central nervous system injury. J Thorac Cardiovasc Surg 112:403–414PubMedCrossRef Ashwal S, Holshouser BA, Hinshaw DB Jr, Schell RM, Bailey L (1996) Proton magnetic resonance spectroscopy in the evaluation of children with congenital heart disease and acute central nervous system injury. J Thorac Cardiovasc Surg 112:403–414PubMedCrossRef
2.
Zurück zum Zitat Bayley N (1993) Administration of the BSID-II, Interpretation guideline and case studies of BSID-II. In: Bayley N (ed) Bayley scales of infants development. Manual, 2nd edn. Psychological Corporation, San Antonio, TX, pp 41–49, 227–232 Bayley N (1993) Administration of the BSID-II, Interpretation guideline and case studies of BSID-II. In: Bayley N (ed) Bayley scales of infants development. Manual, 2nd edn. Psychological Corporation, San Antonio, TX, pp 41–49, 227–232
3.
Zurück zum Zitat Bellinger DC, Jonas RA, Rappaport LA, et al. (1999) Developmental and neurologic status of children after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. N Engl J Med 332:549–555CrossRef Bellinger DC, Jonas RA, Rappaport LA, et al. (1999) Developmental and neurologic status of children after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. N Engl J Med 332:549–555CrossRef
4.
Zurück zum Zitat Bellinger DC, Wypij D, Kuban KG, et al. (1999) Developmental and neurological status of children at 4 years of age after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. Circulation 100:526–532PubMed Bellinger DC, Wypij D, Kuban KG, et al. (1999) Developmental and neurological status of children at 4 years of age after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. Circulation 100:526–532PubMed
5.
Zurück zum Zitat Donofrio MT, Bremer YA, Schieken RM, et al. (2003) Autoregulation of cerebral blood flow in fetuses with congenital heart disease; the brain sparing effect. Pediatr Cardiol 24:436–443PubMedCrossRef Donofrio MT, Bremer YA, Schieken RM, et al. (2003) Autoregulation of cerebral blood flow in fetuses with congenital heart disease; the brain sparing effect. Pediatr Cardiol 24:436–443PubMedCrossRef
6.
Zurück zum Zitat Dunbar-Masterson C, Wypij D, Bellinger DC, et al. (2001) General health status of children with D-transposition of the great arteries after the arterial switch operation. Circulation 104:I138–Il42PubMed Dunbar-Masterson C, Wypij D, Bellinger DC, et al. (2001) General health status of children with D-transposition of the great arteries after the arterial switch operation. Circulation 104:I138–Il42PubMed
7.
Zurück zum Zitat Erb MA, Heinemann MK, Wendel HP, et al. (2000) S-100 after correction of congenital heart defects in neonates: is it a reliable marker for cerebral damage? Ann Thorac Surg 69:1515–1519PubMedCrossRef Erb MA, Heinemann MK, Wendel HP, et al. (2000) S-100 after correction of congenital heart defects in neonates: is it a reliable marker for cerebral damage? Ann Thorac Surg 69:1515–1519PubMedCrossRef
8.
Zurück zum Zitat Groenendaal F, Veenhoven RH, van der GJ, et al. (1994) Cerebral lactate and N-acetyl-aspartate/choline ratios in asphyxiated full-term neonates demonstrated in vivo using proton magnetic resonance spectroscopy. Pediatr Res 35:148–151PubMed Groenendaal F, Veenhoven RH, van der GJ, et al. (1994) Cerebral lactate and N-acetyl-aspartate/choline ratios in asphyxiated full-term neonates demonstrated in vivo using proton magnetic resonance spectroscopy. Pediatr Res 35:148–151PubMed
9.
Zurück zum Zitat Hovels-Gurich HH, Konrad K, Wiesner M, et al. (2002) Long term behavioural outcome after neonatal arterial switch operation for transposition of the great arteries. Arch Dis Child 87:506–510PubMedCrossRef Hovels-Gurich HH, Konrad K, Wiesner M, et al. (2002) Long term behavioural outcome after neonatal arterial switch operation for transposition of the great arteries. Arch Dis Child 87:506–510PubMedCrossRef
10.
Zurück zum Zitat Hovels-Gurich HH, Seghaye MC, Dabritz S, Messmer BJ, von Bernuth G (1997) Cardiological and general health status in preschool and school-age children after neonatal arterial switch operation. Eur J Cardiothorac Surg 12:593–601PubMedCrossRef Hovels-Gurich HH, Seghaye MC, Dabritz S, Messmer BJ, von Bernuth G (1997) Cardiological and general health status in preschool and school-age children after neonatal arterial switch operation. Eur J Cardiothorac Surg 12:593–601PubMedCrossRef
11.
Zurück zum Zitat Hovels-Gurich HH, Seghaye MC, Dabritz S, Messmer BJ, von Bernuth G (1997) Cognitive and motor development in preschool and school-aged children after neonatal arterial switch operation. J Thorac Cardiovasc Surg 114:578–585PubMedCrossRef Hovels-Gurich HH, Seghaye MC, Dabritz S, Messmer BJ, von Bernuth G (1997) Cognitive and motor development in preschool and school-aged children after neonatal arterial switch operation. J Thorac Cardiovasc Surg 114:578–585PubMedCrossRef
12.
Zurück zum Zitat Hovels-Gurich HH, Seghaye MC, Schnitker R, et al. (2002) Long-term neurodevelopmental outcomes in school-aged children after neonatal arterial switch operation. J Thorac Cardiovasc Surg 124:448–458PubMedCrossRef Hovels-Gurich HH, Seghaye MC, Schnitker R, et al. (2002) Long-term neurodevelopmental outcomes in school-aged children after neonatal arterial switch operation. J Thorac Cardiovasc Surg 124:448–458PubMedCrossRef
13.
Zurück zum Zitat Hovels-Gurich HH, Seghaye MC, Sigler M, et al. (2001) Neurodevelopmental outcome related to cerebral risk factors in children after neonatal arterial switch operation. Ann Thorac Surg 71:881–888PubMedCrossRef Hovels-Gurich HH, Seghaye MC, Sigler M, et al. (2001) Neurodevelopmental outcome related to cerebral risk factors in children after neonatal arterial switch operation. Ann Thorac Surg 71:881–888PubMedCrossRef
14.
Zurück zum Zitat Huppi PS, Posse S, Lazeyras F, et al. (1991) Magnetic resonance in preterm and term newborns: IH-spectroscopy in developing human brain. PediatrRes 30:574–578 Huppi PS, Posse S, Lazeyras F, et al. (1991) Magnetic resonance in preterm and term newborns: IH-spectroscopy in developing human brain. PediatrRes 30:574–578
15.
Zurück zum Zitat Kim GE, Lee JH, Cho YP (2002) Can carotid endarterectomy improve metabolic status in patients with asymptomatic internal carotid artery flow lesion? Studies with localized in vivo proton magnetic resonance spectroscopy. J Vase Surg 36:559–564CrossRef Kim GE, Lee JH, Cho YP (2002) Can carotid endarterectomy improve metabolic status in patients with asymptomatic internal carotid artery flow lesion? Studies with localized in vivo proton magnetic resonance spectroscopy. J Vase Surg 36:559–564CrossRef
16.
Zurück zum Zitat Kim GE, Lee JH, Cho YP, Kim ST (2001) Metabolic changes in the ischemic penumbra after carotid endarterectomy in stroke patients by localized in vivo proton magnetic resonance spectroscopy (1H-MRS). Cardiovasc Surg 9:345–355PubMedCrossRef Kim GE, Lee JH, Cho YP, Kim ST (2001) Metabolic changes in the ischemic penumbra after carotid endarterectomy in stroke patients by localized in vivo proton magnetic resonance spectroscopy (1H-MRS). Cardiovasc Surg 9:345–355PubMedCrossRef
17.
Zurück zum Zitat Kim KS, Lee YA, Kim EA (1999) Localized IH MR spectroscopy as early predictor for neurological outcome in high risk newborn infants. Pediatr Res 45:205A Kim KS, Lee YA, Kim EA (1999) Localized IH MR spectroscopy as early predictor for neurological outcome in high risk newborn infants. Pediatr Res 45:205A
18.
Zurück zum Zitat Kim KS, Pi SY, Kim EA (1998) Localized 1H MR spectroscopy as early predictor for outcome in infants with birth asphyxia Proceedings of the sixth conference of the International Society for Magnetic Resonance in Medicine Kim KS, Pi SY, Kim EA (1998) Localized 1H MR spectroscopy as early predictor for outcome in infants with birth asphyxia Proceedings of the sixth conference of the International Society for Magnetic Resonance in Medicine
19.
Zurück zum Zitat Kim KS, Yoon H-S, Lim KH, et al. (2000) Neuronal cell death in newborn rats of unilateral hypoxia ischemic injury by 1H MR spectroscopy and tunnel staining. Proceedings of the eight conference of the International Society for Magnetic Resonance in Medicine Kim KS, Yoon H-S, Lim KH, et al. (2000) Neuronal cell death in newborn rats of unilateral hypoxia ischemic injury by 1H MR spectroscopy and tunnel staining. Proceedings of the eight conference of the International Society for Magnetic Resonance in Medicine
20.
Zurück zum Zitat Kok RD, van den Berg PP, van den Bergh AJ, Nijland R, Heerschap A (2002) Maturation of the human fetal brain as observed by 1H MR spectroscopy. Magii Reson Med 48:611–616CrossRef Kok RD, van den Berg PP, van den Bergh AJ, Nijland R, Heerschap A (2002) Maturation of the human fetal brain as observed by 1H MR spectroscopy. Magii Reson Med 48:611–616CrossRef
21.
Zurück zum Zitat Kreis R, Arcinue E, Ernst T, et al. (1996) Hypoxic encephalopathy after near-drowning studied by quantitative IH-magnetic resonance spectroscopy. J Clin Invest 97:1142–1154PubMedCrossRef Kreis R, Arcinue E, Ernst T, et al. (1996) Hypoxic encephalopathy after near-drowning studied by quantitative IH-magnetic resonance spectroscopy. J Clin Invest 97:1142–1154PubMedCrossRef
22.
Zurück zum Zitat Kreis R, Ernst T, Ross BD (1993) Development of the human brain: in vivo quantification of metabolite and water content with proton magnetic resonance spectroscopy. Magn Reson Med 30:424–437PubMed Kreis R, Ernst T, Ross BD (1993) Development of the human brain: in vivo quantification of metabolite and water content with proton magnetic resonance spectroscopy. Magn Reson Med 30:424–437PubMed
23.
Zurück zum Zitat Kreis R, Farrow N, Ross BD (1990) Diagnosis of hepatic encephalopathy by proton magnetic resonance spectroscopy. Lancet 336:635–636PubMedCrossRef Kreis R, Farrow N, Ross BD (1990) Diagnosis of hepatic encephalopathy by proton magnetic resonance spectroscopy. Lancet 336:635–636PubMedCrossRef
24.
Zurück zum Zitat Kreis R, Farrow N, Ross BD (1991) Localized 1H NMR spectroscopy in patients with chronic hepatic encephalopathy. Analysis of changes in cerebral glutamine, choline and inositols. NMR Biomed 4:109–116PubMed Kreis R, Farrow N, Ross BD (1991) Localized 1H NMR spectroscopy in patients with chronic hepatic encephalopathy. Analysis of changes in cerebral glutamine, choline and inositols. NMR Biomed 4:109–116PubMed
25.
Zurück zum Zitat Kreis R, Hofmann L, Kuhlmann B, et al. (2002) Brain metabolite composition during early human brain development as measured by quantitative in vivo 1H magnetic resonance spectroscopy. Mam Reson Med 48:949–958CrossRef Kreis R, Hofmann L, Kuhlmann B, et al. (2002) Brain metabolite composition during early human brain development as measured by quantitative in vivo 1H magnetic resonance spectroscopy. Mam Reson Med 48:949–958CrossRef
26.
Zurück zum Zitat Kreis R, Ross BD (1992) Cerebral metabolic disturbances in patients with subacute and chronic diabetes mellitus: detection with proton MR spectroscopy. Radiology 184:123–130PubMed Kreis R, Ross BD (1992) Cerebral metabolic disturbances in patients with subacute and chronic diabetes mellitus: detection with proton MR spectroscopy. Radiology 184:123–130PubMed
27.
Zurück zum Zitat Kreis R, Ross BD, Farrow NA, Ackerman Z (1992) Metabolic disorders of the brain in chronic hepatic encephalopathy detected with H-l MR spectroscopy. Radiology 182:19–27PubMed Kreis R, Ross BD, Farrow NA, Ackerman Z (1992) Metabolic disorders of the brain in chronic hepatic encephalopathy detected with H-l MR spectroscopy. Radiology 182:19–27PubMed
28.
Zurück zum Zitat Lee CW, Lee JH, Kim JJ, et al. (1999) Cerebral metabolic abnormalities in congestive heart failure detected by proton magnetic resonance spectroscopy. J Am Coll Cardiol 33:1196–1202PubMedCrossRef Lee CW, Lee JH, Kim JJ, et al. (1999) Cerebral metabolic abnormalities in congestive heart failure detected by proton magnetic resonance spectroscopy. J Am Coll Cardiol 33:1196–1202PubMedCrossRef
29.
Zurück zum Zitat Lee CW, Lee JH, Lim TH, et al. (2001) Prognostic significance of cerebral metabolic abnormalities in patients with congestive heart failure. Circulation 103:2784–2787PubMed Lee CW, Lee JH, Lim TH, et al. (2001) Prognostic significance of cerebral metabolic abnormalities in patients with congestive heart failure. Circulation 103:2784–2787PubMed
30.
Zurück zum Zitat Lee JH, Arcinue E, Ross BD (1994) Brief report: organic osmolytes in the brain of an infant with hypematremia. N Engl J Med 331:439–442PubMedCrossRef Lee JH, Arcinue E, Ross BD (1994) Brief report: organic osmolytes in the brain of an infant with hypematremia. N Engl J Med 331:439–442PubMedCrossRef
31.
Zurück zum Zitat Lee JH, Seo DW, Lee YS, et al. (1999) Proton magnetic resonance spectroscopy (1H-MRS) findings for the brain in patients with liver cirrhosis reflect the hepatic functional reserve. Am J Gastroenterol 94:2206–22l3PubMedCrossRef Lee JH, Seo DW, Lee YS, et al. (1999) Proton magnetic resonance spectroscopy (1H-MRS) findings for the brain in patients with liver cirrhosis reflect the hepatic functional reserve. Am J Gastroenterol 94:2206–22l3PubMedCrossRef
32.
Zurück zum Zitat Lim MK, Suh CH, Kim HJ, et al. (2000) Systemic lupus erythematosus: brain MR imaging and single- voxel hydrogen 1 MR spectroscopy. Radiology 217:43–49PubMed Lim MK, Suh CH, Kim HJ, et al. (2000) Systemic lupus erythematosus: brain MR imaging and single- voxel hydrogen 1 MR spectroscopy. Radiology 217:43–49PubMed
33.
Zurück zum Zitat Mielke G, Benda N (2001) Cardiac output and central distribution of blood flow in the human fetus. Circulation 103:1662–1668PubMed Mielke G, Benda N (2001) Cardiac output and central distribution of blood flow in the human fetus. Circulation 103:1662–1668PubMed
34.
Zurück zum Zitat Naeye RL (1966) Transposition of the great arteries and prenatal growth. Arch Pathol 82:412–418PubMed Naeye RL (1966) Transposition of the great arteries and prenatal growth. Arch Pathol 82:412–418PubMed
35.
Zurück zum Zitat Naeye RL (1967) Anatomic features of growth failure in congenital heart disease. Pediatrics 39:433–440PubMed Naeye RL (1967) Anatomic features of growth failure in congenital heart disease. Pediatrics 39:433–440PubMed
36.
Zurück zum Zitat Newburger JW, Jonas RA, Wernovsky G, et al. (1993) A comparison of the perioperative neurologic effects of hypothermic circulatory arrest versus low-flow cardiopulmonary bypass in infant heart surgery. N Engl J Med 329:1057–1064PubMedCrossRef Newburger JW, Jonas RA, Wernovsky G, et al. (1993) A comparison of the perioperative neurologic effects of hypothermic circulatory arrest versus low-flow cardiopulmonary bypass in infant heart surgery. N Engl J Med 329:1057–1064PubMedCrossRef
37.
Zurück zum Zitat Newburger JW, Silbert AR, Bucldey LP, Fyler DC (1984) Cognitive function and age at repair of transposition of the great arteries in children. N Engl J Med 310: 1495–1499PubMedCrossRef Newburger JW, Silbert AR, Bucldey LP, Fyler DC (1984) Cognitive function and age at repair of transposition of the great arteries in children. N Engl J Med 310: 1495–1499PubMedCrossRef
38.
Zurück zum Zitat Novotny E, Ashwal S, Shevell M (1998) Proton magnetic resonance spectroscopy: an emerging technology in pediatric neurology research. Pediatrics Res 44:1–10 Novotny E, Ashwal S, Shevell M (1998) Proton magnetic resonance spectroscopy: an emerging technology in pediatric neurology research. Pediatrics Res 44:1–10
39.
Zurück zum Zitat Park IS, Yoon SY, Kim YH (2001) Evaluation of cerebral metabolism for children undergoing open heart surgery for closure of artrial septal defect under cardiopulmonary bypass by localized in vivo 1H MR spectroscopy. Cardiol Young 11:32–33 Park IS, Yoon SY, Kim YH (2001) Evaluation of cerebral metabolism for children undergoing open heart surgery for closure of artrial septal defect under cardiopulmonary bypass by localized in vivo 1H MR spectroscopy. Cardiol Young 11:32–33
40.
Zurück zum Zitat Rosenthal GL (1996) Patterns of prenatal growth among infants with cardiovascular malformations: possible fetal hemodynamic effects. Am J Epidemiol 745: 505–513 Rosenthal GL (1996) Patterns of prenatal growth among infants with cardiovascular malformations: possible fetal hemodynamic effects. Am J Epidemiol 745: 505–513
41.
Zurück zum Zitat Ross B, Kreis R, Ernst T (1992) Clinical tools for the 90s: magnetic resonance spectroscopy and metabolite imaging. Eur J Radiol 14:128–140PubMedCrossRef Ross B, Kreis R, Ernst T (1992) Clinical tools for the 90s: magnetic resonance spectroscopy and metabolite imaging. Eur J Radiol 14:128–140PubMedCrossRef
42.
Zurück zum Zitat Ross BD, Ernst T, Kreis R, et al. (1998) 1H MRS in acute traumatic brain injury. J Magn Reson Imaging 8: 829–840PubMed Ross BD, Ernst T, Kreis R, et al. (1998) 1H MRS in acute traumatic brain injury. J Magn Reson Imaging 8: 829–840PubMed
43.
Zurück zum Zitat Ross BD, Jacobson S, Villamil F, et al. (1994) Subclinical hepatic encephalopathy: proton MR spectroscopic abnormalities. Radiology 193:457–463PubMed Ross BD, Jacobson S, Villamil F, et al. (1994) Subclinical hepatic encephalopathy: proton MR spectroscopic abnormalities. Radiology 193:457–463PubMed
44.
Zurück zum Zitat Rudolph AM (2001) Aortopulmonary transposition. In: Rudolph AM (ed) Congenital Diseases of the Heart: Clinical–physiological Considerations, 2nd edn. Futura, New York, pp 680–683 Rudolph AM (2001) Aortopulmonary transposition. In: Rudolph AM (ed) Congenital Diseases of the Heart: Clinical–physiological Considerations, 2nd edn. Futura, New York, pp 680–683
45.
Zurück zum Zitat Sharma R, Choudhary SK, Mohan MR, et al. (2000) Neurological evaluation and intelligence testing in the child with operated congenital heart disease. Ann Thorac Surg 70:575–581PubMedCrossRef Sharma R, Choudhary SK, Mohan MR, et al. (2000) Neurological evaluation and intelligence testing in the child with operated congenital heart disease. Ann Thorac Surg 70:575–581PubMedCrossRef
46.
Zurück zum Zitat Sigler M, Vazquez-Jimenez JF, Grabitz RG, et al. (2001) Time course of cranial ultrasound abnormalities after arterial switch operation in neonates. Ann Thorac Surg 71: 877–880PubMedCrossRef Sigler M, Vazquez-Jimenez JF, Grabitz RG, et al. (2001) Time course of cranial ultrasound abnormalities after arterial switch operation in neonates. Ann Thorac Surg 71: 877–880PubMedCrossRef
47.
Zurück zum Zitat Utens EM, Bieman HJ, Verhulst FC, et al. (1998) Psychopathology in young adults with congenital heart disease. Follow-up results. Eur Heart J 19:647–651PubMedCrossRef Utens EM, Bieman HJ, Verhulst FC, et al. (1998) Psychopathology in young adults with congenital heart disease. Follow-up results. Eur Heart J 19:647–651PubMedCrossRef
48.
Zurück zum Zitat Utens EM, Bieman HJ, Verhulst FC, et al. (1998) Prediction of behavioural and emotional problems in children and adolescents with operated congenital heart disease. Eur Heart J 19:801–807PubMedCrossRef Utens EM, Bieman HJ, Verhulst FC, et al. (1998) Prediction of behavioural and emotional problems in children and adolescents with operated congenital heart disease. Eur Heart J 19:801–807PubMedCrossRef
49.
Zurück zum Zitat Visconti KJ, Bichell DP, Jonas RA, Newburger JW, Bellinger DC (1999) Developmental outcome after surgical versus interventional closure of secundum atrial septal defect in children. Circulation 100:II145–II150PubMed Visconti KJ, Bichell DP, Jonas RA, Newburger JW, Bellinger DC (1999) Developmental outcome after surgical versus interventional closure of secundum atrial septal defect in children. Circulation 100:II145–II150PubMed
50.
Zurück zum Zitat Wray J, Sensky T (2001) Congenital heart disease and cardiac surgery in childhood: effects on cognitive function and academic ability. Heart 85:687–691PubMedCrossRef Wray J, Sensky T (2001) Congenital heart disease and cardiac surgery in childhood: effects on cognitive function and academic ability. Heart 85:687–691PubMedCrossRef
Metadaten
Titel
Metabolic Alterations and Neurodevelopmental Outcome of Infants with Transposition of the Great Arteries
verfasst von
I. Sook Park
S. Young Yoon
J. Yeon Min
Y. Hwue Kim
J. Kok Ko
K. Soo Kim
D. Man Seo
J. Hee Lee
Publikationsdatum
01.10.2006
Erschienen in
Pediatric Cardiology / Ausgabe 5/2006
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-004-0730-5

Weitere Artikel der Ausgabe 5/2006

Pediatric Cardiology 5/2006 Zur Ausgabe

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

29.05.2024 Herzinfarkt Nachrichten

Bei Menschen mit Typ-2-Diabetes sind die Chancen, einen Myokardinfarkt zu überleben, in den letzten 15 Jahren deutlich gestiegen – nicht jedoch bei Betroffenen mit Typ 1.

Erhöhtes Risiko fürs Herz unter Checkpointhemmer-Therapie

28.05.2024 Nebenwirkungen der Krebstherapie Nachrichten

Kardiotoxische Nebenwirkungen einer Therapie mit Immuncheckpointhemmern mögen selten sein – wenn sie aber auftreten, wird es für Patienten oft lebensgefährlich. Voruntersuchung und Monitoring sind daher obligat.

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

24.05.2024 Diabetische Retinopathie Nachrichten

Möglicherweise hängt es von der Art der Diabetesmedikamente ab, wie hoch das Risiko der Betroffenen ist, dass sich sehkraftgefährdende Komplikationen verschlimmern.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.