A.V.G. Bruschke

Leiden University, Leyden, South Holland, Netherlands

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Publications (205)1323 Total impact

  • A V G Bruschke · C E Veltman · M A de Graaf · H W Vliegen
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    ABSTRACT: The clinical significance of myocardial bridging has been a subject of discussion and controversy since the introduction of coronary arteriography (CAG) in the early 1960s. More recently computed tomography coronary angiography (CTCA) has made it possible to visualise the overlying muscular bands and appears to have a higher sensitivity for detecting myocardial bridging than CAG. Combining CTCA with invasive techniques such as CAG should make it possible to improve our understanding of the pathophysiology of myocardial bridging and to provide answers to hitherto unresolved questions. This paper critically reviews the outcomes of previous studies and defines remaining questions that should be answered to optimise the management of the presumably fast growing number of patients in whom a diagnosis of myocardial bridging has been made.
    Netherlands heart journal: monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation 11/2012; 21(1). DOI:10.1007/s12471-012-0355-x · 1.84 Impact Factor
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    Albert V G Bruschke · William C Sheldon · Earl K Shirey · William L Proudfit
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    ABSTRACT: The first "selective" coronary arteriogram was made 50 years ago by Dr. F. Mason Sones at the Cleveland Clinic. Soon afterward coronary arteriography was developed as a diagnostic method suitable for widespread clinical application. This method has revolutionized our understanding of coronary artery disease and has become the basis for selecting and evaluating therapeutic interventions. This Viewpoint commemorates the achievements of the pioneers of coronary arteriography, the difficulties they encountered, and their impact on the development of modern cardiology. Developments during the last half century and prospects for the future are discussed in historical perspective.
    Journal of the American College of Cardiology 12/2009; 54(23):2139-44. DOI:10.1016/j.jacc.2009.06.051 · 16.50 Impact Factor
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    Albert V G Bruschke · J Wouter Jukema
    Journal of the American College of Cardiology 10/2008; 52(11):921-3. DOI:10.1016/j.jacc.2008.06.008 · 16.50 Impact Factor
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    ABSTRACT: Magnetic resonance images were obtained from 32 patients with acute myocardial infarction, using a four-echo technique (echo time (TE) = 30, 60, 90, and 120 ms) pre-gadolinium(Gd)-DTPA injection and a TE = 30 ms sequence pre- and post-Gd-DTPA. Intensity ratios of infarcted and normal myocardium were calculated, as were contrast-to-noise and signal-to-noise ratios. The four intensity ratios pre-Gd-DTPA were 1.20 ±0.15, 1.42 ± 0.22, 1.78 ± 0.38, and 1.99 ± 0.60 for TE = 30, 60, 90, and 120 ms, respectively, and 1.42 ± 0.19 post-Gd-DTPA (p = NS for post-Gd-DTPA vs TE = 60, p = 0.007 for TE = 90 vs TE = 120, p < 0.0001 for all other comparisons). The four contrast-to-noise ratios pre-Gd-DTPA were 1.69 ± 0.97, 2.69 ± 1.13, 3.17 ± 1.15, and 2.90 ± 1.09 for TE = 30, 60, 90, and 120 ms, respectively, and 2.71 ± 1.26 post-Gd-DTPA (p = NS for post-Gd-DTPA vs TE = 60, 90, and 120, p = NS for TE = 120 vs TE = 60 and 90, p< 0.01 for all other comparisons). The four signal-to-noise ratios pre-Gd-DTPA were 8.67 ± 1.47, 6.52 ± 0.76, 5.20 ± 0.64, 4.17 ± 0.53 for TE = 30, 60, 90, and 120 ms, respectively, and 9.17 ± 1.92 post-Gd-DTPA (p = 0.03 for post-Gd-DTPA vs TE = 30, p < 0.0001 for all other comparisons). In conclusion, the detectabilities of acute myocardial infarction were similar at TE = 60 ms and at Gd-DTPA enhanced short-TE MR imaging. However, image quality proved to be superior using the Gd-DTPA enhanced short-TE technique. © 1991 Academic Press, Inc.
    Magnetic Resonance in Medicine 11/2005; 17(2):460 - 469. DOI:10.1002/mrm.1910170217 · 3.57 Impact Factor
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    ABSTRACT: Oxidation susceptibility of lipids in vitro is considered to reflect the exposure of lipids to oxidation stress in vivo which is related to cardiovascular morbidity. This study examined the effect of pravastatin therapy on serum oxidation susceptibility, particularly in relation to endothelial function of coronary arteries. The participants were recruited from the Pravastatin-Related Effects Following Angioplasty on Coronary Endothelium trial, a double-blinded, placebo-controlled, randomized, multi-center study designed to analyze the effect of pravastatin treatment on endothelial function in previously dilated and normal coronary arteries. Serial, graded, intra-coronary acetylcholine infusions were used to assess endothelial function. In vitro, copper-induced, serum oxidation parameters were determined at randomization and at time of coronary endothelial function assessment. Oxidation parameters were determined in 45 patients (pravastatin 23, placebo 22). Pravastatin therapy significantly improved serum oxidation lag time (+8%, P<0.05), maximal diene formation rate (-22%, P<0.01) and total amount of dienes formed after 5 h (-16%, P<0.01). These parameters remained essentially unchanged in the placebo group. Acetylcholine-evoked responses were positively correlated to therapy-induced change in serum oxidation susceptibility in the dilated segment group (r2=0.56, P=0.006). Pravastatin's beneficial effect on endothelial dysfunction of dilated coronary segments may be secondary to pravastatin's improvement of oxidation susceptibility.
    Atherosclerosis 08/2003; 169(2):309-15. DOI:10.1016/S0021-9150(03)00197-7 · 3.99 Impact Factor
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    Heart (British Cardiac Society) 06/2003; 89(5):557-8. DOI:10.1136/heart.89.5.557 · 5.60 Impact Factor
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    ABSTRACT: Endurance training is known to alter the functioning of the autonomic nervous system, a major goal when pursuing fitness. Here, we test the hypothesis that the training-associated rhythmic sensations alone, hence without the usual accompanying physical exercise, accomplish this effect. We studied sixteen resting healthy male volunteers, age (mean±SD) 25.9±3.7 years. During one hour we applied, at marching pace (2 bursts per second), bipolar transcutaneous electrical sensory nerve stimulation to both feet. The stimulation intensity was controlled in such a way that discharges of sensory fibres in the tibial and fibular nerves were induced, while motor fibres were not excited. Heart rate, blood pressure, and baroreflex sensitivity were measured before and after stimulation. Baseline baroreflex sensitivity and systolic blood pressure were 8.7±4.5 ms·mmHg-1 and 117.5±6.4 mmHg, respectively. Directly after rhythmic sensory stimulation baroreflex sensitivity had increased to 10.0±4.1 ms·mmHg-1 (p<0.05). One day later, systolic blood pressure had lowered to 111.7±5.5 mmHg (p<0.01). Rhythmic sensory stimulation entails autonomic adaptations that are comparable with those of exercise. This demonstration of sensory-induced autonomic adaptations without any muscular involvement may help to design alternative, low-effort fitness programmes for specific categories of sedentary, diseased or disabled persons.
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    ABSTRACT: To test the hypothesis that the 3-hydroxy-3-methylglutaryl coenzyme-A reductase inhibitor pravastatin ameliorates endothelium mediated responses of dilated coronary segments: the PREFACE (pravastatin related effects following angioplasty on coronary endothelium) trial. A double blind, randomised, placebo controlled, multicentre study. Four hospitals in the Netherlands. 63 non-smoking, non-hypercholesterolaemic patients scheduled for elective balloon angioplasty (pravastatin 34, placebo 29). The effects of three months of pravastatin treatment (40 mg daily) on endothelium dependent vasomotor function were studied. Balloon angioplasty was undertaken one month after randomisation, and coronary vasomotor function tests using acetylcholine were performed two months after balloon angioplasty. The angiograms were analysed quantitatively. The efficacy measure was the acetylcholine induced change in mean arterial diameter, determined in the dilated segment and in an angiographically normal segment of an adjacent non-manipulated coronary artery. Increasing acetylcholine doses produced vasoconstriction in the dilated segments (p = 0.004) but not in the normal segments. Pravastatin did not affect the vascular response to acetylcholine in either the dilated segments (p = 0.09) or the non-dilated sites. Endothelium dependent vasomotion in normal segments was correlated with that in dilated segments (r = 0.47, p < 0.001). There were fewer procedure related events in the pravastatin group than in the placebo group (p < 0.05). Endothelium dependent vasomotion in normal segments is correlated with that in dilated segments. A significant beneficial effect of pravastatin on endothelial function could not be shown, but in the dilated segments there was a trend towards a beneficial treatment effect in the pravastatin group.
    Heart (British Cardiac Society) 11/2001; 86(5):533-9. · 5.60 Impact Factor
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    ABSTRACT: To determine whether the angiotensin converting enzyme (ACE) and the angiotensin II type 1 receptor (AT(1)R A1166C) gene polymorphism interact to increase the risk of ischaemic events, and whether this can be explained by the progression of angiographically defined coronary atherosclerosis. Prospective defined substudy of the lipid lowering regression trial (REGRESS). University hospital. 885 male patients with stable coronary artery disease. Incidence of ischaemic events during a two year follow up; serial quantitative coronary arteriography (mean segment diameter and minimum obstruction diameter) at baseline and after two years. Patients who carried both the ACE-DD and AT(1)R-CC genotype had significantly more ischaemic events during the two year follow up than those carrying other genotype combinations (p = 0.035, Mantel-Haenszel test for linear association). There was no association between the two genotypes and mean segment diameter or minimum obstruction diameter at baseline or after two years. The suggestion that ACE-DD and AT(1)R-CC genotypes interact to increase the risk of ischaemic events is confirmed. However, this increased risk was not accompanied by increased progression of angiographically defined coronary atherosclerosis.
    Heart (British Cardiac Society) 05/2001; 85(4):458-62. · 5.60 Impact Factor
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    ABSTRACT: Various combinations of sympathetic and vagal tone can yield the same heart rate, while ventricular electrophysiology differs. To demonstrate this in humans, we studied healthy volunteers in the sitting position with horizontal legs. First, heart rate was increased by lowering the legs to 60 degrees and back. Thereafter, heart rate was increased by handgrip. In each subject, a leg-lowering angle was selected at which heart rate matched best with heart rate in the third handgrip minute. Thirteen subjects had a heart rate match better than 1%. Heart rate (control: 65.2+/-9.0 bpm) increased to 72.1+/-8.7 (leg lowering) and to 72.1+/-8.8 (handgrip) bpm. QRS azimuth, QRS duration, maximal T vector, T azimuth, T elevation, ST duration, QRS-T angle and QT interval differed significantly (P<0.05) between leg lowering and handgrip (QT interval 418+/-15 versus 435+/-21 ms). Also, septal dispersion of repolarization, assessed as the time difference between the apex and the end of the T wave in the V2 and V3 leads, differed significantly (V2: 96.7+/-19.3 versus 110.0+/-23.3 ms, P<0.01; V3: 88.7+/-19.3 versus 97.3+/-23.3 ms; P<0.01). Hence, leg lowering and handgrip cause different ventricular depolarization and repolarization. The hypertensive handgrip manoeuvre entails a longer QT interval and probably an increased septal dispersion of repolarization.
    Pflügers Archiv - European Journal of Physiology 03/2001; 441(5):717-24. DOI:10.1007/s004240000487 · 4.10 Impact Factor
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    ABSTRACT: Recent studies have shown that chemical composition and morphology, rather than anatomy (degree of stenosis), determine atherosclerotic plaque instability and predict disease progression. Current clinical diagnostic techniques provide accurate assessment of plaque anatomy, but have limited capability to assess plaque morphology in vivo. Here we describe a technique for a morphology-based diagnosis of atherosclerosis in the coronary arteries using Raman spectroscopy that can potentially be performed in vivo using optical fiber technology. Raman tissue spectra were collected from normal and atherosclerotic coronary artery samples in different stages of disease progression (n=165) from explanted transplant recipient hearts (n=16). Raman spectra from the elastic laminae (EL), collagen fibers (CF), smooth muscle cells (SMC), adventitial adipocytes (AA) or fat cells, foam cells (FC), necrotic core (NC), cholesterol crystals (CC), beta-carotene containing crystals (beta-C), and calcium mineralizations (CM) were used as basis spectra in a linear least squares-minimization (LSM) model to calculate the contribution of these morphologic structures to the coronary artery tissue spectra. We developed a diagnostic algorithm that used the fit-contributions of the various morphologic structures to classify 97 coronary artery samples in an initial calibration data set as either nonatherosclerotic, calcified plaque, or noncalcified atheromatous plaque. The algorithm was subsequently tested prospectively in a second validation data set, and correctly classified 64 (94%) of 68 coronary artery samples. Raman spectroscopy provides information about the morphologic composition of intact human coronary artery without the need for excision and microscopic examination. In the future, it may be possible to use this technique to analyze the morphologic composition of atherosclerotic coronary artery lesions and assess plaque instability and disease progression in vivo.
    Cardiovascular Pathology 03/2001; 10(2):59-68. DOI:10.1016/S1054-8807(01)00063-1 · 2.00 Impact Factor
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    ABSTRACT: We have previously shown that Raman spectroscopy can be used for chemical analysis of intact human coronary artery atherosclerotic lesions ex vivo without tissue homogenization or extraction. Here, we report the chemical analysis of individual cellular and extracellular components of atherosclerotic lesions in different stages of disease progression in situ using Raman microspectroscopy. Thirty-five coronary artery samples were taken from 16 explanted transplant recipient hearts, and thin sections were prepared. Using a high-resolution confocal Raman microspectrometer system with an 830-nm laser light, high signal-to-noise Raman spectra were obtained from the following morphologic structures: internal and external elastic lamina, collagen fibers, fat, foam cells, smooth muscle cells, necrotic core, beta-carotene, cholesterol crystals, and calcium mineralizations. Their Raman spectra were modeled by using a linear combination of basis Raman spectra from the major biochemicals present in arterial tissue, including collagen, elastin, actin, myosin, tropomyosin, cholesterol monohydrate, cholesterol linoleate, phosphatidyl choline, triolein, calcium hydroxyapatite, calcium carbonate, and beta-carotene. The results show that the various morphologic structures have characteristic Raman spectra, which vary little from structure to structure and from artery to artery. The biochemical model described the spectrum of each morphologic structure quite well, indicating that the most essential biochemical components were included in the model. Furthermore, the biochemical composition of each structure, indicated by the fit contributions of the biochemical basis spectra of the morphologic structure spectrum, was very consistent. The Raman spectra of various morphologic structures in normal and atherosclerotic coronary artery may be used as basis spectra in a linear combination model to analyze the morphologic composition of atherosclerotic coronary artery lesions.
    Cardiovascular Pathology 03/2001; 10(2):69-82. DOI:10.1016/S1054-8807(01)00064-3 · 2.00 Impact Factor
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    ABSTRACT: To determine normal Doppler and 2D gradients and flow characteristics of the Freestyle stentless aortic bioprosthesis related to valve size. The Freestyle stentless aortic bioprosthesis is one of the newer aortic xenografts. Only limited data are available of the echocardiographic flow characteristics during a mid-term follow-up period of this valve. Therefore valve performance related to valve size was measured during a follow-up period of two years. 175 consecutive patients with a Freestyle aortic bioprosthesis underwent an echocardiographic and Doppler examination according to a common protocol. Investigations were done within 4 weeks after operation, after 3 to 6 months, and after 1 and 2 years. With a valve size from 19 to 27 mm mean gradients decreased from 8.0 +/- 5.1 mmHg at discharge to 5.8 +/- 3.8 mmHg after 3-6 months (p < 0.001). Thereafter gradients remained stable. The performance index, the ratio of the measured effective orifice area in the patient divided by the effective orifice area measured in vitro increased from 69 +/- 20% at discharge to 79 +/- 29% after one, two and three years. Performance index was especially very high in the smaller sized valves with a performance index of 85 +/- 17% for the 21 mm valve. During follow-up mean gradients remained below 10 mmHg even in the 21 mm valve. Stentless xenografts have ideal haemodynamics, even in the small aortic root.
    International Journal of Cardiac Imaging 11/2000; 16(5):359-64. DOI:10.1023/A:1026521211249
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    ABSTRACT: Computation of the low-frequency (LF) blood pressure variability (BPV) to heart rate variability (HRV) transfer-index is a common method to assess baroreflex sensitivity (BRS), tacitly assuming that all LF-HRV is caused by baroreflex feedback of LF-BPV. However, respiration may also cause HRV by mechanisms not involving the baroreflex. Application of narrow-band (controlled) high-frequency breathing would keep such non-baroreflex-mediated HRV best out of the LF band. Spontaneous breathing, because of its broad-band character, might cause extra, non-baroreflex-mediated, HRV in the LF band, while paced LF breathing would even concentrate most non-baroreflex-mediated HRV in the LF band. Our study addresses the likely resulting BRS overestimation. We recorded HRV and BPV in 20 healthy young subjects in the sitting position. We varied the sympathovagal balance by gradual leg-lowering from horizontal till 60 degrees . At each angle the subjects performed controlled 0.10 Hz, spontaneous, and controlled 0.25 Hz respiration. Resting BRS values were 15.5(7.2), 13.1 (3.7), and 11.6(6.2) ms/mmHg, respectively. Both the 15/min and the free breathing values differed significantly, P< 0.01 and P= 0.04, from the 6/min breathing value. With lowered legs, the BRS values were 8.2(3.4), 8.3(2.9), and 8.3(3.4) ms/mmHg, respectively. Controlled 6/min breathing caused significant BRS overestimation under resting conditions. For the group, spontaneous respiration yielded acceptable BRS values, but individual BRS values deviated sometimes considerably. Conversely, with gravitational load, the respiratory pattern had only minor impact on BRS. Our results demonstrate that the risk of an overestimated BRS value is realistic as long as respiration is not controlled and of high-frequency.
    Journal of Hypertension 11/2000; 18(11):1635-44. DOI:10.1097/00004872-200018110-00015 · 4.72 Impact Factor
  • Circulation 10/2000; 102(14). DOI:10.1161/01.CIR.102.14.1629 · 14.43 Impact Factor
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    ABSTRACT: The Regression Growth Evaluation Statin Study (REGRESS) is a placebo-controlled multicenter study designed to assess the effect of 2-year treatment with pravastatin on the progression and regression of angiographically documented coronary artery disease. One of the secondary end points was the occurrence of 2-year restenosis in the percutaneous transluminal coronary angioplasty (PTCA) block. We randomly assigned eligible patients to receive pravastatin 40 mg once daily or placebo. The end point was the percent diameter stenosis of the target lesion at 24 months, as assessed by (semi)quantitative coronary angiography. Two hundred twenty-one patients underwent scheduled PTCA, which was considered successful in 201 patients. One hundred seventy-eight patients underwent angiographic restudy (89%). The patients in the pravastatin group (n = 109) and placebo group (n = 112) were similar at baseline. Percent diameter stenosis before angioplasty was 78 +/- 14% (mean +/- SD) in the pravastatin group and 80 +/- 14% in the placebo group (p = 0.46). At follow-up, the percent diameter stenosis was 32 +/- 23% in the pravastatin group and 45 +/- 29% in the placebo group (p < 0.001). Clinical restenosis was significantly lower in the pravastatin group (7%) compared with the placebo group (29%) (p < 0.001). Risk reduction for all events was 58%. We conclude that treatment with pravastatin reduces 2-year clinical and angiographic restenosis.
    The American Journal of Cardiology 10/2000; 86(7):742-6. DOI:10.1016/S0002-9149(00)01073-0 · 3.28 Impact Factor
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    ABSTRACT: Raised triglyceride-rich lipoproteins significantly increase the risk for cardiovascular disease. Variation in the activity of the enzyme lipoprotein lipase (LPL), which is crucial in the removal of these lipoproteins, may therefore modulate this risk. Postheparin levels of LPL activity and mass were measured in a large cohort of male coronary artery disease patients participating in the Regression Growth Evaluation Statin Study (REGRESS), a lipid-lowering regression trial. In addition, the relationships between LPL activity and mass and severity of angina pectoris according to the NYHA classification and silent ischemia on 24-hour ambulatory ECG monitoring were assessed. Patients in different LPL activity quartiles and mass had different severities of angina; a total of 47% of patients in the lowest LPL quartile reported class III or IV angina. In contrast, only 29% in the highest activity quartile (P:=0.002) had severe angina. These parameters were supported by ambulatory ECG results, for which the total ischemic burden in the lowest LPL activity quartile was 36. 5+/-104.1 mm x min compared with 14.8+/-38.8 mm x min in the highest quartile of LPL activity (P:=0.001). LPL activity levels were strongly correlated with LPL mass (r=0.70, P:<0.0001). A significant association between the LPL protein mass and NYHA class (P:=0.012) was also demonstrated. We have demonstrated a significant relationship between LPL mass and activity and severity of ischemia as defined by angina class and ambulatory ECG. These results suggest that LPL influences risk for coronary artery disease by both catalytic and noncatalytic mechanisms.
    Circulation 10/2000; 102(14):1629-33. · 14.43 Impact Factor
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    ABSTRACT: Atherosclerotic plaque vulnerability is suggested to be determined by its chemical composition. However, at present there are no in vivo techniques available that can adequately type atherosclerotic plaques in terms of chemical composition. Previous in vitro experiments have shown that Raman spectroscopy can provide such information in great detail. Here we present the results of in vitro and in vivo intravascular Raman spectroscopic experiments, in which dedicated, miniaturized fiber-optic probes were used to illuminate the blood vessel wall and to collect Raman scattered light. The results make clear that an important hurdle to clinical application of Raman spectroscopy in atherosclerosis has been overcome, namely, the ability to obtain in vivo intravascular Raman spectra of high quality. Of equal importance is the finding that the in vivo intravascular Raman signal obtained from a blood vessel is a simple summation of signal contributions of the blood vessel wall and of blood. It means that detailed information about the chemical composition of a blood vessel wall can be obtained by adapting a multiple least-squares fitting method, which was developed previously for the analysis of in vitro spectra, to account for signal contributions of blood.
    Analytical Chemistry 09/2000; 72(16):3771-5. DOI:10.1021/ac000298b · 5.64 Impact Factor
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    ABSTRACT: The aim of the present clinical study was to evaluate whether gender-related differences existed as regards the extent and localization of coronary artery lesions in patients with angiographically documented coronary artery disease, and whether these angiographic findings would lead to differences in further management. Over a 16-year period (1981-1997) we evaluated 1894 patients (1526 men, 368 women) with angiographically documented coronary artery disease (luminal stenosis >/=60%). For each patient the coronary angiographic results and subsequent revascularization procedures (percutaneous transluminal coronary angioplasty or coronary artery bypass graft surgery) were analysed. The study period was divided into the early angioplasty years (1981 to 1989) and the current angioplasty years (1990-1997). No gender differences in extent and localization of coronary angiographic lesions were observed. In men and women the incidence of single-vessel disease was 42% and 40%, two-vessel disease 27% and 27%, three-vessel disease 26% and 24%, and left main disease 5% and 8%, respectively (P=ns). Localization of disease in men and women was 36% and 39% for the left anterior descending coronary artery, 34% and 32% for the right coronary artery, and 27% and 26% for the left circumflex coronary artery, respectively (P=ns). There was a significant shift from multi-vessel disease towards single-vessel disease in both men and women (both P<0.001). As to subsequent management, a significant gender difference in favour of women was observed (P=0.021). Over time, the number of angioplasty procedures increased significantly from 11.6% to 23.2% for men (P<0.001), and for women from 17.6% to 28.0% (P=0.025), whereas the number of coronary artery bypass procedures decreased in men from 34.9% to 29. 5% (P=0.024) and in women from 42.6% to 30.6% (P=0.019). Referral to angioplasty (n=535) and coronary artery bypass surgery (n=616) in relation to the extent of the disease did not show any gender bias in favour of men. Our angiographic findings did not show significant gender differences as regards the extent and localization of coronary artery disease in patients with angiographically documented coronary artery disease. More importantly, no substantial evidence could be found for under-referral of women to subsequent therapeutic management. Therefore our study questions the presence of Yentl syndrome in the current era.
    European Heart Journal 06/2000; 21(11):911-8. DOI:10.1053/euhj.1999.1941 · 15.20 Impact Factor
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    ABSTRACT: Conventional stenting requires predilatation which potentially increases vessel wall injury and cost of the procedure. In this study, the safety and efficacy of direct Jostent Flex (Jomed AB, Helsingborg, Sweden) stent placement was evaluated in 50 patients. Quantitative coronary angiography was performed at baseline, post-stent and 6 months follow-up. Clinical follow-up was done up to 9 months. In 50 patients (38 male/12 female; age 61+/-12 years) with stable (n = 42; 84%) or unstable (n = 8; 16%) angina, 53 Jostent Flex (JF) stents (diameter 3.2+/-0.2 mm) were implanted for 51 stenoses. Direct stenting was successful in 46 stenoses (90%). No stents were lost or damaged when retrieved after unsuccessful direct delivery. Eventually, all stents could be implanted at the target site. Angiographic success (<30% residual stenosis) was achieved in 49 lesions (96%). At 9 months, none of the patients had died. Target lesion revascularization was necessary in 4 (8%) patients at 6 months and in 2 (4%) other patients between 6 and 9 months. Minimal lumen diameter increased from 1.1+/-0.4 to 2.6+/-0.4 mm (p<0.001) after stent placement and 1.8+/-0.6 mm (p<0.001) at 6 months follow-up. Angiographic restenosis (> 50%) at 6 months was present in 24% of 49 treated stenoses. At 6 and 9 months, 39 (78%) and 41 (82%) of the patients were free of anginal symptoms and the ischemic event-free survival was 80% at 9 months. This study demonstrates the safety and efficacy of direct placement of the JF stent as well as favorable clinical and angiographic results up to 9 months after the procedure.
    The Journal of invasive cardiology 05/2000; 12(4):187-93. · 0.95 Impact Factor

Publication Stats

5k Citations
1,323.00 Total Impact Points


  • 1985–2012
    • Leiden University
      • Leiden Amsterdam Center for Drug Research
      Leyden, South Holland, Netherlands
  • 1984–2005
    • Leiden University Medical Centre
      • Department of Cardiology
      Leyden, South Holland, Netherlands
  • 2000
    • University of Groningen
      Groningen, Groningen, Netherlands
  • 1998–2000
    • Academisch Medisch Centrum Universiteit van Amsterdam
      • Department of Vascular Medicine
      Amsterdam, North Holland, Netherlands
  • 1999
    • University of Amsterdam
      Amsterdamo, North Holland, Netherlands
  • 1994–1998
    • Netherlands Institute for Space Research, Utrecht
      Utrecht, Utrecht, Netherlands
  • 1997
    • Reinier de Graaf Groep
      • Department of Cardiology
      Delft, South Holland, Netherlands
    • Bronovo Hospital
      's-Gravenhage, South Holland, Netherlands
  • 1984–1988
    • St. Antonius Ziekenhuis
      • Department of Cardiology
      Nieuwegein, Provincie Utrecht, Netherlands
  • 1986
    • St. Joseph's Hospital
      Savannah, Georgia, United States