Perkutane myokardiale Laser-Revaskularisation: Ein neues Therapieverfahren für Patienten mit koronarer Herzerkrankung und schwerer Angina pectoris ohne konventionelle Therapieoption
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVES: In patients with intractable angina because of end-stage coronary artery disease, transmyocardial laser revascularization (TMR) leads to improvement of angina pectoris and increased exercise capacity. However, surgical thoracotomy is required for TMR with considerable morbidity and mortality. Therefore, a catheter-based laser system has been developed which allows to create laser channels into the myocardium from the left ventricular cavity. PATIENTS AND METHODS: 46 patients (38 m, 8 f) with refractory angina pectoris due to severe coronary artery disease were treated with "percutaneous myocardial laser revascularisation" (PMR). Clinical parameters (severity of angina pectoris, use of additional nitroglycerin) and results of non-invasive tests (exercise-ECG, echocardiography, thallium-scintigraphy) were analysed at baseline and 3, 6 and 12 months after PMR. RESULTS: The PMR procedure was successfully completed in all patients. In 30 patients, one region (anterior, lateral, inferior) of the left ventricle was treated and in 16 patients, 2 or 3 regions were treated. Clinical follow-up demonstrated significant improvement of angina pectoris (CCS-class at baseline: 3.1 +/- 0.2, 3 months after PMR: 1.8 +/- 0.7, 12 months after PMR: 1.5 +/- 0.9) (p < 0.001) and increased exercise capacity (exercise time on standard bicycle ergometry at baseline: 383 +/- 151 s, 3 months after PMR: 494 +/- 140 s, 12 months after PMR: 480 +/- 151 s) (p < 0.05), but thallium scintigraphy failed to show improved perfusion of the laser treated regions. CONCLUSIONS: PMR is a new safe and feasible therapeutic option in patients with refractory angina pectoris due to end-stage coronary artery disease. Initial results show significant improvement of clinical symptoms and an increased exercise capacity but thallium scintigraphy failed to show improved perfusion after PMR.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".