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Leistner DM, Münch C, Steiner J, Erbay A, Riedel M, Gebhard C, Lauten A, Landmesser U, Stähli BE. Impact of acute kidney injury in elderly (≥80 years) patients undergoing percutaneous coronary intervention. J Interv Cardiol 2018; 31:792-798. [DOI: 10.1111/joic.12547] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 07/04/2018] [Accepted: 07/15/2018] [Indexed: 01/23/2023] Open
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Alushi B, Cassese S, Colleran R, Lauten A, Schuepke S, Rai H, Schunkert H, Meier B, Landmesser U, Kastrati A. P715Patent foramen ovale closure versus medical therapy for prevention of recurrent cryptogenic stroke - a meta-analysis of randomized clinical trials. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Alushi B, Jost-Brinkmann F, Leistner D, Staehli BE, Landmesser U, Lauten A. P3182Diagnostic accuracy of high sensitive cardiac troponin T in patients with suspected acute coronary syndrome and severe chronic kidney disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Laule M, Mattig I, Hewing B, Schoebel C, Knebel F, Lauten A, Lembcke A, Thoenes M, Baumann G, Stangl V, Landmesser U, Stangl K, Dreger H. P1488Treatment of severe tricuspid regurgitation in patients with advanced heart failure with caval vein implantation of the edwards sapien XT valve (TRICAVAL): a controlled prospective randomized trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Jakob P, Kacprowski T, Abdelwahed YS, Riedel M, Staehli BE, Kraenkel N, Renikunta H, Meteva D, Seppelt C, Lauten A, Skurk C, Voelker U, Ameling S, Landmesser U, Leistner DM. P767Identification of circulating miRNA-abundances in ruptured versus eroded lesions: A combined optical coherence tomography and miRNA-profiling approach in patients with acute coronary syndrome. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Riedel M, Abdelwahed Y, Seppelt C, Meteva D, Steinbeck L, Lauten A, Staehli BE, Skurk C, Froehlich G, Rauch-Kroehnert U, Mochmann HC, Kraenkel N, Landmesser U, Leistner DM. P572Angiographic guided PCI of ACS causing culprit lesions - Just a gamble? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Veulemanns V, Wanha W, Kubica J, De Cillis E, Bortone AS, Pestrichella V, Zeus T, Jung C, Lauten A, Kelm M, Bliden K, Tantry U, Wojakowski W, Gurbel PA, Navarese EP. P1674Vascular Complications with Transcatheter Aortic Valve Replacement devices. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Veulemans V, Wanha W, Lauten A, De Cillis E, Bortone AS, Pestrichella V, Zeus T, Jung C, Ochala A, Gurbel PA, Wojakowski W, Kelm M, Kubica J, Navarese EP. P4581Short- and long-term mortality in patients with diabetes mellitus after TAVR: Results of an international multicenter registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Muessig JM, Nia AM, Masyuk M, Lauten A, Sacher AL, Brenner T, Franz M, Bloos F, Ebelt H, Schaller SJ, Fuest K, Rabe C, Dieck T, Steiner S, Graf T, Jánosi RA, Meybohm P, Simon P, Utzolino S, Rahmel T, Barth E, Schuster M, Kelm M, Jung C. Clinical Frailty Scale (CFS) reliably stratifies octogenarians in German ICUs: a multicentre prospective cohort study. BMC Geriatr 2018; 18:162. [PMID: 30005622 PMCID: PMC6044022 DOI: 10.1186/s12877-018-0847-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 06/26/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In intensive care units (ICU) octogenarians become a routine patients group with aggravated therapeutic and diagnostic decision-making. Due to increased mortality and a reduced quality of life in this high-risk population, medical decision-making a fortiori requires an optimum of risk stratification. Recently, the VIP-1 trial prospectively observed that the clinical frailty scale (CFS) performed well in ICU patients in overall-survival and short-term outcome prediction. However, it is known that healthcare systems differ in the 21 countries contributing to the VIP-1 trial. Hence, our main focus was to investigate whether the CFS is usable for risk stratification in octogenarians admitted to diversified and high tech German ICUs. METHODS This multicentre prospective cohort study analyses very old patients admitted to 20 German ICUs as a sub-analysis of the VIP-1 trial. Three hundred and eight patients of 80 years of age or older admitted consecutively to participating ICUs. CFS, cause of admission, APACHE II, SAPS II and SOFA scores, use of ICU resources and ICU- and 30-day mortality were recorded. Multivariate logistic regression analysis was used to identify factors associated with 30-day mortality. RESULTS Patients had a median age of 84 [IQR 82-87] years and a mean CFS of 4.75 (± 1.6 standard-deviation) points. More than half of the patients (53.6%) were classified as frail (CFS ≥ 5). ICU-mortality was 17.3% and 30-day mortality was 31.2%. The cause of admission (planned vs. unplanned), (OR 5.74) and the CFS (OR 1.44 per point increase) were independent predictors of 30-day survival. CONCLUSIONS The CFS is an easy determinable valuable tool for prediction of 30-day ICU survival in octogenarians, thus, it may facilitate decision-making for intensive care givers in Germany. TRIAL REGISTRATION The VIP-1 study was retrospectively registered on ClinicalTrials.gov (ID: NCT03134807 ) on May 1, 2017.
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Wernly B, Zappe AK, Unbehaun A, Sinning JM, Jung C, Kim WK, Fichtlscherer S, Lichtenauer M, Hoppe UC, Alushi B, Beckhoff F, Wewetzer C, Franz M, Kretzschmar D, Navarese E, Landmesser U, Falk V, Lauten A. Transcatheter valve-in-valve implantation (VinV-TAVR) for failed surgical aortic bioprosthetic valves. Clin Res Cardiol 2018; 108:83-92. [DOI: 10.1007/s00392-018-1326-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 06/26/2018] [Indexed: 12/19/2022]
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Alushi B, Lauten A, Landmesser U, Kastrati A. Patent foramen ovale closure for patients excluded from the randomized cryptogenic stroke trials: response to letter by Zaman et al. Clin Res Cardiol 2018; 107:1189-1191. [PMID: 29955916 DOI: 10.1007/s00392-018-1306-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 06/15/2018] [Indexed: 11/29/2022]
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Stähli BE, Reinthaler M, Leistner DM, Landmesser U, Lauten A. Transcatheter Aortic Valve Replacement and Concomitant Mitral Regurgitation. Front Cardiovasc Med 2018; 5:74. [PMID: 29971238 PMCID: PMC6018074 DOI: 10.3389/fcvm.2018.00074] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 05/30/2018] [Indexed: 12/24/2022] Open
Abstract
Mitral regurgitation frequently coexists in patients with severe aortic stenosis. Patients with moderate to severe mitral regurgitation at the time of transcatheter aortic valve replacement are at increased risk of future adverse events. Whether concomitant mitral regurgitation is independently associated with worse outcomes after TAVR remains a matter of debate. The optimal therapeutic strategy in these patients-TAVR with evidence-based heart failure therapy, combined TAVR and transcatheter mitral valve intervention, or staged transcatheter therapies-is ill-defined, and guideline-based recommendations in patients at increased risk for open heart surgery are lacking. Hence, a thorough evaluation of the aortic and mitral valve anatomy and function, along with an in-depth assessment of the patients' baseline risk profile, provides the basis for an individualized treatment approach. The aim of this review is therefore to give an overview of the current literature on mitral regurgitation in TAVR, focusing on different diagnostic and therapeutic strategies and optimal clinical decision making.
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Lauten A, Vilser D, Fiedler A, Schneider U. Differentialdiagnose bei kongenitaler rechtsventrikulärer fokaler Dilatation. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1660613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Petri V, Lauten A, Rothaug J, Schleußner E, John U. Bedeutung des interdisziplinären perinatologischen Konsils für Eltern von Kindern mit pränatal diagnostizierten Anomalien von Niere und Harntrakt. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1660612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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115
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Voigt C, Beyer J, Lauten A, Schreyer I, Schleußner E, Schneider U. Familiäre Compound-Heterozygotie für 2 Mutationen im PIEZO1-Gen – eine lysosomale Speicherkrankheit bedingt mutmaßlich eine späte Manifestation eines Hydrops fetalis mit postnatal letalem Ausgang. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1660623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Beckhoff F, Alushi B, Jung C, Navarese E, Franz M, Kretzschmar D, Wernly B, Lichtenauer M, Lauten A. Tricuspid Regurgitation - Medical Management and Evolving Interventional Concepts. Front Cardiovasc Med 2018; 5:49. [PMID: 29892601 PMCID: PMC5985450 DOI: 10.3389/fcvm.2018.00049] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 05/03/2018] [Indexed: 12/27/2022] Open
Abstract
Severe tricuspid regurgitation (TR) is a complex condition of the right ventricle (RV) and tricuspid valve apparatus and is frequently associated with symptomatic heart failure and a significant morbidity and mortality. In these patients, left heart pathologies lead to chronic pressure overload of the RV, eventually causing progressive RV dilatation and functional TR. Therefore, TR cannot be considered as isolated heart valve disease pathology but has to be understood and treated as one component of a complex structural RV pathology and is frequently also a marker of an advanced stage of cardiac disease. In these patients, medical therapy restricted to diuretics and heart failure medication is frequently ineffective. Also, severe TR in the setting of advanced heart failure constitutes a high risk for cardiac surgery. Neither one of these treatment options has demonstrated a beneficial effect on long-term prognosis. The recent innovations in transcatheter technology led to efforts to develop interventional approaches to severe TR. Multiple innovative treatment concepts are currently under preclinical and clinical investigation to replace or repair TV function. However, up to date none of these approaches is established and there is still a lack of clinical data to support the efficacy of transcatheter TR treatment.
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Navarese EP, Kołodziejczak M, Petrescu A, Wernly B, Lichtenauer M, Lauten A, Buffon A, Wanha W, Pestrichella V, Sardella G, Contegiacomo G, Tantry U, Bliden K, Kubica J, Gurbel PA. Role of proprotein convertase subtilisin/kexin type 9 inhibitors in patients with coronary artery disease undergoing percutaneous coronary intervention. Expert Rev Cardiovasc Ther 2018; 16:419-429. [DOI: 10.1080/14779072.2018.1474099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Möllmann H, Linke A, Holzhey DM, Walther T, Manoharan G, Schäfer U, Heinz-Kuck K, Van Boven AJ, Redwood SR, Kovac J, Butter C, Søndergaard L, Lauten A, Schymik G, Worthley SG. Implantation and 30-Day Follow-Up on All 4 Valve Sizes Within the Portico Transcatheter Aortic Bioprosthetic Family. JACC Cardiovasc Interv 2018; 10:1538-1547. [PMID: 28797431 DOI: 10.1016/j.jcin.2017.05.021] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 04/27/2017] [Accepted: 05/04/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the short-term safety and performance of the full range of valve sizes offered within the Portico transcatheter aortic valve replacement system. BACKGROUND The Portico transcatheter aortic heart valve is a fully resheathable, repositionable, and self-expanding bioprosthesis designed to achieve optimal valve position and hemodynamic performance and limit conduction disturbances. METHODS Patients (n = 222) with symptomatic (New York Heart Association functional class ≥II) severe aortic stenosis considered by a multidisciplinary heart team to be at high surgical risk were recruited between December 2011 and September 2015 in this prospective, nonrandomized, multicenter study. Patients were implanted with the full range of Portico heart valves (23, 25, 27, and 29 mm) using the transfemoral approach. The primary endpoint was all-cause mortality at 30 days. Secondary endpoints included valve performance, improvement in functional class, and procedural outcomes as defined by Valve Academic Research Consortium criteria. RESULTS A total of 220 patients (mean age 83.0 ± 4.6 years, 74.3% women, mean Society of Thoracic Surgeons score 5.8%) had valves implanted. All resheathing and repositioning attempts (n = 72) were successful. At 30 days, all-cause mortality was 3.6%. Procedural outcomes included disabling (major) stroke (3.2%), major vascular complications (7.2%), and permanent pacemaker implantation (13.5%). Compared with baseline, 75.8% of patients improved by ≥1 New York Heart Association functional class at 30 days. The rate of moderate paravalvular leak was 5.7%, with no severe paravalvular leak reported. No differences in paravalvular leak incidence and severity were observed among valve sizes (p = 0.24). CONCLUSIONS Across all valve sizes, use of the repositionable Portico transcatheter aortic valve replacement system resulted in safe and effective treatment of aortic stenosis in high-risk patients.
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Bufe A, Di Mario C, Landmesser U, Gessner MM, Sianos G, Garbo R, Dini CS, Lauer B, Boudou N, Grancini L, Avran A, Lauten A, Mashayekhi K, Hildick-Smith D, Escaned J, Buettner HJ, Reifart N, Lapp H, Galassi AR, Werner GS. The Experts "Live" Workshop of the EuroCTO Club 2017, Berlin. EUROINTERVENTION 2018; 13:1987-1990. [PMID: 29674299 DOI: 10.4244/eijv13i17a324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Jirak P, Mirna M, Wernly B, Paar V, Thieme M, Betge S, Franz M, Hoppe U, Lauten A, Kammler J, Schulze PC, Lichtenauer M, Kretzschmar D. Analysis of novel cardiovascular biomarkers in patients with peripheral artery disease. Minerva Med 2018; 109:443-450. [PMID: 29652038 DOI: 10.23736/s0026-4806.18.05628-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Peripheral artery disease (PAD) is a common form of manifestation of atherosclerosis. PAD has a considerable impact on morbidity, hospitalization rates and health-care costs. Biomarkers have been introduced in many cardiovascular disease entities over the last years. However, an analysis on the correlation of biomarker levels and PAD is still lacking. METHODS A total of 106 patients were enrolled in this current study, 51 that were diagnosed with PAD and 55 with excluded coronary and peripheral artery disease as controls. During outpatient visits, plasma samples of all patients were obtained and analyzed for sST2 (hemodynamics and inflammation), galectin-3 (fibrosis and remodeling), GDF-15 (remodeling and inflammation), suPAR (inflammation), and fetuin-A (vascular calcification) by use of ELISA after informed consent. RESULTS Compared with controls, patients with PAD showed significantly higher levels of sST2 (5248 vs. 7503 pg/mL, P<0.001), suPAR (2267 vs. 2414 pg/mL, P=0.02), galectin-3 (2795 vs. 4494 pg/mL, P<0.001), and GDF-15 (549 vs. 767 pg/mL, P<0.001). Fetuin-A showed a trend towards lower levels in patients with PAD (117 vs. 100 ng/mL, P=0.119). CONCLUSIONS Circulating levels of sST2, suPAR, galectin-3, and GDF-15 were significantly elevated in PAD patients. In contrast, fetuin-A levels showed a decrease in PAD patients indicating increased vascular calcification. Thus, by incorporating different pathophysiological processes present in PAD, tested novel biomarkers facilitate a more precise diagnosis as well as a more accurate evaluation of disease severity and progression.
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Alushi B, Lauten A, Cassese S, Colleran R, Schüpke S, Rai H, Schunkert H, Meier B, Landmesser U, Kastrati A. Patent foramen ovale closure versus medical therapy for prevention of recurrent cryptogenic embolism: updated meta-analysis of randomized clinical trials. Clin Res Cardiol 2018; 107:788-798. [PMID: 29644412 DOI: 10.1007/s00392-018-1246-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/09/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND We performed an updated meta-analysis of all randomized-controlled trials (RCTs) comparing patent foramen ovale (PFO) closure with medical therapy for prevention of recurrent ischemic stroke. METHODS AND RESULTS We searched Medline, EMBASE, and Cochrane databases, and proceedings of international meetings for RCTs of patients with cryptogenic stroke and PFO comparing percutaneous PFO closure versus medical therapy for prevention of recurrent ischemic stroke. The primary outcome was a composite ischemic/embolic endpoint comprising stroke, transient ischemic attack (TIA), peripheral embolism, and early death in the intention-to-treat population. Secondary outcomes were all-cause death, stroke, TIA, atrial fibrillation (AF), and major bleeding. Of 3440 enrolled patients across five RCTs, 1829 were allocated to PFO closure and 1611 to medical therapy. The follow-up ranged from 2 to 5.9 years. PFO closure reduced the risk of the composite outcome [HR 0.52, (0.36-0.77); p < 0.01], and stroke, [HR 0.39, (0.19-0.83); p < 0.01], and increased the risk of AF [OR 3.75, (2.44-5.78); p < 0.01] as compared to medical therapy. NNT for stroke was 37 and NNH for AF 49, indicating a net clinical benefit of PFO closure. The meta-analysis had 95% power to detect a 50% relative risk reduction (RRR) in the primary outcome and 89% power to detect a 70% RRR in ischemic stroke. The risk of all-cause death (HR 1.08, p = 0.90), TIA [HR 0.73, (0.49-1.09); p = 0.12], and major bleeding [OR 0.97, (0.44-2.17); p = 0.95] was comparable between the groups. CONCLUSIONS Among patients with cryptogenic stroke and PFO, percutaneous closure of PFO is superior to medical therapy in preventing recurrent ischemic/embolic events and stroke but is associated with an increased risk of AF.
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Kretzschmar D, Lauten A, Schubert H, Bischoff S, Schulze C, Ferrari MW. PERKAT RV: first in vivo data of a novel right heart assist device. EUROINTERVENTION 2018; 13:e2116-e2121. [PMID: 29360066 DOI: 10.4244/eij-d-17-00899] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS Mechanical right ventricular (RV) support offers a treatment option for critically ill patients with RV failure (RVF). We developed an assist device for rapid percutaneous implantation. The aim of the present study was to investigate the implantation procedure, haemodynamic performance and possible side effects of the novel right ventricular assist device - PERKAT RV - in an animal model. METHODS AND RESULTS The PERkutane KATheterpumptechnologie RV (PERKAT RV) device consists of a nitinol chamber covered by foil containing inflow valves. An outlet tube is attached to its distal part. The system is designed for 18 Fr percutaneous implantation. The chamber is unfolded in the inferior vena cava while the outlet tube bypasses the right heart with the tip in the pulmonary trunk. An IABP balloon is placed inside. Balloon deflation generates blood flow into the chamber; during inflation, blood is guided into the pulmonary arteries. Acute RVF was induced by venous injection of Sephadex in seven sheep for evaluation of the device. The PERKAT RV was able to improve haemodynamics immediately generating a median increase in cardiac output of 59%. Longer pump support was evaluated in a second study. Four sheep were supported for eight hours without any problems. CONCLUSIONS The percutaneous implantation and explantation of the PERKAT RV device was possible in the designed way. The sheep studies proved beneficial haemodynamic effects in acute RVF. The system offers easy and safe treatment in acute RVF.
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Haghikia A, Martinovic M, Jacobs S, Moter A, Lauten A. Infektiöse Endokarditis. ZEITSCHRIFT FUR HERZ THORAX UND GEFASSCHIRURGIE 2018. [DOI: 10.1007/s00398-018-0208-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lauten A, Dreger H, Schofer J, Grube E, Beckhoff F, Jakob P, Sinning JM, Stangl K, Figulla HR, Laule M. Caval Valve Implantation for Treatment of Severe Tricuspid Regurgitation. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2017.12.056] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Lauten A, Figulla HR, Unbehaun A, Fam N, Schofer J, Doenst T, Hausleiter J, Franz M, Jung C, Dreger H, Leistner D, Alushi B, Stundl A, Landmesser U, Falk V, Stangl K, Laule M. Interventional Treatment of Severe Tricuspid Regurgitation. Circ Cardiovasc Interv 2018; 11:e006061. [DOI: 10.1161/circinterventions.117.006061] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 12/18/2017] [Indexed: 12/29/2022]
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Martinovic M, Figulla HR, Lauten A. CRT-700.58 A Pulsatile In Vitro-model of Infective Endocarditis. JACC Cardiovasc Interv 2018. [DOI: 10.1016/j.jcin.2018.01.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Arihan O, Wernly B, Lichtenauer M, Franz M, Kabisch B, Muessig J, Masyuk M, Lauten A, Schulze PC, Hoppe UC, Kelm M, Jung C. Blood Urea Nitrogen (BUN) is independently associated with mortality in critically ill patients admitted to ICU. PLoS One 2018; 13:e0191697. [PMID: 29370259 PMCID: PMC5784990 DOI: 10.1371/journal.pone.0191697] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 01/09/2018] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Blood urea nitrogen (BUN) was reported to be associated with mortality in heart failure patients. We aimed to evaluate admission BUN concentration in a heterogeneous critically ill patient collective admitted to an intensive care unit (ICU) for prognostic relevance. METHODS A total of 4176 medical patients (67±13 years) admitted to a German ICU between 2004 and 2009 were included. Follow-up of patients was performed retrospectively between May 2013 and November 2013. Association of admission BUN and both intra-hospital and long-term mortality were investigated by Cox regression. An optimal cut-off was calculated by means of the Youden-Index. RESULTS Patients with higher admission BUN concentration were older, clinically sicker and had more pronounced laboratory signs of multi-organ failure including kidney failure. Admission BUN was associated with adverse long-term mortality (HR 1.013; 95%CI 1.012-1.014; p<0.001). An optimal cut-off was calculated at 28 mg/dL which was associated with adverse outcome even after correction for APACHE2 (HR 1.89; 95%CI 1.59-2.26; p<0.001), SAPS2 (HR 1.85; 95%CI 1.55-2.21; p<0.001) and several parameters including creatinine in an integrative model (HR 3.34; 95%CI 2.89-3.86; p<0.001). We matched 614 patients with admission BUN >28 mg/dL to case-controls ≤ 28mg/dL corrected for APACHE2 scores: BUN above 28 mg/dL remained associated with adverse outcome in a paired analysis with the difference being 5.85% (95%CI 1.23-10.47%; p = 0.02). CONCLUSIONS High BUN concentration at admission was robustly associated with adverse outcome in critically ill patients admitted to an ICU, even after correction for co-founders including renal failure. BUN might constitute an independent, easily available and important parameter for risk stratification in the critically ill.
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Engel LC, Landmesser U, Gigengack K, Wurster T, Manes C, Girke G, Jaguszewski M, Skurk C, Leistner DM, Lauten A, Schuster A, Hamm B, Botnar RM, Makowski MR, Bigalke B. Novel Approach for In Vivo Detection of Vulnerable Coronary Plaques Using Molecular 3-T CMR Imaging With an Albumin-Binding Probe. JACC Cardiovasc Imaging 2018; 12:297-306. [PMID: 29361487 DOI: 10.1016/j.jcmg.2017.10.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/18/2017] [Accepted: 10/18/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study sought to investigate the potential of the noninvasive albumin-binding probe gadofosveset-enhanced cardiac magnetic resonance (GE-CMR) for detection of coronary plaques that can cause acute coronary syndromes (ACS). BACKGROUND ACS are frequently caused by rupture or erosion of coronary plaques that initially do not cause hemodynamically significant stenosis and are therefore not detected by invasive x-ray coronary angiography (XCA). METHODS A total of 25 patients with ACS or symptoms of stable coronary artery disease underwent GE-CMR, clinically indicated XCA, and optical coherence tomography (OCT) within 24 h. GE-CMR was performed approximately 24 h following a 1-time application of gadofosveset-trisodium. Contrast-to-noise ratio (CNR) was quantified within coronary segments in comparison with blood signal. RESULTS A total of 207 coronary segments were analyzed on GE-CMR. Segments containing a culprit lesion in ACS patients (n = 11) showed significant higher signal enhancement (CNR) following gadofosveset-trisodium application than segments without culprit lesions (n = 196; 6.1 [3.9 to 16.5] vs. 2.1 [0.5 to 3.5]; p < 0.001). GE-CMR was able to correctly identify culprit coronary lesions in 9 of 11 segments (sensitivity 82%) and correctly excluded culprit coronary lesions in 162 of 195 segments (specificity 83%). Additionally, segmented areas of thin-cap fibroatheroma (n = 22) as seen on OCT demonstrated significantly higher CNR than segments without coronary plaque or segments containing early atherosclerotic lesions (n = 185; 9.2 [3.3 to 13.7] vs. 2.1 [0.5 to 3.4]; p = 0.001). CONCLUSIONS In this study, we demonstrated for the first time the noninvasive detection of culprit coronary lesions and thin-cap fibroatheroma of the coronary arteries in vivo by using GE-CMR. This method may represent a novel approach for noninvasive cardiovascular risk prediction.
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Curio J, Reinthaler M, Kasner M, Al-Hindwan HSA, Baeckemo-Johansson J, Neumann T, Jacobs S, Lauten A, Landmesser U. Repeated MitraClip procedure in patients with recurrent MR after a successful first procedure: Limitations and outcome. J Interv Cardiol 2017; 31:83-90. [DOI: 10.1111/joic.12457] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 10/06/2017] [Accepted: 10/11/2017] [Indexed: 11/28/2022] Open
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Rohm I, Grün K, Müller LM, Kretzschmar D, Fritzenwanger M, Yilmaz A, Lauten A, Jung C, Schulze PC, Berndt A, Franz M. Increased Serum Levels of Fetal Tenascin-C Variants in Patients with Pulmonary Hypertension: Novel Biomarkers Reflecting Vascular Remodeling and Right Ventricular Dysfunction? Int J Mol Sci 2017; 18:ijms18112371. [PMID: 29117120 PMCID: PMC5713340 DOI: 10.3390/ijms18112371] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 10/31/2017] [Accepted: 11/04/2017] [Indexed: 11/16/2022] Open
Abstract
Pulmonary vascular remodeling is a pathophysiological feature that common to all classes of pulmonary hypertension (PH) and right ventricular dysfunction, which is the major prognosis-limiting factor. Vascular, as well as cardiac tissue remodeling are associated with a re-expression of fetal variants of cellular adhesion proteins, including tenascin-C (Tn-C). We analyzed circulating levels of the fetal Tn-C splicing variants B⁺ and C⁺ Tn-C in serum of PH patients to evaluate their potential as novel biomarkers reflecting vascular remodeling and right ventricular dysfunction. Serum concentrations of B⁺ and C⁺ Tn-C were determined in 80 PH patients and were compared to 40 healthy controls by enzyme-linked immunosorbent assay. Clinical, laboratory, echocardiographic, and functional data were correlated with Tn-C levels. Serum concentrations of both Tn-C variants were significantly elevated in patients with PH (p < 0.05). Significant correlations could be observed between Tn-C and echocardiographic parameters, including systolic pulmonary artery pressure (B⁺ Tn-C: r = 0.31, p < 0.001, C⁺ Tn-C: r = 0.26, p = 0.006) and right atrial area (B⁺ Tn-C: r = 0.46, p < 0.001, C⁺ Tn-C: r = 0.49, p < 0.001), and laboratory values like BNP (B⁺ Tn-C: r = 0.45, p < 0.001, C⁺ Tn-C: r = 0.42, p < 0.001). An inverse correlation was observed between Tn-C variants and 6-minute walk distance as a functional parameter (B⁺ Tn-C: r = -0.54, p < 0.001, C⁺ Tn-C: r = -0.43, p < 0.001). In a multivariate analysis, B⁺ Tn-C, but not C⁺ Tn-C, was found to be an independent predictor of pulmonary hypertension. Both fetal Tn-C variants may represent novel biomarkers that are capable of estimating both pulmonary vascular remodeling and right ventricular load. The potential beneficial impact of Tn-C variants for risk stratification in patients with PH needs further investigation.
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Abstract
Recently, transcatheter therapy has expanded the treatment options for patients with heart valve disease. With the growing understanding of tricuspid regurgitation and its natural history, it becomes increasingly obvious that this patient population is a heterogeneous cohort presenting for treatment in different stages of a continuous disease process. It is still unclear which interventional approach will result in functional and clinical success and in which subtype of patient population. This article reviews the pathophysiologic background and current evidence for caval valve implantation and examines the potential role of this approach for the treatment of severe tricuspid regurgitation.
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Leistner DM, Riedel M, Steinbeck L, Stähli BE, Fröhlich GM, Lauten A, Skurk C, Mochmann HC, Lübking L, Rauch-Kröhnert U, Schnabel RB, Westermann D, Blankenberg S, Landmesser U. Real-time optical coherence tomography coregistration with angiography in percutaneous coronary intervention-impact on physician decision-making: The OPTICO-integration study. Catheter Cardiovasc Interv 2017; 92:30-37. [DOI: 10.1002/ccd.27313] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 08/02/2017] [Accepted: 08/07/2017] [Indexed: 01/01/2023]
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Schernthaner C, Wernly B, Lichtenauer M, Franz M, Lauten A, Schulze PC, Kabisch B, Braun K, Muessig J, Masyuk M, Hoppe UC, Kelm M, Jung C. High peak PaO2 values associated with adverse outcome in patients treated with noninvasive ventilation for acute cardiogenic pulmonary edema and pneumonia. Panminerva Med 2017; 59:290-296. [PMID: 28884567 DOI: 10.23736/s0031-0808.17.03370-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Noninvasive ventilation (NIV) has a sigificant impact on mortality in acute respiratory failure (ARF). Predictive parameters for mortality are of high interest. METHODS We retrospectively analyzed 3759 blood gas analysis and clinical parameters of 475 patients presenting with ARF based on acute cardiogenic pulmonary edema and/or pneumonia. The influence of peak arterial oxygen partial pressure levels (PaO2) with respect to its predictive value for in-hopital and long-term mortality was investigated. RESULTS Overall intra-hospital mortality was 24%. Peak PaO2 levels in kPa were significantly higher in non-survivors (20.01±10.11) compared to survivors (15.65±6.79, P<0.001). A univariate Cox proportional-hazards analysis for long-term mortality revealed associations with maximum PaO2 levels (overall cohort: HR= 1.02; 95% CI: 1.007-1.03; P=0.003; CPE: HR= 1.02; 95% CI: 0.99-1.04, P=0.05, pneumonia: HR= 1.02; 95% CI: 1-1.4, P=0.02). A PaO2 cut-off value of 13 kiloPascal (kPa) was calculated by means of Youden Index and remained true even after correction for APACHE 2 Score (HR= 1.50; 95% CI: 1.00-2.25; P=0.05) and for PaCO2 (HR= 1.63; 95% CI: 1.14-2.33; P=0.01). CONCLUSIONS Peak PaO2 levels were associated with worse in-hopital and long-term mortality in patients treated with NIV due to ARF. These findings may indicate that application of high oxygen may be detrimental in such patients.
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Hoting M, Roczek E, Wewetzer C, Roser M, Nagel P, Tscholl V, Leistner D, Lauten A. P5428Does right ventricular lead-placement for cardiac rhythm management effect tricuspid valve function? Insights from a single center Registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Schneider V, Luebking L, Skurk C, Lauten A, Mochmann C, Schauerte P, Froehlich G, Staehli B, Riedel M, Steinbeck L, Landmesser U, Leistner D. P3312Performance of standard judkins catheters compared to one-catheter concepts in transradial coronary angiography. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Alushi B, Reinthaler M, Staehli B, Bellmann B, Figulla H, Morguet A, Landmesser U, Franz M, Lauten A. 3942Natural history and prognostic significance of pulmonary hypertension in patients undergoing TAVR for severe aortic stenosis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.3942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Engel L, Landmesser U, Gigengack K, Wurster T, Girke G, Jaguszewski M, Skurk C, Leistner D, Lauten A, Schuster A, Hamm B, Botnar R, Bigalke B, Makowski M. 4101Noninvasive 3-tesla cardiovascular magnetic resonance imaging assessment of endothelial permeability in patients with prediabetes and diabetes mellitus using an albumin-binding probe. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.4101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Engel L, Landmesser U, Gigengack K, Wurster T, Jaguszewski M, Girke G, Skurk C, Leistner D, Lauten A, Schuster A, Hamm B, Botnar R, Makowski M, Bigalke B. 2225Identification of vulnerable coronary atherosclerotic plaque using molecular 3T CMR imaging with an albumin-binding probe. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.2225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Steinbeck L, Riedel M, Staehli B, Froehlich G, Lauten A, Skurk C, Mochmann H, Luebking L, Rauch-Kroehnert U, Schnabel R, Westermann D, Blankenberg S, Landmesser U, Leistner D. P2350Real-time optical coherence tomography co-registration with angiography to optimize percutaneous coronary intervention: results of the OPTICO-Integration study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kretzschmar D, Lauten A, Bischoff S, Schulze P, Ferrari M. P3276a novel right heart assist device-the PERKAT RV system. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Goebel B, Heck R, Hamadanchi A, Otto S, Doenst T, Jung C, Lauten A, Figulla HR, Schulze PC, Poerner TC. Vena contracta area for severity grading in functional and degenerative mitral regurgitation: a transoesophageal 3D colour Doppler analysis in 500 patients. Eur Heart J Cardiovasc Imaging 2017; 19:639-646. [DOI: 10.1093/ehjci/jex056] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 03/09/2017] [Indexed: 11/14/2022] Open
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Lauten A, Kamin G, Seeger S, Schleußner E. Lipoprotein(a) als Risikofaktor für habituelle Aborte und der Einfluss von niedermolekularem Heparin: eine Subanalyse aus der ETHiG II Studie. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1601536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Lauten A, Skirl G, Waschke A, Dawczynski K, Schneider U. Kurzfristiges Outcome der fetoskopischen Patchapplikation bei offener Spina bifida und Chiari II Malformation anhand eines Fallbeispiels. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1601532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Schirmer J, Holzhey D, Sinning J, Bauernschmitt R, Schröfel H, Oertel F, Bleiziffer S, Unbehaun A, Holinski S, Lauten A, Frerker C, Kaminski A, Blankenberg S, Reichenspurner H, Conradi L, Schäfer U. Treatment of Native Calcific Mitral Stenosis using Commercially Available Transcatheter Heart Valves (THV): Results from the First German THV Mitral Stenosis Registry. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Wernly B, Lichtenauer M, Jirak P, Eder S, Reiter C, Kammler J, Kypta A, Jung C, Franz M, Hoppe UC, Landmesser U, Figulla HR, Lauten A. Soluble ST2 predicts 1-year outcome in patients undergoing transcatheter aortic valve implantation. Eur J Clin Invest 2017; 47:149-157. [PMID: 28036122 DOI: 10.1111/eci.12719] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 12/28/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Soluble ST2 (sST2) has been introduced as a novel biomarker in patients suffering from heart failure for risk stratification. In this study, we sought to investigate whether sST2 is useful for risk stratification and prediction of mortality in patients undergoing transcatheter aortic valve implantation (TAVI). MATERIALS AND METHODS A total of 274 patients undergoing TAVI were included in this study (149 female; age 81 ± 1 years; EUROSCORE 25 ± 1; STS score 3·8 ± 0·2). Plasma samples were obtained preinterventional and analysed for sST2. Patients were followed up 1 month and 1 year after TAVI. RESULTS In a Cox regression analysis, sST2 plasma concentration was associated with increased mortality (changes per pg/mL sST2 concentration; HR 1·00006 95% (1·00004-1·00009); P < 0·001). A cut-off by means of the Youden Index was calculated (10 070·27 pg/mL), and patients were retrospectively divided into two cohorts, in those above (31·3%) and those below (68·7%) this value. These two groups were then compared regarding mortality both after 30 days and 1 year: whereas 1-month mortality did not differ (7·0% vs. 10·3%, OR 1·50 95% CI (0·60-3·79; P = 0·46)), patients with a sST2 concentration above the cut-off of 10 070·27 pg/mL showed a significantly worse outcome after 1 year (49·2% vs. 23·2%; OR 3·21 95% CI (1·70-6·04); P < 0·001). After correction for confounders in a multivariate Cox regression analysis, sST2 (1·0002 95% CI (1·0001-1·0003); P = 0·001) concentration remained associated with mortality. CONCLUSIONS sST2 levels were associated with 1-year mortality after TAVI. Based on these results, we assume that sST2 might help to identify patients at high risk for death in whom conservative treatment should be considered.
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Weschenfelder F, Lauten A, Fröber R, Schneider U, Schleußner E, Groten T. Sequentielle Fehlbildung bei Adipositas und Gestationsdiabetes. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Grau M, Lauten A, Hoeppener S, Goebel B, Brenig J, Jung C, Bloch W, Suhr F. Regulation of red blood cell deformability is independent of red blood cell-nitric oxide synthase under hypoxia. Clin Hemorheol Microcirc 2016; 63:199-215. [DOI: 10.3233/ch-162044] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Figulla HR, Kiss K, Lauten A. Transcatheter interventions for tricuspid regurgitation - heterotopic technology: TricValve. EUROINTERVENTION 2016; 12:Y116-8. [DOI: 10.4244/eijv12sya32] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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149
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Jung C, Lichtenauer M, Figulla HR, Wernly B, Goebel B, Foerster M, Edlinger C, Lauten A. Microparticles in patients undergoing transcatheter aortic valve implantation (TAVI). Heart Vessels 2016; 32:458-466. [PMID: 27488119 PMCID: PMC5371631 DOI: 10.1007/s00380-016-0885-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 07/29/2016] [Indexed: 12/13/2022]
Abstract
Degenerative aortic stenosis (AS) is the most frequent form of acquired valvular heart disease. AS is known to entail endothelial dysfunction caused by increased mechanical shear stress leading to elevated circulatory levels of microparticles. Endothelial and platelet microparticles (EMP and PMP) are small vesicles that originate from activated cells and thrombocytes. We sought to evaluate whether transcatheter aortic valve implantation (TAVI) procedure would elicit effects on circulating EMP and PMP. 92 patients undergoing TAVI procedure for severe AS were included in this study. Samples were obtained at each visit before TAVI, 1 week post-procedure and at 1, 3 and after 6 months after TAVI and were evaluated using flow cytometry. A 12 month clinical follow-up was also performed. CD62E+ EMP concentration before TAVI was 21.11 % (±6.6 % SD) and declined to 20.99 % (±6.8 % SD) after 1 week, to 16.63 % (±5.4 % SD, p < 0.0001) after 1 month, to 17.08 % (±4.6 % SD, p < 0.0001) after 3 months and to 15.94 % (±5.4 % SD, p < 0.0001) after 6 months. CD31+/CD42b-, CD31+/Annexin+/- EMP remained unchanged. CD31+/CD41b+ PMP evidenced a slight, but statistically significant increase after TAVI and remained elevated during the entire follow-up. Apart from a procedure-related improvement in echocardiographic parameters, TAVI procedure led also to a decline in CD62E+ EMP. The reduction in pressure gradients with less hemodynamic shear stress seems also to have beneficially affected endothelial homeostasis.
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Lauten A, Fröber R, Schleußner E, Groten T. Kloakale Dysgenesie Sequenz und Myelomeningozele in zwei aufeinander folgenden Schwangerschaften bei maternaler Adipositas per magna und Schwangerschaftsdiabetes. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1583590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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