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Weingärtner O, Ulrich C, Lütjohann D, Ismail K, Schirmer S, Vanmierlo T, Böhm M, Laufs U. 655 PLANT STEROL AND STANOL ESTERS INDUCE DIFFERENTIAL EFFECTS ON OXIDATIVE STRESS, INFLAMMATION, LEUCOCYTES, VASCULAR FUNCTION AND TISSUE CONCENTRATIONS IN MICE. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70656-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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102
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Steiner S, Böhm M. Diagnose und Therapie der rechtsventrikulären Dysfunktion. Dtsch Med Wochenschr 2011; 136:1184-6. [DOI: 10.1055/s-0031-1280536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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103
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Schirmer SH, Böhm M. [Update on anti-platelet therapy]. Dtsch Med Wochenschr 2011; 136:1260-4. [PMID: 21630174 DOI: 10.1055/s-0031-1280548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Use of the ADP (P2Y(12))-receptor antagonist clopidogrel is a cornerstone of dual platelet inhibition in acute coronary syndromes and following stent implantation. Because of the metabolization into its active form and the irreversible inhibition of the ADP receptor there are disadvantages to clopidogrel which could limit its efficacy in reducing clinical events. This is particularly problematic in so-called poor responders with reduced metabolizing activity and hence reduced platelet inhibition. Two novel drugs for platelet inhibition in acute coronary syndrome could become relevant in clinical practice. The irreversible ADP-receptor antagonist prasugrel led to stronger platelet inhibition, fewer ischemic events but more bleeding complications compared to clopidogrel in the TRITON-TIMI-38 trial. The reversibly binding, direct-acting ADP-receptor antagonist ticagrelor, which is effective without metabolization, is also superior over clopidogrel in reducing platelet aggregation and decreased the number of ischemic events in the PLATO-trial. However, it did not increase the rate of overall major bleeding and was shown to reduce total mortality. This review article summarizes current data on novel platelet inhibitors and delineates their potential influence on clinical practice.
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104
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Ohlmeier MC, Traupe H, Luger TA, Böhm M. Topical immunotherapy with diphenylcyclopropenone of patients with alopecia areata--a large retrospective study on 142 patients with a self-controlled design. J Eur Acad Dermatol Venereol 2011; 26:503-7. [PMID: 21569118 DOI: 10.1111/j.1468-3083.2011.04114.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although diphenylcyclopropenone (DCP) is frequently used for the treatment of alopecia areata (AA), large studies with more than 100 patients are still scarce. OBJECTIVE To determine the efficacy of DCP immunotherapy in a large cohort of patients with AA who had been treated in our institute from January 2000 to December 2006. METHODS A total of 142 patients with AA undergoing topical DCP therapy in a self-controlled design were evaluated retrospectively. RESULTS Seven patients (4.9%) were anergic to DCP. Two of 135 patients (1.5%) discontinued DCP therapy because of adverse effects. Fifty-one patients (37.8%) had a complete response (CR: >90% re-growth of hair), 20 patients (14.8%) exhibited a partial response (PR: >50-90% re-growth), 26 patients (19.3%) experienced a minimal response (MR: 10-50% re-growth) and 38 patients (28.1%) had no response after DCP therapy (NR: <10% re-growth). Bivariate logistic analysis revealed that severity of hair loss at the beginning of DCP (P=0.001) is the only significant prognostic factor for therapeutic outcome. Twenty-three patients (45.1%) with CR had relapses upon discontinuation of the treatment or even during prolonged DCP therapy. CONCLUSION Topical immunotherapy with DCP of patients with AA is rather effective and mostly well tolerated. The extent of hair loss before therapy is the main predictor for the therapeutic success of DCP. However, DCP therapy is associated with a high degree of relapse of which patients should be well informed.
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105
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Link A, Pöss J, Böhm M. [Diagnosis and treatment of heparin-induced thrombocytopenia]. Dtsch Med Wochenschr 2011; 136:953-62; quiz 963-6. [PMID: 21526460 DOI: 10.1055/s-0031-1275831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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106
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Baumhäkel M, Schlimmer N, Kratz M, Hackett G, Jackson G, Böhm M. Cardiovascular risk, drugs and erectile function--a systematic analysis. Int J Clin Pract 2011; 65:289-98. [PMID: 21314866 DOI: 10.1111/j.1742-1241.2010.02563.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
AIMS Erectile dysfunction is a major problem with an increasing prevalence in cardiovascular high-risk patients due to its association with cardiovascular risk factors. Drugs used for evidence-based treatment of cardiovascular diseases have been reported to decrease erectile function, but possible mechanisms are poorly characterised. METHODS MEDLINE, EMBASE and Cochrane Registry search were performed including manuscripts until January 2010. Searching terms are: 'erectile dysfunction or impotence' in combination with 'ACE-inhibitors', 'angiotensin', 'beta-blockers', 'calcium antagonist' and 'diuretics'. Animal studies, letters, reviews, case-reports and manuscripts other than English language and trials dealing with combination treatment are excluded. RESULTS Analysis of literature revealed five epidemiological trials evaluating the effect of different cardiovascular drugs on erectile function. There were eight trials evaluating the effect of beta-blockers, five trials evaluating the effect of ace-inhibitors or angiotensin-receptor-blockers and one trial evaluating the effect of diuretics on erectile function. Results of these trials demonstrate that only thiazide diuretics and beta-blockers except nebivolol may adversely influence erectile function. ACE-inhibitors, angiotensin-receptor-blockers and calcium-channel-blockers are reported to have no relevant or even a positive effect on erectile function. CONCLUSION Inappropriate patients' concerns about adverse effects of cardiovascular drugs on erectile function might limit the use of important medications in cardiovascular high-risk patients. Knowledge about the effects of drug-treatments on erectile function and about the major role of the endothelium in penile function might improve patients' adherence to evidence based treatment of cardiovascular diseases.
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107
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Fischer H, Schulte J, Rieve P, Böhm M. Technology and Performance of TFA (Thin Film on ASIC-Sensors. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-336-867] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACTA TFA image sensor consists of an amorphous silicon based multilayer structure on top of a crystalline ASIC. The Multilayer acts as the optical detector, whereas the ASIC performs analog or digital signal processing for each individual pixel. Depending on the operation Mode, the dynamic range of the detector exceeds the performance of conventional CCDs by far. Pixel electronics which is adapted to the requirements of the detector can thereby maximize the dynamic range of the complete sensor array. Crosstalk among adjacent pixels can be eliminated by technological or electronic Means.
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Motze F, Seibel K, Schneider B, Hillebrand M, Blecher F, Lulé T, Keller H, Rieve P, Wagner M, Böhm M. UV Imager in TFA Technology. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-557-815] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AbstractAn image sensor with enhanced sensitivity for near ultraviolet radiation (UVA) has been fabricated in TFA (Thin Film on ASIC) technology. The device employs an amorphous silicon pin detector optimized for UV detection by carbonization and layer thickness variation. The front electrode consists of an Al grid or TCO. Measurements show a peak responsivity of 90 mAW-1 at 380 nm. The UV Imager prototype consists of 128 × 128 pixels with a size of 25 μm × 25 [tim each, fabricated in a 0.7 μm CMOS process. Global sensitivity control serves to achieve a dynamic range in excess of 80 dB. The sensor can be used in fields such as chemical, medical and astronomical applications. Furthermore, a UV monitor has been developed, suited to warn of excessive sunlight exposure, considering skin type and sun protection factor.
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Raker V, Maxeiner J, Montermann E, Grabbe S, Taube C, Reske-Kunz A, Sudowe S, Hahn C, Mösges R, Böhm M, Becker B, Kostev K, Kothe A, Köberlein J, Koerner-Rettberg C, Heesen I, Rothoeft T, Hamelmann E, Ballmann M, Eitenmüller A, Piano L, Glowania A, Klimek L, Weber R, Hermelingmeier K, Heubach C, Koschel D, Weber CN, Höffken G, Buhl T, Meynberg H, Kaune K, Hünecke P, Schön M, Fuchs T, Pfützner W, Kneisel A, Kerzel S, Zemlin M, Kettner J, Lehnigk U, Häfner D, Narkus A. Atemwege. ALLERGO JOURNAL 2011. [DOI: 10.1007/bf03362413] [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]
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110
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Muntean A, Böhm M, Kropp J. Moving carbonation fronts in concrete: A moving-sharp-interface approach. Chem Eng Sci 2011. [DOI: 10.1016/j.ces.2010.11.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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111
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Brandt MC, Mahfoud F, Böhm M, Hoppe UC. [Renal sympathetic denervation. A novel interventional treatment option for therapy-resistant arterial hypertension]. Herz 2011; 36:8-11. [PMID: 21222093 DOI: 10.1007/s00059-010-3413-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
As much as one third of patients with arterial hypertension are treatment refractory as they do not reach sufficient blood pressure control despite antihypertensive combination therapy of significant duration. In patients with therapy-resistant hypertension, the kidneys play a central role as activator of the sympathetic nervous system. Sympathetic nervous activation via efferent nerve fibers lying in the adventitia of the renal arteries leads to increased Na(+) reabsorption, increased renin secretion and reduction of renal plasma flow. Via afferent sympathetic fibers in the dorsal root of the spinal chord, the kidneys induce a further augmentation of central sympathetic nervous activity. With the method of renal sympathetic denervation (RSD) an interventional minimally invasive procedure has become available to precisely ablate afferent and efferent sympathetic nervous fibers surrounding the renal artery. Via an ablation catheter with an electrode tip and a radiofrequency generator a series of 4-6 ablation sites are administered in both renal arteries leading to denervation of the sympathetic nerve fibers while keeping the renal artery intact. Recent studies showed a significant and continuous reduction of blood pressure of 25-30 mmHg systolic and 10-15 mmHg diastolic for at least 2 years. Concerning the role of elevated sympathetic nervous system activity in forms of hypertension associated with other disorders, further applications of the procedure appear possible, although these are of a rather speculative nature at this time. The current mainstay of therapy-refractive hypertension is RSD, which is well supported by recent clinical data.
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112
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Weingärtner O, Lütjohann D, Böhm M, Laufs U. [Cholesterol homeostasis and cardiovascular risk]. Dtsch Med Wochenschr 2010; 136:34-8. [PMID: 21181614 DOI: 10.1055/s-0030-1269438] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Hypercholesterolemia is a major risk factor for cardiovascular diseases. Serumcholesterol concentrations are regulated by enteral absorption and hepatic synthesis. Statins inhibit the rate-limiting enzyme of endogenous cholesterol synthesis, HMG-CoA-reductase and reduce serum cholesterol concentrations as well as cardiovascular morbidity. Indirect evidence from smaller studies shows, that patients with high baseline cholesterol absorption may show only a small response to statin treatment in terms of cholesterol lowering. Moreover, evidence from recent clinical studies suggests that increased cholesterol absorption and decreased hepatic cholesterol synthesis is associated with an increased cardiovascular risk. This article reviews the current literature on this issue and suggests prospective clinical studies to analyze whether determination of the baseline relation of cholesterol synthesis and absorption may facilitate an individualized lipid lowering therapy to further reduce cardiovascular risk.
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113
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Bittenbring JT, Chen CH, Fries P, Böhm M, Kilter H. [Typical laboratory constellation of a non-ST-segment elevation myocardial infarction in polymyositis]. Dtsch Med Wochenschr 2010; 135:2456-8. [PMID: 21120785 DOI: 10.1055/s-0030-1269416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
HISTORY AND ADMISSION FINDINGS a 80-year-old women was admitted with a hypertensive crisis. Laboratory tests showed elevated cardiac enzymes (CK, CK-MB and troponin T). She was treated for suspected non-ST segment elevation myocardial infarction. INVESTIGATIONS a cardiovascular examination, which included echocardiography, coronary angiography and magnetic resonance imaging, excluded a cardiac cause of the laboratory reults. After complete assessment the patient was found to have long-standing polymyosits positive for Mi-2 antibodies. This had caused troponin T elevation from the release of regenerating muscles after chronic inflammatory damage. Troponin I, however, is truly cardiomyocyte specific and distinguishes between cardiac and non cardiac origin of CK, CK-MB and troponin T. TREATMENT AND COURSE prednisone medication was started with a single dose of 50mg, then gradually reduced. Follow-up examination merely revealed minimally active polymyositis. CONCLUSION troponin I should be measured in patients with inflammatory myositis/myopathies in order to diagnose and assess cardiac involvement.
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114
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Mahfoud F, Böhm M. [Interventional renal sympathetic denervation - a new approach for patients with resistant hypertension]. Dtsch Med Wochenschr 2010; 135:2422-5. [PMID: 21108158 DOI: 10.1055/s-0030-1269412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The pathophysiology of resistant hypertension is complex. Activation of the sympathetic nervous system has been suggested to be one of the main contributors for maintenance of blood pressure elevation and the development of comorbidities. Catheter-based renal denervation - by ablation of the efferent and afferent renal sympathetic nerves - is a new approach to selectively denervate the kidneys from their sympathetic control. Renal denervation is associated with substantial and sustained blood pressure reduction (24 months), lowers central sympathetic outflow, and reduces whole-body norepinephrine spillover. The procedure is feasible and safe. The randomised controlled Symplicity-HTN-2 trial (results reported at AHA 2010, Nov 13-17) provides important information to determine the role of this new method for the treatment of drug resistant hypertension.
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Boztug K, Schmidt M, Schwarzer A, Banerjee PP, Díez IA, Dewey RA, Böhm M, Nowrouzi A, Ball CR, Glimm H, Naundorf S, Kühlcke K, Blasczyk R, Kondratenko I, Maródi L, Orange JS, von Kalle C, Klein C. Stem-cell gene therapy for the Wiskott-Aldrich syndrome. N Engl J Med 2010; 363:1918-27. [PMID: 21067383 PMCID: PMC3064520 DOI: 10.1056/nejmoa1003548] [Citation(s) in RCA: 397] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The Wiskott-Aldrich syndrome (WAS) is an X-linked recessive primary immunodeficiency disorder associated with thrombocytopenia, eczema, and autoimmunity. We treated two patients who had this disorder with a transfusion of autologous, genetically modified hematopoietic stem cells (HSC). We found sustained expression of WAS protein expression in HSC, lymphoid and myeloid cells, and platelets after gene therapy. T and B cells, natural killer (NK) cells, and monocytes were functionally corrected. After treatment, the patients' clinical condition markedly improved, with resolution of hemorrhagic diathesis, eczema, autoimmunity, and predisposition to severe infection. Comprehensive insertion-site analysis showed vector integration that targeted multiple genes controlling growth and immunologic responses in a persistently polyclonal hematopoiesis. (Funded by Deutsche Forschungsgemeinschaft and others; German Clinical Trials Register number, DRKS00000330.).
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Baumhäkel M, Schirmer S, Böhm M. Neue Antikoagulanzien für die Thromboembolieprophylaxe bei Vorhofflimmern. Dtsch Med Wochenschr 2010; 135:2304-8. [DOI: 10.1055/s-0030-1267516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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117
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Cremers B, Clever Y, Schaffner S, Speck U, Böhm M, Scheller B. Treatment of coronary in-stent restenosis with a novel paclitaxel urea coated balloon. Minerva Cardioangiol 2010; 58:583-588. [PMID: 20948504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Randomized clinical trials investigating the treatment of coronary in-stent restenosis with paclitaxel iopromide coated balloon catheters have shown favorable results. The aim of the present clinical investigation was to assess the efficacy of a novel paclitaxel urea coated angioplasty balloon in the treatment of coronary in-stent restenosis. A total of 26 restenotic bare metal stents in 23 patients with a lesion length of 22.8 ± 11.1 mm and a reference vessel diameter of 2.64 ± 0.31 mm were treated. Up to six months and including the six-month angiographic control, only one target lesion revascularization was necessary; in total, the rate of major adverse cardiovascular events until six-month follow-up was 4.3 %. In-stent late lumen loss was 0.07 ± 0.37 mm, in-segment late lumen loss 0.02 ± 0.50 mm. Binary restenosis was present in one patient (4.3%). The results of this first-in-human series with a paclitaxel urea coated balloon are comparable to paclitaxel iopromide coated balloon catheters. Randomized, controlled clinical trials are warranted to further evaluate this promising approach.
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Schmieder RE, Böhm M. Efficacy and safety of olmesartan medoxomil plus amlodipine in age, gender and hypertension severity defined subgroups of hypertensive patients. J Hum Hypertens 2010; 25:354-63. [PMID: 20686499 DOI: 10.1038/jhh.2010.74] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Effective antihypertensive therapy is crucial for preventing cardiovascular events; however, blood pressure (BP) control rates remain poor. The objective of this analysis was to determine the efficacy of olmesartan/amlodipine in age, severity and gender-based subgroups of patients with moderate-to-severe hypertension uncontrolled by amlodipine monotherapy. Patients with uncontrolled BP after 8 weeks' amlodipine 5 mg monotherapy (n=755) were randomized to continue amlodipine 5 mg or receive olmesartan (10-40 mg) plus amlodipine 5 mg for 8 weeks. Patients whose BP remained suboptimal were up-titrated to olmesartan/amlodipine 20/5, 40/5 or 40/10 mg. Changes in BP and numbers of controlled patients were calculated separately to assess efficacy in patients aged <65 or ≥65 years, in those with moderate or severe hypertension, and in males and females. The antihypertensive effects of olmesartan/amlodipine were similar in patients aged <65 and ≥65 years of age. Compared with patients with moderate hypertension at baseline, those with severe hypertension tended to show higher decreases in BP, but achieved lower goal rates despite this. Females showed larger mean reductions in diastolic (1.61 mm Hg; P=0.003) and systolic BP (1.72 mm Hg; P=0.053) than males, independent of age and dose. This gender difference appeared to be higher and more consistent across dose groups for patients <50 years of age, but the difference in the pattern between both age groups was not statistically significant (P=0.1526). These results suggest that olmesartan/amlodipine is effective and safe in a wide range of patients, regardless of age or hypertension severity. Small differences in responsiveness between females and males may exist, which require further investigation.
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119
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Laufs U, Hoppe UC, Rosenkranz S, Kirchhof P, Böhm M, Diener HC, Endres M, Grond M, Hacke W, Meinertz T, Ringelstein EB, Röther J, Dichgans M. [Cardiac workup after cerebral ischemia. Consensus paper of the Working Group on Heart and Brain of the German Cardiac Society and German Stroke Society]. DER NERVENARZT 2010; 81:444-62. [PMID: 20177655 DOI: 10.1007/s00115-009-2901-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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120
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Ukena C, Mahfoud F, Kindermann M, Gräber S, Kindermann I, Schneider M, Schmieder R, Bramlage P, Volpe M, Thoenes M, Böhm M. Smoking is associated with a high prevalence of microalbuminuria in hypertensive high-risk patients: data from I-SEARCH. Clin Res Cardiol 2010; 99:825-32. [PMID: 20623356 DOI: 10.1007/s00392-010-0194-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Accepted: 06/17/2010] [Indexed: 12/20/2022]
Abstract
BACKGROUND Microalbuminuria (MAU) is a marker of endothelial dysfunction and a predictor of cardiovascular events. The effects of cigarette smoking on the prevalence of MAU in a high-risk population with arterial hypertension are unclear. METHODS The International Survey Evaluating Microalbuminuria Routinely by Cardiologists in patients with Hypertension (I-SEARCH) documented the clinical profile of 20,364 patients with arterial hypertension and cardiovascular risk factors. In this population, 13,690 patients had no history of smoking, 4,057 patients were former smokers and 2,617 patients were current smokers. RESULTS The prevalence of MAU was associated with the smoking status. Consumption of 1-20 cigarettes per day leads to an increase of 6.8% in the prevalence of MAU compared to non-smokers (P < 0.001). Smoking of >20 cigarettes per day was associated with a 12.5% higher prevalence of MAU compared to non-smokers, while former smokers had a 4.7% higher prevalence of MAU. Multivariable analysis revealed that smoking was independently associated with MAU [odds ratio (OR) smoking vs. non-smoking 1.16; 95% confidence interval (CI) 1.01-1.33; P < 0.05]. Particularly, a consumption of >20 cigarettes per day was associated with high odds for MAU (OR 1.33; CI 1.01-1.75; P < 0.05). Interestingly, independently of blood pressure, the use of an angiotensin receptor blocker and an ACE was associated with significantly reduced odds ratio for MAU in the smoking group, while there was no significant association in the non-smoking group. CONCLUSION The prevalence of MAU in hypertensive patients is higher in smokers than in non-smokers with a strong dose dependency.
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Werner C, Filmer A, Groenewold S, Fritsch M, Böhm M, Laufs U. P291 SIMULTANEOUS DETERMINATION OF TRIGLYCERIDE AND GLUCOSE TOLERANCE BY A NOVEL SEQUENTIAL TEST PROTOCOL IN 511 PATIENTS WITH CORONARY ARTERY DISEASE. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70358-5] [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]
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122
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Jacobshagen C, Westermann D, Holubarsch C, Böhm M. Hotline update of clinical trials and registries presented at the American College of Cardiology Congress 2010: ACCORD, INVEST, NAVIGATOR, RACE II, SORT OUT III, CSP-474, DOSE, ASPIRE and more. Clin Res Cardiol 2010; 99:337-44. [PMID: 20396895 PMCID: PMC2876271 DOI: 10.1007/s00392-010-0154-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Accepted: 03/29/2010] [Indexed: 02/06/2023]
Abstract
This article gives an overview on a number of novel clinical trials in the field of cardiovascular medicine, which were presented during the Late Breaking Clinical Trial Sessions at the 59th annual meeting of the American College of Cardiology in Atlanta, USA, from 14th March to 16th March 2010. The data were presented by leading experts in the field with relevant positions in the trials. These comprehensive summaries should provide the readers with the most recent data on diagnostic and therapeutic developments in cardiovascular medicine similar as previously reported (Schirmer SH, van der Laan AM, Bohm M, Mahfoud F in Clin Res Cardiol 98:691-699, 2009; Maier LS, Schirmer SH, Walenta K, Jacobshagen C, Bohm M in Clin Res Cardiol 98:413-419, 2009).
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Werner C, Fürster T, Scharhag J, Böhm M, Laufs U. P399 LONG-TERM ENDURANCE EXERCISE ATTENUATES THE AGING PROCESS IN CIRCULATING LEUKOCYTES. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70466-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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124
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Weingärtner O, Lütjohann D, Rogacev K, Blömer L, Grenner Y, Gräber S, Ulrich C, Girndt M, Böhm M, Fliser D, Laufs U, Heine G. P127 MARKERS OF CHOLESTEROL METABOLISM ARE ASSOCIATED WITH CAROTID INTIMA-MEDIA THICKNESS. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70194-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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125
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Diener HC, Aichner F, Bode C, Böhm M, Eckstein HH, Einhäupl K, Endres M, Forsting F, Gesenhues S, Grond M, Haberl R, Hacke W, Hennerici M, Lyrer P, Link A, Ringelstein B, Ringleb P, Schrader J, Weimar C. Primary and secondary prevention of cerebral ischemia. AKTUELLE NEUROLOGIE 2010. [DOI: 10.1055/s-0029-1223537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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126
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Pöss J, Böhm M, Link A. [32-year-old patient with acute myocardial infarction possibly induced by the appetite suppressant sibutramine]. Dtsch Med Wochenschr 2010; 135:965-8. [PMID: 20446231 DOI: 10.1055/s-0030-1253684] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
HISTORY A 32-year-old, very slightly overweight woman (body mass index of 25) without any cardiovascular risk factors presented with acute chest pain. She reported taking the appetite suppressant sibutramine daily for three months. She was not pregnant and did not remember episodes of serious mental stress or infection during the last few weeks. Physical examination was unsuspicious. INVESTIGATION Laboratory results revealed an elevation of serum markers of myocardial ischemia. The electrocardiogram showed ST segment depressions and T wave inversions in leads II, III and aVF, indicating a nontransmural inferior myocardial infarction. TREATMENT AND COURSE Coronary angiography showed patent coronary arteries with inferior wall hypokinesia. There were no signs of a coronary dissection. Assuming that the acute coronary syndrome had been induced by coronary spasms, the patient was treated with amlodipine and ramipril. CONCLUSION It seemed reasonable to suspect that the intake of sibutramine had induced coronary spasms. However, this is a diagnosis of exclusion. Three case reports have previously been published about acute myocardial infarctions, possibly related to sibutramin intake, in young patients with a negligible cardiovascular risk profile. The European Medicines Agency has questioned the marketing authorisations for sibutramine (January 2010). In patients presenting with acute coronary syndromes which can not be clearly related to cardiovascular risk factors, it is crucial to obtain a complete drug history. Some patients might continue to take sibutramine.
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Buob A, Winter H, Kindermann M, Becker G, Möller JC, Oertel WH, Böhm M. Parasympathetic but not sympathetic cardiac dysfunction at early stages of Parkinson's disease. Clin Res Cardiol 2010; 99:701-6. [PMID: 20443012 DOI: 10.1007/s00392-010-0170-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2010] [Accepted: 04/14/2010] [Indexed: 11/25/2022]
Abstract
BACKGROUND Autonomic cardiovascular dysfunction is common in Parkinson's disease (PD). Imaging studies suggest loss of cardiac sympathetic nerves even in the absence of clinical signs of autonomic dysfunction. Aim of the study was to investigate the functional significance of autonomic cardiovascular denervation at early stages of PD. METHODS Seven PD patients (Hoehn and Yahr class 1 or 1.5) without clinical signs of autonomic dysfunction and seven age-matched healthy control subjects were studied. To evaluate the pre- and post-synaptic components of sympathetic innervation, dose-response curves of isoproterenol (no neuronal uptake) and epinephrine (neuronal uptake) on heart rate, contractility, cardiac output and systemic vascular resistance were determined echocardiographically. Additionally, measurements of baroreflex sensitivity and 24-h heart rate variability were done. RESULTS The chronotropic and inotropic responses during stimulation with isoproterenol and epinephrine were similar in PD patients and control subjects. Assessment of baroreflex sensitivity yielded no difference. Of the parameters of 24-h heart rate variability, only measures of high-frequency heart rate variation that more purely reflect parasympathetic activity were significantly depressed in PD patients as compared with control subjects. CONCLUSIONS The results of our study using direct determination of catecholamine-mediated chronotropic and contractile responses provide evidence against a functionally relevant sympathetic dysfunction. Possibly, sympathetic denervation is incomplete and the remaining fibers are sufficient for the maintenance of autonomic control. In contrast, the depression of several parameters of heart rate variability supports a significant change of parasympathetic activity at an early stage of PD with subclinical autonomic failure.
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Kuhn A, Meuth AM, Bein D, Amler S, Beissert S, Böhm M, Brehler R, Ehrchen J, Grundmann S, Haust M, Ruland V, Schiller M, Schulz P, Ständer S, Sauerland C, Köpcke W, Luger TA, Bonsmann G. Revised Cutaneous Lupus Erythematosus Disease Area and Severity Index (RCLASI): a modified outcome instrument for cutaneous lupus erythematosus. Br J Dermatol 2010; 163:83-92. [PMID: 20394621 DOI: 10.1111/j.1365-2133.2010.09799.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In 2005, a scoring system (CLASI, Cutaneous Lupus Erythematosus Disease Area and Severity Index) was developed for patients with cutaneous lupus erythematosus (CLE) to assess disease 'activity' and 'damage'. However, the CLASI does not give an accurate assessment of the severity in all disease subtypes. OBJECTIVES The main objective of this study was to analyse critically the included parameters of the CLASI and to revise the activity and damage score taking into account various clinical features of the different subtypes of CLE. The revised CLASI (RCLASI) was also validated for use in clinical trials. Patients and methods A RCLASI was designed with regard to the anatomical region (i.e. face, chest, arms) and morphological aspects (i.e. erythema, scaling/hyperkeratosis, oedema/infiltration, scarring/atrophy) of skin lesions and evaluated by nine dermatologists who scored 12 patients with different subtypes of CLE to estimate inter- and intrarater reliability. RESULTS Reliability studies demonstrated an intraclass correlation coefficient (ICC) for an inter-rater reliability of 0.89 for the activity score [95% confidence interval (CI) 0.79-0.96] and of 0.79 for the damage score (95% CI 0.62-0.92). The ICC for intrarater reliability for the activity score was 0.92 (95% CI 0.89-0.95) and the ICC for the damage score was 0.95 (95% CI 0.92-0.98). CONCLUSIONS In the present study, a RCLASI was developed by experts, and reliability studies supported the validity and applicability of the revised scoring instrument for CLE. Thus, the RCLASI is a valuable instrument in multicentre studies and for the clinical evaluation of activity and damage in different disease subtypes.
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Barth C, Kindermann I, Mahfoud F, Buob A, Böhm M. Intrathoracic impedance monitoring detecting pneumonia. Clin Res Cardiol 2010; 99:333-5. [DOI: 10.1007/s00392-010-0127-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Accepted: 01/22/2010] [Indexed: 11/24/2022]
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Hoffmann J, Böhm M, Abele-Ohl S, Weyand M, Ensminger SM. Reduced transplant arteriosclerosis after treatment with MMF and MMF in combination with ganciclovir in a mouse aortic transplant model. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1247064] [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]
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131
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Pöss J, Böhm M, Laufs U. HDL im Rahmen der Atherogenese und HDL-Steigerung durch CETP-Inhibition. Dtsch Med Wochenschr 2010; 135:188-92. [DOI: 10.1055/s-0030-1247862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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132
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Röther J, Laufs U, Böhm M, Willems S, Scheller B, Borggrefe M, Darius H, Endres M, Zeymer U, Diener HC, Grond M, Hacke W, Forsting M, Schumacher M, Hennerici M. [Consensus paper on peri-interventional and postinterventional stroke during cardiac catheter procedures]. DER NERVENARZT 2010; 80:1205-6, 1208-15. [PMID: 19830471 DOI: 10.1007/s00115-009-2874-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Stroke is a serious complication of percutaneous coronary intervention and atrial fibrillation ablation procedures and patients have a high likelihood of persistent neurological deficits. Although formal criteria speak against intravenous or intra-arterial thrombolysis due to pre-existing antithrombotic and anticoagulation therapy, the conditions for recanalizing therapy are optimal due to the occurrence of vessel occlusion in the catheter suite or the chest pain unit. Brain imaging and an interdisciplinary approach are mandatory. In cases of intracerebral vessel occlusion intra-arterial thrombolysis possibly in combination with mechanical clot fragmentation is the first choice therapy. The management of the patient is always an individual therapeutic decision based on stroke severity, the pretreatment with antithrombotic and anticoagulation drugs, the availability of a neuro-interventionalist and the qualification of the local team.
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Redler S, Brockschmidt FF, Forstbauer L, Giehl KA, Herold C, Eigelshoven S, Hanneken S, De Weert J, Lutz G, Wolff H, Kruse R, Blaumeiser B, Böhm M, Becker T, Nöthen MM, Betz RC. The TRAF1/C5 locus confers risk for familial and severe alopecia areata. Br J Dermatol 2009; 162:866-9. [PMID: 20030635 DOI: 10.1111/j.1365-2133.2009.09598.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Alopecia areata (AA) is a common hair loss disorder with a complex mode of inheritance. Autoimmune mechanisms are presumed to be crucial aetiologically. It is plausible that a number of autoimmune disorders may share a common genetic background. This phenomenon has been demonstrated in previous studies, which have shown an overlap of susceptibility alleles between AA and other autoimmune disorders. Recent studies have shown that genetic variants on the TRAF1/C5 (tumor necrosis factor receptor-associated factor 1, complement component 5) locus confer susceptibility to rheumatoid arthritis (RA). OBJECTIVES To examine the role of the TRAF1/C5 locus in the development of AA using a large sample of 1,195 patients with AA and 1280 controls. METHODS We genotyped the two most significant single nucleotide polymorphisms (SNPs) (rs10818488, rs2416808) from a former RA candidate gene study. After having obtained evidence for association, we performed a fine-mapping study and genotyped the locus with an additional 27 SNPs. RESULTS While no significant result was obtained for the overall sample, rs2416808 showed significant associations in the analysis of the subgroups with severe AA and with a positive family history. The most significant P-value for rs2416808 was in familial cases (P = 0.004, P(corr) = 0.026). The fine mapping revealed significant associations for four additional SNPs in the analysis of subgroups, with rs2416808 remaining the most significant marker. CONCLUSIONS Our results point to the involvement of the TRAF1/C5 locus in the aetiology of familial and severe AA, and provide further support for a shared aetiology between AA and other autoimmune disorders.
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Kilter H, Werner M, Roggia C, Reil JC, Schäfers HJ, Kintscher U, Böhm M. The PPAR-gamma agonist rosiglitazone facilitates Akt rephosphorylation and inhibits apoptosis in cardiomyocytes during hypoxia/reoxygenation. Diabetes Obes Metab 2009; 11:1060-7. [PMID: 19732122 DOI: 10.1111/j.1463-1326.2009.01097.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM Results on the cardiovascular effects of PPAR-gamma agonists are conflicting. On one hand, it was suggested that the PPAR-gamma agonist rosiglitazone may increase the risk of cardiovascular events. On the other hand, PPAR-gamma agonists reduce myocardial infarct size and improve myocardial function during ischemia/reperfusion in animal studies in vivo. However, the mechanism of this effect is unclear, and it is open if PPAR-gamma agonists have a direct effect on cardiac myocyte survival in ischemia/reperfusion. The aim of this study was to determine the effect of the PPAR-gamma agonist rosiglitazone on hypoxia/reoxygenation-induced apoptosis of isolated cardiomyocytes. METHODS Isolated rat cardiac myocytes were pretreated with rosiglitazone or vehicle for 30 min before they were subjected to hypoxia for 4 h followed by different times of reoxygenation (5 min to 12 h). Apoptosis was determined by in situ hybridization for DNA fragmentation (TUNEL) as well as detection of cytoplasmic accumulation of histone-associated DNA fragments by enzyme-linked immunosorbent assay (ELISA). Activation of apoptosis regulating intracellular signalling pathways was studied by immunoblotting using phosphospecific antibodies. RESULTS Rosiglitazone significantly reduced apoptosis of isolated cardiomyocytes subjected to hypoxia/reoxygenation, independently determined with two methods. After 4 h of hypoxia and 12 h of reoxygenation, 34 +/- 3.6% of the vehicle treated cardiac myocytes stained positive for DNA fragmentation in the TUNEL staining. Rosiglitazone treatment reduced this effect by 23% (p < 0.01). Even more pronounced, cytoplasmic accumulation of histone-associated DNA fragments detected by ELISA was reduced by 35% (p < 0.05) in the presence of rosiglitazone. This inhibition of hypoxia/reoxygenation-induced apoptosis was associated with an increased reoxygenation-induced rephosphorylation of the protein kinase Akt, a crucial mediator of cardiomyocyte survival in ischemia/reperfusion of the heart. This effect was reversed by GW-9662, an irreversible PPAR-gamma antagonist. However, rosiglitazone did not alter phosphorylation of the MAP kinases ERK1/2 and c-Jun N-terminal kinase (JNK). CONCLUSION It can be concluded that cardiac myocytes are direct targets of PPAR-gamma agonists promoting its survival in ischemia/reperfusion, at least in part by facilitating Akt rephosphorylation. This effect may be of clinical relevance inhibiting the reperfusion-induced injury in patients suffering from myocardial infarction or undergoing cardiac surgery.
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Seeland U, Schäffer A, Selejan S, Hohl M, Reil JC, Müller P, Rosenkranz S, Böhm M. Effects of AT1- and beta-adrenergic receptor antagonists on TGF-beta1-induced fibrosis in transgenic mice. Eur J Clin Invest 2009; 39:851-9. [PMID: 19522835 DOI: 10.1111/j.1365-2362.2009.02183.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Transforming growth factor-beta1 (TGF-beta1) is involved in interstitial remodelling promoting collagen synthesis and suppressing collagen degradation by inhibition of collagenases. TGF-beta1 mediates angiotensin II-dependent effects and modulates beta1-adrenergic signalling. To study the effect of neuroendocrine antagonism on TGF-beta-induced hypertrophic and fibrotic phenotype, we treated TGF-beta1 (Cys223,225Ser) transgenic mice (TGF-beta1-TG) with either the beta1-receptor blocker metoprolol (MET), the angiotensin II type I (AT1)-receptor antagonist telmisartan (TEL) or an antibody blocking TGF-beta1 signalling (TGFbeta1-sR-Ab). MATERIAL AND METHODS Transforming growth factor-beta1-TG mice (8 weeks) overexpressing TGF-beta1 were treated with either TEL (10 mg kg(-1)), MET (350 mg kg(-1)) or a soluble TGF-beta1 receptor antibody (1 mg kg(-1)) for 6 weeks. Morphological analyses of interstitium and cardiomyocytes were related to expression of matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) by immunoblotting and zymography. RESULTS In TGF-beta1-TG mice, myocardial interstitial total collagen content was fourfold elevated compared to that of controls (P < 0.05) and was lowered under the treatment with TEL (P < 0.05). Protein expression of TIMP-1 and -4 was increased in TGF-beta1-TG but inhibited by TEL (TIMP-1 and TIMP-4) and MET (TIMP-1), while collagenase activity was decreased in TGF-beta1-TG and normalized by treatment with TEL (MMP-1 and MMP-13) and MET (MMP-1) (P < 0.05). Morphometric measurements of cardiomyocyte diameter and area demonstrated similar antihypertrophic effects for all treatment groups. CONCLUSION The AT1-antagonist TEL reduced myocardial hypertrophy and interstitial fibrosis in TGF-beta1-TG mice by normalizing MMP/TIMP ratio. beta1-Adrenergic inhibition by MET as well as TGF-beta1 antagonism induced antihypertrophic rather than antifibrotic effects. Inhibition of both renin-angiotensin system and beta1-adrenergic system may exert different but synergistic effects to reduce myocardial remodelling.
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Röther J, Laufs U, Böhm M, Willems S, Scheller B, Borggrefe M, Darius H, Endres M, Zeymer U, Diener HC, Grond M, Hacke W, Forsting M, Schumacher M, Hennerici M. Konsensuspapier „Peri- und postinterventioneller Schlaganfall bei Herzkatheterprozeduren“. DER KARDIOLOGE 2009. [DOI: 10.1007/s12181-009-0214-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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137
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Thoenes M, Neuberger HR, Volpe M, Khan BV, Kirch W, Böhm M. Antihypertensive drug therapy and blood pressure control in men and women: an international perspective. J Hum Hypertens 2009; 24:336-44. [PMID: 19798089 DOI: 10.1038/jhh.2009.76] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cardiovascular death represents the single largest cause of mortality in women with 70% of deaths attributable to modifiable risk factors, such as hypertension. This analysis aims at evaluating, whether there are gender disparities in antihypertensive drug usage and blood pressure (BP) control. We included 18 017 patients with arterial hypertension from the International Survey Evaluating Microalbuminuria Routinely by Cardiologists in patients with Hypertension (I-SEARCH). The study was conducted between September 2005 and March 2006 in 26 countries, and data on patient demographics, cardiovascular disease and risk factors, BP, and cardiovascular drug treatment were collected. Mean systolic blood pressure (SBP) was 2.1 mm Hg higher in women (150.6+/-0.35 mm Hg, n=8357/18 017) than in men (148.5+/-0.35 mm Hg; P<0.0001, n=9526/18 017), whereas no difference in diastolic BP was seen (88.2+/-0.20 vs 88+/-0.20 mm Hg; P=0.198). Gender differences in SBP were more pronounced in diabetic as compared with non-diabetic patients (3.5 vs 1.7 mm Hg, n=4272 vs n=13 611; P<0.0001) and became evident at an age 55 years old. Overall BP-control rate was 33.6% in men and 30.6% in women (P<0.0001) and was lower in diabetic as compared with non-diabetic patients. In all, 30% of patients used one, 40% used two and 30% used > or = 3 drugs without gender differences. Response rates to different drug regimens appeared to be similar. However, women received more frequently thiazides and beta-blockers, and less frequently ACE-inhibitors as monotherapy. Major efforts are required to improve BP-management, especially in women.
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Böhm M. Die Prothesen-Versorgung kurzer und pathologischer Stümpfe der unteren Extremität1). Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0028-1140677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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139
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140
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Daub A, Böhm M, Büchs J. Charakterisierung der hydromechanischen Belastung in begasten Rührreaktoren. CHEM-ING-TECH 2009. [DOI: 10.1002/cite.200950376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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141
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Buob A, Mahfoud F, Böhm M. [Secondary prevention in a diabetic with myocardial infarction treated with a stent]. MMW Fortschr Med 2009; 151:34-35. [PMID: 19739545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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142
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Klaus D, Böhm M, Halle M, Kolloch R, Middeke M, Pavenstädt H, Hoyer J. [Restriction of salt intake in the whole population promises great long-term benefits]. Dtsch Med Wochenschr 2009; 134 Suppl 3:S108-18. [PMID: 19418415 DOI: 10.1055/s-0029-1222573] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Restricting salt intake not only leads to a decrease of blood pressure and a reduction in the incidence of arterial hypertension but also to a fall in cardiovascular morbidity and mortality. But high sodium intake is not only a risk factor for hypertension but also for cardiovascular diseases. Moderate reduction of daily salt intake in the entire population of Germany from the present level of 8-10 mg to 5-6 mg is of great benefit for disease load and to the economy. Any possible risk for a few groups of persons is predictable and can be coped with. General sodium reduction cannot be achieved only by individual advice, instruction or information campaigns but requires a reduction in the sodium content of industrially processed foods, in fast-food chains, restaurants and canteens because they supply 80% of total daily sodium intake. To achieve the target of restricting the sodium intake of the whole population it is recommended that an interdisciplinary and interprofessional task force, "Less salt for all" be established. This is to bring together the expertise of scientific societies and institutions that see their main task in the reduction of cardiovascular mortality and morbidity by primary prevention. Individual prevention in patients at risk can be very significantly improved by population-related preventive measures. These include, in addition to general limitation of sodium intake, continuing change in lifestyle.
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Weingärtner O, Böhm M, Laufs U. 67-jährige Patientin mit abdominellen Schmerzen und ausgeprägter Peritonitis. Dtsch Med Wochenschr 2009; 134:1161-2. [DOI: 10.1055/s-0029-1222584] [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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144
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Mahfoud F, Kindermann I, Kindermann M, Ukena C, Böhm M. Komorbidität: Anämie und Herzinsuffizienz. Dtsch Med Wochenschr 2009; 134:825-30. [DOI: 10.1055/s-0029-1220238] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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145
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Mahfoud F, Ukena C, Böhm M. Direkte Renininhibition: ein neues und viel versprechendes Wirkprinzip in der Herzinsuffizienztherapie? Dtsch Med Wochenschr 2009; 134:759-62. [DOI: 10.1055/s-0029-1220227] [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]
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146
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Gouni-Berthold I, Krone W, Böhm M, Bestehorn KP, Berthold HK. Patterns and predictors of statin prescription in patients with type 2 diabetes in Germany: Data from the DUTY registry. DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0029-1221868] [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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147
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Ukena C, Kindermann M, Mahfoud F, Kindermann I, Böhm M. Kardiopulmonale Interaktionen: Kardiovaskuläre Erkrankungen und COPD. Dtsch Med Wochenschr 2009; 134:818-22. [DOI: 10.1055/s-0029-1220237] [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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148
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Link A, Selejan S, Walenta K, Reil J, Böhm M. Therapie des peri- und postoperativen hypertensiven Notfalls. Dtsch Med Wochenschr 2009; 134:701-7. [DOI: 10.1055/s-0029-1208109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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149
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Schirmer SH, van Royen N, Laufs U, Böhm M. [Mechanisms and potential of the therapeutic stimulation of arteriogenesis]. Dtsch Med Wochenschr 2009; 134:302-6. [PMID: 19197812 DOI: 10.1055/s-0028-1123996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The stimulation of collateral artery growth (arteriogenesis) is a promising alternative approach to non-invasively treat arterial obstructive disease, such as coronary, peripheral or cerebral artery disease. Patients unable to undergo conventional revascularization strategies may benefit from adaptive arteriogenesis. Underlying mechanisms are experimentally validated and include an increase in shear stress after obstruction or occlusion of a major artery; monocyte adhesion, transmigration and perivascular accumulation, secretion of growth factors; and smooth muscle and endothelial cell proliferation and growth of pre-existent collateral arteries. Therapeutic stimulation of arteriogenesis with cytokines has been successfully performed in experimental models. Translation into clinical practice, however, has hitherto been problematic. Reasons for this include differences between the healthy laboratory animal and an often severely diseased patient, possible harmful effects of pro-arteriogenic therapies and unsuitable clinical endpoints for the detection of collateral artery growth. Recent investigations of human arteriogenesis demonstrate significant inter-individual differences and point towards the importance of anti-arteriogenic mechanisms in patients with impaired adaptive arteriogenesis and high cardiovascular risk factors.
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Sunderkötter C, Herrgott I, Brückner C, Moinzadeh P, Pfeiffer C, Gerss J, Hunzelmann N, Böhm M, Krieg T, Müller-Ladner U, Genth E, Schulze-Lohoff E, Meurer M, Melchers I, Riemekasten G. Comparison of patients with and without digital ulcers in systemic sclerosis: detection of possible risk factors. Br J Dermatol 2009; 160:835-43. [PMID: 19183180 DOI: 10.1111/j.1365-2133.2008.09004.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Digital ulcers (DU) are a major complication in the course of systemic sclerosis (SSc). In recent years, efficacious, but expensive therapies (e.g. iloprost, sildenafil, bosentan) have been shown to improve healing or to reduce the recurrence of DU. For optimal management it would be useful to identify the risk factors for DU. Such statistical analyses have been rare because they require a high number of patients. OBJECTIVES To identify potential risk factors for DU in patients with SSc. METHODS We used the registry of the German Network for Systemic Scleroderma and evaluated the data of 1881 patients included by August 2007. We assessed potential risk factors for DU by comparing patients with (24.1%) and without active DU at time of entry (75.9%). RESULTS Multivariate analysis revealed that male sex, presence of pulmonary arterial hypertension (PAH), involvement of the oesophagus, diffuse skin sclerosis (only when PAH was present), anti-Scl70 antibodies, young age at onset of Raynaud's phenomenon (RP), and elevated erythrocyte sedimentation rate (ESR) significantly impacted on the appearance of DU. Certain combinations increased the patients' probability of presenting with DU, with the highest probability (88%) for male patients with early onset of RP, ESR>30 mm h(-1), anti-Scl70 antibodies and PAH. Patients with DU developed RP, skin sclerosis and organ involvement approximately 2-3 years earlier than patients without DU. CONCLUSIONS The results reveal possible risk factors for the occurrence of DU in SSc. As DU are prone to local complications, prophylactic vasoactive treatment for patients presenting with these factors may be justified.
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