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Nagel E, Elgersma KM, Gallagher TT, Johnson KE, Demerath E, Gale CA. Importance of human milk for infants in the clinical setting: Updates and mechanistic links. Nutr Clin Pract 2023; 38 Suppl 2:S39-S55. [PMID: 37721461 PMCID: PMC10513735 DOI: 10.1002/ncp.11037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/15/2023] [Accepted: 06/10/2023] [Indexed: 09/19/2023] Open
Abstract
INTRODUCTION Human milk (HM) is the optimal source of nutrition for infants and has been implicated in multiple aspects of infant health. Although much of the existing literature has focused on the individual components that drive its nutrition content, examining HM as a biological system is needed for meaningful advancement of the field. Investigation of the nonnutritive bioactive components of HM and the maternal, infant, and environmental factors which affect these bioactives is important to better understand the importance of HM provision to infants. This information may inform care of clinical populations or infants who are critically ill, hospitalized, or who have chronic diseases and may benefit most from receiving HM. METHODS In this narrative review, we reviewed literature examining maternal and infant influences on HM composition with a focus on studies published in the last 10 years that were applicable to clinical populations. RESULTS We found multiple studies examining HM components implicated in infant immune and gut health and neurodevelopment. Additional work is needed to understand how donor milk and formula may be used in situations of inadequate maternal HM. Furthermore, a better understanding of how maternal factors such as maternal genetics and metabolic health influence milk composition is needed. CONCLUSION In this review, we affirm the importance of HM for all infants, especially clinical populations. An understanding of how HM composition is modulated by maternal and environmental factors is important to progress the field forward with respect to mechanistic links between HM biology and infant health outcomes.
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Affiliation(s)
- Emily Nagel
- School of Public Health, University of Minnesota-Twin Cities, Minnesota, USA
| | | | | | - Kelsey E Johnson
- Department of Genetics, Cell Biology, and Development, University of Minnesota-Twin Cities, Minnesota, USA
| | - Ellen Demerath
- School of Public Health, University of Minnesota-Twin Cities, Minnesota, USA
| | - Cheryl A. Gale
- Department of Pediatrics, University of Minnesota-Twin Cities, Minnesota, USA
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2
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Nagel E, Dietzel A, Link D, Haueisen J, Klee S. [Progressive pigmented fundus lesion after 23 years-Treatment or observation?]. Ophthalmologie 2023; 120:851-856. [PMID: 36241750 DOI: 10.1007/s00347-022-01729-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 08/21/2022] [Accepted: 08/25/2022] [Indexed: 06/16/2023]
Affiliation(s)
- E Nagel
- Institut für Biomedizinische Technik und Informatik, Technische Universität Ilmenau, Ilmenau, Deutschland.
- Augenarztpraxis Rudolstadt, Rudolstadt, Deutschland.
| | - A Dietzel
- Institut für Biomedizinische Technik und Informatik, Technische Universität Ilmenau, Ilmenau, Deutschland
| | - D Link
- Institut für Biomedizinische Technik und Informatik, Technische Universität Ilmenau, Ilmenau, Deutschland
| | - J Haueisen
- Institut für Biomedizinische Technik und Informatik, Technische Universität Ilmenau, Ilmenau, Deutschland
| | - S Klee
- Institut für Biomedizinische Technik und Informatik, Technische Universität Ilmenau, Ilmenau, Deutschland
- Fachbereich Biostatistics and Data Science, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Krems, Österreich
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3
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Heisel T, Johnson AJ, Gonia S, Dillon A, Skalla E, Haapala J, Jacobs KM, Nagel E, Pierce S, Fields D, Demerath E, Knights D, Gale CA. Bacterial, fungal, and interkingdom microbiome features of exclusively breastfeeding dyads are associated with infant age, antibiotic exposure, and birth mode. Front Microbiol 2022; 13:1050574. [PMID: 36466688 PMCID: PMC9714262 DOI: 10.3389/fmicb.2022.1050574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/26/2022] [Indexed: 11/19/2022] Open
Abstract
The composition and function of early life gut bacterial communities (microbiomes) have been proposed to modulate health for the long term. In addition to bacteria, fungi (mycobiomes) also colonize the early life gut and have been implicated in health disorders such as asthma and obesity. Despite the potential importance of mycobiomes in health, there has been a lack of study regarding fungi and their interkingdom interactions with bacteria during infancy. The goal of this study was to obtain a more complete understanding of microbial communities thought to be relevant for the early life programming of health. Breastmilk and infant feces were obtained from a unique cohort of healthy, exclusively breastfeeding dyads recruited as part of the Mothers and Infants Linked for Healthy Growth (MILk) study with microbial taxa characterized using amplicon-based sequencing approaches. Bacterial and fungal communities in breastmilk were both distinct from those of infant feces, consistent with niche-specific microbial community development. Nevertheless, overlap was observed among sample types (breastmilk, 1-month feces, 6-month feces) with respect to the taxa that were the most prevalent and abundant. Self-reported antibacterial antibiotic exposure was associated with micro- as well as mycobiome variation, which depended upon the subject receiving antibiotics (mother or infant), timing of exposure (prenatal, peri- or postpartum), and sample type. In addition, birth mode was associated with bacterial and fungal community variation in infant feces, but not breastmilk. Correlations between bacterial and fungal taxa abundances were identified in all sample types. For infant feces, congruency between bacterial and fungal communities was higher for older infants, consistent with the idea of co-maturation of bacterial and fungal gut communities. Interkingdom connectedness also tended to be higher in older infants. Additionally, higher interkingdom connectedness was associated with Cesarean section birth and with antibiotic exposure for microbial communities of both breastmilk and infant feces. Overall, these results implicate infant age, birth mode, and antibiotic exposure in bacterial, fungal and interkingdom relationship variation in early-life-relevant microbiomes, expanding the current literature beyond bacteria.
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Affiliation(s)
- Timothy Heisel
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
| | - Abigail J. Johnson
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Sara Gonia
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
| | - Abrielle Dillon
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
| | - Emily Skalla
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States,School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Jacob Haapala
- School of Public Health, University of Minnesota, Minneapolis, MN, United States,HealthPartners Institute, Minneapolis, MN, United States
| | - Katherine M. Jacobs
- Department of Obstetrics, Gynecology, and Women’s Health, University of Minnesota, Minneapolis, MN, United States
| | - Emily Nagel
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Stephanie Pierce
- College of Medicine, University of Oklahoma, Oklahoma City, OK, United States
| | - David Fields
- College of Medicine, University of Oklahoma, Oklahoma City, OK, United States
| | - Ellen Demerath
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Dan Knights
- Department of Computer Science and Engineering, University of Minnesota, Minneapolis, MN, United States
| | - Cheryl A. Gale
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States,*Correspondence: Cheryl A. Gale,
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Van Diemen PA, De Winter RW, Raijmakers PG, Maaniitty T, Robbers LF, Von Bartheld MB, Demirkiran A, Van Rossum AC, Reiber JH, Underwood SR, Knuuti J, Nagel E, Knaapen P, Driessen RS, Danad I. QFR vs. perfusion imaging to predict abnormal FFR in patients with prior coronary artery disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In patients with suspected obstructive coronary artery disease (CAD) and a high pre-test probability, myocardial perfusion imaging (MPI) or referral for invasive coronary angiography (ICA) are viable diagnostic strategies. The present study compared the diagnostic performance of quantitative flow ratio (QFR) and MPI by single-photon emission computed tomography (SPECT), positron emission tomography (PET), and cardiac magnetic resonance imaging (CMR).
Methods
In this PACIFIC-II substudy, 189 patients with prior MI/PCI who were suspected of having symptoms related to myocardial ischemia and underwent SPECT, PET, and CMR before ICA were evaluated for inclusion. ICA was obtained with (109 patients) and without (80 patients) adherence to a QFR acquisition protocol. All major coronary arteries were interrogated by FFR, except for vessels with a subtotal/total occlusion. An FFR ≤0.80 was used to define significant epicardial CAD. QFR analyses (v2.0) were performed based on ICA by a corelab in vascular territories (N=487) in which FFR was obtained. MPI modalities were assessed for presence of ischemia by corelabs, uninterpretable scans were omitted from the diagnostic comparison analyses.
Results
QFR analysis success rate was higher (81%) among vessels acquired using the QFR acquisition protocol compared to vessels obtained without the protocol (52%, p<0.001). Overall, a QFR result was available in 334 (69%) vessels. Among these vessels, QFR had a higher sensitivity (72%) and accuracy (84%) compared to SPECT (46%, p=0.001 and 66%, p<0.001), PET (58%, p=0.032 and 65%, p<0.001), and CMR (33%, p<0.001 and 72%, p<0.001). Whereas specificity of QFR (87%) was similar to CMR (83%, p=0.123) but higher than that of SPECT (71%, p<0.001) and PET (67%, p<0.001). Lastly, QFR exhibited a higher area under the receiver operating characteristic curve (0.89) than SPECT (0.57, p<0.001), PET (0.66, p<0.001), and CMR (0.60, p<0.001).
Conclusions
Provided QFR was analyzable (69% of the vessels), QFR correlated better with FFR (both as measures of epicardial CAD) than MPI as reflected in the diagnostic performance measures for detecting vessels-specific significant epicardial CAD as defined by FFR.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- P A Van Diemen
- Amsterdam UMC - Location VUmc , Amsterdam , The Netherlands
| | - R W De Winter
- Amsterdam UMC - Location VUmc , Amsterdam , The Netherlands
| | - P G Raijmakers
- Amsterdam UMC - Location VUmc , Amsterdam , The Netherlands
| | | | - L F Robbers
- Amsterdam UMC - Location VUmc , Amsterdam , The Netherlands
| | | | - A Demirkiran
- Amsterdam UMC - Location VUmc , Amsterdam , The Netherlands
| | - A C Van Rossum
- Amsterdam UMC - Location VUmc , Amsterdam , The Netherlands
| | - J H Reiber
- Medis Medical Imaging Systems , Leiden , The Netherlands
| | | | - J Knuuti
- Turku University Hospital , Turku , Finland
| | - E Nagel
- University Hospital Frankfurt , Frankfurt , Germany
| | - P Knaapen
- Amsterdam UMC - Location VUmc , Amsterdam , The Netherlands
| | - R S Driessen
- Amsterdam UMC - Location VUmc , Amsterdam , The Netherlands
| | - I Danad
- Amsterdam UMC - Location VUmc , Amsterdam , The Netherlands
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Nagel E, Lauerer M, Henzler D. [Surgery in the balance between humanity, ethics and economics]. Chirurg 2022; 93:242-249. [PMID: 35142907 DOI: 10.1007/s00104-022-01575-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The economic pressure in the healthcare system has noticeably increased in the past few years. The manifestation of an "economization in medicine" development raises questions about the compatibility of physicians' duties and economic incentives in the healthcare system. OBJECTIVE Against this background the article analyzes areas of conflict in the German healthcare system and surgery in particular. The main questions focus on: what lines of conflict can arise between ethical duties and economic requirements and what possibilities for conflict resolution can provide orientation on the macrolevel and microlevel? MATERIAL AND METHODS The article is based on the analysis of normative regulations, guidelines and statements from the self-administrative institutions and multidisciplinary literature from medicine, medical ethics and health economics. Core issues in the conflict area between "humanity-ethics-economics" are structured and recommendations for action are derived. RESULTS AND DISCUSSION Superordinate regulatory framework conditions and their subsequent incentives must not conflict with the ethical principles of medical care, especially the primary orientation to patient welfare. Institutional and individual healthcare providers have a responsibility towards patients first and only secondarily for an economically appropriate spending of public resources. The provision of medical care for people must enable an adequate livelihood. Institutional maximization of profits is to be avoided, especially concerning financial investors. In the corona pandemic, economic disincentives are becoming apparent and necessitate readjustments. Possible recommendations for action are the empowerment of the medical profession and management to engage in a qualified exchange.
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Affiliation(s)
- E Nagel
- Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Prieserstr. 2, 95444, Bayreuth, Deutschland.
| | - M Lauerer
- Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Prieserstr. 2, 95444, Bayreuth, Deutschland
| | - D Henzler
- Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Prieserstr. 2, 95444, Bayreuth, Deutschland
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6
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Puntmann V, Martin S, Vanchin B, Holm N, Giokoglu E, Hoffmann J, Karyou A, Arendt C, Khodamoradi Y, Vehreschild M, Braner A, Rohde G, Zeiher A, Vogl T, Nagel E. Patterns of cardiac involvement in patients with long COVID syndrome using cardiovascular magnetic resonance. Eur Heart J 2021. [PMCID: PMC8767595 DOI: 10.1093/eurheartj/ehab724.1719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Long COVID (LC) is an increasingly recognized late complication of COVID-19 infection. Cardiovascular involvement has also been implicated, however, the type and extent of the underlying cardiovascular injury remains unknown. Purpose To evaluate the association between ongoing symptoms and findings with cardiovascular magnetic resonance (CMR) in consecutive patients recently recovered from COVID-19 illness. Methods Prospective observational cohort study of patients recently recovered from COVID-19 illness and no previously known cardiovascular disease were included between April 2020 and April 2021. Demographic characteristics, cardiac blood markers, and CMR imaging a minimum of 4 weeks from the diagnosis were obtained. Results Of the 389 included patients, 192 (49%) were male, the mean (±standard deviation) age was 44 (±13) years and 61 (16%) required hospitalization during the acute illness. The median (IQR) time interval between COVID-19 diagnosis and CMR was 94 (71–165) days. 298 (77%) of patients continued to experience ongoing cardiovascular symptoms (long COVID, LC), including dyspnea, palpitations, atypical chest pain and fatigue at the time of CMR at least 4 weeks after the infection. In most patients, the symptoms were only effort related 137 (46%), whereas in 98 (33%) the symptoms affected the activities of daily life; 10 (3%) had severe and debilitating symptoms at rest. Compared to those with no LC (NLC, n=91), LC patients were more commonly hospitalized, had significantly higher native T1, native T2, and showed pericardial enhancement and effusion (Figure 1). There were no differences in cardiac biomarkers, left ventricular (LV) and right ventricular ejection fraction and mass. Proportionally, men and women were similarly affected (n=144 (73%) vs. n=157 (80%), p=0.18). Previous hospitalization was associated with hypertension and ongoing detectable troponin. LC status was associated with previous hospitalization and CMR findings of raised native T1 and native T2, and in females also pericardial enhancement. Severity of symptoms were associated with increased native T1 and T2 and decreased end-diastolic volume, whereas cardiac function showed no significant difference. Conclusions In this cohort of patients recently recovered from COVID-19 infection, ongoing cardiovascular symptoms were common. The LC status was related to previous hospitalization and CMR imaging findings of myopericardial inflammation. The extent and type of cardiovascular findings was associated with the severity of symptoms. These findings indicate the need for ongoing investigation of the long-term cardiovascular consequences of COVID-19. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): The German Heart Foundation (Deutsche Herzstiftung) and Bayer AG, Leverkusen, Germany
Figure 1 ![]()
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Affiliation(s)
- V Puntmann
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - S Martin
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - B Vanchin
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - N Holm
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - E Giokoglu
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - J Hoffmann
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - A Karyou
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - C Arendt
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Y Khodamoradi
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - M Vehreschild
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - A Braner
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - G Rohde
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - A Zeiher
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - T Vogl
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - E Nagel
- Wolfgang Goethe University, Frankfurt am Main, Germany
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7
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Puntmann V, Carr-White G, Rolf A, Zainal H, Vasquez M, Zhou H, Arcari L, Valbuena S, Hinojar R, Vidalakis E, Kolentinis M, Martin S, Zeiher A, Marber M, Nagel E. Clinical risk score for individualized risk stratification of patients with clinically suspected myocardial inflammation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
To develop a clinical risk score for individualized risk stratification of patients with clinically suspected myocardial inflammation.
Background
Myocardial inflammation is a prominent cause of non-ischaemic dilated cardiomyopathy, heart failure (HF) and sudden cardiac death.
Methods
This is a prospective multicentre longitudinal study of consecutive patients referred to cardiac magnetic resonance (CMR) with clinically suspected myocardial inflammation between October 2011 and December 2019 as a part of standard diagnostic pathway. Patients were followed up from the date of CMR. The outcome endpoints included major adverse cardiovascular event (MACE, cardiovascular mortality, sudden cardiac death, appropriate device discharge); or death or hospitalisation due to HF). A prognostic model was developed using Cox proportional hazards analysis and validated internally and externally.
Results
The final dataset included 722 subjects (50 years (40–61); males 422 (58%)). During a follow-up period of median 19 (15–23) months, there were 64 (9%) MACE and 130 (18%) HF events. Ten predictor variables qualified for entry into the prognostic model: age, sex, hematocrit, C-reactive protein, high-sensitive troponin-T (TNT), left and right ventricular ejection fraction, native T1 and T2, and late gadolinium enhancement (LGE). The final multivariable Cox regression model included native T2 (Figure 1A), TNT and LGE (Figure 1B) for the primary (Chi-square: 102.0, p<0.001) and secondary endpoint (Chi-square: 166.9, p<0.001), respectively. Cross-validation as well as external validation of the secondary models revealed good performance and no healthcare system effect. Based on the MyoRISK Score, patients were classified into three risk groups with respective event rates for MACE of 0%, 6.3% and 25.1%, and HF endpoint of 1.8%, 17.3% and 44.2%. TNT≥7 pg/ml allowed to efficiently preselect patients prior to CMR.
Conclusions
This is the first systematic assessment of outcomes in patients with clinically suspected myocardial inflammation, providing a non-invasive estimation of the probability of adverse events based on a score using readily available clinical parameters.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): DZHK
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Affiliation(s)
- V Puntmann
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | | | - A Rolf
- Kerckhoff Heart and Thorax Center, Cardiology, Bad Nauheim, Germany
| | - H Zainal
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - M Vasquez
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - H Zhou
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - L Arcari
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - S Valbuena
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - R Hinojar
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - E Vidalakis
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - M Kolentinis
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - S Martin
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - A Zeiher
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - M Marber
- King's College Hospital, London, United Kingdom
| | - E Nagel
- Wolfgang Goethe University, Frankfurt am Main, Germany
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8
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Thanner M, Nagel E, Hornung R. Ökonomie als Schwestertugend der Medizin? Mit dem Werte- und Entwicklungsquadrat nach Schulz von Thun von der Konfrontation zur konstruktiven Wirkung. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M Thanner
- Kantonsspital St. Gallen, Frauenklinik
| | - E Nagel
- Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth
| | - R Hornung
- Kantonsspital St. Gallen, Frauenklinik
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Arendt C, De Leuw P, Haberl A, Kann G, Wolf T, Stephan C, Schuettfort G, Arcari L, Vasquez M, Albrecht M, Escher F, Vogl T, Zeiher A, Nagel E, Puntmann V. Outcomes of cardiovascular magnetic resonance imaging in people living with HIV. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background/Introduction
People living with human immunodeficiency virus (HIV, PLWH) are at increased risk of cardiovascular disease (CVD). HIV infection and accelerated traditional risk factors due to highly-active antiretroviral therapy (HAART) are proposed mechanisms for increased rate of heart failure (HF). The pathophysiological drivers of myocardial dysfunction and worse cardiovascular outcome in HIV remain poorly understood.
Purpose
To examine prognostic relationships of cardiac imaging measures with cardiovascular outcome in PLWH on HAART.
Methods
This is a prospective observational longitudinal study using cardiac magnetic resonance (CMR) imaging in consecutive PLHWH on long-term HAART who were screened for underlying CVD and followed up clinically for adjudicated adverse cardiovascular events (cardiovascular mortality, non-fatal acute coronary syndrome, an appropriate device discharge, or a documented HF hospitalization). Imaging protocol included routine assessment of cardiac volumes and function, scar by late gadolinium enhancement, myocardial perfusion and native T1 /T2 mapping. Time-to-event analysis was performed from the index CMR exam to the first single event per patient Systematic risk scores for CVD (Framingham risk score (FRS), Data Collection on Adverse effects of anti-HIV Drugs score, D:A:D and MAGGIC integer score) were calculated using original online calculators.
Results
156 participants (males 62%, 50 [42-57] years of age) were included. 24 events were observed (4 HF deaths, 1 sudden cardiac death, 2 non-fatal acute myocardial infarction, 1 appropriate device discharge and 16 HF hospitalizations) during a median follow-up of 13 [9-19] months. Patients with events had higher native T1 (ms, 1149 [1115-1163] ms vs. 1110 [1075-1138] ms), native T2 (ms, 40 [38-41] vs. 37 [36-39]), LV mass index (g/m², 65 [49-77] vs. 57 [49-64]) p < 0.05 for all). In multivariable analyses, native T1 was independently predictive of adverse events (ChiSq 15.9, p < 0.001, native T1 (10 ms) hazard ratio (95% confidence interval) 1.20 (1.08-1.33), p = 0.001), followed by a model that also included LV mass (ChiSq 17.1, p < 0.001). Traditional cardiovascular risk scores were not predictive of the adverse events.
Conclusions
Native myocardial T1 and LV mass by CMR, as opposed to traditional cardiovascular risk scores, predict cardiovascular outcome in PLWH, together reflecting the pathological myocardial remodeling of myocardial fibrosis and inflammation that potentially explain higher rates of HF in PLWH as compared to the non-infected population. These findings may inform personalized approaches to screening and early intervention to reduce the burden of HF.
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Affiliation(s)
- C Arendt
- Goethe University Hospital, Frankfurt, Germany
| | - P De Leuw
- Infektiologikum, Frankfurt am Main, Germany
| | - A Haberl
- Goethe University Hospital, Frankfurt, Germany
| | - G Kann
- Infektiologikum, Frankfurt am Main, Germany
| | - T Wolf
- Goethe University Hospital, Frankfurt, Germany
| | - C Stephan
- Goethe University Hospital, Frankfurt, Germany
| | | | - L Arcari
- Sapienza University of Rome, Rome, Italy
| | - M Vasquez
- Enrique Baltodano Briceño Hospital, Liberia, Costa Rica
| | - M Albrecht
- Goethe University Hospital, Frankfurt, Germany
| | - F Escher
- Institute of Cardiac Diagnostics and Therapy (IKDT), Berlin, Germany
| | - T Vogl
- Goethe University Hospital, Frankfurt, Germany
| | - A Zeiher
- Goethe University Hospital, Frankfurt, Germany
| | - E Nagel
- Goethe University Hospital, Frankfurt, Germany
| | - V Puntmann
- Goethe University Hospital, Frankfurt, Germany
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10
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Doom JR, Reid BM, Nagel E, Gahagan S, Demerath EW, Lumeng JC. Integrating anthropometric and cardiometabolic health methods in stress, early experiences, and development (SEED) science. Dev Psychobiol 2021; 63:593-621. [PMID: 32901949 PMCID: PMC8113013 DOI: 10.1002/dev.22032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 05/31/2020] [Accepted: 08/04/2020] [Indexed: 12/26/2022]
Abstract
Within Stress, Early Experiences, and Development (SEED) science, there is a growing body of research demonstrating complex associations not only between stress, development, and psychopathology, but also with chronic disease risk factors. We argue that it is important for SEED researchers to consider including child anthropometric and physical health measures to more comprehensively capture processes of risk and resilience. Broader adoption of harmonized anthropometry and health measures in SEED research will facilitate collaborations, yielding larger datasets for research in high-risk populations, and greater opportunity to replicate existing findings. In this review, we identify optimal anthropometric and cardiometabolic health measurement methods used from infancy through adolescence, including those that are low-burden and inexpensive. Methods covered include: waist, hip, and head circumference, height, length, weight, pubertal development, body composition, blood pressure, arterial stiffness, carotid intima media thickness, and serum measures of cardiometabolic risk and inflammation. We provide resources for SEED researchers to integrate these methods into projects or to better understand these methods when reading the literature as well as where to find collaborators for more in-depth studies incorporating these measures. With broader integration of psychological and physical health measures in SEED research, we can better inform theory and interventions to promote health and resilience in individuals who have experienced early stress.
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Affiliation(s)
- Jenalee R Doom
- Department of Psychology, University of Denver, Denver, CO, USA
| | - Brie M Reid
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Emily Nagel
- Department of Food Science and Nutrition, University of Minnesota, Minneapolis, MN, USA
| | - Sheila Gahagan
- Department of Pediatrics, University of California, San Diego, CA, USA
| | - Ellen W Demerath
- Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN, USA
| | - Julie C Lumeng
- Department of Pediatrics, Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
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11
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Nagel E, Desjardins C, Earthman C, Ramel S, Demerath E. Weight for length measures may not accurately reflect adiposity in preterm infants born appropriate for gestational age during hospitalisation or after discharge from the neonatal intensive care unit. Pediatr Obes 2021; 16:e12744. [PMID: 33140910 PMCID: PMC8026714 DOI: 10.1111/ijpo.12744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 09/19/2020] [Accepted: 10/05/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Weight/length (W/L) indices are poor surrogates for adiposity in preterm infants born appropriate for gestational age (AGA) at birth, but whether the association subsequently improves is unknown. OBJECTIVE To determine if W/L indices accurately reflect adiposity in premature infants born AGA in later infancy. METHODS Associations between W/L indices and fat mass, fat mass index and percent body fat (%BF) obtained via air displacement plethysmography (ADP) were examined in 260 preterm infants (majority born AGA) at 28 to 63 weeks' postmenstrual age (PMA). Accuracy of W/L indices as indicators of adiposity was assessed by proportion of variance explained (R2 ) and root mean square error from linear regression of adiposity on W/L indices and proportion of infants misclassified by W/L indices. Accuracy was further compared in term vs preterm infants at term-equivalent age. The impact of early vs late preterm status on associations between W/L indices and %BF was also examined. RESULTS BMI and W/L were most strongly associated with %BF but yielded poorly fitting models (maximum R2 = 0.35; 53% misclassification). A significant interaction of W/L indices and early vs late preterm status on %BF revealed that estimation of %BF differs by status. Accuracy of W/L indices was worse in preterm infants at term-equivalent age. CONCLUSIONS W/L indices were not good indicators of adiposity in preterm infants from 28 to 63 weeks' PMA (born AGA) with all categories of W/L indices combined. Future research should examine whether results are similar in preterm infants born with disproportionate W/L or who experience disproportionate growth postnatally.
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Affiliation(s)
- Emily Nagel
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Minneapolis, Minnesota,School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota
| | | | - Carrie Earthman
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware
| | - Sara Ramel
- Department of Pediatrics, University of Minnesota-Twin Cities, Minneapolis, Minnesota
| | - Ellen Demerath
- School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota
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12
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Kolentinis M, Carerj LM, Vidalakis E, Gawor M, Vasquez M, D Angelo T, Arcari L, Zainal H, Zhou H, Abrecht M, Arendt C, Vogl TJ, Nagel E, Puntmann VO. Determination of scar area using native and post contrast T1 mapping: a validation study. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Goethe University Hospital
Introduction
Late gadolinium enhancement (LGE) with Full Width Half Maximum (FWHM) is the standard imaging method for the measurement of the scar area in ischemic heart disease, a major determinant of adverse outcome. T1 mapping techniques have become increasingly applied in everyday clinical practice. Agreement in area quantification between T1 mapping and LGE for the scar extent has not been systematically assessed.
Purpose
This study aims to ascertain concordance between the area determined by native and post contrast T1 mapping against LGE to determine scar area in patients with a prior myocardial infarction. It also examines intra and inter-observer reproducibility for these two methods.
Methods
Subendocardial scar was evaluated in 132 patients with ischemic heart disease using LGE, native and post contrast T1 mapping in 3 short axis slices. Native and postcontrast T1 mapping was performed using GoetheCVI®MOLLI sequence (Gadovist® 0.1mmol/kg). FWHM method was applied for LGE and compared with the manually delineated area of scar in native and postcontrast T1 mapping acquisitions within the identical slices. The presence of the scar was defined as LGE >3% of the myocardial mass. Bland-Altman methods were employed to assess concordance between techniques and reproducibly between observers.
Results
In comparison to LGE, area measurements in native T1 acquisitions underestimated infarct size (9,1% vs 12,6%, p = 0.01), while postcontrast T1 overestimated it (19,4% vs 12,6%, p < 0.001). The disparity between the measurements was accentuated with larger scar areas (Figure 1). Intraobserver reproducibility (native T1: intra/inter MD ± SD, CoV, postcontrast T1: intra/inter) was similar with both methods, whereas interobserver variability for native T1 mapping acquisition was worse.
Conclusions
We demonstrate that measurements of the area of myocardial scar by T1 mapping acquisitions yield considerably different results in comparison to the standard LGE-based FWHM method. High observer agreement indicates that these differences are genuinely related to the type of the underlying acquisition and the differences in detected signal. The approaches are not interchangeable. However, the importance of these results for predicting patient outcome is yet to be elucidated. Nonetheless, these results were consistent in the inter and intraobserver analysis for post contrast T1 mapping, although native T1 mapping failed to show similar consistency.
Figure 1: Bland-Altmann plot of differences (mean ± upper and lower limit of agreement-LOA) in scar area extent (percentage) between LGE and native T1 mapping (A), LGE and post contrast T1 mapping (B). The difference increases linearly for larger scar areas when using post contrast mapping, which does not apply for native mapping.
Abstract Figure 1
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Affiliation(s)
- M Kolentinis
- Cardiology Frankfurt Sachsenhausen, Frankfurt, Germany
| | - LM Carerj
- Cardiology Frankfurt Sachsenhausen, Frankfurt, Germany
| | - E Vidalakis
- Cardiology Frankfurt Sachsenhausen, Frankfurt, Germany
| | - M Gawor
- Cardiology Frankfurt Sachsenhausen, Frankfurt, Germany
| | - M Vasquez
- Cardiology Frankfurt Sachsenhausen, Frankfurt, Germany
| | - T D Angelo
- Cardiology Frankfurt Sachsenhausen, Frankfurt, Germany
| | - L Arcari
- Cardiology Frankfurt Sachsenhausen, Frankfurt, Germany
| | - H Zainal
- Cardiology Frankfurt Sachsenhausen, Frankfurt, Germany
| | - H Zhou
- Cardiology Frankfurt Sachsenhausen, Frankfurt, Germany
| | - M Abrecht
- Cardiology Frankfurt Sachsenhausen, Frankfurt, Germany
| | - C Arendt
- Cardiology Frankfurt Sachsenhausen, Frankfurt, Germany
| | - TJ Vogl
- Cardiology Frankfurt Sachsenhausen, Frankfurt, Germany
| | - E Nagel
- Cardiology Frankfurt Sachsenhausen, Frankfurt, Germany
| | - VO Puntmann
- Cardiology Frankfurt Sachsenhausen, Frankfurt, Germany
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13
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Zhou H, Puntmann V, Nagel E. Comparison of the T2 effects of three T1 mapping sequences of the myocardium at 3T and 1.5T. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Purpose
To compare the T2 effects of three T1 mapping sequences of the myocardium at 3T and 1.5T.
Materials and Methods
We measured native T1 values by three T1 mapping sequences (FFM, MPI and LONG) and T2 values of 630 consecutive subjects (patients and healthy volunteers) in a mid-ventricular short axis slice by regions of interest (ROIs) placed conservatively within the septal myocardium. Correlations between myocardial T1 and T2 values were analyzed.
Results
Native T1 values differed significantly depending on the sequence, with MPI providing consistently higher mean values than FFM and LONG, LONG providing higher mean values than FFM (all p < 0.001). T1 by FFM, MPI and LONG in the total population, disease group, non-ischaemic cardiomyopathy group were all weakly related to T2 at 3T. The correlation coefficient of MPI were the highest in the total population and disease group, but there is no significant difference in correlation coefficients (all p > 0.05). Similarly, T1 by FFM, LONG in the total population, disease group, NICM group were all weakly-moderately related to T2 at 1.5T. In the control group, only T1 by MPI was moderately and positively related to T2(r = 0.469, p = 0.037). In the ischaemic cardiomyopathy group, only T1 by MPI was weakly and positively related to T2 (r = 0.334, p = 0.011). In the stress condition, T1 by FFM and MPI was weakly and positively related to T2 (r = 0.280,0.210, p = 0.001,0.012, respectively).
Conclusion
The T2 effects existed in three T1 mapping sequences of the myocardium in varying degrees, we should consider the potential bias from T2 when analyzing the abnormal T1 values of myocardium.
Abstract Figure.
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Affiliation(s)
- H Zhou
- Xiangya Hospital Central South University, Changsha, China
| | - V Puntmann
- JW Goethe University, Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Frankfurt am Main, Germany
| | - E Nagel
- JW Goethe University, Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Frankfurt am Main, Germany
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14
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Yilmaz A, Bauersachs J, Bengel F, Büchel R, Kindermann I, Klingel K, Knebel F, Meder B, Morbach C, Nagel E, Schulze-Bahr E, Aus dem Siepen F, Frey N. Diagnosis and treatment of cardiac amyloidosis: position statement of the German Cardiac Society (DGK). Clin Res Cardiol 2021; 110:479-506. [PMID: 33459839 PMCID: PMC8055575 DOI: 10.1007/s00392-020-01799-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/21/2020] [Indexed: 12/15/2022]
Abstract
Systemic forms of amyloidosis affecting the heart are mostly light-chain (AL) and transthyretin (ATTR) amyloidoses. The latter is caused by deposition of misfolded transthyretin, either in wild-type (ATTRwt) or mutant (ATTRv) conformation. For diagnostics, specific serum biomarkers and modern non-invasive imaging techniques, such as cardiovascular magnetic resonance imaging (CMR) and scintigraphic methods, are available today. These imaging techniques do not only complement conventional echocardiography, but also allow for accurate assessment of the extent of cardiac involvement, in addition to diagnosing cardiac amyloidosis. Endomyocardial biopsy still plays a major role in the histopathological diagnosis and subtyping of cardiac amyloidosis. The main objective of the diagnostic algorithm outlined in this position statement is to detect cardiac amyloidosis as reliably and early as possible, to accurately determine its extent, and to reliably identify the underlying subtype of amyloidosis, thereby enabling subsequent targeted treatment.
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Affiliation(s)
- A Yilmaz
- Sektion für Herzbildgebung, Klinik für Kardiologie, Universitätsklinikum Münster, Von-Esmarch-Str. 48, 48149, Münster, Germany.
| | - J Bauersachs
- Klinik für Kardiologie und Angiologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - F Bengel
- Klinik für Nuklearmedizin, Medizinische Hochschule Hannover, Hannover, Germany
| | - R Büchel
- Klinik für Nuklearmedizin, Universitätsspital Zürich, Zurich, Switzerland
| | - I Kindermann
- Klinik für Innere Medizin III (Kardiologie, Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg, Germany
| | - K Klingel
- Institut für Pathologie und Neuropathologie, Universität Tübingen, Tübingen, Germany
| | - F Knebel
- Medizinische Klinik m.S. Kardiologie und Angiologie, Charite Universitätsmedizin Berlin Campus Mitte, Berlin, Germany
| | - B Meder
- Klinik für Innere Medizin III, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - C Morbach
- Klinik für Innere Medizin III, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - E Nagel
- Interdisziplinäres Amyloidosezentrum Nordbayern, Deutsches Zentrum für Herzinsuffizienz, Medizinische Klinik I der Universität Würzburg, Würzburg, Germany
| | - E Schulze-Bahr
- Institut für Experimentelle und translationale kardiovaskuläre Bildgebung, Universitätsklinikum Frankfurt, Frankfurt, Germany
| | - F Aus dem Siepen
- Institut für Genetik von Herzerkrankungen (IfGH), Universitätsklinikum Münster, Münster, Germany
| | - N Frey
- Klinik für Innere Medizin III, Schwerpunkt Kardiologie und Angiologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany.,Kommission für Klinische Kardiovaskuläre Medizin, Deutsche Gesellschaft für Kardiologie, Düsseldorf, Germany
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15
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Faragli A, Tanacli R, Kolp C, Abawi D, Lapinskas T, Stehning C, Schnackenburg B, Lo Muzio FP, Fassina L, Pieske B, Nagel E, Post H, Kelle S, Alogna A. Cardiovascular magnetic resonance-derived left ventricular mechanics-strain, cardiac power and end-systolic elastance under various inotropic states in swine. J Cardiovasc Magn Reson 2020; 22:79. [PMID: 33256761 PMCID: PMC7708216 DOI: 10.1186/s12968-020-00679-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 10/06/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance (CMR) strain imaging is an established technique to quantify myocardial deformation. However, to what extent left ventricular (LV) systolic strain, and therefore LV mechanics, reflects classical hemodynamic parameters under various inotropic states is still not completely clear. Therefore, the aim of this study was to investigate the correlation of LV global strain parameters measured via CMR feature tracking (CMR-FT, based on conventional cine balanced steady state free precession (bSSFP) images) with hemodynamic parameters such as cardiac index (CI), cardiac power output (CPO) and end-systolic elastance (Ees) under various inotropic states. METHODS Ten anaesthetized, healthy Landrace swine were acutely instrumented closed-chest and transported to the CMR facility for measurements. After baseline measurements, two steps were performed: (1) dobutamine-stress (Dobutamine) and (2) verapamil-induced cardiovascular depression (Verapamil). During each protocol, CMR images were acquired in the short axisand apical 2Ch, 3Ch and 4Ch views. MEDIS software was utilized to analyze global longitudinal (GLS), global circumferential (GCS), and global radial strain (GRS). RESULTS Dobutamine significantly increased heart rate, CI, CPO and Ees, while Verapamil decreased them. Absolute values of GLS, GCS and GRS accordingly increased during Dobutamine infusion, while GLS and GCS decreased during Verapamil. Linear regression analysis showed a moderate correlation between GLS, GCS and LV hemodynamic parameters, while GRS correlated poorly. Indexing global strain parameters for indirect measures of afterload, such as mean aortic pressure or wall stress, significantly improved these correlations, with GLS indexed for wall stress reflecting LV contractility as the clinically widespread LV ejection fraction. CONCLUSION GLS and GCS correlate accordingly with LV hemodynamics under various inotropic states in swine. Indexing strain parameters for indirect measures of afterload substantially improves this correlation, with GLS being as good as LV ejection fraction in reflecting LV contractility. CMR-FT-strain imaging may be a quick and promising tool to characterize LV hemodynamics in patients with varying degrees of LV dysfunction.
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Affiliation(s)
- A Faragli
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - R Tanacli
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - C Kolp
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - D Abawi
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - T Lapinskas
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu Street 2, 50161, Kaunas, Lithuania
| | - C Stehning
- Clinical Science, Philips Healthcare, Röntgenstr. 24, 22335, Hamburg, Germany
| | - B Schnackenburg
- Clinical Science, Philips Healthcare, Röntgenstr. 24, 22335, Hamburg, Germany
| | - F P Lo Muzio
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Via S. Francesco 22, 37129, Verona, Italy
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - L Fassina
- Department of Electrical, Computer and Biomedical Engineering (DIII), Centre for Health Technologies (CHT), University of Pavia, Via Ferrata 5, 27100, Pavia, Italy
| | - B Pieske
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - E Nagel
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany
| | - H Post
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany
- Department of Cardiology, Contilia Heart and Vessel Centre, St. Marien-Hospital Mülheim, 45468, Mülheim, Germany
| | - S Kelle
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - A Alogna
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
- Berlin Institute of Health (BIH), Berlin, Germany.
- DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany.
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16
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Arendt C, De Leuw P, Haberl A, Stephan C, Vasquez M, Arcari L, Zhou H, Zainal H, Albrecht M, Vogl T, Zeiher A, Nagel E, Puntmann V. In-depth phenotyping of cardiac diseases by MRI in HIV-positive people reveals diverse and independent forms of myocardial involvement. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
It is increasingly recognised that non-ischaemic and ischaemic myocardial involvement represent important drivers of cardiac diseases in people living with HIV (PLWH). Non-invasive measurements with cardiac magnetic resonance (CMR) directly inform on the type of myocardial damage.
Purpose
To screen for the prevalence and type of cardiovascular disease (CVD) in PLWH using stress CMR in a cohort with highly active antiretroviral therapy (HAART).
Methods
This prospective cross-sectional study enrolled consecutive PLWH undergoing standardised evaluation for CVD using imaging. All participants underwent a standardised CMR protocol in a 3 Tesla scanner for function and volumes (cine), stress perfusion (regadenosone), scar (late gadolinium enhancement (LGE)), diffuse fibrosis (native T1-mapping) and oedema (native T2-mapping). Blood samples were additionally collected prior to CMR.
Results
141 participants were identified (n=32 in category C/AIDS). 16 patients had previously documented (n=23) myocardial diseases: myocarditis, n=1 non-obstructive coronary artery disease (CAD), n=8 myocardial infarction, n=3 congestive heart failure, n=3, and arrhythmia, n=8. Mean value for hs-cTnT, CRP and NT-proBNP was 9±18ng/l, 0.3±0.6mg/l and 104±229ng/l. 14 subjects had impaired LV-EF (<50%) and 35 presented borderline LV-EF (50–55%). Myocardial LGE was present in 28 patients: non-ischemic pattern, n=16, ischemic pattern, n=11, and both patterns, n=1. Two patients had relevant inducible ischaemia, whereas a pattern of microvascular disease (MVD) was found in 26 patients. 72 subjects had diffuse fibrosis and 25 had active inflammation. Elevated native T1/T2 was significantly associated with low (<350/μl), current, and initial CD4-count (χ2=5.317, p=0.021; χ2=3.841, p=0.050), just as with category C/AIDS (χ2=4.949, p=0.026). Native T2 showed a significant correlation with initial CD4-count (r=−0.252, p=0.008) and current NT-proBNP (r=0.190, p=0.030), but not with other laboratory values.
Conclusions
CMR in PLWH reveal high prevalence of cardiac involvement, which is predominantly non-ischaemic inflammatory in origin. MVD is a major presentation compared to relevant ischaemia due to epicardial CAD. Individual cardiovascular risk assessment in PLWH using CMR may bear a potential for personalised treatment.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): The German Centre for Cardiovascular Research (DZHK)
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Affiliation(s)
- C Arendt
- University Hospital Frankfurt, Frankfurt am Main, Germany
| | - P De Leuw
- Infektiologikum, Frankfurt am Main, Germany
| | - A Haberl
- University Hospital Frankfurt, Frankfurt am Main, Germany
| | - C Stephan
- University Hospital Frankfurt, Frankfurt am Main, Germany
| | - M Vasquez
- Enrique Baltodano Briceño Hospital, Liberia, Costa Rica
| | - L Arcari
- Sapienza University of Rome, Rome, Italy
| | - H Zhou
- Central South University, Changsha, China
| | - H Zainal
- Universiti Teknologi MARA, Sg. Buloh, Malaysia
| | - M Albrecht
- University Hospital Frankfurt, Frankfurt am Main, Germany
| | - T Vogl
- University Hospital Frankfurt, Frankfurt am Main, Germany
| | - A Zeiher
- University Hospital Frankfurt, Frankfurt am Main, Germany
| | - E Nagel
- University Hospital Frankfurt, Frankfurt am Main, Germany
| | - V Puntmann
- University Hospital Frankfurt, Frankfurt am Main, Germany
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Arendt C, De Leuw P, Haberl A, Stephan C, Vasquez M, Arcari L, Zhou H, Zainal H, Albrecht M, Vogl T, Zeiher A, Nagel E, Puntmann V. Myocardial fibrosis and inflammation are predictors of heart failure outcomes in people living with HIV. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
People living with HIV (PLWH) have higher prevalence of heart failure (HF), which cannot be fully related to traditional cardiovascular disease (CVD) risk factor< or coronary artery disease. Tissue characterisation by cardiac magnetic resonance (CMR), such as with T1 and T2 mapping, is a unique diagnostic approach to provide non-invasive insights into the underlying myocardial pathophysiology.
Purpose
To examine prognostic associations of CMR measures, conventional and modified CVD risk scores with HF outcome in PLWH on long-term highly active antiretroviral therapy (HAART).
Methods
Consecutive PLWH underwent prospectively standardized evaluation of HF using CMR, risk scores and blood markers. CMR protocol included T1 and T2 mapping, perfusion and scar imaging. MAGGIC, Framingham and D:A:D risk scores were collected. Primary HF endpoint was defined as hospitalization or mortality due to HF, and time-to-even analysis from the index CMR to the first event per patient was performed.
Results
141 PLWH (61% males, 48.0 [40.1–54.6] years, CD4 count 655 [411–909] cells/μl) were included. 16 HF events were observed (12 hospitalizations and 4 deaths) during a median follow-up of 13 [9–16] months. Baseline myocardial native T1, T2, left ventricular volumes and troponin were significant univariate predictors of the HF endpoint. The only signifcant (p<0.001) independent predictor in the multivariate analysis was myocardial native T1 (T1 ≥4 SD, HR (95% CI): 5.0 [1.8–13.4]). Conventional and modified CVD risk scores showed no prognostic association with HF outcomes.
Conclusions
Our results show that presence and severity of myocardial inflammation and predominantly diffuse fibrosis detected by T2 and T1 mapping strongly relates to HF events in contrast to conventional and traditional CVD risk scores.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): The German Centre for Cardiovascular Research (DZHK)
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Affiliation(s)
- C Arendt
- University Hospital Frankfurt, Frankfurt am Main, Germany
| | - P De Leuw
- Infektiologikum, Frankfurt am Main, Germany
| | - A Haberl
- University Hospital Frankfurt, Frankfurt am Main, Germany
| | - C Stephan
- University Hospital Frankfurt, Frankfurt am Main, Germany
| | - M Vasquez
- Enrique Baltodano Briceño Hospital, Liberia, Costa Rica
| | - L Arcari
- Sapienza University of Rome, Rome, Italy
| | - H Zhou
- Central South University, Changsha, China
| | - H Zainal
- Universiti Teknologi MARA, Sg. Buloh, Malaysia
| | - M Albrecht
- University Hospital Frankfurt, Frankfurt am Main, Germany
| | - T Vogl
- University Hospital Frankfurt, Frankfurt am Main, Germany
| | - A Zeiher
- University Hospital Frankfurt, Frankfurt am Main, Germany
| | - E Nagel
- University Hospital Frankfurt, Frankfurt am Main, Germany
| | - V Puntmann
- University Hospital Frankfurt, Frankfurt am Main, Germany
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18
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Nagel E, Carerj ML, Arendt CT, Puntmann VO. Erratum to: After ISCHEMIA: Is cardiac MRI a reliable gatekeeper for invasive angiography and myocardial revascularization? Herz 2020; 45:505. [PMID: 32613316 DOI: 10.1007/s00059-020-04963-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In the above mentioned article, the family name of the second author was not given correctly: it is Carerj instead of Careri.The authors apologize for this mistake.The original article has been ….
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Affiliation(s)
- E Nagel
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
| | - M L Carerj
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
- Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional; Imaging, Policlinico G. Martino, University Hospital Messina, Messina, Italy
| | - C T Arendt
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - V O Puntmann
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
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19
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Nagel E, Hickey M, Teigen L, Kuchnia A, Holm T, Earthman C, Demerath E, Ramel S. Can Ultrasound Measures of Muscle and Adipose Tissue Thickness Predict Body Composition of Premature Infants in the Neonatal Intensive Care Unit? JPEN J Parenter Enteral Nutr 2020; 45:323-330. [DOI: 10.1002/jpen.1829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 03/03/2020] [Indexed: 01/19/2023]
Affiliation(s)
- Emily Nagel
- Department of Food Science and Nutrition University of Minnesota–Twin Cities Minneapolis Minnesota USA
| | - Marie Hickey
- Department of Pediatrics University of Minnesota–Twin Cities Minneapolis Minnesota USA
| | - Levi Teigen
- Department of Gastroenterology University of Minnesota–Twin Cities Minneapolis Minnesota USA
| | - Adam Kuchnia
- Department of Nutritional Sciences University of Wisconsin–Madison Madison Wisconsin USA
| | - Tara Holm
- Department of Radiology University of Minnesota–Twin Cities Minneapolis Minnesota USA
| | - Carrie Earthman
- Department of Behavioral Health and Nutrition University of Delaware Newark Delaware USA
| | - Ellen Demerath
- School of Public Health University of Minnesota–Twin Cities Minneapolis Minnesota USA
| | - Sara Ramel
- Department of Pediatrics University of Minnesota–Twin Cities Minneapolis Minnesota USA
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20
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Nagel E, Hickey M, Teigen L, Kuchnia A, Curran K, Soumekh L, Earthman C, Demerath E, Ramel S. Clinical Application of Body Composition Methods in Premature Infants. JPEN J Parenter Enteral Nutr 2020; 44:785-795. [DOI: 10.1002/jpen.1803] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 01/08/2020] [Accepted: 01/15/2020] [Indexed: 01/25/2023]
Affiliation(s)
- Emily Nagel
- Department of Food Science and NutritionUniversity of Minnesota‐Twin Cities Minneapolis MN USA
| | - Marie Hickey
- Department of PediatricsUniversity of Minnesota‐Twin Cities Minneapolis MN USA
| | - Levi Teigen
- Department of GastroenterologyUniversity of Minnesota‐Twin Cities Minneapolis MN USA
| | - Adam Kuchnia
- Department of Nutritional SciencesUniversity of Wisconsin‐Madison Madison WI USA
| | - Kent Curran
- Department of PediatricsAlbany Medical Center Albany NY USA
| | - Lisa Soumekh
- School of MedicineUniversity of Minnesota‐Twin Cities Minneapolis MN USA
| | | | - Ellen Demerath
- School of Public HealthUniversity of Minnesota‐Twin Cities Minneapolis MN USA
| | - Sara Ramel
- Department of PediatricsUniversity of Minnesota‐Twin Cities Minneapolis MN USA
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21
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Zainal Abidin H, Zhou H, Arcari L, Arendt C, Nagel E, Puntmann V. Corrigendum to “Assessment of myocardial tissue characterization in hypertension with left ventricular diastolic dysfunction” [Int. J. Cardiol., 297S (2019) 7–8]. Int J Cardiol 2020. [DOI: 10.1016/j.ijcard.2020.01.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Faragli A, Tanacli R, Kolp C, Lapinskas T, Stehning C, Schnackenburg B, Lo Muzio FP, Perna S, Pieske B, Nagel E, Post H, Kelle S, Alogna A. Cardiovascular magnetic resonance feature tracking in pigs: a reproducibility and sample size calculation study. Int J Cardiovasc Imaging 2020; 36:703-712. [PMID: 31950298 PMCID: PMC7125242 DOI: 10.1007/s10554-020-01767-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/02/2020] [Indexed: 12/18/2022]
Abstract
Cardiovascular magnetic resonance feature tracking (CMR-FT) is a novel technique for non-invasive assessment of myocardial motion and deformation. Although CMR-FT is standardized in humans, literature on comparative analysis from animal models is scarce. In this study, we measured the reproducibility of global strain under various inotropic states and the sample size needed to test its relative changes in pigs. Ten anesthetized healthy Landrace pigs were investigated. After baseline (BL), two further steps were performed: (I) dobutamine-induced hyper-contractility (Dob) and (II) verapamil-induced hypocontractility (Ver). Global longitudinal (GLS), circumferential (GCS) and radial strain (GRS) were assessed. This study shows a good to excellent inter- and intra-observer reproducibility of CMR-FT in pigs under various inotropic states. The highest inter-observer reproducibility was observed for GLS at both BL (ICC 0.88) and Ver (ICC 0.79). According to the sample size calculation for GLS, a small number of animals could be used for future trials.
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Affiliation(s)
- A Faragli
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany
| | - R Tanacli
- Department of Internal Medicine / Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - C Kolp
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany
| | - T Lapinskas
- Department of Internal Medicine / Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.,Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu Street 2, 50161, Kaunas, Lithuania
| | - C Stehning
- Clinical Science, Philips Healthcare, Röntgenstr. 24, 22335, Hamburg, Germany
| | - B Schnackenburg
- Clinical Science, Philips Healthcare, Röntgenstr. 24, 22335, Hamburg, Germany
| | - F P Lo Muzio
- Department of Surgery, Dentistry, Paedriatics and Gynaecology, University of Verona, Via S. Francesco 22, 37129, Verona, Italy.,Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - S Perna
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, P.O. Box 32038, Zallaq, Bahrain
| | - B Pieske
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany.,Department of Internal Medicine / Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - E Nagel
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - H Post
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany.,Department of Cardiology, Contilia Heart and Vessel Centre, St. Marien-Hospital Mülheim, Kaiserstraße 50, 45468, Mülheim, Germany
| | - S Kelle
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany
| | - A Alogna
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany. .,Berlin Institute of Health (BIH), Berlin, Germany. .,DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany.
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23
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Vasquez M, Zainal H, Zhou H, Arcari L, Sokalskis V, Vasa-Nicotera M, Zeiher A, Nagel E, Puntmann V. P5277Head to head comparison of MOLLI sequences against hs-troponin in patients with biopsy proven myocarditis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Increase in native T1 mapping values provides insight into presence of disease and its evolution. Despite the surge of evidence, the immediate clinical application of these techniques is complicated by several variants of T1 mapping sequences, whose diagnostic bioequivalence is not known.
Methods
We undertook an intra-individual comparison of two native T1 measurements based on modified Look-Locker (MOLLI) schemes, MOLLI 3(2)3(2)5 (flip angle, FA 50°, T1-FFM) and MOLLI 5(3)3 (FA 35°, T1 Long) in 30 patients with myocarditis proven by left ventricular endomyocardial biopsy. We examined their agreement with high-sensitive troponin T (hs-TnT) levels, as the reference standard for myocyte injury. All patients underwent a routine cardiovascular magnetic resonance (CMR) scan using a 3-Tesla clinical scanner. Native T1 values were estimated using a septal region of interest (ROI) in a single mid ventricular short axis (SAX) slice. Areas of late gadolinium enhancement (LGE) were excluded from ROIs. Venous blood was sampled at the time of the CMR study and hs-TnT analyzed using standardized commercially available test kits. A p value <0.05 was considered statistically significant.
Results
Native T1 by T1-FFM was moderately associated with MOLLI 5(3)3 (FA 35°) (Pearsons r=0.877, p<0.0001), however the Bland Altman analysis showed a poor agreement with a fixed bias of 46ms (p 0.001) and evidence of proportional bias (p 0.008). There was a significant correlation between native T1-FFM and hs-TnT (rho=0,500, p 0.018), whereas T1 Long showed no association (rho=0,374, p 0,086).
Conclusions
Although native T1 by T1 Long showed a moderate correlation with the native T1 FFM in patients with biopsy proven myocarditis, only T1 FFM had a significant correlation with hsTnT suggesting a greater sensitivity for myocardial injury.
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Affiliation(s)
- M Vasquez
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - H Zainal
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - H Zhou
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - L Arcari
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - V Sokalskis
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | | | - A Zeiher
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - E Nagel
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - V Puntmann
- Wolfgang Goethe University, Frankfurt am Main, Germany
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24
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Zainal Abidin HA, Klingel K, Rolf A, Keller T, Zhou H, Vasquez M, Escher F, Lassner D, Vasa-Nicotera M, Zeiher A, Schultheiss P, Nagel E, Puntmann V. 5035Comparative assessment of diagnostic algorithms of myocardial inflammation by endomyocardial biopsy and tissue mapping by CMR against high-sensitive troponin in viral myocarditis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Myocarditis is defined by inflammatory involvement of the myocardium, either histologically by evidence of myocardial necrosis and cellular infiltration on endomyocardial biopsy (EMB), or non-invasively by presence of myocardial oedema using tissue mapping with cardiovascular magnetic resonance (CMR). Objective: to undertake intra-individual comparisons of EMB vs. CMR diagnostic algorithms of myocardial inflammation, as well as against an independent gold-standard of myocardial injury, high-sensitive troponin (hs-TropT).
Methods
Prospective multicentre study of consecutive patients (n=109) with clinical diagnosis of myocarditis. EMBs were analysed by 2 reference centres using the ESC diagnostic and their local algorithms. The CMR criteria used sequence-specific cut-offs for native T1 and T2 (standard deviation, SD); myocardial inflammation T1 ≥2SD, T2 ≥2SD and no inflammation: T1 and T2<2SD, with subcategories for acute/high-grade: T1 ≥5SD, T2 ≥2SD; chronic/low-grade: T1 ≥2SD, T2 ≥2SD; healed: T1 <2SD, T2 <2SD but myocardial impairment and non-inflammatory cardiomyopathy: T1 ≥2SD, T2 <2SD.
Results
The agreement between ESC criteria and CMR criteria (AUC: 0.56, p=0.381) was poor. There was a significant agreement between myocardial injury (hs-TropT ≥13.9 ng/L) and CMR criteria (AUC: 0.84, p<0.001), but not ESC algorithm. hs-TropT levels had significant associations with native T1 and T2 (r=0.37 and 0.35, p<0.001), but not with immunohistochemical inflammatory markers. Viral presence was similarly proportioned between inflammatory/non-inflammatory subjects, irrespective of the algorithm.
AUC of CMR and EMB versus hs-TroponinT
Conclusions
Poor agreement between CMR and EMB-based diagnostic algorithms suggests non-overlapping definitions of myocardial inflammatory involvement. Excellent agreement between CMR algorithm and hs-TropT reiterates its high sensitivity for inflammatory myocardial injury.
Acknowledgement/Funding
1. National Institute for Health Research (NIHR) Biomedical Research Centre 2. German Centre for Cardiovascular Research (DZHK)
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Affiliation(s)
- H A Zainal Abidin
- Department of Cardiology, Universiti Teknologi MARA (UiTM), Sungai Buloh, Malaysia
| | - K Klingel
- Institute for Pathology and Neuropathology, University Hospital Tubingen, Tubingen, Germany
| | - A Rolf
- Department of Cardiology, Kerckhoff Hospital, University Giessen, Bad Nauheim, Germany
| | - T Keller
- Department of Cardiology, Kerckhoff Hospital, University Giessen, Bad Nauheim, Germany
| | - H Zhou
- Department of Radiology, Xiang Ya Hospital, Central South University, Changsha, China
| | - M Vasquez
- Department of Cardiology, Enrique Baltodano Briceno Hospital, Liberia, Costa Rica
| | - F Escher
- Institute of Cardiac Diagnostics and Therapy (IKDT), Berlin, Germany
| | - D Lassner
- Institute of Cardiac Diagnostics and Therapy (IKDT), Berlin, Germany
| | - M Vasa-Nicotera
- Department of Cardiology, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany
| | - A Zeiher
- Department of Cardiology, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany
| | - P Schultheiss
- Institute of Cardiac Diagnostics and Therapy (IKDT), Berlin, Germany
| | - E Nagel
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - V Puntmann
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Frankfurt, Frankfurt am Main, Germany
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25
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Vasquez M, Puntmann V, Nagel E. P5282Comparison of cardiovascular magnetic resonance ejection fraction and left ventricular volumes by long axis feature tracking strain analysis versus standard short axis stack contour tracing. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Cardiovascular magnetic resonance (CMR) feature tracking (FT) is based on the recognition of endocardial features obtained during standard CMR cine imaging to be tracked and followed throughout the cardiac cycle. Global longitudinal strain (GLS) has been proposed as a superior measure for diagnosis and prognosis than ejection fraction (EF). However, EF remains an important primary parameter to describe cardiac function. A rapid determination of GLS based on three long axis views (LAX) allows for a simultaneous calculation of EF without additional imaging or post-processing promising a significant reduction of scan and post-processing time.
Purpose
The purpose of this work is to compare the LV volumes and EF obtained during assessment of GLS based on CMR feature tracking with standard analysis of a short axis (SAX) stack used as the reference standard.
Methods
75 consecutive patients underwent a routine clinical scan obtaining a full SAX stack as well as 3 standard LAX views using either 3-Tesla or 1,5-Tesla clinical scanners. We determined LV volumes and EF based on the reference standard as well as feature tracking analysis with additional GLS. A p value <0.01 was considered statistically significant.
Results
Mean EF was 45.9% using standard SAX (range, 13%-72%) and 51.1% using triplanar feature tracking (r=0.950; p<0.0001, figure 1A). Bland-Altman analysis showed a systematic bias of 5,27%; without proportional bias (figure 1B). End-diastolic volumes (r=0,975; p<0.0001) and end-systolic volumes (r=0.985; p<0.0001) demonstrated similar results. Mean GLS was −17.3% (range: −30,7% to −3,3%) and was significantly correlated with standard EF (r=−0,884; p<0.0001). Classification of EF into categories: reduced, mid-range or preserved (<40%, 40–49%, ≥50%) remain unchanged in 79% of patients when using EF by feature tracking analysis. Twelve of 16 reclassifications occurred in the mid-range category.
Figure 1
Conclusion
There is a good correlation between EF obtained by rapid post-processing of GLS with EF based on a full SAX stack resulting in an identical categorization in 79% of patients. Reduction of EF within the mid-range might be best assesses by the standard SAX stack.
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Affiliation(s)
- M Vasquez
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - V Puntmann
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - E Nagel
- Wolfgang Goethe University, Frankfurt am Main, Germany
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26
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Stokke TM, Sarvari SI, Bjerring AW, Haugaa KH, Elahi MT, Hoedemakers SI, Rademakers F, Monaghan M, Sicari R, Engvall J, Nagel E, Zamorano JL, Ukkonen H, D'hooge J, Edvardsen T. P606High intermodality variability in ejection fraction measured by echocardiography, cardiac magnetic resonance and single photon emission computed tomography in chronic coronary artery disease patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Clinical treatment strategies are often based on measurement of left ventricular ejection fraction (LVEF). There is limited evidence about variations in LVEF when measured by different imaging modalities.
Purpose
To investigate the intermodality variability of LVEF measured by two-dimensional echocardiography (2DE), three-dimensional echocardiography (3DE), cardiac magnetic resonance (CMR), and single photon emission computed tomography (SPECT) in patients with chronic coronary artery disease (CAD).
Methods
Patients from a multicenter study (DOPPLER-CIP – Determining optimal noninvasive parameters for the prediction of left ventricular remodeling in chronic ischemic patients) with chronic CAD were included. LVEF was measured by CMR and at least one additional modality. In each modality, LVEF was measured by a core laboratory independently of the other modalities. Measurements of LVEF by CMR were compared to 2DE, 3DE and SPECT using correlation and Bland-Altman plots.
Results
A total of 343 patients were included. Mean age was 63.9±8.3 years and 253 (74%) were males. Mean LVEF by CMR was 61.8±11.6%. Correlations between CMR LVEF and other modalities were moderate for 2DE and 3DE, and good for SPECT (Figure A-C). CMR had significantly greater correlation to SPECT, compared to 2DE and 3DE. Bland-Altman plots indicated relatively wide limits of agreement between all modalities, ranging from 31% to 42% (Figure, D-F). Mean absolute difference of LVEF between CMR and other modalities were 8.5% for 2DE, 9.0% for 3DE, and 8.3% for SPECT. The percentage of measurements that fell within a range of 5% difference compared to CMR LVEF was 41% for 2DE, 34% for 3DE and 37% for SPECT (all p>0.05).
Conclusions
In a multicenter study with chronic CAD patients, LVEF assessed by CMR had better correlation to SPECT, compared to 2DE and 3DE. However, there was considerable variability among all three modalities that were compared to CMR. Awareness of these variations are important in clinical management.
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Affiliation(s)
- T M Stokke
- Center for Cardiological Innovation, Department of Cardiology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - S I Sarvari
- Center for Cardiological Innovation, Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - A W Bjerring
- Center for Cardiological Innovation, Department of Cardiology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - K H Haugaa
- Center for Cardiological Innovation, Department of Cardiology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - M T Elahi
- KU Leuven, Lab on Cardiovascular Imaging and Dynamics, Leuven, Belgium
| | - S I Hoedemakers
- KU Leuven, Lab on Cardiovascular Imaging and Dynamics, Leuven, Belgium
| | - F Rademakers
- University Hospitals (UZ) Leuven, Department of Cardiovascular Sciences and KU Leuven, Leuven, Belgium
| | - M Monaghan
- Kings College Hospital, Department of Non-invasive Cardiology, London, United Kingdom
| | - R Sicari
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - J Engvall
- Linkoping University, Department of Clinical Physiology and Department of Medical and Health Sciences, Linkoping, Sweden
| | - E Nagel
- University Hospital Frankfurt, Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt am Main, Germany
| | - J L Zamorano
- University Hospital Ramon y Cajal de Madrid, Cardiovascular Imaging Unit, Madrid, Spain
| | - H Ukkonen
- Turku University Hospital, Department of Medicine, Turku, Finland
| | - J D'hooge
- KU Leuven, Lab on Cardiovascular Imaging and Dynamics, Leuven, Belgium
| | - T Edvardsen
- Center for Cardiological Innovation, Department of Cardiology, Oslo University Hospital and University of Oslo, Oslo, Norway
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27
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Morales JC, Mustill AJ, Ribas I, Davies MB, Reiners A, Bauer FF, Kossakowski D, Herrero E, Rodríguez E, López-González MJ, Rodríguez-López C, Béjar VJS, González-Cuesta L, Luque R, Pallé E, Perger M, Baroch D, Johansen A, Klahr H, Mordasini C, Anglada-Escudé G, Caballero JA, Cortés-Contreras M, Dreizler S, Lafarga M, Nagel E, Passegger VM, Reffert S, Rosich A, Schweitzer A, Tal-Or L, Trifonov T, Zechmeister M, Quirrenbach A, Amado PJ, Guenther EW, Hagen HJ, Henning T, Jeffers SV, Kaminski A, Kürster M, Montes D, Seifert W, Abellán FJ, Abril M, Aceituno J, Aceituno FJ, Alonso-Floriano FJ, Ammler-von Eiff M, Antona R, Arroyo-Torres B, Azzaro M, Barrado D, Becerril-Jarque S, Benítez D, Berdiñas ZM, Bergond G, Brinkmöller M, Del Burgo C, Burn R, Calvo-Ortega R, Cano J, Cárdenas MC, Guillén CC, Carro J, Casal E, Casanova V, Casasayas-Barris N, Chaturvedi P, Cifuentes C, Claret A, Colomé J, Czesla S, Díez-Alonso E, Dorda R, Emsenhuber A, Fernández M, Fernández-Martín A, Ferro IM, Fuhrmeister B, Galadí-Enríquez D, Cava IG, Vargas MLG, Garcia-Piquer A, Gesa L, González-Álvarez E, Hernández JIG, González-Peinado R, Guàrdia J, Guijarro A, de Guindos E, Hatzes AP, Hauschildt PH, Hedrosa RP, Hermelo I, Arabi RH, Otero FH, Hintz D, Holgado G, Huber A, Huke P, Johnson EN, de Juan E, Kehr M, Kemmer J, Kim M, Klüter J, Klutsch A, Labarga F, Labiche N, Lalitha S, Lampón M, Lara LM, Launhardt R, Lázaro FJ, Lizon JL, Llamas M, Lodieu N, López Del Fresno M, Salas JFL, López-Santiago J, Madinabeitia HM, Mall U, Mancini L, Mandel H, Marfil E, Molina JAM, Martín EL, Martín-Fernández P, Martín-Ruiz S, Martínez-Rodríguez H, Marvin CJ, Mirabet E, Moya A, Naranjo V, Nelson RP, Nortmann L, Nowak G, Ofir A, Pascual J, Pavlov A, Pedraz S, Medialdea DP, Pérez-Calpena A, Perryman MAC, Rabaza O, Ballesta AR, Rebolo R, Redondo P, Rix HW, Rodler F, Trinidad AR, Sabotta S, Sadegi S, Salz M, Sánchez-Blanco E, Carrasco MAS, Sánchez-López A, Sanz-Forcada J, Sarkis P, Sarmiento LF, Schäfer S, Schlecker M, Schmitt JHMM, Schöfer P, Solano E, Sota A, Stahl O, Stock S, Stuber T, Stürmer J, Suárez JC, Tabernero HM, Tulloch SM, Veredas G, Vico-Linares JI, Vilardell F, Wagner K, Winkler J, Wolthoff V, Yan F, Osorio MRZ. A giant exoplanet orbiting a very-low-mass star challenges planet formation models. Science 2019; 365:1441-1445. [PMID: 31604272 DOI: 10.1126/science.aax3198] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 08/27/2019] [Indexed: 01/03/2023]
Abstract
Surveys have shown that super-Earth and Neptune-mass exoplanets are more frequent than gas giants around low-mass stars, as predicted by the core accretion theory of planet formation. We report the discovery of a giant planet around the very-low-mass star GJ 3512, as determined by optical and near-infrared radial-velocity observations. The planet has a minimum mass of 0.46 Jupiter masses, very high for such a small host star, and an eccentric 204-day orbit. Dynamical models show that the high eccentricity is most likely due to planet-planet interactions. We use simulations to demonstrate that the GJ 3512 planetary system challenges generally accepted formation theories, and that it puts constraints on the planet accretion and migration rates. Disk instabilities may be more efficient in forming planets than previously thought.
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Affiliation(s)
- J C Morales
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain. .,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - A J Mustill
- Lund Observatory, Department of Astronomy and Theoretical Physics, Lund University, Box 43, SE-221 00 Lund, Sweden
| | - I Ribas
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - M B Davies
- Lund Observatory, Department of Astronomy and Theoretical Physics, Lund University, Box 43, SE-221 00 Lund, Sweden
| | - A Reiners
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - F F Bauer
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - D Kossakowski
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - E Herrero
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - E Rodríguez
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - M J López-González
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - C Rodríguez-López
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - V J S Béjar
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - L González-Cuesta
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - R Luque
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - E Pallé
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - M Perger
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - D Baroch
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - A Johansen
- Lund Observatory, Department of Astronomy and Theoretical Physics, Lund University, Box 43, SE-221 00 Lund, Sweden
| | - H Klahr
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - C Mordasini
- Physikalisches Institut, Universität Bern, CH-3012 Bern, Switzerland
| | - G Anglada-Escudé
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,School of Physics and Astronomy, Queen Mary University of London, London E1 4NS, UK
| | - J A Caballero
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - M Cortés-Contreras
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - S Dreizler
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - M Lafarga
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - E Nagel
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - V M Passegger
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - S Reffert
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - A Rosich
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - A Schweitzer
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - L Tal-Or
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany.,Department of Geophysics, Raymond and Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
| | - T Trifonov
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - M Zechmeister
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - A Quirrenbach
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - P J Amado
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - E W Guenther
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - H-J Hagen
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - T Henning
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - S V Jeffers
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - A Kaminski
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - M Kürster
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - D Montes
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - W Seifert
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - F J Abellán
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Departamento de Astronomía y Astrofísica, Universidad de Valencia, E-46100 Burjassot, Spain
| | - M Abril
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - J Aceituno
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - F J Aceituno
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - F J Alonso-Floriano
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Leiden Observatory, Leiden University, 2300 RA Leiden, Netherlands
| | - M Ammler-von Eiff
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany.,Max Planck Institute for Solar System Research, D-37077 Göttingen, Germany
| | - R Antona
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - B Arroyo-Torres
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - M Azzaro
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - D Barrado
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - S Becerril-Jarque
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - D Benítez
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - Z M Berdiñas
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,Departamento de Astronomía, Universidad de Chile, Camino El Observatorio, 1515 Las Condes, Santiago, Chile
| | - G Bergond
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - M Brinkmöller
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - C Del Burgo
- Instituto Nacional de Astrofísica, Óptica y Electrónica, Santa María Tonantzintla, Puebla, Mexico
| | - R Burn
- Physikalisches Institut, Universität Bern, CH-3012 Bern, Switzerland
| | - R Calvo-Ortega
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - J Cano
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - M C Cárdenas
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - C Cardona Guillén
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - J Carro
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - E Casal
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - V Casanova
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - N Casasayas-Barris
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - P Chaturvedi
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - C Cifuentes
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain.,Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - A Claret
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - J Colomé
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - S Czesla
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - E Díez-Alonso
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Departamento de Explotación y Prospeción de Minas, Escuela de Minas, Energía y Materiales, Universidad de Oviedo, E-33003 Oviedo, Asturias, Spain
| | - R Dorda
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain.,Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - A Emsenhuber
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ 85721, USA
| | - M Fernández
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - A Fernández-Martín
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - I M Ferro
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - B Fuhrmeister
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - D Galadí-Enríquez
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - I Gallardo Cava
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Observatorio Astronómico Nacional (OAN-Instituto Geográfico Nacional), E-28803 Alcalá de Henares, Spain
| | | | - A Garcia-Piquer
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - L Gesa
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - E González-Álvarez
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), E-28850 Torrejón de Ardoz, Madrid, Spain
| | - J I González Hernández
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - R González-Peinado
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - J Guàrdia
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - A Guijarro
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - E de Guindos
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - A P Hatzes
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - P H Hauschildt
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - R P Hedrosa
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - I Hermelo
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - R Hernández Arabi
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - F Hernández Otero
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - D Hintz
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - G Holgado
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain.,Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - A Huber
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - P Huke
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - E N Johnson
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - E de Juan
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - M Kehr
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - J Kemmer
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - M Kim
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany.,Institut für Theoretische Physik und Astrophysik, D-24118 Kiel, Germany
| | - J Klüter
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany.,Zentrum für Astronomie der Universität Heidelberg, Astronomisches Rechen-Institut, D-69120 Heidelberg, Germany
| | - A Klutsch
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Institut für Astronomie und Astrophysik, Eberhard Karls Universität, D-72076 Tübingen, Germany
| | - F Labarga
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - N Labiche
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - S Lalitha
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - M Lampón
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - L M Lara
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - R Launhardt
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - F J Lázaro
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - J-L Lizon
- European Organisation for Astronomical Research in the Southern Hemisphere, D-85748 Garching bei München, Germany
| | - M Llamas
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - N Lodieu
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - M López Del Fresno
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - J F López Salas
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - J López-Santiago
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Department of Signal Theory and Communications, Universidad Carlos III de Madrid, E-28911 Leganés, Madrid, Spain.,Gregorio Marañón Health Research Institute, E-28007 Madrid, Spain
| | - H Magán Madinabeitia
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - U Mall
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - L Mancini
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany.,Department of Physics, University of Rome Tor Vergata, I-00133 Roma, Italy.,Istituto Nazionale di Astrofisica-Osservatorio Astrofisico di Torino, I-10025 Pino Torinese, Italy.,International Institute for Advanced Scientific Studies, I-84019 Vietri sul Mare (SA), Italy
| | - H Mandel
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - E Marfil
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - J A Marín Molina
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - E L Martín
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), E-28850 Torrejón de Ardoz, Madrid, Spain
| | - P Martín-Fernández
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - S Martín-Ruiz
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - H Martínez-Rodríguez
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Department of Physics and Astronomy and Pittsburgh Particle Physics, Astrophysics and Cosmology Center, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - C J Marvin
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - E Mirabet
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain.,Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - A Moya
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain.,School of Physics and Astronomy, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.,Stellar Astrophysics Centre, Department of Physics and Astronomy, Aarhus University, DK-8000 Aarhus C, Denmark
| | - V Naranjo
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - R P Nelson
- School of Physics and Astronomy, Queen Mary University of London, London E1 4NS, UK
| | - L Nortmann
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - G Nowak
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - A Ofir
- Department of Earth and Planetary Sciences, Weizmann Institute of Science, Rehovot 76100, Israel
| | - J Pascual
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - A Pavlov
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - S Pedraz
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - D Pérez Medialdea
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | | | - M A C Perryman
- School of Physics, University College Dublin, Belfield Downs, Dublin D14 YH57, Ireland
| | - O Rabaza
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,Dpto. Ingeniería Civil, Universidad de Granada, E-18071 Granada, Spain
| | - A Ramón Ballesta
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - R Rebolo
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - P Redondo
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain
| | - H-W Rix
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - F Rodler
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain.,European Southern Observatory, Vitacura, Casilla 19001, Santiago de Chile
| | - A Rodríguez Trinidad
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - S Sabotta
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - S Sadegi
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany.,Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - M Salz
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | | | - M A Sánchez Carrasco
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - A Sánchez-López
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - J Sanz-Forcada
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - P Sarkis
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - L F Sarmiento
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - S Schäfer
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - M Schlecker
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - J H M M Schmitt
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - P Schöfer
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - E Solano
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - A Sota
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - O Stahl
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - S Stock
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - T Stuber
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - J Stürmer
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany.,Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL 60637, USA
| | - J C Suárez
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,Dpto. Física Teórica y del Cosmos, Universidad de Granada, E-18071 Granada, Spain
| | - H M Tabernero
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), E-28850 Torrejón de Ardoz, Madrid, Spain
| | - S M Tulloch
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, UK
| | - G Veredas
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - J I Vico-Linares
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - F Vilardell
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - K Wagner
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - J Winkler
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - V Wolthoff
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - F Yan
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - M R Zapatero Osorio
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), E-28850 Torrejón de Ardoz, Madrid, Spain
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Zainal Abidin HA, Zhou H, Arcari L, Albrecht M, Arendt C, Vasquez M, Sokalkis V, Puntmann V, Nagel E. 25Standardisation of post processing methods of Native T1: analytical study of multivendor comparisons. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez111.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- H A Zainal Abidin
- Universiti Teknologi MARA, Cardiology Department, Selangor, Malaysia
| | - H Zhou
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - L Arcari
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - M Albrecht
- Department of Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - C Arendt
- Department of Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - M Vasquez
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - V Sokalkis
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - V Puntmann
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - E Nagel
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Frankfurt, Frankfurt am Main, Germany
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29
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Arcari L, Hinojar R, Carr-White G, Zainal H, Zhou H, Vasques M, Rolf A, Hauser I, Vogl TJ, Zehier AM, Volpe M, Nagel E, Puntmann V. 24Excess of myocardial water and fibrosis define myocardial hypertrophy in uremic but not in hypertrophic cardiomyopathy - TrueTypeCKD study. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez111.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L Arcari
- DZHK Centre for Cardiovascular Imaging, Institute of Experimental and Translational Cardiovascular Imaging, Frankfurt am Main, Germany
| | - R Hinojar
- University Hospital Ramon y Cajal de Madrid, Department of Cardiology, Madrid, Spain
| | - G Carr-White
- Guys and St Thomas’ NHS Trust, Department of Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - H Zainal
- DZHK Centre for Cardiovascular Imaging, Institute of Experimental and Translational Cardiovascular Imaging, Frankfurt am Main, Germany
| | - H Zhou
- DZHK Centre for Cardiovascular Imaging, Institute of Experimental and Translational Cardiovascular Imaging, Frankfurt am Main, Germany
| | - M Vasques
- DZHK Centre for Cardiovascular Imaging, Institute of Experimental and Translational Cardiovascular Imaging, Frankfurt am Main, Germany
| | - A Rolf
- Kerckhoff Clinic, Department of Cardiology, Bad Nauheim, Germany
| | - I Hauser
- JW Goethe University, Department of Nephrology, Frankfurt am Main, Germany
| | - T J Vogl
- JW Goethe University, Department of Radiology, Frankfurt am Main, Germany
| | - A M Zehier
- JW Goethe University, Department of Cardiology, Frankfurt am Main, Germany
| | - M Volpe
- Sapienza University of Rome, Cardiology Unit, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Rome, Italy
| | - E Nagel
- DZHK Centre for Cardiovascular Imaging, Institute of Experimental and Translational Cardiovascular Imaging, Frankfurt am Main, Germany
| | - V Puntmann
- DZHK Centre for Cardiovascular Imaging, Institute of Experimental and Translational Cardiovascular Imaging, Frankfurt am Main, Germany
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30
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Zainal Abidin HA, Arendt C, De Leuw P, Zhou H, Arcari L, Nagel E, Puntmann V. 263Tertiary syphillis manifested as myocarditis. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez127.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- H A Zainal Abidin
- Cardiology Unit, Universiti Teknologi MARA Sg. Buloh, Sg. Buloh, Malaysia
| | - C Arendt
- Department of Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - P De Leuw
- Department of Infectious Disease, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - H Zhou
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - L Arcari
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - E Nagel
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - V Puntmann
- Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Frankfurt, Frankfurt am Main, Germany
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31
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Kim RJ, Simonetti OP, Westwood M, Kramer CM, Narang A, Friedrich MG, Powell AJ, Carr JC, Schulz-Menger J, Nagel E, Chan WS, Bremerich J, Ordovas KG, Rollings RC, Patel AR, Ferrari VA. Guidelines for training in cardiovascular magnetic resonance (CMR). J Cardiovasc Magn Reson 2018; 20:57. [PMID: 30111368 PMCID: PMC6094559 DOI: 10.1186/s12968-018-0481-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 07/19/2018] [Indexed: 11/10/2022] Open
Abstract
These "Guidelines for training in Cardiovascular Magnetic Resonance" were developed by the Certification Committee of the Society for Cardiovascular Magnetic Resonance (SCMR) and approved by the SCMR Board of Trustees.
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Affiliation(s)
- R. J. Kim
- Duke University Medical Center, Durham, USA
| | | | | | - C. M. Kramer
- University of Virginia Health System, Charlottesville, USA
| | - A. Narang
- University of Chicago Medicine, Chicago, USA
| | | | | | | | | | - E. Nagel
- Goethe University Frankfurt, Frankfurt, Germany
| | - W. S. Chan
- Queen Mary Hospital, High West, Hong Kong
| | | | - K. G. Ordovas
- University of California San Francisco, San Francisco, USA
| | | | - A. R. Patel
- University of Chicago Medicine, Chicago, USA
| | - V. A. Ferrari
- Hospital of the University of Pennsylvania, Philadelphia, USA
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32
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Pathan F, Zainal Abidin HA, Zhou H, Dangelo T, Elen E, Arendt C, Puntmann V, Nagel E. P5643Vector aligned flow imaging to evaluate diastolic function on cardiac magnetic resonance. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- F Pathan
- Menzies Research Institute, Hobart, Australia
| | - H A Zainal Abidin
- Goethe Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt, Germany
| | - H Zhou
- Goethe Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt, Germany
| | - T Dangelo
- G. Martino University Hospital Messina, Department of Biomedical Sciences and Morphological and Functional Imaging, Messina, Italy
| | - E Elen
- National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - C Arendt
- Goethe Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt, Germany
| | - V Puntmann
- Goethe Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt, Germany
| | - E Nagel
- Goethe Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt, Germany
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33
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Winau L, Pathan F, Heinke R, Haslbauer J, Puntmann V, Nagel E. P5640Global longitudinal and circumferential strain in combination with ejection fraction: an approach to measure cardiac function in ischaemic, dilative and inflammatory disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L Winau
- JW Goethe University, kardiovaskuläre Bildgebung, Frankfurt am Main, Germany
| | - F Pathan
- JW Goethe University, kardiovaskuläre Bildgebung, Frankfurt am Main, Germany
| | - R Heinke
- JW Goethe University, kardiovaskuläre Bildgebung, Frankfurt am Main, Germany
| | - J Haslbauer
- JW Goethe University, kardiovaskuläre Bildgebung, Frankfurt am Main, Germany
| | - V Puntmann
- JW Goethe University, kardiovaskuläre Bildgebung, Frankfurt am Main, Germany
| | - E Nagel
- JW Goethe University, kardiovaskuläre Bildgebung, Frankfurt am Main, Germany
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34
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Pathan F, Zhou H, Zainal Abidin HA, Dangelo T, Elen E, Arendt C, Puntmann V, Nagel E. P3694Rapid two breath hold real time cardiovascular magnetic resonance for assessment of biventricular function. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- F Pathan
- Menzies Research Institute, Hobart, Australia
| | - H Zhou
- Goethe Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt, Germany
| | - H A Zainal Abidin
- Goethe Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt, Germany
| | - T Dangelo
- G. Martino University Hospital Messina, Department of Biomedical Sciences and Morphological and Functional Imaging, Messina, Italy
| | - E Elen
- National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - C Arendt
- Goethe Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt, Germany
| | - V Puntmann
- Goethe Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt, Germany
| | - E Nagel
- Goethe Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt, Germany
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35
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Zhou H, Zainal HA, Arendt C, Pathan F, Wichmann J, Angelo T, Vogl T, Zeiher A, Nagel E, Puntmann V. P3700Comparison of different cardiac magnetic resonance imaging sequences of T1 mapping. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- H Zhou
- JW Goethe University, Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt am Main, Germany
| | - H A Zainal
- JW Goethe University, Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt am Main, Germany
| | - C Arendt
- JW Goethe University, Institute of Diagnostic and Interventional Radiology, Frankfurt am Main, Germany
| | - F Pathan
- JW Goethe University, Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt am Main, Germany
| | - J Wichmann
- JW Goethe University, Institute of Diagnostic and Interventional Radiology, Frankfurt am Main, Germany
| | - T Angelo
- JW Goethe University, Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt am Main, Germany
| | - T Vogl
- JW Goethe University, Institute of Diagnostic and Interventional Radiology, Frankfurt am Main, Germany
| | - A Zeiher
- JW Goethe University, Cardiology, Frankfurt am Main, Germany
| | - E Nagel
- JW Goethe University, Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt am Main, Germany
| | - V Puntmann
- JW Goethe University, Institute for Experimental and Translational Cardiovascular Imaging, Frankfurt am Main, Germany
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36
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Kuchnia AJ, Teigen L, Nagel E, Ligthart-Melis G, Mulasi U, Weijs P, Earthman CP. Protein in the Hospital: Gaining Perspective and Moving Forward. JPEN J Parenter Enteral Nutr 2018; 42:270-278. [PMID: 29356030 DOI: 10.1002/jpen.1068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 11/14/2017] [Indexed: 12/15/2022]
Abstract
Provision of adequate protein is crucial for optimizing outcomes in hospitalized patients. However, the methodologies upon which current recommendations are based have limitations, and little is known about true requirements in any clinical population. In this tutorial, we aim to give clinicians an understanding of how current protein recommendations were developed, an appreciation for the limitations of these recommendations, and an overview of more sophisticated approaches that can be applied to better define protein requirements. A broader perspective of the challenges and opportunities in determining clinical protein requirements can help clinicians think critically about the individualized nutrition care they provide to their patients with the goal of administering adequate protein to optimize outcomes.
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Affiliation(s)
- Adam J Kuchnia
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Levi Teigen
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Emily Nagel
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Gerdien Ligthart-Melis
- Center for Translational Research in Aging & Longevity, Department of Health & Kinesiology, Texas A&M University, College Station, Texas, USA
| | - Urvashi Mulasi
- Department of Family and Consumer Sciences, California State University, Sacramento, California, USA
| | - Peter Weijs
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Carrie P Earthman
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
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37
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Abstract
PURPOSE The study examined the influence of individual blood pressure changes overtime on retinal vessel diameter and the latter's response to flicker light. METHODS The diameter of a retinal arterial and venous segment was measured continuously on-line with a Dynamic Vessel Analyzer in 20 patients twice (mean interval between examinations of 24 months). Eleven patients had no cardiovascular disease. Nine patients had arterial hypertension and were untreated at the time of the first measurement; at the time of the second measurement they were undergoing various antihypertensive therapies. Each test consisted of a 50-s baseline plus three 20-s periods of flicker stimulation followed by an 80-s period of observation. During the examinations the blood pressure was measured at 1-minute intervals. RESULTS In the hypertension group changes in the mean arterial blood pressure (MAP) correlated significantly with changes in the arterial baseline diameter (y = -0.1 - 0.37x, r =0.74, p (increase) <0.03). A comparison of the two measurements showed no such relationship in the group of cardiovascularly healthy subjects. The venous baseline and the arterial and venous flicker response did not change significantly in either group between the two measurements and showed no relationship to blood pressure changes. CONCLUSIONS In hypertensive subjects, long-term therapy-related changes in blood pressure induced a change in the arterial baseline by approximately +3.7 microm/-10 mmHg MAP. An influence of lowering MAP to the arterial flicker response could not be detected.
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Affiliation(s)
- E Nagel
- Technical University, Ilmenau, Germany.
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38
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Abstract
PURPOSE Regulation of ocular blood flow might be impaired in glaucoma patients. We compared the reaction of retinal vessels to a short-term increase of intraocular pressure (IOP), using a retinal vessel analyzer (RVA), in normal volunteers, ocular hypertensive patients (OH) and primary open angle glaucoma patients (POAG). METHODS Ten healthy subjects (56+/-8 years, IOP 13.7+/-1.6 mmHg), 10 OH patients (55+/-12 years, IOD 23.4+/-4.1 mmHg) and 11 POAG patients (60+/-11 years, IOP 23.3+/-1.95 mmHg) were evaluated. Arterial and venous retinal vessel diameter was measured continuously before, during and after raising IOP to suprasystolic values by the suction cup method, described as ocular oscillo-dynamography. RESULTS The change in vessel diameter after the IOP rise differed in its temporal sequence and in absolute values depending on the group examined. In the retinal branch veins the reduction of vessel diameter during the IOP rise was significantly different in POAG (0%+/-6.7) and volunteers (-6.7%+/-8.5; p = 0.06) and in POAG and OH (-6.7%+/-7.0; p = 0.04). At 70-130 sec after IOP increase a dilatation occurred, again differing significantly in POAG (+5.8%+/-3.9) and volunteers (+9.7%+/-4.3; p = 0.03). Systemic blood pressure did not show any significant differences between groups or during the course of the examination. DISCUSSION At short-term rise in IOP leads to less retinal vessel reaction in POAG patients than in volunteers and OH. This might be due to impaired autoregulation to ocular perfusion changes in POAG patients.
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Affiliation(s)
- E Nagel
- Technical University, Ilmenau, Germany.
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39
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Pathan F, Puntmann V, Zhou H, Zainal Abidin H, D’Angelo T, Arendt C, Elen E, Winau L, Marwick T, Nagel E. Real-Time Rapid Two-Breath-Hold Cardiovascular Magnetic Resonance to Image Entire Left and Right Ventricle. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Pathan F, Puntmann V, Zainal Abidin H, Zhou H, Elen E, D’Angelo T, Arendt C, Winau L, Marwick T, Nagel E. Echo Plane Flow Imaging to Evaluate Diastolic Function on Cardiac Magnetic Resonance. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Teigen LM, Kuchnia AJ, Nagel E, Deuth C, Vock DM, Mulasi U, Earthman CP. Impact of Software Selection and ImageJ Tutorial Corrigendum on Skeletal Muscle Measures at the Third Lumbar Vertebra on Computed Tomography Scans in Clinical Populations. JPEN J Parenter Enteral Nutr 2017; 42:933-941. [DOI: 10.1002/jpen.1036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 10/11/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Levi M. Teigen
- Department of Food Science and Nutrition; University of Minnesota-Twin Cities; Minneapolis Minnesota USA
| | - Adam J. Kuchnia
- Department of Food Science and Nutrition; University of Minnesota-Twin Cities; Minneapolis Minnesota USA
| | - Emily Nagel
- Department of Food Science and Nutrition; University of Minnesota-Twin Cities; Minneapolis Minnesota USA
| | - Christopher Deuth
- Department of Food Science and Nutrition; University of Minnesota-Twin Cities; Minneapolis Minnesota USA
| | - David M. Vock
- Division of Biostatistics; University of Minnesota-Twin Cities; Minneapolis Minnesota USA
| | - Urvashi Mulasi
- Department of Family and Consumer Sciences (Nutrition and Food/Dietetics); California State University; Sacramento California USA
| | - Carrie P. Earthman
- Department of Food Science and Nutrition; University of Minnesota-Twin Cities; Minneapolis Minnesota USA
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Nucci AM, Ellsworth K, Michalski A, Nagel E, Wessel J. Survey of Nutrition Management Practices in Centers for Pediatric Intestinal Rehabilitation. Nutr Clin Pract 2017; 33:528-538. [PMID: 28731841 DOI: 10.1177/0884533617719670] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Nutrition management of pediatric intestinal failure (IF) requires interdisciplinary coordination of parenteral nutrition (PN) and enteral nutrition (EN) support. Nutrition strategies used by specialists in pediatric intestinal rehabilitation to promote gut adaptation and manage complications have not been previously summarized. METHODS A practice survey was distributed to members of the dietitian subgroup of the American Society for Parenteral and Enteral Nutrition Pediatric Intestinal Failure Section. The survey included 24 open-ended questions related to PN and enteral feeding strategies, nutrition management of PN-associated liver disease, and laboratory monitoring. RESULTS Dietitians from 14 centers completed the survey. Management components for patients at risk for cholestasis were consistent and included fat minimization, trace element modification, avoiding PN overfeeding, and providing EN. Parenteral amino acid solutions designed for infants/young children are used in patients <1 or 2 years of age. Trace minerals are dosed individually in 10 of 14 centers. Eleven centers prescribe a continuous infusion of breast milk or elemental formula 1-2 weeks after resection while 3 centers determine the formula type by the extent of resection. Most (86%) centers do not have a protocol for initiating oral/motor therapy. Laboratory panel composition varied widely by center. The selection and frequency of use depended on clinical variables, including cholestatic status, exclusive vs partial PN dependence, postrepletion verification vs routine monitoring, intestinal anatomy, and acuity of care. CONCLUSION EN and PN management strategies are relatively consistent among U.S. centers. Collaborative initiatives are necessary to define better practices and establish laboratory monitoring guidelines.
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Affiliation(s)
| | | | - Austin Michalski
- University of Michigan, C.S. Mott Children's Hospital, Grand Rapids, Michigan, USA
| | - Emily Nagel
- Helen DeVos Children's Hospital, Grand Rapids, Michigan, USA
| | - Jackie Wessel
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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Kaiser K, Schorling E, Gumbert L, Lauerer M, Nagel E. Gesundheitsversorgung von Asylsuchenden nach dem Asylbewerberleistungsgesetz: Wahrnehmung und Präferenzen der Bevölkerung. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- K Kaiser
- Universität Bayreuth, Institut für Medizinmanagement und Gesundheitswissenschaften, Bayreuth
| | - E Schorling
- Universität Bayreuth, Institut für Medizinmanagement und Gesundheitswissenschaften, Bayreuth
| | - L Gumbert
- Universität Bayreuth, Institut für Medizinmanagement und Gesundheitswissenschaften, Bayreuth
| | - M Lauerer
- Universität Bayreuth, Institut für Medizinmanagement und Gesundheitswissenschaften, Bayreuth
| | - E Nagel
- Universität Bayreuth, Institut für Medizinmanagement und Gesundheitswissenschaften, Bayreuth
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Winau L, Hinojar R, D'Angelo T, Sangle S, D'Cruz D, Braner A, Schnoes K, Zeiher A, Burhkardt H, Nagel E, Puntmann V. P1330Association between aortic stiffness and myocardial native t1 is stronger in the presence of active myocardial inflammation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Johnson AJ, Matthie JR, Kuchnia A, Teigen LM, Beckman LM, Mager JR, Nicklay SA, Mulasi U, Sibley SD, Nagel E, Earthman CP. Evaluation of Advanced Bioimpedance Spectroscopy Models for Measuring Body Composition in Healthy Adults (NHANES 1999-2004) and Those Undergoing Massive Weight Loss Following Roux-en-Y Gastric Bypass Surgery. BRASPEN J 2017; 32:193-202. [PMID: 31396584 PMCID: PMC6687078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Bioimpedance spectroscopy (BIS) devices utilize biophysical modeling to generate body composition data. The addition of body mass index (BMI) to modified Xitron-Hanai-based mixture equations improved BIS estimates of intracellular water (ICW), particularly at the extremes of BMI. A 3-compartment model for distinguishing excess fluid (ExF) from normally hydrated lean (NHLT) and adipose tissue may further improve BIS estimates. OBJECTIVE We aimed to validate a BIS approach based on the Chamney model for determining fat mass (FM) in healthy individuals (NHANES) and for measuring FM changes in individuals undergoing massive weight loss. METHODS Using adult NHANES 1999-2004 (2821 female, 3063 male) and longitudinal pre-to-post-RYGB (15F) data, we compared dual-energy-X-ray absorptiometry (DXA) and BIS for FM. We applied BIS adiposity-corrected values to Chamney equations for normally hydrated lean and adipose tissue (NHLT, NHAT) and FM. Method agreement was evaluated by correlations, paired t-tests, root mean square error (RMSE), Bland-Altman (B-A) analysis, and concordance correlation coefficients (CCC). RESULTS Method agreement between BIS and DXAFM was good in healthy adults (r=0.96, CCC=0.93, p<.0001), and pre-to-post-RYGB (r=0.93-0.98, CCC=0.81-0.86, p<.001). Although cross-sectional FM measures differed, FM change measures post-RYGB did not (35.6±8.9 vs. 35.2±9.2 kg, BIS vs. DXA) and agreed well (r=0.84, p<.0001). The 15 subjects with follow-up measurements at 1 year lost 11.5±9.8 kg FFM by DXA, but only 1.3±2.5 kg of NHLT by BIS, suggesting that the FFM loss may have been mostly adipose tissue water. CONCLUSIONS Incorporation of the Chamney model into BIS algorithms is a major conceptual advancement for assessing and monitoring body composition. Its ability to differentiate ICW and extracellular water (ECW) in NHLT and NHAT, as well as excess ECW is promising, and would facilitate lean tissue monitoring in obesity and acute/chronic disease.
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Affiliation(s)
- Abigail J. Johnson
- PhD, RD. University of Minnesota-Twin Cities, Department of Food Science and Nutrition, St. Paul, MN, USA
| | | | - Adam Kuchnia
- MS, RD. University of Minnesota-Twin Cities, Department of Food Science and Nutrition, St. Paul, MN, USA
| | - Levi M. Teigen
- RD. University of Minnesota-Twin Cities, Department of Food Science and Nutrition, St. Paul, MN, USA
| | - Lauren M. Beckman
- PhD, RD. University of Minnesota-Twin Cities, Department of Food Science and Nutrition, St. Paul, MN, USA
| | - Jennifer R. Mager
- PhD, RD. University of Minnesota-Twin Cities, Department of Food Science and Nutrition, St. Paul, MN, USA
| | - Sarah A. Nicklay
- MS, RD. University of Minnesota-Twin Cities, Department of Food Science and Nutrition, St. Paul, MN, USA
| | - Urvashi Mulasi
- PhD, RD. University of Minnesota-Twin Cities, Department of Food Science and Nutrition, St. Paul, MN, USA
| | - Shalamar D. Sibley
- MD, MPH. University of Minnesota-Twin Cities, Department of Medicine, Minneapolis, MN, USA
| | - Emily Nagel
- MS, RD. University of Minnesota-Twin Cities, Department of Food Science and Nutrition, St. Paul, MN, USA
| | - Carrie P. Earthman
- PhD, RD. University of Minnesota-Twin Cities, Department of Food Science and Nutrition, St. Paul, MN, USA
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Dao Van M, Lauerer M, Nagel E. Präferenzen der Bevölkerung bei der Organallokation – Ein Discrete Choice Experiment zur Analyse des Spannungsfeldes von Dringlichkeit und Erfolgsaussicht. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1586650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Nagel E, Sahr F, Jarrett O. Impact of Ebola on loss to follow-up of HIV-infected soldiers and their
dependents in Sierra Leone. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Dao Van M, Lauerer M, Schätzlein V, Nagel E. [The Trade-Off between Chance of Success and Urgency in Organ Allocation: A Discrete Choice Experiment to Elicit Public Preferences]. Gesundheitswesen 2016; 78:454-9. [PMID: 27438162 DOI: 10.1055/s-0042-107668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE According to the German Organ Transplantation Act, donor organs must be allocated with particular regard to chance of success and urgency. However, the objectives of these guiding criteria - the efficient use of available organs and meeting the most urgent need - are in conflict with each other, as success rate of transplantation (TX) ordinarily diminishes when urgency increases. Current allocation guidelines balance these criteria differently depending on the organ. This is only justified in part by medical reasons. Thus, further considerations are essential to develop consistent allocation rules. Therefore, a discussion on the stated trade-off considering the far-reaching consequences of such allocation decisions is indispensable. This also implies taking account of public preferences. METHODS In this pilot study, preferences of 250 participants were assessed using a Discrete Choice Experiment. Choice-sets for the allocation of a donor organ included 2 patients, who were characterized by 3 success- and 2 urgency-based attributes. Data analysis was performed by Counting Analysis and Hierarchical Bayes estimation as well as Student's t-tests for subgroup analysis. RESULTS All attributes influenced allocation decisions significantly (p≤0.01). Both, patients with greater chance of success and higher urgency were preferred. As a whole, chance of success and urgency were equally important for the allocation of organs (53 and 47%, respectively). The importance of the success- and urgency-based criteria was quantified as follows: The post-TX 5-year probability of survival was weighted with 31%, the expected post-TX quality of life and the surgery survival rate with 11% each, the pre-TX 3-month mortality with 35% and the pre-TX quality of life with 12%. Subgroup analysis revealed significant differences. CONCLUSION The pilot study was successful in analyzing the balance of the guiding criteria chance of success and urgency without referring to a specific kind of organ. This type of results allows comparing current allocation rules and public preferences. These results could help decision makers to take into account public preferences developing organ-specific guidelines. A stronger involvement of citizens in decision making could gain confidence in transplantation medicine, increase the willingness to donate and potentially counteract the scarcity of organs and thereby the tragedy of the distributional conflict. Therefore the continuation of this project is advisable.
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Affiliation(s)
- M Dao Van
- Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Bayreuth
| | - M Lauerer
- Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Bayreuth
| | - V Schätzlein
- Institut für Sportwissenschaft und Sport, FAU Erlangen-Nürnberg, Erlangen
| | - E Nagel
- Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Bayreuth
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Giusca S, Kelle S, Nagel E, Buss S, Voss A, Puntmann V, Fleck E, Katus H, Korosoglou G. Differences in the prognostic relevance of myocardial ischaemia and scar by cardiac magnetic resonance in patients with and without diabetes mellitus. Eur Heart J Cardiovasc Imaging 2016; 17:812-820. [DOI: 10.1093/ehjci/jev220] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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50
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Klemm M, Dietzel A, Nagel E, Schweitzer D. Repeatability of wide-field autofluorescence lifetime imaging at the human retina in healthy volunteers. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M. Klemm
- Biomedical Engineering Group; Technische Universität Ilmenau; Ilmenau Germany
| | - A. Dietzel
- Biomedical Engineering Group; Technische Universität Ilmenau; Ilmenau Germany
| | - E. Nagel
- Biomedical Engineering Group; Technische Universität Ilmenau; Ilmenau Germany
| | - D. Schweitzer
- Experimental Ophthalmology; University of Jena; Jena Germany
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