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Reissmann B, Wenzel JP, Lemoine MD, Rottner L, My I, Moser F, Obergassel J, Nies M, Rieß J, Ismaili D, Nikorowitsch J, Kirchhof P, Rillig A, Metzner A, Ouyang F. Reply to the Editor- Anterior mitral line and pulsed field ablation: Different energy source, similar results? Heart Rhythm 2024:S1547-5271(24)00358-8. [PMID: 38521383 DOI: 10.1016/j.hrthm.2024.03.045] [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] [Received: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 03/25/2024]
Affiliation(s)
- Bruno Reissmann
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany.
| | - Jan-Per Wenzel
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Marc D Lemoine
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Laura Rottner
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Ilaria My
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Fabian Moser
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Julius Obergassel
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Moritz Nies
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Jan Rieß
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Djemail Ismaili
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Julius Nikorowitsch
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Paulus Kirchhof
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany; Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Andreas Rillig
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Andreas Metzner
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Feifan Ouyang
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Wenzel JP, Lemoine MD, Rottner L, My I, Moser F, Obergassel J, Nies M, Rieß J, Ismaili D, Nikorowitsch J, Ouyang F, Kirchhof P, Rillig A, Metzner A, Reissmann B. Repeat pulmonary vein isolation and anterior line ablation using a novel point-by-point pulsed-field ablation system. Heart Rhythm 2024; 21:250-257. [PMID: 38036235 DOI: 10.1016/j.hrthm.2023.11.021] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/16/2023] [Accepted: 11/24/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Pulsed-field ablation (PFA) is a nonthermal energy source for ablation of cardiac arrhythmias. This study investigated the prospective outcomes of a novel PFA generator in conjunction with a commercially available, contact force-sensing, focal ablation catheter. OBJECTIVE The purpose of this study was to assess the feasibility, safety, and lesion characteristics of point-by-point PFA in consecutive patients undergoing repeat ablation of atrial fibrillation (AF). METHODS The study involved reisolation of pulmonary veins (PVs) with electrical reconnection and the creation of an anterior line (AL) in patients with anterior substrate or durable pulmonary vein isolation (PVI). RESULTS In 24 patients (46% female; mean age 67 ± 10 years; 67% persistent AF), successful reisolation of 27 of 27 reconnected PVs (100%) was performed. In 19 patients, AL ablation was performed, with bidirectional block in 16 (84%), median ablation time 26 [21, 33] minutes, and first-pass bidirectional block in 13 patients (68%). Acute AL reconduction occurred in 8 of 19 patients (42%). Among these 8 patients, a subsequent sustained block of the AL was achieved in 5 (63%). Ultra-high-density electroanatomic mapping revealed homogeneous but relatively large low-voltage areas in the ablated regions. Median procedural, left atrial dwell, and fluoroscopy times were 100 [90, 109] minutes, 83 [75, 98] minutes, and 10 [8, 13] minutes, respectively. No major or minor complications occurred. CONCLUSION This study demonstrated feasibility, acute efficacy, and safety of point-by-point PFA for repeat PVI and AL ablation. Further studies are warranted to assess the long-term durability and comparison with established ablation methods.
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Affiliation(s)
- Jan-Per Wenzel
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Marc D Lemoine
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Laura Rottner
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Ilaria My
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Fabian Moser
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Julius Obergassel
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Moritz Nies
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Jan Rieß
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Djemail Ismaili
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Julius Nikorowitsch
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Feifan Ouyang
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Paulus Kirchhof
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany; Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Andreas Rillig
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Andreas Metzner
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Bruno Reissmann
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany.
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Nikorowitsch J, Bei der Kellen R, Haack A, Magnussen C, Prochaska J, Wild PS, Dörr M, Twerenbold R, Schnabel RB, Kirchhof P, Blankenberg S, Markus MRP, Wenzel JP. Correlation of systolic and diastolic blood pressure with echocardiographic phenotypes of cardiac structure and function from three German population-based studies. Sci Rep 2023; 13:14525. [PMID: 37666935 PMCID: PMC10477248 DOI: 10.1038/s41598-023-41571-x] [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: 05/02/2023] [Accepted: 08/29/2023] [Indexed: 09/06/2023] Open
Abstract
Arterial hypertension is considered a risk factor for the development of heart failure. Here we investigate cross-sectional associations of systolic and diastolic blood pressure with subtle functional and morphological changes of left ventricular echocardiographic parameters representing early dysfunction in three representative German population-based studies. We assessed 26,719 individuals without symptomatic heart failure from the Hamburg City Health Study (HCHS, n = 7396, derivation cohort), the Gutenberg Health Study (GHS, 14,715, validation cohort) and the Study of Health in Pomerania (SHIP, 4608, validation cohort). Multivariable linear regression analyses with systolic and diastolic blood pressure as continuous exposure variables were adjusted for common cardiovascular risk factors and antihypertensive medication. Both systolic and diastolic blood pressure were consistently associated with measures of left ventricular hypertrophy (β per standard deviation (SD) for LV mass (g) and systolic blood pressure: 5.09 (p < 0.001); diastolic blood pressure: 2.29 (p < 0.001) in HCHS). Systolic blood pressure correlated with declining diastolic function (β per SD for E/e': 0.29, p < 0.001 in HCHS) and diastolic blood pressure with declining systolic function (β per SD for LVEF, in %: - 0.15; p = 0.041 in HCHS) in all cohorts. Pending further validation, our results from three independent German population samples suggest differential effects of systolic versus diastolic blood pressure on left ventricular structure and function.
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Affiliation(s)
- Julius Nikorowitsch
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany.
| | | | - Alena Haack
- Epidemiological Study Center, Hamburg, Germany
| | - Christina Magnussen
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Jürgen Prochaska
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Germany
| | - Marcus Dörr
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Raphael Twerenbold
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Epidemiological Study Center, Hamburg, Germany
- Center for Population Health Innovation (POINT Institute), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Renate B Schnabel
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Epidemiological Study Center, Hamburg, Germany
| | - Paulus Kirchhof
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Stefan Blankenberg
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Epidemiological Study Center, Hamburg, Germany
- Center for Population Health Innovation (POINT Institute), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Cardio-CARE, Medizincampus Davos, Davos, Switzerland
| | - Marcello Ricardo Paulista Markus
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- German Center for Diabetes Research (DZD), Partner Site Greifswald, Greifswald, Germany
| | - Jan-Per Wenzel
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Epidemiological Study Center, Hamburg, Germany
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My I, Lemoine MD, Butt M, Mencke C, Loeck FW, Obergassel J, Rottner L, Wenzel JP, Schleberger R, Moser J, Moser F, Kirchhof P, Reissmann B, Ouyang F, Rillig A, Metzner A. Acute lesion extension following pulmonary vein isolation with two novel single shot devices: Pulsed field ablation versus multielectrode radiofrequency balloon. J Cardiovasc Electrophysiol 2023; 34:1802-1807. [PMID: 37473404 DOI: 10.1111/jce.16001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/12/2023] [Accepted: 07/02/2023] [Indexed: 07/22/2023]
Abstract
INTRODUCTION Pulsed-field ablation (PFA) and the multielectrode radiofrequency balloon (RFB) are two novel ablation technologies to perform pulmonary vein isolation (PVI). It is currently unknown whether these technologies differ in lesion formation and lesion extent. We compared the acute lesion extent after PVI induced by PFA and RFB by measuring low-voltage area in high-density maps and the release of biomolecules reflecting cardiac injury. METHODS PVI was performed with a pentaspline catheter (FARAPULSE) applying PFA or with the compliant multielectrode RFB (HELIOSTAR). Before and after PVI high-density mapping with CARTO 3 was performed. In addition, blood samples were taken before transseptal puncture and after post-PVI remapping and serum concentrations of high-sensitive Troponin I were quantified by immunoassay. RESULTS Sixty patients undergoing PVI by PFA (n = 28, age 69 ± 12 year, 60% males, 39.3% persistent atrial fibrillation [AF]) or RFB (n = 32, age 65 ± 13 year, 53% males, 21.9% persistent AF) were evaluated. Acute PVI was achieved in all patients in both groups. Mean number of PFA pulses was 34.2 ± 4.5 and mean number RFB applications was 8.5 ± 3 per patient. Total posterior ablation area was significantly larger in PFA (20.7 ± 7.7 cm²) than in RFB (7.1 ± 2.09 cm²; p < .001). Accordingly, posterior ablation area for each PV resulted in larger lesions after PFA versus RFB (LSPV 5.2 ± 2.7 vs. 1.9 ± 0.8 cm², LIPV 5.5 ± 2.3 vs. 1.9 ± 0.8 cm², RSPV 4.7 ± 1.9 vs. 1.6 ± 0.5 cm², RIPV 5.3 ± 2.1 vs. 1.6 ± 0.7 cm,² respectively; p < .001). In a subset of 38 patients, increase of hsTropI was higher after PFA (625 ± 138 pg/mL, n = 28) versus RFB (148 ± 36 pg/mL, n = 10; p = .049) supporting the evidence of larger lesion extent by PFA. CONCLUSION PFA delivers larger acute lesion areas and higher troponin release upon successful PVI than multielectrode RFB-based PVI in this single-center series.
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Affiliation(s)
- Ilaria My
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Marc D Lemoine
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Mahi Butt
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Celine Mencke
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Fabian W Loeck
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Julius Obergassel
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Laura Rottner
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Jan-Per Wenzel
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Ruben Schleberger
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Julia Moser
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Fabian Moser
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Paulus Kirchhof
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Bruno Reissmann
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Feifan Ouyang
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Andreas Rillig
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Andreas Metzner
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
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Wenzel JP, Lemoine MD, Rottner L, My I, Moser F, Obergassel J, Nies M, Rieß J, Ismaili D, Nikorowitsch J, Ouyang F, Kirchhof P, Rillig A, Metzner A, Reissmann B. Nonthermal Point-by-Point Pulmonary Vein Isolation Using a Novel Pulsed Field Ablation System. Circ Arrhythm Electrophysiol 2023; 16:e012093. [PMID: 37638409 DOI: 10.1161/circep.123.012093] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Affiliation(s)
- Jan-Per Wenzel
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., F.O., P.K., A.R., A.M., B.R.)
- German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Luebeck, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., P.K., A.R., A.M., B.R.)
| | - Marc D Lemoine
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., F.O., P.K., A.R., A.M., B.R.)
- German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Luebeck, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., P.K., A.R., A.M., B.R.)
| | - Laura Rottner
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., F.O., P.K., A.R., A.M., B.R.)
- German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Luebeck, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., P.K., A.R., A.M., B.R.)
| | - Ilaria My
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., F.O., P.K., A.R., A.M., B.R.)
- German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Luebeck, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., P.K., A.R., A.M., B.R.)
| | - Fabian Moser
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., F.O., P.K., A.R., A.M., B.R.)
- German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Luebeck, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., P.K., A.R., A.M., B.R.)
| | - Julius Obergassel
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., F.O., P.K., A.R., A.M., B.R.)
- German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Luebeck, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., P.K., A.R., A.M., B.R.)
| | - Moritz Nies
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., F.O., P.K., A.R., A.M., B.R.)
- German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Luebeck, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., P.K., A.R., A.M., B.R.)
| | - Jan Rieß
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., F.O., P.K., A.R., A.M., B.R.)
- German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Luebeck, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., P.K., A.R., A.M., B.R.)
| | - Djemail Ismaili
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., F.O., P.K., A.R., A.M., B.R.)
- German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Luebeck, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., P.K., A.R., A.M., B.R.)
| | - Julius Nikorowitsch
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., F.O., P.K., A.R., A.M., B.R.)
- German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Luebeck, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., P.K., A.R., A.M., B.R.)
| | - Feifan Ouyang
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., F.O., P.K., A.R., A.M., B.R.)
| | - Paulus Kirchhof
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., F.O., P.K., A.R., A.M., B.R.)
- German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Luebeck, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., P.K., A.R., A.M., B.R.)
- Institute of Cardiovascular Sciences, University of Birmingham, United Kingdom (P.K.)
| | - Andreas Rillig
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., F.O., P.K., A.R., A.M., B.R.)
- German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Luebeck, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., P.K., A.R., A.M., B.R.)
| | - Andreas Metzner
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., F.O., P.K., A.R., A.M., B.R.)
- German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Luebeck, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., P.K., A.R., A.M., B.R.)
| | - Bruno Reissmann
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., F.O., P.K., A.R., A.M., B.R.)
- German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Luebeck, Germany (J.-P.W., M.D.L., L.R., I.M., F.M., J.O., M.N., J.R., D.I., J.N., P.K., A.R., A.M., B.R.)
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6
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My I, Bordignon S, Butt M, Rottner L, Marc L, Moser F, Wenzel JP, Obergassel J, Schleberger R, Moser J, Dinshaw L, Kirchhof P, Reissmann B, Ouyang F, Chun KRJ, Schmidt B, Rillig A, Metzner A. Novel Radiofrequency Balloon Catheter - Impact of Ablation Parameters on Single-Shot Isolation. Circ J 2023:CJ-23-0220. [PMID: 37286488 DOI: 10.1253/circj.cj-23-0220] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Indexed: 06/09/2023]
Abstract
BACKGROUND A novel multielectrode radiofrequency balloon (RFB) catheter has been released for pulmonary vein isolation (PVI).Methods and Results: In this observational study consecutive patients with drug-refractory paroxysmal or persistent atrial fibrillation (AF) undergoing first-time PVI were enrolled in 2 high-volume ablation centers. All procedures were conducted in conjunction with a 3D-mapping system. Clinical, procedural and ablation parameters were systematically analyzed. 105 patients (58% male; 52% paroxysmal AF, 68±11.3 years mean age, left atrial volume index 38.6±14.8 mL/m2) were included. 241/412 (58.5%) PVs were successfully isolated with a single shot (SS), with a time-to-isolation of 11.6±8 s. Total number of radiofrequency applications was 892 (mean 2.2/PV), resulting in successful isolation of 408/412 (99%) PVs at the end of the procedure. Mean electrodes' impedance drop was significantly higher in the SS-PVI compared with non-SS applications (21.5±6.6 vs. 18.6±6.5 Ohm). Concordantly, higher temperature rise was observed in the SS vs. non-SS applications (10.9±4.9℃ vs. 9.6±4.7℃). CONCLUSIONS In this multicenter real-world study, mean impedance drop and temperature rise were associated with successful SS-PVI applying the novel RFB catheter. These parameters may help to guide efficient usage of the new RF balloon.
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Affiliation(s)
- Ilaria My
- Department of Cardiology, University Heart and Vascular Center Hamburg
| | | | - Mahi Butt
- Department of Cardiology, University Heart and Vascular Center Hamburg
| | - Laura Rottner
- Department of Cardiology, University Heart and Vascular Center Hamburg
| | - Lemoine Marc
- Department of Cardiology, University Heart and Vascular Center Hamburg
| | - Fabian Moser
- Department of Cardiology, University Heart and Vascular Center Hamburg
| | - Jan-Per Wenzel
- Department of Cardiology, University Heart and Vascular Center Hamburg
| | - Julius Obergassel
- Department of Cardiology, University Heart and Vascular Center Hamburg
| | - Ruben Schleberger
- Department of Cardiology, University Heart and Vascular Center Hamburg
| | - Julia Moser
- Department of Cardiology, University Heart and Vascular Center Hamburg
| | - Leon Dinshaw
- Department of Cardiology, University Heart and Vascular Center Hamburg
| | - Paulus Kirchhof
- Department of Cardiology, University Heart and Vascular Center Hamburg
- Institute of Cardiovascular Sciences, University of Birmingham
| | - Bruno Reissmann
- Department of Cardiology, University Heart and Vascular Center Hamburg
| | - Feifan Ouyang
- Department of Cardiology, University Heart and Vascular Center Hamburg
| | | | - Boris Schmidt
- Cardioangiologisches Centrum Bethanien
- Med. Klinik 3, Kardiologie, Universitätsklinikum Frankfurt
| | - Andreas Rillig
- Department of Cardiology, University Heart and Vascular Center Hamburg
| | - Andreas Metzner
- Department of Cardiology, University Heart and Vascular Center Hamburg
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7
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Senftinger J, Nikorowitsch J, Borof K, Ojeda F, Aarabi G, Beikler T, Mayer C, Behrendt CA, Walther C, Zyriax BC, Twerenbold R, Blankenberg S, Wenzel JP. Coffee consumption and associations with blood pressure, LDL-cholesterol and echocardiographic measures in the general population. Sci Rep 2023; 13:4668. [PMID: 36949243 PMCID: PMC10033706 DOI: 10.1038/s41598-023-31857-5] [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] [Received: 12/15/2022] [Accepted: 03/18/2023] [Indexed: 03/24/2023] Open
Abstract
Coffee, next to water the most widespread beverage, is attributed both harmful and protective characteristics concerning cardiovascular health. This study aimed to evaluate associations of coffee consumption with cardiac biomarkers, echocardiographic, electrocardiographic parameters and major cardiovascular diseases. We performed a cross-sectional analysis of 9009 participants of the population-based Hamburg City Health Study (HCHS), enrolled between 2016 and 2018 median age 63 [IQR: 55; 69] years. Coffee consumption was classified into three groups: < 3 cups/day (low), 3-4 cups/day (moderate), > 4 cups/day (high). In linear regression analyses adjusted for age, sex, body mass index, diabetes, hypertension, smoking, and additives, high coffee consumption correlated with higher LDL-cholesterol (β = 5.92; 95% CI 2.95, 8.89; p < 0.001). Moderate and high coffee consumption correlated with lower systolic (β = - 1.91; 95% CI - 3.04, - 0.78; p = 0.001; high: β = - 3.06; 95% CI - 4.69, - 1.44; p < 0.001) and diastolic blood pressure (β = - 1.05; 95% CI - 1.67, - 0.43; p = 0.001; high: β = - 1.85; 95% CI - 2.74, - 0.96; p < 0.001). Different levels of coffee consumption did neither correlate with any investigated electrocardiographic or echocardiographic parameter nor with prevalent major cardiovascular diseases, including prior myocardial infarction and heart failure. In this cross-sectional analysis, high coffee consumption correlated with raised LDL-cholesterol levels and lower systolic and diastolic blood pressure. However, major cardiovascular diseases including heart failure and its diagnostic precursors were not associated with coffee consumption, connoting a neutral role of coffee in the context of cardiovascular health.
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Affiliation(s)
- Juliana Senftinger
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julius Nikorowitsch
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Katrin Borof
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Epidemiological Study Center, Hamburg, Germany
| | - Francisco Ojeda
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, Hamburg, Germany
| | - Carola Mayer
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian-Alexander Behrendt
- Department of Vascular Medicine, German Aortic Center Hamburg, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carolin Walther
- Department of Periodontics, Preventive and Restorative Dentistry, Hamburg, Germany
| | - Birgit-Christiane Zyriax
- Midwifery Science - Health Care Research and Prevention, Institute for Health Services in Dermatology and Nursing (IVDP), Hamburg, Germany
| | - Raphael Twerenbold
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Epidemiological Study Center, Hamburg, Germany
- University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Blankenberg
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Jan-Per Wenzel
- Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Epidemiological Study Center, Hamburg, Germany.
- University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany.
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8
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Lemoine MD, Mencke C, Nies M, Obergassel J, Scherschel K, Wieboldt H, Schleberger R, My I, Rottner L, Moser J, Kany S, Wenzel JP, Moser F, Dinshaw L, Münkler P, Reissmann B, Ouyang F, Meyer C, Blankenberg S, Zeller T, Fabritz L, Rillig A, Metzner A, Kirchhof P. Pulmonary Vein Isolation by Pulsed-field Ablation Induces Less Neurocardiac Damage Than Cryoballoon Ablation. Circ Arrhythm Electrophysiol 2023; 16:e011598. [PMID: 36938715 DOI: 10.1161/circep.122.011598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Affiliation(s)
- Marc D Lemoine
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf. (M.D.L., C. Mencke, M.N., J.O., H.W., R.S., I.M.).,DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Celine Mencke
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf. (M.D.L., C. Mencke, M.N., J.O., H.W., R.S., I.M.).,DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Moritz Nies
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf. (M.D.L., C. Mencke, M.N., J.O., H.W., R.S., I.M.).,DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Julius Obergassel
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf. (M.D.L., C. Mencke, M.N., J.O., H.W., R.S., I.M.).,DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Katharina Scherschel
- Division of Cardiology/Angiology/Intensive Care, EVK Düsseldorf, cNEP, Cardiac Neuro- and Electrophysiology Research Consortium & Institute for Neural and Sensory Physiology, Medical Faculty, Heinrich Heine Univ Düsseldorf, Germany (K.S., C. Meyer)
| | - Hartwig Wieboldt
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf. (M.D.L., C. Mencke, M.N., J.O., H.W., R.S., I.M.).,University Center of Cardiovascular Sciences, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf. (H.W., T.Z., L.F.)
| | - Ruben Schleberger
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf. (M.D.L., C. Mencke, M.N., J.O., H.W., R.S., I.M.).,DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Ilaria My
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf. (M.D.L., C. Mencke, M.N., J.O., H.W., R.S., I.M.).,DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Laura Rottner
- DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Julia Moser
- DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Shinwan Kany
- DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Jan-Per Wenzel
- DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Fabian Moser
- DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Leon Dinshaw
- DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Paula Münkler
- DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Bruno Reissmann
- DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Feifan Ouyang
- DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Christian Meyer
- Division of Cardiology/Angiology/Intensive Care, EVK Düsseldorf, cNEP, Cardiac Neuro- and Electrophysiology Research Consortium & Institute for Neural and Sensory Physiology, Medical Faculty, Heinrich Heine Univ Düsseldorf, Germany (K.S., C. Meyer)
| | - Stefan Blankenberg
- DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Tanja Zeller
- University Center of Cardiovascular Sciences, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf. (H.W., T.Z., L.F.).,DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Larissa Fabritz
- University Center of Cardiovascular Sciences, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf. (H.W., T.Z., L.F.).,DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.).,Institute of Cardiovascular Sciences, University of Birmingham, United Kingdom (L.F., P.K.)
| | - Andreas Rillig
- DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Andreas Metzner
- DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.)
| | - Paulus Kirchhof
- DZHK, partner Site Hamburg/Kiel/Lübeck (M.D.L., C. Mencke, M.N., J.O., R.S., I.M., L.R., J.M., S.K., J.-P.W., F.M., L.D., P.M., B.R., F.O., S.B., T.Z., L.F., A.R., A.M., P.K.).,Institute of Cardiovascular Sciences, University of Birmingham, United Kingdom (L.F., P.K.)
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9
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Rottner L, Obergassel J, Borof K, My I, Moser F, Lemoine M, Wenzel JP, Kirchhof P, Ouyang F, Reissmann B, Metzner A, Rillig A. A novel saline-based occlusion tool allows for dye-less cryoballoon-based pulmonary vein isolation and fluoroscopy reduction. Front Cardiovasc Med 2023; 10:1156500. [PMID: 37034336 PMCID: PMC10080139 DOI: 10.3389/fcvm.2023.1156500] [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: 02/01/2023] [Accepted: 03/07/2023] [Indexed: 04/11/2023] Open
Abstract
Background Cryoballoon (CB)- based pulmonary vein isolation (PVI) remains guided by fluoroscopy and dye. The novel saline injection-based occlusion tool allows for pulmonary vein (PV)-occlusion assessment without the need for dye injection. Aim To compare KODEX-EPD guided CB-PVI using the novel saline injection-based workflow with conventional cryoablation for acute efficacy, fluoroscopy exposure and dye volume. Methods Consecutive atrial fibrillation (AF)- patients undergoing CB-PVI in conjunction with KODEX-EPD (CryoEPD group) were analyzed. Patients undergoing conventional CB-PVI (Cryo group) in the same time period acted as controls. Results One hundred forty patients [91/140 (65%) persistent AF] were studied. Seventy patients underwent CryoEPD procedures [64 ± 13 years, 21 (30%) female] and seventy patients underwent Cryo procedures [68 ± 10 years, 27 (39%) female].A total of 560 PVs were identified and successfully isolated. Mean procedure time was 66 ± 15 min for the CryoEPD group, and 65 ± 19 min for the Cryo group (p = 0.3). Fluoroscopy time (CryoEPD 6 ± 4 min; Cryo 13 ± 6 min, p < 0.001) and dose area product (CryoEPD 193 [111; 297] cGycm2; Cryo 381 [268; 614] cGycm2, p < 0.001) were lower in patients undergoing CryoEPD compared with Cryo procedures. No dye was needed in the CryoEPD group while 53 ± 18 ml dye per patient were administered for the Cryo group (p < 0.001). The overall complication rate was comparable between both groups (p = 0.5). Conclusion KODEX-EPD guided AF-ablation enables dye-free CB-based PVI with reduced fluoroscopy exposure when compared to conventional CB-ablation, without differences in acute procedural outcomes or procedure duration.
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Affiliation(s)
- Laura Rottner
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
- Correspondence: Laura Rottner
| | - Julius Obergassel
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Katrin Borof
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Ilaria My
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Fabian Moser
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Marc Lemoine
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Jan-Per Wenzel
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Paulus Kirchhof
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Feifan Ouyang
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Bruno Reissmann
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Andreas Metzner
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Andreas Rillig
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
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10
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Fluschnik N, Tahir E, Erley J, Müllerleile K, Metzner A, Wenzel JP, Guerreiro H, Adam G, Blankenberg S, Kirchhof P, Tönnis T, Nikorowitsch J. 3 Tesla magnetic resonance imaging in patients with cardiac implantable electronic devices: a single centre experience. Europace 2022; 25:571-577. [PMID: 36413601 PMCID: PMC9935018 DOI: 10.1093/europace/euac213] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 11/01/2022] [Indexed: 11/23/2022] Open
Abstract
AIMS Three Tesla (T) magnetic resonance imaging (MRI) provides critical imaging information for many conditions. Owing to potential interactions of the magnetic field, it is largely withheld from patients with cardiac implantable electronic devices (CIEDs). Therefore, we assessed the safety of 3T MRI in patients with '3T MRI-conditional' and 'non-3T MRI-conditional' CIEDs. METHODS AND RESULTS We performed a retrospective single-centre analysis of clinically indicated 3T MRI examinations in patients with conventional pacemakers, cardiac resynchronization devices, and implanted defibrillators from April 2020 to May 2022. All CIEDs were interrogated and programmed before and after scanning. Adverse events included all-cause death, arrhythmias, loss of capture, inappropriate anti-tachycardia therapies, electrical reset, and lead or generator failure during or shortly after MRI. Changes in signal amplitude and lead impedance were systematically assessed. Statistics included median and interquartile range. A total of 132 MRI examinations were performed on a 3T scanner in 97 patients. Thirty-five examinations were performed in patients with 'non-3T MRI-conditional' CIEDs. Twenty-six scans were performed in pacemaker-dependent patients. No adverse events occurred during or shortly after MRI. P-wave or R-wave reductions ≥ 50 and ≥ 25%, respectively, were noted after three (2.3%) scans, all in patients with '3T MRI-conditional' CIEDs. Pacing and shock impedance changed by ± 30% in one case (0.7%). Battery voltage and stimulation thresholds did not relevantly change after MRI. CONCLUSION Pending verification in independent series, our data suggest that clinically indicated MRI scans at 3T field strength should not be withheld from patients with cardiac pacemakers or defibrillators.
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Affiliation(s)
- Nina Fluschnik
- Corresponding author. Phone: +49 (0) 40 7410 18576, Fax: +49 (0) 40 7410 58206, E-mail address:
| | - Enver Tahir
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr 52, 20251 Hamburg, Germany
| | - Jennifer Erley
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr 52, 20251 Hamburg, Germany
| | - Kai Müllerleile
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20251 Hamburg, Germany
| | - Andreas Metzner
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20251 Hamburg, Germany
| | - Jan-Per Wenzel
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20251 Hamburg, Germany,German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Martinistr 52, 20251 Hamburg, Germany
| | - Helena Guerreiro
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20251 Hamburg, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr 52, 20251 Hamburg, Germany
| | - Stefan Blankenberg
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20251 Hamburg, Germany,German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Martinistr 52, 20251 Hamburg, Germany
| | - Paulus Kirchhof
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20251 Hamburg, Germany,German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Martinistr 52, 20251 Hamburg, Germany,Institute of Cardiovascular Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Tobias Tönnis
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20251 Hamburg, Germany
| | - Julius Nikorowitsch
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20251 Hamburg, Germany,German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Martinistr 52, 20251 Hamburg, Germany
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11
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Camen S, Nagel L, Bei Der Kellen R, Barow E, Schneider JN, Blankenberg S, Kirchhof P, Wenzel JP, Thomalla G, Schnabel RB. Signals for reduced cognitive function are associated with subtle signs of atrial cardiomyopathy and left ventricular diastolic dysfunction – insights from a large population based study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.038] [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/Introduction
In recent years, it has been proposed that a thrombogenic atrial substrate due to various alterations in (left) atrial morphology and function could contribute to atrial thromboembolism even in the absence of (clinically overt) atrial fibrillation. This so-called atrial cardiomyopathy may pose a risk of stroke and cognitive decline beyond the presence of atrial fibrillation.
Purpose
To define the association of echocardiographic parameters of left atrial cardiomyopathy and left ventricular diastolic dysfunction with cognitive function in individuals free of clinically overt atrial fibrillation or stroke.
Methods
Data from the first 10,000 participants of a large German population-based cohort study were analysed. Of these, 8264 individuals underwent standardized transthoracic echocardiography and cognitive function testing at baseline. Parameters of left ventricular systolic and diastolic function as well as left atrial function were systematically assessed, including left atrial global peak strain. Cognitive function was quantified using the Animal Naming Test and the Trail Making Test A and B. We performed linear regression analyses with incremental adjustment to examine the association of echocardiographic parameters with the performance on the neuropsychological tests.
Results
After exclusion of 463 individuals with known AF and 309 individuals with prior/known stroke or severe depression, 7492 individuals were analysed (mean age 61.9±8.4 years, 52.3% women, median left ventricular ejection fraction 59% [25th/75th percentile 56/62%], median left atrial volume index 25.0 ml/m2 [25th/75th percentile 20/30 ml/m2]). In multivariable-adjusted analyses, E/e'-ratio was significantly associated with a worse performance on the Animal Naming Test (−0.24 per one standard deviation [SD] increase, 95% confidence interval [CI] −0.42 to −0.06), the Trail Making Test A (0.76 per one SD increase, 95% CI 0.35–1.17) and B (1.1 per one SD increase, 95% CI 0.09–2.11). Left atrial strain was associated with worse performance on Trail Making Test B (−1.39 per one SD increase, 95% CI −2.46 to −0.32). Increased left atrial volume index was associated with worse performance on the ANT (0.2, 95% CI 0.03–0.37).
Conclusions
Subtle echocardiographic signs of atrial cardiomyopathy and left ventricular diastolic dysfunction are associated with worse performance on cognitive function tests in a German middle-aged population.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): The Hamburg City Health Study (HCHS) is supported by the University Medical Center Hamburg-Eppendorf and by various grants from different institutions/organizations.
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Affiliation(s)
- S Camen
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - L Nagel
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | | | - E Barow
- The University Medical Center Hamburg-Eppendorf, Department for Neurology , Hamburg , Germany
| | - J N Schneider
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - S Blankenberg
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - P Kirchhof
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - J P Wenzel
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - G Thomalla
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - R B Schnabel
- University Heart & Vascular Center Hamburg , Hamburg , Germany
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12
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Wenzel JP, Nikorowitsch J, Bei der Kellen R, Dohm L, Girdauskas E, Lund G, Bannas P, Blankenberg S, Kölbel T, Cavus E, Müllerleile K, Kaul MG, Adam G, Weinrich JM. Comparison of cine cardiac magnetic resonance and echocardiography derived diameters of the aortic root in a large population-based cohort. Sci Rep 2022; 12:15307. [PMID: 36096919 PMCID: PMC9468025 DOI: 10.1038/s41598-022-19461-5] [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] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/30/2022] [Indexed: 12/01/2022] Open
Abstract
Transthoracic echocardiography (TTE) and cine cardiac magnetic resonance imaging (CMR) are established imaging methods of the aortic root. We aimed to evaluate the comparability of measurements in TTE and standard cine CMR sequences of the aortic root. Our study included 741 subjects (mean age 63.5 ± 8 years, 43.7% female) from the Hamburg City Health Study (HCHS). Subjects underwent CMR and TTE. Aortic root measurements were performed at the level of the aortic annulus (AoAn), sinus of Valsalva (SoV), and sinotubular junction (STJ) by standard cine CMR in left ventricular long axis and left ventricular outflow tract view. Measurements were performed applying the leading-edge to leading-edge (LL) convention and inner-edge to inner-edge (II) convention in TTE and the II convention in CMR. Inter correlation coefficients (ICCs) demonstrated high inter- and intraobserver reproducibility for CMR and TTE measurements of SoV and STJ (ICCs 0.9–0.98) and moderate reproducibility for AoAn (ICCs 0.68–0.91). CMR measurements of SoV and STJ showed strong agreement with TTE: while correlations were comparable (r = 0.75–0.85) bias was lower with TTE II (bias − 0.1 to − 0.74) versus TTE LL measurements (mean bias − 1.49 to − 2.58 mm). The agreement for AoAn was fair (r = 0.51–0.57) with variable bias (mean bias 0.39–3.9). Standard cine CMR and TTE derived aortic root measurements are reproducible and comparable with higher agreement for TTE II instead of LL measurements. These results support an interchangeable application of TTE and standard CMR for screening of aortic root diseases thereby possibly reducing redundant multimodality imaging.
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Affiliation(s)
- Jan-Per Wenzel
- Department of Cardiology, University Heart and Vascular Center Hamburg, UKE Hamburg, Hamburg, Germany. .,Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Julius Nikorowitsch
- Department of Cardiology, University Heart and Vascular Center Hamburg, UKE Hamburg, Hamburg, Germany
| | - Ramona Bei der Kellen
- Department of Cardiology, University Heart and Vascular Center Hamburg, UKE Hamburg, Hamburg, Germany
| | - Luisa Dohm
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Evaldas Girdauskas
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, UKE Hamburg, Hamburg, Germany
| | - Gunnar Lund
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Bannas
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Blankenberg
- Department of Cardiology, University Heart and Vascular Center Hamburg, UKE Hamburg, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Tilo Kölbel
- Department of Vascular Medicine, German Aortic Center Hamburg, University Heart and Vascular Center Hamburg, UKE Hamburg, Hamburg, Germany
| | - Ersin Cavus
- Department of Cardiology, University Heart and Vascular Center Hamburg, UKE Hamburg, Hamburg, Germany
| | - Kai Müllerleile
- Department of Cardiology, University Heart and Vascular Center Hamburg, UKE Hamburg, Hamburg, Germany
| | - Michael Gerhard Kaul
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julius Matthias Weinrich
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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13
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Wenzel JP, Nikorowitsch J, Bei der Kellen R, Magnussen C, Bonin-Schnabel R, Westermann D, Twerenbold R, Kirchhof P, Blankenberg S, Schrage B. Heart failure in the general population and impact of the 2021 European Society of Cardiology Heart Failure Guidelines. ESC Heart Fail 2022; 9:2157-2169. [PMID: 35445582 PMCID: PMC9288760 DOI: 10.1002/ehf2.13948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/12/2022] [Accepted: 04/06/2022] [Indexed: 12/12/2022] Open
Abstract
AIM The diagnosis of heart failure (HF) has been refined in several steps in recent years, reflecting evolving diagnostic and therapeutic approaches. The European Society of Cardiology (ESC) recently published a modified definition of HF in the 2021 heart failure (HF) guidelines. The impact of this new diagnostic algorithm on the prevalence of HF is not known. The aim of this study was to describe the contemporary prevalence of HF in a representative, completely phenotyped sample from the general population. METHODS AND RESULTS This analysis was conducted among 7074 participants (aged 45-78 years, 51.5% women) from the population-based Hamburg City Health Study. Compared with the 2016 version, HF prevalence increased with the 2021 HF guidelines from 4.31% to 4.83% (12% increase). This increase was driven by a higher number of subjects with HF with reduced/mildly-reduced ejection fraction (0.47% to 0.52%; 1.37% to 2.12%), while the number of subjects with HF with preserved ejection fraction decreased from 2.46% to 2.19%. Importantly, this did not impact the known risk factor profiles of the phenotypes. Although four drugs are recommended for all subjects with HFrEF in the new guidelines, several adjunctive therapies are recommended for dedicated cases/scenarios (e.g. <1% eligibility for ivabradine/vericiguat/devices). CONCLUSION Heart failure remains common in a contemporary general population sample. The number of patients with HF will increase when the current diagnostic criteria are applied. This offers opportunities to initiate preventive therapies, especially in patients with HFmrEF and HFrEF.
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Affiliation(s)
- Jan-Per Wenzel
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany.,Epidemiological Study Centre, Hamburg, Germany
| | - Julius Nikorowitsch
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | | | - Christina Magnussen
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Renate Bonin-Schnabel
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Dirk Westermann
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Raphael Twerenbold
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany.,Epidemiological Study Centre, Hamburg, Germany.,University Centre of Cardiovascular Science, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | - Paulus Kirchhof
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany.,Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Stefan Blankenberg
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany.,Epidemiological Study Centre, Hamburg, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Benedikt Schrage
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
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14
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Wenzel JP, Kellen RBD, Magnussen C, Blankenberg S, Schrage B, Schnabel R, Nikorowitsch J. Diastolic dysfunction in individuals with and without heart failure with preserved ejection fraction. Clin Res Cardiol 2022; 111:416-427. [PMID: 34269862 PMCID: PMC8971165 DOI: 10.1007/s00392-021-01907-x] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/07/2021] [Indexed: 12/01/2022]
Abstract
AIM Left ventricular diastolic dysfunction (DD), a common finding in the general population, is considered to be associated with heart failure with preserved ejection faction (HFpEF). Here we evaluate the prevalence and correlates of DD in subjects with and without HFpEF in a middle-aged sample of the general population. METHODS AND RESULTS From the first 10,000 participants of the population-based Hamburg City Health Study (HCHS), 5913 subjects (mean age 64.4 ± 8.3 years, 51.3% females), qualified for the current analysis. Diastolic dysfunction (DD) was identified in 753 (12.7%) participants. Of those, 11.2% showed DD without HFpEF (ALVDD) while 1.3% suffered from DD with HFpEF (DDwHFpEF). In multivariable regression analysis adjusted for major cardiovascular risk factors, ALVDD was associated with arterial hypertension (OR 2.0, p < 0.001) and HbA1c (OR 1.2, p = 0.007). Associations of both ALVDD and DDwHFpEF were: age (OR 1.7, p < 0.001; OR 2.7, p < 0.001), BMI (OR 1.2, p < 0.001; OR 1.6, p = 0.001), and left ventricular mass index (LVMI). In contrast, female sex (OR 2.5, p = 0.006), atrial fibrillation (OR 2.6, p = 0.024), CAD (OR 7.2, p < 0.001) COPD (OR 3.9, p < 0.001), and QRS duration (OR 1.4, p = 0.005) were strongly associated with DDwHFpEF but not with ALVDD. CONCLUSION The prevalence of DD in a sample from the first 10,000 participants of the population-based HCHS was 12.7% of whom 1.3% suffered from HFpEF. DD with and without HFpEF showed significant associations with different major cardiovascular risk factors and comorbidities warranting further research for their possible role in the formation of both ALVDD and DDwHFpEF.
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Affiliation(s)
- Jan-Per Wenzel
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
- Epidemiological Study Center, Hamburg, Germany
| | | | - Christina Magnussen
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Stefan Blankenberg
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Epidemiological Study Center, Hamburg, Germany
| | - Benedikt Schrage
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Renate Schnabel
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Julius Nikorowitsch
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
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15
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Petersen EL, Goßling A, Adam G, Aepfelbacher M, Behrendt CA, Cavus E, Cheng B, Fischer N, Gallinat J, Kühn S, Gerloff C, Koch-Gromus U, Härter M, Hanning U, Huber TB, Kluge S, Knobloch JK, Kuta P, Schmidt-Lauber C, Lütgehetmann M, Magnussen C, Mayer C, Muellerleile K, Münch J, Nägele FL, Petersen M, Renné T, Riedl KA, Rimmele DL, Schäfer I, Schulz H, Tahir E, Waschki B, Wenzel JP, Zeller T, Ziegler A, Thomalla G, Twerenbold R, Blankenberg S. Multi-organ assessment in mainly non-hospitalized individuals after SARS-CoV-2 infection: The Hamburg City Health Study COVID programme. Eur Heart J 2022; 43:1124-1137. [PMID: 34999762 PMCID: PMC8755397 DOI: 10.1093/eurheartj/ehab914] [Citation(s) in RCA: 86] [Impact Index Per Article: 43.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/24/2021] [Accepted: 12/25/2021] [Indexed: 01/09/2023] Open
Abstract
AIMS Long-term sequelae may occur after SARS-CoV-2 infection. We comprehensively assessed organ-specific functions in individuals after mild to moderate SARS-CoV-2 infection compared with controls from the general population. METHODS AND RESULTS Four hundred and forty-three mainly non-hospitalized individuals were examined in median 9.6 months after the first positive SARS-CoV-2 test and matched for age, sex, and education with 1328 controls from a population-based German cohort. We assessed pulmonary, cardiac, vascular, renal, and neurological status, as well as patient-related outcomes. Bodyplethysmography documented mildly lower total lung volume (regression coefficient -3.24, adjusted P = 0.014) and higher specific airway resistance (regression coefficient 8.11, adjusted P = 0.001) after SARS-CoV-2 infection. Cardiac assessment revealed slightly lower measures of left (regression coefficient for left ventricular ejection fraction on transthoracic echocardiography -0.93, adjusted P = 0.015) and right ventricular function and higher concentrations of cardiac biomarkers (factor 1.14 for high-sensitivity troponin, 1.41 for N-terminal pro-B-type natriuretic peptide, adjusted P ≤ 0.01) in post-SARS-CoV-2 patients compared with matched controls, but no significant differences in cardiac magnetic resonance imaging findings. Sonographically non-compressible femoral veins, suggesting deep vein thrombosis, were substantially more frequent after SARS-CoV-2 infection (odds ratio 2.68, adjusted P < 0.001). Glomerular filtration rate (regression coefficient -2.35, adjusted P = 0.019) was lower in post-SARS-CoV-2 cases. Relative brain volume, prevalence of cerebral microbleeds, and infarct residuals were similar, while the mean cortical thickness was higher in post-SARS-CoV-2 cases. Cognitive function was not impaired. Similarly, patient-related outcomes did not differ. CONCLUSION Subjects who apparently recovered from mild to moderate SARS-CoV-2 infection show signs of subclinical multi-organ affection related to pulmonary, cardiac, thrombotic, and renal function without signs of structural brain damage, neurocognitive, or quality-of-life impairment. Respective screening may guide further patient management.
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Affiliation(s)
- Elina Larissa Petersen
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- Population Health Research Department, University Heart and Vascular Center, Hamburg, Germany
| | - Alina Goßling
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- Population Health Research Department, University Heart and Vascular Center, Hamburg, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Aepfelbacher
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian-Alexander Behrendt
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- Population Health Research Department, University Heart and Vascular Center, Hamburg, Germany
| | - Ersin Cavus
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- Population Health Research Department, University Heart and Vascular Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Bastian Cheng
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nicole Fischer
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jürgen Gallinat
- Clinic and Policlinic for Psychiatry and Psychotherapy, University Clinic Hamburg-Eppendorf, Hamburg, Germany
| | - Simone Kühn
- Clinic and Policlinic for Psychiatry and Psychotherapy, University Clinic Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Uwe Koch-Gromus
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Uta Hanning
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias B. Huber
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Kluge
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johannes K. Knobloch
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Piotr Kuta
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg- Eppendorf, Hamburg, Germany
| | | | - Marc Lütgehetmann
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christina Magnussen
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- Population Health Research Department, University Heart and Vascular Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Carola Mayer
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kai Muellerleile
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- Population Health Research Department, University Heart and Vascular Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Julia Münch
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- Population Health Research Department, University Heart and Vascular Center, Hamburg, Germany
| | - Felix Leonard Nägele
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marvin Petersen
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Renné
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg- Eppendorf, Hamburg, Germany
- Center for Thrombosis and Hemostasis (CTH), Johannes Gutenberg University Medical Center, Mainz, Germany
- Irish Centre for Vascular Biology, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Katharina Alina Riedl
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- Population Health Research Department, University Heart and Vascular Center, Hamburg, Germany
| | - David Leander Rimmele
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ines Schäfer
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- Population Health Research Department, University Heart and Vascular Center, Hamburg, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Enver Tahir
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benjamin Waschki
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Hospital Itzehoe, Pneumology, Itzehoe, Germany
- Airway Research Center North (ARCN), German Center for Lung Research (DZL), LungenClinic Grosshansdorf, Grosshansdorf, Germany
| | - Jan-Per Wenzel
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- Population Health Research Department, University Heart and Vascular Center, Hamburg, Germany
| | - Tanja Zeller
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
- University Center of Cardiovascular Science, University Heart and Vascular Center, Hamburg, Germany
| | - Andreas Ziegler
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- Cardio-CARE, Medizincampus Davos, Davos, Switzerland
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Raphael Twerenbold
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- Population Health Research Department, University Heart and Vascular Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
- University Center of Cardiovascular Science, University Heart and Vascular Center, Hamburg, Germany
| | - Stefan Blankenberg
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- Population Health Research Department, University Heart and Vascular Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
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16
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Wenzel JP, Petersen E, Nikorowitsch J, Müller J, Kölbel T, Reichenspurner H, Blankenberg S, Girdauskas E. Aortic root dimensions as a correlate for aortic regurgitation's severity. Int J Cardiovasc Imaging 2021; 37:3439-3449. [PMID: 34232460 PMCID: PMC8604845 DOI: 10.1007/s10554-021-02337-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/01/2021] [Indexed: 01/08/2023]
Abstract
To evaluate the prevalence of aortic regurgitation (AR) and associations between the individual aortic root components and AR severity in the general population. The study included the first 10,000 participants of the population-based Hamburg City Health Study (HCHS) of whom 8259 subjects, aged 62.23 ± 8.46 years (51.3% females), enrolled 2016-2018, provided echocardiographic data. 69 subjects with bicuspid valves and 23 subjects with moderate/severe aortic stenosis were excluded. Aortic root dimensions were measured using state-of-the-art cardiac ultrasound, including the aortic annulus, sinus of Valsalva, sinotubular junction (STJ), and ascending aorta, in diastole and systole. The distribution of AR was: 932 (11.4%) mild, 208 (2.5%) moderate, and 20 (0.24%) severe. Patients with moderate or severe AR were predominantly male at advanced age who had hypertension, coronary artery disease, atrial fibrillation, and renal dysfunction. Increasing AR severity correlated with higher absolute and indexed aortic root diameters (e.g., end-diastolic sinus of Valsalva for no-mild-moderate-severe AR in mm ± standard deviation: 34.06 ± 3.81; 35.65 ± 4.13; 36.13 ± 4.74; 39.67 ± 4.61; p < 0.001). In binary logistic regression analysis, all aortic root components showed significant associations with moderate/severe AR. Mid-systolic STJ showed the strongest association with moderate/severe AR (OR 1.33, 95% confidence interval 1.25-1.43, p < 0.001). AR was prevalent in 14.2%, of whom 2.8% showed moderate/severe AR. All assessed aortic root diameters correlated with the prevalence and severity of AR. STJ diameter had the strongest association with moderate/severe AR possibly reflecting the pathophysiological impact of an increasingly dilated STJ in the context of an ageing aorta.
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Affiliation(s)
- Jan-Per Wenzel
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
- Epidemiological Study Center, Hamburg, Germany
| | | | - Julius Nikorowitsch
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | | | - Tilo Kölbel
- Department of Vascular Medicine, German Aortic Center Hamburg University Heart and Vascular Center, Hamburg, Germany
| | - Hermann Reichenspurner
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Stefan Blankenberg
- Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Epidemiological Study Center, Hamburg, Germany
| | - Evaldas Girdauskas
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany
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17
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Wenzel JP, Petersen E, Nikorowitsch J, Senftinger J, Sinning C, Theissen M, Petersen J, Reichenspurner H, Girdauskas E. Transthoracic echocardiographic reference values of the aortic root: results from the Hamburg City Health Study. Int J Cardiovasc Imaging 2021; 37:3513-3524. [PMID: 34324091 PMCID: PMC8604854 DOI: 10.1007/s10554-021-02354-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/16/2021] [Indexed: 11/10/2022]
Abstract
Here we generate up-to-date reference values of transthoracic echocardiographic aortic root dimensions matched by sex, age, and body surface area (BSA) derived from the population-based Hamburg City Health Study (HCHS) cohort. In 1687 healthy subjects (mean age 57.1 ± 7.7, 681 male and 1006 female), derived from the first prospectively-recruited 10,000 HCHS participants, dimensions of the aortic root were measured in systole and diastole using state-of-the-art 2-dimensional transthoracic echocardiography. Diameters were assessed at four levels: aortic annulus, Sinus of Valsalva, sinotubular junction, and ascending aorta. Female sex was associated with significantly smaller absolute aortic root dimensions, while indexing for BSA resulted in a reverse effect at all levels. There was a strong age dependency of all aortic root diameters as well as aortic annulus/sinotubular junction ratio for both sexes. Multivariate analysis revealed age, sex, weight, height, and BSA to be significant determinants of aortic root size. Finally, formulas were generated for the calculation of individual aortic root reference values considering age, sex, weight, and height. We provide population-based reference values of aortic root diameters based on a standardized transthoracic echocardiographic protocol of the population-based HCHS which may support the diagnosis, monitoring, and treatment of aortic root disease.
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Affiliation(s)
- Jan-Per Wenzel
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
- Epidemiological Study Centre, Hamburg, Germany
| | | | - Julius Nikorowitsch
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | - Juliana Senftinger
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | - Christoph Sinning
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Matthias Theissen
- Department of Cardiovascular Surgery, University Heart Centre Hamburg, Hamburg, Germany
| | - Johannes Petersen
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Department of Cardiovascular Surgery, University Heart Centre Hamburg, Hamburg, Germany
| | | | - Evaldas Girdauskas
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Department of Cardiovascular Surgery, University Heart Centre Hamburg, Hamburg, Germany
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18
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Rimmele DL, Borof K, Wenzel JP, Jensen M, Behrendt CA, Waldeyer C, Schnabel RB, Zeller T, Debus ES, Blankenberg S, Gerloff C, Thomalla G. Differential association of flow velocities in the carotid artery with plaques, intima media thickness and cardiac function. Atheroscler Plus 2021; 43:18-23. [PMID: 36644504 PMCID: PMC9833222 DOI: 10.1016/j.athplu.2021.07.020] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/12/2021] [Accepted: 07/21/2021] [Indexed: 01/18/2023]
Abstract
Background and aims We aimed to determine the association of carotid intima media thickness (CIMT), carotid plaques, and heart function with peak systolic velocity (PSV) of the common (CCA) and internal carotid artery (ICA) in a cross-sectional study. Methods In the population-based Hamburg-City-Health-Study participants between 45 and 74 years were recruited. Cardio-vascular risk factors were assessed by history, blood samples, and clinical examination. CIMT, plaques, and PSV were determined by carotid ultrasound. Serum N-terminal brain natriuretic peptide (NT-proBNP) was determined as a biomarker for cardiac dysfunction, and left ventricular ejection fraction (LVEF) was quantified by echocardiography. Participants with carotid stenosis were excluded. Data were analyzed by multivariate linear regression. Results We included 8567 participants, median age was 62 years, 51.8% were women. Median CIMT was 0.75 mm, NT-proBNP 80 pg/ml, LVEF 58.5%, and 30.4% had carotid plaques. For women PSV decreased in decades from 89 to 73 cm/s in CCAs and 78 to 66 cm/s in ICAs, and for men from 91 to 76 cm/s in CCAs and from 70 to 66 cm/s in ICAs. Corrected for age, sex, red blood cell count, and blood pressure, in CCAs lower PSV was associated with carotid plaques (p < 0.001; β = -0.03), lower CIMT (p = 0.005; β = 0.007), higher levels of log-transformed NT-proBNP (p < 0.001; β = -0.01), and lower LVEF (p < 0.001; β = 0.01). In ICAs, lower PSV was independently associated with lower CIMT (p < 0.001; β = 0.02) and lower EF (p = 0.001; β = 0.007). Conclusions Markers of cardiac dysfunction and plaques are associated with lower and CIMT with higher flow velocities in the carotid arteries. Clinical Trial Registration http://www.clinicaltrials.gov, NCT03934957.
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Affiliation(s)
- David Leander Rimmele
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Corresponding author. Department of Neurology, University Medical Centre Hamburg-Eppendorf Martinistr. 52, D-20246, Hamburg, Germany.
| | - Katrin Borof
- Epidemiological Study Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan-Per Wenzel
- Department of Cardiology, University Heart and Vascular Center UKE Hamburg, Hamburg, Germany
| | - Märit Jensen
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK) Partner Site Hamburg/Kiel/Lübeck, Germany
| | - Christian-A. Behrendt
- Department of Vascular Medicine, University Heart and Vascular Center UKE Hamburg, Hamburg, Germany
| | - Christoph Waldeyer
- Department of Cardiology, University Heart and Vascular Center UKE Hamburg, Hamburg, Germany
| | - Renate B. Schnabel
- Department of Cardiology, University Heart and Vascular Center UKE Hamburg, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK) Partner Site Hamburg/Kiel/Lübeck, Germany
| | - Tanja Zeller
- Department of Cardiology, University Heart and Vascular Center UKE Hamburg, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK) Partner Site Hamburg/Kiel/Lübeck, Germany
| | - E. Sebastian Debus
- Department of Vascular Medicine, University Heart and Vascular Center UKE Hamburg, Hamburg, Germany
| | - Stefan Blankenberg
- Department of Cardiology, University Heart and Vascular Center UKE Hamburg, Hamburg, Germany
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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19
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Jagodzinski A, Johansen C, Koch-Gromus U, Aarabi G, Adam G, Anders S, Augustin M, der Kellen RB, Beikler T, Behrendt CA, Betz CS, Bokemeyer C, Borof K, Briken P, Busch CJ, Büchel C, Brassen S, Debus ES, Eggers L, Fiehler J, Gallinat J, Gellißen S, Gerloff C, Girdauskas E, Gosau M, Graefen M, Härter M, Harth V, Heidemann C, Heydecke G, Huber TB, Hussein Y, Kampf MO, von dem Knesebeck O, Konnopka A, König HH, Kromer R, Kubisch C, Kühn S, Loges S, Löwe B, Lund G, Meyer C, Nagel L, Nienhaus A, Pantel K, Petersen E, Püschel K, Reichenspurner H, Sauter G, Scherer M, Scherschel K, Schiffner U, Schnabel RB, Schulz H, Smeets R, Sokalskis V, Spitzer MS, Terschüren C, Thederan I, Thoma T, Thomalla G, Waschki B, Wegscheider K, Wenzel JP, Wiese S, Zyriax BC, Zeller T, Blankenberg S. Rationale and Design of the Hamburg City Health Study. Eur J Epidemiol 2019; 35:169-181. [PMID: 31705407 PMCID: PMC7125064 DOI: 10.1007/s10654-019-00577-4] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 10/31/2019] [Indexed: 01/19/2023]
Abstract
The Hamburg City Health Study (HCHS) is a large, prospective, long-term, population-based cohort study and a unique research platform and network to obtain substantial knowledge about several important risk and prognostic factors in major chronic diseases. A random sample of 45,000 participants between 45 and 74 years of age from the general population of Hamburg, Germany, are taking part in an extensive baseline assessment at one dedicated study center. Participants undergo 13 validated and 5 novel examinations primarily targeting major organ system function and structures including extensive imaging examinations. The protocol includes validate self-reports via questionnaires regarding lifestyle and environmental conditions, dietary habits, physical condition and activity, sexual dysfunction, professional life, psychosocial context and burden, quality of life, digital media use, occupational, medical and family history as well as healthcare utilization. The assessment is completed by genomic and proteomic characterization. Beyond the identification of classical risk factors for major chronic diseases and survivorship, the core intention is to gather valid prevalence and incidence, and to develop complex models predicting health outcomes based on a multitude of examination data, imaging, biomarker, psychosocial and behavioral assessments. Participants at risk for coronary artery disease, atrial fibrillation, heart failure, stroke and dementia are invited for a visit to conduct an additional MRI examination of either heart or brain. Endpoint assessment of the overall sample will be completed through repeated follow-up examinations and surveys as well as related individual routine data from involved health and pension insurances. The study is targeting the complex relationship between biologic and psychosocial risk and resilience factors, chronic disease, health care use, survivorship and health as well as favorable and bad prognosis within a unique, large-scale long-term assessment with the perspective of further examinations after 6 years in a representative European metropolitan population.
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Affiliation(s)
- Annika Jagodzinski
- Department of General and Interventional Cardiology, University Heart and Vascular Center, Hamburg, Germany. .,German Center for Cardiovascular Research (DZHK) Partner Site Hamburg/Lübeck/Kiel, Munich, Germany. .,Epidemiological Study Center, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
| | - Christoffer Johansen
- Epidemiological Study Center, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,Oncology Clinic, Finsen Center, Copenhagen, Denmark.,Survivorship Research Unit, The Danish Cancer Society Research Center, Copenhagen, Denmark.,Institute for Medical Biometry and Epidemiology (IMBE), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Uwe Koch-Gromus
- Faculty of Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Ghazal Aarabi
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gerhard Adam
- Department of Diagnostics and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Sven Anders
- Department for Forensic Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Ramona B der Kellen
- Epidemiological Study Center, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - Christian S Betz
- Department of Otolaryngology, Head and Neck Surgery, Head and Neurocenter, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Carsten Bokemeyer
- Department of Oncology, Hematology, BMT with Section Pneumology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Katrin Borof
- Epidemiological Study Center, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Peer Briken
- Institute for Sexual Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Chia-Jung Busch
- Department of Otolaryngology, Head and Neck Surgery, Head and Neurocenter, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Christian Büchel
- Institute for Systemic Neurosciences, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Stefanie Brassen
- Institute for Systemic Neurosciences, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Eike S Debus
- Department of Vascular Medicine, University Heart and Vascular Center, Hamburg, Germany
| | - Larissa Eggers
- Epidemiological Study Center, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Jens Fiehler
- Clinic of Neuroradiological Diagnostics and Intervention, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Simone Gellißen
- Clinic of Neuroradiological Diagnostics and Intervention, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Evaldas Girdauskas
- Department for Cardiovascular Surgery, University Heart and Vascular Center, Hamburg, Germany
| | - Martin Gosau
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Markus Graefen
- Prostate Cancer Center, Martini-Clinic, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Volker Harth
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Christoph Heidemann
- Epidemiological Study Center, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Guido Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias B Huber
- Medical Clinic and Polyclinic III, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Yassin Hussein
- Epidemiological Study Center, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Marvin O Kampf
- Epidemiological Study Center, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Olaf von dem Knesebeck
- Institute for Medical Sociology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Alexander Konnopka
- Institute for Health Economics and Healthcare Research, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Hans-Helmut König
- Institute for Health Economics and Healthcare Research, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Robert Kromer
- Clinic of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Christian Kubisch
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Sonja Loges
- Department of Oncology, Hematology, BMT with Section Pneumology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,Institute for Tumor Biology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Bernd Löwe
- Institute for Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Gunnar Lund
- Department of Diagnostics and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Christian Meyer
- German Center for Cardiovascular Research (DZHK) Partner Site Hamburg/Lübeck/Kiel, Munich, Germany.,Department of Electrophysiology, Hamburg University Heart Center, University Heart and Vascular Center, Hamburg, Germany
| | - Lina Nagel
- Epidemiological Study Center, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Albert Nienhaus
- Competence Center for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Klaus Pantel
- Institute for Tumor Biology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Elina Petersen
- Epidemiological Study Center, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Klaus Püschel
- Department for Forensic Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Hermann Reichenspurner
- Department for Cardiovascular Surgery, University Heart and Vascular Center, Hamburg, Germany
| | - Guido Sauter
- Department of Pathology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Martin Scherer
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Katharina Scherschel
- German Center for Cardiovascular Research (DZHK) Partner Site Hamburg/Lübeck/Kiel, Munich, Germany.,Department of Electrophysiology, Hamburg University Heart Center, University Heart and Vascular Center, Hamburg, Germany
| | - Ulrich Schiffner
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Renate B Schnabel
- Department of General and Interventional Cardiology, University Heart and Vascular Center, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK) Partner Site Hamburg/Lübeck/Kiel, Munich, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Vladislavs Sokalskis
- Epidemiological Study Center, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Martin S Spitzer
- Clinic of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Claudia Terschüren
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Imke Thederan
- Prostate Cancer Center, Martini-Clinic, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Tom Thoma
- Epidemiological Study Center, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Benjamin Waschki
- Department of General and Interventional Cardiology, University Heart and Vascular Center, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK) Partner Site Hamburg/Lübeck/Kiel, Munich, Germany.,Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany
| | - Karl Wegscheider
- Institute for Medical Biometry and Epidemiology (IMBE), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Jan-Per Wenzel
- Department of General and Interventional Cardiology, University Heart and Vascular Center, Hamburg, Germany.,Epidemiological Study Center, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Susanne Wiese
- Epidemiological Study Center, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Birgit-Christiane Zyriax
- German Center for Cardiovascular Research (DZHK) Partner Site Hamburg/Lübeck/Kiel, Munich, Germany.,Competence Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Tanja Zeller
- Department of General and Interventional Cardiology, University Heart and Vascular Center, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK) Partner Site Hamburg/Lübeck/Kiel, Munich, Germany.,Epidemiological Study Center, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Stefan Blankenberg
- Department of General and Interventional Cardiology, University Heart and Vascular Center, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK) Partner Site Hamburg/Lübeck/Kiel, Munich, Germany
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20
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Fijak M, Damm LJ, Wenzel JP, Aslani F, Walecki M, Wahle E, Eisel F, Bhushan S, Hackstein H, Baal N, Schuler G, Konrad L, Rafiq A, O'Hara L, Smith LB, Meinhardt A. Influence of Testosterone on Inflammatory Response in Testicular Cells and Expression of Transcription Factor Foxp3 in T Cells. Am J Reprod Immunol 2015; 74:12-25. [DOI: 10.1111/aji.12363] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 01/02/2015] [Indexed: 01/31/2023] Open
Affiliation(s)
- Monika Fijak
- Department of Anatomy and Cell Biology; Justus-Liebig-University; Giessen Germany
| | - Lara-Jil Damm
- Department of Anatomy and Cell Biology; Justus-Liebig-University; Giessen Germany
| | - Jan-Per Wenzel
- Department of Anatomy and Cell Biology; Justus-Liebig-University; Giessen Germany
| | - Ferial Aslani
- Department of Anatomy and Cell Biology; Justus-Liebig-University; Giessen Germany
| | - Magdalena Walecki
- Department of Anatomy and Cell Biology; Justus-Liebig-University; Giessen Germany
| | - Eva Wahle
- Department of Anatomy and Cell Biology; Justus-Liebig-University; Giessen Germany
| | - Florian Eisel
- Department of Anatomy and Cell Biology; Justus-Liebig-University; Giessen Germany
| | - Sudhanshu Bhushan
- Department of Anatomy and Cell Biology; Justus-Liebig-University; Giessen Germany
| | - Holger Hackstein
- Institute for Clinical Immunology and Transfusion Medicine; Justus-Liebig-University; Giessen Germany
| | - Nelli Baal
- Institute for Clinical Immunology and Transfusion Medicine; Justus-Liebig-University; Giessen Germany
| | - Gerhard Schuler
- Clinic for Obstetrics; Gynecology and Andrology of Large and Small Animals; Faculty of Veterinary Medicine; Justus-Liebig-University; Giessen Germany
| | - Lutz Konrad
- Department of Obstetrics and Gynaecology; Faculty of Medicine; Justus-Liebig-University; Giessen Germany
| | - Amir Rafiq
- Department of Anatomy and Cell Biology; Justus-Liebig-University; Giessen Germany
| | - Laura O'Hara
- MRC Centre for Reproductive Health; University of Edinburgh; Edinburgh UK
| | - Lee B. Smith
- MRC Centre for Reproductive Health; University of Edinburgh; Edinburgh UK
| | - Andreas Meinhardt
- Department of Anatomy and Cell Biology; Justus-Liebig-University; Giessen Germany
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