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McLaughlin V, Hoeper M, Tamura Y, Backer A, Boyanova N, Kracker H, Larbalestier A, Lassen C, Sanna L, Humbert M. UNISUS study design: a phase 3 superiority study comparing the efficacy, safety, and tolerability of macitentan 75 mg vs macitentan 10 mg in patients with pulmonary arterial hypertension (PAH). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
While advances in PAH-specific therapies have substantially improved survival, there is still an unmet need to improve long-term outcomes in PAH.
Purpose
The UNISUS study is the first head-to-head superiority study in PAH, comparing the time to morbidity or mortality (M/M) with macitentan 75 mg vs macitentan 10 mg in PAH patients.
Methods
UNISUS, an ongoing multicentre, prospective, double-blind (DB), adaptive, event-driven superiority study randomises PAH patients 1:1 to receive macitentan 75 mg or macitentan 10 mg, with a target enrolment of ∼900 patients. Efficacy and safety are continuously assessed by an independent data monitoring committee (IDMC), who advises on pre-specified adaptive changes in study conduct, including expansion of the study population. An independent clinical event committee adjudicates all M/M events. The initial population was restricted to patients in functional class (FC) II/III, aged 18–75 years and excluded those with portopulmonary hypertension (PoPH) and those who were PAH treatment-naïve or receiving a prostanoid analogue. Stable (≥3 months) background PAH-therapy may be maintained, except for endothelin receptor agonists (ERAs), which must be stopped the day before initiating study drug. The study is comprised of a screening period, a 4-week run-in period (if ERA treatment-naïve or on sub-optimal ERA dose), and an event-driven DB treatment period, followed by a 2-year open-label extension with macitentan 75 mg. Initiation of macitentan 75 mg occurs after a 4-week up-titration step with macitentan 37.5 mg (Figure 1). The primary endpoint is time to first on-treatment M/M event, defined as first of: all-cause death, PAH-related hospitalisation, or PAH-related disease progression (confirmed ≥15% decrease in 6-minute walk distance (6MWD) and either FC worsening or addition of PAH therapy). Other endpoints include change from baseline to Week 24 in 6MWD and PAH-SYMPACT symptom scores; time to PAH-related hospitalisation or death; time to all-cause death (may be supplemented with data from an external control arm derived from the CARE PAH study [NCT04955990]); and the safety and tolerability of the study drugs. Figure 2 shows planned assessments and sub-studies. To maximise patient retention, add-on PAH therapies are allowed after a M/M event and, for patients at risk of withdrawing and unable to attend visits, the investigator may consider options for reduced follow-up.
Results
After 60 patients had been exposed for ≥8 weeks, the IDMC reviewed unblinded safety/tolerability data and recommended to expand recruitment from the restricted population to the target population (i.e., including patients: with PoPH, in FC II–IV, from any PAH therapy background [including naïve], aged ≥18 years).
Conclusion
UNISUS is the first head-to-head superiority study in PAH; with over 200 patients enrolled, it is currently recruiting the target population.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Actelion Pharmaceuticals Ltd., a Janssen pharmaceutical company of Johnson & Johnson.
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Affiliation(s)
- V McLaughlin
- University of Michigan, Division of Cardiovascular Medicine , Ann Arbor , United States of America
| | - M Hoeper
- Hannover Medical School , Hannover , Germany
| | - Y Tamura
- International University of Health and Welfare School of Medicine, Department of Cardiology , Tokyo , Japan
| | - A Backer
- Actelion Pharmaceuticals Ltd. , Allschwil , Switzerland
| | - N Boyanova
- Actelion Pharmaceuticals Ltd. , Allschwil , Switzerland
| | - H Kracker
- Actelion Pharmaceuticals Ltd. , Allschwil , Switzerland
| | | | - C Lassen
- Actelion Pharmaceuticals Ltd. , Allschwil , Switzerland
| | - L Sanna
- Actelion Pharmaceuticals Ltd. , Allschwil , Switzerland
| | - M Humbert
- Université Paris-Saclay, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Le Kremlin-Bicêtre , Paris , France
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Greer M, Mueller C, Vagi R, Wolf-Maras R, Klintschar M, Jaeger B, Schwerk N, Fuehner T, Salman J, Hoeper M, Haverich A, Ius F. Out of the Frying-Pan and into the Fire: Transplant Candidate Selection in Acute Lung Failure Due to SARS-CoV-2 Infection. J Heart Lung Transplant 2022. [PMCID: PMC8988482 DOI: 10.1016/j.healun.2022.01.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The COVID-19 pandemic led to unprecedented rates of acute lung failure (ALF), and a rise in lung transplantation (LTx) referrals. Data on LTx in ALF is limited to LTx outcomes, and the unpredictable course of SARS-CoV-2 makes candidate selection challenging. This study summarizes our experiences, in both patients transplanted and those we declined. Methods LTx referrals for ALF due to SARS-CoV-2 between 01Apr20-01Oct21 were reviewed. Set parameters were collected prospectively. Acceptance criteria reflected previous guidance. Cases were discussed at our multi-disciplinary meeting and suitable candidates evaluated at source before transfer for consent and listing. Internal follow-up and external data from declined patients were retrospectively analysed, with survival to discharge and length of hospital stay as end-points. Results 45 patients were referred (78% male). Median age was 55.8 [IQR 47.6-59.8] years. 36 (80%) required both mechanical ventilation and vvECMO, of median duration 46 [31-82] and 34 [24-72] days respectively. Consolidation was the commonest CT finding (47%). Bacterial colonisation (23/45, 51%), coagulopathy (21/45, 47%) and hepatic dysfunction (11/45, 24%) were common. Twenty-two patients were conscious, of whom 21 were evaluated. Five patients died during evaluation, from either sepsis or bleeding. One failed evaluation, and one withdrew consent. Six patients improved, making urgent LTx unnecessary, with 5 attending our review clinic. Of the 8 patients successfully evaluated, one died unexpectantly awaiting transfer, one improved at listing and a further patient died of sepsis after listing. Three patients underwent LTx, all being discharged home at 3 months post-LTx. Conclusion LTx candidate selection in critically ill SARS-CoV2 patients is challenging. Late recovery, particularly in non-fibrotic ALF is not unusual. Decision-making needs to include “acceptable morbidity” as a prelude to delayed evaluation and perhaps listing. More data is needed about declined candidates, particularly unweanable sedated patients with single-organ failure. Even successful awake recipients may experience significant psychological injury, underlining previous arguments in sedated patients. Equity to all candidates needs consideration, given the extraordinary demands on organ availability and care resources.
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Franz M, Aburahma K, Siemeni T, Avsar M, Bobylev D, Schwerk N, Mueller C, Sommer W, Boethig D, Greer M, Tudorache I, Warnecke G, Hoeper M, Haverich A, Kuehn C, Salman J, Ius F. Influence of Donor-Recipient Age Mismatch in Young Lung Transplant Recipients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Franz M, Aburahma K, Siemeni T, Avsar M, Bobylev D, Schwerk N, Müller C, Sommer W, Boethig D, Greer M, Tudorache I, Warnecke G, Hoeper M, Haverich A, Salman J, Ius F. Influence of Donor-Recipient Age Mismatch in Young Lung Transplant Recipients. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Franz M, Aburahma K, Siemeni T, Avsar M, Bobylev D, Schwerk N, Müller C, Sommer W, Greer M, Tudorache I, Warnecke G, Hoeper M, Haverich A, Ius F, Salman J. 10-Year Experience with Postoperatively Extended Intraoperative Extracorporeal Membrane Oxygenation in Lung Transplantation for Patients with Severe Pulmonary Hypertension. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Barco S, Valerio L, Jankowski M, Hoeper M, Klok F, Leuchte H, Mayer E, Meyer F, Neurohr C, Opitz C, Seyfarth H, Trudzinski F, Wachter R, Wilkens H, Wild P. Functional outcomes and quality of life during long-term follow-up after acute pulmonary embolism: analysis of the prospective multicentre FOCUS study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
It is unclear to which extent persistence of symptoms and/or residual haemodynamic impairment clinical course of pulmonary embolism are associated with worse quality of life (QoL).
Aims
To study the correlation between symptoms and haemodynamic impairment with QoL during the first year after acute pulmonary embolism (PE).
Methods
The Follow-Up after acute pulmonary embolism (FOCUS) study prospectively enrolled and followed consecutive adult patients diagnosed with acute symptomatic objectively diagnosed PE. In the present analysis, we considered patients who completed the Pulmonary Embolism QoL (PEmb-QoL) Questionnaire at predefined visits 3 and 12 months after acute PE. The PEmb-QoL score ranges from 0% (best QoL) to 100% (worst QoL). We evaluated at these two time points the correlation between persisting symptoms (group: symptoms), elevation of natriuretic peptides or residual right ventricular dysfunction (group: RVD), or their combination (group: symptoms + RVD) and QoL.
Results
A total of 617 patients were included; their median age was 62 years, 44% were women; 8% had active cancer, and 21% previous venous thromboembolism. At 3 months, patients with neither symptoms nor RVD (n=302) had the highest quality of life (median score 18%, 25th–75th percentile: 8%–34%), followed by those without symptoms but with RVD (n=255; median score 19%, 25th–75th percentile: 7%–34%), and by those with symptoms only (n=131; median PEmb-QoL 31%, 25th–75th percentile: 18%–49%). Patients with both symptoms and RVD (n=170) had the worst quality of life (median score 38%, 25th–75th percentile: 19%–53%); Figure 1A. At 12 months, we found an overall improvement of PEmb-QoL score. The degree of this QoL improvement varied across groups, being largest for patients who recovered from having symptoms + RVD at 3 months to normalization of at least one at 12 months. The change in QoL from 3 to 12 months was smaller both in patients who had neither symptoms nor RVD and in patients who had no recovery in either symptoms or RVD; Figure 1B.
Conclusions
Persistent symptoms after PE, especially in patients with elevated biomarkers or residual echocardiographic dysfunction, were the main drivers of QoL at 3 months as well as of the course of QoL over time.
Figure 1
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): University Medical Center of the Johannes Gutenberg University, Mainz, Germany; German Federal Ministry of Education and Research
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Affiliation(s)
- S Barco
- University Medical Center Mainz, Center for Thrombosis and Hemostasis, Mainz, Germany
| | - L Valerio
- University Medical Center Mainz, Center for Thrombosis and Hemostasis, Mainz, Germany
| | - M Jankowski
- University Medical Center Mainz, Center for Thrombosis and Hemostasis, Mainz, Germany
| | - M.M Hoeper
- Medizinische Hochschule Hannover, Klinik für Pneumologie, Hannover, Germany
| | - F.A Klok
- Leiden University Medical Center, Department of Thrombosis and Hemostasis, Leiden, Netherlands (The)
| | - H.H Leuchte
- Hospital Neuwittelsbach, Fachklinik für Innere Medizin, Munich, Germany
| | - E Mayer
- Kerckhoff Heart and Lung Center, Department of Thoracic Surgery, Bad Nauheim, Germany
| | - F.J Meyer
- Clinic Bogenhausen, Klinik für Pneumologie und Pneumologische Onkologie, Munich, Germany
| | - C Neurohr
- LMU Klinikum der Universität München, Medizinische Klinik und Poliklinik, Munich, Germany
| | - C Opitz
- DRK Kliniken Berlin
- Westend, Klinik für Innere Medizin, Berlin, Germany
| | - H.J Seyfarth
- Universitätsklinikum AöR, Department of Pneumology, Leipzig, Germany
| | | | - R Wachter
- Universitätsklinikum AöR, Klinik und Poliklinik für Kardiologie, Leipzig, Germany
| | - H Wilkens
- Saarland University Hospital, Homburg, Germany
| | - P.S Wild
- University Medical Center Mainz, Center for Thrombosis and Hemostasis, Mainz, Germany
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Galie N, Sitbon O, Doelberg M, Gibbs J, Hoeper M, Martin N, Mathai S, McLaughlin V, Perchenet L, Simonneau G, Chin K. Long-term outcomes in newly diagnosed pulmonary arterial hypertension (PAH) patients receiving initial triple oral combination therapy: insights from the randomised controlled TRITON study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2288] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Long-term outcomes are important in PAH.
Purpose
To evaluate the long-term efficacy and safety of initial triple oral therapy with selexipag, macitentan and tadalafil vs initial double oral therapy with macitentan and tadalafil in PAH.
Methods
TRITON, a multicentre, double-blind, placebo-controlled, phase 3b study, randomised 1:1 newly diagnosed, treatment-naïve PAH patients to initial triple vs double therapy. Macitentan and tadalafil were initiated at randomisation and selexipag/placebo at day 15 (uptitrated to wk 12). Efficacy and safety were assessed in a blinded manner until the last patient randomised completed wk 26 (end of observation period). Pulmonary vascular resistance (PVR; primary endpoint) and 6-minute walk distance (6MWD) were assessed at wk 26. Other secondary endpoints included time to first disease progression event (centrally adjudicated) to end of observation period +7 days. Time to all-cause mortality up to end of observation period was analysed post-hoc.
Results
247 patients were randomised to initial triple (n=123) or initial double therapy (n=124); baseline characteristics were balanced between groups. Median follow-up was 77.6 (initial triple) and 75.8 wks (initial double). Initial triple and initial double therapy improved PVR (by 54% and 52%) and 6MWD (by 55 and 56 m), with no difference between groups. A 41% reduction in the risk of first disease progression event driven by PAH-related hospitalisation and all-cause death was observed with initial triple vs initial double therapy (hazard ratio 0.59, 95% CI 0.32–1.09, p=0.087; Figure). Two patients died in the initial triple vs 9 in the initial double therapy group (hazard ratio 0.23, 95% CI 0.05–1.04). Adverse events were consistent with the known safety profiles of the study drugs.
Conclusions
In TRITON, assessments at wk 26 showed marked improvements in both treatment arms, with no difference between groups. Exploratory analysis indicated a signal for improved long-term outcome with initial triple versus initial double therapy.
Funding Acknowledgement
Type of funding source: Other. Main funding source(s): Actelion Pharmaceuticals Ltd.
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Affiliation(s)
- N Galie
- University of Bologna, Bologna, Italy
| | - O Sitbon
- Hôpital Bicêtre, Université Paris-Sud, Le Kremlin Bicêtre, Paris, France
| | - M Doelberg
- Actelion Pharmaceuticals Ltd, Allschwil, Switzerland
| | - J.S.R Gibbs
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - M.M Hoeper
- Hannover Medical School and German Centre for Lung Research, Hannover, Germany
| | - N Martin
- Actelion Pharmaceuticals Ltd, Allschwil, Switzerland
| | - S.C Mathai
- Johns Hopkins University School of Medicine, Baltimore, United States of America
| | - V McLaughlin
- University of Michigan, Ann Arbor, United States of America
| | - L Perchenet
- Actelion Pharmaceuticals Ltd, Allschwil, Switzerland
| | - G Simonneau
- Hôpital Bicêtre, Université Paris-Sud, Le Kremlin Bicêtre, Paris, France
| | - K Chin
- UT Southwestern Medical Center, Dallas, United States of America
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Langleben D, Gaine S, Sitbon O, Channick R, Chin K, Di Scala L, Galiè N, Hoeper M, McLaughlin V, Preiss R, Rubin L, Simonneau G, Tapson V, Ghofrani H, Lang I. THE IMPACT OF TIME FROM DIAGNOSIS AT BASELINE ON LONG-TERM OUTCOME IN THE GRIPHON STUDY: SELEXIPAG IN PULMONARY ARTERIAL HYPERTENSION (PAH). Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Hinrichs J, Maschke S, Winther H, Meine T, Werncke T, Olsson K, Hoeper M, Baumgart J, Wacker F, Renne J, Meyer B. 03:00 PM Abstract No. 151 2D parametric parenchymal blood flow (2D-PPBF) measurements for monitoring of balloon pulmonary angioplasty (BPA) as treatment of chronic thromboembolic pulmonary hypertension (CTEPH). J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Galie N, Gaine S, Channick R, Ghofrani HA, Hoeper M, Lang I, McLaughlin V, Preiss R, Rubin L, Shiraga Y, Simonneau G, Sitbon O, Tapson V, Chin K. 3016Long-term survival and safety with selexipag in patients with pulmonary arterial hypertension: results from the GRIPHON study and its open-label extension. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- N Galie
- Bologna University Hospital, Department of Experimental, Diagnostic, and Specialty Medicine, Bologna, Italy
| | - S Gaine
- Mater Misericordiae University Hospital, National Pulmonary Hypertension Unit, Dublin, Ireland
| | - R Channick
- Massachusetts General Hospital, Pulmonary and Critical Care, Boston, United States of America
| | - H A Ghofrani
- University of Giessen and Marburg Lung Center (UGMLC) and German Center of Lung Research, Giessen, Germany; Imperial College London, Department of Medicine, London, United Kingdom
| | - M Hoeper
- Hannover Medical School and German Centre for Lung Research, Department of Respiratory Medicine, Hannover, Germany
| | - I Lang
- Medical University of Vienna, Division of Cardiology, Vienna, Austria
| | - V McLaughlin
- University of Michigan Health System, Department of Internal Medicine, Ann Arbor, United States of America
| | - R Preiss
- Actelion Pharmaceuticals Ltd, Allschwil, Switzerland
| | - L Rubin
- University of California San Diego, Department of Medicine, San Diego, United States of America
| | - Y Shiraga
- Actelion Pharmaceuticals Ltd, Allschwil, Switzerland
| | - G Simonneau
- Assistance Publique–Hôpitaux de Paris, Service de Pneumologie, Hôpital Bicêtre and, Laboratoire d'Excellence en Recherche sur le Médicament et Innovation Thérapeutique, Université Paris-Sud, Le Kremlin–Bicêtre; Inserm Unité 999, Le Plessis Robinson, France
| | - O Sitbon
- Assistance Publique–Hôpitaux de Paris, Service de Pneumologie, Hôpital Bicêtre and, Laboratoire d'Excellence en Recherche sur le Médicament et Innovation Thérapeutique, Université Paris-Sud, Le Kremlin–Bicêtre; Inserm Unité 999, Le Plessis Robinson, France
| | - V Tapson
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - K Chin
- University of Texas Southwestern Medical Center, Dallas, United States of America
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Ius F, Sommer W, Tudorache I, Avsar M, Siemeni T, Böthig D, Puntigam J, Optenhöfel J, Welte T, Haverich A, Hoeper M, Kühn C, Warnecke G. Veno-Veno-Arterial Extracorporeal Membrane Oxygenation in Patients with Respiratory Failure. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Ius F, Fegbeutel C, Kühn C, Tudorache I, Warnecke G, Roumieh M, Koigeldiyev N, Olsson K, Hoeper M, Haverich A, Cebotari S. Perioperative Extracorporeal Membrane Oxygenation-Based Protocol for Acute Pulmonary Embolectomy: Technique and Preliminary Results. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Maschke S, Meyer B, Hoeper M, Olsson K, Wacker F, Hinrichs J. Evaluation der 2D-Perfusions-Angiografie bei Patienten mit chronischer thromboembolischer pulmonaler Hypertonie (CTEPH) vor und nach pulmonaler Ballonangioplastie (BPA). ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- S Maschke
- Medizinische Hochschule Hannover, Radiologie, Hannover
| | - B Meyer
- Medizinische Hochschule Hannover, Radiologie, Hannover
| | - M Hoeper
- Medizinische Hochschule Hannover, Pneumologie, Hannover
| | - K Olsson
- Medizinische Hochschule Hannover, Pneumologie, Hannover
| | - F Wacker
- Medizinische Hochschule Hannover, Radiologie, Hannover
| | - J Hinrichs
- Medizinische Hochschule Hannover, Radiologie, Hannover
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Hachulla E, Gaine S, Channick R, Discala L, Galiè N, Ghofrani H, Hoeper M, Lang I, Mclaughlin V, Preiss R, Rubin L, Simonneau G, Sitbon O, Tapson V, Chin K. Cibler la voie de la prostacycline dans le traitement des HTAP associées aux connectivites : expérience de Griphon – étude contrôlée, randomisée avec le selexipag. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Olschewski H, Behr J, Bremer H, Claussen M, Douschan P, Halank M, Held M, Hoeper M, Holt S, Klose H, Krüger S, Lange T, Reichenberger F, Skowasch D, Ulrich S, Wilkens H, Seeger W. Pulmonale Hypertonie bei Lungenkrankheiten: Empfehlungen der Kölner Konsensus-Konferenz 2016. Dtsch Med Wochenschr 2016; 141:S57-S61. [DOI: 10.1055/s-0042-114528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rosenkranz S, Ghofrani H, Grünig E, Klose H, Olschewski H, Hoeper M. Kölner Konsensus Konferenz zur pulmonalen Hypertonie 2016. Dtsch Med Wochenschr 2016. [DOI: 10.1055/s-0042-115441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Langleben D, Beghetti M, Channick R, Chin K, DiScala L, Gaine S, Ghofrani H, Hoeper M, Lang I, McLaughlin V, Preiss R, Rubin L, Simonneau G, Sitbon O, Tapson V, Galiè N. SELEXIPAG FOR PULMONARY ARTERIAL HYPERTENSION ASSOCIATED WITH CONGENITAL HEART DISEASE (PAH-CHD) AFTER DEFECT CORRECTION: INSIGHTS FROM THE RANDOMISED CONTROLLED GRIPHON STUDY. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Hinrichs J, Werncke T, Kaireit T, Hoeper M, Olsson K, Wacker F, Falck CV, Schatka I, Meyer B. Einschätzung des Schweregrads der chronisch thromboembolischen pulmonalen Hypertonie (CTEPH) mittels Single Photon Emission Computed Tomography (SPECT) im Vergleich zur C-Arm CT (CACT). ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Maschke S, Schönfeld C, Kaireit T, Cebotari S, Hoeper M, Wacker F, Vogel-Claussen J. MRT-basierte Bestimmung der biventrikulären regionalen Myokardfunktion bei Patienten mit chronisch-thrombembolischer pulmonaler Hypertonie (CTEPH) vor und nach pulmonaler Endarteriektomie (PEA). ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hinrichs J, Marquardt S, Renne J, Falck CV, Hoeper M, Olsson K, Wacker F, Meyer B. Chronisch thromboembolische pulmonale Hypertonie: Diagnostischer Zugewinn durch C-Arm CT im Vergleich zur digitalen Subtraktionsangiografie. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Schönfeld C, Cebotari S, Hinrichs J, Renne J, Kaireit T, Gutberlet M, Voskrebenzev A, Hoeper M, Welte T, Olsson K, Wacker F, Haverich A, Vogel-Claussen J. Quantifizierung der regionalen Lungengewebsdurchblutung und kardialer Funktionsparameter mittels MRT zur Beurteilung der hämodynamischen Veränderungen vor und 12 Tage nach pulmonaler Endarteriektomie. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hinrichs J, Renne J, Flack CV, Hoeper M, Olsson K, Wacker F, Meyer B. Vergleich von C-Arm CT und Multi-Detektor CT bei Patienten mit chronisch thromboembolischer pulmonaler Hypertonie. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Galiè N, Channick R, Chin K, Frey A, Gaine S, Ghofrani A, Hoeper M, Lang I, McLaughlin V, Preiss R, Rubin L, Sitbon O, Stefani M, Tapson V, Simonneau G. Effect of Selexipag on Morbidity/Mortality in Pulmonary Arterial Hypertension: Results of the GRIPHON Study. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ius F, Sommer W, Tudorache I, Avsar M, Siemeni T, Salman J, Greer M, Optenhöfel J, Hoeper M, Gottlieb J, Welte T, Haverich A, Kühn C, Warnecke G. Intraoperative Cardiopulmonary Support With Extracorporeal Membrane Oxygenation in Lung Transplantation: Favorable Outcomes in High Risk Patients. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ius F, Sommer W, Tudorache I, Avsar M, Siemeni T, Salman J, Greer M, Puntigam J, Hoeper M, Gottlieb J, Welte T, Haverich A, Kühn C, Warnecke G. Intra-Operative Indication Extracorporeal Membrane Oxygenation for Cardiopulmonary Support During Lung Transplantation: Risk Factors and Mid-Term Results. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Biancosino C, Tudorache I, Hoeper M, Ius F, Yablonskii P, Fegbeutel C, Haverich A, Cebotari S. 332-I * NOVEL APPROACH FOR PULMONARY ENDARTERECTOMY FACILITATES ACCESS TO THE LEFT LOWER LOBE BRANCHES. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gorenflo M, Pittrow D, Huscher D, Ziesenitz V, Praus A, Ewert P, Apitz C, Stiller B, Weil J, Abdul-Khaliq H, Berger F, Breuer J, Hansmann G, Michel-Behnke I, Stein J, Hoeper M, Kaemmerer H. Charakterisierung und Therapie pädiatrischer Patienten mit pulmonaler Hypertension: COMPERA-Kids Register. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1394015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kaemmerer H, Pittrow D, Huscher D, Tiede H, Delcroix M, Gorenflo M, D’alto M, Pujol C, Praus A, Engelhardt A, Ewert P, Hoeper M. Behandlungscharakteristika von Erwachsenen mit PAH assoziiert mit angeborenen Herzfehlern. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1394022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Grünig E, Grimminger F, Hoeper M, Rosenkranz S, Ghofrani HA. Die Bedeutung von Riociguat in der Behandlung der pulmonal-arteriellen Hypertonie. Pneumologie 2013. [DOI: 10.1055/s-0033-1344972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- E. Grünig
- Zentrum für Pulmonale Hypertonie an der Thoraxklinik am Universitätsklinikum Heidelberg
| | - F. Grimminger
- Med. Klinik IV und V, Innere Medizin, Universitätsklinikum Gießen und Marburg
| | - M. Hoeper
- Klinik für Pneumologie, Medizinische Hochschule Hannover
| | - S. Rosenkranz
- Klinik und Poliklinik für Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin an der Universitätsklinik Köln
| | - H.-A. Ghofrani
- Med. Klinik II, Innere Medizin, Universitätsklinikum Gießen und Marburg
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Ghofrani HA, Grimminger F, Halank M, Grünig E, Mayer E, Neurohr C, Wilkens H, Hoeper M. Riociguat zur Therapie der inoperablen chronisch thromboembolischen pulmonalen Hypertonie: Eine randomisierte, doppelblinde, placebokontrollierte Phase-III-Studie (CHEST-1). Pneumologie 2013. [DOI: 10.1055/s-0033-1344974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- H.-A. Ghofrani
- Med. Klinik II, Innere Medizin, Universitätsklinikum Gießen und Marburg, Gießen
| | - F. Grimminger
- Med. Klinik IV und V, Innere Medizin, Universitätsklinikum Gießen und Marburg; Gießen
| | - M. Halank
- Med. Klinik I, Bereich Pneumologie, Universitätsklinikum Dresden
| | - E. Grünig
- Zentrum für Pulmonale Hypertonie an der Thoraxklinik am Universitätsklinikum Heidelberg
| | - E. Mayer
- Abteilung für Thoraxchirurgie Kerckhoff Klinik Bad Nauheim
| | - C. Neurohr
- Med. Klinik I und Poliklinik, Klinikum d. Universität München
| | - H. Wilkens
- Med. Klinik und Poliklinik, Abt. Pneumologie, Universitätsklinikum des Saarlandes, Homburg
| | - M. Hoeper
- Klinik für Pneumologie, Medizinische Hochschule Hannover
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Kaemmerer H, Gorenflo M, Hoeper M, Huscher D, Ewert P, Pittrow D. Pulmonalarterielle Hypertonie bei angeborenen Herzfehlern: Problemstellung und Versorgungslage. Dtsch Med Wochenschr 2013. [DOI: 10.1055/s-0033-1353943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- H. Kaemmerer
- Klinik für Kinderkardiologie und angeborene Herzfehler, Deutsches Herzzentrum München, Klinik an der Technischen Universität München
| | - M. Gorenflo
- Klinik für Kinderkardiologie und angeborene Herzfehler, Universitätsklinikum Heidelberg
| | - M. Hoeper
- Klinik für Pneumologie, Medizinische Hochschule Hannover
| | - D. Huscher
- Deutsches Rheuma-Forschungszentrum Berlin und Rheumatologie, Charité - Universitätsmedizin Berlin
| | - P. Ewert
- Klinik für Kinderkardiologie und angeborene Herzfehler, Deutsches Herzzentrum München, Klinik an der Technischen Universität München
| | - D. Pittrow
- Institut für Klinische Pharmakologie, Medizinische Fakultät, Technische Universität Dresden
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Kaemmerer H, Gorenflo M, Hoeper M, Huscher D, Ewert P, Pittrow D. [Pulmonary arterial hypertension in patients with congenital heart disease: current issues and health care situation]. Dtsch Med Wochenschr 2013; 138:1247-52. [PMID: 23720182 DOI: 10.1055/s-0033-1343189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Defects of the heart and associated large vessels (CHD) are among the most frequent congenital anomalies. Owing to improved interdisciplinary management, about 90% of CHD patients reach adulthood. Up to 10% maintain or newly develop pulmonary arterial hypertension (PAH) over time, which impairs exercise tolerance and prognosis. Data on the health care situation of patients with PAH-CHD are limited. The ongoing Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA, ClinTrials.gov Identifier NCT01347216) prospectively documents adult patients with all forms of pulmonary hypertension, if treated with PAH drugs (mean follow-up 40 months). As of 16 November 2012, 8% of the 3642 patients in the database had PAH-CHD. Of the latter, 104 were documented in great detail in specific CHD report forms. These patients were on average 39 years old, men in 39%, had a mean 6-minute walk distance of 370 ± 102 meters, and were in NYHA functional class I/II in 39%, III in 59%, und IV in 3%. Mean quality of life on the 100-point visual analogue scale (EQ-5 D) was 51. PAH-CHD patients received monotherapy in 80%, combination therapy in 9%, and no PAH drugs in 11%. Only 20% were on oral anticoagulation (OAC). Mean 4-year survival in incident patients (PAH-CHD diagnosis after start of the registry in 2007) was 79%, compared with 72% in patients with idiopathic PAH (IPAH). According to these registry data, patients with PAH-CHD have impaired exercise capacity, and substantially reduced quality of life. They receive combination therapy or OAC, respectively, less frequently than IPAH patients, however, their survival rate is higher.
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Affiliation(s)
- H Kaemmerer
- Klinik für Kinderkardiologie und angeborene Herzfehler, Deutsches Herzzentrum München, Klinik an der Technischen Universität München.
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Schoenfeld C, Gutberlet M, Hinrichs J, Renne J, Hueper K, Sourbron S, Hoeper M, Welte T, Wacker F, Vogel-Claussen J. MRT perfusions-gewichtete Fourier Dekompositionsmethode korreliert mit quantitativer dynamischer MRT-Perfusion der Lunge bei Patienten mit chronisch thromboembolischer pulmonaler Hypertonie (CTEPH). ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gutberlet M, Schönfeld C, Renne J, Hinrichs J, Berding G, Hoeper M, Welte T, Bengel F, Wacker F, Vogel-Claussen J. Vergleich der SPECT mit der dynamischen, kontrastmittelverstärkten Perfusions-MRT und der MR-Fourier-Dekomposition zur Diagnose der chronischen thromboembolischen pulmonalen Hypertonie (CTEPH). ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Grannas G, Hoeper M, Gottlieb J, Richter N, Strassburg CP, Manns M, Welte T, Haverich A, Klempnauer J, Warnecke G, Lehner F. 12 Years of Experience in Combined Lung and Liver Transplantation - Changes Over Time and Long Term Outcome. Transplantation 2012. [DOI: 10.1097/00007890-201211271-00724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tudorache I, Kühn C, Wiesner O, Olsson K, Hadem J, Sommer W, Bara C, Welte T, Gottlieb J, Hoeper M, Haverich A, Warnecke G. 218 Not the Right, but the Left Ventricle Causes the Problem after Lung Transplantation for Pulmonary Artery Hypertension – Awake ECMO for Postoperative LV Remodelling. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Sommer W, Warnecke G, Fuehner T, Tongers J, Strüber M, Schieffer B, Hoeper M, Haverich A, Kühn C. ECMO in awake patients with acute cardiac failure as bridge to decision. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Ghofrani HA, Hoeper M, Halank M, Meyer F, Stähler G, Behr J, Ewert R, Binnen T, Weimann G, Grimminger F. Riociguat bei chronisch thromboembolischer pulmonaler Hypertonie und pulmonal-arterieller Hypertonie: Erste Langzeitdaten aus der Verlängerung einer Phase-II-Studie. Pneumologie 2011. [DOI: 10.1055/s-0030-1256819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Halank M, Knudsen L, Seyfarth HJ, Ewert R, Wiedemann B, Kolditz M, Höffken G, Hoeper M. Ambrisentan Improves Exercise Capacity and Symptoms in Patients with Portopulmonary Hypertension. Z Gastroenterol 2011; 49:1258-62. [DOI: 10.1055/s-0031-1273393] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Hoeper M, Andreas S, Bastian A, Claussen M, Ghofrani H, Gorenflo M, Grohé C, Günther A, Halank M, Hammerl P, Held M, Krüger S, Lange T, Reichenberger F, Sablotzki A, Staehler G, Stark W, Wirtz H, Witt C, Behr J. Pulmonale Hypertonie bei chronischen Lungenerkrankungen. Pneumologie 2010; 65:208-18. [DOI: 10.1055/s-0030-1255970] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rosenkranz S, Ghofrani H, Grünig E, Hoeper M. Kölner Konsensus-Konferenz zur pulmonalen Hypertonie 2010 – Präambel. Dtsch Med Wochenschr 2010; 135 Suppl 3:S64-6. [DOI: 10.1055/s-0030-1263313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ghofrani H, Distler O, Gerhardt F, Gorenflo M, Grünig E, Haefeli W, Held M, Hoeper M, Kähler CM, Kaemmerer H, Klose H, Köllner V, Kopp B, Mebus S, Meyer A, Miera O, Pittrow D, Riemekasten G, Rosenkranz S, Schranz D, Voswinckel R, Olschewski H. Therapie der pulmonal arteriellen Hypertonie (PAH). Dtsch Med Wochenschr 2010; 135 Suppl 3:S87-101. [DOI: 10.1055/s-0030-1263316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hoeper M, Ghofrani H, Gorenflo M, Grünig E, Schranz D, Rosenkranz S. Diagnostik und Therapie der pulmonalen Hypertonie: Europäische Leitlinien 2009. Dtsch Med Wochenschr 2010. [DOI: 10.1055/s-0030-1248657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hoeper M, Ghofrani H, Gorenflo M, Grünig E, Schranz D, Rosenkranz S. Diagnostik und Therapie der pulmonalen Hypertonie: Europäische Leitlinien 2009. Pneumologie 2010; 64:401-14. [DOI: 10.1055/s-0029-1244112] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wilkens H, Grimminger F, Hoeper M, Stähler G, Ehlken B, Plesnila-Frank C, Berger K, Resch A, Ghofrani A. Burden of pulmonary arterial hypertension in Germany. Respir Med 2010; 104:902-10. [PMID: 20149617 DOI: 10.1016/j.rmed.2010.01.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [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] [Received: 08/16/2009] [Revised: 12/27/2009] [Accepted: 01/07/2010] [Indexed: 11/24/2022]
Abstract
This study aimed to describe health care provision, resource consumption and related costs, as well as treatment patterns and quality of life in adult patients with pulmonary arterial hypertension (PAH) in Germany. Data for this retrospective and prospective cost-of-illness-study were derived from hospitals, general practitioners and patients. Costs were evaluated from the perspective of third party payer and patient. Quality of life data were collected by using three validated instruments. A total of 167 patients were enrolled at 10 hospitals. Time period from first occurrence of symptoms to confirmed diagnosis of PAH was 2.3 years on average. Mean number of GP visits was 1.5 per patient per month, and within 15 months, inpatient stays were reported for 50% of patients. The ratio of combination therapy to single-drug therapy for endothelin receptor antagonists, phosphodiesterase-5-inhibitor and prostacyclin analogues increased significantly during 15 months. Treatment costs were, on average, euro47,400 per patient per year, arising mainly from drugs. Compared to the general population, quality of life of PAH patients was considerably impaired. This is the first study which evaluated aspects of the medical and economic consequences of PAH based on a large cohort of PAH patients in Germany.
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Affiliation(s)
- H Wilkens
- Department of Pneumology, Universitätsklinikum des Saarlandes/Homburg, Kirrberger Strasse 1, 66424 Homburg/Saar, Germany.
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Golpon H, Sauer C, Nickel N, Hoeper M, Welte T. Phagozytose apoptotischer Zellen durch pulmonale Gefäßzellen – Auswirkungen auf die vaskuläre Homöostase. Pneumologie 2010. [DOI: 10.1055/s-0029-1247915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hoeper M, Ghofrani H, Grimminger F, Rosenkranz S. Dana Point: Was ist neu in der Therapie der pulmonalen Hypertonie? Dtsch Med Wochenschr 2008; 133 Suppl 6:S191-5. [DOI: 10.1055/s-0028-1091236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ehlken N, Mereles D, Ghofrani A, Hoeper M, Halank M, Meyer J, Karger G, Wilkens H, Herth F, Olschewski H, Gruenig E. Niedrig dosierte Atem- und Bewegungstherapie verbessert die körperliche Leistungsfähigkeit und die Lebensqualität bei Patienten mit schwerer chronischer pulmonaler Hypertonie. Pneumologie 2006. [DOI: 10.1055/s-2006-933807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Behr J, Borst MM, Winkler J, Hoeper M, Halank M, Ghofrani A, Klose H, Wilkens H, Stähler G. [A role for combination therapy in pulmonary arterial hypertension]. Pneumologie 2005; 59:730-5. [PMID: 16222588 DOI: 10.1055/s-2005-915556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
For patients with pulmonary arterial hypertension (PAH) two first line therapies - iloprost inhalation (Ventavis) and bosentan (Tracleer) -- are available in Germany. A third substance, sildenafil, is already approved in the US and will be approved for this indication in the European Union soon. Patients with PAH can be stabilized or improved with a specific mono-therapy for a limited period of time only. Therefore, the question arises when and how to initiate treatment escalation. The available data from controlled clinical trials are insufficient to give a definite answer to these questions. Moreover, it is still unclear which combination of the above mentioned substances may be superior in the treatment of PAH. On the other hand, combination therapy is already reality in clinical practice. Based on this background experts from specialized centers dealing with PAH discussed the scientific basis of the role of combination therapy in PAH patients during a workshop held on April 22/23. 2005 in Wiesbaden. The goal of this workshop was to formulate a common position with regard to combination therapy of PAH on the basis of the available scientific data and clinical experience.
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Affiliation(s)
- J Behr
- Medizinische Klinik und Poliklinik I, Schwerpunkt Pneumologie, Klinikum der Ludwig-Maximilians-Universität München-Grosshadern.
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