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Pinsdorf D, Messiha D, Petrikhovich O, Bahar M, Steinmetz M, Mahabadi AA, Dykun I, Lortz J, Rassaf T, Rammos C. Differences in treatment strategies for LDL-cholesterol reduction in a university lipid clinic vs. standard care apart from the use of PCSK9 inhibitors. J Clin Lipidol 2023; 17:504-511. [PMID: 37271601 DOI: 10.1016/j.jacl.2023.05.100] [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] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/01/2023] [Accepted: 05/22/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Lipid-lowering therapy (LLT) in patients with cardiovascular disease (CVD) is insufficient despite clear guideline recommendations. Lipid clinics have specialized in patients with dyslipidemia, but the magnitude and reduction of low-density lipoprotein cholesterol (LDL-C) in lipid clinics has not yet been studied in depth. OBJECTIVE To assess LDL-C reduction in very high-risk CVD patients achieved in a lipid clinic through different forms of LLT in comparison to standard care without the initiation of PSCK9 inhibitors. METHODS Data from 96 lipid clinic patients were analyzed retrospectively and compared to 84 standard care patients. Very high-risk patients were defined according to the European Society of Cardiology (ESC). Different combinations of LLT focusing on statins and ezetimibe were investigated. Achievement of LDL-C treatment goals according to ESC guidelines as well as LDL-C reduction were assessed. RESULTS Baseline and follow-up data of 180 very high-risk CVD patients (mean age 67.7 (±9.8) y; 60.6% male) were used. Achievement of the LDL-C goal in lipid clinic patients increased significantly from 14.6% at baseline to 41.7% at the latest visit (p<0.001) while standard care patients improved from 21.4% to 33.3% (p=0.08). The largest relative LDL-C reduction via an adjustment in LLT was achieved by initiation of high-intensity statins (50.8 ± 4.9%, n = 5, p < 0.05). CONCLUSION Treatment in a lipid clinic leads to a superior LDL-C goal achievement in very high-risk CVD patients as compared to standard care with the highest reduction under LLT with high-intensity statins and ezetimibe. Referral algorithms have to be established for high-risk patients.
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Affiliation(s)
- David Pinsdorf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Daniel Messiha
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Olga Petrikhovich
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Mikail Bahar
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Steinmetz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Amir Abbas Mahabadi
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Iryna Dykun
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Julia Lortz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Christos Rammos
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany.
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2
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Rammos C, Manzke A, Lortz J, Messiha D, Petrikhovich O, Jánosi RA, Steinmetz M, Rassaf T. Mechanical atherothrombectomy improves endothelial function through plaque burden reduction in PAD. VASA 2022; 51:377-385. [DOI: 10.1024/0301-1526/a001034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Summary: Background: Endothelial dysfunction defines outcomes and serves as a surrogate parameter for the progression of cardiovascular disease. For symptomatic peripheral artery disease (PAD) endovascular treatment is the primary revascularization strategy, which affects endothelial function. Interventional mechanical atherothrombectomy (MATH) provides advantages when treating complex atherosclerotic and thrombotic lesions. We now aimed to determine the impact and mechanisms of MATH on endothelial function. Patients and methods: Endothelial function was determined using flow-mediated dilation (FMD) before and after lower limb intervention with a six-month follow-up in the target and control vessel in 15 PAD MATH+DCB treated patients and compared to 15 non-Math controls. In a further cohort of 20 patients the impact of MATH and DCB on vascular structure and virtual histology was assessed through intravascular ultrasound (IVUS) and compared to DCB treatment alone. Results: Improved endothelial function after 6 months was observed in both groups for the target and nontarget vessel. When comparing the changes from baseline endothelial function, treatment with MATH+DCB was superior to DCB treatment in the target vessel. IVUS revealed a greater improvement in luminal area and plaque burden reduction after MATH treatment. Virtual histology disclosed MATH-associated changes in plaque composition evidenced by alterations in fibrous volume and reductions in superficial calcium. Conclusions: We demonstrate an improved endothelial function after MATH treatment as compared to DCB treatment. The improved vessel function is evidenced by MATH-related plaque burden reduction, improved luminal gain and a decrease in superficial calcification. Clinicaltrials.gov: NCT04092972.
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Affiliation(s)
- Christos Rammos
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Anna Manzke
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Julia Lortz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Daniel Messiha
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Olga Petrikhovich
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Rolf Alexander Jánosi
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Steinmetz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
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Radecke T, Nashtar MA, Korste S, Hendgen-Cotta UB, Rassaf T, Rammos C, Gunzer M, Steinmetz M. A critical review of wire injury induced aortic valve stenosis in mice. J Mol Cell Cardiol 2022; 169:71-73. [PMID: 35598534 DOI: 10.1016/j.yjmcc.2022.05.004] [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] [Received: 03/26/2022] [Revised: 04/30/2022] [Accepted: 05/11/2022] [Indexed: 10/18/2022]
Affiliation(s)
- T Radecke
- West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Germany
| | - M A Nashtar
- West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Germany
| | - S Korste
- West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Germany
| | - U B Hendgen-Cotta
- West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Germany
| | - T Rassaf
- West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Germany
| | - C Rammos
- West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Germany
| | - M Gunzer
- Institute for Experimental Immunology and Imaging, University of Duisburg-Essen, Germany
| | - M Steinmetz
- West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Germany.
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4
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Bojko J, Khoury M, Masson W, Weber A, Hilgers C, Bourauel C, Steinmetz M, Welle K, Schildberg FA, Kabir K. Erratum: Impact of Long-term, High-fat, and High-calorie Diet on Murine Vertebrae Bones. Z Orthop Unfall 2022; 160:e1. [PMID: 35235974 DOI: 10.1055/a-1770-7268] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jessica Bojko
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
| | - Mona Khoury
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
| | - Werner Masson
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
| | - Anna Weber
- Oral Technology, School of Dentistry, University of Bonn
| | - Cäcilia Hilgers
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
| | | | - Martin Steinmetz
- Department of Cardiology, Heart Center Bonn, University Hospital Bonn
| | - Kristian Welle
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
| | | | - Koroush Kabir
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
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Ulrich S, Balmer C, Becker K, Bruhs J, Danne F, Debus V, Dewein L, Doll U, Fleck T, Grafmann M, Greil S, Grosser U, Saur P, Skrzypek S, Steinmetz M. COVID-19 Infection after Pediatric Heart Transplantation in Germany, Austria, and Switzerland. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S. Ulrich
- Department of Pediatric Cardiology and Intensive Care Medicine, Chairwoman of the Working Group Thoracic Organ Transplantation DGPK, LMU, München, Deutschland
| | - C. Balmer
- Children's Hospital Zurich, Zürich, Switzerland
| | - K. Becker
- Department of Pediatric Cardiology, University Hospital Schleswig-Holstein, Kiel, Deutschland
| | - J. Bruhs
- Center of Congential Heart Disease, HDZ-NRW, Ruhr-University, Bad Oeynhausen, Bad Oeynhausen, Deutschland
| | - F. Danne
- Department of Pediatric Cardiology, DHZ Berlin, Berlin, Deutschland
| | - V. Debus
- Department of Pediatric Cardiology, University Hospital Münster, Münster, Deutschland
| | - L. Dewein
- Department of Pediatrics, University Hospital Ulm, Ulm, Deutschland
| | - U. Doll
- Department of Pediatric Cardiology, University Hospital Erlangen, Erlangen, Deutschland
| | - T. Fleck
- Department of Pediatric Cardiology, University Hospital Freiburg, Freiburg, Deutschland
| | - M. Grafmann
- Department of Pediatric Cardiology, UKE Hamburg, Hamburg, Deutschland
| | - S. Greil
- Department of Pediatric Cardiology, University Hospital Wien, Vienna, Austria
| | - U. Grosser
- Department of Pediatric Cardiology, University Hospital Hannover, Hanover, Deutschland
| | - P. Saur
- Department of Pediatric Cardiology, University Hospital Heidelberg, Heidelberg, Deutschland
| | - S. Skrzypek
- Kinderherzzentrum Giessen, Gießen, Deutschland
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Uden T, Seidel F, Opgen-Rhein B, Boecker D, Wannenmacher B, Rentzsch A, Reineker K, Böhne M, Wiegand G, Hecht T, Blank AE, Fischer M, Kaestner M, Steinmetz M, Freudenthal N, Fischer G, Ruf B, Boethig D, Pickardt T, Beerbaum P, Schubert S, Messroghli D. Scar and Edema Imaging by CMR in Pediatric Myocarditis—Preliminary Results from the MYKKE-Registry. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- T. Uden
- Medizinische Hochschule Hannover, Hannover, Deutschland
| | - F. Seidel
- German Heart Institute Berlin, Berlin, Deutschland
| | - B. Opgen-Rhein
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - D. Boecker
- University Hospital Erlangen, Erlangen, Deutschland
| | - B. Wannenmacher
- Kinderkardiologie, Herzzentrum Leipzig, Leipzig, Deutschland
| | - A. Rentzsch
- Saarland University Medical Center, Homburg an der Saar, Deutschland
| | - K. Reineker
- Department of Congenital Heart Disease and Paediatric Cardiology, University Heart Centre Freiburg - Bad Krozingen, Medical Centre-University of Freiburg, Freiburg, Deutschland
| | - M. Böhne
- Medizinische Hochschule Hannover, Hannover, Deutschland
| | - G. Wiegand
- Department of Pediatric Cardiology, University of Tuebingen, Tübingen, Deutschland
| | - T. Hecht
- HDZ NRW, Bad Oeynhausen, Deutschland
| | - A.-E. Blank
- Pediatric Heart Center, Giessen, Deutschland
| | - M. Fischer
- Klinikum der Universität München, München, Deutschland
| | | | - M. Steinmetz
- University Medicine Göttingen, Göttingen, Deutschland
| | - N. Freudenthal
- Pediatric Cardiology, Universitätsklinikum Bonn, Bonn, Deutschland
| | - G. Fischer
- Department of Congenital Heart Disease and Pediatric Cardiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - B. Ruf
- Pediatric Cardiology, Deutsches Herzzentrum München, Munich, Deutschland
| | - D. Boethig
- Medizinische Hochschule Hannover, Hannover, Deutschland
| | - T. Pickardt
- Competence Network for Congenital Heart Defects, Berlin, Deutschland
| | - P. Beerbaum
- Medizinische Hochschule Hannover, Hannover, Deutschland
| | - S. Schubert
- German Heart Institute Berlin, Berlin, Deutschland
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7
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Bojko J, Khoury M, Masson W, Weber A, Hilgers C, Bourauel C, Steinmetz M, Welle K, Schildberg FA, Kabir K. Impact of Long-term, High-fat, and High-cholesterol Diet on Murine Vertebrae Bones. Z Orthop Unfall 2021; 159:659-665. [PMID: 32702758 DOI: 10.1055/a-1194-5554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
As the percentage of overweight individuals in the population rises, diseases associated with excess weight resulting from poor nutrition are becoming more and more widespread. So far, the influence of weight or nutrition on bone health has shown conflicting results. In the literature, the existing studies disagree about the effect of diet on bones. Therefore, this study investigated the impact of a long-term, high-fat, and high-cholesterol diet on the spine in a mouse model. Wild-type mice were randomly separated into two groups; one group received a high-fat and high-cholesterol diet, and a control group was fed with a regular diet since birth for a duration of 8 months. The first to fifth thoracic vertebrae were extracted and investigated using histology and micro-CT. Samples were analyzed regarding different parameters: percentage of bone structure compared to the whole vertebra and the amount and thickness of the trabeculae. Both methods of the analysis showed similar results. Diet did not have a significant impact on the bone density of the vertebrae. The micro-CT examination showed that the average bone percentage of the examined vertebra was 6% (p = 0.2330) higher in the control group compared to the diet group. The same tendency was demonstrated in histology even though with a smaller difference of only 5%. The results of both methods were comparable and showed trends for the influence of different diets but not significant impacts. In summary, this study showed that a high-fat and high-cholesterol diet has a slightly negative impact on bone density. In order to further analyze the effects of different diets on bone composition, structure, and density, additional long-term studies should be carried out, and more parameters such as movement and genetic factors should be analyzed. Furthermore, other parameters such as exercise and genetic factors that could have a secondary influence on obesity should be investigated.
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Affiliation(s)
- Jessica Bojko
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
| | - Mona Khoury
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
| | - Werner Masson
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
| | - Anna Weber
- Oral Technology, School of Dentistry, University of Bonn
| | - Cäcilia Hilgers
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
| | | | - Martin Steinmetz
- Department of Cardiology, Heart Center Bonn, University Hospital Bonn
| | - Kristian Welle
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
| | | | - Koroush Kabir
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
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Rammos C, Steinmetz M, Lortz J, Mahabadi AA, Petrikhovich O, Kirsch K, Hering R, Schulz M, Rassaf T. Peripheral artery disease in Germany (2009-2018): Prevalence, frequency of specialized ambulatory care and use of guideline-recommended therapy - A population-based study. Lancet Reg Health Eur 2021; 5:100113. [PMID: 34557822 PMCID: PMC8454876 DOI: 10.1016/j.lanepe.2021.100113] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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] [Indexed: 12/24/2022]
Abstract
Background Peripheral artery disease (PAD) patients have high morbidity and mortality rates, demonstrating a need for improved treatment strategies. While underuse and undertreatment have been reported, there is no clear picture of patterns in population-level disease prevalence, prescription of guideline-recommended pharmacotherapy, or frequency of contact with dedicated specialists. We present population-level data on changes in prevalence, care and treatment of PAD from 2009 to 2018 in Germany. Methods We analyzed the ambulatory claims data for all statutorily insured patients comprising 70.1 million patients each year and 87% of the German population. Prevalence was assessed by documentation of PAD and stratified by age and sex within the 10-year study timeframe. In addition, current ambulatory care, stratified by vascular specialists (vascular surgeons or angiologists), internists, cardiologists and primary care physicians, were examined. Findings Prevalence increased from 1·85% in 2009 to 3·14% in 2018, affecting 2·3 million patients in 2018 and more males (55%) than females (45%). A low level of visits to vascular specialists, with 11·1% receiving care from vascular surgeons and 8·1% from angiologists, was shown. Moreover, analysis of guideline-recommended prescriptions revealed increasing, but still insufficient, prescription frequencies among PAD patients between 2009 and 2016, from 42·6% to 56% for statins and from 40·2% to 48·0% for antiplatelets. Interpretation Our results show that the prevalence of PAD in Germany, as assessed by outpatient PAD documentation, is increasing and PAD patients are underutilizing specialized vascular care; moreover, the prescription frequency of guideline-recommended therapies remains low. There is a clear need to improve the referral and treatment algorithms in the high-risk PAD population. Funding None.
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Affiliation(s)
- Christos Rammos
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Martin Steinmetz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Julia Lortz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Amir A Mahabadi
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Olga Petrikhovich
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Kristina Kirsch
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Ramona Hering
- Department of Data Science and Healthcare Analyses, Central Research Institute for Ambulatory Healthcare in Germany (Zi), Germany
| | - Mandy Schulz
- Department of Data Science and Healthcare Analyses, Central Research Institute for Ambulatory Healthcare in Germany (Zi), Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
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9
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Paldán K, Steinmetz M, Simanovski J, Rammos C, Ullrich G, Jánosi RA, Moebus S, Rassaf T, Lortz J. Supervised Exercise Therapy Using Mobile Health Technology in Patients With Peripheral Arterial Disease: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2021; 9:e24214. [PMID: 34398800 PMCID: PMC8406106 DOI: 10.2196/24214] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/16/2020] [Accepted: 02/24/2021] [Indexed: 01/18/2023] Open
Abstract
Background Mobile health interventions are intended to support complex health care needs in chronic diseases digitally, but they are mainly targeted at general health improvement and neglect disease-specific requirements. Therefore, we designed TrackPAD, a smartphone app to support supervised exercise training in patients with peripheral arterial disease. Objective This pilot study aimed to evaluate changes in the 6-minute walking distance (meters) as a primary outcome measure. The secondary outcome measures included changes in physical activity and assessing the patients’ peripheral arterial disease–related quality of life. Methods This was a pilot two-arm, single-blinded, randomized controlled trial. Patients with symptomatic PAD (Fontaine stage IIa/b) and access to smartphones were eligible. Eligible participants were randomly assigned to the study, with the control group stratified by the distance covered in the 6-minute walking test using the TENALEA software. Participants randomized to the intervention group received usual care and the mobile intervention (TrackPAD) for the follow-up period of 3 months, whereas participants randomized to the control group received routine care only. TrackPAD records the frequency and duration of training sessions and pain levels using manual user input. Clinical outcome data were collected at the baseline and after 3 months via validated tools (the 6-minute walk test and self-reported quality of life). The usability and quality of the app were determined using the Mobile Application Rating Scale user version. Results The intervention group (n=19) increased their mean 6-minute walking distance (83 meters, SD 72.2), while the control group (n=20) decreased their mean distance after 3 months of follow-up (–38.8 meters, SD 53.7; P=.01). The peripheral arterial disease–related quality of life increased significantly in terms of “symptom perception” and “limitations in physical functioning.” Users’ feedback showed increased motivation and a changed attitude toward performing supervised exercise training. Conclusions Besides the rating providing a valuable support tool for the user group, the mobile intervention TrackPAD was linked to a change in prognosis-relevant outcome measures combined with enhanced coping with the disease. The influence of mobile interventions on long-term prognosis must be evaluated in the future. Trial Registration ClinicalTrials.gov NCT04947228; https://clinicaltrials.gov/ct2/show/NCT04947228
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Affiliation(s)
- Katrin Paldán
- Institute for Urban Public Health, University Clinic of Essen, University of Duisburg-Essen, Germany, Essen, Germany.,Personal Analytics Centre of Competence, Department of Engineering Sciences, University of Duisburg-Essen, Essen, Germany
| | - Martin Steinmetz
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Jan Simanovski
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Christos Rammos
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Greta Ullrich
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Rolf Alexander Jánosi
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Susanne Moebus
- Institute for Urban Public Health, University Clinic of Essen, University of Duisburg-Essen, Germany, Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Julia Lortz
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
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Rammos C, Steinmetz M, Johnstone M, Manzke A, Lortz J, Petrikhovich O, Hendgen-Cotta U, Jánosi RA, Rassaf T. The impact of percutaneous peripheral interventions on endothelial function. VASA 2021; 50:423-430. [PMID: 34233505 DOI: 10.1024/0301-1526/a000963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Treatment of symptomatic peripheral artery disease (PAD) through endovascular interventions is the primary revascularization strategy. Interventions restore perfusion but may cause severe injury to the vascular endothelium, which regulates vascular tone. Endothelial dysfunction is involved in the progression of cardiovascular disease, with higher incidences of vascular events. We aimed to determine the impact of percutaneous interventions on change in endothelial function. Patients and methods: Endothelial function was determined using flow-mediated dilation (FMD) before, the day after lower limb intervention with paclitaxel-coated balloons or stent guided interventions and after a six-month follow-up in the target limb, control limb and the systemic circulation in 42 PAD patients aged 70.2±9 years and 66% men. Additionally, macro- and microvascular function were assessed. Results: In PAD patients aged 70.2±9 years and 66% men, we observed an immediate enhancement of macro-, microvascular and endothelial function after endovascular treatment (FMD of superficial femoral artery (SFA) 3.7±0.2% to 4.1±0.1%, n=42, p=0.02), a sustained long-term improvement after 6-months (FMD SFA 3.7±0.2% to 4.2±0.1%, n=42, p=0.01), and moreover an improved systemic endothelial function (FMD brachial artery 4.3±0.1% to 4.7±0.2, n=42, p=0.01) following peripheral interventions. Subgroup analysis however revealed that following paclitaxel-based percutaneous intervention, the paclitaxel dosage applied was inversely related to the chronic improvement in local endothelial function (r=-0.6, n=22, p=0.005) without evidence for systemic effects (r=-0.25, p=0.27). Conclusions: We demonstrate an improved local and systemic endothelial function after treatment of atherosclerotic peripheral disease with a distinguished response after endovascular intervention with higher dosage of applied paclitaxel restraining the benefits. Further studies have to determine the optimal interventional strategy with respect to different treatment modalities to maintain vessel functions.
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Affiliation(s)
- Christos Rammos
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| | - Martin Steinmetz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| | - Mirjam Johnstone
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| | - Anna Manzke
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| | - Julia Lortz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| | - Olga Petrikhovich
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| | - Ulrike Hendgen-Cotta
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| | - Rolf A Jánosi
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
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11
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Schuster A, Lange T, Backhaus SJ, Strohmeyer C, Boom P, Matz J, Kowallick JT, Steinmetz M, Kutty S, Bigalke B, Desch S, Hasenfuss G, Thiele H, Stiermaier T, Eitel I. Fully automated cardiac assessment for diagnostic and prognostic stratification following myocardial infarction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Cardiovascular magnetic resonance (CMR) imaging is considered the reference methodology for cardiac morphology and function but requires manual post-processing. Whether novel artificial intelligence (AI) -based automated analyses deliver similar information for risk stratification is unknown. Therefore, this study aimed to investigate feasibility and prognostic implications of AI-based analyses.
Methods
CMR data (n = 1017 patients) from two myocardial infarction multi-center trials were included. Analyses of biventricular parameters including ejection fraction (EF) were manually and automatically assessed using conventional and AI-based software. Obtained parameters entered regression analyses for prediction of major adverse clinical events (MACE) defined as death, reinfarction or congestive heart failure within one-year after the acute event.
Results
Both manual and uncorrected automated volumetric assessments showed similar impact on outcome on univariate (LVEF HR 0.93, [95% CI 0.91-0.95]; p < 0.001 for manual and HR 0.94 [0.92-0.96]; p < 0.001 for automated) and multivariable analyses (LVEF HR 0.95, [0.92-0.98]; p = 0.001 for manual and HR 0.95 [CI 0.92-0.98]; p = 0.001 for automated). Manual correction of the automated contours did not lead to improved risk prediction (LVEF AUC 0.67 automated vs. 0.68 automated corrected, p = 0.49). There was acceptable agreement (bias: 2.6%, 95% limits of agreement [LOA] -9.1-14.2%, intraclass correlation coefficient [ICC] 0.88 [0.77-0.93] for LVEF) of manual and automated volumetric assessments.
Conclusions
User independent volumetric analyses performed by fully automated software are feasible and results are equally predictive of MACE compared with conventional analyses in patients following myocardial infarction.
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Affiliation(s)
- A Schuster
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - T Lange
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - SJ Backhaus
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - C Strohmeyer
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - P Boom
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - J Matz
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - JT Kowallick
- University Medical Center Goettingen (UMG), Department of Diagnostic& Interventional Radiology, German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - M Steinmetz
- University Medical Center of Gottingen (UMG), Department of Pediatric Cardiology, Goettingen, Germany
| | - S Kutty
- Johns Hopkins University School of Medicine, Helen B. Taussig Heart Center, Baltimore, United States of America
| | - B Bigalke
- Charite - Campus Benjamin Franklin, Department of Cardiology, Berlin, Germany
| | - S Desch
- Heart Center of Leipzig, Department of Internal Medicine/Cardiology, Leipzig, Germany
| | - G Hasenfuss
- University Medical Center Goettingen (UMG), Department of Cardiology and Pneumology and German Center for Cardiovascular Research (DZHK), Goettingen, Germany
| | - H Thiele
- Heart Center of Leipzig, Department of Internal Medicine/Cardiology, Leipzig, Germany
| | - T Stiermaier
- University Heart Center, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Luebeck, Germany
| | - I Eitel
- University Heart Center, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), Luebeck, Germany
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12
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Messiha D, Kleinhans M, Rammos C, Dissemond J, Rassaf T, Steinmetz M. A Case of Critical Essential Thrombocythemia Complicated by Severe Lower-Extremity Arterial Disease. Am J Case Rep 2021; 22:e928340. [PMID: 33550325 PMCID: PMC7877793 DOI: 10.12659/ajcr.928340] [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] [Indexed: 11/26/2022]
Abstract
Patient: Male, 66-year-old Final Diagnosis: Essential thrombocythemia with CML • peripheral artery disease Symptoms: Fever • infection • necrosis • pain Medication: — Clinical Procedure: — Specialty: Cardiology • Dermatology • Diagnostics, Laboratory • Hematology
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Affiliation(s)
- Daniel Messiha
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany
| | - Monika Kleinhans
- Department of Dermatology, Venerology, and Allergology, University Hospital Essen, Essen, Germany
| | - Christos Rammos
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany
| | - Joachim Dissemond
- Department of Dermatology, Venerology, and Allergology, University Hospital Essen, Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany
| | - Martin Steinmetz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany
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13
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Messiha D, Halfmann L, Azizy O, Steinmetz M, Rassaf T, Rammos C. Endovascular treatment of peripheral artery disease is associated with improved central hemodynamics and ventricular function. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2381] [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
Peripheral artery disease (PAD) is a major manifestation of atherosclerosis and a risk factor for morbidity and mortality. PAD itself is associated with increased arterial stiffness with impact on cardiac functions. Previous studies have demonstrated that augmentation index (AIx) and central blood pressure (CBP) correlate with increased cardiovascular mortality. This mechanism has been described as arterio-ventricular (AV) coupling with altered ventricular afterload and a depressed ventricular function, measured by global longitudinal strain (GLS). The impact of PAD-related endovascular treatment on arterial stiffness, central hemodynamics and potential impact on AV coupling has not been elucidated until now.
Purpose
Aim of the study was to investigate, if endovascular treatment of PAD improves cardiac function via enhanced central hemodynamics and AV coupling.
Methods
To this aim 77 patients with known symptomatic PAD who underwent interventions in the iliac and femoropopliteal arteries were included in a cross-sectional study. AIx, CBP and GLS were determined using dedicated waveform analysis and echocardiography before and after endovascular treatment.
Results
Mean age was 65.1±10.4 years with 66.2% male patients. Symptoms were classified by Fontaine classification (stage IIb 80.7%, stage III 5.8% and stage IV 13.5%). Iliac vessel intervention was performed in 16 and femoropopliteal intervention in 61 cases. A stentless approach was feasible in 55 patients with DCB treatment and atherectomy.
After endovascular treatment, peripheral perfusion was enhanced (ABI 0.45±0.6 vs 0.81±0.5, p<0.0001). Moreover, central hemodynamics were improved (AIX 33.7±3% vs 27.9±2%, p=0.0008; AP 17.8±2 mmHg vs 14.0±2 mmHg, p=0.0004; central PP 52.4±6 mmHg vs 46.4±6 mmHg, p=0.0001). Impressively, left ventricular function was also significantly improved (GLS −15.7±2.3% vs −17.1±2.8%, p=0.005) with an improvement in AV coupling (PWV/GLS ratio −0.58m/sec% vs −0.56m/sec%, p<0.01).
Conclusion
Our results demonstrate that endovascular treatment of the peripheral vessels is associated with an improvement of central hemodynamics and left ventricular function via enhanced AV coupling. These prognostic relevant markers of cardiovascular disease could point to an overall potential mortality benefit through PAD treatment. Further investigation of the underlying mechanisms of AV coupling in the setting of endovascular treatment of PAD with impact on cardiovascular mortality is needed in this high-risk population.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- D Messiha
- University hospital Essen, Essen, Germany
| | - L Halfmann
- University hospital Essen, Essen, Germany
| | - O Azizy
- University hospital Essen, Essen, Germany
| | | | - T Rassaf
- University hospital Essen, Essen, Germany
| | - C Rammos
- University hospital Essen, Essen, Germany
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14
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Rammos C, Petrikhovich O, Mahabadi A, Steinmetz M, Lortz J, Hering R, Schulz M, Rassaf T. Prevalence, specialized ambulatory care and guideline-recommended therapy of peripheral vascular diseases in Germany. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Cardiovascular diseases are the leading causes of death in the industrialized world. In addition to coronary heart disease, PAD defines morbidity and is associated with increased mortality. Guideline-recommended therapy and specialized ambulatory care is essential for optimal treatment. Knowledge of the treatment structures, contact with dedicated specialists and pharmacotherapy in the outpatient area are essential for improving treatment, reducing symptoms and finally improve mortality in this high-risk population.
Methods
The study is based on the ambulatory claims data of the panel doctors services according to § 295 SGB V and drug prescription data according to § 300 SGB V. The prevalence of PAD in Germany (medical diagnoses of PAD ICD I70.2–9) was analyzed by age and gender-specific characteristics with a timeframe of 10 years (2009–2018). In addition, the current ambulatory care structure was examined subdivided by vascular specialist (vascular surgeons or angiologists) and primary care physicians (internal medicine or general practitioners). Additionally, the prescription of guideline-recommended pharmacotherapy like statins and antiplatelet inhibitors was analyzed for the years 2009–2016.
Results
An increase of PAD diagnosis was observed with a maximum in 2018 with 2.280.000 patients in Germany. The rise of PAD patients strongly correlates with increased age (age group 50–59: 243.000, age group 60–69: 533.000, age group 70–79: 735.000, age group 75–79: 438.000, age group 80–89: 710.000) and more commonly affects males (55%) than females (45%). Access to vascular specialist was low for all age groups with only 11% of patients receiving care from vascular surgeons and only 9% from angiologists. However, 99% received care by a primary care physician.
The prescription of lipid-lowering drugs and platelet aggregation inhibitors in the current analysis period from 2009–2016 is insufficient, with only 46% receiving statins and 29% receiving antiplatelets and 15% oral anticoagulation,
Conclusion
There are relevant differences in age and gender-specific prevalence of PAD in Germany. In addition to the regular care provided by primary care physicians, PAD patients are in need for specialized vascular care. Guideline recommended prescriptions are alarmingly low in PAD patients. There is a clear need to improve the treatment algorithms in the high-risk PAD population.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- C Rammos
- University of Duisburg-Essen, West German Heart Center, Essen, Germany
| | - O Petrikhovich
- University of Duisburg-Essen, West German Heart Center, Essen, Germany
| | - A Mahabadi
- University of Duisburg-Essen, West German Heart Center, Essen, Germany
| | - M Steinmetz
- University of Duisburg-Essen, West German Heart Center, Essen, Germany
| | - J Lortz
- University of Duisburg-Essen, West German Heart Center, Essen, Germany
| | - R Hering
- Central Research Institute for Ambulatory Healthcare in Germany (Zi), Department of Data Science and Healthcare Analyses, Berlin, Germany
| | - M Schulz
- Central Research Institute for Ambulatory Healthcare in Germany (Zi), Department of Data Science and Healthcare Analyses, Berlin, Germany
| | - T Rassaf
- University of Duisburg-Essen, West German Heart Center, Essen, Germany
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15
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Steinmetz M, Radecke T, Boss T, Stumpf MJ, Lortz J, Nickenig G, Kania A, Rassaf T, Rammos C, Schaefer CA. Radial artery occlusion after cardiac catheterization and impact of medical treatment. VASA 2020; 49:463-466. [PMID: 32669060 DOI: 10.1024/0301-1526/a000892] [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] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Summary: Background: The transradial artery approach is the preferred access for cardiac catheterization according to current guidelines. However, the most common complication is radial artery occlusion (RAO). Despite the rare indication for surgical reopening, the occluded radial artery is not available for further procedures or as a potential bypass graft. Still, treatment regimens for RAO are scarce. We now determined whether the addition of antithrombotic to antiplatelet therapy improves the rate of partial or complete regain of patency in RAO following transradial cardiac catheterization in a retrospective analysis. Patients and methods: In a two-center tertiary referral hospital retrospective analysis 4135 files of patients who had undergone transradial catheterization were screened for documented RAO. 141 patients were identified and 138 patients with complete information on the medical regimen and ultrasound examinations for a maximum of 3 months were included in the analysis, whereas 3 patients were excluded due to missing or incomplete follow-up information. Results: 3.3% of all patients that had undergone transradial catheterization featured an oligosymptomatic RAO, confirmed by color-coded duplex sonography. 21% of patients with additional anticoagulation regained full patency vs. 9% without additional anticoagulation (p = 0.07). 40% of patients with anticoagulation featured a partial or full regain of patency vs. 16% of patients without additional anticoagulation for a maximum of 3 months treatment (p = 0.006). No major bleedings were reported during the follow-up visits. Conclusions: RAO remains a rare complication of cardiac catheterization. The addition of antithrombotic therapy for 3 months appears to safely improve the partial or even full regain of radial patency in case of postinterventional RAO.
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Affiliation(s)
- Martin Steinmetz
- West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Germany
| | - Tobias Radecke
- West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Germany
| | - Tomasz Boss
- Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Germany
| | - Max J. Stumpf
- Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Germany
| | - Julia Lortz
- West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Germany
| | - Georg Nickenig
- Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Germany
| | - Alexander Kania
- Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany
| | - Tienush Rassaf
- West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Germany
| | - Christos Rammos
- West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Germany
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16
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Lortz J, Lortz TP, Johannsen L, Rammos C, Steinmetz M, Lind A, Rassaf T, Jánosi RA. Clinical process optimization of transfemoral transcatheter aortic valve implantation. Future Cardiol 2020; 17:321-327. [PMID: 32945193 DOI: 10.2217/fca-2020-0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background: The avoidance of prolonged hospital stay is a major goal in the management of transcatheter aortic valve implantation (TAVI) - medically and economically. Materials & methods: We compared the time range of the preprocedural length of stay in 2014/2015 with 2016/2017, after the implementation of the TAVI coordinator in 2016. This included restructured pathways for screening and pre-interventional diagnosis, performed examinations during the inpatient stay and major outcome variables. Results: After 2016, we observed a significant reduction in preprocedural length of stay (admission to procedure) compared with 2014/2015 (11.3 ± 7.9 vs 7.5 ± 5.6 days, p = 0.001). There was no difference in other major outcome variables. Conclusion: The introduction of the TAVI coordinator caused a shortening of preprocedural length of stay.
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Affiliation(s)
- Julia Lortz
- Department of Cardiology & Vascular Medicine, West German Heart & Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Tobias Peter Lortz
- Department of Cardiology & Vascular Medicine, West German Heart & Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Laura Johannsen
- Department of Cardiology & Vascular Medicine, West German Heart & Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Christos Rammos
- Department of Cardiology & Vascular Medicine, West German Heart & Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Steinmetz
- Department of Cardiology & Vascular Medicine, West German Heart & Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Alexander Lind
- Department of Cardiology & Vascular Medicine, West German Heart & Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology & Vascular Medicine, West German Heart & Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Rolf Alexander Jánosi
- Department of Cardiology & Vascular Medicine, West German Heart & Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
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17
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Bojko J, Khoury M, Masson W, Weber A, Hilgers C, Bourauel C, Steinmetz M, Welle K, Schildberg FA, Kabir K. Correction: Impact of Long-term, High-fat, and High-cholesterol Diet on Murine Vertebrae Bones. Z Orthop Unfall 2020; 159:e4. [PMID: 32767289 DOI: 10.1055/a-1229-5687] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Jessica Bojko
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
| | - Mona Khoury
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
| | - Werner Masson
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
| | - Anna Weber
- Oral Technology, School of Dentistry, University of Bonn
| | - Cäcilia Hilgers
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
| | | | - Martin Steinmetz
- Department of Cardiology, Heart Center Bonn, University Hospital Bonn
| | - Kristian Welle
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
| | | | - Koroush Kabir
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn
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18
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Lortz J, Simanovski J, Kuether T, Kreitschmann-Andermahr I, Ullrich G, Steinmetz M, Rammos C, Jánosi RA, Moebus S, Rassaf T, Paldán K. Needs and Requirements in the Designing of Mobile Interventions for Patients With Peripheral Arterial Disease: Questionnaire Study. JMIR Form Res 2020; 4:e15669. [PMID: 32663154 PMCID: PMC7435621 DOI: 10.2196/15669] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 11/11/2019] [Accepted: 03/29/2020] [Indexed: 12/24/2022] Open
Abstract
Background The development of mobile interventions for noncommunicable diseases has increased in recent years. However, there is a dearth of apps for patients with peripheral arterial disease (PAD), who frequently have an impaired ability to walk. Objective Using a patient-centered approach for the development of mobile interventions, we aim to describe the needs and requirements of patients with PAD regarding the overall care situation and the use of mobile interventions to perform supervised exercise therapy (SET). Methods A questionnaire survey was conducted in addition to a clinical examination at the vascular outpatient clinic of the West-German Heart and Vascular Center of the University Clinic Essen in Germany. Patients with diagnosed PAD were asked to answer questions on sociodemographic characteristics, PAD-related need for support, satisfaction with their health care situation, smartphone and app use, and requirements for the design of mobile interventions to support SET. Results Overall, a need for better support of patients with diagnosed PAD was identified. In total, 59.2% (n=180) expressed their desire for more support for their disease. Patients (n=304) had a mean age of 67 years and half of them (n=157, 51.6%) were smartphone users. We noted an interest in smartphone-supported SET, even for people who did not currently use a smartphone. “Information,” “feedback,” “choosing goals,” and “interaction with physicians and therapists” were rated the most relevant components of a potential app. Conclusions A need for the support of patients with PAD was determined. This was particularly evident with regard to disease literacy and the performance of SET. Based on a detailed description of patient characteristics, proposals for the design of mobile interventions adapted to the needs and requirements of patients can be derived.
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Affiliation(s)
- Julia Lortz
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Jan Simanovski
- Centre for Urban Epidemiology, Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Tabea Kuether
- Centre of Competence Personal Analytics at the University of Duisburg-Essen, Department of Engineering Sciences, University of Duisburg-Essen, Duisburg, Germany
| | | | - Greta Ullrich
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Steinmetz
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Christos Rammos
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Rolf Alexander Jánosi
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Susanne Moebus
- Centre for Urban Epidemiology, Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Katrin Paldán
- Centre for Urban Epidemiology, Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany.,Centre of Competence Personal Analytics at the University of Duisburg-Essen, Department of Engineering Sciences, University of Duisburg-Essen, Duisburg, Germany
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19
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Steinmetz M, Laurans L, Nordsiek S, Weiß L, van der Veken B, Ponnuswamy P, Esposito B, Vandestienne M, Giraud A, Göbbel C, Steffen E, Radecke T, Potteaux S, Nickenig G, Rassaf T, Tedgui A, Mallat Z. Thymic stromal lymphopoietin is a key cytokine for the immunomodulation of atherogenesis with Freund's adjuvant. J Cell Mol Med 2020; 24:5731-5739. [PMID: 32285594 PMCID: PMC7214169 DOI: 10.1111/jcmm.15235] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 08/16/2019] [Revised: 02/04/2020] [Accepted: 02/15/2020] [Indexed: 01/06/2023] Open
Abstract
Adaptive immune responses regulate the development of atherosclerosis, with a detrimental effect of type 1 but a protective role of type 2 immune responses. Immunization of Apolipoprotein E‐deficient (ApoE−/−) mice with Freund's adjuvant inhibits the development of atherosclerosis. However, the underlying mechanisms are not fully understood. Thymic stromal lymphopoietin (TSLP) is an IL7‐like cytokine with essential impact on type 2 immune responses (Th2). Thymic stromal lymphopoietin is strongly expressed in epithelial cells of the skin, but also in various immune cells following appropriate stimulation. In this study, we investigated whether TSLP may be crucial for the anti‐atherogenic effect of Freund's adjuvant. Subcutaneous injection of complete Freund's adjuvant (CFA) rapidly led to the expression of TSLP and IL1β at the site of injection. In male mice, CFA‐induced TSLP occurred in immigrated monocytes—and not epithelial cells—and was dependent on NLRP3 inflammasome activation and IL1β‐signalling. In females, CFA‐induced TSLP was independent of IL1β and upon ovariectomy. CFA/OVA led to a more pronounced imbalance of the T cell response in TSLPR−/− mice, with increased INFγ/IL4 ratio compared with wild‐type controls. To test whether TSLP contributes to the anti‐atherogenic effects of Freund's adjuvant, we treated ApoE−/− and ApoE−/−/TSLPR−/− mice with either CFA/IFA or PBS. ApoE−/− mice showed less atherogenesis upon CFA/IFA compared with PBS injections. ApoE−/−/TSLPR−/− mice had no attenuation of atherogenesis upon CFA/IFA treatment. Freund's adjuvant executes significant immune‐modulating effects via TSLP induction. TSLP‐TSLPR signalling is critical for CFA/IFA‐mediated attenuation of atherosclerosis.
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Affiliation(s)
- Martin Steinmetz
- Klinik für Kardiologie und Angiologie, Westdeutsches Herz- und Gefäßzentrum, Universitätsklinikum Essen, Essen, Germany.,Paris Cardiovascular Research Center, INSERM U970, Paris, France.,Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany
| | - Ludivine Laurans
- Paris Cardiovascular Research Center, INSERM U970, Paris, France
| | - Sarah Nordsiek
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany
| | - Lena Weiß
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany
| | | | | | - Bruno Esposito
- Paris Cardiovascular Research Center, INSERM U970, Paris, France
| | | | - Andreas Giraud
- Paris Cardiovascular Research Center, INSERM U970, Paris, France
| | - Cristina Göbbel
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany
| | - Eva Steffen
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany
| | - Tobias Radecke
- Klinik für Kardiologie und Angiologie, Westdeutsches Herz- und Gefäßzentrum, Universitätsklinikum Essen, Essen, Germany
| | | | - Georg Nickenig
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany
| | - Tienush Rassaf
- Klinik für Kardiologie und Angiologie, Westdeutsches Herz- und Gefäßzentrum, Universitätsklinikum Essen, Essen, Germany
| | - Alain Tedgui
- Paris Cardiovascular Research Center, INSERM U970, Paris, France
| | - Ziad Mallat
- Paris Cardiovascular Research Center, INSERM U970, Paris, France.,Division of Cardiovascular Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
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20
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Stöckigt F, Eichhorn L, Beiert T, Knappe V, Radecke T, Steinmetz M, Nickenig G, Peeva V, Kudin AP, Kunz WS, Berwanger C, Kamm L, Schultheis D, Schlötzer-Schrehardt U, Clemen CS, Schröder R, Schrickel JW. Heart failure after pressure overload in autosomal-dominant desminopathies: Lessons from heterozygous DES-p.R349P knock-in mice. PLoS One 2020; 15:e0228913. [PMID: 32126091 PMCID: PMC7053759 DOI: 10.1371/journal.pone.0228913] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/27/2020] [Indexed: 11/21/2022] Open
Abstract
Background Mutations in the human desmin gene (DES) cause autosomal-dominant and -recessive cardiomyopathies, leading to heart failure, arrhythmias, and AV blocks. We analyzed the effects of vascular pressure overload in a patient-mimicking p.R349P desmin knock-in mouse model that harbors the orthologue of the frequent human DES missense mutation p.R350P. Methods and results Transverse aortic constriction (TAC) was performed on heterozygous (HET) DES-p.R349P mice and wild-type (WT) littermates. Echocardiography demonstrated reduced left ventricular ejection fraction in HET-TAC (WT-sham: 69.5 ± 2.9%, HET-sham: 64.5 ± 4.7%, WT-TAC: 63.5 ± 4.9%, HET-TAC: 55.7 ± 5.4%; p<0.01). Cardiac output was significantly reduced in HET-TAC (WT sham: 13088 ± 2385 μl/min, HET sham: 10391 ± 1349μl/min, WT-TAC: 8097 ± 1903μl/min, HET-TAC: 5793 ± 2517μl/min; p<0.01). Incidence and duration of AV blocks as well as the probability to induce ventricular tachycardias was highest in HET-TAC. We observed reduced mtDNA copy numbers in HET-TAC (WT-sham: 12546 ± 406, HET-sham: 13526 ± 781, WT-TAC: 11155 ± 3315, HET-TAC: 8649 ± 1582; p = 0.025), but no mtDNA deletions. The activity of respiratory chain complexes I and IV showed the greatest reductions in HET-TAC. Conclusion Pressure overload in HET mice aggravated the clinical phenotype of cardiomyopathy and resulted in mitochondrial dysfunction. Preventive avoidance of pressure overload/arterial hypertension in desminopathy patients might represent a crucial therapeutic measure.
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Affiliation(s)
- Florian Stöckigt
- Department of Cardiology, University Hospital Bonn, Bonn, Germany
- Department of Cardiology, Krankenhaus Porz, Urbacher Weg, Cologne, Germany
- * E-mail:
| | - Lars Eichhorn
- Department of Anesthesiology, University Hospital Bonn, Bonn, Germany
| | - Thomas Beiert
- Department of Cardiology, University Hospital Bonn, Bonn, Germany
| | - Vincent Knappe
- Department of Cardiology, University Hospital Bonn, Bonn, Germany
| | - Tobias Radecke
- Department of Cardiology, University Hospital Essen, Hufelandstraße, Essen, Germany
| | - Martin Steinmetz
- Department of Cardiology, University Hospital Essen, Hufelandstraße, Essen, Germany
| | - Georg Nickenig
- Department of Cardiology, University Hospital Bonn, Bonn, Germany
| | - Viktoriya Peeva
- Institute of Experimental Epileptology and Cognition Research, Bonn, Germany
- Department of Epileptology, University Hospital of Bonn, Bonn, Germany
| | - Alexei P. Kudin
- Institute of Experimental Epileptology and Cognition Research, Bonn, Germany
- Department of Epileptology, University Hospital of Bonn, Bonn, Germany
| | - Wolfram S. Kunz
- Institute of Experimental Epileptology and Cognition Research, Bonn, Germany
- Department of Epileptology, University Hospital of Bonn, Bonn, Germany
| | - Carolin Berwanger
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Linder Höhe, Cologne, Germany
| | - Lisa Kamm
- Institute of Neuropathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage, Erlangen, Germany
| | - Dorothea Schultheis
- Institute of Neuropathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage, Erlangen, Germany
| | - Ursula Schlötzer-Schrehardt
- Department of Opthalmology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage, Erlangen, Germany
| | - Christoph S. Clemen
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Linder Höhe, Cologne, Germany
- Institute of Neuropathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage, Erlangen, Germany
- Center for Biochemistry, Institute of Biochemistry I, Medical Faculty, University of Cologne, Cologne, Germany
- Center for Physiology and Pathophysiology, Institute of Vegetative Physiology, Medical Faculty, University of Cologne, Cologne, Germany
| | - Rolf Schröder
- Institute of Neuropathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage, Erlangen, Germany
| | - Jan W. Schrickel
- Department of Cardiology, University Hospital Bonn, Bonn, Germany
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21
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Steinmetz M, Rammos C, Rassaf T, Lortz J. Digital interventions in the treatment of cardiovascular risk factors and atherosclerotic vascular disease. Int J Cardiol Heart Vasc 2020; 26:100470. [PMID: 32021904 PMCID: PMC6994620 DOI: 10.1016/j.ijcha.2020.100470] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 01/01/2020] [Accepted: 01/12/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Martin Steinmetz
- West German Heart and Vascular Center, Department of Cardiology and Angiology, University Hospital Essen, Germany
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22
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Steffen E, Mayer von Wittgenstein WBE, Hennig M, Niepmann ST, Zietzer A, Werner N, Rassaf T, Nickenig G, Wassmann S, Zimmer S, Steinmetz M. Murine sca1/flk1-positive cells are not endothelial progenitor cells, but B2 lymphocytes. Basic Res Cardiol 2020; 115:18. [PMID: 31980946 PMCID: PMC6981106 DOI: 10.1007/s00395-020-0774-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 01/02/2020] [Indexed: 12/12/2022]
Abstract
Circulating sca1+/flk1+ cells are hypothesized to be endothelial progenitor cells (EPCs) in mice that contribute to atheroprotection by replacing dysfunctional endothelial cells. Decreased numbers of circulating sca1+/flk1+ cells correlate with increased atherosclerotic lesions and impaired reendothelialization upon electric injury of the common carotid artery. However, legitimate doubts remain about the identity of the putative EPCs and their contribution to endothelial restoration. Hence, our study aimed to establish a phenotype for sca1+/flk1+ cells to gain a better understanding of their role in atherosclerotic disease. In wild-type mice, sca1+/flk1+ cells were mobilized into the peripheral circulation by granulocyte-colony stimulating factor (G-CSF) treatment and this movement correlated with improved endothelial regeneration upon carotid artery injury. Multicolor flow cytometry analysis revealed that sca1+/flk1+ cells predominantly co-expressed surface markers of conventional B cells (B2 cells). In RAG2-deficient mice and upon B2 cell depletion, sca1+/flk1+ cells were fully depleted. In the absence of monocytes, sca1+/flk1+ cell levels were unchanged. A PCR array focused on cell surface markers and next-generation sequencing (NGS) of purified sca1+/flk1+ cells confirmed their phenotype to be predominantly that of B cells. Finally, the depletion of B2 cells, including sca1+/flk1+ cells, in G-CSF-treated wild-type mice partly abolished the endothelial regenerating effect of G-CSF, indicating an atheroprotective role for sca1+/flk1+ B2 cells. In summary, we characterized sca1+/flk1+ cells as a subset of predominantly B2 cells, which are apparently involved in endothelial regeneration.
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Affiliation(s)
- Eva Steffen
- Herzzentrum Bonn, Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
| | | | - Marie Hennig
- Herzzentrum Bonn, Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Sven Thomas Niepmann
- Herzzentrum Bonn, Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Andreas Zietzer
- Herzzentrum Bonn, Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Nikos Werner
- Krankenhaus der Barmherzigen Brüder, Innere Medizin III, Trier, Germany
| | - Tienush Rassaf
- Westdeutsches Herz- und Gefäßzentrum, Klinik für Kardiologie und Angiologie, Universitätsklinikum Essen, Essen, Germany
| | - Georg Nickenig
- Herzzentrum Bonn, Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Sven Wassmann
- Cardiology Pasing, Munich, Germany.,University of the Saarland, Homburg, Saar, Germany
| | - Sebastian Zimmer
- Herzzentrum Bonn, Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Martin Steinmetz
- Westdeutsches Herz- und Gefäßzentrum, Klinik für Kardiologie und Angiologie, Universitätsklinikum Essen, Essen, Germany
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23
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Stumpf MJ, Mahn T, Steinmetz M, Fimmers R, Pizarro C, Nickenig G, Skowasch D, Schahab N, Schaefer CA. Pseudoxanthoma elasticum – also a microvascular disease. VASA 2020; 49:57-62. [DOI: 10.1024/0301-1526/a000811] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Summary: Background: Pseudoxanthoma elasticum (PXE) is a heritable recessive disease characterized by calcification and fragmentation of soft connective tissue. Besides progressive loss of vision, alternations of the skin, and early-onset atherosclerosis different reports have suggested a microvascular manifestation of PXE and restrictive lung disease. Aim of this study was to elaborate a specific pattern of capillary alterations in PXE as well as to contemplate a possible connection to restrictive lung disease. Patients and methods: 53 consecutive patients with PXE and 26 controls were studied. All patients underwent nailfold capillaroscopy, body plethysmography, capillary blood gas analysis, and venous puncture to assess titer of autoantibodies. Results: PXE was associated with highly pathological alterations of capillaries compared to control. Atypical capillaries, such as ramifications and bushy forms, as well as dilatations varied at highest significance (p < .001). This effect was mirrored by perivascular edema, density and tortuous capillaries. Titer of anti-nuclear autoantibodies were not elevated in patients with PXE. Further analysis revealed negative correlation between vital capacity and presence of atypical capillaries. Conclusions: This study firstly describes the pattern of nailfold capillaries in PXE. Capillaries are highly pathological and consist of ramifications and bushy forms as well as dilatations. Frequently, tortuous capillaries, pericapillary edema and reduced denseness of capillary loops occur. Frequency of atypical capillaries is negatively correlated with vital capacity which can be interpreted as further lead on restrictive lung disease.
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Affiliation(s)
- Max Jonathan Stumpf
- Medical Clinic II, Cardiology, Pneumology and Angiology, University Hospital Bonn, Bonn, Germany
| | - Thorsten Mahn
- Medical Clinic II, Cardiology, Pneumology and Angiology, University Hospital Bonn, Bonn, Germany
| | - Martin Steinmetz
- Clinic for Cardiology and Angiology, University Hospital Essen, Essen, Germany
| | - Rolf Fimmers
- Institute for Medical Biometry, Computer Science and Epidemiology, University of Bonn, Bonn, Germany
| | - Carmen Pizarro
- Medical Clinic II, Cardiology, Pneumology and Angiology, University Hospital Bonn, Bonn, Germany
| | - Georg Nickenig
- Medical Clinic II, Cardiology, Pneumology and Angiology, University Hospital Bonn, Bonn, Germany
| | - Dirk Skowasch
- Medical Clinic II, Cardiology, Pneumology and Angiology, University Hospital Bonn, Bonn, Germany
| | - Nadjib Schahab
- Medical Clinic II, Cardiology, Pneumology and Angiology, University Hospital Bonn, Bonn, Germany
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24
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Degener F, Opgen-Rhein B, Wagner R, Boehne M, Boecker D, Reineker K, Wiegand G, Racolta A, Müller G, Kiski D, Rentzsch A, Fischer M, Papakostas K, Ruf B, Hannes T, Khalil M, Kaestner M, Steinmetz M, ÖZcan S, Fischer G, Freudenthal N, Schweigmann U, Pickardt T, Huber C, Messroghli D, Schubert S. Prognostic Parameters for a Severe Disease Course in Pediatric Patients with Suspected Myocarditis: Data from the Prospective Multicenter Registry “MYKKE”. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705542] [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: 10/24/2022]
Affiliation(s)
| | | | | | | | | | | | - G. Wiegand
- University of Tuebingen, Tuebingen, Germany
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25
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Rammos C, Halfmann L, Lortz J, Steinmetz M, Janosi A, Rassaf T. P948Rapid and automated risk stratification by determination of aortic stiffness in healthy and cardiovascular diseased. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0542] [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 and aims
Aortic stiffness is an independent predictor of cardiovascular morbidity and mortality and thus simple, rapid and preferably automated techniques are indispensableto persue a global approach in risk statification. A novel oscillometric based carotido-femoral pulse-wave velocity (cfPWV) was investigated, regarding diagnostic accuracy, sensitivity and specificity and with emphasis on costs, training curves and procedural time effort.
Methods
In a single-center crossover study, we evaluated subjects free of known cardiovascular disease (CVD) and CVD subjects and a subgroup with peripheral artery disease (PAD) undergoing ankle-brachial index (ABI) and PWV measurements using oscillometry (BoSo, Bosch + Sohn, Germany) compared to tonometry (SphymoCor, Atcor Australia). Pearson's correlation analysis was used to assess the relationship of PWV measurements for both methods. Moreover, examination times and costs were compared.
Results
A total of 174 study subjects underwent assessment of oscillometric and tonometric PWV measurements. CVD-free subjects (n=57) were younger (60.4±15.6 vs. 67±12.9 years, p=0.003) compared to CVD subjects (n=117). PWV measurements showed significant correlations in CVD-free subjects (r=0.797, p<0.001), in CVD subjects (r=0.817, p<0.001) and the subgroup of PAD subjects (r=0.807, p<0.001). Sensitivity, specificity, positive predictive value and negative predictive value of the oscillometric measurement for detecting arterial stiffness reached 93%, 84%, 86%, and 92%. The examination time of the oscillometric method was shorter compared to tonometry (4.4±0.5 vs. 9.2±0.8 min, p<0.001) in line with reduced costs.
Conclusion
Using a simple and rapid automated oscillometric method, we provide good diagnostic accuracy for the determination of aortic stiffness through PWV, both in CVD-free and in CVD subjects. This might help in terms of cost-effectiveness and simplification in daily practice to screen for cardiovascular morbidity and for vascular damage in atherosclerosis.
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Affiliation(s)
- C Rammos
- University of Duisburg-Essen, West German Heart Center, Essen, Germany
| | - L Halfmann
- University of Duisburg-Essen, West German Heart Center, Essen, Germany
| | - J Lortz
- University of Duisburg-Essen, West German Heart Center, Essen, Germany
| | - M Steinmetz
- University of Duisburg-Essen, West German Heart Center, Essen, Germany
| | - A Janosi
- University of Duisburg-Essen, West German Heart Center, Essen, Germany
| | - T Rassaf
- University of Duisburg-Essen, West German Heart Center, Essen, Germany
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26
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Backhaus SJ, Staab W, Steinmetz M, Ritter CO, Lotz J, Hasenfuss G, Kowallick JT, Schuster A. P5284Fully automated quantification of biventricular volumes and function in cardiovascular magnetic resonance: applicability to clinical routine settings. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0255] [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
Cardiovascular magnetic resonance (CMR) represents the clinical gold standard for the assessment of biventricular morphology and function. Since manual post-processing is time-consuming and prone to observer variability, efforts have been directed towards automated volumetric quantification. In this study, we sought to validate the accuracy of a novel approach providing fully automated quantification of biventricular volumes and function in a “real-world” clinical setting.
Methods
Three-hundred CMR examinations were randomly selected from the local data base. Fully automatic quantification of left ventricular (LV) mass, LV and right ventricular (RV) end-diastolic and systolic volumes (EDV/ESV), stroke volume (SV) and ejection fraction (EF) were performed overnight using commercially available software. Parameters were compared to manual assessments. Sub-group analyses were further performed according to image quality, scanner field strength, the presence of implanted aortic valves and repaired Tetralogy of Fallot (ToF).
Results
Biventricular automatic segmentation was feasible in all 300 cases. Overall agreement between fully automated and manually derived LV parameters was good (LV-EF: intra-class correlation coefficient [ICC] 0.95; bias −2.5% [SD 5.9%]), whilst RV agreement was lower (RV-EF: ICC 0.72; bias 5.8% [SD 9.6%]). Lowest agreement was observed in case of severely altered anatomy, e.g. marked RV dilation but normal LV dimensions in repaired ToF (LV parameters ICC 0.73–0.91; RV parameters ICC 0.41–0.94) and/or reduced image quality (LV parameters ICC 0.86–0.95; RV parameters ICC 0.56–0.91), which was more common on 3.0T than on 1.5T.
Conclusions
Fully automated assessment of biventricular morphology and function is robust and accurate in a clinical routine setting with good image quality and can be performed without any user interaction. However, in case of demanding anatomy (e.g. repaired ToF, severe LV hypertrophy) or reduced image quality, quality check and manual re-contouring is still required.
Acknowledgement/Funding
DZHK - German Centre for Cardiovascular Research
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Affiliation(s)
| | - W Staab
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - M Steinmetz
- University Medical Center Göttingen, Department of Pediatric Cardiology and Intensive Care Medicine, Goettingen, Germany
| | - C O Ritter
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - J Lotz
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - G Hasenfuss
- Heart Centre Goettingen, Goettingen, Germany
| | - J T Kowallick
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Göttingen, Germany
| | - A Schuster
- Heart Centre Goettingen, Goettingen, Germany
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27
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Paldán K, Simanovski J, Ullrich G, Steinmetz M, Rammos C, Jánosi RA, Moebus S, Rassaf T, Lortz J. Feasibility and Clinical Relevance of a Mobile Intervention Using TrackPAD to Support Supervised Exercise Therapy in Patients With Peripheral Arterial Disease: Study Protocol for a Randomized Controlled Pilot Trial. JMIR Res Protoc 2019; 8:e13651. [PMID: 31244477 PMCID: PMC6617911 DOI: 10.2196/13651] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 02/07/2019] [Revised: 05/09/2019] [Accepted: 05/10/2019] [Indexed: 01/13/2023] Open
Abstract
Background Peripheral arterial disease (PAD) is a common and severe disease with a highly increased cardiovascular morbidity and mortality. Through the circulatory disorder and the linked undersupply of oxygen carriers in the lower limbs, the ongoing decrease of the pain-free walking distance occurs with a significant reduction in patients’ quality of life. Studies including activity monitoring for patients with PAD are rare and digital support to increase activity via mobile health technologies is mainly targeted at patients with cardiovascular disease in general. The special requirement of patients with PAD is the need to reach a certain pain level to improve the pain-free walking distance. Unfortunately, both poor adherence and availability of institutional resources are major problems in patient-centered care. Objective The objective of this trackPAD pilot study is to evaluate the feasibility of a mobile phone–based self tracking app to promote physical activity and supervised exercise therapy (SET) in particular. We also aim for a subsequent patient centered adjustment of the app prototype based on the results of the app evaluation and process evaluation. Methods This study was designed as a closed user group trial, with assessors blinded, and parallel group study with face-to-face components for assessment with a follow-up of 3 months. Patients with symptomatic PAD (Fontaine stage IIa or IIb) and possession of a mobile phone were eligible. Eligible participants were randomly assigned into study and control group, stratified by their distance covered in the 6-min walk test, using the software TENALEA. Participants randomized to the study group received usual care and the mobile intervention (trackPAD) for the follow-up period of 3 months, whereas participants randomized to the control group received only usual care. TrackPAD records the frequency and duration of training sessions and pain level using manual user input. Clinical outcome data were collected at the baseline and after 3 months via validated tools (6-min walk test, ankle-brachial index, and duplex ultrasound at the lower arteries) and self-reported quality of life. Usability and quality of the app was determined using the user version of the Mobile Application Rating Scale. Results The study enrolled 45 participants with symptomatic PAD (44% male). Of these participants, 21 (47%) were randomized to the study group and 24 (53%) were randomized to the control group. The distance walked in the 6-min walk test was comparable in both groups at baseline (study group: mean 368.1m [SD 77.6] vs control group: mean 394.6m [SD 100.6]). Conclusions This is the first trial to test a mobile intervention called trackPAD that was designed especially for patients with PAD. Its results will provide important insights in terms of feasibility, effectiveness, and patient preferences of an app-based mobile intervention supporting SET for the conservative treatment of PAD. International Registered Report Identifier (IRRID) DERR1-10.2196/13651
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Affiliation(s)
- Katrin Paldán
- Centre for Urban Epidemiology, Institute for Medical Informatics, Biometry und Epidemiology, University of Duisburg-Essen, Essen, Germany.,Centre of Competence Personal Analytics at the University of Duisburg-Essen, Department of Engineering Sciences, University of Duisburg-Essen, Duisburg, Germany
| | - Jan Simanovski
- Centre for Urban Epidemiology, Institute for Medical Informatics, Biometry und Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Greta Ullrich
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Steinmetz
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Christos Rammos
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Rolf Alexander Jánosi
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Susanne Moebus
- Centre for Urban Epidemiology, Institute for Medical Informatics, Biometry und Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Julia Lortz
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
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28
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Unterberg-Buchwald C, Fasshauer M, Staab W, Steinmetz M, Kowallick J, Ritter CO. P408Unusual case of pericardial effusion. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez109.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Unterberg-Buchwald
- Universitaetsmedizin Goettingen, Dept. of Cardiology and Pneumology, Insitute of Diag. and Interv. Radiology, Goettingen, Germany
| | - M Fasshauer
- Institute of Diagn. and Interv. Radiology, Goettingen, Germany
| | - W Staab
- Institute of Diagn. and Interv. Radiology, Goettingen, Germany
| | - M Steinmetz
- Universitatesmedizin Goettingen, Dep.t of Pediatric Cardiology and Intensive Care medicine, Goettingen, Germany
| | - J Kowallick
- Institute of Diagn. and Interv. Radiology, Goettingen, Germany
| | - C O Ritter
- Institute of Diagn. and Interv. Radiology, Goettingen, Germany
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29
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Unterberg-Buchwald C, Kowallick J, Fasshauer M, Steinmetz M, Backhaus S, Lotz J, Ritter CO. P392Fulminant autoimmune myocarditis in Hashimoto thyreoidtis. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez109.033] [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)
- C Unterberg-Buchwald
- Universitaetsmedizin Goettingen, Dept. of Cardiology and Pneumology, Insitute of Diag. and Interv. Radiology, Goettingen, Germany
| | - J Kowallick
- Institute of Diagn. and Interv. Radiology, Goettingen, Germany
| | - M Fasshauer
- Institute of Diagn. and Interv. Radiology, Goettingen, Germany
| | - M Steinmetz
- Universitatesmedizin Goettingen, Dep.t of Pediatric Cardiology and Intensive Care medicine, Goettingen, Germany
| | - S Backhaus
- Universitatesmedizin, Dept. of Cardiology and Pneumology, Goettingen, Germany
| | - J Lotz
- Institute of Diagn. and Interv. Radiology, Goettingen, Germany
| | - C O Ritter
- Institute of Diagn. and Interv. Radiology, Goettingen, Germany
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Lortz J, Halfmann L, Burghardt A, Steinmetz M, Radecke T, Jánosi RA, Rassaf T, Rammos C. Rapid and automated risk stratification by determination of the aortic stiffness in healthy subjects and subjects with cardiovascular disease. PLoS One 2019; 14:e0216538. [PMID: 31083703 PMCID: PMC6513068 DOI: 10.1371/journal.pone.0216538] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 04/23/2019] [Indexed: 12/24/2022] Open
Abstract
Background Aortic stiffness is an independent predictor of cardiovascular morbidity and mortality; thus, simple, rapid and preferably automated techniques are indispensable for pursuing a global risk stratification approach. We present an oscillometric technique for determination of the carotid-femoral pulse wave velocity (cfPWV), including the diagnostic accuracy, sensitivity and specificity, with emphasis on the training curve and procedural duration. Methods In a single-centre crossover study, we evaluated subjects free of known cardiovascular disease (CVD), subjects with CVD and a subgroup of subjects with peripheral artery disease (PAD) in terms of ankle-brachial index (ABI) and PWV measurements determined by oscillometry compared to tonometry. Pearson’s correlation analysis was used to assess the relationship of the PWV measurements determined by both methods. Moreover, the time and cost of the examinations were compared. Results A total of 176 study subjects underwent assessments to obtain oscillometric and tonometric PWV measurements. The CVD-free subjects (n = 59) were younger (60.4±15.6 vs. 67.5±12.9 years, p = 0.003) than the subjects with CVD (n = 117). The PWV measurements showed significant correlations in CVD-free subjects (r = 0.797, p<0.001), in subjects with CVD (r = 0.817, p<0.001) and in the subgroup of subjects with PAD (r = 0.807, p<0.001). The examination duration was shorter for the oscillometric method than the tonometric method (4.4±0.5 vs. 9.2±0.8 min, p<0.001). Conclusion Using a simple and rapid automated oscillometric method, we achieved good diagnostic accuracy for the determination of aortic stiffness through the PWV in both subjects with and without CVD. This method might be helpful in daily practice in terms of saving time and reducing procedural complexity for screening for cardiovascular morbidities and vascular damage in cases of atherosclerosis.
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Affiliation(s)
- Julia Lortz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Lennard Halfmann
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Amelie Burghardt
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Steinmetz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Tobias Radecke
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Rolf Alexander Jánosi
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Christos Rammos
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
- * E-mail:
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Elder MJ, Webster SJ, Fitzmaurice TJ, Shaunak ASD, Steinmetz M, Chee R, Mallat Z, Cohen ES, Williams DL, Gaston JSH, Goodall JC. Dendritic Cell-Derived TSLP Negatively Regulates HIF-1α and IL-1β During Dectin-1 Signaling. Front Immunol 2019; 10:921. [PMID: 31139177 PMCID: PMC6519317 DOI: 10.3389/fimmu.2019.00921] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 11/22/2018] [Accepted: 04/10/2019] [Indexed: 02/02/2023] Open
Abstract
Thymic stromal lymphopoietin (TSLP) is a functionally pleotropic cytokine important in immune regulation, and TSLP dysregulation is associated with numerous diseases. TSLP is produced by many cell types, but has predominantly been characterized as a secreted factor from epithelial cells which activates dendritic cells (DC) that subsequently prime T helper (TH) 2 immunity. However, DC themselves make significant amounts of TSLP in response to microbial products, but the functional role of DC-derived TSLP remains unclear. We show that TSLPR signaling negatively regulates IL-1β production during dectin-1 stimulation of human DC. This regulatory mechanism functions by dampening Syk phosphorylation and is mediated via NADPH oxidase-derived ROS, HIF-1α and pro-IL-1β expression. Considering the profound effect TSLPR signaling has on the metabolic status and the secretome of dectin-1 stimulated DC, these data suggest that autocrine TSLPR signaling could have a fundamental role in modulating immunological effector responses at sites removed from epithelial cell production of TSLP.
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Affiliation(s)
- Matthew J. Elder
- Department of Medicine, School of Clinical Medicine, Addenbrookes Hospital, University of Cambridge, Cambridge, United Kingdom,Early Oncology R&D Division, AstraZeneca, Cambridge, United Kingdom
| | - Steve J. Webster
- Department of Medicine, School of Clinical Medicine, Addenbrookes Hospital, University of Cambridge, Cambridge, United Kingdom,Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Timothy J. Fitzmaurice
- Department of Medicine, School of Clinical Medicine, Addenbrookes Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Aran S. D. Shaunak
- Department of Medicine, School of Clinical Medicine, Addenbrookes Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Martin Steinmetz
- Unit 970, INSERM, Paris Cardiovascular Research Center, Paris, France
| | - Ronnie Chee
- Department of Immunology, Royal Free Hospital, London, United Kingdom
| | - Ziad Mallat
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - E. Suzanne Cohen
- Biopharmaceutical Research Division, AstraZeneca, Cambridge, United Kingdom
| | - David L. Williams
- Department of Surgery, Center for Inflammation, Infectious Disease and Immunity, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States
| | - J. S. Hill Gaston
- Department of Medicine, School of Clinical Medicine, Addenbrookes Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Jane C. Goodall
- Department of Medicine, School of Clinical Medicine, Addenbrookes Hospital, University of Cambridge, Cambridge, United Kingdom,*Correspondence: Jane C. Goodall
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Steinmetz M, Schmitter C, Radecke T, Stundl A, Nickenig G, Schaefer C, Schahab N, Vasa-Nicotera M, Sinning JM. Brief report - Telomere length is a poor biomarker to predict 1-year mortality or cardiovascular comorbidity in patients with transcatheter aortic valve replacement. PLoS One 2019; 14:e0213250. [PMID: 30861019 PMCID: PMC6413932 DOI: 10.1371/journal.pone.0213250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 02/19/2019] [Indexed: 11/25/2022] Open
Abstract
Background Transcatheter aortic valve replacement (TAVR) is a therapeutic option for patients with aortic valve stenosis at increased surgical risk. Telomeres are an established marker for cellular senescence and have served to evaluate cardiovascular diseases including severe aortic valve stenosis. In our study, we hypothesized that telomere length may be a predictor for outcome and associated with comorbidities in patients with TAVR. Methods and results We analyzed leucocyte telomere length from 155 patients who underwent TAVR and correlated the results with 1-year mortality and severe comorbidities. The cohort was subdivided into 3 groups according to telomere length. Although a trend for a positive correlation of telomere length with a lower EuroSCORE could be found, telomere length was not associated with survival, aortic valve opening area or cardiovascular comorbidities (peripheral, coronary or cerebrovascular disease). Interestingly, long telomeres were significantly correlated to a reduced left ventricular ejection fraction (LVEF). Conclusion In elderly patients with severe aortic valve stenosis, leucocyte telomere length did not predict post-procedural survival. The correlation between long telomere length and reduced LVEF in these patients deserves further attention.
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Affiliation(s)
- Martin Steinmetz
- Universitätsklinikum Essen, Klinik für Kardiologie und Angiologie, Essen, Germany
- Universitätsklinkum Bonn, Medizinische Klinik und Poliklinik II, Bonn, Germany
- * E-mail:
| | - Charlotte Schmitter
- Universitätsklinkum Bonn, Medizinische Klinik und Poliklinik II, Bonn, Germany
| | - Tobias Radecke
- Universitätsklinikum Essen, Klinik für Kardiologie und Angiologie, Essen, Germany
| | - Anja Stundl
- Universitätsklinkum Bonn, Medizinische Klinik und Poliklinik II, Bonn, Germany
| | - Georg Nickenig
- Universitätsklinkum Bonn, Medizinische Klinik und Poliklinik II, Bonn, Germany
| | - Christian Schaefer
- Universitätsklinkum Bonn, Medizinische Klinik und Poliklinik II, Bonn, Germany
| | - Nadjib Schahab
- Universitätsklinkum Bonn, Medizinische Klinik und Poliklinik II, Bonn, Germany
| | - Mariuca Vasa-Nicotera
- Universitätsklinkum Bonn, Medizinische Klinik und Poliklinik II, Bonn, Germany
- Universitätsklinikum Frankfurt, Klinik für Kardiologie, Frankfurt, Germany
| | - Jan-Malte Sinning
- Universitätsklinkum Bonn, Medizinische Klinik und Poliklinik II, Bonn, Germany
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33
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Rammos C, Radecke T, Lortz J, Steinmetz M, Rassaf T. Guidelines adherence or chronic total occlusion recanalization of the superficial femoral artery with a stentless approach: The next frontier? SAGE Open Med Case Rep 2019; 7:2050313X18823445. [PMID: 30719307 PMCID: PMC6349981 DOI: 10.1177/2050313x18823445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 07/18/2018] [Accepted: 12/14/2018] [Indexed: 12/24/2022] Open
Abstract
In patients with intermittent claudication and long chronic total occlusions of the superficial femoral artery, a primary surgical bypass or stenting is recommended. However, due to the invasive nature, high complication rates and patient-related comorbidities, surgery is currently not the preferred method and full lesion stenting for long chronic total occlusions has the obvious consequences of permanent metallic implants. We report a case of a patient with a long chronic total occlusion of the superficial femoral artery with intermittent claudication. Endorsing an endovascular-first strategy, he was treated via an antegrade and retrograde approach with a complete recanalization and a stentless treatment with rotational atherectomy and drug-coated balloons. We believe this is a feasible endovascular strategy for the treatment of long chronic total occlusions of the superficial femoral artery for patients refusing open surgery. Further investigations are needed to evaluate long-term clinical outcomes of these novel techniques.
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Affiliation(s)
- Christos Rammos
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Tobias Radecke
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Julia Lortz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Steinmetz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
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Wisotzki L, Bacon R, Brinchmann J, Cantalupo S, Richter P, Schaye J, Schmidt KB, Urrutia T, Weilbacher PM, Akhlaghi M, Bouché N, Contini T, Guiderdoni B, Herenz EC, Inami H, Kerutt J, Leclercq F, Marino RA, Maseda M, Monreal-Ibero A, Nanayakkara T, Richard J, Saust R, Steinmetz M, Wendt M. Author Correction: Nearly all the sky is covered by Lyman-α emission around high-redshift galaxies. Nature 2018; 563:E31. [PMID: 30377312 DOI: 10.1038/s41586-018-0664-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Change history: In this Letter, author M. Akhlaghi should be associated with affiliation (2) rather than (3). This error has been corrected online.
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Affiliation(s)
- L Wisotzki
- Leibniz-Institut für Astrophysik Potsdam (AIP), Potsdam, Germany.
| | - R Bacon
- Université Lyon, Université Lyon 1, ENS de Lyon, CNRS, Centre de Recherche Astrophysique de Lyon, Saint-Genis-Laval, France
| | - J Brinchmann
- Leiden Observatory, Leiden University, Leiden, The Netherlands.,Instituto de Astrofísica e Ciências do Espaço, Universidade do Porto, CAUP, Porto, Portugal
| | - S Cantalupo
- Department of Physics, ETH Zürich, Zürich, Switzerland
| | - P Richter
- Institut für Physik und Astronomie, Universität Potsdam, Potsdam, Germany
| | - J Schaye
- Leiden Observatory, Leiden University, Leiden, The Netherlands
| | - K B Schmidt
- Leibniz-Institut für Astrophysik Potsdam (AIP), Potsdam, Germany
| | - T Urrutia
- Leibniz-Institut für Astrophysik Potsdam (AIP), Potsdam, Germany
| | - P M Weilbacher
- Leibniz-Institut für Astrophysik Potsdam (AIP), Potsdam, Germany
| | - M Akhlaghi
- Université Lyon, Université Lyon 1, ENS de Lyon, CNRS, Centre de Recherche Astrophysique de Lyon, Saint-Genis-Laval, France
| | - N Bouché
- Institut de Recherche en Astrophysique et Planétologie (IRAP), Université de Toulouse, CNRS, Toulouse, France
| | - T Contini
- Institut de Recherche en Astrophysique et Planétologie (IRAP), Université de Toulouse, CNRS, Toulouse, France
| | - B Guiderdoni
- Université Lyon, Université Lyon 1, ENS de Lyon, CNRS, Centre de Recherche Astrophysique de Lyon, Saint-Genis-Laval, France
| | - E C Herenz
- Department of Astronomy, Stockholm University, AlbaNova University Centre, Stockholm, Sweden
| | - H Inami
- Université Lyon, Université Lyon 1, ENS de Lyon, CNRS, Centre de Recherche Astrophysique de Lyon, Saint-Genis-Laval, France
| | - J Kerutt
- Leibniz-Institut für Astrophysik Potsdam (AIP), Potsdam, Germany
| | - F Leclercq
- Université Lyon, Université Lyon 1, ENS de Lyon, CNRS, Centre de Recherche Astrophysique de Lyon, Saint-Genis-Laval, France
| | - R A Marino
- Department of Physics, ETH Zürich, Zürich, Switzerland
| | - M Maseda
- Leiden Observatory, Leiden University, Leiden, The Netherlands
| | - A Monreal-Ibero
- Instituto de Astrofísica de Canarias (IAC), La Laguna, Tenerife, Spain.,Universidad de La Laguna, Departamento Astrofísica, La Laguna, Tenerife, Spain
| | - T Nanayakkara
- Leiden Observatory, Leiden University, Leiden, The Netherlands
| | - J Richard
- Université Lyon, Université Lyon 1, ENS de Lyon, CNRS, Centre de Recherche Astrophysique de Lyon, Saint-Genis-Laval, France
| | - R Saust
- Leibniz-Institut für Astrophysik Potsdam (AIP), Potsdam, Germany
| | - M Steinmetz
- Leibniz-Institut für Astrophysik Potsdam (AIP), Potsdam, Germany
| | - M Wendt
- Leibniz-Institut für Astrophysik Potsdam (AIP), Potsdam, Germany.,Institut für Physik und Astronomie, Universität Potsdam, Potsdam, Germany
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Pfeifer P, Steinmetz M, Ackerschott A, Dregger H, Jehle J, Nickenig G, Latz E, Zimmer S. P5128Role of CLEC4E expression in development of aortic valve stenosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- P Pfeifer
- University Hospital Bonn, Department of Internal Medicine II Cardiology, Pneumology, and Angiology, Bonn, Germany
| | | | - A Ackerschott
- University Hospital Bonn, Department of Internal Medicine II Cardiology, Pneumology, and Angiology, Bonn, Germany
| | - H Dregger
- University Hospital Bonn, Department of Internal Medicine II Cardiology, Pneumology, and Angiology, Bonn, Germany
| | - J Jehle
- University Hospital Bonn, Department of Internal Medicine II Cardiology, Pneumology, and Angiology, Bonn, Germany
| | - G Nickenig
- University Hospital Bonn, Department of Internal Medicine II Cardiology, Pneumology, and Angiology, Bonn, Germany
| | - E Latz
- University Hospital Bonn, Institute of Innate Immunity Biomedical Center, Bonn, Germany
| | - S Zimmer
- University Hospital Bonn, Department of Internal Medicine II Cardiology, Pneumology, and Angiology, Bonn, Germany
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Steffen E, Mayer Von Wittgenstein WBE, Nickenig G, Zimmer S, Steinmetz M. P4229Mouse sca1/flk-1 positive cells are no endothelial progenitors but B cells. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- E Steffen
- University Hospital Bonn, Cardiology, Bonn, Germany
| | | | - G Nickenig
- University Hospital Bonn, Cardiology, Bonn, Germany
| | - S Zimmer
- University Hospital Bonn, Cardiology, Bonn, Germany
| | - M Steinmetz
- University Hospital of Essen (Ruhr), Cardiology, Essen, Germany
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Rammos C, Burghardt A, Lortz J, Azizy O, Jánosi RA, Steinmetz M, Rassaf T. Impact of anticoagulation and vasoactive medication on regained radial artery patency after catheterization: a case-control study. Eur J Med Res 2018; 23:25. [PMID: 29788990 PMCID: PMC5964909 DOI: 10.1186/s40001-018-0324-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 05/14/2018] [Indexed: 01/10/2023] Open
Abstract
Background Radial artery access is the primary approach for coronary interventions due to higher safety profile in comparison to femoral access. Radial artery occlusion (RAO) is the main complication of transradial catheterization that can lead to severe symptoms and a permanent artery occlusion. The incidence of RAO after transradial access ranges from 5 to 38% and data regarding treatment is scarce. Whether anticoagulation and vasoactive medication provides an additional benefit in recovery of radial artery patency (RAP) after catheterization has not been investigated in detail. Aim The objective was to investigate the impact of anticoagulation and vasoactive medication on regained patency after documented RAO following transradial catheterization. Patients and methods Overall 2635 patients were screened. 2215 (84%) catheterizations were performed by femoral and 420 (16%) by radial access. In 30 patients RAO was observed. In case of RAO patients were classified in three groups: Anticoagulation, anticoagulation added with alprostadil and controls. Follow-up was conducted after 3 months with ultrasound and clinical examination. Results Eight patients received anticoagulation and 11 patients anticoagulation together with alprostadil. Eleven patients served as controls. Recovery of RAP after catheterization was higher following either treatment (79.5%) compared to controls (0%, p = 0.006). Subgroup analysis yielded a higher RAP recovery in patients treated with anticoagulation (62.5%) as compared to controls (0%, p = 0.002). No effect on regained RAP was found with additional alprostadil therapy (33.3%) compared to anticoagulation therapy (62.5%, p = 0.229). Conclusion RAO should be treated with anticoagulation to regain patency. Addition of vasoactive medication does not lead to further beneficial effects. Further research is needed regarding preventive and therapeutic strategies following RAO.
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Affiliation(s)
- C Rammos
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, Medical Faculty, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
| | - A Burghardt
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, Medical Faculty, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - J Lortz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, Medical Faculty, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - O Azizy
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, Medical Faculty, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - R A Jánosi
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, Medical Faculty, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - M Steinmetz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, Medical Faculty, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - T Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, Medical Faculty, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
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Beiert T, Knappe V, Tiyerili V, Stöckigt F, Effelsberg V, Linhart M, Steinmetz M, Klein S, Schierwagen R, Trebicka J, Roell W, Nickenig G, Schrickel JW, Andrié RP. Chronic lower-dose relaxin administration protects from arrhythmia in experimental myocardial infarction due to anti-inflammatory and anti-fibrotic properties. Int J Cardiol 2018; 250:21-28. [DOI: 10.1016/j.ijcard.2017.09.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 08/30/2017] [Accepted: 09/06/2017] [Indexed: 12/11/2022]
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Degener F, Opgen-Rhein B, Böhne M, Weigelt A, Wagner R, Müller G, Racolta A, Rentzsch A, Papakostas K, Reineker K, Kiski D, Ruf B, Wiegand G, Hannes T, Khalil M, Fischer M, Kaestner M, Steinmetz M, Fischer G, Freudenthal N, Pickardt T, Messroghli D, Schubert S. Four-Year Experience of the German Multicenter Registry for Pediatric Patients with Suspected Myocarditis: MYKKE. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628324] [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: 10/28/2022]
Affiliation(s)
- F. Degener
- Deutsches Herzzentrum Berlin, Klinik für Angeborene Herzfehler - Kinderkardiologie, Berlin, Germany
| | - B. Opgen-Rhein
- Charité - Universitätsmedizin Berlin, Klinik für Pädiatrie mit Schwerpunkt Kardiologie, Berlin, Germany
| | - M. Böhne
- Medizinische Hochschule Hannover, Kinderkardiologie, Hannover, Germany
| | - A. Weigelt
- Universitätsklinikum Erlangen, Kinderkardiologie, Erlangen, Germany
| | - R. Wagner
- Herzzentrum Leipzig, Kinderkardiologie, Leipzig, Germany
| | - G. Müller
- Universitäres Herzzentrum Hamburg, Kinderkardiologie, Hamburg, Germany
| | - A. Racolta
- Herz- und Diabeteszentrum NRW, Zentrum für angeborene Herzfehler, Bad Oeynhausen, Germany
| | - A. Rentzsch
- Universität des Saarlandes, Kinderkardiologie, Homburg/Saar, Germany
| | - K. Papakostas
- Klinikum Links der Weser, Strukturelle und angeborene Herzfehler / Kinderkardiologie, Bremen, Germany
| | - K. Reineker
- Universitäts Herzzentrum Freiburg Bad Krozingen, Kinderkardiologie, Freiburg, Germany
| | - D. Kiski
- Universitätsklinikum Münster, Klinik für Kinder- und Jugendmedizin/Pädiatrische Kardiologie, Münster, Germany
| | - B. Ruf
- Deutsches Herzzentrum München, Technische Universität München, Angeborene Herzfehler/Kinderkardiologie, München, Germany
| | - G. Wiegand
- Universitätskinderklinik Tübingen, Kinderkardiologie, Tübingen, Germany
| | - T. Hannes
- Uniklinik Köln, Klinik für angeborene Herzfehler und Pädiatrische Kardiologie, Köln, Germany
| | - M. Khalil
- Universitätsklinik Giessen, Abteilung für Kinderkardiologie, Giessen, Germany
| | - M. Fischer
- Klinikum der Universität München, Abteilung Kinderkardiologie und Pädiatrische Intensivmedizin, München, Germany
| | - M. Kaestner
- Universitätsklinikum Ulm, Kinderkardiologie, Ulm, Germany
| | - M. Steinmetz
- Universitätsmedizin Göttingen, Klinik für Pädiatrische Kardiologie und Intensivmedizin, Göttingen, Germany
| | - G. Fischer
- Universitätsklinikum Schleswig-Holstein, Klinik für angeborene Herzfehler und Kinderkardiologie, Kiel, Germany
| | - N. Freudenthal
- Universitätsklinikum Bonn, Abteilung für Kinderkardiologie, Bonn, Germany
| | - T. Pickardt
- Kompetenznetz Angeborene Herzfehler, Berlin, Germany
| | - D. Messroghli
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Berlin, Berlin, Germany
| | - S. Schubert
- Deutsches Herzzentrum Berlin, Klinik für Angeborene Herzfehler - Kinderkardiologie, Berlin, Germany
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Pfeifer P, Steinmetz M, Habel S, Lorenz J, Ackerschott A, Dregger H, Jehle J, Kraemer B, Nickenig G, Latz E, Zimmer S. P2713CLEC4E expression in human atherosclerosis and on circulating monocytes of patients with coronary artery disease and myocardial infarction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sedaghat A, Weber M, Steinmetz M, Schueler R, Werner N, Stundl A, Welz A, Mellert F, Zur B, Nickenig G, Holdenrieder S, Schiller W, Sinning J. 3864The role of myocardial fibrosis in the recovery of left ventricular ejection fraction after TAVI. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.3864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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42
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Unterberg-Buchwald C, Ritter C, Reupke V, Wilke R, Steinmetz M, Schuster A, Lotz J, Uecker M. P1428Real time guidance for targeted endomyocardial biopsy in a minipig model. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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43
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Pfeifer P, Ebert S, Ackerschott A, Jansen F, Steinmetz M, Jehle J, Latz E, Franklin B, Nickenig G, Werner N, Zimmer S. P1762Inflammasome-induced endothelial microparticles impair cellular function in recipient cells. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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44
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Pfeifer P, Ackerschott A, Ebert S, Jehle J, Steinmetz M, Franklin B, Latz E, Jansen F, Nickenig G, Werner N, Zimmer S. P4943Inflammasome induced endothelial microparticles impair cellular function in human coronary arterial smooth muscle cells. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p4943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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45
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Schenk L, Hösch O, Schuster A, Kowallick J, Staab W, Kutty S, Otto T, Seehase M, Lotz J, Paul T, Steinmetz M. The Value of the Newly Validated Cardiovascular Magnetic Resonance Derived Total Right/Left Volume Index in the Course of Ebstein Anomaly: A Prospective Long-Term Follow-up Study. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- L. Schenk
- Department of Paediatric Cardiology and Intensive Care Medicine, Georg-August-University Göttingen, Göttingen, Germany
| | - O. Hösch
- Department of Paediatric Cardiology and Intensive Care Medicine, Georg-August-University Göttingen, Göttingen, Germany
| | - A. Schuster
- Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany
| | - J. Kowallick
- Department of Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany
| | - W. Staab
- Department of Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany
| | - S. Kutty
- University of Nebraska Medical Center, University of Nebraska Medical Center/ Children's Hospital and Medical Center, Omaha, United States
| | - T. Otto
- Department of Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany
| | - M. Seehase
- Department of Paediatric Cardiology and Intensive Care Medicine, Georg-August-University Göttingen, Göttingen, Germany
| | - J. Lotz
- Department of Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany
| | - T. Paul
- Department of Paediatric Cardiology and Intensive Care Medicine, Georg-August-University Göttingen, Göttingen, Germany
| | - M. Steinmetz
- Department of Paediatric Cardiology and Intensive Care Medicine, Georg-August-University Göttingen, Göttingen, Germany
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Degener F, Opgen-Rhein B, Schmidt F, Weigelt A, Wagner R, Müller G, Rentzsch A, Racolta A, Papakostas K, Wiegand G, Ruf B, Hannes T, Reineker K, Kiski D, Khalil M, Steinmetz M, Fischer G, Pickardt T, Messroghli D, Schubert S. Update on Baseline Data and First 1-Year Follow-up of the German Multicenter Myocarditis Registry for Pediatric Patients: “MYKKE”. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1599006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- F. Degener
- Deutsches Herzzentrum Berlin, Klinik für Angeborene Herzfehler/Kinderkardiologie, Berlin, Germany
| | - B. Opgen-Rhein
- Charité Universitätsmedizin Berlin, Klinik für Pädiatrie mit Schwerpunkt Kardiologie, Berlin, Germany
| | - F. Schmidt
- Medizinische Hochschule Hannover, Kinderkardiologie, Hannover, Germany
| | - A. Weigelt
- Universitätsklinikum Erlangen, Kinderkardiologie, Erlangen, Germany
| | - R. Wagner
- Herzzentrum Leipzig, Kinderkardiologie, Leipzig, Germany
| | - G. Müller
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - A. Rentzsch
- Universitätsklinikum des Saarlandes, Kinderkardiologie, Hombrg/Saar, Germany
| | - A. Racolta
- Herz- und Diabeteszentrum NRW, Zentrum für angeborene Herzfehler, Bad Oeynhausen, Germany
| | - K. Papakostas
- Klinikum Links der Weser, Strukturelle und angeborene Herzfehler / Kinderkardiologie, Bremen, Germany
| | - G. Wiegand
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Kinderkardiologie, Tübingen, Germany
| | - B. Ruf
- Deutsches Herzzentrum München, Technische Universität München, Angeborene Herzfehler/Kinderkardiologie, München, Germany
| | - T. Hannes
- Uniklinik Köln, Kinderkardiologie, Köln, Germany
| | - K. Reineker
- Universitäts-Herzzentrum Freiburg Bad Krozingen, Klinik für angeborene Herzfehler und Pädiatrische Kardiologie, Freiburg, Germany
| | - D. Kiski
- Universitätsklinikum Münster, Klinik für Kinder- und Jugendmedizin/Pädiatrische Kardiologie, Münster, Germany
| | - M. Khalil
- Universitätsklinik Gießen, Abteilung für Kinderkardiologie, Giessen, Germany
| | - M. Steinmetz
- Universitätsmedizin Göttingen, Kinderherzklinik, Klinik für Pädiatrische Kardiologie und Intensivmedizin, Göttingen, Germany
| | - G. Fischer
- Universitätsklinikum Schleswig-Holstein, Klinik für angeborene Herzfehler und Kinderkardiologie, Kiel, Germany
| | - T. Pickardt
- Kompetenznetz Angeborene Herzfehler, Berlin, Germany
| | - D. Messroghli
- Deutsches Herzzentrum Berlin, Klinik für Angeborene Herzfehler/Kinderkardiologie, Berlin, Germany
| | - S. Schubert
- Deutsches Herzzentrum Berlin, Klinik für Angeborene Herzfehler/Kinderkardiologie, Berlin, Germany
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Steinmetz M, Nickenig G, Sauerbruch T, Eyer F, Rabe C. Effect of hemoperfusion on flecainide serum concentration - a case report. Clin Toxicol (Phila) 2016; 55:153-154. [PMID: 27728980 DOI: 10.1080/15563650.2016.1241400] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Martin Steinmetz
- a Department of Internal Medicine II , University of Bonn , Bonn , Germany
| | - Georg Nickenig
- a Department of Internal Medicine II , University of Bonn , Bonn , Germany
| | - Tilman Sauerbruch
- b Medical ICU, Department of Internal Medicine I , University of Bonn , Bonn , Germany
| | - Florian Eyer
- c Toxicological ICU, Department of Clinical Toxicology , Klinikum rechts der Isar, Technical University of Munich , Munich , Germany
| | - Christian Rabe
- d Medical ICU, Department of Internal Medicine I,University of Bonn, Bonn, Germany; Toxicological ICU,Department of Clinical Toxicology , Klinikum rechts derIsar, Technical University of Munich , Munich , Germany
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Kotecha R, Modugula S, Angelov L, Benzel E, Reddy C, Prayson R, Kalfas I, Schlenk R, Krishnaney A, Steinmetz M, Bingaman W, Suh J, Chao S. The Role of Adjuvant Radiation Therapy in Patients With Myxopapillary Ependymomas. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.874] [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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49
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Asdonk T, Steinmetz M, Krogmann A, Ströcker C, Lahrmann C, Motz I, Paul-Krahe K, Flender A, Schmitz T, Barchet W, Hartmann G, Nickenig G, Zimmer S. MDA-5 activation by cytoplasmic double-stranded RNA impairs endothelial function and aggravates atherosclerosis. J Cell Mol Med 2016; 20:1696-705. [PMID: 27130701 PMCID: PMC4993381 DOI: 10.1111/jcmm.12864] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 03/03/2016] [Indexed: 12/12/2022] Open
Abstract
Recent studies have highlighted the relevance of viral nucleic acid immunorecognition by pattern recognition receptors in atherogenesis. Melanoma differentiation associated gene 5 (MDA-5) belongs to the intracellular retinoic acid inducible gene-I like receptors and its activation promotes pro-inflammatory mechanisms. Here, we studied the effect of MDA-5 stimulation in vascular biology. To gain insights into MDA-5 dependent effects on endothelial function, cultured human coronary artery endothelial cells (HCAEC) were transfected with the synthetic MDA-5 agonist polyIC (long double-stranded RNA). Human coronary endothelial cell expressed MDA-5 and reacted with receptor up-regulation upon stimulation. Reactive oxygen species formation, apoptosis and the release of pro-inflammatory cytokines was enhanced, whereas migration was significantly reduced in response to MDA-5 stimulation. To test these effects in vivo, wild-type mice were transfected with 32.5 μg polyIC/JetPEI or polyA/JetPEI as control every other day for 7 days. In polyIC-treated wild-type mice, endothelium-dependent vasodilation and re-endothelialization was significantly impaired, vascular oxidative stress significantly increased and circulating endothelial microparticles and circulating endothelial progenitor cells significantly elevated compared to controls. Importantly, these effects could be abrogated by MDA-5 deficiency in vivo. Finally, chronic MDA-5 stimulation in Apolipoprotein E/toll-like receptor 3 (TLR3) double(-) deficient (ApoE(-/-) /TLR3(-/-) ) mice-enhanced atherosclerotic plaque formation. This study demonstrates that MDA-5 stimulation leads to endothelial dysfunction, and has the potential to aggravate atherosclerotic plaque burden in murine atherosclerosis. Thus, the spectrum of relevant innate immune receptors in vascular diseases and atherogenesis might not be restricted to TLRs but also encompasses the group of RLRs including MDA-5.
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Affiliation(s)
- Tobias Asdonk
- Department of Medicine/Cardiology, University of Bonn, Bonn, Germany
| | - Martin Steinmetz
- Department of Medicine/Cardiology, University of Bonn, Bonn, Germany
| | | | | | | | - Inga Motz
- Department of Medicine/Cardiology, University of Bonn, Bonn, Germany
| | | | - Anna Flender
- Department of Medicine/Cardiology, University of Bonn, Bonn, Germany
| | - Theresa Schmitz
- Department of Medicine/Cardiology, University of Bonn, Bonn, Germany
| | - Winfried Barchet
- Institute for Clinical Chemistry and Clinical Pharmacology, University of Bonn, Bonn, Germany
| | - Gunther Hartmann
- Institute for Clinical Chemistry and Clinical Pharmacology, University of Bonn, Bonn, Germany
| | - Georg Nickenig
- Department of Medicine/Cardiology, University of Bonn, Bonn, Germany
| | - Sebastian Zimmer
- Department of Medicine/Cardiology, University of Bonn, Bonn, Germany
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Steinmetz M, Broder M, Kowallick J, Llamata P, Kutty S, Seehase M, Staab W, Unterberg-Buchwald C, Lotz J, Paul T, Hasenfuß G, Schuster A. Atrioventricular Mechanics and Heart Failure in Ebstein's Anomaly—A Cardiovascular Magnetic Resonance Imaging Study. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571855] [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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