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Noureddine S, Roux-Claudé P, Laurent L, Ritter O, Dolla P, Karaer S, Claudé F, Eberst G, Westeel V, Barnig C. Evaluation of long-term sequelae by cardiopulmonary exercise testing 12 months after hospitalization for severe COVID-19. BMC Pulm Med 2023; 23:13. [PMID: 36635717 PMCID: PMC9834678 DOI: 10.1186/s12890-023-02313-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/05/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Cardiopulmonary exercise testing (CPET) is an important clinical tool that provides a global assessment of the respiratory, circulatory and metabolic responses to exercise which are not adequately reflected through the measurement of individual organ system function at rest. In the context of critical COVID-19, CPET is an ideal approach for assessing long term sequelae. METHODS In this prospective single-center study, we performed CPET 12 months after symptom onset in 60 patients that had required intensive care unit treatment for a severe COVID-19 infection. Lung function at rest and chest computed tomography (CT) scan were also performed. RESULTS Twelve months after severe COVID-19 pneumonia, dyspnea was the most frequently reported symptom although only a minority of patients had impaired respiratory function at rest. Mild ground-glass opacities, reticulations and bronchiectasis were the most common CT scan abnormalities. The majority of the patients (80%) had a peak O2 uptake (V'O2) considered within normal limits (median peak predicted O2 uptake (V'O2) of 98% [87.2-106.3]). Length of ICU stay remained an independent predictor of V'O2. More than half of the patients with a normal peak predicted V'O2 showed ventilatory inefficiency during exercise with an abnormal increase of physiological dead space ventilation (VD/Vt) (median VD/VT of 0.27 [0.21-0.32] at anaerobic threshold (AT) and 0.29 [0.25-0.34] at peak) and a widened median peak alveolar-arterial gradient for O2 (35.2 mmHg [31.2-44.8]. Peak PetCO2 was significantly lower in subjects with an abnormal increase of VD/Vt (p = 0.001). Impairments were more pronounced in patients with dyspnea. Peak VD/Vt values were positively correlated with peak D-Dimer plasma concentrations from blood samples collected during ICU stay (r2 = 0.12; p = 0.02) and to predicted diffusion capacity of the lung for carbon monoxide (DLCO) (r2 = - 0.15; p = 0.01). CONCLUSIONS Twelve months after severe COVID-19 pneumonia, most of the patients had a peak V'O2 considered within normal limits but showed ventilatory inefficiency during exercise with increased dead space ventilation that was more pronounced in patients with persistent dyspnea. TRIAL REGISTRATION NCT04519320 (19/08/2020).
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Affiliation(s)
- Sofia Noureddine
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France
| | - Pauline Roux-Claudé
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France
| | - Lucie Laurent
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France
| | - Ophélie Ritter
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France
| | - Pauline Dolla
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France
| | - Sinan Karaer
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France
| | - Frédéric Claudé
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France
| | - Guillaume Eberst
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France ,grid.7459.f0000 0001 2188 3779Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France and UMR 1098, University of Franche-Comté, Besançon, France
| | - Virginie Westeel
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France ,grid.7459.f0000 0001 2188 3779Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France and UMR 1098, University of Franche-Comté, Besançon, France
| | - Cindy Barnig
- grid.411158.80000 0004 0638 9213Department of Chest Disease, University Hospital Besançon, 25000 Besançon, France ,grid.7459.f0000 0001 2188 3779UMR1098, University of Franche-Comté, INSERM, EFS BFC, F-25000 Besançon, France
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Pagonas N, Sasko B, Seibert F, Ritter O, Babel N, Westhoff T. Association of propionate with coronary artery disease in a large cross-sectional study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2347] [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
Microbiome has been linked to the pathogenesis of coronary artery disease (CAD) but data providing direct evidence for an association of short-chain fatty acids (SCFA) like propionate with CAD are lacking.
Purpose
To study the association of propionate in blood samples with the presence of CAD
Methods
This was a cross-sectional study enrolling patients admitted to invasive coronary angiography in a university hospital in Germany. Patients were prospectively recruited between from March 2017 to January 2020. Patients with known or suspected CAD and risk factors for cardiovascular diseases were screened for eligibility to participate in the trial. Main exclusion criteria were inflammatory/rheumatic disease, active cancer disease and acute infection. Blood sampling was performed after overnight fasting and before invasive procedures. Measurement of propionate was performed though liquid chromatography.
Results
The study included 691 patients (median n [IQR] age, 69 [60–78] years; 406 men [59%]). A total of 368 had invasively confirmed CAD with at least one coronary artery stenosis ≥50% and 323 had non CAD and 194 had invasively excluded CAD. 129 additional patients without suspicion for CAD and without diabetes/smoking were also recruited in the no CAD group. CAD patients had significant lower levels of propionate (median) 6.08 μM (IQR, 4.31–7.65) compared to the no CAD groups 6.92 μM (4.89–9.25, <0.05). Linear regression multivariate analysis adjusted for age, gender, body mass index, hypertension, smoking, diabetes and hyperlipidemia revealed an odds ratio of 0.92 (CI 0.89–0,96, p<0.001) for propionate as predictor of CAD.
Conclusions
The study provides large-scale data for a protective role of propionate in the development of CAD, independent of the presence of other known cardiovascular risk factors.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Internal Grant, Medical School of Brandenburg
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Affiliation(s)
- N Pagonas
- University Hospital Brandenburg , Brandenburg , Germany
| | - B Sasko
- University Hospital Brandenburg , Brandenburg , Germany
| | - F Seibert
- Ruhr University Bochum (RUB), Marien Hospital Herne , Bochum , Germany
| | - O Ritter
- University Hospital Brandenburg , Brandenburg , Germany
| | - N Babel
- Ruhr University Bochum (RUB), Marien Hospital Herne , Bochum , Germany
| | - T Westhoff
- Ruhr University Bochum (RUB), Marien Hospital Herne , Bochum , Germany
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Pagonas N, Weiland L, Jaensch M, Dammernmann W, Christ M, Ritter O, Westhoff T, Kelesidis T, Sasko B. Reduced antioxiadant high-density lipoprotein function in patients with acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1290] [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
High-density lipoprotein (HDL) function rather than concentration plays an important role in the pathogenesis of cardiovascular diseases associated with oxidative stress and inflammation such as coronary artery disease (CAD). In the last years, inflammation has been identified to have a pivotal role in the pathogenesis of acute coronary syndrome (ACS).
Purpose
The aim of the present study is to determine whether reduced antioxidant function of HDL is associated with ACS.
Methods
197 patients with ACS were prospectively recruited and blood samples were taken in the first 48h after enrollment. Patients with chronic coronary syndrome CCS (n=727) and with invasively excluded CAD (no CAD, n=498) from another cohort from our group served as control patients. A validated cell-free biochemical assay was used to determine reduced HDL antioxidant function as assessed by increased HDL-lipid peroxide content (HDLox) normalized by HDL-C levels and the mean value of a pooled serum control from healthy participants (nHDLox; no units).
Results
Patients with ACS had significantly increased HDLox blood levels compared to patients with CCS and to patients without CAD (p<0.001, Figure 1A). Prior intake of statins did not influenc the differences of HDLox among the groups (Figure 1B). In the regression analysis increased HDLox was a strong risk factor for the presence of ACS compared to CCS (odds ratio 4.09 (2.98–5.62), p<0.001, Figure 2).
Conclusions
HDL peroxidation is associated with the presence of ACS independent of the presence of other traditional risk factors.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): BIOX
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Affiliation(s)
- N Pagonas
- University Hospital Brandenburg , Brandenburg , Germany
| | - L Weiland
- University Hospital Brandenburg , Brandenburg , Germany
| | - M Jaensch
- University Hospital Brandenburg , Brandenburg , Germany
| | - W Dammernmann
- University Hospital Brandenburg , Brandenburg , Germany
| | - M Christ
- Knappschaftskrankenhaus, Cardiology , Bottrop , Germany
| | - O Ritter
- University Hospital Brandenburg , Brandenburg , Germany
| | - T Westhoff
- Ruhr University Bochum (RUB), Marien Hospital Herne , Bochum , Germany
| | - T Kelesidis
- University of California Los Angeles, David Geffen School of Medicine , Los Angeles , United States of America
| | - B Sasko
- University Hospital Brandenburg , Brandenburg , Germany
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H, Fechner S, Mages V, Martens E, Methe H, Schmidt T, Schaeffer B, Hoffmann B, Moser J, Heitmann K, Willems S, Willems S, Klaus C, Lange I, Durak M, Esen E, Mibach F, Mibach H, Utech A, Gabelmann M, Stumm R, Ländle V, Gartner C, Goerg C, Kaul N, Messer S, Burkhardt D, Sander C, Orthen R, Kaes S, Baumer A, Dodos F, Barth A, Schaeffer G, Gaertner J, Winkler J, Fahrig A, Aring J, Wenzel I, Steiner S, Kliesch A, Kratz E, Winter K, Schneider P, Haag A, Mutscher I, Bosch R, Taggeselle J, Meixner S, Schnabel A, Shamalla A, Hötz H, Korinth A, Rheinert C, Mehltretter G, Schön B, Schön N, Starflinger A, Englmann E, Baytok G, Laschinger T, Ritscher G, Gerth A, Dechering D, Eckardt L, Kuhlmann M, Proskynitopoulos N, Brunn J, Foth K, Axthelm C, Hohensee H, Eberhard K, Turbanisch S, Hassler N, Koestler A, Stenzel G, Kschiwan D, Schwefer M, Neiner S, Hettwer S, Haeussler-Schuchardt M, Degenhardt R, Sennhenn S, Steiner S, Brendel M, Stoehr A, Widjaja W, Loehndorf S, Logemann A, Hoskamp J, Grundt J, Block M, Ulrych R, Reithmeier A, Panagopoulos V, Martignani C, Bernucci D, Fantecchi E, Diemberger I, Ziacchi M, Biffi M, Cimaglia P, Frisoni J, Boriani G, Giannini I, Boni S, Fumagalli S, Pupo S, Di Chiara A, Mirone P, Fantecchi E, Boriani G, Pesce F, Zoccali C, Malavasi VL, Mussagaliyeva A, Ahyt B, Salihova Z, Koshum-Bayeva K, Kerimkulova A, Bairamukova A, Mirrakhimov E, Lurina B, Zuzans R, Jegere S, Mintale I, Kupics K, Jubele K, Erglis A, Kalejs O, Vanhear K, Burg M, Cachia M, Abela E, Warwicker S, Tabone T, Xuereb R, Asanovic D, Drakalovic D, Vukmirovic M, Pavlovic N, Music L, Bulatovic N, Boskovic A, Uiterwaal H, Bijsterveld N, De Groot J, Neefs J, van den Berg N, Piersma F, Wilde A, Hagens V, Van Es J, Van Opstal J, Van Rennes B, Verheij H, Breukers W, Tjeerdsma G, Nijmeijer R, Wegink D, Binnema R, Said S, Erküner Ö, Philippens S, van Doorn W, Crijns H, Szili-Torok T, Bhagwandien R, Janse P, Muskens A, van Eck M, Gevers R, van der Ven N, Duygun A, Rahel B, Meeder J, Vold A, 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L, O’Donohoe L, Mozid A, Dymond H, Lloyd-Jones H, Saunders G, Simmons D, Coles D, Cotterill D, Beech S, Kidd S, Wrigley B, Petkar S, Smallwood A, Jones R, Radford E, Milgate S, Metherell S, Cottam V, Buckley C, Broadley A, Wood D, Allison J, Rennie K, Balian L, Howard L, Pippard L, Board S, Pitt-Kerby T. Epidemiology and impact of frailty in patients with atrial fibrillation in Europe. Age Ageing 2022; 51:6670566. [PMID: 35997262 DOI: 10.1093/ageing/afac192] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent. OBJECTIVES We aim to perform a comprehensive evaluation of frailty in a large European cohort of AF patients. METHODS A 40-item frailty index (FI) was built according to the accumulation of deficits model in the AF patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Association of baseline characteristics, clinical management, quality of life, healthcare resources use and risk of outcomes with frailty was examined. RESULTS Among 10,177 patients [mean age (standard deviation) 69.0 (11.4) years, 4,103 (40.3%) females], 6,066 (59.6%) were pre-frail and 2,172 (21.3%) were frail, whereas only 1,939 (19.1%) were considered robust. Baseline thromboembolic and bleeding risks were independently associated with increasing FI. Frail patients with AF were less likely to be treated with oral anticoagulants (OACs) (odds ratio 0.70, 95% confidence interval 0.55-0.89), especially with non-vitamin K antagonist OACs and managed with a rhythm control strategy, compared with robust patients. Increasing frailty was associated with a higher risk for all outcomes examined, with a non-linear exponential relationship. The use of OAC was associated with a lower risk of outcomes, except in patients with very/extremely high frailty. CONCLUSIONS In this large cohort of AF patients, there was a high burden of frailty, influencing clinical management and risk of adverse outcomes. The clinical benefit of OAC is maintained in patients with high frailty, but not in very high/extremely frail ones.
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Affiliation(s)
- Marco Proietti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giulio Francesco Romiti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Translational and Precision Medicine, Sapienza - University of Rome, Italy
| | - Marco Vitolo
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Stephanie L Harrison
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
| | - Francisco Marin
- Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBER-CV, Murcia, Spain
| | - Michael Näbauer
- Department of Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Clinical Center of Serbia, Belgrade, Serbia
| | - Gheorghe-Andrei Dan
- University of Medicine, 'Carol Davila', Colentina University Hospital, Bucharest, Romania
| | - Aldo P Maggioni
- ANMCO Research Center, Heart Care Foundation, Florence, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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5
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Eberst G, Claudé F, Laurent L, Meurisse A, Roux-Claudé P, Barnig C, Vernerey D, Paget-Bailly S, Bouiller K, Chirouze C, Behr J, Grillet F, Ritter O, Karaer S, Pili-Floury S, Winiszewski H, Samain E, Decavel P, Capellier G, Westeel V. Result of one-year, prospective follow-up of intensive care unit survivors after SARS-CoV-2 pneumonia. Ann Intensive Care 2022; 12:23. [PMID: 35262794 PMCID: PMC8905558 DOI: 10.1186/s13613-022-00997-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction Survivors of viral ARDS are at risk of long-term physical, functional and neuropsychological complications resulting from the lung injury itself, but also from potential multiorgan dysfunction, and the long stay in the intensive care unit (ICU). Recovery profiles after severe SARS-CoV-2 pneumonia in intensive care unit survivors have yet to be clearly defined. Material and methods The goal of this single-center, prospective, observational study was to systematically evaluate pulmonary and extrapulmonary function at 12 months after a stay in the ICU, in a prospectively identified cohort of patients who survived SARS-CoV-2 pneumonia. Eligible patients were assessed at 3, 6 and 12 months after onset of SARS-CoV-2. Patients underwent physical examination, pulmonary function testing, chest computed tomography (CT) scan, a standardized six-minute walk test with continuous oximetry, overnight home respiratory polygraphy and have completed quality of life questionnaire. The primary endpoint was alteration of the alveolar–capillary barrier compared to reference values as measured by DLCO, at 12 months after onset of SARS-CoV-2 symptoms. Results In total, 85 patients (median age 68.4 years, (interquartile range [IQR] = 60.1–72.9 years), 78.8% male) participated in the trial. The median length of hospital stay was 44 days (IQR: 20–60) including 17 days in ICU (IQR: 11–26). Pulmonary function tests were completed at 3 months (n = 85), 6 months (n = 80), and 12 months (n = 73) after onset of symptoms. Most patients showed an improvement in DLCO at each timepoint (3, 6, and 12 months). All patients who normalized their DLCO did not subsequently deteriorate, except one. Chest CT scans were abnormal in 77 patients (96.3%) at 3 months and although the proportion was the same at 12 months, but patterns have changed. Conclusion We report the results of a comprehensive evaluation of 85 patients admitted to the ICU for SARS-CoV-2, at one-year follow-up after symptom onset. We show that most patients had an improvement in DLCO at each timepoint. Trial registration: Clinical trial registration number: NCT04519320. Supplementary Information The online version contains supplementary material available at 10.1186/s13613-022-00997-8. The most interesting findings were that most patients showed an improvement in their DLCO at 3, 6, and 12 months, and all patients but one who normalized their DLCO did not deteriorate afterwards. Only 11% of patients had persistent impairment of DLCO at 1 year.
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Affiliation(s)
- Guillaume Eberst
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France. .,Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France. .,UMR 1098, University of Franche-Comté, Besançon, France.
| | - Fréderic Claudé
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Lucie Laurent
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Aurelia Meurisse
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Pauline Roux-Claudé
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Cindy Barnig
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Dewi Vernerey
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Sophie Paget-Bailly
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Kevin Bouiller
- Department of Infectious Disease, University Hospital of Besançon, Besançon, France
| | - Catherine Chirouze
- Department of Infectious Disease, University Hospital of Besançon, Besançon, France
| | - Julien Behr
- Department of Radiology, University Hospital of Besançon, Besançon, France
| | - Franck Grillet
- Department of Radiology, University Hospital of Besançon, Besançon, France
| | - Ophélie Ritter
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Sinan Karaer
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Sébastien Pili-Floury
- Anesthesia and Intensive Care Unit, University Hospital of Besançon, Besançon, France
| | - Hadrien Winiszewski
- Medical Intensive Care Unit, University Hospital of Besançon, Besançon, France
| | - Emmanuel Samain
- Anesthesia and Intensive Care Unit, University Hospital of Besançon, Besançon, France.,Research Unit EA3920, Université de Franche Comté, Besançon, France
| | - Pierre Decavel
- Laboratory of Clinical Functional Exploration of Movement, Department of Physical Medicine and Rehabilitation, University Hospital of Besançon, Besançon, France
| | - Gilles Capellier
- Medical Intensive Care Unit, University Hospital of Besançon, Besançon, France.,Research Unit EA3920, Université de Franche Comté, Besançon, France.,Australian and New Zealand Intensive Care Research Center, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Virginie Westeel
- Respiratory Medicine Department, University Hospital of Besançon, 3 Boulevard Fleming, 25030, Besançon, France.,Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
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6
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Traore I, Eberst G, Claudé F, Laurent L, Meurisse A, Paget-Bailly S, Roux-Claudé P, Jacoulet P, Barnig C, Martarello R, Poirson B, Bouiller K, Chirouze C, Behr J, Grillet F, Ritter O, Pili-Floury S, Winiszewski H, Samain E, Capellier G, Westeel V. Prevalence and Characteristics of Sleep Apnea in Intensive Care Unit Survivors After SARS-CoV-2 Pneumonia. Nat Sci Sleep 2022; 14:2213-2225. [PMID: 36578669 PMCID: PMC9791936 DOI: 10.2147/nss.s377946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Sleep apnea (SA) was reported as possibly exacerbating symptoms of COVID-19, a disease induced by SARS-CoV-2 virus. The same comorbidities are common with both pathologies. This study aimed to estimate the prevalence, characteristics of SA and variation in AHI three months after severe COVID-19 requiring intensive care unit (ICU) admission. METHODS A prospective cohort of patients admitted to ICU for severe COVID-19 underwent an overnight home polygraphy 3 months after onset of symptoms, as part of a comprehensive follow-up program (pulmonary function tests, 6-minute walk tests and chest CT-scan). Patients with an apnea hypopnea index (AHI) ≥5 were considered as having SA. We performed a comparative descriptive analysis of 2 subgroups according to the existence, severity of SA and indication for effective SA treatment: patients with absent or mild SA (AHI <15) vs patients with moderate to severe SA (AHI ≥15). RESULTS Among 68 patients included, 62 (91%) had known comorbidities (34 hypertension, 21 obesity, 20 dyslipidemia, 16 type 2 diabetes). It has been observed a preexisting SA for 13 patients (19.1%). At 3 months, 62 patients (91%) had SA with 85.5% of obstructive events. Twenty-four patients had no or a mild SA (AHI <15) and 44 had moderate to severe SA (AHI ≥15). Ischemic heart disease exclusively affected the moderate to severe SA group. Except for thoracic CT-scan which revealed less honeycomb lesions, COVID-19 symptoms were more severe in the group with moderate to severe SA, requiring a longer curarization, more prone position sessions and more frequent tracheotomy. CONCLUSION SA involved 91% of patients in our population at 3 months of severe COVID-19 and was mainly obstructive type. Although SA might be a risk factor as well as consequences of ICU care in severe COVID-19 infection, our results underline the importance of sleep explorations after an ICU stay for this disease.
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Affiliation(s)
- Ibrahim Traore
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Guillaume Eberst
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France.,Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Fréderic Claudé
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Lucie Laurent
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Aurelia Meurisse
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Sophie Paget-Bailly
- Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
| | - Pauline Roux-Claudé
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Pascale Jacoulet
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Cindy Barnig
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Rachel Martarello
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Bastien Poirson
- Department of Geriatrics, University Hospital of Besançon, Besançon, France
| | - Kevin Bouiller
- Department of Infectious Disease, University Hospital of Besançon, Besançon, France
| | - Catherine Chirouze
- Department of Infectious Disease, University Hospital of Besançon, Besançon, France
| | - Julien Behr
- Department of Radiology, University Hospital of Besançon, Besançon, France
| | - Franck Grillet
- Department of Radiology, University Hospital of Besançon, Besançon, France
| | - Ophélie Ritter
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France
| | - Sébastien Pili-Floury
- Anesthesia and Intensive Care Unit, University Hospital of Besançon, Besançon, France
| | - Hadrien Winiszewski
- Medical Intensive Care Unit, University Hospital of Besançon, Besançon, France
| | - Emmanuel Samain
- Anesthesia and Intensive Care Unit, University Hospital of Besançon, Besançon, France.,Research Unit EA3920, Université de Franche Comté, Besançon, France
| | - Gilles Capellier
- Medical Intensive Care Unit, University Hospital of Besançon, Besançon, France.,Research Unit EA3920, Université de Franche Comté, Besançon, France.,Australian and New Zealand Intensive Care Research Center, Department of Epidemiology and Preventive Medicine, Monash University, Monash, Australia
| | - Virginie Westeel
- Respiratory Medicine Department, University Hospital of Besançon, Besançon, France.,Methodology and Quality of Life in Oncology Unit, University Hospital, Besançon, France.,UMR 1098, University of Franche-Comté, Besançon, France
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7
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Ritter O, Pagonas N, Eisert M, Patschan D, Nordbeck P, Buschmann I, Sasko B, Andresen H. ICD exchange in the elderly. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0693] [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
ICD therapy in elderly patients is controversially discussed, since survival benefits might be attenuated by non-arrhythmic causes of death.
Purpose
This study aimed to investigate the outcome of septua- and octogenarians after ICD generator exchange (GE).
Methods
506 patients undergoing elective GE were analysed to determine the incidence of ICD shocks and survival after GE. For further analysis, patients were divided according to age (70 – 79 or ≥80 years) and previous ICD therapy: patients that did not experience a shock and patients that received at least one shock from prior ICDs.
Results
The effect of the ICD on all-cause mortality and arrhythmic death was determined for two groups (patients with 70 – 79 and ≥80 years). Comparing septua- with octogenarians, similar left ventricular ejection fraction (35.6±11.2% vs. 32.4±8.9%) and baseline prevalence of NYHA class 3 or 4 heart failure (17.1% vs. 14.7%) was found. Older patients were more likely to die of non-arrhythmic death (22% per year vs. 8% per year, p<0.001). We also investigated the necessity of ICD therapy dependent on whether ICD therapy occurred during the previous battery live. Septuagenarians and octogenarians with previous shocks had a higher incidence of further ICD therapy in the following battery life period (41% vs. 19%, p<0.001, and 22% vs. 17%, p<0.001).
Conclusion
Decision making for ICD generator exchange among elderly patients should be considered carefully for an individual patient during clinical practice.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- O Ritter
- University Hospital Brandenburg, Department of Internal Medicine I, Brandenburg an der Havel, Germany
| | - N Pagonas
- University Hospital Brandenburg, Department of Internal Medicine I, Brandenburg an der Havel, Germany
| | - M Eisert
- Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - D Patschan
- University Hospital Brandenburg, Department of Internal Medicine I, Brandenburg an der Havel, Germany
| | - P Nordbeck
- Department of Medicine I, University of Wuerzburg, Wuerzburg, Germany
| | - I Buschmann
- University Hospital Brandenburg, Department of Internal Medicine I, Brandenburg an der Havel, Germany
| | - B Sasko
- Department of Internal Medicine IV - Cardiology, Bottrop, Germany
| | - H Andresen
- University Hospital Brandenburg, Department of Internal Medicine I, Brandenburg an der Havel, Germany
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8
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Jaensch M, Trum M, Williams T, Schmitt J, Schuh K, Qadri F, Maier L, Bader M, Ritter O. Investigations regarding the role of NOS1AP in the heart using a conditional overexpression mouse model. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3217] [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: 11/15/2022] Open
Abstract
Abstract
Background
35.3% of deaths in 2019 in Germany are caused by cardiovascular diseases (Destatis). 95% of these people were 60 years and older. To increase survival rate in elderly patients we investigate the relevance of altered expression of neuronal nitric oxide synthase 1 (NOS1) adaptor protein (NOS1AP) acting as an L-type calcium channel (CaV1.2) modulator via directing NOS1 to CaV1.2 on cardiac electrophysiology. Genome-wide association studies have linked genetic polymorphisms in NOS1AP to variations in QT interval duration (QTc). The QT interval reflects ventricular de- and repolarization. It may predispose individuals to ventricular tachycardia and sudden cardiac death (SCD) if prolonged, shortened or otherwise unregularly. In addition, about 20% of families with a clinically proven diagnosis of long QT syndrome (LQTS) host no mutation in any of the 16 associated genes.
Methods and results
Transgenic mice with conditional overexpression of NOS1AP in cardiac myocytes were used as model organism. We confirmed the interaction of NOS1AP with NOS1 and CaV1.2. Electrocardiography in NOS1AP overexpressing mice showed atrial and ventricular tachycardia both spontaneously and upon programmed stimulation associated with a significant decrease in QTc. Heart rates in NOS1AP overexpressing mice were similar to non-induced animals. Survival was significantly reduced (only 60% after 12 weeks vs. 100% in non-induced mice). Induced QTc alterations and accompanied deaths subsided upon re-administration of doxycycline.
Whole-cell patch-clamp measurements in isolated adult ventricular myocytes were performed and action potential duration at 90% of repolarization (APD90) was significantly reduced in induced transgenic NOS1AP overexpressing mice compared to control littermates.
In addition, we investigated the functional effect of the human SNP rs16847548 (T/C) located within the NOS1AP promoter. The SNP was found to decrease the transcriptional activity of NOS1AP in vitro and therefore, potentially leading to a decrease in NOS1AP expression in humans.
Conclusion
Myocardial overexpression of NOS1AP leads to short QT syndrome with increased susceptibility to atrial and ventricular arrhythmias and cardiac death. In accordance, APD90 is significantly shortened in overexpressing animals. The human SNP rs16847548, which is located in the promoter region of NOS1AP, results in a reduced NOS1AP promoter activity in vitro, hereby providing an explanation for the frequently published elongation of QT intervals. In summary, not only mutations in ion channels themselves but also genetic alterations in the expression of ion channel modulators such as NOS1AP, have an impact on QTc and arrhythmogenesis and represent a promising therapeutic target for LQTS patients.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Gesundheitscampus Brandenburg (MWFK)
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Affiliation(s)
- M Jaensch
- University Hospital Brandenburg, Department of Internal Medicine I, Brandenburg an der Havel, Germany
| | - M Trum
- University Hospital Regensburg, Department of Internal Medicine II, Regensburg, Germany
| | - T Williams
- University Hospital Würzburg, Comprehensive Heart Failure Center and Department of Internal Medicine I, Wuerzburg, Germany
| | - J Schmitt
- Heinrich Heine University, Department of Pharmacology and Clinical Pharmacology, Duesseldorf, Germany
| | - K Schuh
- University of Wuerzburg, Institute of Physiology, Wuerzburg, Germany
| | - F Qadri
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Molecular Biology of Peptide Hormones, Berlin, Germany
| | - L Maier
- University Hospital Regensburg, Department of Internal Medicine II, Regensburg, Germany
| | - M Bader
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Molecular Biology of Peptide Hormones, Berlin, Germany
| | - O Ritter
- University Hospital Brandenburg, Department of Internal Medicine I, Brandenburg an der Havel, Germany
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9
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Pagonas N, Sasko B, Mueller R, Jaensch M, Dammermann W, Hillmeister P, Buschmann I, Ritter O, Westhoff TH, Kelesidis T. High-density lipoprotein lipid peroxidation in association with presence of coronary artery disease and atrial fibrillation in a large cross-sectional study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3433] [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
The function of high-density lipoprotein (HDL) cholesterol may play a more important role in the prevention of cardiovascular disease compared to the concentration of the HDL. Cardiovascular diseases such as coronary artery disease (CAD) and atrial fibrillation (AF) have been linked to impaired HDL function.
Purpose
The aim of the present study is to assess a biochemical measure of the antioxidant function of HDL and its association with presence of CAD and AF.
Methods
Patients admitted for elective cardiac catheterization were recruited in this cross-sectional study. Out of 1231 participants that were included in the analyses, 727 patients had confirmed CAD (CAD group), 369 patients had no CAD (no CAD group) and 129 persons were included as a control group. HDL function was measured in sera by determination of HDL-lipid peroxidation content (HDLox) assessed by a validated fluorometric cell-free biochemical assay and was normalized for the levels of HDL cholesterol (normalized HDLox/HDL-C ratio or nHDLox; no units). Results are expressed as median with interquartile range. Associations of nHDLox with presence of CAD and AF were assessed by univariate and multivariate analyses.
Results
Participants in the CAD group had higher levels of nHDLox (0.80, 0.61–1.03) compared to the no CAD (0.70, 0.55–0.93) and control (0.66, 0.55–1.03, no units, p<0.001) group. Out of 1206 participants, 233 (19%) had AF and 973 (81%) had no AF. Patients with AF have also higher nHDLox (0.82, 0.60–10.03) compared to persons without AF (0.73, 0.58–0.98, p=0.03). In univariate analysis nHDLox was associated with CAD (p<0.001). In multivariate analysis adjusted for age, gender, CAD, BMI and hypertension, nHDLox was a strong independent predictor of atrial fibrillation (p=0.015) but was not an independent predictor of CAD (p>0.05)
Conclusions
Reduced antioxidant function of HDL (increased HDLox measured by a biochemical assay), a metric of HDL function, is increased in patients with atherosclerosis and manifested CAD and is also associated with the presence of atrial fibrillation independent of the presence of CAD.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Medical School of Brandenburg-MHB Fontane
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Affiliation(s)
- N Pagonas
- University Hospital Brandenburg, Brandenburg, Germany
| | - B Sasko
- University Hospital Brandenburg, Brandenburg, Germany
| | - R Mueller
- University Hospital Brandenburg, Brandenburg, Germany
| | - M Jaensch
- University Hospital Brandenburg, Brandenburg, Germany
| | - W Dammermann
- University Hospital Brandenburg, Brandenburg, Germany
| | - P Hillmeister
- University Hospital Brandenburg, Brandenburg, Germany
| | - I Buschmann
- University Hospital Brandenburg, Brandenburg, Germany
| | - O Ritter
- University Hospital Brandenburg, Brandenburg, Germany
| | - T H Westhoff
- Ruhr University Bochum (RUB), Marien Hospital Herne, Bochum, Germany
| | - T Kelesidis
- University of California Los Angeles, David Geffen School of Medicine, Los Angeles, United States of America
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10
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Nahmias O, Ritter O, Sagawa Y, Roux P, Degano B, Soumagne T. Ventilatory adaptation during eccentric cycling in patients with severe COPD: Potential implications for exercise training. Respir Physiol Neurobiol 2021; 292:103706. [PMID: 34062283 DOI: 10.1016/j.resp.2021.103706] [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] [Received: 03/23/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Eccentric (ECC) cycling is viewed as an alternative to concentric (CON) cycling for exercise training in patients with severe COPD as it induces a much lower ventilatory demand for a given mechanical load than CON cycling. However, a more hyperpneic breathing pattern (i.e., higher fB and lower tidal volume (VT)) during ECC than during CON has been reported in healthy subjects. RESEARCH QUESTION Do patients with severe COPD develop a more hyperpneic breathing pattern during ECC than during CON cycling, and is it associated with differences in dynamic hyperinflation, ventilatory efficiency and cardiometabolic adaptation? METHODS Fourteen patients with severe COPD performed incremental CON and ECC cardiopulmonary exercise tests (CPET). Several physiological parameters including VT, fB, inspiratory capacity (IC) and oxygen consumption (V̇O2) were recorded at each workload increment during CPET. RESULTS At the highest identical minute ventilation (V̇E) achieved during ECC and CON (28.6 ± 4.6 L.min-1), VT was lower (1010 ± 218 vs. 1100 ± 233 mL; p = 0.02), fB was higher (29.0 ± 5.1 vs. 27.0 ± 5.5 min-1; p = 0.03), IC(% baseline) was lower (84 ± 10 vs. 78 ± 9; p < 0.01) and markers of ventilatory efficiency were poorer during ECC than during CON. Similar results were found at the highest identical V̇O2 achieved during ECC and CON. CONCLUSION The finding of a more hyperpneic ventilatory pattern during ECC cycling together with a lower IC and a poorer ventilatory efficiency suggests that ECC exercise training should be decided with caution in patients with severe COPD.
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Affiliation(s)
- Olympe Nahmias
- Department of Respiratory Physiology, University Hospital of Besançon, Besançon, France; Department of Physical Medicine and Rehabilitation, University Hospital of Besançon, Besançon, France
| | - Ophélie Ritter
- Department of Respiratory Physiology, University Hospital of Besançon, Besançon, France
| | - Yoshimasa Sagawa
- Laboratory of Clinical Functional Exploration of Movement, University Hospital of Besançon, Besançon, France; Clinical Investigation Center, INSERM CIC 1431, University Hospital of Besançon, Besançon, France
| | - Pauline Roux
- Department of Respiratory Physiology, University Hospital of Besançon, Besançon, France
| | - Bruno Degano
- Department of Respiratory Medicine, University Hospital of Grenoble Alpes, Grenoble, France; HP2, INSERM U1042, University Grenoble Alpes, Grenoble, France
| | - Thibaud Soumagne
- Department of Respiratory Physiology, University Hospital of Besançon, Besançon, France.
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11
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Andresen H, Sasko B, Patschan D, Pagonas N, Ritter O. Effective treatment of electrical storm by a wearable cardioverter defibrillator in a patient with severely impaired left ventricular function after myocardial infarction: a case report. J Med Case Rep 2021; 15:243. [PMID: 33993888 PMCID: PMC8126431 DOI: 10.1186/s13256-021-02833-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/29/2021] [Indexed: 12/20/2022] Open
Abstract
Background The implantation of cardioverter defibrillators (ICDs) is an established therapy in the prevention of sudden cardiac death in patients with systolic dysfunction after myocardial infarction. To avoid immediate implantation of an ICD, wearable cardioverter defibrillator vests (WCD) can be used to protect patients against malignant rhythm disorders, while at the same time drug-based heart failure therapy has to be initiated. This drug therapy can improve left ventricular ejection fraction and primary prophylactic cardioverter defibrillator implantation may not be necessary. However, the recent Vest Prevention of Early Sudden Death Trial (VEST) questioned the regular use of the WCD in this setting. Case presentation A 47-year-old Caucasian man with severely impaired left ventricular function early after myocardial infarction was prescribed a WCD as primary prophylaxis to prevent sudden cardiac death. Seven days after the patient was supplied with a WCD, the patient suffered from an electrical storm with recurrent ventricular tachycardia (VT), which was successfully terminated 17 times by the WCD. On coronary angiography, the formerly infarct-related right coronary artery had TIMI (Thrombolysis in Myocardial Ischemia Trial) III flow, and a remaining stenosis in the left anterior descending artery (LAD) was stented, which did not stop recurrent VT. In the electrophysiology (EP) study, a focus was mapped in the left inferior ventricle, which was ablated. This stopped the VT. A second radio-frequency (RF) ablation in the same area was necessary after 14 days. Finally, a permanent cardioverter defibrillator was implanted. Conclusion We report the case of a patient who survived recurrent episodes of VT early after myocardial infarction by effective defibrillation with a WCD. The WCD is a useful device to bridge time until a final decision for implantation of a defibrillator.
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Affiliation(s)
- Henrike Andresen
- Department of Cardiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany.
| | - B Sasko
- Department of Cardiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - D Patschan
- Department of Cardiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - N Pagonas
- Department of Cardiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - O Ritter
- Department of Cardiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
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12
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Asmus K, Erfurt S, Ritter O, Patschan S, Patschan D. AKI Epidemiology and Outcomes: A Retrospective Cohort Study from the Prenephrology Era. Int J Nephrol 2021; 2021:5549316. [PMID: 33986959 PMCID: PMC8093068 DOI: 10.1155/2021/5549316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/12/2021] [Accepted: 04/18/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Acute kidney injury substantially worsens the prognosis of hospitalized patients. The Brandenburg Medical School was founded in 2014, and a nephrology section was opened in summer 2017. The aim of the study was to analyze AKI epidemiology and outcomes in one of two university hospitals belonging to the medical school. The period of interest dated from January to December 2015. METHODS The investigation was designed as a single-center, retrospective cohort study at the Brandenburg Hospital of the Brandenburg Medical School. All in-hospital patients treated between January and the end of December 2015 were included. AKI was defined as specified in the 2012 published KDIGO criteria (criteria 1 and 2). Four parameters were evaluated in particular: AKI incidence, in-hospital mortality, frequency of renal replacement therapy, and renal recovery during the stay at the hospital. RESULTS A total number of 5,300 patients were included in the analysis. AKI was diagnosed in 490 subjects (10.1%). The in-hospital mortality was 26%. The following conditions/parameters significantly differed between survivors (s) and nonsurviving (ns) subjects: duration of in-hospital treatment (s > ns), AKI onset (outpatient vs. in-hospital) (outpatient in s > ns), dialysis due to AKI (s < ns), vasopressor administration (s < ns), and invasive ventilation (s < ns). 5.6% received dialysis therapy, and renal recovery occurred in 31% of all surviving AKI subjects. CONCLUSION Both, the AKI incidence and the frequency of dialysis were lower than reported in the literature. However, fewer subjects recovered from AKI. These discrepant findings possibly result from the lack of prehospitalization creatinine values, the lack of follow-up data, and a generally lower awareness for the need to perform renal replacement therapy in AKI.
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Affiliation(s)
- K. Asmus
- Zentrum für Innere Medizin 1, Kardiologie, Angiologie, Nephrologie, Klinikum Brandenburg, Medizinische Hochschule Brandenburg, Brandenburg, Germany
| | - S. Erfurt
- Zentrum für Innere Medizin 1, Kardiologie, Angiologie, Nephrologie, Klinikum Brandenburg, Medizinische Hochschule Brandenburg, Brandenburg, Germany
| | - O. Ritter
- Zentrum für Innere Medizin 1, Kardiologie, Angiologie, Nephrologie, Klinikum Brandenburg, Medizinische Hochschule Brandenburg, Brandenburg, Germany
| | - S. Patschan
- Zentrum für Innere Medizin 1, Kardiologie, Angiologie, Nephrologie, Klinikum Brandenburg, Medizinische Hochschule Brandenburg, Brandenburg, Germany
| | - D. Patschan
- Zentrum für Innere Medizin 1, Kardiologie, Angiologie, Nephrologie, Klinikum Brandenburg, Medizinische Hochschule Brandenburg, Brandenburg, Germany
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13
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Fedi A, Keddache S, Quétant S, Guillien A, Antoniadis A, Soumagne T, Ritter O, Glérant JC, Cottin V, Degano B, Aguilaniu B. Concurrence of 1- and 3-Min Sit-to-Stand Tests with the 6-Min Walk Test in Idiopathic Pulmonary Fibrosis. Respiration 2021; 100:571-579. [PMID: 33849043 DOI: 10.1159/000515335] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 02/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In idiopathic pulmonary fibrosis (IPF), some physiological parameters measured during a 6-min walk test (6-MWT) impart reliable prognostic information. Sit-to-stand tests (STSTs) are field exercise tests that are easier to implement than the 6-MWT in daily practice. OBJECTIVES The aims of the study were to test the reproducibility and compare 2 STSTs (the 1-min STST [1-STST] and the semi-paced 3-min chair rise test [3-CRT]) in IPF, and to determine if selected physiological parameters (speed of displacement and changes in pulse oxygen saturation [SpO2]) are interchangeable between the STSTs and the 6-MWT. METHODS Thirty-three patients with stable IPF were studied in 3 French expert centers. To test reproducibility, intra-class correlations (ICCs) of parameters measured during tests performed 7-14 days apart were calculated. To test interchangeability, the agreement and correlation of physiological responses measured during STSTs and during 6-MWT were studied. RESULTS Vertical displacements and changes in SpO2 during both STSTs were reproducible, with ICCs ranging from 0.78 [0.63-0.87] to 0.95 [0.92-0.97]. Vertical displacements during 1-STST and 3-CRT were correlated with 6-MWT distance (correlation coefficients (r) of 0.72 and 0.77, respectively; p < 0.001). Similarly, correlations were found between changes in SpO2 measured during the 2 STSTs and the 6-MWT, with coefficients ranging from 0.73 to 0.91 (p < 0.001). Distance walked and SpO2 during 6-MWT were well estimated from vertical displacement and SpO2 during the 2 STSTs, respectively. CONCLUSION The correlations found between the 2 STSTs and the 6-MWT suggest that STSTs may be of interest to assess displacement and exercise-induced changes in SpO2 in IPF patients.
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Affiliation(s)
- Arnaud Fedi
- Department of Respiratory Medicine and Physiology, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Sophia Keddache
- Department of Respiratory Medicine, Centre Hospitalier Régional et Universitaire, Besançon, Besançon, France
| | - Sébastien Quétant
- Department of Respiratory Medicine and Physiology, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Alicia Guillien
- Team of environmental epidemiology applied to Reproduction and Respiratory health, IAB, Univ. Grenoble Alpes, Inserm, CNRS, Grenoble, France
| | - Anestis Antoniadis
- Jean Kuntzmann Laboratory, Department of Statistics, Univ. Grenoble Alpes, Grenoble, France
| | - Thibaud Soumagne
- Department of Respiratory Medicine, Centre Hospitalier Régional et Universitaire, Besançon, Besançon, France
| | - Ophélie Ritter
- Department of Respiratory Medicine, Centre Hospitalier Régional et Universitaire, Besançon, Besançon, France
| | - Jean-Charles Glérant
- Department of Respiratory Physiology, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France
| | - Vincent Cottin
- Department of Respiratory Medicine, National reference coordinating center for rare pulmonary diseases, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, INRAE, UMR754, member of ERN-LUNG, RespiFil, OrphaLung, Lyon, France
| | - Bruno Degano
- Department of Respiratory Medicine and Physiology, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.,HP2 Laboratory, INSERM U1042, Univ. Grenoble Alpes, Grenoble, France
| | - Bernard Aguilaniu
- Department of Respiratory Medicine and Physiology, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
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14
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Pagonas N, Mueller R, Weiland L, Jaensch M, Westhoff T, Buschmann I, Sasko B, Ritter O, Kelesidis T. Oxidation of HDL in patients with coronary artery disease. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1521] [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
The function of high-density lipoprotein (HDL) cholesterol may play a more important role in the prevention of cardiovascular disease compared to the concentration of the HDL. The aim of the present study is to assess a novel cell-free test to quantify oxidation of HDL and its association to coronary artery disease (CAD).
We performed a prospective trial by including patients undergoing elective cardiac catheterization and healthy controls. A total of 895 subjects were included. In 483 patients CAD was confirmed (CAD group) and in 241 patients CAD was ruled-out (no CAD). Control patients (n=171) had no known CAD, had no diabetes and were not smokers. HDL function was measured in serum samples by determining its HDL-lipid peroxidation by a novel fluorometric cell-free biochemical assay. HDL lipid peroxide content (HDLox) is adjusted for the HDL cholesterol and has no units.
Patients with confirmed CAD had higher levels of HDLox (0.92±0.58, no units) compared to patients with no CAD (0.8±0.46, no units) and controls (0.78±0.41, no units, p=0.003). HDL-Cholesterol was lower in the CAD group (50.7±17.7mg/dl) compared to no CAD (58.4±17.6mg/dl) and healthy subjects (59.1±15.9mg/dl, p<0.001). HDLox was a strong predictor of coronary artery disease status (odds ratio for coronary disease 1.69; 95% confidence interval [CI], 1.24 to 2.38; P=0.001).
Oxidation of HDL, a metric of HDL function, measured by a cell-free biochemical assay, is increased in patients with CAD and is a predictor of the disease.
Logistic Regression analysis
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): Medical School of Brandenburg
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Affiliation(s)
- N Pagonas
- University Hospital Brandenburg, Department of Cardiology, Brandenburg, Germany
| | - R Mueller
- University Hospital Brandenburg, Department of Cardiology, Brandenburg, Germany
| | - L Weiland
- University Hospital Brandenburg, Department of Cardiology, Brandenburg, Germany
| | - M Jaensch
- University Hospital Brandenburg, Department of Cardiology, Brandenburg, Germany
| | - T.H Westhoff
- Ruhr University Bochum (RUB), Marien Hospital Herne, Bochum, Germany
| | - I.R Buschmann
- University Hospital Brandenburg, Department of Cardiology, Brandenburg, Germany
| | - B Sasko
- University Hospital Brandenburg, Department of Cardiology, Brandenburg, Germany
| | - O Ritter
- University Hospital Brandenburg, Department of Cardiology, Brandenburg, Germany
| | - T.H Kelesidis
- University of California Los Angeles, David Geffen School of Medicine, Los Angeles, United States of America
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Ritter O, Isacco L, Rakobowchuk M, Tordi N, Laroche D, Bouhaddi M, Degano B, Mourot L. Cardiorespiratory and Autonomic Nervous System Responses to Prolonged Eccentric Cycling. Int J Sports Med 2019; 40:453-461. [PMID: 31108562 DOI: 10.1055/a-0783-2581] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Offering large muscle benefits despite low metabolic demand, continuous eccentric exercise appears to be an interesting alternative to concentric exercise. Nevertheless, further knowledge is needed about prolonged eccentric exercise. This work sought to investigate the cardiovascular responses to prolonged constant-load eccentric compared to concentric cycling. Ten healthy males performed two 45-min exercise sessions of either concentric or eccentric cycling separated by a month and matched for heart rate during the first 5 min of exercise. Cardiorespiratory, autonomic nervous system and vascular responses were assessed at rest, and during exercise and recovery. During cycling, oxygen uptake, cardiac output and systolic blood pressure were similar but heart rate and diastolic blood pressure were greater whereas stroke volume was lower during eccentric than concentric cycling (118±21 vs. 104±10 bpm; 77±9 vs. 65±8 mmHg; 122±12 vs. 135±13 mL). Baroreflex and noradrenaline concentration were altered during eccentric cycling, and after eccentric exercise, vascular tone was greater than after concentric cycling. We observed increased cardiovascular strain and altered baroreflex activity during eccentric compared with concentric exercise, suggesting eccentric cycling triggers greater sympathetic activity.
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Affiliation(s)
- Ophélie Ritter
- Centre Hospitalier Universitaire de Besançon, Physiologie - Explorations Fonctionnelles, Besançon, France
| | - Laurie Isacco
- EA 3920 Prognostic markers and regulatory factors of cardiovascular diseases and Exercise Performance Health Innovation Platform, Univ. Bourgogne Franche-Comté, Besançon, France
| | - Mark Rakobowchuk
- Department of Biological Sciences, Thompson Rivers University, Kamloops, Canada
| | - Nicolas Tordi
- PEPITE EA 4267 and Exercise Performance Health Innovation Platform, Univ. Bourgogne Franche-Comté, Besançon, France
| | - Davy Laroche
- INSERM U1093 - Cognition, Action, et Plasticité Sensorimotrice, Univ. Bourgogne Franche-Comté, Dijon, France
| | - Malika Bouhaddi
- EA 3920 Prognostic markers and regulatory factors of cardiovascular diseases and Exercise Performance Health Innovation Platform, Univ. Bourgogne Franche-Comté, Besançon, France
| | - Bruno Degano
- Centre Hospitalier Universitaire Grenoble Alpes, Service Hospitalier Universitaire Pneumologie Physiologie (SHUPP), Grenoble, France
| | - Laurent Mourot
- EA 3920 Prognostic markers and regulatory factors of cardiovascular diseases and Exercise Performance Health Innovation Platform, Univ. Bourgogne Franche-Comté, Besançon, France
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16
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Pagonas N, Vlatsas S, Bauer F, Seibert FS, Sasko B, Buschmann I, Ritter O, Kelesidis T, Westhoff TH. The impact of aerobic and isometric exercise on different measures of dysfunctional high-density lipoprotein in patients with hypertension. Eur J Prev Cardiol 2019; 26:1301-1309. [PMID: 31067131 DOI: 10.1177/2047487319848199] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Exercise training increases high-density lipoprotein (HDL) cholesterol, but its effect on HDL function is unclear. In hypertensives, exercise improves endothelial dysfunction, which is related to HDL function. In the present study, we assess for the first time the effects of different exercise modalities on two cell-free assays of HDL function. DESIGN The study was conducted as a prospective randomized controlled trial in 75 hypertensive patients. METHODS Patients were randomized in three groups: (a) handgrip isometric training five times weekly; (b) placebo-handgrip; and (c) aerobic exercise training at least three times per week. HDL function was assessed in serum samples at baseline and after 12 weeks of training by two independent assays that determine the proinflammatory phenotype (haptoglobin content) of a specific amount of HDL (Haptoglobin-HDL [HPHDL]) and oxidized HDL (HDLox) as a measure of reduced antioxidant function of HDL. HDL function measures were normalized by the measures of a pooled control of sera from healthy participants and by HDL-C levels (normalized ratio, no units). RESULTS Aerobic exercise led to significant reduction of the HDLox from 0.99 ± 0.27 to 0.90 ± 0.29 (no units, p = 0.03). The HPHDL did not change in any training group. Changes of HDLox correlated with reduction of the systolic blood pressure only after aerobic exercise (R = 0.64, p = 0.03). CONCLUSIONS Aerobic but not isometric exercise improves the antioxidant function of HDL in patients with hypertension. This improvement correlates positively with reductions of blood pressure.
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Affiliation(s)
- Nikolaos Pagonas
- 1 Department of Cardiology, Medical University of Brandenburg, Germany.,2 Medical Department I, Marien Hospital Herne, Ruhr-University of Bochum, Germany
| | - Stergios Vlatsas
- 3 Department of Nephrology, Charité - Campus Benjamin Franklin, Berlin, Germany
| | - Frederic Bauer
- 2 Medical Department I, Marien Hospital Herne, Ruhr-University of Bochum, Germany
| | - Felix S Seibert
- 2 Medical Department I, Marien Hospital Herne, Ruhr-University of Bochum, Germany
| | - B Sasko
- 1 Department of Cardiology, Medical University of Brandenburg, Germany
| | - I Buschmann
- 4 Department of Angiology, Medical University of Brandenburg, Germany
| | - O Ritter
- 1 Department of Cardiology, Medical University of Brandenburg, Germany
| | - Theodoros Kelesidis
- 5 Department of Medicine, David Geffen School of Medicine, University of California, LA, USA
| | - Timm H Westhoff
- 2 Medical Department I, Marien Hospital Herne, Ruhr-University of Bochum, Germany
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17
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Seidlmayer LK, Riediger F, Pagonas N, Nordbeck P, Ritter O, Sasko B. Description of a novel RyR2 mutation in a juvenile patient with symptomatic catecholaminergic polymorphic ventricular tachycardia in sleep and during exercise: a case report. J Med Case Rep 2018; 12:298. [PMID: 30296944 PMCID: PMC6176516 DOI: 10.1186/s13256-018-1825-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 03/13/2018] [Accepted: 08/30/2018] [Indexed: 12/02/2022] Open
Abstract
Background Catecholaminergic polymorphic ventricular tachycardia is an inherited disease presenting with arrhythmic events during physical exercise or emotional stress. If untreated, catecholaminergic polymorphic ventricular tachycardia is a highly lethal condition: About 80% of affected individuals experience recurrent syncope, and 30% experience cardiac arrest. Catecholaminergic polymorphic ventricular tachycardia is caused by mutations in genes encoding ryanodine receptor type 2 (RyR2) and cardiac calsequestrin (CASQ2). In cases of sympathoadrenergic activation, both mutations result in a spontaneous Ca2+ release in cardiac cells, facilitating ventricular arrhythmias. Case presentation We present a case of a 17-year-old Caucasian boy who survived sudden cardiac death caused by ventricular fibrillation while performing running exercise in a fitness center. The diagnostic workup included blood tests, coronary angiography, electrophysiological testing, and cardiac magnetic resonance imaging, but all results were normal. Because the patient’s medical history included recurrent syncope during physical and emotional stress, we strongly suspected catecholaminergic polymorphic ventricular tachycardia as the underlying disease. Genetic screening was performed and confirmed the diagnosis, revealing a new heterozygous point mutation in the gene for RyR2, c.12520T>A (p.F4174 l, exon 90, RyR2 gene). The patient was discharged from our hospital after undergoing implantation of an implantable cardioverter defibrillator for secondary prevention. Shortly after implantation, the implantable cardioverter defibrillator terminated a sustaining ventricular tachycardia episode by antitachycardic pacing. This episode occurred early in the morning while the patient was asleep. Conclusions We present a case of catecholaminergic polymorphic ventricular tachycardia associated with a novel single point mutation in the RyR2 gene, which, to the best of our knowledge, has not been described in the literature so far. Our patient experienced arrhythmic events under both resting conditions and physical activity, an uncommon finding in patients with catecholaminergic polymorphic ventricular tachycardia. This novel mutation may cause arrhythmias independent of sympathoadrenergic stimulation, but further evidence is needed to prove causality.
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Affiliation(s)
- L K Seidlmayer
- Internal Medicine 1, Department of Cardiology, University Hospital of Wurzburg, Oberduerrbacherstrasse 6, 97080, Wurzburg, Germany.,Comprehensive Heart Failure Center, Am Schwarzenberg 15, 97078, Wurzburg, Germany
| | - F Riediger
- Department of Cardiology, Brandenburg Medical School Brandenburg - Theodor Fontane (MHB), University Hospital Brandenburg, Hochstrasse 29, 14470, Brandenburg an der Havel, Germany
| | - N Pagonas
- Department of Cardiology, Brandenburg Medical School Brandenburg - Theodor Fontane (MHB), University Hospital Brandenburg, Hochstrasse 29, 14470, Brandenburg an der Havel, Germany
| | - P Nordbeck
- Internal Medicine 1, Department of Cardiology, University Hospital of Wurzburg, Oberduerrbacherstrasse 6, 97080, Wurzburg, Germany.,Comprehensive Heart Failure Center, Am Schwarzenberg 15, 97078, Wurzburg, Germany
| | - O Ritter
- Department of Cardiology, Brandenburg Medical School Brandenburg - Theodor Fontane (MHB), University Hospital Brandenburg, Hochstrasse 29, 14470, Brandenburg an der Havel, Germany
| | - B Sasko
- Department of Cardiology, Brandenburg Medical School Brandenburg - Theodor Fontane (MHB), University Hospital Brandenburg, Hochstrasse 29, 14470, Brandenburg an der Havel, Germany.
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Sasko B, Riediger F, Pagonas N, Rueckert M, Nordbeck P, Seidlmayer L, Ritter O. P5784Survival after icd exchange in the elderly. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5784] [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)
- B Sasko
- Städtisches Klinikum, Medical School Brandenburg (MHB) - Theodor Fontane, Cardiology, Brandenburg an der Havel, Germany
| | - F Riediger
- Städtisches Klinikum, Medical School Brandenburg (MHB) - Theodor Fontane, Cardiology, Brandenburg an der Havel, Germany
| | - N Pagonas
- Städtisches Klinikum, Medical School Brandenburg (MHB) - Theodor Fontane, Cardiology, Brandenburg an der Havel, Germany
| | - M Rueckert
- Städtisches Klinikum, Medical School Brandenburg (MHB) - Theodor Fontane, Cardiology, Brandenburg an der Havel, Germany
| | - P Nordbeck
- University Hospital of Wuerzburg, Internal Medicine 1, Cardiology, Würzburg, Germany
| | - L Seidlmayer
- University Hospital of Wuerzburg, Internal Medicine 1, Cardiology, Würzburg, Germany
| | - O Ritter
- Städtisches Klinikum, Medical School Brandenburg (MHB) - Theodor Fontane, Cardiology, Brandenburg an der Havel, Germany
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Schwarze K, Kribben A, Ritter O, Müller GA, Patschan D. Autophagy activation in circulating proangiogenic cells aggravates AKI in type I diabetes mellitus. Am J Physiol Renal Physiol 2018; 315:F1139-F1148. [PMID: 29897281 DOI: 10.1152/ajprenal.00502.2017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Acute kidney injury (AKI) occurs frequently in hospitals worldwide, but the therapeutic options are limited. Diabetes mellitus (DM) affects more and more people around the globe. The disease worsens the prognosis of AKI even further. In recent years, cell-based therapies have increasingly been applied in experimental AKI. The aim of the study was to utilize two established autophagy inducers for pharmacological preconditioning of so-called proangiogenic cells (PACs) in PAC treatment of diabetic AKI. Insulin-dependent DM was induced in male C57/Bl6N mice by intraperitoneal injections of streptozotocine. Six weeks later, animals underwent bilateral renal ischemia for 45 min, followed by intravenous injections of either native or zVAD (benzyloxycarbonyl-Val-Ala-Asp-fluoro-methylketone)- or Z-Leu-Leu-Leu-al (MG132)-pretreated syngeneic murine PACs. Mice were analyzed 48 h (short term) and 6 wk (long term) later, respectively. DM worsened postischemic AKI, and PAC preconditioning with zVAD and MG132 resulted in a further decline of excretory kidney function. Injection of native PACs reduced fibrosis in nondiabetic mice, but cell preconditioning promoted interstitial matrix accumulation significantly. Both substances aggravated endothelial-to-mesenchymal transition (EndoMT) under diabetic conditions; these effects occurred either exclusively in the short (zVAD) or in the short and long term (MG132). Preconditioned cells stimulated the autophagocytic flux in intrarenal endothelial cells, and all experimental groups displayed increased endothelial abundances of senescence-associated β-galactosidase, a marker of premature cell senescence. Pharmacological autophagy activation may not serve as an effective strategy for improving PAC competence in diabetic AKI in general. On the contrary, several outcome parameters (excretory function, fibrosis, EndoMT) may even be worsened.
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Affiliation(s)
- K Schwarze
- Clinic of Nephrology and Rheumatology, University Hospital of Göttingen , Göttingen , Germany
| | - A Kribben
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen , Essen , Germany
| | - O Ritter
- Department of Cardiology, Pulmology, Angiology, and Nephrology, Brandenburg Medical School, University Hospital Brandenburg , Brandenburg , Germany
| | - G A Müller
- Clinic of Nephrology and Rheumatology, University Hospital of Göttingen , Göttingen , Germany
| | - D Patschan
- Department of Cardiology, Pulmology, Angiology, and Nephrology, Brandenburg Medical School, University Hospital Brandenburg , Brandenburg , Germany
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20
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Rakobowchuk M, Isacco L, Ritter O, Represas A, Bouhaddi M, Degano B, Tordi N, Mourot L. Muscle Oxygenation Responses to Low-intensity Steady Rate Concentric and Eccentric Cycling. Int J Sports Med 2018; 39:173-180. [DOI: 10.1055/s-0043-121272] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractMuscle deoxygenation responses provide information about the training impulse of an exercise session enabling adaptation to be predicted. Our aim was to investigate muscle oxygenation profiles during prolonged low-intensity eccentric and concentric cycling. Twelve healthy men performed two 45-min exercise sessions of concentric (CON) and eccentric (ECC) cycling, matched for the same heart rate at the start of each session. Mechanical power output during ECC was ~2.5 times that of CON (210±40 W vs. 82±16 W). Oxygen uptake, blood lactate, cardiac output and systolic arterial pressure responses did not differ between exercises. Heart rate was similar at 5 min of each exercise bout but progressively increased during ECC and was higher at 15, 30 and 45 min of ECC compared to CON (+10 bpm), with a trend for a lower stroke volume. Diastolic and mean blood pressures were higher during ECC. No significant differences were observed in muscle oxygenation profiles. Muscle oxygenation responses during prolonged low-intensity exercise were not affected by the type of muscle action at the same metabolic demand and cardiac output.
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Affiliation(s)
- Mark Rakobowchuk
- Department of Biological Sciences, Thompson Rivers University Faculty of Science, Kamloops, Canada
| | - Laurie Isacco
- Prognostic markers and regulatory factors of cardiovascular diseases and Exercise Performance, Univ. of Bourgogne Franche-Comté, Health, Innovation platform, Besançon, France
| | - Ophélie Ritter
- PEPITE and Exercise Performance Health Innovation Platform, Univ. of Bourgogne Franche-Comté, Besançon, France
| | - Alicia Represas
- Department Functional Biology and Health Sciences, Univ. of Vigo, Vigo, Spain
| | - Malika Bouhaddi
- Prognostic markers and regulatory factors of cardiovascular diseases, Univ. of Bourgogne Franche-Comté, Besançon, France
| | - Bruno Degano
- Prognostic markers and regulatory factors of cardiovascular diseases, Univ. of Bourgogne Franche-Comté, Besançon, France
| | - Nicolas Tordi
- PEPITE and Exercise Performance Health Innovation Platform, Univ. of Bourgogne Franche-Comté, Besançon, France
| | - Laurent Mourot
- Research Unit EA3920 Prognostic Markers and Regulatory Factors of Cardiovascular Diseases and Exercise Performance, Exercise Performance Health, Innovation Platform, Univ. Bourgogne Franche-Comté, Besançon, France and Tomsk Polytechnic University, Tomsk, Russia
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Hillmeister P, Liebeskind D, Ritter O, Buschmann I, Hetzel A, Reinhard M, Buschmann E. P4305Short-term external counterpulsation augments cerebral blood flow and tissue oxygenation in chronic cerebrovascular occlusive disease. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4305] [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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Seidlmayer LK, Muench L, Liu D, Hu K, Kolodzeiski A, Knackstedt L, Sych L, Ertl G, Ritter O, Nordbeck P. P958ICD generator replacement in patients not receiving appropriate therapy during the initial battery lifespan. Europace 2017. [DOI: 10.1093/ehjci/eux151.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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23
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Roux P, Guillien A, Soumagne T, Ritter O, Laplante JJ, Travers C, Dalphin JC, Peiffer G, Laurent L, Degano B. Smoking habits in French farmers: a cross-sectional study. BMC Public Health 2017; 17:166. [PMID: 28160776 PMCID: PMC5292143 DOI: 10.1186/s12889-017-4030-4] [Citation(s) in RCA: 7] [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: 09/30/2016] [Accepted: 01/12/2017] [Indexed: 11/10/2022] Open
Abstract
Background Farmers are exposed to multiple air contaminants that may interact with tobacco smoking in the development of respiratory diseases. Farmers are currently considered to smoke less than non-farmers, but precise data in different categories of age and farming activities are lacking. Methods Smoking habits were studied in a cross-sectional study involving 4105 farmers and 996 non-farming controls aged 40–74 years in 9 French departments between October 2012 and May 2013. Three age groups were defined (40–54, 55–64 and 65-74years). Farmers were divided into four activity groups, namely cattle breeders, livestock farmers working in confined spaces, crop farmers and others. Smoking prevalence was compared between farmers and controls, and odds ratios (ORs) for smoking adjusted for age were calculated. Results The adjusted OR for ever-smoking was lower among farmers than among non-farmers in all age categories, but the ORs for current smoking were similar in farmers and controls. Smoking prevalence varied according to the type of farming activity, and was lower than in non-farming controls only among cattle breeders and confined livestock farmers. In farmers, the proportion of smokers was higher in the youngest age categories compared with the older age classes. Conclusions Our results confirm that the prevalence of ever-smokers is lower in farmers than in non-farmers. Nevertheless, our data show that active smoking prevalence is similar in farmers and in non-farmers. This suggests that farmers, just like non-farmers, should be targeted by primary prevention campaigns against smoking.
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Affiliation(s)
- Pauline Roux
- Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU), Besançon, France.,Service de Pneumologie, CHRU, Besançon, France
| | | | | | | | | | | | - Jean-Charles Dalphin
- Service de Pneumologie, CHRU, Besançon, France.,Unité Mixte de Recherche, Centre National de la Recherche Scientifique Chrono-Environnement, Université de Franche-Comté, Besançon, France
| | | | - Lucie Laurent
- Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU), Besançon, France.,Service de Pneumologie, CHRU, Besançon, France
| | - Bruno Degano
- Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU), Besançon, France. .,EA 3920, Université de Franche-Comté, Besançon, France. .,Physiologie-Explorations Fonctionnelles, CHU Jean Minjoz, Besançon Cedex, 25030, France.
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Rakobowchuk M, Ritter O, Wilhelm EN, Isacco L, Bouhaddi M, Degano B, Tordi N, Mourot L. Divergent endothelial function but similar platelet microvesicle responses following eccentric and concentric cycling at a similar aerobic power output. J Appl Physiol (1985) 2017; 122:1031-1039. [PMID: 28153942 DOI: 10.1152/japplphysiol.00602.2016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 01/03/2017] [Accepted: 01/27/2017] [Indexed: 01/06/2023] Open
Abstract
Endothelial function and microvesicle concentration changes after acute bouts of continuous eccentric exercise have not been assessed previously nor compared with concentric exercise at similar aerobic power outputs. This method of training may be useful among some clinical populations, but acute responses are not well described. As such, 12 healthy males completed 2 experimental sessions of either 45 min of eccentric or concentric cycling at a matched aerobic power output below the ventilatory threshold. Brachial artery vascular function was assessed throughout 5 min of forearm ischemia and 3 min thereafter, before and at 5 and 40 min of recovery following each exercise session [flow-mediated dilation (FMD)]. Venous blood samples were acquired before each vascular function assessment. FMD significantly decreased after eccentric cycling by 40 min of recovery (P < 0.05), but was unaltered after concentric exercise. No differences in peak hyperemic blood flow velocity occurred neither between modalities nor at any time point (P > 0.05). Platelet-derived microvesicles increased by ~20% after both exercise modalities (P < 0.05) while endothelial-derived microvesicles were unchanged (P > 0.05). Moderate relationships with cardiac output, a surrogate for shear stress, and norepinephrine were apparent (P < 0.05), but there were no relationships with inflammatory or acute phase proteins. In summary, eccentric endurance exercise induced macrovascular endothelial dysfunction; however, endothelial activation determined by endothelial microvesicles did not occur suggesting that this modality may induce oxidative stress but no significant endothelial damage. In addition, the increase in platelet microvesicle concentrations may induce beneficial microvascular adaptations as suggested by previous research.NEW & NOTEWORTHY Continuous eccentric cycling exercise induces substantial skeletal muscle, tendon, and bone strain providing a potentially beneficial stimulus among clinical populations. This modality also induces temporary endothelial dysfunction but no apparent damage or activation of the endothelium indicated by microvesicle production, whereas proangiogenic platelet microvesicles are released similarly following both concentric and eccentric cycling and may relate to the shear stress and catecholamine response to exercise.
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Affiliation(s)
- Mark Rakobowchuk
- Department of Biological Sciences, Faculty of Science, Thompson Rivers University, Kamloops, Canada;
| | - Ophélie Ritter
- EA 4267 Exercise Performance Health Innovation Platform, University Bourgogne Franche-Comté University, Besancon, France
| | - Eurico Nestor Wilhelm
- Centre for Sports Medicine and Human Performance, Brunel University London, London, United Kingdom; and
| | - Laurie Isacco
- EA 3920 Exercise Performance Health Innovation Platform, University Bourgogne Franche-Comté University, Besançon, France
| | - Malika Bouhaddi
- EA 3920 Exercise Performance Health Innovation Platform, University Bourgogne Franche-Comté University, Besançon, France
| | - Bruno Degano
- EA 3920 Exercise Performance Health Innovation Platform, University Bourgogne Franche-Comté University, Besançon, France
| | - Nicolas Tordi
- EA 4267 Exercise Performance Health Innovation Platform, University Bourgogne Franche-Comté University, Besancon, France
| | - Laurent Mourot
- EA 3920 Exercise Performance Health Innovation Platform, University Bourgogne Franche-Comté University, Besançon, France
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Isacco L, Ritter O, Tordi N, Laroche D, Degano B, Bouhaddi M, Rakobowchuk M, Mourot L. Similar substrate oxidation rates in concentric and eccentric cycling matched for aerobic power output. Appl Physiol Nutr Metab 2016; 41:1204-1207. [DOI: 10.1139/apnm-2016-0107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study investigated substrate oxidation in concentric and eccentric cycling matched for aerobic power output in the postprandial state. Energy expenditure, respiratory exchange ratio, and fat and carbohydrate oxidation rates were measured at rest and after 15, 30, and 45 min of eccentric and concentric cycling in 12 men. Absolute and relative aerobic power output and energy expenditure were similar during concentric and eccentric exercise. No effect of exercise modality was observed for substrate metabolism.
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Affiliation(s)
- Laurie Isacco
- EA 3920 and Exercise Performance Health Innovation Platform, Franche-Comté University, 25000 Besançon, France
| | - Ophélie Ritter
- EA 4267 and Exercise Performance Health Innovation Platform, Franche-Comté University, 25000 Besançon, France
- Cardiac and Pulmonary Rehabilitation Centre of Franche-Comté, 25770 Franois, France
| | - Nicolas Tordi
- EA 4267 and Exercise Performance Health Innovation Platform, Franche-Comté University, 25000 Besançon, France
- Inserm CIC-CIT 808, Regional University Hospital of Besançon, 25000 Besançon, France
| | - Davy Laroche
- Inserm CIC-P 803, Technologic Investigation Platform, University Hospital of Dijon, 21079 Dijon, France
| | - Bruno Degano
- EA 3920 and Exercise Performance Health Innovation Platform, Franche-Comté University, 25000 Besançon, France
- Physiology–Functional Explorations, Regional University Hospital of Besançon, 25000 Besançon, France
| | - Malika Bouhaddi
- EA 3920 and Exercise Performance Health Innovation Platform, Franche-Comté University, 25000 Besançon, France
- Physiology–Functional Explorations, Regional University Hospital of Besançon, 25000 Besançon, France
| | - Mark Rakobowchuk
- Faculty of Science, Department of Biological Sciences, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada
| | - Laurent Mourot
- EA 3920 and Exercise Performance Health Innovation Platform, Franche-Comté University, 25000 Besançon, France
- Inserm CIC-CIT 808, Regional University Hospital of Besançon, 25000 Besançon, France
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Ritter O, Tordi N, Mourot L, Malika B, Laroche D, Besson D, Casillas J, Degano B. Étude de la ventilation au cours d’un exercice de pédalage excentrique dans la BPCO modérée à sévère. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.480] [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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Ritter O, Lieseberg C, Maier- Leibnitz H, Papkow A, Schmeiser K, Bothe W. Untersuchung der Streuung von Positronen an Elektronen in der Wilsonschen Nebelkammer. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/zna-1951-0504] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
In einer "langsamen", mit Methan gefüllten Wilson-Kammer, die hier beschrieben wird, wird die Streuung von Positronen aus Cu64 an Elektronen untersucht. Aus 5000 Aufnahmen mit 2900 m ausgewerteter Positronenbahnlänge wird die Häufigkeit von Stößen mit verschiedener Energieübertragung im Energiebereich 100-400 ekV bestimmt und mit der Theorie von Möller-Bhabha verglichen. Innerhalb der experimentellen Unsicherheit besteht Übereinstimmung zwischen den beobachteten und den berechneten Absolutwerten. Ein Dreierstoß zwischen einem Positron und zwei Elektronen wurde beobachtet.
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Affiliation(s)
- O. Ritter
- Physikalisehen Institut der Universität Heidelberg und dem Institut für Physik im Max-Planck-Institut für medizinische Forschung in Heidelberg
| | - C. Lieseberg
- Physikalisehen Institut der Universität Heidelberg und dem Institut für Physik im Max-Planck-Institut für medizinische Forschung in Heidelberg
| | - H. Maier- Leibnitz
- Physikalisehen Institut der Universität Heidelberg und dem Institut für Physik im Max-Planck-Institut für medizinische Forschung in Heidelberg
| | - A. Papkow
- Physikalisehen Institut der Universität Heidelberg und dem Institut für Physik im Max-Planck-Institut für medizinische Forschung in Heidelberg
| | - K. Schmeiser
- Physikalisehen Institut der Universität Heidelberg und dem Institut für Physik im Max-Planck-Institut für medizinische Forschung in Heidelberg
| | - W. Bothe
- Physikalisehen Institut der Universität Heidelberg und dem Institut für Physik im Max-Planck-Institut für medizinische Forschung in Heidelberg
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Williams T, Hundertmark M, Schraut S, Schoenberger J, Nordbeck P, Voll S, Muehlfelder M, Elsner I, Ritter O. Eyes absent homolog 4 regulates p27Kip1 and aggravates pressure overload-induced adverse cardiac remodeling. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3245] [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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Nordbeck P, Bauer WR, Ritter O. Comments on 'Safe magnetic resonance image scanning of the pacemaker patient: current technologies and future directions'. Europace 2012; 14:1532; author reply 1532-3. [DOI: 10.1093/europace/eus112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Reiter T, Ritter O, Beer M, Petritsch B. An unusual finding after resuscitation: contusio cordis. Clin Res Cardiol 2012; 101:767-70. [PMID: 22476822 DOI: 10.1007/s00392-012-0449-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 03/22/2012] [Indexed: 11/28/2022]
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Nordbeck P, Beer M, Geistert W, Kaufmann R, Köstler H, Pabst T, Warmuth M, Gensler D, Reiter T, Hoffmeister S, Jakob P, Ladd M, Quick H, Bauer W, Ritter O. Katheterablation bei Herzrhythmusstörungen unter MR-Echtzeitbildgebung. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0031-1300860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Gensler D, Fidler F, Ehses P, Warmuth M, Reiter T, Düring M, Ritter O, Ladd ME, Quick HH, Jakob PM, Bauer WR, Nordbeck P. MR safety: Fast T
1
thermometry of the RF-induced heating of medical devices. Magn Reson Med 2012; 68:1593-9. [PMID: 22287286 DOI: 10.1002/mrm.24171] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Revised: 12/01/2011] [Accepted: 12/29/2011] [Indexed: 11/11/2022]
Affiliation(s)
- D Gensler
- Research Center for Magnetic Resonance Bavaria e.V., Würzburg, Germany.
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Kickuth R, Goltz JP, Reichling C, Kenn W, Hahn D, Ritter O. C-Arm Flachdetektor-CT in Kombination mit einem neuartigen elektromagnetischen Navigationssystem bei der Steuerung perkutaner Biopsien: Erste klinische Erfahrungen. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279343] [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: 10/18/2022]
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Ritter O, Marggraf M, Weng A, Beer M, Hahn D, Köstler H. Absolutquantifizierung der myokardialen Perfusion in der 3T MRT in freier Atmung. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279439] [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: 10/18/2022]
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Goltz JP, Ritter O, Kellersmann R, Kenn W, Bühler C, Hahn D, Kickuth R. Endovaskuläre Behandlung von Patienten mit einer kritischen Ischämie der unteren Extremität: 6-Monats-Ergebnisse nach Implantation eines neuen, selbst-expandierbaren helikalen Nitinolstents (SUPERA®). ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279345] [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: 10/18/2022]
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Hofmann U, Hu K, Walter F, Burkard N, Ertl G, Bauersachs J, Ritter O, Frantz S, Bonz A. Pharmacological pre- and post-conditioning with the sphingosine-1-phosphate receptor modulator FTY720 after myocardial ischaemia-reperfusion. Br J Pharmacol 2010; 160:1243-51. [PMID: 20590616 DOI: 10.1111/j.1476-5381.2010.00767.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Our recent experiments demonstrated that the Sphingosine-1-phosphate (S1P) receptor agonist FTY720 (2-amino-2-[2-(4-octylphenyl)ethyl]-1,3-propanediol hydrochloride) improves recovery of function after myocardial ischaemia-reperfusion ex vivo. Therefore, we tested the hypothesis that pharmacological post-conditioning with FTY720 reduces infarct size after myocardial ischaemia-reperfusion in vivo. EXPERIMENTAL APPROACH Myocardial ischaemia was induced in Wistar rats by ligation of the left coronary artery for 45 min. FTY720 (0.5 mg kg(-1)) was applied i.p. either once, before reperfusion, or twice, 24 h before myocardial ischaemia and before reperfusion. After 24 h reperfusion, we determined infarct size by triphenyltetrazolium chloride staining and granulocyte infiltration by immunohistochemistry. Tumour necrosis factor-alpha (TNF)-alpha concentration was determined by elisa. S1P receptor expression was studied by Western blot. Calcium transients were evaluated in Indo-1-loaded cardiomyocytes. KEY RESULTS In both groups, FTY720 significantly reduced lymphocyte count in peripheral blood. FTY720 treatment attenuated granulocyte infiltration and TNF-alpha protein expression in reperfused myocardium. However, both treatment regimens were not able to reduce infarct size. FTY720 increased mortality due to induction of fatal ventricular tachyarrhythmias when administered once before reperfusion, but protected against reperfusion arrhythmias when given 24 h prior to ischaemia. Pretreatment selectively down-regulated S1P(1) receptor expression within the myocardium. S1P receptor agonists did not induce calcium deregulation in cardiomyocytes. CONCLUSIONS AND IMPLICATIONS FTY720 applied during reperfusion did not reduce infarct size but increased mortality during myocardial ischaemia-reperfusion due to induction of arrhythmias. Pretreatment with FTY720 before ischaemia abrogated the deleterious pro-arrhythmic effects without reducing infarct size.
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Affiliation(s)
- U Hofmann
- Department of Internal Medicine I, University Hospital Wuerzburg, Würzburg, Germany.
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Hudelist G, Oberwinkler K, Singer C, Tuttlies F, Rauter G, Ritter O, Keckstein J. Die kombinierte Anwendung von klinischer Untersuchung und transvaginal-Ultraschall (TVS) zur präoperativen Diagnose der tief infiltrierenden Endometriose. Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1225238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Hudelist G, Oberwinkler K, Singer C, Tuttlies F, Rauter G, Ritter O, Keckstein J. Combination of transvaginal sonography and clinical examination for preoperative diagnosis of pelvic endometriosis. Hum Reprod 2009; 24:1018-24. [DOI: 10.1093/humrep/dep013] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Fattorusso V, Ritter O. Aperçu statistique sur quelques variations constitutionnelles du système cardio-vasculaire. Cardiology 2008. [DOI: 10.1159/000164835] [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: 11/19/2022]
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Maier LS, Maack C, Ritter O, Böhm M. Hotline update of clinical trials and registries presented at the German Cardiac Society meeting 2008. Clin Res Cardiol 2008; 97:356-63. [DOI: 10.1007/s00392-008-0664-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Accepted: 04/08/2008] [Indexed: 11/25/2022]
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Hudelist G, Oberwinkler KH, Rauter G, Tuttlies F, Ritter O, Keckstein J. Endometriose – Wertigkeit der klinischen und transvaginal-Ultraschall (TVS) Untersuchung zur präoperativen Diagnosestellung. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2008-1078323] [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: 10/21/2022] Open
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Fruscalzo A, Tuttlies F, Ritter O, Rauter G, Kandolf O, Oberwinkler KH, Pasterk C, Keckstein J. Gynaecological examination coupled with transvaginal ultrasound in the diagnosis of rectosigmoid endometriosis. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-989152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Weckmann U, Ritter O, Jung A, Branch T, de Wit M. Magnetotelluric measurements across the Beattie magnetic anomaly and the Southern Cape Conductive Belt, South Africa. ACTA ACUST UNITED AC 2007. [DOI: 10.1029/2005jb003975] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
AbstractWe compare recent magnetotelluric investigations of four large fault systems: (i) the actively deforming, ocean-continent interplate San Andreas Fault (SAF); (ii) the actively deforming, continent-continent interplate Dead Sea Transform (DST); (iii) the currently inactive, trench-linked intraplate West Fault (WF) in northern Chile; and (iv) the Waterberg Fault/Omaruru Lineament (WF/OL) in Namibia, a fossilized intraplate shear zone formed during early Proterozoic continental collision. These fault zones show both similarities and marked differences in their electrical subsurface structure. The central segment of the SAF is characterized by a zone of high conductivity extending to a depth of several kilometres and attributed to fluids within a highly fractured damage zone. The WF exhibits a less pronounced but similar fault-zone conductor (FZC) that can be explained by meteoric waters entering the fault zone. The DST appears different as it shows a distinct lack of a FZC and seems to act primarily as an impermeable barrier to cross-fault fluid transport. Differences in the electrical structure of these faults within the upper crust may be linked to the degree of deformation localization within the fault zone. At the DST, with no observable fault-zone conductor, strain may have been localized for a considerable time span along a narrow, metre-scale damage zone with a sustained strength difference between the shear plane and the surrounding host rock. In the case of the SAF, a positive correlation of conductance and fault activity is observed, with more active fault segments associated with wider, deeper and more conductive fault-zone anomalies. Fault-zone conductors, however, do not uniquely identify specific architectural or hydrological units of a fault. A more comprehensive whole-fault picture for the brittle crust can be developed in combination with seismicity and structural information. Giving a window into lower-crustal shear zones, the fossil WF/OL in Namibia is imaged as a subvertical, 14 km-deep, 10 km-wide zone of high and anisotropic conductivity. The present level of exhumation suggests that the WF/OL penetrated the entire crust as a relatively narrow shear zone. Contrary to the fluid-driven conductivity anomalies of active faults, the anomaly here is attributed to graphitic enrichment along former shear planes. Once created, graphite is stable over very long time spans and thus fault/shear zones may remain conductive long after activity ceases.
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Affiliation(s)
- O. Ritter
- GeoForschungsZentrum Potsdam, Telegrafenberg
D-14473 Potsdam, Germany
| | - A. Hoffmann-Rothe
- GeoForschungsZentrum Potsdam, Telegrafenberg
D-14473 Potsdam, Germany
| | - P. A. Bedrosian
- GeoForschungsZentrum Potsdam, Telegrafenberg
D-14473 Potsdam, Germany
| | - U. Weckmann
- GeoForschungsZentrum Potsdam, Telegrafenberg
D-14473 Potsdam, Germany
| | - V. Haak
- GeoForschungsZentrum Potsdam, Telegrafenberg
D-14473 Potsdam, Germany
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Abstract
Influenza is a common disease in the population. Influenza vaccination is performed routinely and is usually well tolerated. Minor local or systemic side effects like fever and myalgia are described. Rarely there are more severe adverse events. Systemic vasculitis has been reported in some cases. In this case we report on a female patient with secondary vasculitis and myocardial infarction after influenza vaccination. The patient received cortisol and recovered. The literature about influenza vaccination, its side effects and recommendations about vaccination in patients with coronary artery disease is reviewed.
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Affiliation(s)
- O Ritter
- Medizinische Universitätsklinik Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany.
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Abstract
The basic helix-loop-helix transcription factors eHAND and dHAND are involved in developmental cardiac growth and differentiation. We investigated HAND gene expression in the normal and in the hypertrophied right and left ventricle of patients with tetralogy of Fallot (ToF) and hypertrophic obstructive cardiomyopathy (HOCM). HAND mRNA was constitutively expressed in the hypertrophied heart and increased in the hypertrophic tissue of both patient groups. HAND genes had a complementary left-right cardiac asymmetry of expression with dHAND predominantly in the right and eHAND in the left ventricle. The two cardiac bHLH factors have the ability to form heterodimers with the ubiquitous bHLH protein E12, subsequently recognizing E-boxes in the promoter region of target genes like ALC-1. We found a highly significant positive correlation between HAND and ALC-1 mRNA. The total ALC-1 protein level in ToF was smaller than in HOCM, although ALC-1 mRNA as well as HAND mRNA levels were significantly higher. ToF patients expressed around four times more ALC-1 mRNA for similar amounts of ALC-1 than HOCM patients. Suggesting disturbed ALC-1 translation in ToF, we found ALC-1 antisense mRNA expression in the hypertrophied, but not in the normal, ventricles. The higher the antisense/sense ALC-1 mRNA ratio, the lower ALC-1 protein was expressed.
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Affiliation(s)
- O Ritter
- Max Delbrück Center for Molecular Medicine, 13122 Berlin, Germany
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Ritter O, Luther HP, Haase H, Baltas LG, Baumann G, Schulte HD, Morano I. Expression of atrial myosin light chains but not alpha-myosin heavy chains is correlated in vivo with increased ventricular function in patients with hypertrophic obstructive cardiomyopathy. J Mol Med (Berl) 1999; 77:677-85. [PMID: 10569205 DOI: 10.1007/s001099900030] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The adult rodent heart adapts to increased work load by reexpression of its fetal genes, for example, beta-myosin heavy chain (MHC), in order to improve contractile function. However, the human ventricle regulates contractility by expression of atrial essential myosin light chain (ALC-1) rather than beta-MHC. We evaluated the impact of both mechanisms in patients with hypertrophic cardiomyopathy. MHC isoform expression was quantified at the mRNA and protein levels by reverse transcriptase polymerase chain reaction and immunoblotting, respectively. Although alpha-MHC mRNA was detected in control and hypertrophied human ventricular tissue, alpha-MHC protein was not observed. Similarly, we investigated the expression of ALC-1 by two-dimensional polyacrylamide gel electrophoresis and the clinical and hemodynamic parameters of the patients with hypertrophic cardiomyopathy. We found a significant positive correlation between ALC-1 protein expression and dP/dtmax in the hypertrophied human ventricle in vivo. Correlations between dP/dtmax and expression of protein for the ryanodine receptor and L-type Ca2+ channel were excluded. Our data suggest that reexpression of ALC-1 improves the contractile state of the adult human heart. We propose that two evolutionarily divergent compensatory mechanisms for increased work demand exist in the mammalian heart: MHC regulation in rodents and essential MLC regulation, of cardiac contractility, in humans.
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Affiliation(s)
- O Ritter
- Max Delbrück Center for Molecular Medicine, Berlin, Germany
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Abstract
Skeletal muscle contraction of Limulus polyphemus, the horseshoe crab, seemed to be regulated in a dual manner, namely Ca2+ binding to the troponin complex as well phosphorylation of the myosin light chains (MLC) by a Ca2+/calmodulin-dependent myosin light chain kinase. We investigated muscle contraction in Limulus skinned fibers in the presence of Ca2+ and of Ca2+/calmodulin to find out which of the two mechanisms prevails in Limulus skeletal muscle contraction. Although skinned fibers revealed high basal MLC mono- and biphosphorylation levels (0.48 mol phosphate/mol 31 kDa MLC; 0.52 mol phosphate/mol 21 kDa MLC), the muscle fibers were fully relaxed at pCa 8. Upon C2+ or Ca2+/calmodulin activation, the fibers developed force (357+/-78.7 mN/mm2; 338+/-69.7 mN/mm2, respectively) while the MLC phosphorylation remained essentially unchanged. We conclude that Ca2+ activation is the dominant regulatory mechanism in Limulus skeletal muscle contraction.
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Affiliation(s)
- O Ritter
- Max Delbrück Center for Molecular Medicine, Berlin, Germany
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Sussman JL, Lin D, Jiang J, Manning NO, Prilusky J, Ritter O, Abola EE. Protein Data Bank (PDB): database of three-dimensional structural information of biological macromolecules. Acta Crystallogr D Biol Crystallogr 1998; 54:1078-84. [PMID: 10089483 DOI: 10.1107/s0907444998009378] [Citation(s) in RCA: 437] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The Protein Data Bank (PDB) at Brookhaven National Laboratory, is a database containing experimentally determined three-dimensional structures of proteins, nucleic acids and other biological macromolecules, with approximately 8000 entries. Data are easily submitted via PDB's WWW-based tool AutoDep, in either mmCIF or PDB format, and are most conveniently examined via PDB's WWW-based tool 3DB Browser.
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Affiliation(s)
- J L Sussman
- Biology Department, Building 463, Brookhaven National Laboratory, Upton, NY 11973-5000, USA.
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