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Kaiser P, Fay K, Karimian-Tabrizi A, Miskovic A, Emrich F, Moritz A, Walther T, Holubec T. Minimally Invasive Mitral Valve Surgery via Right Anterolateral Minithoracotomy: 20 Years’ Experience from a Single Center. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- P. Kaiser
- Department of Cardiac Surgery, University Hospital Frankfurt, Frankfurt am Main, Deutschland
| | - K. Fay
- Department of Cardiac Surgery, University Hospital Frankfurt, Frankfurt am Main, Deutschland
| | - A. Karimian-Tabrizi
- Department of Cardiac Surgery, University Hospital Frankfurt, Frankfurt am Main, Deutschland
| | - A. Miskovic
- Department of Cardiac Surgery, University Hospital Frankfurt, Frankfurt am Main, Deutschland
| | - F. Emrich
- University Hospital Frankfurt, Frankfurt am Main, Deutschland
| | - A. Moritz
- Department of Cardiac Surgery, University Hospital Frankfurt, Frankfurt am Main, Deutschland
| | - T. Walther
- Department of Cardiac Surgery, University Hospital Frankfurt, Frankfurt am Main, Deutschland
| | - T. Holubec
- Department of Cardiac Surgery, University Hospital Frankfurt, Frankfurt am Main, Deutschland
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Nicin L, Bruening RS, Kattih B, Glaser SF, Abplanalp WT, Schroeter SM, Arsalan M, Holubec T, Emrich F, Meder B, Reich C, Walther T, Zeiher AM, John D, Dimmeler S. The human cell atlas of the hypertrophic heart reveals impaired inter-cellular cross-talks. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1783] [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
Introduction
The pathophysiology of cardiac hypertrophy is multifactorial and is accompanied by the dysregulation of various signaling pathways contributing to cardiac dysfunction and heart failure. While the hypertrophic response of cardiomyocytes (CM) has been extensively studied, the interplay of CMs with the non-parenchymal cells in the heart is less explored. Here, we apply high-resolution transcriptomic analysis on single cell level allowing the identification of cellular responses and communication in the hypertrophic human heart.
Results
We analyzed single nuclei RNA sequencing data of cardiac tissues from five patients with aortic stenosis and cardiac hypertrophy and 13 matched healthy subjects. Bioinformatic data analysis of 88,536 nuclei followed by clustering led to the identification of specific heterogenic cell type signatures. Analyzing cell type specific gene expression signatures, we found the expected up-regulation of the cardiac stress MYH7 (4.15-fold), CMYA5 (4.89-fold) and XIRP2 (6.13-fold) in cardiomyocytes (CM) (all p<0.0001). Fibroblasts showed increased expression of genes associated with fibrosis and activation markers such as periostin (POSTN; 6.84-fold, p<0.0001). In-silico analysis of intercellular communication pathways revealed a striking downregulation of ligand-receptor interactions between CMs and other cells in hypertrophic compared to healthy controls indicating that CMs are less responsive to signals from fibroblasts and endothelial cells (ECs) in the hypertrophied heart. Particularly, CM showed reduced expression of receptor tyrosine kinases of the Ephrin family and FGF-family members. Specifically, Ephrin-B1 was significantly downregulated in CMs of the hypertrophic hearts (0.01-fold, p<0.0001). The down-regulation of Ephrin-B1 was additionally validated on protein level using histological sections of hypertrophic cardiomyopathy patients (n=6) versus healthy controls (n=5) (0.66-fold, p=0.02). In-vitro studies in neonatal cardiomyocytes further demonstrated that activation of the Ephrin-B1 receptor by the agonist Ephrin-B2 induced cardioprotective effects. Thus, Ephrin-B2 inhibited phenylephrine (PE) induced Nppb expression by 0.775-fold (vs. PE) and hypertrophic growth (0.774-fold reduction of cell size vs. PE). Similar findings were observed in PE-stimulated human cardiac organoids, which showed a 0.58-fold reduction of size in response to Ephrin-B2 treatments compared to PE alone.
Conclusion
Investigating the cross-talk in cardiac hypertrophy reveals novel disturbed communication signatures, with a striking reduction in the intercellular communication pathways of CMs. Reduced expression of receptors of the Ephrin family, particularly Ephrin-B1, in CM may prevent cardioprotective signaling by the agonist Ephrin-B2, which is highly expressed in ECs, leading to inhibition of cardioprotective cross-talk between ECs and CMs in the hypertrophic heart.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Dr. Rolf M. Schwiete StiftungDie Deutsche ForschungsgemeinschaftGerman Center for Cardiovascular Research
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Affiliation(s)
- L Nicin
- Johann Wolfgang Goethe University, Institute for Cardiovascular Regeneration, Frankfurt am Main, Germany
| | - R S Bruening
- Johann Wolfgang Goethe University, Institute for Cardiovascular Regeneration, Frankfurt am Main, Germany
| | - B Kattih
- Johann Wolfgang Goethe University, Institute for Cardiovascular Regeneration, Frankfurt am Main, Germany
| | - S F Glaser
- Johann Wolfgang Goethe University, Institute for Cardiovascular Regeneration, Frankfurt am Main, Germany
| | - W T Abplanalp
- Johann Wolfgang Goethe University, Institute for Cardiovascular Regeneration, Frankfurt am Main, Germany
| | - S M Schroeter
- Johann Wolfgang Goethe University, Institute for Cardiovascular Regeneration, Frankfurt am Main, Germany
| | - M Arsalan
- Goethe University Hospital, Department of Cardiac Surgery, Frankfurt am Main, Germany
| | - T Holubec
- Goethe University Hospital, Department of Cardiac Surgery, Frankfurt am Main, Germany
| | - F Emrich
- Goethe University Hospital, Department of Cardiac Surgery, Frankfurt am Main, Germany
| | - B Meder
- University Hospital, Institute for Cardiomyopathies, Heidelberg, Germany
| | - C Reich
- University Hospital, Institute for Cardiomyopathies, Heidelberg, Germany
| | - T Walther
- Goethe University Hospital, Department of Cardiac Surgery, Frankfurt am Main, Germany
| | - A M Zeiher
- Goethe University Hospital, Department of Cardiology, Frankfurt am Main, Germany
| | - D John
- Johann Wolfgang Goethe University, Institute for Cardiovascular Regeneration, Frankfurt am Main, Germany
| | - S Dimmeler
- Johann Wolfgang Goethe University, Institute for Cardiovascular Regeneration, Frankfurt am Main, Germany
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Girdauskas E, Kempfert J, Kuntze T, Holubec T, Krane M, Borger M, Eden M, Bramlage P, Pausch J, Gross TMS, Müller L, Reichenspurner H. Standardized Subannular Repair for Treatment of Secondary Mitral Regurgitation: Initial Results from the Reform-MR Registry. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Thaqi N, Cetinkaya A, Holubec T, Skwara W, Richter M, Schönburg M, Doss M, Walter T. Minimally Invasive Mitral Valve Repair for Posterior Leaflet Prolapse Comparison of Surgical Techniques. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- N. Thaqi
- Kerckhoff Klinik, Heart Surgery, Bad Nauheim, Germany
| | - A. Cetinkaya
- Kerckhoff Klinik, Heart Surgery, Bad Nauheim, Germany
| | - T. Holubec
- Kerckhoff Klinik, Heart Surgery, Bad Nauheim, Germany
| | - W. Skwara
- Kerckhoff Klinik, Heart Surgery, Bad Nauheim, Germany
| | - M. Richter
- Kerckhoff Klinik, Heart Surgery, Bad Nauheim, Germany
| | - M. Schönburg
- Kerckhoff Klinik, Heart Surgery, Bad Nauheim, Germany
| | - M. Doss
- Kerckhoff Klinik, Heart Surgery, Bad Nauheim, Germany
| | - T. Walter
- Kerckhoff Klinik, Heart Surgery, Bad Nauheim, Germany
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Van Linden A, Arsalan M, Hecker F, Holubec T, Doss M, Liebetrau C, Köhne J, Walther T. One Year Clinical Outcome and Biomarker Levels after Randomized Comparison of Two Supraannular Pericardial Aortic Xenografts. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A. Van Linden
- Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - M. Arsalan
- Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - F. Hecker
- Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - T. Holubec
- Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - M. Doss
- Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - C. Liebetrau
- Kerckhoff-Klinik, Kardiologie, Bad Nauheim, Germany
| | - J. Köhne
- Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - T. Walther
- Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany
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Van Linden S, Schönburg M, Doss M, Van Linden A, Arsalan M, Holubec T, Walther T. Minimally Invasive Video-Assisted Mitral Valve Repair in Barlow Disease Using Open Annuloplasty Bands. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- S. Van Linden
- Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - M. Schönburg
- Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - M. Doss
- Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - A. Van Linden
- Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - M. Arsalan
- Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - T. Holubec
- Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - T. Walther
- Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany
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Köhne J, Doss M, Van Linden A, Arsalan M, Holubec T, Kim W, Liebetrau C, Walther T. Prior Prosthetic Hip Replacement Is Related to Different Outcomes of Transapical versus Transfemoral Transcatheter Aortic Valve Implantation. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- J. Köhne
- Kerckhoff Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - M. Doss
- Kerckhoff Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - A. Van Linden
- Kerckhoff Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - M. Arsalan
- Kerckhoff Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - T. Holubec
- Kerckhoff Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - W.K. Kim
- Kerckhoff Klinik, Kardiologie, Bad Nauheim, Germany
| | - C. Liebetrau
- Kerckhoff Klinik, Kardiologie, Bad Nauheim, Germany
| | - T. Walther
- Kerckhoff Klinik, Herzchirurgie, Bad Nauheim, Germany
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Zacek P, Holubec T, Vobornik M, Dominik J, Takkenberg J, Harrer J, Vojacek J. Quality of life after aortic valve repair is similar to Ross patients and superior to mechanical valve replacement: a cross-sectional study. BMC Cardiovasc Disord 2016; 16:63. [PMID: 27039180 PMCID: PMC4818911 DOI: 10.1186/s12872-016-0236-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Accepted: 03/23/2016] [Indexed: 11/21/2022] Open
Abstract
Background In patients after aortic valve surgery, the quality of life is hypothesized to be influenced by the type of the valve procedure. A cross-sectional study on the postoperative quality of life was carried out in patients after aortic valve-sparing surgery (with regards to the age of the patient), Ross procedure and mechanical aortic valve replacement. Methods Quality of life was studied in 139 patients after aortic valve surgery divided into four study groups (Y – aortic valve-sparing procedure at the age below 50 years, mean age 36.2 years; O – aortic valve-sparing procedure at the age 50 years and over, mean age 59.2 years; R – Ross procedure, mean age 37.8 years and M – mechanical aortic valve replacement at the age below 50 years, mean age 39.2 years). SF-36 Short Form and valve-specific questionnaires were mailed to the patients after 6 months or later following surgery (median 26.9 months). Results In SF-36, the younger aortic valve repair patients and the Ross patients scored significantly better in 4 of 4 physical subscales and in 2 of 4 mental subscales than the older aortic valve repair and mechanical valve replacement patients. In the valve-specific questionnaire; however, all 3 groups free of anticoagulation (Y, O, and R) displayed greater freedom from negative valve-related concerns. Conclusions Postoperative quality of life is influenced by the type of aortic valve procedure and is negatively linked with mechanical prosthesis implantation and long-term anticoagulation. Aortic valve-sparing strategy should be considered in cases with suitable valve morphology due to favorable clinical results and beneficial impact on the long-term quality of life.
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Affiliation(s)
- Pavel Zacek
- Department of Cardiac Surgery, Charles University in Prague, Faculty of Medicine and Faculty Hospital, Sokolska 581, 50005, Hradec Kralove, Czech Republic.
| | - T Holubec
- Department of Cardiac Surgery, Kerckhoff Heart and Lung Center, Bad Nauheim, Germany
| | - M Vobornik
- Department of Cardiac Surgery, Charles University in Prague, Faculty of Medicine and Faculty Hospital, Sokolska 581, 50005, Hradec Kralove, Czech Republic
| | - J Dominik
- Department of Cardiac Surgery, Charles University in Prague, Faculty of Medicine and Faculty Hospital, Sokolska 581, 50005, Hradec Kralove, Czech Republic
| | - J Takkenberg
- Department of Cardio-Thoracic Surgery, Erasmus MC, Rotterdam, The Netherlands
| | - J Harrer
- Department of Cardiac Surgery, Charles University in Prague, Faculty of Medicine and Faculty Hospital, Sokolska 581, 50005, Hradec Kralove, Czech Republic
| | - J Vojacek
- Department of Cardiac Surgery, Charles University in Prague, Faculty of Medicine and Faculty Hospital, Sokolska 581, 50005, Hradec Kralove, Czech Republic
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Starck CT, Stepuk A, Holubec T, Steffel J, Stark JW, Falk V. Compression coil provides increased lead control in extraction procedures. Europace 2014; 17:499-503. [DOI: 10.1093/europace/euu272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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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Sündermann S, Sromicki J, Rodriguez Cetina Biefer H, Emmert M, Seifert B, Holubec T, Falk V, Jacobs S. Mitral valve surgery; Right lateral minithoracotomy or sternotomy? A systematic review and meta-analysis. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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