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Tan L, Zhou H, Lai Z, Yang G, Zheng F, Xiao F, Xiong Z, Huang X, Xiong Z. Brain peptides modified exosome-mediated drug delivery system for adriamycin-induced nephropathy treatment. NANOMEDICINE : NANOTECHNOLOGY, BIOLOGY, AND MEDICINE 2025; 66:102819. [PMID: 40174740 DOI: 10.1016/j.nano.2025.102819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2024] [Revised: 03/10/2025] [Accepted: 03/27/2025] [Indexed: 04/04/2025]
Abstract
Mitigation of adriamycin (ADR)-induced nephropathy remains a significant challenge in clinical management. Brain-targeted administration of losartan demonstrates comparable nephroprotective effects at a 1:500 concentration relative to gavage administration. This study established an exosome-based nano-delivery platform (ExoACP) to reduce drug dosage for alleviating ADR-induced nephropathy. The platform was rigorously tested for toxicity and blood-brain barrier penetration. Additionally, the role and possible mechanism of ExoACP-Los in alleviating ADR-induced nephropathy in mice were investigated. ExoACP showed enhanced penetration in brain microvascular endothelial cells, with a 7.20-fold increase in uptake. In the ADR model, ExoACP-Los exhibited anti-inflammatory and anti-fibrotic effects by downregulating the renin-angiotensin system, reducing extracellular matrix deposition by nearly half. These findings suggest ExoACP-Los can alleviate ADR-induced nephropathy by enhancing targeted drug delivery to the brain while reducing losartan. Overall, ExoACP holds significant potential for future clinical applications in chronic nephropathy.
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Affiliation(s)
- Lishan Tan
- Department of Nephrology, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Huisong Zhou
- Department of Nephrology, Peking University Shenzhen Hospital, Shenzhen 518000, China; Department of Nephrology, Wenjiang District People's Hospital, Chengdu 610203, China
| | - Zhiwei Lai
- Department of Nephrology, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Guang Yang
- Department of Nephrology, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Fengping Zheng
- Department of Nephrology, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Fei Xiao
- Department of Nephrology, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Zuying Xiong
- Department of Nephrology, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Xiaoyan Huang
- Department of Nephrology, Peking University Shenzhen Hospital, Shenzhen 518000, China; Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen 518000, China.
| | - Zibo Xiong
- Department of Nephrology, Peking University Shenzhen Hospital, Shenzhen 518000, China.
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Yakoub M, Rahman M, Kleimann P, Hoffe J, Feige M, Bouvain P, Alter C, Kluczny JI, Reidel S, Nederlof R, Hering L, Argov D, Arifaj D, Kantauskaite M, Meister J, Kleinewietfeld M, Rump LC, Jantsch J, Flögel U, Müller DN, Temme S, Stegbauer J. Transient High Salt Intake Promotes T-Cell-Mediated Hypertensive Vascular Injury. Hypertension 2024; 81:2415-2429. [PMID: 39411864 DOI: 10.1161/hypertensionaha.124.23115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 09/18/2024] [Indexed: 11/22/2024]
Abstract
BACKGROUND Dietary high salt (HS) intake has a strong impact on cardiovascular diseases. Here, we investigated the link between HS-aggravated immune responses and the development of hypertensive vascular disease. METHODS ApolipoproteinE-deficient mice were transiently treated with HS (1% NaCl) via drinking water for 2 weeks, followed by a washout period, and subsequent Ang II (angiotensin II) infusion (1000 ng/kg per min for 10 days) to induce abdominal aortic aneurysms/dissections and inflammation. RESULTS While transient HS intake alone triggered nonpathologic infiltration of activated T cells into the aorta, subsequent Ang II infusion increased mortality and the incidence of abdominal aortic aneurysms/dissections and atherosclerosis compared with hypertensive control mice. There were no differences in blood pressure between both groups. In transient HS-treated hypertensive mice, the aortic injury was associated with increased inflammation, accumulation of neutrophils, monocytes, CD69+CD4+ T cells, as well as CD4+ and CD8+ memory T cells. Mechanistically, transient HS intake increased expression levels of aortic RORγt as well as splenic CD4+TH17 and CD8+TC1 T cells in Ang II-treated mice. Isolated aortas of untreated mice were incubated with supernatants of TH17, TH1, or TC1 cells polarized in vitro under HS or normal conditions which revealed that secreted factors of HS-differentiated TH17 and TC1 cells, but not TH1 cells accelerated endothelial dysfunction. CONCLUSIONS Our data suggest that transient HS intake induces a subclinical T-cell-mediated aortic immune response, which is enhanced by Ang II. We propose a 2-hit model, in which HS acts as a predisposing factor to enhance hypertension-induced TH17 and TC1 polarization and aortic disease.
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Affiliation(s)
- Mina Yakoub
- Department of Nephrology, Faculty of Medicine, University Hospital (M.Y., M.R., J.H., M.F., L.H., D. Argov, D. Arifaj, M. Kantauskaite, L.C.R., J.S.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Masudur Rahman
- Department of Nephrology, Faculty of Medicine, University Hospital (M.Y., M.R., J.H., M.F., L.H., D. Argov, D. Arifaj, M. Kantauskaite, L.C.R., J.S.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Patricia Kleimann
- Experimental Cardiovascular Imaging, Department of Molecular Cardiology (P.K., P.B., U.F., S.T.), Heinrich-Heine-University, Düsseldorf, Germany
- Department of Molecular Cardiology (P.K., P.B., C.A.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Jasmina Hoffe
- Department of Nephrology, Faculty of Medicine, University Hospital (M.Y., M.R., J.H., M.F., L.H., D. Argov, D. Arifaj, M. Kantauskaite, L.C.R., J.S.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Milena Feige
- Department of Nephrology, Faculty of Medicine, University Hospital (M.Y., M.R., J.H., M.F., L.H., D. Argov, D. Arifaj, M. Kantauskaite, L.C.R., J.S.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Pascal Bouvain
- Experimental Cardiovascular Imaging, Department of Molecular Cardiology (P.K., P.B., U.F., S.T.), Heinrich-Heine-University, Düsseldorf, Germany
- Department of Molecular Cardiology (P.K., P.B., C.A.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Christina Alter
- Department of Molecular Cardiology (P.K., P.B., C.A.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Jennifer Isabel Kluczny
- Department of Anaesthesiology, Faculty of Medicine, University Hospital (J.-I.K., S.T.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Sophia Reidel
- Institut für Herz-Kreislauf-Physiologie (S.R., R.N.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Rianne Nederlof
- Institut für Herz-Kreislauf-Physiologie (S.R., R.N.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Lydia Hering
- Department of Nephrology, Faculty of Medicine, University Hospital (M.Y., M.R., J.H., M.F., L.H., D. Argov, D. Arifaj, M. Kantauskaite, L.C.R., J.S.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Doron Argov
- Department of Nephrology, Faculty of Medicine, University Hospital (M.Y., M.R., J.H., M.F., L.H., D. Argov, D. Arifaj, M. Kantauskaite, L.C.R., J.S.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Denada Arifaj
- Department of Nephrology, Faculty of Medicine, University Hospital (M.Y., M.R., J.H., M.F., L.H., D. Argov, D. Arifaj, M. Kantauskaite, L.C.R., J.S.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Marta Kantauskaite
- Department of Nephrology, Faculty of Medicine, University Hospital (M.Y., M.R., J.H., M.F., L.H., D. Argov, D. Arifaj, M. Kantauskaite, L.C.R., J.S.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Jaroslawna Meister
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Institute for Diabetes Researc at Heinrich Heine University, Düsseldorf, Germany (J.M.)
- German Center for Diabetes Research (DZD e.V.), München-Neuherberg, Germany (J.M.)
| | - Markus Kleinewietfeld
- VIB Laboratory of Translational Immunomodulation, VIB Center for Inflammation Research (IRC) (M. Kleinewietfeld), Hasselt University, Diepenbeek, Belgium
- Department of Immunology, Biomedical Research Institute (M. Kleinewietfeld), Hasselt University, Diepenbeek, Belgium
- University Multiple Sclerosis Center (UMSC) (M. Kleinewietfeld), Hasselt University, Diepenbeek, Belgium
| | - Lars Christian Rump
- Department of Nephrology, Faculty of Medicine, University Hospital (M.Y., M.R., J.H., M.F., L.H., D. Argov, D. Arifaj, M. Kantauskaite, L.C.R., J.S.), Heinrich-Heine-University, Düsseldorf, Germany
- Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty and University Hospital Düsseldorf (L.C.R., U.F., S.T., J.S.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Jonathan Jantsch
- Institute for Medical Microbiology, Immunology and Hygiene, Center for Molecular Medicine Cologne (CMMC), University of Cologne, Germany (J.J.)
| | - Ulrich Flögel
- Experimental Cardiovascular Imaging, Department of Molecular Cardiology (P.K., P.B., U.F., S.T.), Heinrich-Heine-University, Düsseldorf, Germany
- Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty and University Hospital Düsseldorf (L.C.R., U.F., S.T., J.S.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Dominik N Müller
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (D.N.M.)
- Experimental and Clinical Research Center, a cooperation of Charité-Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany (D.N.M.)
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany (D.N.M.)
- DZHK (German Centre for Cardiovascular Research), Germany (D.N.M.)
| | - Sebastian Temme
- Experimental Cardiovascular Imaging, Department of Molecular Cardiology (P.K., P.B., U.F., S.T.), Heinrich-Heine-University, Düsseldorf, Germany
- Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty and University Hospital Düsseldorf (L.C.R., U.F., S.T., J.S.), Heinrich-Heine-University, Düsseldorf, Germany
- Department of Anaesthesiology, Faculty of Medicine, University Hospital (J.-I.K., S.T.), Heinrich-Heine-University, Düsseldorf, Germany
| | - Johannes Stegbauer
- Department of Nephrology, Faculty of Medicine, University Hospital (M.Y., M.R., J.H., M.F., L.H., D. Argov, D. Arifaj, M. Kantauskaite, L.C.R., J.S.), Heinrich-Heine-University, Düsseldorf, Germany
- Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty and University Hospital Düsseldorf (L.C.R., U.F., S.T., J.S.), Heinrich-Heine-University, Düsseldorf, Germany
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Nienhaus F, Walz M, Rothe M, Jahn A, Pfeiler S, Busch L, Stern M, Heiss C, Vornholz L, Cames S, Cramer M, Schrauwen-Hinderling V, Gerdes N, Temme S, Roden M, Flögel U, Kelm M, Bönner F. Quantitative assessment of angioplasty-induced vascular inflammation with 19F cardiovascular magnetic resonance imaging. J Cardiovasc Magn Reson 2023; 25:54. [PMID: 37784080 PMCID: PMC10546783 DOI: 10.1186/s12968-023-00964-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/13/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Macrophages play a pivotal role in vascular inflammation and predict cardiovascular complications. Fluorine-19 magnetic resonance imaging (19F MRI) with intravenously applied perfluorocarbon allows a background-free direct quantification of macrophage abundance in experimental vascular disease models in mice. Recently, perfluorooctyl bromide-nanoemulsion (PFOB-NE) was applied to effectively image macrophage infiltration in a pig model of myocardial infarction using clinical MRI scanners. In the present proof-of-concept approach, we aimed to non-invasively image monocyte/macrophage infiltration in response to carotid artery angioplasty in pigs using 19F MRI to assess early inflammatory response to mechanical injury. METHODS In eight minipigs, two different types of vascular injury were conducted: a mild injury employing balloon oversize angioplasty only (BA, n = 4) and a severe injury provoked by BA in combination with endothelial denudation (BA + ECDN, n = 4). PFOB-NE was administered intravenously three days after injury followed by 1H and 19F MRI to assess vascular inflammatory burden at day six. Vascular response to mechanical injury was validated using X-ray angiography, intravascular ultrasound and immunohistology in at least 10 segments per carotid artery. RESULTS Angioplasty was successfully induced in all eight pigs. Response to injury was characterized by positive remodeling with predominantly adventitial wall thickening and concomitant infiltration of monocytes/macrophages. No severe adverse reactions were observed following PFOB-NE administration. In vivo 19F signals were only detected in the four pigs following BA + ECDN with a robust signal-to-noise ratio (SNR) of 14.7 ± 4.8. Ex vivo analysis revealed a linear correlation of 19F SNR to local monocyte/macrophage cell density. Minimum detection limit of infiltrated monocytes/macrophages was estimated at approximately 410 cells/mm2. CONCLUSIONS In this proof-of-concept study, 19F MRI enabled quantification of monocyte/macrophage infiltration after vascular injury with sufficient sensitivity. This may provide the opportunity to non-invasively monitor vascular inflammation with MRI in patients after angioplasty or even in atherosclerotic plaques.
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Affiliation(s)
- Fabian Nienhaus
- Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital and Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Moritz Walz
- Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital and Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Maik Rothe
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, Düsseldorf, Germany
| | - Annika Jahn
- Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital and Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
- Central Animal Research Facility, Heinrich Heine University, Düsseldorf, Germany
| | - Susanne Pfeiler
- Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital and Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Lucas Busch
- Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital and Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Manuel Stern
- Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital and Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Christian Heiss
- Department of Clinical and Experimental Medicine, University of Surrey, Faculty of Health and Medical Sciences, Guildford, UK
- Department of Vascular Medicine, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
| | - Lilian Vornholz
- Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital and Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Sandra Cames
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, Düsseldorf, Germany
| | - Mareike Cramer
- Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital and Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Vera Schrauwen-Hinderling
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, Düsseldorf, Germany
| | - Norbert Gerdes
- Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital and Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
- Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Sebastian Temme
- Experimental Cardiovascular Imaging, Department of Molecular Cardiology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Experimental Anesthesiology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, Düsseldorf, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Ulrich Flögel
- Experimental Cardiovascular Imaging, Department of Molecular Cardiology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Malte Kelm
- Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital and Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
- Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Florian Bönner
- Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital and Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany.
- Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.
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Hof S, Marcus C, Kuebart A, Schulz J, Truse R, Raupach A, Bauer I, Flögel U, Picker O, Herminghaus A, Temme S. A Toolbox to Investigate the Impact of Impaired Oxygen Delivery in Experimental Disease Models. Front Med (Lausanne) 2022; 9:869372. [PMID: 35652064 PMCID: PMC9149176 DOI: 10.3389/fmed.2022.869372] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/25/2022] [Indexed: 12/29/2022] Open
Abstract
Impaired oxygen utilization is the underlying pathophysiological process in different shock states. Clinically most important are septic and hemorrhagic shock, which comprise more than 75% of all clinical cases of shock. Both forms lead to severe dysfunction of the microcirculation and the mitochondria that can cause or further aggravate tissue damage and inflammation. However, the detailed mechanisms of acute and long-term effects of impaired oxygen utilization are still elusive. Importantly, a defective oxygen exploitation can impact multiple organs simultaneously and organ damage can be aggravated due to intense organ cross-talk or the presence of a systemic inflammatory response. Complexity is further increased through a large heterogeneity in the human population, differences in genetics, age and gender, comorbidities or disease history. To gain a deeper understanding of the principles, mechanisms, interconnections and consequences of impaired oxygen delivery and utilization, interdisciplinary preclinical as well as clinical research is required. In this review, we provide a "tool-box" that covers widely used animal disease models for septic and hemorrhagic shock and methods to determine the structure and function of the microcirculation as well as mitochondrial function. Furthermore, we suggest magnetic resonance imaging as a multimodal imaging platform to noninvasively assess the consequences of impaired oxygen delivery on organ function, cell metabolism, alterations in tissue textures or inflammation. Combining structural and functional analyses of oxygen delivery and utilization in animal models with additional data obtained by multiparametric MRI-based techniques can help to unravel mechanisms underlying immediate effects as well as long-term consequences of impaired oxygen delivery on multiple organs and may narrow the gap between experimental preclinical research and the human patient.
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Affiliation(s)
- Stefan Hof
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Carsten Marcus
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Anne Kuebart
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Jan Schulz
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Richard Truse
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Annika Raupach
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Inge Bauer
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Ulrich Flögel
- Experimental Cardiovascular Imaging, Department of Molecular Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Olaf Picker
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Anna Herminghaus
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Sebastian Temme
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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