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Martillo M, Ebner B, Munagala M. Postoperative Outcomes of Patients with Chagas Cardiomyopathy Undergoing Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.585] [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: 04/05/2023] Open
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2
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Martillo M, Ebner B, Munagala M. Postoperative Outcomes of Patient with Sarcoidosis Undergoing Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.584] [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: 04/05/2023] Open
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3
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Ebner B. The test of exponentiality based on the mean residual life function revisited. J Nonparametr Stat 2023. [DOI: 10.1080/10485252.2023.2178831] [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: 02/21/2023]
Affiliation(s)
- B. Ebner
- Institute of Stochastics, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
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4
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Ebner B, Liebenberg SC, Visagie IJH. A new omnibus test of fit based on a characterization of the uniform distribution. STATISTICS-ABINGDON 2022. [DOI: 10.1080/02331888.2022.2133121] [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: 10/31/2022]
Affiliation(s)
- B. Ebner
- Institute of Stochastics, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - S. C. Liebenberg
- School of Mathematical and Statistical Sciences, North-West University, Potchefstroom, South Africa
| | - I. J. H. Visagie
- School of Mathematical and Statistical Sciences, North-West University, Potchefstroom, South Africa
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Olarte N, Vincent L, Ebner B, Grant J, Maning J, Hernandez R, Rivera-Rodriguez B, Giraldo M, Mendoza I. Atrioventricular nodal ablation with pacemaker implant is associated with improved safety outcomes compared to pulmonary vein isolation of atrial fibrillation with heart failure. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Pulmonary vein isolation (PVI) and atrioventricular nodal ablation (AVNA) with pacemaker implant have both been advocated for patients with atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF). Direct comparisons between the two are limited.
Purpose
We sought to compare outcomes and complications following PVI versus AVNA with implant of a cardiac implantable electronic device (CIED) among patients with AF and HFrEF.
Methods
We queried the National Inpatient Sample from 2011 to 2019, using relevant ICD-9 and -10 diagnostic and procedural codes for AF, HFrEF, ablation, and CIED implant to identify our study cohort. Exclusion criteria included presence of a pre-existing CIED, ventricular arrhythmias, non-AF supraventricular arrhythmias, and surgical AF ablation. Baseline characteristics included age, sex, race, and comorbidities related to AF and cardiovascular disease. Severity of comorbidities was assessed via Deyo-Charlson Comorbidity Index (Deyo-CCI). Outcomes investigated include all-cause mortality, major adverse cardiovascular events (MACE), extra-cardiac procedural complications, length of stay, and total hospital charges. Outcomes associations were analyzed using multivariate logistic regression adjusted for baseline characteristics that were significantly different (P<0.05) between cohorts expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI). SPSS v28.0 (IBM, Armonk, NY) was used to carry out all calculations.
Results
We identified 3,565 encounters for PVI and 1,355 for AVNA with CIED implant among hospitalized patients with AF and HFrEF. Patients who underwent AVNA were more often older (73.8 vs 66.2 years), with more severe comorbidities (mean Deyo-CCI score 2.9 vs 2.6) and were more likely to have an emergent procedure performed (81.3% vs 69.7%; p<0.001 for all). However, the AVNA cohort had less mortality (0.5% vs 1.2%, p=0.03), MACE (6.1% vs 7.8%, p=0.04), and total complications (12.7% vs 16.3%, p=0.002), but longer hospital stay (8.0 vs 6.5 days) and higher total charges ($201,100 vs $159,382; p<0.001 for both). After adjusting for confounders, AVNA remained independently associated with decreased odds of mortality (aOR: 0.370; 95% CI [0.159–0.862], p=0.02), MACE (aOR: 0.552; 95% CI [0.420–0.726], p<0.001), and total complications (aOR: 0.708; 95% CI [0.589–0.852], p<0.001).
Conclusion
Despite older age with more severe comorbidities and less elective procedures, hospitalized patients with AF and HFrEF who underwent AVNA with CIED implant had improved safety outcomes compared to PVI. Further studies comparing the intermediate and long-term outcomes and efficacy between therapies are needed to better delineate which would best serve this population.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Olarte
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - L Vincent
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - B Ebner
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - J Grant
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - J Maning
- Northwestern University, Cardiology , Chicago , United States of America
| | - R Hernandez
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - B Rivera-Rodriguez
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - M Giraldo
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - I Mendoza
- Jackson Memorial Hospital, Cardiology , Miami , United States of America
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Olarte N, Vincent L, Ebner B, Grant J, Maning J, Hernandez R, Rivera-Rodriguez B, Giraldo M, Grazette L. Assessing outcomes following catheter ablation of ventricular tachycardia in patients with durable left ventricular assist devices. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.692] [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
Management of ventricular tachycardia (VT) after implant of a durable left ventricular assist device (LVAD) is challenging, without consensus on optimal therapy. Multiple small studies have examined catheter ablation of VT in these patients with low reported incidence of complications.
Purpose
We sought to evaluate periprocedural outcomes following VT ablation among LVAD recipients.
Methods
We queried the National Inpatient Sample from 2011 to 2019 to conduct our study. Baseline characteristics include age, sex, race, and comorbidities related to cardiovascular disease. Comorbidity severity was assessed using the Deyo-Charlson Comorbidity Index (Deyo-CCI). Patients with any supraventricular arrhythmias were excluded. Outcomes investigated include heart transplant procedure, all-cause mortality, major adverse cardiovascular events (MACE), and periprocedural complications. Multivariate regression was used to analyze outcomes associations adjusted for baseline characteristics that were significantly different (P<0.05) between cohorts expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI). SPSS v28.0 (IBM, Armonk, NY) was used to carry out all calculations.
Results
We identified 56 patients who underwent ablation among 2,202 LVAD recipients hospitalized for VT. Patients who underwent ablation were more likely to have ischemic cardiomyopathy (33.9% vs. 22.2%, p=0.03) or an automated implantable cardioverter-defibrillator (55.4% vs 34.3%, p=0.001). There were otherwise no significant differences between cohorts (mean Deyo-CCI score of 2.3 for both, p=0.48). Between those who did and did not undergo ablation, there were no significant differences in heart transplant (5.4 vs 5.0%, p=0.9), mortality (7.1% vs 7.0%, p=0.96), total strokes (3.6% vs 5.0%, p=0.48), myocardial infarction (3.6% vs 4.6%, p=0.71), overall MACE (8.9% vs 10.2%, p=0.26) or total complications (35.7% vs 41.9%, p=0.35). There were no incidents of pump thrombosis in the ablation group, but 92 events (4.3%) were found in the medical therapy group. Multivariate analysis affirmed no significant association between ablation and mortality (aOR 1.277, CI [0.450–3.629]), MACE (aOR 1.125, CI [0.436–2.902]), or total complications (aOR 0.932, CI [0.528–1.645]).
Conclusion
Overall complications following VT ablation among LVAD patients were higher than previously reported but no statistically significant differences were found compared to conservative management. While ablation appears safe to perform, particularly among those with structural heart disease and ischemic cardiomyopathy, longer duration studies are needed to determine the efficacy of this procedure.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Olarte
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - L Vincent
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - B Ebner
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - J Grant
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - J Maning
- Northwestern University, Cardiology , Chicago , United States of America
| | - R Hernandez
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - B Rivera-Rodriguez
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - M Giraldo
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - L Grazette
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
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Olarte N, Vincent L, Loyd Q, Ebner B, Grant J, Maning J, Hernandez RJ, Rivera-Rodriguez B, Giraldo M, Lambrakos L. Gender disparities in ventricular tachycardia: evaluating clinical outcomes and interventions. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Gender differences in the etiology of ventricular arrhythmia are well-known and can potentially affect clinical outcomes. Women have been under-represented in studies investigating ventricular tachycardia (VT). Thus, gender differences in clinical outcomes of VT are poorly defined.
Purpose
We sought to elucidate the clinical outcomes and interventions among women with VT.
Methods
We used the National Inpatient Sample to identify patients aged 18 and older admitted with VT from 2011 to 2019. Observations missing data on age, sex and mortality were excluded. Baseline characteristics include age, race, and comorbidities related to cardiovascular disease. Severity of comorbidities was assessed via the Deyo-Charlson Comorbidity Index (Deyo-CCI) score. Outcomes investigated include all-cause mortality, major adverse cardiovascular events (MACE), and incidence of catheter ablation, cardioversion, and automated implantable cardioverter defibrillator (AICD) insertion. Gender and outcomes association were analyzed using multivariable logistic regression adjusted for baseline characteristics that were significantly different (P<0.05) between cohorts expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI). SPSS v28.0 (IBM, Armonk, NY) was used to carry out all calculations.
Results
Between 2011 and 2019, there were an estimated 3,544,445 hospital admissions for VT, of which, 33.8% were women, who were more likely to be older (69.2 vs 68.0 years) and of minority descent (30.3% vs 26.7%) compared to men. Women were less likely to have coronary artery disease (43.5% vs 62.2%) or ischemic cardiomyopathy (5.0% vs 11.9%) and had a lower mean Deyo-CCI score (2.2 vs 2.4; p<0.001 for all). Women had a higher incidence of mortality (10.6% vs 9.2%) and ischemic stroke (5.3% vs 4.5%), but less acute coronary syndrome (17.6% vs 21.4%; p<0.001 for all). Overall incidence of MACE was lower among women (28.6% vs 31.4%; p<0.001). Multivariate regression analysis demonstrated that female sex remained independently associated with increased odds for all-cause mortality (aOR: 1.089; 95% CI: [1.062–1.116], p<0.001) although decreased odds for MACE (aOR: 0.952; 95% CI: [0.939–0.965]). Female sex was also independently associated with decreased odds for cardioversion (aOR: 0.936; 95% CI: [0.910–0.963]), AICD insertion, (aOR: 0.737; 95% CI: [0.711–0.764]) and ablation (aOR: 0.806; 95% CI: [0.766–0.847]; all p<0.001).
Conclusion
In this retrospective analysis of patients hospitalized with VT, women had less coronary artery disease and less MACE, yet all-cause mortality was higher. Female sex was also independently associated with fewer interventions, including AICD insertion and ablation. Although there are gender differences in risk factors and causes of VT, this does not fully explain disparities in care and outcomes. Further studies are needed to explore and elucidate these gender disparities.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Olarte
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - L Vincent
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - Q Loyd
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - B Ebner
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - J Grant
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - J Maning
- Northwestern University, Cardiology , Chicago , United States of America
| | - R J Hernandez
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - B Rivera-Rodriguez
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - M Giraldo
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - L Lambrakos
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
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Westhofen T, Schott M, Keller P, Tamalunas A, Atzler M, Ebner B, Stief C, Magistro G. Surgical efficiency of “one-lobe” technique vs. “three-lobe” technique for Holmium Laser Enucleation of the Prostate (HoLEP). Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00455-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Haller H, Saha F, Ebner B, Kowoll A, Anheyer D, Dobos G, Berger B, Choi K. Emotional Release and Physical Symptom Improvement: An Qualitative Analysis of Therapeutic Mechanisms of Neural Therapy. J Acupunct Meridian Stud 2018. [DOI: 10.1016/j.jams.2018.08.129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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10
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Ebner A, Kuerbis N, Brandt A, Zatschler B, Weinert S, Poitz DM, Ebner B, Augstein A, Wunderlich C, El-Armouche A, Strasser RH. Endothelial Nitric Oxide Synthase-Induced Hypertrophy and Vascular Dysfunction Contribute to the Left Ventricular Dysfunction in Caveolin-1−/− Mice. Can J Cardiol 2017; 33:1716-1724. [DOI: 10.1016/j.cjca.2017.09.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 09/19/2017] [Accepted: 09/20/2017] [Indexed: 02/02/2023] Open
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Lange SA, Jung J, Jaeck A, Hitschold T, Ebner B. Subclinical Myocardial Impairment Occurred in Septal and Anterior LV Wall Segments After Anthracycline-Embedded Chemotherapy and did not Worsen During Adjuvant Trastuzumab Treatment in Breast Cancer Patients. Cardiovasc Toxicol 2015; 16:193-206. [DOI: 10.1007/s12012-015-9328-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Christoph M, Herold J, Berg-Holldack A, Rauwolf T, Ziemssen T, Schmeisser A, Weinert S, Ebner B, Ibrahim K, Strasser RH, Braun-Dullaeus RC. Effects of the Peroxisome Proliferator-Activated Receptor-γ Agonist Pioglitazone on Peripheral Vessel Function and Clinical Parameters in Nondiabetic Patients: A Double-Center, Randomized Controlled Pilot Trial. Cardiology 2015; 131:165-71. [DOI: 10.1159/000376570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 01/20/2015] [Indexed: 11/19/2022]
Abstract
Objective: Despite the advanced therapy with statins, antithrombotics, and antihypertensive agents, the medical treatment of atherosclerotic disease is less than optimal. Therefore, additional therapeutic antiatherosclerotic options are desirable. This pilot study was performed to assess the potential antiatherogenic effect of the peroxisome proliferator-activated receptor-γ agonist pioglitazone in nondiabetic patients. Methods: A total of 54 nondiabetic patients were observed in a prospective, double-blind, placebo-controlled study. Patients were randomized to pioglitazone or placebo. The following efficacy parameters were determined by serial analyses: artery pulse wave analysis and carotid-femoral pulse wave velocity (PWV), static and dynamic retinal vessel function, and the common carotid intima-media thickness (IMT). The main secondary endpoint was the change in different biochemical markers. Results: After 9 months, no relevant differences could be determined in the two treatment groups in PWV (pioglitazone 14.3 ± 4.4 m/s vs. placebo 14.2 ± 4.2 m/s), retinal arterial diameter (pioglitazone 112.1 ± 23.3 µm vs. placebo 117.9 ± 21.5 µm) or IMT (pioglitazone 0.85 ± 0.30 mm vs. placebo 0.79 ± 0.15 mm). Additionally, there were no differences in the change in biochemical markers like cholesteryl ester transfer protein, low-density lipoprotein cholesterol, high-sensitivity C-reactive protein or white blood cell count. Conclusions: Treatment with a peroxisome proliferator-activated receptor-γ agonist in nondiabetic patients did not improve the function of large and small peripheral vessels (PPP Trial, clinicaltrialsregister.eu: 2006-000186-11).
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Ebner B, Lange SA, Hollenbach D, Steinbronn N, Ebner A, Fischaleck C, Braun-Dullaeus R, Weinbrenner C, Strasser RH. In Situ Postconditioning With Neuregulin-1β Is Mediated by a PI3K/Akt-Dependent Pathway. Can J Cardiol 2015; 31:76-83. [DOI: 10.1016/j.cjca.2014.10.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 10/12/2014] [Accepted: 10/26/2014] [Indexed: 11/27/2022] Open
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14
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Kovacs A, Assabiny A, Lakatos B, Apor A, Nagy A, Kutyifa V, Merkely B, Ulbrich S, Sveric K, Rady M, Strasser R, Ebner B, Lervik Nilsen LC, Brekke B, Missant C, Ortega A, Haemers P, Tong L, Sutherland G, D'hooge J, Stoylen A, Gurzun MM, Ionescu A, Santoro A, Federico Alvino F, Carlo Gaetano Sassi C, Giovanni Antonelli G, Sergio Mondillo S, Chumarnaya T, Alueva Y, Kochmasheva V, Mikhailov S, Ostern O, Solovyova O, Revishvili A, Markhasin V, Rodriguez Munoz D, Carbonell Sanroman A, Moya Mur J, Fernandez Santos S, Lazaro Rivera C, Valverde Gomez M, Casas Rojo E, Garcia Martin A, Fernandez-Golfin C, Zamorano Gomez J, Kanda T, Fujita M, Masuda M, Iida O, Okamoto S, Ishihara T, Nanto K, Shiraki T, Takahara M, Uematsu M, Kolesnyk MY, Victor K, Lux D, Carr-White G, Barrett N, Glover G, Langrish C, Meadows C, Ioannou N, Castaldi B, Vida V, Argiolas A, Maschietto N, Cerutti A, Biffanti R, Reffo E, Padalino M, Stellin G, Milanesi O, Simova I, Katova T, Galderisi M, Lalov I, Onciul S, Alexandrescu A, Petre I, Zamfir D, Onut R, Tautu O, Dorobantu M, Caldas A, Ladeia A, D'almeida J, Guimaraes A, Ball C, Abdelmoneim Mohamed S, Huang R, Zysek V, Mantovani F, Scott C, Mccully R, Mulvagh S, Lee JH, Cho G, Mihaila S, Muraru D, Aruta P, Piasentini E, Cavalli G, Ucci L, Peluso D, Vinereanu D, Iliceto S, Badano L, Ozawa K, Funabashi N, Takaoka H, Kamata T, Nomura F, Kobayashi Y, Ovsianas J, Valuckiene Z, Mizariene V, Jurkevicius R, Reskovic Luksic V, Dosen D, Cekovic S, Separovic Hanzevacki J, Simova I, Katova T, Santoro C, Galderisi M, Kalcik M, Cakal B, Gursoy M, Astarcioglu M, Yesin M, Gunduz S, Karakoyun S, Cersit S, Toprak C, Ozkan M. Club 35 Poster session 3: Friday 5 December 2014, 08:30-18:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu263] [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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Wiedemann S, Ebner B, Ibrahim K, Scherf L, Heidrich FM, Strasser RH. Percutaneous transjugular removal of an intracardial bone cement fragment after dorsal stabilization. Circ Cardiovasc Interv 2014; 7:410-3. [PMID: 24944304 DOI: 10.1161/circinterventions.113.001128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Stephan Wiedemann
- From the Department of Internal Medicine and Cardiology, Technische Universität Dresden, Herzzentrum Dresden University Hospital, Dresden, Germany.
| | - Bernd Ebner
- From the Department of Internal Medicine and Cardiology, Technische Universität Dresden, Herzzentrum Dresden University Hospital, Dresden, Germany
| | - Karim Ibrahim
- From the Department of Internal Medicine and Cardiology, Technische Universität Dresden, Herzzentrum Dresden University Hospital, Dresden, Germany
| | - Lisa Scherf
- From the Department of Internal Medicine and Cardiology, Technische Universität Dresden, Herzzentrum Dresden University Hospital, Dresden, Germany
| | - Felix M Heidrich
- From the Department of Internal Medicine and Cardiology, Technische Universität Dresden, Herzzentrum Dresden University Hospital, Dresden, Germany
| | - Ruth H Strasser
- From the Department of Internal Medicine and Cardiology, Technische Universität Dresden, Herzzentrum Dresden University Hospital, Dresden, Germany
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Christoph M, Herold J, Berg-Holldack A, Rauwolf T, Ziemssen T, Schmeisser A, Weinert S, Ebner B, Said S, Strasser RH, Braun-Dullaeus RC. Effects of the PPARγ agonist pioglitazone on coronary atherosclerotic plaque composition and plaque progression in non-diabetic patients: a double-center, randomized controlled VH-IVUS pilot-trial. Heart Vessels 2014; 30:286-95. [PMID: 24519403 DOI: 10.1007/s00380-014-0480-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 01/24/2014] [Indexed: 11/25/2022]
Abstract
Despite the advanced therapy with statins, antithrombotics and antihypertensive agents, the medical treatment of coronary artery disease is less than optimal. Therefore, additional therapeutic anti-atherosclerotic options are desirable. This VH-IVUS study (intravascular ultrasonography with virtual histology) was performed to assess the potential anti-atherogenic effect of the PPARγ agonist pioglitazone in non-diabetic patients. A total of 86 non-culprit atherosclerotic lesions in 54 patients with acute coronary syndrome were observed in a 9-month prospective, double-blind, and placebo-controlled IVUS study. Patients were randomized to receive either 30 mg pioglitazone (Pio) or placebo (Plac). As primary efficacy parameter, the change of relative plaque content of necrotic core was determined by serial VH-IVUS analyses. Main secondary endpoint was the change of total plaque volume. In contrast to placebo, in the pioglitazone-treated group, the relative plaque content of necrotic core decreased significantly (Pio -1.3 ± 6.9% vs. Plac +2.6 ± 6.5%, p < 0.01). In comparison to the placebo group, the plaques in pioglitazone-treated patients showed significantly greater reduction of the total plaque volume (Pio -16.1 ± 26.4 mm3 vs. Plac -1.8 ± 30.9 mm3, p = 0.02). Treatment with a PPARγ agonist in non-diabetic patients results in a coronary artery plaque stabilization on top of usual medical care.
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Affiliation(s)
- Marian Christoph
- Heart Center, University of Dresden, University Hospital, Germany, Fetscherstrasse 76, 01307, Dresden, Germany,
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Ebner A, Steinbronn N, Mitschke J, Poitz DM, Ebner B, Strasser RH, Wunderlich C. Can moderate training reverse hypertrophic cardiomyopathy in a mouse model of vascular dysfunctional eNOS? Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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18
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Ebner B, Lange SA, Eckert T, Wischniowski C, Ebner A, Braun-Dullaeus RC, Weinbrenner C, Wunderlich C, Simonis G, Strasser RH. Uncoupled eNOS annihilates neuregulin-1β-induced cardioprotection: a novel mechanism in pharmacological postconditioning in myocardial infarction. Mol Cell Biochem 2012; 373:115-23. [PMID: 23065382 DOI: 10.1007/s11010-012-1480-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 10/03/2012] [Indexed: 10/27/2022]
Abstract
Myocardial infarct size can be limited by pharmacological postconditioning (pPC) with cardioprotective agents. Cardioprotective effects of neuregulin-1β (NRG) via activation of protein kinase B (Akt) and downstream pathways like endothelial nitric oxide synthase (eNOS) have been postulated based on results from cell culture experiments. The purpose of this study was to investigate if eNOS may be involved in pPC with NRG. NRG application in an ex vivo mouse model (C57Bl6) of ischemia-reperfusion injury was analyzed. Unexpectedly, the infarct size increased when NRG was infused starting 5 min prior to reperfusion, even though protective Akt and GSK3β phosphorylation were enhanced. In eNOS deficient mice, however, NRG significantly reduced the infarct size. Co-infusion of NRG and L-arginine (Arg) lead to a reduction in infarct size in wild type animals. Electron paramagnetic resonance measurements revealed that NRG treatment prior to reperfusion leads to an enhanced release of reactive oxygen species compared to controls and this effect is blunted by co-infusion of Arg. This study documents the cardioprotective mechanisms of NRG signaling to be mediated by GSK3β inactivation. This is the first study to show that this protection fails in situations with dysfunctional eNOS. In eNOS deficient mice NRG exerts its protective effect via the GSK3β pathway, suggesting that the eNOS can limit cardioprotection. As dysfunctional eNOS has been described in cardiovascular risk factors like diabetes, hypertension, and hypercholesterolemia these findings can help to explain lack of postconditioning performance in models of cardiovascular co-morbidities.
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Affiliation(s)
- Bernd Ebner
- Department of Medicine/Cardiology, Heart Center Dresden, University Hospital, University of Technology Dresden, Dresden, Germany.
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Christoph M, Ebner B, Stolte D, Ibrahim K, Kolschmann S, Strasser RH, Schön S. Broken heart syndrome: Tako Tsubo cardiomyopathy associated with an overdose of the serotonin-norepinephrine reuptake inhibitor Venlafaxine. Eur Neuropsychopharmacol 2010; 20:594-7. [PMID: 20451358 DOI: 10.1016/j.euroneuro.2010.03.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [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] [Received: 02/10/2010] [Revised: 03/26/2010] [Accepted: 03/29/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To describe a case of Tako Tsubo cardiomyopathy [TTC] in a patient after an overdose of the serotonin-norepinephrine reuptake inhibitor [SNRI] Venlafaxine. METHODS We present a case study including clinical and laboratory data. Current relevant literature is reviewed and summarized in regard to Tako Tsubo syndrome and SNRI. RESULTS A 43year-old woman was admitted with acute angina pectoris after accidentally taking an overdose on Venlafaxine in order to treat major depression. Because of the ECG-T-wave-inversions in the precordial leads, the slightly increased Troponin/Creatine kinase levels and the apical systolic dysfunction of the left ventricle in echocardiogram a cardiac catheterization was performed. Coronary artery disease could be excluded by coronary angiography. The followed laevocardiography and cardiac MRI scan showed apical akinesis and basal hypercontractibility typical for apical ballooning (Tako Tsubo cardiomyopathy). Urine analysis revealed elevated normetanephrine level potentially caused by Venlafaxine. Six weeks after the first admission the echocardiogram showed a complete recovery to normal left ventricular function. CONCLUSIONS To our knowledge this is the first reported case of an overdose of Venlafaxine (SNRI) associated Tako Tsubo cardiomyopathy.
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Affiliation(s)
- Marian Christoph
- University of Technology Dresden, Department of Cardiology, Heart Center, University Hospital, Dresden, Germany.
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Abstract
BACKGROUND Emulsified perfluorocarbons (PFCs) are preferentially phagocytized by monocytes/macrophages and are readily detected by (19)F MRI. This study tests the hypothesis that (19)F MRI can be used to quantitate pulmonary inflammation by tracking of infiltrating PFC-loaded monocytes. METHODS AND RESULTS Pneumonia was induced in mice by intratracheal instillation of lipopolysaccharides (LPS) followed by intravenous injection of PFCs. Whereas regular (1)H MRI provided no evidence of lung injury 24 hours after LPS, the concurrent (19)F images clearly show PFC accumulation in both pulmonary lobes. Imaging at 48 hours after LPS revealed signals in (1)H images at the same location as the 24-hour (19)F signals. Thus, progressive pneumonia was first predicted by (19)F MRI early after PFC administration. Without LPS, at no time were (19)F signals observed within the lung. Histology and fluorescence-activated cell sorting (FACS) combined with (19)F MRI confirmed the presence of infiltrating PFC-loaded monocytes/macrophages after LPS challenge. Additional experiments with graded doses of LPS demonstrated that (19)F signal intensity strongly correlated with both LPS dose and pathological markers of lung inflammation. In separate studies, dexamethasone and CGS21680 (adenosine 2A receptor agonist) were used to demonstrate the ability of (19)F MRI to monitor anti-inflammatory therapies. CONCLUSIONS PFCs serve as a contrast agent for the prognostic and quantitative assessment of pulmonary inflammation by in vivo (19)F MRI, which is characterized by a high degree of specificity due to the lack of any (19)F background. Because PFCs are biochemically inert, this approach may also be suitable for human applications.
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Affiliation(s)
- Bernd Ebner
- Institut für Herz- und Kreislaufphysiologie, Heinrich-Heine-Universität, Düsseldorf, Germany
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Wunderlich C, Schmeisser A, Heerwagen C, Ebner B, Schober K, Braun-Dullaeus RC, Schwencke C, Kasper M, Morawietz H, Strasser RH. Chronic NOS inhibition prevents adverse lung remodeling and pulmonary arterial hypertension in caveolin-1 knockout mice. Pulm Pharmacol Ther 2008; 21:507-15. [DOI: 10.1016/j.pupt.2007.11.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Revised: 11/08/2007] [Accepted: 11/21/2007] [Indexed: 01/08/2023]
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Peters M, Dasilva A, Weckermann D, Oberneder R, Ebner B, Kirchinger P, Fetter A, Köhne-Volland R, Baeuerle P, Gjorstrup P. Phase I study of the novel fully human monoclonal antibody MT201, directed against epithelial cellular adhesion molecule (Ep-CAM), in patients with hormone-refractory prostate cancer (HRPC). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.2600] [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: 11/20/2022] Open
Affiliation(s)
- M. Peters
- Micromet AG, München, Germany; Augsburg Hospital, Augsburg, Germany; Klinikum Planegg, Planegg, Germany; Metronomia AG, München, Germany
| | - A. Dasilva
- Micromet AG, München, Germany; Augsburg Hospital, Augsburg, Germany; Klinikum Planegg, Planegg, Germany; Metronomia AG, München, Germany
| | - D. Weckermann
- Micromet AG, München, Germany; Augsburg Hospital, Augsburg, Germany; Klinikum Planegg, Planegg, Germany; Metronomia AG, München, Germany
| | - R. Oberneder
- Micromet AG, München, Germany; Augsburg Hospital, Augsburg, Germany; Klinikum Planegg, Planegg, Germany; Metronomia AG, München, Germany
| | - B. Ebner
- Micromet AG, München, Germany; Augsburg Hospital, Augsburg, Germany; Klinikum Planegg, Planegg, Germany; Metronomia AG, München, Germany
| | - P. Kirchinger
- Micromet AG, München, Germany; Augsburg Hospital, Augsburg, Germany; Klinikum Planegg, Planegg, Germany; Metronomia AG, München, Germany
| | - A. Fetter
- Micromet AG, München, Germany; Augsburg Hospital, Augsburg, Germany; Klinikum Planegg, Planegg, Germany; Metronomia AG, München, Germany
| | - R. Köhne-Volland
- Micromet AG, München, Germany; Augsburg Hospital, Augsburg, Germany; Klinikum Planegg, Planegg, Germany; Metronomia AG, München, Germany
| | - P. Baeuerle
- Micromet AG, München, Germany; Augsburg Hospital, Augsburg, Germany; Klinikum Planegg, Planegg, Germany; Metronomia AG, München, Germany
| | - P. Gjorstrup
- Micromet AG, München, Germany; Augsburg Hospital, Augsburg, Germany; Klinikum Planegg, Planegg, Germany; Metronomia AG, München, Germany
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Wystub S, Ebner B, Fuchs C, Weich B, Burmester T, Hankeln T. Interspecies comparison of neuroglobin, cytoglobin and myoglobin: Sequence evolution and candidate regulatory elements. Cytogenet Genome Res 2004; 105:65-78. [PMID: 15218260 DOI: 10.1159/000078011] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2003] [Accepted: 12/08/2003] [Indexed: 11/19/2022] Open
Abstract
Neuroglobin and cytoglobin are two novel members of the vertebrate globin family. Their physiological role is poorly understood, although both proteins bind oxygen reversibly and may be involved in cellular oxygen homeostasis. Here we investigate the selective constraints on coding and non-coding sequences of the neuroglobin and cytoglobin genes in human, mouse, rat and fish. Neuroglobin and cytoglobin are highly conserved, displaying very low levels of non-synonymous nucleotide substitutions. An oxygen supply function predicts distinct modes of gene regulation, involving hypoxia-responsive transcription factors. To detect conserved candidate regulatory elements, we compared the neuroglobin and cytoglobin genes in mammals and fish. The myoglobin gene was included to test if it also contains hypoxia-responsive regulatory elements. Long conserved non-coding sequences, indicative of gene-regulatory elements, were found in the cytoglobin and myoglobin, but not in the neuroglobin gene. Sequence comparison and experimental data allowed us to delimit upstream regions of the neuroglobin and cytoglobin genes that contain the putative promoters, defining candidate regulatory regions for functional tests. The neuroglobin and the myoglobin genes both lack conserved hypoxia-responsive elements (HREs) for transcriptional activation, but contain conserved hypoxia-inducible mRNA stabilization signals in their 3' untranslated regions. The cytoglobin gene, in contrast, harbors both conserved HREs and mRNA stabilization sites, strongly suggestive of an oxygen-dependent regulation.
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Affiliation(s)
- S Wystub
- Institute of Molecular Genetics and Institute of Zoology, Johannes Gutenberg University Mainz, Mainz, Germany
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Ebner B, Grimm A, Hahn F. [Late results of implantation of dual head prostheses in hip para-articular fractures]. Aktuelle Traumatol 1994; 24:152-154. [PMID: 7942310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
In the hospital of Aalen through the years 1985 to 1993 a total of 545 patients have been treated by using a "Duokopf"-prosthesis. The average age was 82.6 years. In a retrospective study the mobility and survival rate after surgery of 109 patients, who had undergone such treatment because of a hip fracture, were found out. The survival rate one year after surgery was within the range of the survival rate of the normal population at that age: The evaluation of the mobility one year after implantation with 57% surviving patients, who are able to walk without aid is a good result. None of the patients showed a protrusio acetabuli. Although the evaluation of the presented results is limited, since, due to the high average age, the mortality rate after surgery was extreme, the Duokopf prosthesis has proved to bring up good long term results.
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Affiliation(s)
- B Ebner
- Abteilung für Unfall- und Wiederherstellungschirurgie des Kreiskankenhauses Aalen
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Müller K, Ebner B, Hömberg V. Maturation of fastest afferent and efferent central and peripheral pathways: no evidence for a constancy of central conduction delays. Neurosci Lett 1994; 166:9-12. [PMID: 8190366 DOI: 10.1016/0304-3940(94)90828-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.2] [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: 01/29/2023]
Abstract
The maturation of the fastest afferent and efferent central and peripheral pathways was analysed using the recording of somatosensory evoked potentials of the median nerve stimulation for afferent conduction and magnetoelectrical stimulation of motor cortex to the thenar muscles for efferent conduction. Both afferent and efferent central pathways showed a prolonged maturational pattern with adult values being reached by the age of 5 to 7 years for the afferent and by the age of around 10 years for the efferent pathway. In contrast, the maturation for peripheral afferent and efferent pathways showed a similar trend with a fairly constant conduction velocity reached around the age of 3 years. There was no evidence for a constancy of central conduction delays in both afferent and efferent pathway which has been supposed as a possible mechanism for a temporal stability in feedback loops involved in motor learning processes during development. It is concluded that the prolonged maturational central conduction time precludes the usage of a fixed temporal timing pattern during development in the human sensory motor system.
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Affiliation(s)
- K Müller
- Department of Pediatrics, Heinrich-Heine-Universität Düsseldorf, FRG
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