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Rezaeian P, Shufelt C, Wei J, Pacheco C, Cook-Wiens G, Berman D, Tamarappoo B, Thomson L, Nelson M, Anderson R, Petersen J, Handberg E, Pepine C, Merz CB. Arterial stiffness assessment in coronary microvascular dysfunction and heart failure with preserved ejection fraction: An initial report from the WISE-CVD continuation study. Am Heart J Plus 2024; 41:100390. [PMID: 38600957 PMCID: PMC11004063 DOI: 10.1016/j.ahjo.2024.100390] [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] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 04/12/2024]
Abstract
Background Heart failure with preserved ejection fraction (HFpEF) is the most common cardiac complication in patients with coronary microvascular dysfunction (CMD), yet its underlying pathways remain unclear. Aortic pulse-wave velocity (aPWV) is an indicator of large artery stiffness and a predictor for cardiovascular disease. However, aPWV in CMD and HFpEF is not well characterized and may provide understanding of disease progression. Methods Among participants without obstructive coronary artery disease, we evaluated 51 women with suspected CMD and 20 women and men with evidence of HFpEF. All participants underwent aPWV measurement (SphygmoCor, Atcor Medical) with higher aPWV indicating greater vascular stiffness. Cardiac magnetic resonance imaging (CMRI) assessed left ventricular (LV) ejection fraction, CMD via myocardial perfusion reserve index (MPRI), and ventricular remodeling via LV mass-volume ratio. . Statistical analysis was performed using Wilcoxon rank sum tests, Pearson correlations and linear regression analysis. Results Compared to the suspected CMD group, the HFpEF participants were older (65 ± 12 vs 56 ± 11 yrs., p = 0.002) had higher BMI (31.0 ± 4.3 vs 27.8 ± 6.7 kg/m2, p = 0.013), higher aPWV (10.5 ± 2.0 vs 8.0 ± 1.6 m/s, p = 0.05) and lower MPRI (1.5 ± 0.3 vs1.8 ± 0.3, p = 0.02), but not remodeling. In a model adjusted for cardiovascular risk factors, the HFpEF group had a lower LVEF (estimate -4.78, p = 0.0437) than the suspected CMD group. Conclusions HFpEF participants exhibit greater arterial stiffness and lower myocardial perfusion reserve, with lower LVEF albeit not remodeling, compared to suspected CMD participants. These findings suggest arterial stiffness may contribute to progression from CMD to HFpEF. Prospective work is needed and ongoing.
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Affiliation(s)
- P. Rezaeian
- Torrance Memorial Medical Center-A Cedars-Sinai Affiliate, Torrance, CA, USA
| | - C.L. Shufelt
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - J. Wei
- Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA
| | - C. Pacheco
- Hôspital Pierre-Boucher, Centre Hospitalier de l'Université de Montréal, Université de Montreal, QC, Canada
| | - G. Cook-Wiens
- Torrance Memorial Medical Center-A Cedars-Sinai Affiliate, Torrance, CA, USA
| | - D. Berman
- Taper Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - B. Tamarappoo
- Taper Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - L.E. Thomson
- Taper Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - M.D. Nelson
- The University of Texas at Arlington, Arlington, TX, USA
| | - R.D. Anderson
- Division of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - J. Petersen
- Division of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - E.M. Handberg
- Division of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - C.J. Pepine
- Division of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - C.N. Bairey Merz
- Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA
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Fadahunsi N, Petersen J, Metz S, Jakobsen A, Vad Mathiesen C, Silke Buch-Rasmussen A, Kurgan N, Kjærgaard Larsen J, Andersen RC, Topilko T, Svendsen C, Apuschkin M, Skovbjerg G, Hendrik Schmidt J, Houser G, Elgaard Jager S, Bach A, Deshmukh AS, Kilpeläinen TO, Strømgaard K, Madsen KL, Clemmensen C. Targeting postsynaptic glutamate receptor scaffolding proteins PSD-95 and PICK1 for obesity treatment. Sci Adv 2024; 10:eadg2636. [PMID: 38427737 PMCID: PMC10906926 DOI: 10.1126/sciadv.adg2636] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/29/2024] [Indexed: 03/03/2024]
Abstract
Human genome-wide association studies (GWAS) suggest a functional role for central glutamate receptor signaling and plasticity in body weight regulation. Here, we use UK Biobank GWAS summary statistics of body mass index (BMI) and body fat percentage (BF%) to identify genes encoding proteins known to interact with postsynaptic α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) and N-methyl-d-aspartate (NMDA) receptors. Loci in/near discs large homolog 4 (DLG4) and protein interacting with C kinase 1 (PICK1) reached genome-wide significance (P < 5 × 10-8) for BF% and/or BMI. To further evaluate the functional role of postsynaptic density protein-95 (PSD-95; gene name: DLG4) and PICK1 in energy homeostasis, we used dimeric PSD-95/disc large/ZO-1 (PDZ) domain-targeting peptides of PSD-95 and PICK1 to demonstrate that pharmacological inhibition of PSD-95 and PICK1 induces prolonged weight-lowering effects in obese mice. Collectively, these data demonstrate that the glutamate receptor scaffolding proteins, PICK1 and PSD-95, are genetically linked to obesity and that pharmacological targeting of their PDZ domains represents a promising therapeutic avenue for sustained weight loss.
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Affiliation(s)
- Nicole Fadahunsi
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Jonas Petersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Sophia Metz
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Alexander Jakobsen
- Molecular Neuropharmacology and Genetics Laboratory, Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Cecilie Vad Mathiesen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Alberte Silke Buch-Rasmussen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
- Global Drug Discovery, Novo Nordisk A/S, Måløv, Denmark
| | - Nigel Kurgan
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Jeppe Kjærgaard Larsen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Rita C. Andersen
- Molecular Neuropharmacology and Genetics Laboratory, Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Charlotte Svendsen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Mia Apuschkin
- Molecular Neuropharmacology and Genetics Laboratory, Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Grethe Skovbjerg
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
- Gubra, Hørsholm, Denmark
| | - Jan Hendrik Schmidt
- Molecular Neuropharmacology and Genetics Laboratory, Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Grace Houser
- Molecular Neuropharmacology and Genetics Laboratory, Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sara Elgaard Jager
- Molecular Neuropharmacology and Genetics Laboratory, Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anders Bach
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Atul S. Deshmukh
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Tuomas O. Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Kristian Strømgaard
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Kenneth L. Madsen
- Molecular Neuropharmacology and Genetics Laboratory, Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christoffer Clemmensen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
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3
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Yuan X, Liu B, Cuevas P, Brunski J, Aellos F, Petersen J, Koehne T, Bröer S, Grüber R, LeBlanc A, Zhang X, Xu Q, Helms J. Linking the Mechanics of Chewing to Biology of the Junctional Epithelium. J Dent Res 2023; 102:1252-1260. [PMID: 37555395 PMCID: PMC10626588 DOI: 10.1177/00220345231185288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
The capacity of a tissue to continuously alter its phenotype lies at the heart of how an animal is able to quickly adapt to changes in environmental stimuli. Within tissues, differentiated cells are rigid and play a limited role in adapting to new environments; however, differentiated cells are replenished by stem cells that are defined by their phenotypic plasticity. Here we demonstrate that a Wnt-responsive stem cell niche in the junctional epithelium is responsible for the capability of this tissue to quickly adapt to changes in the physical consistency of a diet. Mechanical input from chewing is required to both establish and maintain this niche. Since the junctional epithelium directly attaches to the tooth surface via hemidesmosomes, a soft diet requires minimal mastication, and consequently, lower distortional strains are produced in the tissue. This reduced strain state is accompanied by reduced mitotic activity in both stem cells and their progeny, leading to tissue atrophy. The atrophied junctional epithelium exhibits suboptimal barrier functions, allowing the ingression of bacteria into the underlying connective tissues, which in turn trigger inflammation and mild alveolar bone loss. These data link the mechanics of chewing to the biology of tooth-supporting tissues, revealing how a stem cell niche is responsible for the remarkable adaptability of the junctional epithelium to different diets.
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Affiliation(s)
- X. Yuan
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - B. Liu
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - P. Cuevas
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - J. Brunski
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - F. Aellos
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - J. Petersen
- Department of Orthodontics, University of Leipzig Medical Center, Saxony, Germany
| | - T. Koehne
- Department of Orthodontics, University of Leipzig Medical Center, Saxony, Germany
| | - S. Bröer
- Institute of Pharmacology and Toxicology, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - R. Grüber
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - A. LeBlanc
- Centre for Oral, Clinical & Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, UK
| | - X. Zhang
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Q. Xu
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- The Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, China
| | - J.A. Helms
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
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Terrones-Campos C, Ledergerber B, Forbes N, Smith AG, Petersen J, Helleberg M, Lundgren J, Specht L, Vogelius IR. Prediction of Radiation-induced Lymphopenia following Exposure of the Thoracic Region and Associated Risk of Infections and Mortality. Clin Oncol (R Coll Radiol) 2023; 35:e434-e444. [PMID: 37149425 DOI: 10.1016/j.clon.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/08/2023] [Accepted: 04/11/2023] [Indexed: 05/08/2023]
Abstract
AIMS Large blood volumes are irradiated when the heart is exposed to radiation. The mean heart dose (MHD) may be a good surrogate for circulating lymphocytes exposure. We investigated the association between MHD and radiation-induced lymphopenia and explored the impact of the end-of-radiation-therapy (EoRT) lymphocyte count on clinical outcomes. MATERIALS AND METHODS In total, 915 patients were analysed: 303 patients with breast cancer and 612 with intrathoracic tumours: oesophageal cancer (291), non-small cell lung cancer (265) and small cell lung cancer (56). Heart contours were generated using an interactive deep learning delineation process and an individual dose volume histogram for each heart was obtained. A dose volume histogram for the body was extracted from the clinical systems. We compared different models analysing the effect of heart dosimetry on the EoRT lymphocyte count using multivariable linear regression and assessed goodness of fit. We published interactive nomograms for the best models. The association of the degree of EoRT lymphopenia with clinical outcomes (overall survival, cancer treatment failure and infection) was investigated. RESULTS An increasing low dose bath to the body and MHD were associated with a low EoRT lymphocyte count. The best models for intrathoracic tumours included dosimetric parameters, age, gender, number of fractions, concomitant chemotherapy and pre-treatment lymphocyte count. Models for patients with breast cancer showed no improvement when adding dosimetric variables to the clinical predictors. EoRT lymphopenia grade ≥3 was associated with decreased survival and increased risk of infections among patients with intrathoracic tumours. CONCLUSION Among patients with intrathoracic tumours, radiation exposure to the heart contributes to lymphopenia and low levels of peripheral lymphocytes after radiotherapy are associated with worse clinical outcomes.
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Affiliation(s)
- C Terrones-Campos
- Centre of Excellence for Health, Immunity and Infections (CHIP), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
| | - B Ledergerber
- Centre of Excellence for Health, Immunity and Infections (CHIP), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - N Forbes
- Centre of Excellence for Health, Immunity and Infections (CHIP), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - A G Smith
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - J Petersen
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - M Helleberg
- Centre of Excellence for Health, Immunity and Infections (CHIP), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - J Lundgren
- Centre of Excellence for Health, Immunity and Infections (CHIP), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - L Specht
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - I R Vogelius
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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5
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Falk S, Petersen J, Svendsen C, Romero-Leguizamón CR, Jørgensen SH, Krauth N, Ludwig MQ, Lundø K, Roostalu U, Skovbjerg G, Nielsen DAG, Ejdrup AL, Pers TH, Dmytriyeva O, Hecksher-Sørensen J, Gether U, Kohlmeier KA, Clemmensen C. GLP-1 and nicotine combination therapy engages hypothalamic and mesolimbic pathways to reverse obesity. Cell Rep 2023:112466. [PMID: 37148870 DOI: 10.1016/j.celrep.2023.112466] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 03/22/2023] [Accepted: 04/18/2023] [Indexed: 05/08/2023] Open
Abstract
Glucagon-like peptide-1 receptor (GLP-1R) agonists promote nicotine avoidance. Here, we show that the crosstalk between GLP-1 and nicotine extends beyond effects on nicotine self-administration and can be exploited pharmacologically to amplify the anti-obesity effects of both signals. Accordingly, combined treatment with nicotine and the GLP-1R agonist, liraglutide, inhibits food intake and increases energy expenditure to lower body weight in obese mice. Co-treatment with nicotine and liraglutide gives rise to neuronal activity in multiple brain regions, and we demonstrate that GLP-1R agonism increases excitability of hypothalamic proopiomelanocortin (POMC) neurons and dopaminergic neurons in the ventral tegmental area (VTA). Further, using a genetically encoded dopamine sensor, we reveal that liraglutide suppresses nicotine-induced dopamine release in the nucleus accumbens in freely behaving mice. These data support the pursuit of GLP-1R-based therapies for nicotine dependence and encourage further evaluation of combined treatment with GLP-1R agonists and nicotinic receptor agonists for weight loss.
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Affiliation(s)
- Sarah Falk
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jonas Petersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Svendsen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Cesar R Romero-Leguizamón
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Heide Jørgensen
- Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nathalie Krauth
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Q Ludwig
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kathrine Lundø
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Grethe Skovbjerg
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Gubra, Hørsholm, Denmark
| | - Duy Anh Gurskov Nielsen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Aske Lykke Ejdrup
- Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tune H Pers
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Oksana Dmytriyeva
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Ulrik Gether
- Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kristi A Kohlmeier
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christoffer Clemmensen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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6
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Yildirim Y, Reuter L, Odah S, Petersen J, Pahrmann C, Reichenspurner H, Pecha S. Nanotechnological Coating Reduces Bacterial Growth on Vascular Prostheses: An In Vitro Bioluminescence Imaging Study. Thorac Cardiovasc Surg 2023. [DOI: 10.1055/s-0043-1761740] [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: 03/22/2023]
Affiliation(s)
- Y. Yildirim
- University Heart and Vascular Center Hamburg, Hamburg, Deutschland
| | - L. Reuter
- University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
| | - S. Odah
- University Heart and Vascular Center Hamburg, Hamburg, Deutschland
| | | | - C. Pahrmann
- University Heart and Vascular Center Hamburg, Hamburg, Deutschland
| | | | - S. Pecha
- University Heart and Vascular Center Hamburg, Hamburg, Deutschland
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7
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Petersen J, Butt JH, Yafasova A, Torp-Pedersen C, Soerensen R, Kruuse C, Vinding NE, Gundlund A, Koeber L, Fosboel EL, Oestergaard L. Prognosis and antithrombotic practice patterns in recurrent and transient atrial fibrillation following acute coronary syndrome: a nationwide study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.379] [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
First-time detected atrial fibrillation (AF) during acute coronary syndrome (ACS) aggravates the prognosis and increases the risk of ischemic stroke. In this setting, AF may present as brief and transient or with recurrent episodes after discharge. However, data on the association between transient or recurrent AF and ischemic stroke in patients with ACS are sparse. Further, despite being associated with ischemic stroke, first-time detected AF patients have been reported with low oral anticoagulation (OAC) rates.
Purpose
To examine the associated rate of ischemic stroke and mortality in ACS survivors with transient or recurrent AF and to assess the antithrombotic practice patterns one year after ACS.
Methods
Using data from Danish nationwide registries, we identified all patients with first-time ACS, without known AF prior to ACS, from 2000–2017 who were alive one year after ACS discharge (index date). According to a grace period between ACS discharge and one year after ACS discharge, patients were categorized into: i) no AF; ii) first-time detected AF during ACS admission without AF recurrence (transient AF); and iii) first-time detected AF during ACS admission with a subsequent recurrent AF episode (recurrent AF). Patients who developed AF during the grace period were excluded. Patients were followed from one year post ACS discharge, and two-year rates of ischemic stroke and mortality were compared using multivariable adjusted Cox proportional hazards analysis. Further, we assessed the prescribed OAC rates in a three-month period following the index date.
Results
We included 116,793 patients surviving one year post ACS discharge: 111,708 (95.6%) without AF (64.9% male, median age 64 years), 2,671 (2.3%) with transient AF (58.0% male, median age 74 years), and 2,414 (2.1%) with recurrent AF (55.2% male, median age 76 years). The cumulative two-year incidence of ischemic stroke was 0.9%, 1.5%, and 2.3% for patients without AF, transient AF, and recurrent AF, respectively (Figure 1). The cumulative two-year incidence of mortality was 7.4%, 12.1%, and 20.3% for patients without AF, transient AF, and recurrent AF, respectively (Figure 1). Compared to those without AF, the adjusted two-year rates of outcomes were as follows: ischemic stroke: HR 1.15 (95% CI: 0.81–1.61) for patients with transient AF and HR 1.50 (95% CI: 1.14–1.98) for patients with recurrent AF; mortality: HR 0.98 (95% CI: 0.87–1.10) for patients with transient AF and HR 1.35 (95% CI: 1.23–1.49) for patients with recurrent AF (Figure). We identified that 20.9% for transient AF and 42.2% for recurrent AF were prescribed OAC therapy in the three-month period after one year.
Conclusion
In patients surviving one year after ACS with first-time detected AF, a recurrent AF episode was associated with an increased long-term rate of ischemic stroke and mortality, while transient AF yielded no statistically difference as compared with patients without AF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Petersen
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - J H Butt
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - A Yafasova
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | | | - R Soerensen
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - C Kruuse
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - N E Vinding
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - A Gundlund
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - L Koeber
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - E L Fosboel
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - L Oestergaard
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
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8
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Tas A, Fosboel E, Butt J, Weeke P, Kristensen S, Burcharth J, Vinding N, Petersen J, Koeber L, Vester-Andersen M, Gundlund A. Perioperative atrial fibrillation in major emergency abdominal surgery: does it affect postoperative outcome? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.520] [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
Atrial fibrillation (AF) in relation to surgery remains a clinical challenge. Major emergency abdominal surgery (e.g. ileus, perforation) is associated with postoperative complications and mortality. However, the prevalence and impact of perioperative AF in this setting is not well examined.
Purpose
We compared 30-days and 1-year outcomes (i.e. hospitalization of any causes, AF-related hospitalization, thromboembolic events and all-cause mortality) in patients who did and did not develop perioperative AF (POAF) in relation to their major emergency abdominal surgery.
Methods
We crosslinked data from Danish nationwide registries and identified all patients who underwent major emergency abdominal surgery (2000–2018) and discharged alive. Patients who developed POAF during hospitalization were matched in a 1:3 ratio on age, sex, year of surgery and category of surgery with those without POAF. Starting follow up at discharge, we examined the rates of outcomes at 30-days and 1-year post-discharge. The cumulative incidences and ratios of outcomes were assessed with the Aalen Johanson estimator together with Kaplan-Meier estimator and multivariable Cox regression analysis, respectively.
Results
We identified 891 patients with POAF and 64,914 patients without POAF. The matched cohort were composed of 889 patients with POAF and 2667 patients without POAF with a median age of 79 years [25th-75th percentile; 72–84 years] and 45.2% males. In general, patients with POAF had higher comorbid burden compared with patients without POAF. The cumulative incidences of a hospitalization of any cause after 30-days post-discharge were 31.2% and 22.3% in patients with and without POAF, respectively. The corresponding numbers for AF-related hospitalization were 20.8% and 1.2%, respectively. In adjusted analyses, POAF was associated with a significantly higher risk of hospitalization of any causes together with AF-related hospitalization (Figure 1 and 2).
The cumulative incidences of a thromboembolic event after 30-days post-discharge were 2.2% and 0.9% in patients with and without POAF, respectively. The corresponding numbers for all-cause mortality were 9.7% and 3.2%, respectively. In adjusted analyses, POAF was associated with a significantly higher risk of a thromboembolic event together with all-cause mortality within 30-days of follow up as well as 1-year of follow up. However, the results regarding thromboembolic events did not reach statistical significance after 1-year of follow up (Figure 1 and 2).
Conclusions
Perioperative atrial fibrillation in relation to major emergency abdominal surgery was associated with higher 30-days and 1-year rates of hospitalizations of any causes, atrial fibrillation related hospitalization, a thromboembolic event and all-cause mortality. These findings suggest that perioperative atrial fibrillation is a strong prognostic marker of increased morbidity following major emergency abdominal surgery.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Tas
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - E Fosboel
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - J Butt
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - P Weeke
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - S Kristensen
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - J Burcharth
- Herlev-Gentofte University Hospital, Department of Surgucal Gastroenterology , Gentofte , Denmark
| | - N Vinding
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - J Petersen
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - L Koeber
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - M Vester-Andersen
- Herlev-Gentofte University Hospital, Department of Anesthesiology , Gentofte , Denmark
| | - A Gundlund
- Herlev-Gentofte University Hospital, Department of Cardiology , Gentofte , Denmark
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Wild C, Lang F, Gerhäuser AS, Schmidt MW, Kowalewski KF, Petersen J, Kenngott HG, Müller-Stich BP, Nickel F. Telestration with augmented reality for visual presentation of intraoperative target structures in minimally invasive surgery: a randomized controlled study. Surg Endosc 2022; 36:7453-7461. [PMID: 35266048 PMCID: PMC9485092 DOI: 10.1007/s00464-022-09158-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 02/18/2022] [Indexed: 11/30/2022]
Abstract
AIMS In minimally invasive surgery (MIS), intraoperative guidance has been limited to verbal communication without direct visual guidance. Communication issues and mistaken instructions in training procedures can hinder correct identification of anatomical structures on the MIS screen. The iSurgeon system was developed to provide visual guidance in the operating room by telestration with augmented reality (AR). METHODS Laparoscopic novices (n = 60) were randomized in two groups in a cross-over design: group 1 trained only with verbal guidance first and then with additional telestration with AR on the operative screen and vice versa for group 2. Training consisted of laparoscopic basic training and subsequently a specifically designed training course, including a porcine laparoscopic cholecystectomy (LC). Outcome included time needed for training, performance with Global Operative Assessment of Laparoscopic Skills (GOALS), and Objective Structured Assessment of Technical Skills (OSATS) score for LC, complications, and subjective workload (NASA-TLX questionnaire). RESULTS Telestration with AR led to significantly faster total training time (1163 ± 275 vs. 1658 ± 375 s, p < 0.001) and reduced error rates. LC on a porcine liver was performed significantly better (GOALS 21 ± 5 vs. 18 ± 4, p < 0.007 and OSATS 67 ± 11 vs. 61 ± 8, p < 0.015) and with less complications (13.3% vs. 40%, p < 0.020) with AR. Subjective workload and stress were significantly reduced during training with AR (33.6 ± 12.0 vs. 30.6 ± 12.9, p < 0.022). CONCLUSION Telestration with AR improves training success and safety in MIS. The next step will be the clinical application of telestration with AR and the development of a mobile version for remote guidance.
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Affiliation(s)
- C Wild
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - F Lang
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - A S Gerhäuser
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - M W Schmidt
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - K F Kowalewski
- Department of Urology, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - J Petersen
- German Cancer Research Center, 69120, Heidelberg, Germany
| | - H G Kenngott
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - B P Müller-Stich
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - F Nickel
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.
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Klotz S, Ketels G, Petersen J, Stock S, Girdauskas E. Interdisciplinary and cross-sectoral perioperative care model in cardiac surgery: Implementation in the setting of minimally-invasive heart valve surgery (increase) – Study protocol for a randomized controlled trial. Clin Nutr ESPEN 2022. [DOI: 10.1016/j.clnesp.2022.06.098] [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: 11/25/2022]
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Arnold S, Wallmeier P, Schubach F, Ihorst G, Aries P, Bergner R, Bremer JP, Görl N, Hellmich B, Henes J, Hoyer B, Kangowski A, Kötter I, Metzler C, Müller-Ladner U, Schaier M, Schönermark U, Thiel J, Unger L, Venhoff N, Weinmann-Menke J, Petersen J, Iking-Konert C, Lamprecht P. AB0622 The Joint Vasculitis Registry in German-speaking countries (GeVas) – subgroup analysis of 113 GPA-patients. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundGranulomatosis with polyangiitis (GPA) is the second most frequent vasculitis in Germany with an annual incidence of 34 per million and a prevalence of 210 per million [1]. GPA is characterized by its chronic course, frequent relapses, significant overall morbidity and mortality, and substantial socio-economic impact. Multiorgan involvement affecting the respiratory tract, kidney, and other organs is common. Limited variants also occur [2]. So far, prospective long-term observational data on the disease course of GPA are missing in Germany. Therefore, the Joint Vasculitis Registry in German-speaking countries (GeVas) has been established to follow the course of patients recently diagnosed with vasculitis or a change of their treatment due to a relapse (inception cohort). The GeVas registry allows long-term follow-up of a substantial cohort of vasculitis patients in a multicenter setting.ObjectivesTo present the first data on the follow-up of newly diagnosed and relapsing GPA enrolled in the GeVas registry.MethodsGeVas is a prospective, web-based, multicenter, clinician-driven registry for the documentation of organ manifestations, damage, long-term outcomes, and therapy regimens in various types of vasculitis. Recruitment started in June 2019. By January 2022, 17 centers in Germany were initiated and started enrolling patients. Meanwhile, more than 350 patients have been documented in the registry. Sites in Austria and the German-speaking cantons of Switzerland will be integrated soon [3].ResultsBy mid-October 2021, the participating centers included 113 patients with GPA. The majority of patients were PR3-ANCA positive and affected by general symptoms, ENT, lung, renal, and neurological involvement. Patients commonly received cyclophosphamide or rituximab in combination with glucocorticoids for the induction of remission. Fewer patients received methotrexate or other immunosuppressants. Patient characteristics and therapy are summarized in Table 1.Table 1.Patient characteristics (n = 113). *Unless otherwise specified.CategoryFeaturen (%)*AgeAge (years); median [range]60 [51 - 70]GenderMale61 (54.0)Female52 (46.0)Reason for inclusion in the registryNewly diagnosed vasculitis57 (51.4)Relapse56 (49.6)ANCA statusPR3-ANCA99 (87.6)MPO-ANCA4 (3.6)ANCA negative9 (7.9)Organ manifestationGeneral symptoms86 (76.1)ENT69 (61.1)Lung/chest66 (58.4)Renal35 (31.0)Cardiovascular7 (6.2)GI3 (2.7)Neurological27 (23.9)TherapyGlucocorticoid102 (90.3)Rituximab56 (49.6)Cyclophosphamide37 (32.7)Methotrexate and other immunosuppressants, respectively26 (23.0) and 19 (16.8), respectivelyConclusionHere, we present the first interim analysis of the GeVas registry. Clinical manifestations of GPA reported herein show less frequent renal involvement in comparison with a recent report from another European registry (POLVAS) and an UK study [4, 5]. This is potentially related to the predominance of recruiting rheumatology centers thus far. By contrast, respiratory tract involvement is more frequent and PR3-ANCA less common in Japan [5]. Further data are prospectively documented and a follow up analysis is in progress.References[1]Hellmich B, et al. New insights into the epidemiology of ANCA-associated vasculitides in Germany: results from a claims data study. Rheumatology 2021;60:4868-73.[2]Kitching AR, et al. ANCA-associated vasculitis. Nat Rev Dis Primers 2020;6:71.[3]Iking-Konert C, et al. The Joint Vasculitis Registry in German-speaking countries (GeVas) – a prospective, multicenter registry for the follow-up of long-term outcomes in vasculitis. BMC Rheumatol 2021;5:40.[4]Wójcik K, et al. Clinical characteristics of Polish patients with ANCA-asscoiated vasculitides – retrospective analysis of POLVAS registry. Clin Rheumatol 2019;38:2553-63.[5]Furuta S, et al. Comparison of the phenotype and outcome of granulomatosis with polyangiitis between UK and Japanese cohorts. J Rheumatol 2017;44:216-22.AcknowledgementsGeVas was supported by unrestricted grants by: DGRh, John Grube Foundation, Vifor and Roche PharmaDisclosure of InterestsSabrina Arnold: None declared, Pia Wallmeier: None declared, Fabian Schubach: None declared, Gabriele Ihorst: None declared, Peer Aries: None declared, Raoul Bergner Consultant of: VIFOR, Jan Philip Bremer: None declared, Norman Görl: None declared, Bernhard Hellmich: None declared, Jörg Henes: None declared, Bimba Hoyer: None declared, Antje Kangowski: None declared, Ina Kötter: None declared, Claudia Metzler: None declared, Ulf Müller-Ladner: None declared, Matthias Schaier: None declared, Ulf Schönermark: None declared, Jens Thiel: None declared, Leonore Unger: None declared, Nils Venhoff Speakers bureau: Roche and Vifor: speaker honoraries, Consultant of: Roche and Vifor: advisory boards, Grant/research support from: John-Grube Research Award 2021, Julia Weinmann-Menke: None declared, Jana Petersen: None declared, Christof Iking-Konert Speakers bureau: Lecture fees from: Chugai, GSK, Roche, and Vifor, Consultant of: Consulting fees from: Chugai, GSK, Roche, and Vifor, Grant/research support from: Research grants for GeVas: Roche, Vifor, DGRh, John Grube Foundation, Peter Lamprecht Speakers bureau: Chugai, GSK, Roche, and Vifor, Consultant of: Chugai, GSK, Roche, and Vifor, Grant/research support from: DGRh, John Grube Foundation, Roche, and Vifor
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Wallmeier P, Arnold S, Schubach F, Ihorst G, Aries P, Bergner R, Bremer JP, Görl N, Hellmich B, Henes J, Hoyer B, Kangowski A, Kötter I, Magnus T, Metzler C, Müller-Ladner U, Schaier M, Schönermark U, Thiel J, Unger L, Venhoff N, Weinmann-Menke J, Petersen J, Lamprecht P, Iking-Konert C. POS0800 THE JOINT VASCULITIS REGISTRY IN GERMAN-SPEAKING COUNTRIES (GeVas) – SUBGROUP ANALYSIS OF 131 GCA-PATIENTS REFERENCES:. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe most frequent form of vasculitis in elderly people is giant cell arteritis (GCA) with an annual incidence rate less than 10 per 100,000 persons over the age of 50. Like most vasculitides, GCA is characterized by chronicity and relapses, leading to significant overall morbidity and higher mortality in a subset of patients with aortic involvement and dissection. Most studies carried out so far have been retrospective, used monocentric study designs and small patient cohorts. Therefore, the Joint Vasculitis Registry in German-speaking countries (GeVas) has been established to record patients, who have been recently diagnosed with vasculitis or who have changed their treatment due to a relapse (inception cohort). The GeVas-Registry allows a long-term follow-up of a substantial cohort of vasculitis patients in a prospective and multicenter manner.ObjectivesTo describe the subgroup of GCA and its characteristics within the GeVas registry.MethodsGeVas is a prospective, web-based, multicenter, clinician-driven registry for the documentation of organ manifestations, damage, long-term outcomes, and therapy regimens in various types of vasculitis. Recruitment started in June 2019. By January 2022, 17 centers in Germany were initiated and have begun enrolling patients. Meanwhile, more than 350 patients have been documented in the registry. Sites in Austria and the German-speaking cantons of Switzerland will be integrated soon (1).ResultsBy mid-October 2021, the participating centers recruited 131 GCA patients into the registry. 21.7% of patients (n=28) were enrolled in the registry due to relapse, and 78.3% (n=101) due to a first-time diagnosis. In accordance with long-standing epidemiology data, the majority of patients (67,2%), were female (n=88), and 32.8% (n=43) were male. Mean age was 74 years (max. 92y, min. 52y). The most frequently recorded organ manifestations in GCA patients addressed cranial and ophthalmic symptoms, and the cardiovascular system. However, vascular lung/chest involvement was also observed in 3% of cases (n=4). Out of the 131 patients, 97.7% (n=128) received immunosuppressive therapy, three refused to take any medication. An equal number of patients were treated with glucocorticoid (GC) therapy. While about two equal parts were treated by stable long term oral GC therapy (47,7%, n=62) or by i.v. pulse therapy followed by tapering (49,2%, n=64), only about 2.3% (n=3) were treated by oral GC therapy with intermittent i.v. pulses. 48.5% (n=63) of patients received tocilizumab as additional immunosuppressive therapy, 19.2% (n=25) methotrexate, and 18.5% (n=24) cyclophosphamide i.v. pulses.ConclusionIn June 2019, we successfully established the prospective multicenter vasculitis registry GeVAS. It describes the first systematically recorded prospective GCA cohort in German-speaking countries. Its characteristics correspond to those that can be expected from the literature, with some unexpected finding e.g. the high proportion of patients treated with cyclosphosphamid, probably reflecting a sicker patient population with e.g. aortic or central nervous involvement. After 2.5 years of follow-up documentation, the first long-term results will be systematically evaluated and interpreted. The newly acquired data on disease manifestation, diagnostics and therapy regimens will provide important insights into the treatment of GCA patients in Germany and may generate further research goals.ReferencesTrial registration: German Clinical Trials Register (Deutsches Register Klinischer Studien): DRKS00011866. Registered 10 May 2019. 3[1]C Iking-Konert; P Wallmeier; S Arnold; S Adler; K de Groot; B Hellmich; B Hoyer; K Holl-Ulrich; Ihorst; M Kaufmann; I Kötter; U Müller-Ladner; T Magnus; J. Rech; H. Schulze-Koops; N. Venhoff; T. Wiech; P. Villiger; F. Schubach; P. Lamprecht. The Joint Vasculitis Registry in German-speaking countries (GeVas) – a prospective, multicenter registry for the follow-up of long-term outcomes in vasculitis. BMC Rheumatol. 2021 Jul 31;5(1):40. doi: 10.1186/s41927-021-00206-2.AcknowledgementsGeVas was supported by unrestricted grants by: DGRh, John Grube Foundation, Vifor and Roche PharmaDisclosure of InterestsPia Wallmeier: None declared, Sabrina Arnold: None declared, Fabian Schubach: None declared, Gabriele Ihorst: None declared, Peer Aries: None declared, Raoul Bergner Consultant of: Advisory Board VIFOR, Grant/research support from: John-Grube Research Award 2021, Jan Philip Bremer: None declared, Norman Görl: None declared, Bernhard Hellmich: None declared, Jörg Henes: None declared, Bimba Hoyer: None declared, Antje Kangowski: None declared, Ina Kötter: None declared, Tim Magnus: None declared, Claudia Metzler: None declared, Ulf Müller-Ladner: None declared, Matthias Schaier: None declared, Ulf Schönermark: None declared, Jens Thiel: None declared, Leonore Unger: None declared, Nils Venhoff Speakers bureau: Roche and Vifor, Consultant of: Roche and Vifor, Grant/research support from: John-Grube Research Award 2021, Julia Weinmann-Menke: None declared, Jana Petersen: None declared, Peter Lamprecht Speakers bureau: Lecture fees from: Chugai, GSK, Roche, Consultant of: Consulting & lecture fees from: Chugai, GSK, Roche, and Vifor., Grant/research support from: Research grants for GeVas: DGRh, John Grube Foundation, Roche, and Vifor, Christof Iking-Konert Speakers bureau: lecture fees from: Chugai, GSK, Roche, and Vifor., Consultant of: Consulting fees from: Chugai, GSK, Roche, and Vifor., Grant/research support from: Research grants for GeVas: DGRh, John Grube Foundation, Roche, and Vifor;
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Ismaili D, Gurr K, Horvath A, Yuan L, Lemoine MD, Schulz C, Sani J, Petersen J, Reichenspurner H, Kirchhof P, Jespersen T, Eschenhagen T, Hansen A, Koivumaki JT, Christ T. Regulation of APD and force by Na+/Ca2+ exchanger in hiPSC-cardiomyocytes. Europace 2022. [DOI: 10.1093/europace/euac053.625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): BMBF
Introduction
Human induced pluripotent stem cell-derived cardiomyocytes (HiPSC-CM) are an emerging, powerful tool to study human cardiac physiology, pharmacology and toxicology, to model cardiovascular diseases or even to use for cardiac repair. Understanding the similarities and differences between hiPSC-CM and adult human cardiomyocytes is critical for their use. Here we focus on sodium calcium exchanger (NCX) who plays a crucial role in the Ca2+-homeostasis in the mammalian heart. Importantly, alterations in NCX expression in human heart are associated with various cardiac pathologies such as heart failure or arrhythmias. In order to investigate whether hiPSC-CM could serve as model for adult human heart NCX we measured the properties of NCX in hiPSC-CM and human ventricular tissue. Rat ventricular tissue was used for comparison.
Methods
HiPSC-CM were differentiated from a healthy iPSC line and dissociated from engineered heart tissue (EHT). Adult human and rat cardiomyocytes were digested from ventricular samples. We measured NCX current by the whole-cell patch clamp technique at 37 °C. Standard sharp microelectrodes were used to record action potentials (AP). Contractile force in human and rat ventricular samples was measured isometrically. A video-optical contractility test system was used to measure force in EHT. SEA0400 (10 µM) was used to block NCX.
Results
NCX currents could be measured in every hiPSC-CM. The NCX current densities in hiPSC-CM were larger than in human ventricular cardiomyocytes (3.2±0.2 pA/pF n=28 vs. 1.3±0.2 pA/pF n=15, p<0.05), but lower than reported for rat left ventricular cardiomyocytes using the same protocol. SEA0400 shortened APD90 markedly in EHT (264.1±24.9 ms to 191±31.6 ms, n=4) and to a lesser extent in rat ventricular tissue (54.4±3.9 ms to 48.9±4.2 ms, n=7). Shortening in human left ventricular preparations was tiny (320±22.1 ms to 305.5±20.3 ms, n=6) and not different from time-matched controls (TMC). Resting membrane potential, action potential amplitude and upstroke velocity were not affected neither in EHT nor in left ventricular preparations (rat and human). Force was significantly increased by NCX block in rat ventricle (by 31±5.4%, n=18) and EHT (by 20.8±3.9%, n=4), but in human left ventricular preparations there was only a tendency to attenuate spontaneous run-down (-3.7±4.3% n=8 with SEA vs. -6.2±3.7% n=12 in TMC).
Conclusion
HiPSC-CM possess NCX in the physiological range. HiPSC-CM show NCX-effects on APD and force as predicted from rat ventricle and in full accordance with cardiac physiology. Lack of NCX effect in human adult ventricles that had been already reported previously needs further investigations.
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Affiliation(s)
- D Ismaili
- University Heart & Vascular Center Hamburg, Department of Cardiology, Hamburg, Germany
| | - K Gurr
- University Medical Center Hamburg Eppendorf, Institute of Experimental Pharmacology and Toxicology, Hamburg, Germany
| | - A Horvath
- University Medical Center Hamburg Eppendorf, Institute of Experimental Pharmacology and Toxicology, Hamburg, Germany
| | - L Yuan
- University Medical Center Hamburg Eppendorf, Institute of Experimental Pharmacology and Toxicology, Hamburg, Germany
| | - MD Lemoine
- University Heart & Vascular Center Hamburg, Department of Cardiology, Hamburg, Germany
| | - C Schulz
- University Medical Center Hamburg Eppendorf, Institute of Experimental Pharmacology and Toxicology, Hamburg, Germany
| | - J Sani
- University Medical Center Hamburg Eppendorf, Institute of Experimental Pharmacology and Toxicology, Hamburg, Germany
| | - J Petersen
- University Heart & Vascular Center Hamburg, Department of Cardiovascular Surgery, Hamburg, Germany
| | - H Reichenspurner
- University Heart & Vascular Center Hamburg, Department of Cardiovascular Surgery, Hamburg, Germany
| | - P Kirchhof
- University Heart & Vascular Center Hamburg, Department of Cardiology, Hamburg, Germany
| | - T Jespersen
- University of Copenhagen, Department of Biomedical Sciences, Copenhagen, Denmark
| | - T Eschenhagen
- University Medical Center Hamburg Eppendorf, Institute of Experimental Pharmacology and Toxicology, Hamburg, Germany
| | - A Hansen
- University Medical Center Hamburg Eppendorf, Institute of Experimental Pharmacology and Toxicology, Hamburg, Germany
| | - JT Koivumaki
- Tampere University, BioMediTech, Faculty of Medicine and Health Technology, Tampere, Finland
| | - T Christ
- University Medical Center Hamburg Eppendorf, Institute of Experimental Pharmacology and Toxicology, Hamburg, Germany
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Smith A, Petersen J, Wahlstedt I, Risumlund S, Felter M, Hansen V, Vogelius I. PD-0065 Corrective-annotation auto-completion enables faster organ contouring. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02735-9] [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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Sjölin M, Vogelius I, K N, Jensen G, Bak M, Kjær-Kristoffersen F, Nøttrup T, Friborg J, Hansen V, Petersen J. PO-1634 QA of dose originating from deformable image registration of planning CT to CBCT on the Ethos system. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03598-8] [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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Forbes N, Smith A, Petersen J, Terrones-Campos C, Reekie J, Darkner S, Specht L, Vogelius I. MO-0716 Radiotherapy exposure and association with observed cardiovascular toxicity in over 5000 patients. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02414-8] [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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Jensen S, Erichsen T, Jensen M, Balling P, Petersen J, Poulsen P, Muren L. PO-1572 Development of deformable 3D anthropomorphic dosimetry systems for proton therapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03536-8] [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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von Stuelpnagel CC, Petersen J, Augustin M, Sommer R. [Dermatological care of elderly people with psoriasis before and after entering a nursing home : A qualitative analysis from the perspective of medical providers]. Hautarzt 2022; 73:627-633. [PMID: 35482046 PMCID: PMC9047578 DOI: 10.1007/s00105-022-04989-4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 11/22/2022]
Abstract
Hintergrund Demografische Veränderungen bewirken einen steilen Anstieg der Anzahl der über 65-Jährigen. Damit verbunden ist die Zunahme der Anzahl pflegebedürftiger, multimorbid Erkrankter. National wie auch international gibt es keine Informationen insbesondere zur Versorgung von Psoriasiserkrankten im Setting Pflegeheim und zur Frage, wie diese durch den Eintritt in ein Pflegeheim beeinflusst wird. Fragestellung Ziel war es, anhand von Interviews bzw. Fokusgruppen die Ergebnisse vorausgehender Routinedatenanalysen zur Versorgung Psoriasiserkrankter in Pflegeheimen mit medizinischen Versorgern (Dermatologen, Allgemeinmediziner, Pflegedienstleitungen und Pflegekräfte) zu diskutieren, Schwierigkeiten der Versorgung aufzudecken und abschließend Handlungsempfehlungen für eine zukunftsfähige gerontodermatologische Versorgung abzuleiten. Material und Methoden Durchgeführt wurden qualitative Leitfaden-gestützte Interviews und Fokusgruppen mit Dermatologen (n = 5), Allgemeinmedizinern (n = 7), Pflegekräften (n = 7) und Pflegedienstleitungen (n = 2). Die Daten wurden inhaltsanalytisch ausgewertet. Ergebnisse Die Auswertung ergab insgesamt 344 Aussagen, die insgesamt 14 Hauptkategorien zugeordnet werden konnten. Die Ergebnisse zeigen, dass für die Versorgungsqualität von Menschen mit Hautkrankheiten, insbesondere Psoriasis, in Pflegeinrichtungen ein Verbesserungsbedarf besteht. Dieser zeigt sich sowohl auf ärztlicher als auch auf pflegerischer Ebene. Laut der Versorger (N = 21) kann dies insbesondere durch eine verstärkte digitale Versorgung, dermatologische Schulungen für Hausärzte und Pflegefachkräfte sowie engere Kooperationen zwischen den einzelnen Disziplinen adressiert werden. Schlussfolgerung Digitale Pflegekonsile, aber auch eine spezifische Leitlinie zur „Haut des alternden Menschen“ können von Nutzen sein, um die dermatologische Versorgungssituation im Pflegeheim zu verbessern und somit das Wohlbefinden der Betroffenen zu steigern.
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Affiliation(s)
- C C von Stuelpnagel
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - J Petersen
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - M Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - R Sommer
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
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Von Stumm M, Petersen J, Pausch J, Holst T, Gross TS, Sinn M, Reichenspurner H, Girdauskas E. Valvular Cardiomyopathy Persists Postoperatively in Aortic Regurgitation Patients: Data from cMRI-Based Cohort Study. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742919] [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)
- M. Von Stumm
- Deutsches Herzzentrum München, München, Deutschland
| | | | - J. Pausch
- Department of Cardiovascular Surgery, University Heart Center Hamburg GmbH, Hamburg, Deutschland
| | - T. Holst
- Universitäres Herzzentrum Hamburg GmbH Abteilung für Herzchirurgie und Gefäßchirurgie, Hamburg, Deutschland
| | - T.M. Sequeira Gross
- Department of Cardiac and Thoracic Surgery, University Hospital Augsburg, Augsburg, Deutschland
| | - M. Sinn
- Hamburg, Hamburg, Deutschland
| | | | - E. Girdauskas
- Department of Cardiovascular Surgery, University Heart Center, Augsburg, Deutschland
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20
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Stolfa P, Petersen J, Alassar Y, Reichenspurner H, Pecha S. Predictors of Rhythm Outcome in Patients Undergoing Concomitant AF Ablation: A Single-Center Experience of More than 1,000 Patients. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742808] [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. Stolfa
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herzchirurgie, Hamburg, Deutschland
| | - J. Petersen
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herzchirurgie, Hamburg, Deutschland
| | - Y. Alassar
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herzchirurgie, Hamburg, Deutschland
| | - H. Reichenspurner
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herzchirurgie, Hamburg, Deutschland
| | - S. Pecha
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herzchirurgie, Hamburg, Deutschland
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21
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Pecha S, Yildirim Y, Petersen J, Tönnis T, Kirchhof P, Reichenspurner H. Minimally Invasive Epicardial Left-Ventricular Lead Implantation and Simultaneous Left Atrial Appendage Clipping. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742809] [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)
- S. Pecha
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - Y. Yildirim
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - J. Petersen
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - T. Tönnis
- Kardiologie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Kardiologie, Hamburg, Deutschland
| | - P. Kirchhof
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Kardiologie, Hamburg, Deutschland
| | - H. Reichenspurner
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
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22
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Yildirim Y, Yildirim S, Petersen J, Alassar Y, Sinning C, Conradi L, Reichenspurner H, Pecha S. Left-Atrial Strain Predicts Rhythm Outcome in Patients with Persistent Atrial Fibrillation Undergoing Left-Atrial Cryoablation during Minimally Invasive Endoscopic Mitral Valve Repair. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742939] [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)
- Y. Yildirim
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - S. Yildirim
- Kardiologie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Kardiologie, Hamburg, Deutschland
| | - J. Petersen
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - Y. Alassar
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - C. Sinning
- Kardiologie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Kardiologie, Hamburg, Deutschland
| | - L. Conradi
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - H. Reichenspurner
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - S. Pecha
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
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23
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Petersen J, Meißner V, Wosgien K, Vettorazzi E, Blankenberg S, Conradi L, Girdauskas E, Reichenspurner H. Physical and Mental Recovery in Patients with Severe Aortic Valve Stenosis at Low-to-Intermediate Risk: SAVR versus TAVR. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742923] [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)
| | - V. Meißner
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Deutschland
| | - K. Wosgien
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Deutschland
| | - E. Vettorazzi
- Department of Medical Biometry and Epidemiology, Hamburg, Deutschland
| | | | | | - E. Girdauskas
- Department of Cardiac and Thoracic Surgery, University Hospital Augsburg, Augsburg, Deutschland
| | - H. Reichenspurner
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
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24
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Holst T, Petersen J, Waschki B, Sinning C, Rybczynski M, Reichenspurner H, Girdauskas E. Evaluation of Exercise Capacity after Aortic Valve Surgery for Aortic Regurgitation in Nonelderly Patients: Repair versus Replacement. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742918] [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)
- T. Holst
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - J. Petersen
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - B. Waschki
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Kardiologie, Hamburg, Deutschland
| | - C. Sinning
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Kardiologie, Hamburg, Deutschland
| | - M. Rybczynski
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Kardiologie, Hamburg, Deutschland
| | - H. Reichenspurner
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - E. Girdauskas
- Klinik für herz- und thoraxchirurgie, Universitätsklinikum Augsburg, Augsburg, Deutschland
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25
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Bavo F, de-Jong H, Petersen J, Falk-Petersen CB, Löffler R, Sparrow E, Rostrup F, Eliasen JN, Wilhelmsen KS, Barslund K, Bundgaard C, Nielsen B, Kristiansen U, Wellendorph P, Bogdanov Y, Frølund B. Structure-Activity Studies of 3,9-Diazaspiro[5.5]undecane-Based γ-Aminobutyric Acid Type A Receptor Antagonists with Immunomodulatory Effect. J Med Chem 2021; 64:17795-17812. [PMID: 34908407 DOI: 10.1021/acs.jmedchem.1c00290] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The 3,9-diazaspiro[5.5]undecane-based compounds 2027 and 018 have previously been reported to be potent competitive γ-aminobutyric acid type A receptor (GABAAR) antagonists showing low cellular membrane permeability. Given the emerging peripheral application of GABAAR ligands, we hypothesize 2027 analogs as promising lead structures for peripheral GABAAR inhibition. We herein report a study on the structural determinants of 2027 in order to suggest a potential binding mode as a basis for rational design. The study identified the importance of the spirocyclic benzamide, compensating for the conventional acidic moiety, for GABAAR ligands. The structurally simplified m-methylphenyl analog 1e displayed binding affinity in the high-nanomolar range (Ki = 180 nM) and was superior to 2027 and 018 regarding selectivity for the extrasynaptic α4βδ subtype versus the α1- and α2- containing subtypes. Importantly, 1e was shown to efficiently rescue inhibition of T cell proliferation, providing a platform to explore the immunomodulatory potential for this class of compounds.
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Affiliation(s)
- Francesco Bavo
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Heleen de-Jong
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Jonas Petersen
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen, Denmark
| | - Christina Birkedahl Falk-Petersen
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Rebekka Löffler
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Emma Sparrow
- Antibody and Vaccine Group, Centre for Cancer Immunology, MP127, University of Southampton Faculty of Medicine, Southampton, Hants SO16 6YD, United Kingdom
| | - Frederik Rostrup
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Jannik Nicklas Eliasen
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Kristine S Wilhelmsen
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Kasper Barslund
- Translational DMPK, H. Lundbeck A/S, Ottiliavej 9, 2500 Valby, Denmark
| | | | - Birgitte Nielsen
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Uffe Kristiansen
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Petrine Wellendorph
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Yury Bogdanov
- Antibody and Vaccine Group, Centre for Cancer Immunology, MP127, University of Southampton Faculty of Medicine, Southampton, Hants SO16 6YD, United Kingdom
| | - Bente Frølund
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
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26
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Backer V, Aanaes K, Hansen S, Petersen J, von Buchwald C. Global airways – a novel Standard Tests for Asthma, allergic Rhinitis, and chronic Rhinosinusitis (STARR-15). Rhinology 2021; 60:63-72. [DOI: 10.4193/rhin21.195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background: Global airway disease, with symptoms from both upper and lower airways, is a challenging problem for clinicians. Our goal is to design one single standard test for the awareness of global airway diseases to be used in clinical setting. Material and Methods: During 2019, rhinologists and pulmonologists generated a pool of items based on literature, patient-reported outcome measures and clinical experience. The items were administered to 206 patients with known asthma, CRS, allergic rhinitis, or a combination thereof. The patients also completed the Asthma Control Questionnaire (ACQ-5) and the Sino-Nasal Outcome Test (SNOT-22). Using a mix of clinical knowledge and data-driven methods a global airways questionnaire was developed. Results: Mean ACQ score was highest in patients with all three, whereas the highest SNOT-22 score was observed in patients with CRS and asthma. After the development process, analysis of responses from 206 patients to 44 items on a new global airway’s questionnaire led to identification of 15 items that form the STARR-15 questionnaire with three underlying domains (an allergic rhinitis sub-factor, a CRS sub-factor and an asthma sub-factor). Conclusion: STARR-15 represents the first global airways questionnaire, to be used when examining patients with upper and lower airways symptoms. Future analyses are warranted to evaluate the clinical and psychometric properties of STARR-15.
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27
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Reid A, Klein A, Lin D, Abbate A, Luis SA, Petersen J, Portman M, Winnowski D, Malinowski A, Marden L, Paolini JF, Martin D. RESONANCE Registry: rationale and design of the retrospective and prospective longitudinal, observational registry in pediatric and adult patients with recurrent pericarditis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3173] [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
Annually in the United States (US), an estimated 80–90,000 patients are diagnosed with acute pericarditis and 15–30% experience recurrent pericarditis (RP), resulting in increased morbidity and reduced health-related quality of life (HRQoL). Treatment options include non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine. Corticosteroids (CS) are often added to the treatment plan in RP despite CS-associated adverse events and inherent potentiation of recurrence with long-term treatment. A recent Phase 3 clinical trial RHAPSODY (NCT03737110) demonstrated efficacy and safety of rilonacept, an interleukin-1 α and β cytokine trap, in patients with RP. RHAPSODY data helped support FDA approval of the first therapy for RP. With the emergence of this targeted therapy, there is increased interest to learn more about this disease with the goal to better inform treatment and management decisions and improve long-term outcomes.
Purpose
RESONANCE Registry aims to evaluate the natural history of RP by collecting retrospective and prospective, longitudinal physician- and patient-reported outcomes data in real-world clinical practice across the US.
Methods
RP patients with active disease (recurrence within 3 years) will have both retrospective and prospective data collected (Figure 1) for as long as their RP is managed up to 5 years. For patients with inactive disease (no recurrence within 3 years), data collection will be retrospective (Figure 2). Up to 500 patients in the US are planned for enrollment at pediatric and adult medical centers, with the potential for expansion to European sites. Additionally, patients will be recruited through a novel, internet-based technology platform and screened for eligibility at a “decentralized” trial site. The registry will include variables obtained from health records, including baseline characteristics and medical history, as well as patient reported outcome (PRO) measures collected every 3 months. The RESONANCE protocol is designed to include a broad population of pediatric and adult patients, regardless of etiology or treatment course, including patients treated with rilonacept. Data will be analyzed to understand disease heterogeneity, variability in treatment and management, and impact on HRQoL. The protocol and Case Report Forms (CRFs) were developed in collaboration with physicians, patients, and patient advocates.
Conclusions
Registries utilize real-world data to fill knowledge gaps in the management of less common diseases such as RP. The RESONANCE Registry is the first RP registry designed to collect data across a broad range of patients regardless of treatment. The registry will also serve as a connection point for physicians to further educate and empower patients with information about their disease. In addition, PRO data may enable greater insights into the understanding of the burden of RP from the patient's perspective.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Kiniksa Pharmaceuticals
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Affiliation(s)
- A Reid
- Kiniksa Pharmaceuticals Corp., Lexington, United States of America
| | - A Klein
- Cleveland Clinic, Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Cleveland, United States of America
| | - D Lin
- Abbott Northwestern Hospital, Minneapolis Heart Institute, Minneapolis, United States of America
| | - A Abbate
- Virginia Commonwealth University, VCU Pauley Heart Center, Richmond, United States of America
| | - S A Luis
- Mayo Clinic, Division of Cardiovascular Ultrasound, Department of Cardiovascular Medicine, Rochester, United States of America
| | - J Petersen
- Swedish Medical Center, Seattle, United States of America
| | - M Portman
- Seattle Children's Hospital, Seattle, United States of America
| | - D Winnowski
- Pericarditis Alliance, Albany, United States of America
| | - A Malinowski
- Kiniksa Pharmaceuticals Corp., Lexington, United States of America
| | - L Marden
- Kiniksa Pharmaceuticals Corp., Lexington, United States of America
| | - J F Paolini
- Kiniksa Pharmaceuticals Corp., Lexington, United States of America
| | - D Martin
- Kiniksa Pharmaceuticals Corp., Lexington, United States of America
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28
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Isensee J, van Cann M, Despang P, Araldi D, Moeller K, Petersen J, Schmidtko A, Matthes J, Levine JD, Hucho T. Depolarization induces nociceptor sensitization by CaV1.2-mediated PKA-II activation. J Cell Biol 2021; 220:212600. [PMID: 34431981 PMCID: PMC8404467 DOI: 10.1083/jcb.202002083] [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: 02/13/2020] [Revised: 06/14/2021] [Accepted: 08/05/2021] [Indexed: 01/20/2023] Open
Abstract
Depolarization drives neuronal plasticity. However, whether depolarization drives sensitization of peripheral nociceptive neurons remains elusive. By high-content screening (HCS) microscopy, we revealed that depolarization of cultured sensory neurons rapidly activates protein kinase A type II (PKA-II) in nociceptors by calcium influx through CaV1.2 channels. This effect was modulated by calpains but insensitive to inhibitors of cAMP formation, including opioids. In turn, PKA-II phosphorylated Ser1928 in the distal C terminus of CaV1.2, thereby increasing channel gating, whereas dephosphorylation of Ser1928 involved the phosphatase calcineurin. Patch-clamp and behavioral experiments confirmed that depolarization leads to calcium- and PKA-dependent sensitization of calcium currents ex vivo and local peripheral hyperalgesia in the skin in vivo. Our data suggest a local activity-driven feed-forward mechanism that selectively translates strong depolarization into further activity and thereby facilitates hypersensitivity of nociceptor terminals by a mechanism inaccessible to opioids.
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Affiliation(s)
- Jörg Isensee
- Department of Anesthesiology and Intensive Care Medicine, Translational Pain Research, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Marianne van Cann
- Department of Anesthesiology and Intensive Care Medicine, Translational Pain Research, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Patrick Despang
- Department of Pharmacology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Dioneia Araldi
- Division of Neuroscience, Departments of Medicine and Oral & Maxillofacial Surgery, University of California, San Francisco, San Francisco, CA
| | - Katharina Moeller
- Department of Anesthesiology and Intensive Care Medicine, Translational Pain Research, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Jonas Petersen
- Institute for Pharmacology and Clinical Pharmacy, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Achim Schmidtko
- Institute for Pharmacology and Clinical Pharmacy, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jan Matthes
- Department of Pharmacology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Jon D Levine
- Division of Neuroscience, Departments of Medicine and Oral & Maxillofacial Surgery, University of California, San Francisco, San Francisco, CA
| | - Tim Hucho
- Department of Anesthesiology and Intensive Care Medicine, Translational Pain Research, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
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29
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Sprenger J, Petersen J, Neumann N, Reichenspurner H, Russ D, Detter C, Schlaefer A. Tracking heart surface features to determine myocardial contrast agent enrichment. Current Directions in Biomedical Engineering 2021. [DOI: 10.1515/cdbme-2021-1012] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Fluorescent cardiac imaging can be applied for intraoperative quality control after a coronary bypass grafting surgery to ensure the myocardial perfusion by evaluating the increasing contrast agent enrichment in the heart. The motion due to the beating heart impedes the interpretation of the contrast agent enrichment in the vessels and leads to noisy enrichment curves. We propose tracking of the heart surface features to compensate for the motion of the beating heart and thereby improve the analysis of the contrast agent enrichment. Furthermore, we propose a vessel segmentation pipeline for a local evaluation of contrast agent enrichment directly in the vessels.
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Affiliation(s)
- J. Sprenger
- Institute of Medical Technology and Intelligent Systems, Hamburg University of Technology, Hamburg , Germany
| | - J. Petersen
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg , Germany
| | - N. Neumann
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Hospital Hamburg-Eppendorf, Hamburg , Germany
| | - H. Reichenspurner
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg , Germany
| | - D. Russ
- Institut für Lasertechnologien in der Medizin und Meßtechnik, University of Ulm, Ulm , Germany
| | - C. Detter
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg , Germany
| | - A. Schlaefer
- Institute of Medical Technology and Intelligent Systems, Hamburg University of Technology, Hamburg , Germany
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30
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Augustin M, Garbe C, Hagenström K, Petersen J, Pereira MP, Ständer S. Prevalence, incidence and presence of comorbidities in patients with prurigo and pruritus in Germany: A population-based claims data analysis. J Eur Acad Dermatol Venereol 2021; 35:2270-2276. [PMID: 34192369 DOI: 10.1111/jdv.17485] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/07/2021] [Accepted: 06/17/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND There are currently no published population-based data on prurigo and pruritus epidemiology in Germany. OBJECTIVES We present the prevalence, incidence and comorbidity frequency of prurigo and pruritus in Germany. METHODS This was a retrospective healthcare research study based on anonymized routine data from the German health insurance company DAK-Gesundheit. Evaluations were carried out for 2 006 003 adults who were insured as of 31 December 2010. Prurigo and pruritus diagnoses were based on International Classification of Diseases, Tenth Revision, German Modification (ICD-10-GM) codes. RESULTS Prevalence was determined to be 0.21% (adjusted for sex and age 0.19%) for prurigo and 2.21% (adjusted 2.14%) for pruritus in 2010. The adjusted rates extrapolated to the total German population in 2010 show that 130 685 adults would have received a prurigo diagnosis and 1 461 024 a diagnosis of pruritus. In 2011, incidence of new prurigo and pruritus cases was 0.13% (adjusted 0.12%, extrapolated 77 263 cases) and 1.51% (adjusted 1.46%, extrapolated 978 885), respectively. Adults with prurigo suffered most frequently from hypertension (35.16%), hyperlipidaemia (24.95%) and depression (21.97%); all were reported more frequently in patients with prurigo compared with the general population (P < 0.001). Similarly, adults with pruritus suffered most frequently from hypertension (31.28%), hyperlipidaemia (23.52%) and depression (18.91%) compared with patients without pruritus (P < 0.001). CONCLUSIONS Our data show that prurigo is a relatively rare but significant disease and that pruritus is frequent and very variable in appearance, and both have a high comorbidity burden.
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Affiliation(s)
- M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - C Garbe
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - K Hagenström
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - J Petersen
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M P Pereira
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - S Ständer
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
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31
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Pacheco C, AlBadri A, Anderson R, Petersen J, Marpuri S, Cook-Wiens G, Pepine C, Mancini G, Merz CB, Wei J. Coronary atheroma burden predicts flow reserve in women with ischemia and nonobstructive coronary artery disease. Am Heart J Plus 2021; 6:100027. [PMID: 38560556 PMCID: PMC10976284 DOI: 10.1016/j.ahjo.2021.100027] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/10/2021] [Accepted: 06/10/2021] [Indexed: 04/04/2024]
Abstract
Background Women with signs and symptoms of ischemia and no obstructive coronary artery disease often have coronary microvascular dysfunction (CMD) with reduced coronary flow reserve (CFR), and compensatory coronary remodeling. Angiographic measurements of epicardial coronary anatomy (AMCA) may improve understanding of relations between CFR and atherosclerosis. We investigated AMCA and CFR in women evaluated for CMD. Methods Women consecutively enrolled in the Women's Ischemia Syndrome Evaluation CVD Continuation (NCT00832702) were included. All underwent clinically indicated coronary function testing measuring CFR. AMCA included coronary angiographic atheroma burden (AB), percent diameter stenosis (PDS), and tapering reference diameter Z score (RDZ), derived for the left main and left anterior descending coronary epicardial segments. Results The 51 women were aged 55.8 ± 10.8 years, with 19(38%) hypertensive, 10(20.4%) hyperlipidemic, 4(7.8%) diabetic, 13(25.5%) prior smokers, and mean CFR 3.0 ± 0.8. Both average and maximal AB negatively correlated with CFR (r = -0.30 and -0.31, with p = 0.04 for both), as did average and maximal PDS (r = -0.38 and -0.41 with p = 0.009 and p = 0.005) while average RDZ was directly related (r = 0.37, p = 0.01). Multiple linear regression analyses revealed that both average PDS (Units of CFR -0.03 95% CI: -0.06, -0.002, p = 0.023) and maximal PDS (-0.04 95% CI -0.07, -0.01, p = 0.007) were negatively related to CFR. Conclusions Measures of epicardial coronary atheroma burden, size and tapering are related to CFR, suggesting that atherosclerotic anatomical findings may contribute to or be a consequence of CMD, with further work is needed to investigate these measures as treatment targets.
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Affiliation(s)
- C. Pacheco
- Hôpital Pierre-Boucher, Centre Hospitalier de l'Université de Montréal, Université de Montreal, QC, Canada
| | - A. AlBadri
- Emory University, Atlanta, GA, United States of America
| | - R.D. Anderson
- University of Florida, Gainesville, FL, United States of America
| | - J. Petersen
- University of Florida, Gainesville, FL, United States of America
| | - S. Marpuri
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
| | - G. Cook-Wiens
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
| | - C.J. Pepine
- University of Florida, Gainesville, FL, United States of America
| | | | - C.N. Bairey Merz
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
| | - J. Wei
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
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Nottmeier C, Liao N, Simon A, Decker MG, Luther J, Schweizer M, Yorgan T, Kaucka M, Bockamp E, Kahl-Nieke B, Amling M, Schinke T, Petersen J, Koehne T. Wnt1 Promotes Cementum and Alveolar Bone Growth in a Time-Dependent Manner. J Dent Res 2021; 100:1501-1509. [PMID: 34009051 PMCID: PMC8649456 DOI: 10.1177/00220345211012386] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Indexed: 11/24/2022] Open
Abstract
The WNT/β-catenin signaling pathway plays a central role in the biology
of the periodontium, yet the function of specific extracellular WNT
ligands remains poorly understood. By using a
Wnt1-inducible transgenic mouse model targeting
Col1a1-expressing alveolar osteoblasts,
odontoblasts, and cementoblasts, we demonstrate that the WNT ligand
WNT1 is a strong promoter of cementum and alveolar bone formation in
vivo. We induced Wnt1 expression for 1, 3, or 9 wk in
Wnt1Tg mice and analyzed them at the age of 6 wk and 12 wk.
Micro–computed tomography (CT) analyses of the mandibles revealed a
1.8-fold increased bone volume after 1 and 3 wk of
Wnt1 expression and a 3-fold increased bone
volume after 9 wk of Wnt1 expression compared to
controls. In addition, the alveolar ridges were higher in Wnt1Tg mice
as compared to controls. Nondecalcified histology demonstrated
increased acellular cementum thickness and cellular cementum volume
after 3 and 9 wk of Wnt1 expression. However, 9 wk of
Wnt1 expression was also associated with
periodontal breakdown and ectopic mineralization of the pulp. The
composition of this ectopic matrix was comparable to those of cellular
cementum as demonstrated by quantitative backscattered electron
imaging and immunohistochemistry for noncollagenous proteins. Our
analyses of 52-wk-old mice after 9 wk of Wnt1
expression revealed that Wnt1 expression affects
mandibular bone and growing incisors but not molar teeth, indicating
that Wnt1 influences only growing tissues. To further
investigate the effect of Wnt1 on cementoblasts, we
stably transfected the cementoblast cell line (OCCM-30) with a vector
expressing Wnt1-HA and performed proliferation as
well as differentiation experiments. These experiments demonstrated
that Wnt1 promotes proliferation but not
differentiation of cementoblasts. Taken together, our findings
identify, for the first time, Wnt1 as a critical
regulator of alveolar bone and cementum formation, as well as provide
important insights for harnessing the WNT signal pathway in
regenerative dentistry.
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Affiliation(s)
- C Nottmeier
- Department of Orthodontics, University Medical Center Hamburg, Hamburg, Germany.,Department of Orthodontics, University of Leipzig Medical Center, Leipzig, Germany
| | - N Liao
- Department of Orthodontics, University Medical Center Hamburg, Hamburg, Germany.,Department of Orthodontics, College of Stomatology, North China University of Science and Technology, Tangshan, China
| | - A Simon
- Department of Orthodontics, University Medical Center Hamburg, Hamburg, Germany
| | - M G Decker
- Department of Orthodontics, University Medical Center Hamburg, Hamburg, Germany
| | - J Luther
- Department of Osteology and Biomechanics, University Medical Center Hamburg, Hamburg, Germany
| | - M Schweizer
- ZMNH, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Yorgan
- Department of Osteology and Biomechanics, University Medical Center Hamburg, Hamburg, Germany
| | - M Kaucka
- Max Planck Institute for Evolutionary Biology, Plön, Germany
| | - E Bockamp
- Institute for Translational Immunology and Research Center for Immunotherapy, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - B Kahl-Nieke
- Department of Orthodontics, University Medical Center Hamburg, Hamburg, Germany
| | - M Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg, Hamburg, Germany
| | - T Schinke
- Department of Osteology and Biomechanics, University Medical Center Hamburg, Hamburg, Germany
| | - J Petersen
- Department of Orthodontics, University of Leipzig Medical Center, Leipzig, Germany.,Department of Osteology and Biomechanics, University Medical Center Hamburg, Hamburg, Germany
| | - T Koehne
- Department of Orthodontics, University Medical Center Hamburg, Hamburg, Germany.,Department of Orthodontics, University of Leipzig Medical Center, Leipzig, Germany
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Petersen J, Hutchinson C, Zinser G, Holtsche M, Thode M, Kahle B. Vaskuläre Malformationen – Anamnese und Klinik als wichtiges Werkzeug auf dem Weg zur Diagnose. Phlebologie 2021. [DOI: 10.1055/a-1391-9786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
ZusammenfassungVaskuläre Malformationen sind eine heterogene Gruppe von embryonalen Gefäßfehlbildungen, welche als venöse, arterielle, lymphatische oder kombinierte Anomalien auftreten können 1
2
3
4. Typischerweise sind diese bereits bei Geburt vorhanden. VMF sind äußerst variabel im klinischen Erscheinungsbild, je nachdem welche Gefäße betroffen sind.Bei vorwiegend lymphatischen Malformationen steht die Schwellung der betroffenen Körperregion im Vordergrund 5. Kapilläre Malformationen treten in der Regel als Naevus flammeus in Erscheinung. Die Erweiterung von Kapillargefäßen führt zu einer permanenten lividen Rötung im Hautniveau des betroffenen Areals.Dieser Fall beschreibt einen Patienten mit einer ausgedehnten kombinierten venös-kapillären und lymphatischen Malformation mit Betonung des Gesichts, des Rückens und der unteren Extremität. Aufgrund der auffälligen Schwellung der Unterlippe wurde er mit der Verdachtsdiagnose eines Melkersson-Rosenthal-Syndroms in unserer Ambulanz vorstellig.
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Affiliation(s)
- J. Petersen
- Klinik für Dermatologie, Venerologie und Allergologie, UKSH Campus Lübeck
| | - C. Hutchinson
- Klinik für Dermatologie, Venerologie und Allergologie, UKSH Campus Lübeck
| | - G. Zinser
- Klinik für Dermatologie, Venerologie und Allergologie, UKSH Campus Lübeck
| | - M. Holtsche
- Klinik für Dermatologie, Venerologie und Allergologie, UKSH Campus Lübeck
| | - M. Thode
- Klinik für Dermatologie, Venerologie und Allergologie, UKSH Campus Lübeck
| | - Birgit Kahle
- Klinik für Dermatologie, Venerologie und Allergologie, UKSH Campus Lübeck
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Petersen J, Yildirim Y, Tönnis T, Reichenspurner H, Pecha S. Transvenous Lead Extraction in Patients with Grownup Congenital Heart Disease. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725711] [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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35
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Petersen J, Grammatika-Pavlidou N, Bork NI, Reichenspurner H, Nikolaev VO, Girdauskas E, Molina CE. Differential β-Adrenergic Signaling and Camp Dynamics in Left and Right Ventricles from Patients with Valve Disease. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725842] [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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36
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Böning H, Petersen J, Sinning C, Yildirim S, Yildirim Y, Reichenspurner H, Pecha S. Echocardiographic Evaluation of Different LAA Closure Techniques during Concomitant Surgical AF Ablation. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725714] [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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37
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Petersen J, Castro L, Bengaard AK, Pecha S, Steenpass A, Meyer C, Reichenspurner H, Jespersen T, Eschenhagen T, Christ T. IK,ACh Does Not Mediate Negative Inotropy and Antiarrhythmic Action of Muscarinic Receptor Activation in Human Atrium. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725598] [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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Dietz J, Spengler U, Müllhaupt B, Schulze Zur Wiesch J, Piecha F, Mauss S, Seegers B, Hinrichsen H, Antoni C, Wietzke-Braun P, Peiffer KH, Berger A, Matschenz K, Buggisch P, Backhus J, Zizer E, Boettler T, Neumann-Haefelin C, Semela D, Stauber R, Berg T, Berg C, Zeuzem S, Vermehren J, Sarrazin C, Giostra E, Berning M, Hampe J, De Gottardi A, Rauch A, Semmo N, Discher T, Trauth J, Fischer J, Gress M, Günther R, Heinzow H, Schmidt J, Herrmann A, Stallmach A, Hilgard G, Deterding K, Lange C, Ciesek S, Wedemeyer H, Hoffmann D, Klinker H, Schulze P, Kocheise F, Müller-Schilling M, Kodal A, Kremer A, Ganslmayer M, Siebler J, Lammert F, Rissland J, Löbermann M, Götze T, Canbay A, Lohse A, von Felden J, Jordan S, Maieron A, Moradpour D, Chave JP, Moreno C, Müller T, Muche M, Epple HJ, Port K, von Hahn T, Cornberg M, Manns M, Reinhardt L, Ellenrieder V, Rockstroh J, Schattenberg J, Sprinzl M, Galle P, Roeb E, Steckstor M, Schmiegel W, Brockmeyer N, Seufferlein T, Stremmel W, Strey B, Thimme R, Teufel A, Vogelmann R, Ebert M, Tomasiewicz K, Trautwein C, Tacke F, Koenen T, Weber T, Zachoval R, Mayerle J, Raziorrouh B, Angeli W, Beckebaum S, Doberauer C, Durmashkina E, Hackelsberger A, Erhardt A, Garrido-Lüneburg A, Gattringer H, Genné D, Gschwantler M, Gundling F, Hametner S, Schöfl R, Hartmann C, Heyer T, Hirschi C, Jussios A, Kanzler S, Kordecki N, Kraus M, Kullig U, Wollschläger S, Magenta L, Beretta-Piccoli BT, Menges M, Mohr L, Muehlenberg K, Niederau C, Paulweber B, Petrides A, Pinkernell M, Piso R, Rambach W, Reiser M, Riecken B, Rieke A, Roth J, Schelling M, Schlee P, Schneider A, Scholz D, Schott E, Schuchmann M, Schulten-Baumer U, Seelhoff A, Stich A, Stickel F, Ungemach J, Walter E, Weber A, Winzer T, Abels W, Adler M, Audebert F, Baermann C, Bästlein E, Barth R, Barthel K, Becker W, Behrends J, Benninger J, Berger F, Berzow D, Beyer T, Bierbaum M, Blaukat O, Bodtländer A, Böhm G, Börner N, Bohr U, Bokemeyer B, Bruch H, Bucholz D, Burkhard O, Busch N, Chirca C, Delker R, Diedrich J, Frank M, Diehl M, Dienethal A, Dietel P, Dikopoulos N, Dreck M, Dreher F, Drude L, Ende K, Ehrle U, Baumgartl K, Emke F, Glosemeyer R, Felten G, Hüppe D, Fischer J, Fischer U, Frederking D, Frick B, Friese G, Gantke B, Geyer P, Schwind H, Glas M, Glaunsinger T, Goebel F, Göbel U, Görlitz B, Graf R, Gruber H, Härter G, Herder M, Heuchel T, Heuer S, Höffl KH, Hörster H, Sonne JU, Hofmann W, Holst F, Hunstiger M, Hurst A, Jägel-Guedes E, John C, Jung M, Kallinowski B, Kapzan B, Kerzel W, Khaykin P, Klarhof M, Klüppelberg U, Klugewitz K, Knapp B, Knevels U, Kochsiek T, Körfer A, Köster A, Kuhn M, Langekamp A, Künzig B, Link R, Littman M, Löhr H, Lutz T, Knecht G, Lutz U, Mainz D, Mahle I, Maurer P, Mayer C, Meister V, Möller H, Heyne R, Moritzen D, Mroß M, Mundlos M, Naumann U, Nehls O, Ningel K, Oelmann A, Olejnik H, Gadow K, Pascher E, Petersen J, Philipp A, Pichler M, Polzien F, Raddant R, Riedel M, Rietzler S, Rössle M, Rufle W, Rump A, Schewe C, Hoffmann C, Schleehauf D, Schmidt K, Schmidt W, Schmidt-Heinevetter G, Schmidtler-von Fabris J, Schnaitmann E, Schneider L, Schober A, Niehaus-Hahn S, Schwenzer J, Seidel T, Seitel G, Sick C, Simon K, Stähler D, Stenschke F, Steffens H, Stein K, Steinmüller M, Sternfeld T, Strey B, Svensson K, Tacke W, Teuber G, Teubner K, Thieringer J, Tomesch A, Trappe U, Ullrich J, Urban G, Usadel S, von Lucadou A, Weinberger F, Werheid-Dobers M, Werner P, Winter T, Zehnter E, Zipf A. Efficacy of Retreatment After Failed Direct-acting Antiviral Therapy in Patients With HCV Genotype 1-3 Infections. Clin Gastroenterol Hepatol 2021; 19:195-198.e2. [PMID: 31706062 DOI: 10.1016/j.cgh.2019.10.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 06/04/2019] [Revised: 09/19/2019] [Accepted: 10/25/2019] [Indexed: 02/07/2023]
Abstract
Hepatitis C virus infection is causing chronic liver disease, cirrhosis, and hepatocellular carcinoma. By combining direct-acting antivirals (DAAs), high sustained virologic response rates (SVRs) can be achieved. Resistance-associated substitutions (RASs) are commonly observed after DAA failure, and especially nonstructural protein 5A (NS5A) RASs may impact retreatment options.1-3 Data on retreatment of DAA failure patients using first-generation DAAs are limited.4-7 Recently, a second-generation protease- and NS5A-inhibitor plus sofosbuvir (voxilaprevir/velpatasvir/sofosbuvir [VOX/VEL/SOF]) was approved for retreatment after DAA failure.8 However, this and other second-generation regimens are not available in many resource-limited countries or are not reimbursed by regular insurance, and recommendations regarding the selection of retreatment regimens using first-generation DAAs are very important. This study aimed to analyze patients who were re-treated with first-generation DAAs after failure of a DAA combination therapy.
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Affiliation(s)
- Julia Dietz
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Ulrich Spengler
- Department of Internal Medicine I, University of Bonn, Bonn, and German Center for Infection Research (DZIF), Partner Site, Cologne-Bonn, Germany
| | - Beat Müllhaupt
- Swiss Hepato-Pancreato-Biliary Center and Department of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
| | - Julian Schulze Zur Wiesch
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Felix Piecha
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Stefan Mauss
- Center for HIV and Hepatogastroenterology, Düsseldorf, Germany
| | - Barbara Seegers
- Gastroenterologisch-Hepatologisches Zentrum Kiel, Kiel, Germany
| | | | - Christoph Antoni
- Department of Internal Medicine II, University Hospital Mannheim, Mannheim, Germany
| | | | - Kai-Henrik Peiffer
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Peter Buggisch
- Institute for Interdisciplinary Medicine IFI, Hamburg, Germany
| | - Johanna Backhus
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Eugen Zizer
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Tobias Boettler
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Neumann-Haefelin
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - David Semela
- Division of Gastroenterology and Hepatology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Rudolf Stauber
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Thomas Berg
- Department of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Christoph Berg
- Department of Internal Medicine I, University of Tübingen, Tübingen, Germany
| | - Stefan Zeuzem
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Johannes Vermehren
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Christoph Sarrazin
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany; Medizinische Klinik 2, St Josefs-Hospital, Wiesbaden, Germany.
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Petersen J, Gebauer A, Böning H, Chokair F, Girdauskas E, Conradi L, Reichenspurner H, Pecha S. Rhythm Outcome after Cryoablation and LAA Clipping during Minimally Invasive Mitral Valve Surgery Using 3D Endoscopy. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725716] [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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Pecha S, Petersen J, Hakmi S, Yildirim Y, Tönnis T, Reichenspurner H. Safety and Efficacy of Transvenous Laser Lead Extraction in Octogenarians. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725812] [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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Holst T, Petersen J, Waschki B, Rybczynski M, Reichenspurner H, Girdauskas E. Patient-Reported Outcomes after Aortic Valve Surgery in Nonelderly Patients. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725731] [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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Yildirim Y, Petersen J, Tönnis T, Reichenspurner H, Pecha S. Hybrid Transvenous Lead Extraction during Valvular Endocarditis Surgery. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725816] [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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von Stumm M, Petersen J, Pausch J, Holst T, Gross TMS, Martin S, Reichenspurner H, Girdauskas E. Predictive Value of Myocardial Native T1 on Left Ventricular Re-Remodeling after Valvular Surgery. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725765] [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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Petersen J, Jensen A, Bruun N, Kamper A, Butt J, Borgersen E, Pedersen C, Chaudry M, Kober L, Fosbol E, Ostergaard L. Prognosis of short- and long-term dialysis in patients with infective endocarditis: a nationwide study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2017] [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
Infective endocarditis (IE) may be complicated by acute kidney injury, yet data on the use of dialysis and subsequent reversibility are sparse. We set out to examine the prognosis of short- and long-term dialysis in patients with IE.
Methods
Using Danish nationwide registries we identified patients with first-time IE from 2000 to 2017. Dialysis naïve patients were grouped into: those who were treated with dialysis during admission with IE and those who were not. The cumulative incidence of continuous use of dialysis was examined one year post-discharge Multivariable adjusted Cox proportional hazard analysis was used to examine one-year mortality for patients surviving IE based on use of dialysis.
Results
We included 7,307 patients with IE; 416 patients (5.7%) initiated dialysis treatment during admission with IE and these were younger, had more comorbidities and more often underwent cardiac valve surgery during admission with IE compared with non-dialysis patients (47.4% vs. 20.9%). In patients with both surgical intervention and dialysis treatment, 153 (77.7%) initiated dialysis on- or after the date of surgery. The in-hospital mortality was 40.4% and 19.0% for patients with and without dialysis, respectively (p<0.0001). Of those who started dialysis and survived hospitalisation, 78.4% became dialysis-free within one year after discharge. Among those who survived one week subsequent to IE discharge, we identified 5,520 who never had dialysis, 204 patients without continued use of dialysis, and 40 patients with a continued use of dialysis. The corresponding mortality risk at one year was 15.2%, 13.5%, and 41.6% (Figure), respectively. Compared with patients not treated with dialysis, those who became dialysis-free at discharge showed no increased risk of one year mortality in adjusted analysis (HR=1.45, 95% CI: 0.97–2.20), while patients who continued dialysis had an increased associated risk of mortality (HR=2.00, 95% CI: 1.20–3.33).
Conclusion
In dialysis-naïve patients with IE, more than 1 in 20 patients initiated dialysis treatment during admission. Dialysis identified a high-risk group with an in-hospital mortality of 40%–twice as high as their counterparts. In dialysis patients surviving admission with IE, almost 80% became dialysis-free and showed better long-term survival than those who continued dialysis after discharge.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J Petersen
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | - A.D Jensen
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | - N.E Bruun
- Zealand University Hospital, Roskilde, Denmark
| | - A Kamper
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | - J.W Butt
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | - E Borgersen
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | | | - M.S Chaudry
- Gentofte University Hospital, Gentofte, Denmark
| | - L Kober
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | - E.L Fosbol
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | - L Ostergaard
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
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Petersen J, Gaekel D, Girdauskas E, Reichenspurner H, Detter C. Long-Term Outcome after Aortic Valve-Sparing Root Surgery in Patients with Connective Tissue Disorder. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Petersen J, Gaekel D, Girdauskas E, Reichenspurner H, Detter C. Long-Term Single-Center Experience in Aortic Root Surgery: Aortic Valve-Sparing Surgery versus Bentall Procedure. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Petersen J, Lenz A, Adam G, Reichenspurner H, Bannas P, Girdauskas E. Changes of Wall Shear Stress after Congenital Aortic Valve Repair Measured by 4D Flow Cardiovascular Magnetic Resonance Imaging. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Petersen J, Naito S, Detter C, Reichenspurner H, Girdauskas E. Antegrade versus Retrograde Arterial Perfusion in Minimally Invasive Mitral Valve Surgery: Axillary versus Femoral. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Naito S, Petersen J, Sequeira Gross TM, Reichenspurner H, Zeller T, Girdauskas E. Signaling Pathways in the Development of Bicuspid Aortopathy: from the Expression Patterns of Circulating microRNAs to the Formation of Aortic Aneurysm. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Von Stumm M, Petersen J, Westermann D, Reichenspurner H, Girdauskas E. Treatment strategies for mixed aortic valve disease in nonelderly patients. Expert Rev Cardiovasc Ther 2019; 17:873-882. [DOI: 10.1080/14779072.2019.1702520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 10/25/2022]
Affiliation(s)
- Maria Von Stumm
- Department of Cardiovascular Surgery, University Heart Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J. Petersen
- Department of Cardiovascular Surgery, University Heart Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D. Westermann
- Department of Cardiology, University Heart Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hermann Reichenspurner
- Department of Cardiovascular Surgery, University Heart Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Evaldas Girdauskas
- Department of Cardiovascular Surgery, University Heart Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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