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Linder M. 1591P Swedish national population-based study of direct oral anticoagulants and low molecular weight heparin treatment for thromboembolism in cancer patients: The OSCAR SWE study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1684] [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: 11/01/2022] Open
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Streckenbach A, Sinn M, Brandi L, Ludwig S, Linder M, Schofer N, Seiffert M, Lund G, Schaefer A, Tahir E, Adam G, Meyer M. 483 High-pitch Non-ecg-gated Ct Angiography Fortranscatheter Aortic Valvereplacement Planning: A Comparison To A Ecg-gated Cta Protocol And Impact On Clinical Outcome. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Grundmann D, Linder M, Gossling A, Voigtlaender L, Ludwig S, Waldschmidt L, Demal T, Bhadra O, Seiffert M, Schaefer A, Reichenspurner H, Blankenberg S, Westermann D, Conradi L, Schofer N. Diagnostic value and prognostic impact of various invasively derived hemodynamic parameters in patients with severe aortic stenosis undergoing TAVI. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1620] [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
Ejection time (ET) and Acceleration time (AT) have been described as echocardiographic markers for aortic stenosis (AS).1 Moreover, in a recent study time between invasively measured left ventricular and aortic systolic pressure peaks (T-LVAo) was associated with anatomic AS severity.2 However, the diagnostic value of these parameters has not been validated in a larger patient cohort and their prognostic impact in AS patients undergoing transcatheter aortic valve implantation (TAVI) remains unknown.
Purpose
We aimed to assess the diagnostic value and prognostic impact of ET, AT, and T-LVAo as assessed by invasive measurements in patients undergoing TAVI for severe AS.
Methods
This retrospective single-centre analysis studied 1478 patients undergoing TAVI from 2014 to 2019 for severe AS. All patients received echocardiographic, multislice computed tomography (MSCT) and invasive hemodynamic evaluation with simultaneous pressure measurements in left ventricle and aorta prior to TAVI. Anatomic AS severity was assessed according to MSCT-derived aortic valve calcification density (AVCd) defined as calcium volume per annulus area. All hemodynamic parameters were calculated offline using a dedicated software.
Results
Median patients' age was 81.2 (76.8–84.7) years and 807 (54.6%) were women. Predicted operative risk for mortality was 3.8 (2.6–5.7)% according to STS Score. Medians of invasively derived parameters were 70.0 ms (46.0–98.0) for T-LVAo, 308.0 ms (276.0–336.0) for ET, 180.0 ms (146.0–206.0) for AT. In spline analysis correlation of T-LVAo (Spearman: r=0.35; p<0.001) and ET (Spearman: r=0.18; p<0.001) with AVCd was significant but weak. AT showed negligible correlation with ACVd (Spearman: r=−0.05; p=0.089). The optimal cutoff for death (CD) according to C-statistic was 274 ms for ET and 158 ms for AT. Patients with ET or AT ≥ CD showed lower short and mid-term mortality rates compared to patients with ET or AT < CD (ET ≥ vs. < CD: mortality at 1-year: 14.5 vs. 31.9%, 3-years: 28.3 vs. 53.5%, all p<0.001; AT ≥ vs < CD: mortality at 1-year: 15.5 vs. 25.9%, p<0.001, 3-years: 34.0 vs. 41.0%, p=0.0032). Moreover, multivariate analysis for mortality identified ET (HR 0.58 [95% CI 0.43–0.77; p<0.001]) and AT (HR 0.65 [95% CI 0.49–0.86; p=0.0027]) to be associated with beneficial outcome after TAVI, independent from clinical risk factors and echocardiography-derived parameters like LVEF, mean gradient or stroke volume index. In contrast, T-LVAo showed no prognostic impact according to uni- or multivariate analyses.
Conclusion
T-LVAo provides the highest diagnostic value among the investigational hemodynamic parameters, however correlation with AVCd was weak. ET and AT are strong independent outcome predictors beyond clinical risk factors and standard echocardiographic parameters in AS patients following TAVI. Accordingly, use of ET and AT might improve risk assessment in patients scheduled for TAVI.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Grundmann
- University Heart Center Hamburg, Hamburg, Germany
| | - M Linder
- University Heart Center Hamburg, Hamburg, Germany
| | - A Gossling
- University Heart Center Hamburg, Hamburg, Germany
| | | | - S Ludwig
- University Heart Center Hamburg, Hamburg, Germany
| | | | - T Demal
- University Heart Center Hamburg, Hamburg, Germany
| | - O Bhadra
- University Heart Center Hamburg, Hamburg, Germany
| | - M Seiffert
- University Heart Center Hamburg, Hamburg, Germany
| | - A Schaefer
- University Heart Center Hamburg, Hamburg, Germany
| | | | | | - D Westermann
- University Heart Center Hamburg, Hamburg, Germany
| | - L Conradi
- University Heart Center Hamburg, Hamburg, Germany
| | - N Schofer
- University Heart Center Hamburg, Hamburg, Germany
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Linder M, Pogge von Strandmann E. The Role of Extracellular HSP70 in the Function of Tumor-Associated Immune Cells. Cancers (Basel) 2021; 13:cancers13184721. [PMID: 34572948 PMCID: PMC8466959 DOI: 10.3390/cancers13184721] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/08/2021] [Accepted: 09/14/2021] [Indexed: 12/24/2022] Open
Abstract
Simple Summary The intracellular heat shock protein 70 (HSP70) is essential for cells to respond to stress, for instance, by refolding damaged proteins or inhibiting apoptosis. However, in cancer, HSP70 is overexpressed and can translocate to the extracellular milieu, where it emerged as an important modulator of tumor-associated immune cells. By targeting the tumor microenvironment (TME) through different mechanisms, extracellular HSP70 can trigger pro- or anti-tumorigenic responses. Therefore, understanding the pathways and their consequences is crucial for therapeutically targeting cancer and its surrounding microenvironment. In this review, we summarize current knowledge on the translocation of extracellular HSP70. We further elucidate its functions within the TME and provide an overview of potential therapeutic options. Abstract Extracellular vesicles released by tumor cells (T-EVs) are known to contain danger-associated molecular patterns (DAMPs), which are released in response to cellular stress to alert the immune system to the dangerous cell. Part of this defense mechanism is the heat shock protein 70 (HSP70), and HSP70-positive T-EVs are known to trigger anti-tumor immune responses. Moreover, extracellular HSP70 acts as an immunogen that contributes to the cross-presentation of major histocompatibility complex (MHC) class I molecules. However, the release of DAMPs, including HSP70, may also induce chronic inflammation or suppress immune cell activity, promoting tumor growth. Here, we summarize the current knowledge on soluble, membrane-bound, and EV-associated HSP70 regarding their functions in regulating tumor-associated immune cells in the tumor microenvironment. The molecular mechanisms involved in the translocation of HSP70 to the plasma membrane of tumor cells and its release via exosomes or soluble proteins are summarized. Furthermore, perspectives for immunotherapies aimed to target HSP70 and its receptors for cancer treatment are discussed and presented.
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Linder M. Using epidemiological methods to quantify the risk of serious infections in children with atopic dermatitis. Br J Dermatol 2021; 185:11-12. [PMID: 34114215 DOI: 10.1111/bjd.20395] [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] [Received: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 11/30/2022]
Affiliation(s)
- M Linder
- Centre for Pharmacoepidemiology, Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, 171 76, Sweden
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Schäfer A, Plassmeier F, Schofer N, Ludwig S, Schneeberger Y, Linder M, Demal TJ, Seiffert M, Blankenberg S, Reichenspurner H, Westermann D, Conradi L. Early Commercial Experience with a Novel Balloon-Expandable Transcatheter Heart Valve: 30-Day Outcomes and Implications of Preprocedural Computed Tomography. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725723] [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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Bhadra OD, Demal TJ, Schneeberger Y, Ludwig S, Waldschmidt L, Grundmann D, Voigtlaender L, Linder M, Schofer N, Blankenberg S, Reichenspurner H, Seiffert M, Conradi L, Westermann D, Schaefer A. Comparison of Two Contemporary Balloon-Expandable Transcatheter Heart Valves: Sapien 3 versus Sapien 3 Ultra. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725831] [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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Demal TJ, Gordon C, Bhadra OD, Linder M, Ludwig S, Voigtländer L, Waldschmidt L, Schirmer J, Schofer N, Seiffert M, Blankenberg S, Reichenspurner H, Westermann D, Conradi L. Transcatheter Aortic Valve-in-Valve Implantation versus Redo Surgery: A Contemporary Comparative Analysis. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725666] [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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Waldschmidt L, Gossling A, Ludwig S, Linder M, Voigtlaender L, Schaefer A, Bhadra O, Schirmer J, Reichenspurner H, Blankenberg S, Westermann D, Seiffert M, Conradi L, Schofer N. Prevalence and prognostic impact of left ventricular outflow tract calcification in patients with severe aortic stenosis undergoing transfemoral TAVI using second-generation devices. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Left ventricular outflow tract (LVOT) calcification is known to be associated with adverse outcomes after TAVI in patients receiving first-generation transcatheter heart valves (THV). Second-generation THV have been shown to improve outcomes of TAVI patients. Thus, aim of this study is to assess the prevalence of LVOT calcification as well as its impact on procedural and clinical outcomes in patients with severe aortic stenosis undergoing transfemoral TAVI with second-generation THV in a real-world patient cohort.
Methods
In this retrospective single-center analysis patients receiving transfemoral TAVI with second-generation THV for the treatment of aortic stenosis (AS) between 05/2012 and 06/2018 and with adequate CT data were included (n=836). Amount of LVOT calcification was measured quantitatively from contrast-enhanced multislice CT using a dedicated software. Baseline characteristics and outcomes were compared according to presence of significant LVOT calcification (none/≤10 mm3 vs. >10 mm3). Procedural and clinical outcome were assessed in accordance with VARC-2 criteria. All-cause mortality was assessed by Kaplan-Meier method, median follow-up was 1.4 years.
Results
Significant LVOT calcification was present in 37.0% of patients. Patients with LVOT calcification were older (all results as follows without (w/o) vs. with (w) LVOT calcification: 81.4 (77.1, 84.8) vs. 82.3 (78.0, 86.3) years, p=0.006), but presented similar STS scores compared to those without LVOT calcification (5.4±4.7 vs. 5.4±3.5%, p=0.94). Moreover, patients with LVOT calcification had higher mean transvalvular gradients at baseline (30.0 (21.0, 41.0) vs. 37.0 (25.7, 47.0) mmHg, p<0.001) and higher aortic valve calcium volume (380.7 (226.8, 632.1) vs. 663.6 (364.5, 1070.3) mm3, p<0.001). There were no significant differences in rate of device success (97.0 vs. 94.2%, p=0.11), renal failure (2.6 vs. 2.3%, p=1.00), myocardial infarction (0.9 vs. 1.2%, p=1.00) or rate of permanent pacemaker implantation at 30 days after TAVI (16.6 vs. 17.2%, p=0.91). However, rate of TIA/stroke was significantly higher in patients with LVOT calcification (2.1 vs. 6.2%, p=0.0098). Furthermore, patients with LVOT calcification had a higher rate of more than mild paravalvular leakage at discharge (3.8 vs. 7.6%, p=0.033). Rate of 1 year all-cause mortality (17.8 vs. 21.2%, p=0.23) was not significantly different between both groups.
Conclusions
Significant LVOT calcification is present in a substantial proportion of patients receiving TAVI. In such patients, higher rates of cerebrovascular events and more than mild PVL occurred compared to those without significant LVOT calcification even with currently available second-generation THV. Although these findings did not translate into higher mortality rates in the present study, they underline the need for further optimization of THV technology in order to improve outcomes among all TAVI patients.
Figure 1. 1-year mortality
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- L Waldschmidt
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Gossling
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Ludwig
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Linder
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L Voigtlaender
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Schaefer
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - O Bhadra
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Schirmer
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Reichenspurner
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Blankenberg
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D Westermann
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Seiffert
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L Conradi
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - N Schofer
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Ludwig S, Pellegrini C, Gossling A, Rheude T, Waldschmidt L, Bhadra O, Linder M, Schirmer J, Seiffert M, Reichenspurner H, Blankenberg S, Westermann D, Conradi L, Joner M, Schofer N. The adverse impact of HFpEF in patients with aortic stenosis: evaluation of the H2FPEF score for risk assessment among patients with preserved ejection fraction undergoing TAVI. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2622] [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
The H2FPEF score enables identification of patients with high probability of prevalent heart failure with preserved ejection fraction (HFpEF). High H2FPEF scores have proven to be associated with adverse outcome in patients with known HFpEF.
Objective
The aim of this study was to assess the prognostic impact of the H2FPEF score in patients undergoing Transcatheter Aortic Valve Implantation (TAVI) for severe aortic stenosis (AS) and preserved left ventricular ejection fraction (EF).
Methods
In this multi-centre study a total of 832 patients from two German high-volume centres, who received TAVI for severe AS and preserved EF (≥50%), were identified for calculation of the H2FPEF score. Score variables included BMI >30 kg/m2, arterial hypertension, atrial fibrillation, systolic pulmonary artery pressure >31 mmHg, age >60 years, and invasively assessed elevated LV filling pressure. Patients were dichotomized according to low (1–5 points; n=570) and high H2FPEF scores (6–9 points; n=262). Kaplan-Meier and Cox regression analyses were applied to assess the prognostic impact of the H2FPEF score. Median follow-up time was 1.08 years.
Results
Patients presenting with high H2FPEF scores had higher prevalence of moderate to severe mitral and tricuspid regurgitation compared to those with low H2FPEF scores. Stroke volume index (SVI) (Figure 1A) and mean transvalvular gradient (Pmean) consistently decreased with increasing H2FPEF score. All-cause mortality 30 days after TAVI was significantly higher in patients with high H2FPEF scores (p<0.0001). This finding was consistent both after 1 year (p<0.0001) and 3 years (p<0.0001) (Figure 1B). Multivariate analysis revealed a high H2FPEF score to be independently predictive for all-cause mortality (HR 1.62, 95% CI: 1.11–2.38, p=0.013). Among the single H2FPEF score parameters atrial fibrillation was the strongest independent predictor of adverse outcome.
Conclusion
An elevated H2FPEF score of ≥6 is independently predictive for mortality in patients with preserved EF undergoing TAVI for severe AS, which might be due to a higher proportion of paradoxical low flow low gradient AS in these patients. Our findings provide evidence that the H2FPEF score may help identify AS patients with preserved ejection fraction that are at higher risk for adverse outcome after TAVI.
Spline/SVI (A) and 3y-mortality KM (B)
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Ludwig
- University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - C Pellegrini
- Deutsches Herzzentrum Muenchen Technical University of Munich, Department of Cardiology, Munich, Germany
| | - A Gossling
- University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - T Rheude
- Deutsches Herzzentrum Muenchen Technical University of Munich, Department of Cardiology, Munich, Germany
| | - L Waldschmidt
- University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - O.D Bhadra
- University Heart & Vascular Center Hamburg, Department of Cardiovascular Surgery, Hamburg, Germany
| | - M Linder
- University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - J Schirmer
- University Heart & Vascular Center Hamburg, Department of Cardiovascular Surgery, Hamburg, Germany
| | - M Seiffert
- University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - H Reichenspurner
- University Heart & Vascular Center Hamburg, Department of Cardiovascular Surgery, Hamburg, Germany
| | - S Blankenberg
- University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - D Westermann
- University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - L Conradi
- University Heart & Vascular Center Hamburg, Department of Cardiovascular Surgery, Hamburg, Germany
| | - M Joner
- Deutsches Herzzentrum Muenchen Technical University of Munich, Department of Cardiology, Munich, Germany
| | - N Schofer
- University Heart and Vascular Center Hamburg, Hamburg, Germany
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Kadri R, Bacharouch J, Elkhoury K, Ben Messaoud G, Kahn C, Desobry S, Linder M, Tamayol A, Francius G, Mano JF, Sánchez-González L, Arab-Tehrany E. Role of active nanoliposomes in the surface and bulk mechanical properties of hybrid hydrogels. Mater Today Bio 2020; 6:100046. [PMID: 32259100 PMCID: PMC7096761 DOI: 10.1016/j.mtbio.2020.100046] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/16/2020] [Accepted: 02/17/2020] [Indexed: 11/03/2022] Open
Abstract
Nanoliposomes are widely used as delivery vehicles for active compounds. Nanoliposomes from rapeseed phospholipids were incorporated into interpenetrating polymer network hydrogels of gelatin methacryloyl and alginate. The multiscale physicochemical properties of the hydrogels are studied both on the surface and through the thickness of the 3D network. The obtained composite hydrogels exhibited strong mechanical properties and a highly porous surface. The blend ratio, as well as the concentration of nanoliposomes, affects the properties of the hydrogels. Nanofunctionalized hydrogels induced keratinocyte growth. These advantageous characteristics may open up many applications of the developed hydrogels in drug delivery and tissue engineering.
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Affiliation(s)
- R Kadri
- Université de Lorraine, Laboratoire Ingénierie des Biomolécules, TSA 40602, Vandoeuvre-lès-Nancy, F-54518, France
| | - J Bacharouch
- Université de Lorraine, Laboratoire Ingénierie des Biomolécules, TSA 40602, Vandoeuvre-lès-Nancy, F-54518, France
| | - K Elkhoury
- Université de Lorraine, Laboratoire Ingénierie des Biomolécules, TSA 40602, Vandoeuvre-lès-Nancy, F-54518, France
| | - G Ben Messaoud
- Université de Lorraine, Laboratoire Ingénierie des Biomolécules, TSA 40602, Vandoeuvre-lès-Nancy, F-54518, France
| | - C Kahn
- Université de Lorraine, Laboratoire Ingénierie des Biomolécules, TSA 40602, Vandoeuvre-lès-Nancy, F-54518, France
| | - S Desobry
- Université de Lorraine, Laboratoire Ingénierie des Biomolécules, TSA 40602, Vandoeuvre-lès-Nancy, F-54518, France
| | - M Linder
- Université de Lorraine, Laboratoire Ingénierie des Biomolécules, TSA 40602, Vandoeuvre-lès-Nancy, F-54518, France
| | - A Tamayol
- Department of Mechanical and Materials Engineering, University of Nebraska, Lincoln, NE, 68508, USA
| | - G Francius
- Université de Lorraine, Laboratoire de Chimie Physique et Microbiologie pour L'Environnement, UMR 7564, Villers-lès-Nancy, F-54601, France.,CNRS, Laboratoire de Chimie Physique et Microbiologie pour L'Environnement, UMR 7564, Villers-lès-Nancy, F-54601, France
| | - J F Mano
- Department of Chemistry, CICECO - Aveiro Institute of Materials, University of Aveiro, 3810-193, Aveiro, Portugal
| | - L Sánchez-González
- Université de Lorraine, Laboratoire Ingénierie des Biomolécules, TSA 40602, Vandoeuvre-lès-Nancy, F-54518, France
| | - E Arab-Tehrany
- Université de Lorraine, Laboratoire Ingénierie des Biomolécules, TSA 40602, Vandoeuvre-lès-Nancy, F-54518, France
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Johnsen S, Madsen M, Linder M, Sulo G, Ghanima W, Gislason G, Halvorsen S, Hohnloser SH, Jenkins A, Al-Khalili F, Tell GS, Ehrenstein V. P3470Comparative effectiveness and safety of non-vitamin K oral anticoagulants and warfarin in non-valvular atrial fibrillation - a cohort study in 3 Nordic countries. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0342] [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
Non-vitamin K oral anticoagulants (NOACs) are an alternative to warfarin in the prevention of stroke in non-valvular atrial fibrillation (NVAF). Nordic countries have high quality of warfarin treatment, making them an especially suitable setting for assessing effectiveness and safety of NOACs against warfarin.
Purpose
The BEYOND Pooled (BEnefit of NOACs studY of nOn-valvular AF patieNts in NorDic countries) study compared risks of ischaemic or haemorrhagic stroke/systemic embolism (S/SE), and risk of bleeding with acute hospitalisation with an overnight stay (bleeding) in NVAF patients treated with apixaban, dabigatran or rivaroxaban, each compared with warfarin treatment.
Methods
A cohort study of treatment-naïve adult NVAF patients dispensed apixaban, dabigatran, rivaroxaban or warfarin was identified from 01 Jan 2013 to 31 Dec 2016. The population and study variables were identified from national registries in Denmark, Norway and Sweden. After 1:1 propensity score (PS) matching for each NOAC-warfarin comparison, individual-level data were pooled across the countries. Cox proportional-hazards regression was used to estimate adjusted hazard ratios (aHRs) of the endpoints.
Results
PS matched NOAC cohort sizes were: apixaban (55,696) dabigatran (28,526) and rivaroxaban (30,701), and the total follow-up in the PS-matched population was 291,171 years (mean 1.3 years). During the follow-up, 35,450 oral anticoagulation (OAC) patients had a S/SE and 38,620 OAC patients had bleeding. Adjusted HRs for the two endpoints are presented in the table. PH assumption has not been formally tested but cum incidence curves did not indicate substantial differences in the effects over time.
Table 1. Adjusted hazard ratios (aHR) of stroke/systemic embolism and bleeding for non-vitamin K oral anticoagulants versus warfarin Endpoint Apixaban vs Warfarin: aHR (95% CI) Dabigatran vs Warfarin: aHR (95% CI) Rivaroxaban vs Warfarin: aHR (95% CI) Stroke/SE 0.93 (0.85–1.03) 0.89 (0.80–1.00) 0.97 (0.88–1.08) Bleeding 0.72 (0.67–0.77) 0.87 (0.80–0.95) 1.12 (1.04–1.20)
Conclusions
Relative to warfarin, apixaban and dabigatran were associated with lower rates of bleeding whereas rivaroxaban was associated with a higher rate. The three NOACs had comparable rates of stroke and systemic embolism relative to warfarin.
Acknowledgement/Funding
This study was funded by the Pfizer/Bristol-Myers Squibb Alliance.
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Affiliation(s)
- S Johnsen
- Aalborg University, Department of Clinical Medicine, Aalborg, Denmark
| | - M Madsen
- Aarhus University Hospital, Department of Clinical Epidemiology, Aarhus, Denmark
| | - M Linder
- Karolinska Institute, Centre for Pharmacoepidemiology, Stockholm, Sweden
| | - G Sulo
- Norwegian Institute of Public Health, Centre for Disease Burden, Bergen, Norway
| | - W Ghanima
- Oestfold Hospital Trust, Department of Hematology, Fredrikstad, Norway
| | - G Gislason
- Gentofte Hospital - Copenhagen University Hospital, Department of Cardiology, Hellerup, Denmark
| | - S Halvorsen
- Ulleval University Hospital, Department of Cardiology, Oslo, Norway
| | - S H Hohnloser
- JW Goethe University, Department of Cardiology, Frankfurt am Main, Germany
| | - A Jenkins
- Pfizer Ltd, Tadworth, United Kingdom
| | - F Al-Khalili
- Sophiahemmets Hospital, Heart, Lung and Allergy Clinic, Stockholm, Sweden
| | - G S Tell
- University of Bergen, Department of Global Public Health and Primary Care, Bergen, Norway
| | - V Ehrenstein
- Aarhus University Hospital, Department of Clinical Epidemiology, Aarhus, Denmark
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Ludwig S, Voigtlaender L, Ruebsamen N, Kalbacher D, Koell B, Linder M, Waldschmidt L, Schirmer J, Seiffert M, Conradi L, Schaefer U, Reichenspurner H, Blankenberg S, Westermann D, Schofer N. P3858High H2FPEF score is an independent predictor of adverse outcome in patients with severe aortic stenosis and preserved ejection fraction undergoing TAVR. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
Recently, the H2FPEF score has been developed in an evidence-based approach relying on simple clinical and echocardiographic variables. It enables the identification of patients with high probability of prevalent heart failure with preserved ejection fraction (HFpEF) which is associated with a dismal prognosis. Left ventricular diastolic dysfunction, a key mechanism in HFpEF, is also a common finding in patients with severe aortic stenosis.
Objective
To assess the prognostic impact of the H2FPEF score in patients with preserved ejection fraction and severe aortic stenosis undergoing Transcatheter Aortic Valve Replacement (TAVR).
Methods
Among 1148 patients with preserved ejection fraction who received TAVR at our institution between 2013 and 2018, data for calculation of the H2FPEF score was available in 535 patients. Score variables include BMI >30 kg/m2, arterial hypertension, atrial fibrillation, pulmonary hypertension >35 mmHg, age >60 years, and elevated LV filling pressure. Patients were dichotomized according to “low” (1–5 points; n=377) and “high” H2FPEF scores (6–9; n=158). Kaplan-Meier survival curves and Cox regression analyses were used to assess the prognostic impact of H2FPEF scores. Median follow-up time was 0.3 years.
Results
TAVR patients presenting with high H2FPEF scores had higher prevalence of moderate to severe mitral regurgitation (19.4% vs. 33.6%, p<0.001) as well as tricuspid regurgitation (15.2% vs. 35.1%, p<0.001), and presented with lower stroke volume index (42.2 ml/m2 vs. 36.0 ml/m2, p<0.001) compared to those with low H2FPEF scores. All-cause mortality one year after TAVR was significantly higher in patients in the high H2FPEF score group (10.5% vs. 21.0%, p=0.0019, Figure 1). Multivariate analysis revealed a high H2FPEF score to be independently predictive for 1-year all-cause mortality (HR 2.66, 95% CI: 1.41–5.02, p=0.025). Among the single H2FPEF score variables, atrial fibrillation (HR 3.45, 95% CI: 1.86–6.40, p<0.001) and systolic pulmonary hypertension >55 mmHg (HR=2.68, 95% CI: 0.97–7.40, p=0.057) were strong independent predictors of adverse outcome.
Figure 1. All-cause mortality of patients undergoing TAVR after one year stratified by low (1–5 points) and high (6–9) H2FPEF score
Conclusion
An elevated H2FPEF score of >6 is independently predictive for mortality in patients with preserved ejection fraction undergoing TAVR for severe aortic stenosis. Our findings provide evidence that the H2FPEF score, which was meant for diagnostic use originally, is able to serve as a prognostic tool in patients with preserved ejection fraction undergoing TAVR, highlighting the adverse impact of diastolic dysfunction in patients with preserved ejection fraction and aortic stenosis.
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Affiliation(s)
- S Ludwig
- University Heart Center Hamburg, Hamburg, Germany
| | | | - N Ruebsamen
- University Heart Center Hamburg, Hamburg, Germany
| | - D Kalbacher
- University Heart Center Hamburg, Hamburg, Germany
| | - B Koell
- University Heart Center Hamburg, Hamburg, Germany
| | - M Linder
- University Heart Center Hamburg, Hamburg, Germany
| | | | - J Schirmer
- University Heart Center Hamburg, Hamburg, Germany
| | - M Seiffert
- University Heart Center Hamburg, Hamburg, Germany
| | - L Conradi
- University Heart Center Hamburg, Hamburg, Germany
| | - U Schaefer
- University Heart Center Hamburg, Hamburg, Germany
| | | | | | - D Westermann
- University Heart Center Hamburg, Hamburg, Germany
| | - N Schofer
- University Heart Center Hamburg, Hamburg, Germany
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14
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Waldschmidt L, Drolz A, Heimburg P, Gossling A, Schofer N, Voigtlaender L, Ludwig S, Linder M, Reichenspurner H, Blankenberg S, Schaefer U, Westermann D, Conradi L, Kluwe J, Seiffert M. P1848Prevalence and outcomes in patients with Heyde syndrome after transcatheter aortic valve implantation, a single centre experience. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Heyde syndrome is known as the association of severe aortic stenosis (AS) and recurrent gastrointestinal bleeding (GIB) from angiodysplasia. To date only few data exist regarding the prevalence of Heyde syndrome and results after transcatheter aortic valve implantation (TAVI) for the treatment of AS.
Purpose
We sought to evaluate the prevalence of Heyde syndrome in a routine clinical cohort of patients undergoing TAVI and analyze the effectiveness of treatment of AS regarding recurrent GIB in these patients.
Methods
We conducted a retrospective single-center analysis of 2545 consecutive patients who underwent TAVI for the treatment of AS in 2008–2017. Patients with a history of GIB were identified. The diagnosis of Heyde syndrome was defined as a clinical triad of presence of severe AS, a history of recurrent GIB, and an endoscopic diagnosis of angiodysplasia. GIB of unknown origin or related to other causes was defined as bleeding unrelated to angiodysplasia. Clinical outcomes of patients with Heyde syndrome were evaluated with emphasis on bleeding complications and recurrence of GIB.
Results
A history of GIB prior to TAVI was detected in 190 patients (7.5%) of the TAVI cohort. Among them, 143 patients had a GIB unrelated to angiodysplasia (5.6%) and 47 patients (1.8%) were diagnosed with Heyde syndrome. Median age and STS-PROM were 80.7 (75.3, 84.0) years and 4.7 (2.7, 9.0) respectively in Heyde patients. TAVI was successfully performed in all cases (66% endovascular access, 34% transapical access). The effective orifice areas increased from 0.8±0.1 cm2 to 2.1±0.5 cm2. Periprocedural major/life-threatening bleeding was found in 6 patients (12.8%), mainly access-related and none due to GIB. In 51% of Heyde-patients transfusion of 4.5±5.7 packed red blood cells was required during the index hospitalisation. During a mean follow-up of 12 months, recurrent GIB after TAVI was detected in 32% of patients with Heyde syndrome. In contrast only 18% of patients with GIB unrelated to angiodysplasia (Non-Heyde) had recurrent GIB after TAVI. In patients diagnosed with Heyde syndrome and recurrent GIB after TAVI the rate of residual mild or moderate paravalvular regurgitation was higher compared to those with an unremarkable course (73% vs. 37%, p=0.045).
Figure 1. 1-year Follow-Up
Conclusions
A relevant number of patients presenting for treatment of AS can be diagnosed with Heyde syndrome. In these patients TAVI can be successfully performed with moderate incidence of periprocedural bleeding complications but significant transfusion rates. Regardless of successful treatment of AS, recurrent GIB was detected in a significant number of Heyde patients during follow-up. The possible association with residual paravalvular regurgitation requires further investigation to improve treatment options in patients with Heyde syndrome.
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Affiliation(s)
- L Waldschmidt
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Drolz
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Heimburg
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Gossling
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - N Schofer
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L Voigtlaender
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Ludwig
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Linder
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Reichenspurner
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Blankenberg
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - U Schaefer
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D Westermann
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L Conradi
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Kluwe
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Seiffert
- The University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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15
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Castro L, Pecha S, Amin S, Linder M, Gosau N, Willems S, Reichenspurner H, Hakmi S. Up to 5-Year Follow-up after Transvenous Lead Extraction Procedures. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678947] [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: 10/27/2022]
Affiliation(s)
- L. Castro
- Klinik für Herzchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - S. Pecha
- Klinik für Herzchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - S. Amin
- Klinik für Herzchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - M. Linder
- Klinik für Allgemeine und Interventionelle Kardiologie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - N. Gosau
- Kardiologie mit Schwerpunkt Elektrophysiologie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - S. Willems
- Kardiologie mit Schwerpunkt Elektrophysiologie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - H. Reichenspurner
- Klinik für Herzchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - S. Hakmi
- Klinik für Herzchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
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16
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Demal J, Pecha S, Castro L, Vogler J, Gosau N, Linder M, Willems S, Reichenspurner H, Hakmi S. In-Hospital Mortality after Transvenous Lead Extraction. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678795] [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: 10/27/2022]
Affiliation(s)
- J.T. Demal
- Universitäres Herzzentrum Hamburg, Klinik und Poliklinik für Herz- und Gefäßchirurgie, Hamburg, Germany
| | - S. Pecha
- Universitäres Herzzentrum Hamburg, Klinik und Poliklinik für Herz- und Gefäßchirurgie, Hamburg, Germany
| | - L. Castro
- Universitäres Herzzentrum Hamburg, Klinik und Poliklinik für Herz- und Gefäßchirurgie, Hamburg, Germany
| | - J. Vogler
- Universitäres Herzzentrum Lübeck, Medizinische Klinik II/Kardiologie, Angiologie, Intensivmedizin, Lübeck, Germany
| | - N. Gosau
- Universitäres Herzzentrum Hamburg, Klinik für Kardiologie - Schwerpunkt Elektrophysiologie, Hamburg, Germany
| | - M. Linder
- Universitäres Herzzentrum Hamburg, Klinik für Allgemeine und Interventionelle Kardiologie, Hamburg, Germany
| | - S. Willems
- Universitäres Herzzentrum Hamburg, Klinik für Kardiologie - Schwerpunkt Elektrophysiologie, Hamburg, Germany
| | - H. Reichenspurner
- Universitäres Herzzentrum Hamburg, Klinik und Poliklinik für Herz- und Gefäßchirurgie, Hamburg, Germany
| | - S. Hakmi
- Universitäres Herzzentrum Hamburg, Klinik und Poliklinik für Herz- und Gefäßchirurgie, Hamburg, Germany
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Abstract
SummaryBy means of a new model, the fowl plague of chickens, further evidence is given that viruses may trigger blood coagulation. Macroscopically, hemorrhages were observed, whereas microscopic studies revealed platelet and fibrin thrombi in the small vessels of various organs. Hematologic studies demonstrated an increase in the clotting time and a decrease in the activities of clotting factors I, II, VIII and X, and drop in platelet counts. Heparin could diminish the hemorrhages but did not influence the survival time of the animals.
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Castro L, Pecha S, Linder M, Vogler J, Gosau N, Willems S, Reichenspurner H, Hakmi S. Laser Lead Extraction in Patients with Venous Stenosis or Occlusion: System Upgrade or Revision Is Needed. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628085] [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: 10/28/2022]
Affiliation(s)
- L. Castro
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Pecha
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - M. Linder
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - J. Vogler
- Department of Cardiology, Electrophysiology, University Heart Center Hamburg, Hamburg, Germany
| | - N. Gosau
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Willems
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - H. Reichenspurner
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Hakmi
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
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20
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Ekstrand C, Baricault B, Linder M, Lafaurie M, Sailler L, Lapeyre-Mestre M, Kieler H, Bahmanyar S, Moulis G. Incidence des thromboses veineuses et artérielles et expositions aux médicaments cardiovasculaires chez les adultes atteints de PTI primaire incident et non-splénectomisés en Suède et en France. Études populationnelle à l’échelle des deux pays. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.402] [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: 11/26/2022]
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21
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Castro L, Pecha S, Linder M, Vogler J, Gosau N, Meyer C, Willems S, Reichenspurner H, Hakmi S. The wearable cardioverter defibrillator as a bridge to reimplantation in patients with ICD or CRT-D-related infections. J Cardiothorac Surg 2017; 12:99. [PMID: 29178898 PMCID: PMC5702096 DOI: 10.1186/s13019-017-0669-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 11/16/2017] [Indexed: 10/03/2023] Open
Abstract
Background The approach to treat device infection in patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) is a challenging procedure. Optimal treatment is complete extraction of the infected device. To protect these patients from sudden cardiac arrest while waiting for reimplantation and to avoid recurrent infection, a wearable cardioverter defibrillator (WCD) seems to be a valuable solution. Therefore, we investigated the management and outcome of patients with ICD or CRT-D infections using the WCD as a bridge to re-implantation after lead extraction procedures. Methods We conducted a retrospective study on consecutive patients who underwent ICD or CRT-D removal due to device-related local or systemic infections. All patients were prescribed a WCD at our center between 01/2012 and 10/2015. All patients returned to our outpatient clinic for regular ICD or CRT-D monitoring initially 1 and 3 months after reimplantation followed by 6-months intervals. Results Twenty-one patients (mean age 65.0 ± 8.0 years, male 76.2%) were included in the study. Complete lead extraction was achieved in all patients. While waiting for reimplantation one patient experienced a symptomatic episode of sustained ventricular tachycardia. This episode was converted successfully into sinus rhythm by a single 150 J shock. Mean follow-up time 392 ± 206 days, showing survival rate of 100% and freedom from reinfection in all patients. Conclusion The WCD seems to be a valuable bridging option for patients with ICD or CRT-D infections, showing no recurrent device infection.
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Affiliation(s)
- L Castro
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.
| | - S Pecha
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - M Linder
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - J Vogler
- Department of Cardiology, Electrophysiology, University Heart Center Hamburg, Hamburg, Germany
| | - N Gosau
- Department of Cardiology, Electrophysiology, University Heart Center Hamburg, Hamburg, Germany
| | - C Meyer
- Department of Cardiology, Electrophysiology, University Heart Center Hamburg, Hamburg, Germany
| | - S Willems
- Department of Cardiology, Electrophysiology, University Heart Center Hamburg, Hamburg, Germany
| | - H Reichenspurner
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S Hakmi
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
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22
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Dostert G, Kahn CJF, Menu P, Mesure B, Cleymand F, Linder M, Velot É, Arab-Tehrany E. Nanoliposomes of Marine Lecithin, a New Way to Deliver TGF-β1. J BIOMATER TISS ENG 2017. [DOI: 10.1166/jbt.2017.1670] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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23
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Pecha S, Linder M, Castro L, Gosau N, Willems S, Reichenspurner H, Hakmi S. P1767The challenge of aggressive adhesions: tool combination for successful lead extraction. Europace 2017. [DOI: 10.1093/ehjci/eux161.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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24
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Pecha S, Linder M, Castro L, Vogler J, Gosau N, Willems S, Reichenspurner H, Hakmi S. P1766Do we need to interrupt oral anticoagulation for transvenous lead extraction with powered sheaths? Europace 2017. [DOI: 10.1093/ehjci/eux161.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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25
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Tenyang N, Womeni HM, Tiencheu B, Villeneuve P, Linder M. Effect of refrigeration time on the lipid oxidation and fatty acid profiles of catfish ( Arius maculatus) commercialized in Cameroon. Grasas y Aceites 2017. [DOI: 10.3989/gya.0335161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The effects of refrigeration at 4 °C during 9 days on the quality and stability of catfish oil were evaluated using a change in fatty acid composition by gas chromatography (GC), commonly used analytical indexes (acid and peroxide values), and analysis by Fourier transform infrared (FTIR) spectroscopy. The results revealed that lipid deterioration, hydrolysis and oxidation occurred throughout the cold storage (4 °C). Refrigeration induced the lipolysis of triglycerides by lipases and phospholipases. It also affected the fatty acids composition of the catfish. The progressive loss of unsaturation was monitored by the decrease in the absorbance band at 3012 cm-1 on FTIR spectra and the lowest value was observed in the catfish muscle at 9 days of refrigeration. Eicosapentaenoic C20:5ω3 (EPA) and docosahexaenoic C22:6ω3 (DHA) acids were the polyunsaturated fatty acids most affected during refrigeration. Refrigeration for less than 5 days was found to be the best conditions for the preservation of the catfish.
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26
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Bloch Y, Linder M, Kallman N, Nitzan U, Maoz H, Segev A, Koubi M, Lurie I. ECT patient views. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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27
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Linder M, Pecha S, Castro L, Zipfel S, Gosau N, Willems S, Reichenspurner H, Hakmi S. The Challenge of Aggressive Adhesions: Tool Combination for Successful Lead Extraction. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M. Linder
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Pecha
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - L. Castro
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Zipfel
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - N. Gosau
- Department of Cardiology - Elektrophysiology, University Heart Center Hamburg, Hamburg, Germany
| | - S. Willems
- Department of Cardiology - Elektrophysiology, University Heart Center Hamburg, Hamburg, Germany
| | - H. Reichenspurner
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Hakmi
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
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28
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Harmel E, Schofer N, Deuschl F, Linder M, Reichenspurner H, Blankenberg S, Schäfer U, Conradi L. Latest Generation Transcatheter Heart Valves in Small Aortic Annuli: Predictors for Increased Transprosthetic Gradients. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- E. Harmel
- University Heart Center Hamburg, Departments of Cardiovascular Surgery and Cardiology, Hamburg, Germany
| | - N. Schofer
- University Heart Center Hamburg, Departments of Cardiovascular Surgery and Cardiology, Hamburg, Germany
| | - F. Deuschl
- University Heart Center Hamburg, Departments of Cardiovascular Surgery and Cardiology, Hamburg, Germany
| | - M. Linder
- University Heart Center Hamburg, Departments of Cardiovascular Surgery and Cardiology, Hamburg, Germany
| | - H. Reichenspurner
- University Heart Center Hamburg, Departments of Cardiovascular Surgery and Cardiology, Hamburg, Germany
| | - S. Blankenberg
- University Heart Center Hamburg, Departments of Cardiovascular Surgery and Cardiology, Hamburg, Germany
| | - U. Schäfer
- University Heart Center Hamburg, Departments of Cardiovascular Surgery and Cardiology, Hamburg, Germany
| | - L. Conradi
- University Heart Center Hamburg, Departments of Cardiovascular Surgery and Cardiology, Hamburg, Germany
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29
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Linder M, Schofer N, Deuschl F, Seiffert M, Blankenberg S, Reichenspurner H, Schäfer U, Conradi L. Extent and Pattern of Aortic Root Calcification: Does It Impact the Need for Permanent Pacemaker Implantation? Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M. Linder
- University Heart Center Hamburg, Departments of Cardiovascular Surgery and Cardiology, Hamburg, Germany
| | - N. Schofer
- University Heart Center Hamburg, Departments of Cardiovascular Surgery and Cardiology, Hamburg, Germany
| | - F. Deuschl
- University Heart Center Hamburg, Departments of Cardiovascular Surgery and Cardiology, Hamburg, Germany
| | - M. Seiffert
- University Heart Center Hamburg, Departments of Cardiovascular Surgery and Cardiology, Hamburg, Germany
| | - S. Blankenberg
- University Heart Center Hamburg, Departments of Cardiovascular Surgery and Cardiology, Hamburg, Germany
| | - H. Reichenspurner
- University Heart Center Hamburg, Departments of Cardiovascular Surgery and Cardiology, Hamburg, Germany
| | - U. Schäfer
- University Heart Center Hamburg, Departments of Cardiovascular Surgery and Cardiology, Hamburg, Germany
| | - L. Conradi
- University Heart Center Hamburg, Departments of Cardiovascular Surgery and Cardiology, Hamburg, Germany
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30
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Castro L, Pecha S, Linder M, Zipfel S, Gosau N, Willems S, Reichenspurner H, Hakmi S. CRT Device Explantation: A Temporary Bridging Solution for Bi-Ventricular Pacing is Needed. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- L. Castro
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
| | - S. Pecha
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
| | - M. Linder
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
| | - S. Zipfel
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
| | - N. Gosau
- Universitäres Herzzentrum Hamburg, Klinik für Elektrophysiologie, Hamburg, Germany
| | - S. Willems
- Universitäres Herzzentrum Hamburg, Klinik für Elektrophysiologie, Hamburg, Germany
| | - H. Reichenspurner
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
| | - S. Hakmi
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
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31
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Seoudy H, Pecha S, Gosau N, Linder M, Zipfel S, Willems S, Treede H, Reichenspurner H, Hakmi S. Limitations in the Extraction of Active Fixation Coronary Sinus Leads. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H. Seoudy
- UKE, Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Pecha
- UKE, Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - N. Gosau
- UKE, Department of Cardiology-Electrophysiology, University Heart Center Hamburg, Hamburg, Germany
| | - M. Linder
- UKE, Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Zipfel
- UKE, Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Willems
- UKE, Department of Cardiology-Electrophysiology, University Heart Center Hamburg, Hamburg, Germany
| | - H. Treede
- Department of Cardiac and Thoracic Surgery, University Hospital Halle (Saale), Halle (Saale), Germany
| | - H. Reichenspurner
- UKE, Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Hakmi
- UKE, Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
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Schofer N, Deuschl F, Schön G, Seiffert M, Linder M, Schäfer A, Schirmer J, Reichenspurner H, Blankenberg S, Conradi L, Schäfer U. Balloon-Expandable versus Mechanically Expandable Transcatheter Heart Valves: Comparison of Procedural, Clinical, and Functional Outcomes. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- N. Schofer
- University Heart Center Hamburg, UKE, Departments of Cardiology and Cardiovascular Surgery, Hamburg, Germany
| | - F. Deuschl
- University Heart Center Hamburg, UKE, Departments of Cardiology and Cardiovascular Surgery, Hamburg, Germany
| | - G. Schön
- University Hospital Hamburg-Eppendorf, Institute of Medical Biometry and Epidemiology, Hamburg, Germany
| | - M. Seiffert
- University Heart Center Hamburg, UKE, Departments of Cardiology and Cardiovascular Surgery, Hamburg, Germany
| | - M. Linder
- University Heart Center Hamburg, UKE, Departments of Cardiology and Cardiovascular Surgery, Hamburg, Germany
| | - A. Schäfer
- University Heart Center Hamburg, UKE, Departments of Cardiology and Cardiovascular Surgery, Hamburg, Germany
| | - J. Schirmer
- University Heart Center Hamburg, UKE, Departments of Cardiology and Cardiovascular Surgery, Hamburg, Germany
| | - H. Reichenspurner
- University Heart Center Hamburg, UKE, Departments of Cardiology and Cardiovascular Surgery, Hamburg, Germany
| | - S. Blankenberg
- University Heart Center Hamburg, UKE, Departments of Cardiology and Cardiovascular Surgery, Hamburg, Germany
| | - L. Conradi
- University Heart Center Hamburg, UKE, Departments of Cardiology and Cardiovascular Surgery, Hamburg, Germany
| | - U. Schäfer
- University Heart Center Hamburg, UKE, Departments of Cardiology and Cardiovascular Surgery, Hamburg, Germany
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Ekstrand C, Linder M, Cherif H, Kieler H, Bahmanyar S. Increased susceptibility to infections before the diagnosis of immune thrombocytopenia. J Thromb Haemost 2016; 14:807-14. [PMID: 26792007 DOI: 10.1111/jth.13267] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 10/02/2015] [Accepted: 01/07/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Infections after diagnosis of primary chronic immune thrombocytopenia (cITP) have mostly been connected to the immunomodulation treatment. Infections may trigger autoimmune diseases and may be a complication of an already impaired immune system. OBJECTIVES To investigate the association of cITP with infection before diagnosis. We also estimated the incidence of cITP based on the new definition by the International ITP Working Group. METHODS We identified 1087 adults with primary cITP between 2006 and 2012 using the Swedish Patient Register. Data on infections not already associated with secondary ITP were also retrieved from the register. The standardized incidence ratios (SIRs), using the rates from the general population, and 95% confidence intervals (CIs) were estimated as a measure of relative risk. We used data from the Prescribed Drug Register to estimate SIR for anti-infective treatment. RESULTS The incidence of cITP was 2.30 per 100 000 person-years (95% CI, 2.15-2.45). cITP was associated with an increased risk of serious infections requiring inpatient or outpatient care within 5 years before cITP diagnosis (SIR = 8.74; 95% CI, 7.47-10.18). Higher magnitude SIRs were observed for candidiasis, viral infection at an unspecified site and acute upper respiratory infections. For anti-infective drugs the SIR was 1.37 (1.25-1.50) and the highest SIRs were observed for amoxicillin, macrolides, nitrofurantoin and antivirals. CONCLUSION Patients with cITP have increased risks of infection and anti-infective treatments before their cITP diagnosis, with a more marked risk for candidiasis and viral infections. The findings indicate that infection is not only related to the immunomodulation treatment but also to the disease itself.
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Affiliation(s)
- C Ekstrand
- Centre for Pharmacoepidemiology, Department of Medicine, Karolinska Institutet, Solna, Sweden
| | - M Linder
- Centre for Pharmacoepidemiology, Department of Medicine, Karolinska Institutet, Solna, Sweden
| | - H Cherif
- Department of Medical Science Hematology, Uppsala Universitet, Uppsala, Sweden
| | - H Kieler
- Centre for Pharmacoepidemiology, Department of Medicine, Karolinska Institutet, Solna, Sweden
| | - S Bahmanyar
- Centre for Pharmacoepidemiology, Department of Medicine, Karolinska Institutet, Solna, Sweden
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Pecha S, Linder M, Castro L, Gosau N, Willems S, Treede H, Reichenspurner H, Hakmi S. Laser Lead Extraction: Comparison of Infected vs. Non-infected Leads. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hakmi S, Pecha S, Castro L, Linder M, Gosau N, Willems S, Treede H, Reichenspurner H. Tricuspid Valve Regurgitation after Laser Lead Extraction. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Linder M, Pecha S, Zipfel S, Castro L, Gosau N, Willems S, Reichenspurner H, Hakmi S. Lead Extraction with High-Frequency Laser Sheaths: A Single-Center Experience. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Linder M, Seiffert M, Schofer N, Deuschl F, Schoen G, Schirmer J, Treede H, Blankenberg S, Reichenspurner H, Schaefer U, Conradi L. Device Landing Zone Calcification and Its Impact on Post Procedural Paravalvular Leakage after Transcatheter Aortic Valve Implantation with Two Generations of Balloon-expandable Transcatheter Heart Valves. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Castro L, Pecha S, Linder M, Zipfel S, Gosau N, Willems S, Reichenspurner H, Hakmi S. The Wearable Defibrillator as a Bridge to Reimplantation in Patients with ICD or CRT-D Infections. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hasan M, Ben Messaoud G, Michaux F, Tamayol A, Kahn CJF, Belhaj N, Linder M, Arab-Tehrany E. Chitosan-coated liposomes encapsulating curcumin: study of lipid–polysaccharide interactions and nanovesicle behavior. RSC Adv 2016. [DOI: 10.1039/c6ra05574e] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Despite various spectacular therapeutic properties, curcumin has low bioavailability mainly due to its poor solubility in water.
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Affiliation(s)
- M. Hasan
- Université de Lorraine
- LIBio
- ENSAIA
- F-54505 Vandoeuvre-lès-Nancy
- France
| | - G. Ben Messaoud
- Université de Lorraine
- LIBio
- ENSAIA
- F-54505 Vandoeuvre-lès-Nancy
- France
| | - F. Michaux
- Université de Lorraine
- LIBio
- ENSAIA
- F-54505 Vandoeuvre-lès-Nancy
- France
| | - A. Tamayol
- Center for Biomedical Engineering
- Department of Medicine
- Brigham and Women's Hospital
- Harvard Medical School
- Boston
| | - C. J. F. Kahn
- Aix-Marseille Université
- IFSTTAR
- F-13016 Marseille
- France
| | - N. Belhaj
- Lucasmeyer Cosmetics
- ZA les Belles Fontaines
- 91160 Champlan
- France
| | - M. Linder
- Université de Lorraine
- LIBio
- ENSAIA
- F-54505 Vandoeuvre-lès-Nancy
- France
| | - E. Arab-Tehrany
- Université de Lorraine
- LIBio
- ENSAIA
- F-54505 Vandoeuvre-lès-Nancy
- France
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Linder M, Tschernig T. Vasculogenic mimicry: Possible role of effector caspase-3, caspase-6 and caspase-7. Ann Anat 2015; 204:114-7. [PMID: 26704356 DOI: 10.1016/j.aanat.2015.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 08/25/2015] [Revised: 11/02/2015] [Accepted: 11/18/2015] [Indexed: 11/24/2022]
Abstract
Vasculogenic mimicry (VM) describes the process by which aggressive cancer cells form extracellular matrix-rich, vessel-like mesh works, which supply nutrients and oxygen. Furthermore, it offers a new route for tumor cell invasion and metastasis and thus a correspondingly poor prognosis and survival rate for affected patients. Effector caspases are well known for their apoptotic function, whereas a non-apoptotic function in tumor progression is highly disputed. Caspase-3, -6 and -7 are expressed in aggressive tumor cells in a non-mutated form, indicating an active function independent of apoptosis. This review summarizes the possible functions of the above-mentioned caspases in VM. We also discuss the possible involvement of caspases in potential mechanisms towards the formation of vessel-like structures. Furthermore, this review illustrates the importance of new studies in the ongoing investigation into the role of effector caspases in VM, invasion, and migration of aggressive tumor cells.
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Affiliation(s)
- Manuel Linder
- Center of Human and Molecular Biology, Saarland University, Saarbruecken, Germany
| | - Thomas Tschernig
- Department of Anatomy and Cell Biology, Saarland University, Homburg, Saar, Germany.
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Hasan M, Belhaj N, Benachour H, Barberi-Heyob M, Kahn CJF, Jabbari E, Linder M, Arab-Tehrany E. Liposome encapsulation of curcumin: physico-chemical characterizations and effects on MCF7 cancer cell proliferation. Int J Pharm 2014; 461:519-28. [PMID: 24355620 DOI: 10.1016/j.ijpharm.2013.12.007] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [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: 10/24/2013] [Revised: 12/06/2013] [Accepted: 12/09/2013] [Indexed: 12/29/2022]
Abstract
The role of curcumin (diferuloylmethane), for cancer treatment has been an area of growing interest. However, due to its low absorption, the poor bioavailability of curcumin limits its clinical use. In this study, we reported an approach of encapsulation a curcumin by nanoliposome to achieve an improved bioavailability of a poorly absorbed hydrophobic compound. We demonstrated that liposomal preparations to deliver curcumin increase its bioavailability. Liposomes composed of salmon's lecithin also improved curcumin bioavailability compared to those constituted of rapeseed and soya lecithins. A real-time label-free cell analysis system based on real-time cell impedance monitoring was used to investigate the in vitro cytotoxicity of liposomal preparations.
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Affiliation(s)
- M Hasan
- Université de Lorraine, Laboratoire d'ingénierie des Biomolecules, EA 4367, France
| | - N Belhaj
- Université de Lorraine, Laboratoire d'ingénierie des Biomolecules, EA 4367, France
| | - H Benachour
- Université de Lorraine, CRAN, UMR 7039, Campus Sciences, BP 70239, Vandœuvre-lès-Nancy Cedex 54506, France; CNRS, CRAN, UMR 7039, Vandœuvre-lès-Nancy, France
| | - M Barberi-Heyob
- Université de Lorraine, CRAN, UMR 7039, Campus Sciences, BP 70239, Vandœuvre-lès-Nancy Cedex 54506, France; CNRS, CRAN, UMR 7039, Vandœuvre-lès-Nancy, France; CNRS, GdR 3049 "Médicaments Photoactivables - Photochimiothérapie (PHOTOMED)", France; Centre Alexis Vautrin, CRLCC, Avenue de Bourgogne, Vandœuvre-lès-Nancy Cedex 54519, France
| | - C J F Kahn
- Aix-Marseille Univ, LBA, F-13916 Marseille, France; IFSTTAR, LBA, F-13916 Marseille, France
| | - E Jabbari
- Department of Chemical Engineering, SWNG Engineering Center, Rm 2C02, University of South Carolina, 301 South Main Street, Columbia, SC 29208, United States
| | - M Linder
- Université de Lorraine, Laboratoire d'ingénierie des Biomolecules, EA 4367, France
| | - E Arab-Tehrany
- Université de Lorraine, Laboratoire d'ingénierie des Biomolecules, EA 4367, France.
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Zhang HY, Cleymand F, Noël C, Kahn CJF, Linder M, Dahoun A, Henrion G, Arab-Tehrany E. Effects of Ar-H2-N2 microwave plasma on chitosan and its nanoliposomes blend thin films designed for tissue engineering applications. Carbohydr Polym 2013; 93:401-11. [PMID: 23499075 DOI: 10.1016/j.carbpol.2012.12.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 12/05/2012] [Accepted: 12/07/2012] [Indexed: 11/24/2022]
Abstract
This work addresses the functionalization of chitosan thin films and its nanoliposomes blend films by a microwave-excited Ar/N2/H2 surface-wave plasma treatment which was found an effective tool to modify surface properties. Changes in the film properties (wettability, chemical composition, morphology) induced by the plasma treatment are studied using water contact angle measurements, X-ray photoelectron spectroscopy and scanning probe microscopy. The results suggest that hydrophilicity of the films is improved by plasma treatment in a plasma condition dependency manner. Water contact angle of chitosan films before and after plasma treatment are, respectively, 101° and 27°. Besides chemical changes on the surface, the nanoliposomes incorporation and plasma treatment also induce morphological modifications. Moreover, a correlation is found between the nanoliposomes composition and size, and the effects of plasma treatment. It is shown that the plasma treatment significantly improves the chitosan film functionalization. The effect of N2 content (88% and 100%) in the plasma gas mixture on the film etching is also pointed out.
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Affiliation(s)
- H Y Zhang
- CNRS, Institut Jean Lamour, UMR 7198, F-54042 Nancy, France.
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Linder M, von Minckwitz G, Kamischke A, Rudlowski C, Eggemann H, Nekljudova V, Loibl S. Abstract OT2-2-05: A prospective, randomised multi-centre phase II study evaluating the adjuvant, neoadjuvant or palliative treatment with tamoxifen +/− GnRH analogue versus aromatase inhibitor + GnRH analogue in male breast cancer patients (GBG-54 MALE). Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-ot2-2-05] [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: 11/16/2022]
Abstract
Abstract
Background: Breast cancer (BC) in men is a rare disease accounting for 0.5–1% of all BC. The only available information on endocrine therapies derives from few retrospective case series and studies with small numbers of patients (pts). Treatment strategies are not based on data from prospective, randomised clinical studies and optimal therapy is unknown. Current clinical management is extrapolated from principles established for female BC. As 90% of male pts have hormone receptor positive BC, they receive tamoxifen 20mg as standard adjuvant therapy.
Although women benefit from treatment with aromatase inhibitors (AI), only case reports exist of men treated with AI. Data from other entities show, that AI only suppresses oestradiol of 40–50% with an increase of testosterone. Among men on AIs, the hypothalamic-pituitary feedback loop results in an increase substrate for aromatisation. By adding a gonadotropin-releasing hormone analogue (GnRH), the feedback loop would be interrupted and complete oestrogen suppression may be achieved.
Patients and Methods: The MALE study is a prospective, randomized, phase II study in which 48 male pts will be included in the adjuvant, neoadjuvant and metastatic setting. In a 3-arm design, endocrine therapies are compared consisting of tamoxifen 20mg daily versus tamoxifen daily+GnRH on day 1 and after 3 months versus exemestane 25mg daily+GnRH on day 1 and after 3 months. The treatment duration is 6 months. The primary aim is to determine the oestradiol suppression after 3 months. Secondary endpoints are to compare the oestradiol suppression after 6 months and to assess the compliance (with standardized questionnaires as Aging Male Symptom Score, International Index of Erectile function and International Prostate Symptom Score), safety and toxicity profile. The determination of the predefined hormones at baseline and after 3 and 6 months will be measured centrally. After the antihormonal treatment, all pts should be treated according to local recommendations. Included can be men with primary or metastatic endocrine sensitive BC with an indication of an endocrine therapy who did not receive prior antihormonal therapy; prior chemotherapy is allowed.
16 evaluable pts per group are needed for the Kruskal-Wallis-Test to have 80% power to detect at the 5% significance level a difference. The translational research programme includes the determination of cytochrome P450 polymorphisms, the hormone receptor activity and aromatase expression of the tumour tissue.
Results: The time of recruitment should not exceed 2 years with 36 recruiting sites in Germany. As no study specific treatment or investigation is planned after the end of treatment, surgery and follow up are not part of this study, however information on the health status of the pts will be collected. The trial has been opened in May 2012 and is currently recruiting.
Conclusion: This is the first study randomizing men with BC to investigate the ability to suppress estradiol of different endocrine regimen.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr OT2-2-05.
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Affiliation(s)
- M Linder
- German Breast Group, Neu-Isenburg; Kinderwunschzentrum Münster, Germany; Universitätsfrauenklinik Bonn; Universitätsfrauenklinik Magdeburg
| | - G von Minckwitz
- German Breast Group, Neu-Isenburg; Kinderwunschzentrum Münster, Germany; Universitätsfrauenklinik Bonn; Universitätsfrauenklinik Magdeburg
| | - A Kamischke
- German Breast Group, Neu-Isenburg; Kinderwunschzentrum Münster, Germany; Universitätsfrauenklinik Bonn; Universitätsfrauenklinik Magdeburg
| | - C Rudlowski
- German Breast Group, Neu-Isenburg; Kinderwunschzentrum Münster, Germany; Universitätsfrauenklinik Bonn; Universitätsfrauenklinik Magdeburg
| | - H Eggemann
- German Breast Group, Neu-Isenburg; Kinderwunschzentrum Münster, Germany; Universitätsfrauenklinik Bonn; Universitätsfrauenklinik Magdeburg
| | - V Nekljudova
- German Breast Group, Neu-Isenburg; Kinderwunschzentrum Münster, Germany; Universitätsfrauenklinik Bonn; Universitätsfrauenklinik Magdeburg
| | - S Loibl
- German Breast Group, Neu-Isenburg; Kinderwunschzentrum Münster, Germany; Universitätsfrauenklinik Bonn; Universitätsfrauenklinik Magdeburg
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Sarlin T, Nakari-Setälä T, Linder M, Penttilä M, Haikara A. Fungal Hydrophobins as Predictors of the Gushing Activity of Malt. Journal of the Institute of Brewing 2012. [DOI: 10.1002/j.2050-0416.2005.tb00655.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Bouché M, Molenda M, Linder M, Wörner A. Untersuchung des Reaktionssystems CaCl2/H2O zur thermochemischen Wärmespeicherung. CHEM-ING-TECH 2012. [DOI: 10.1002/cite.201250252] [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: 11/08/2022]
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Roßkopf C, Linder M, Wörner A. Optimierung der Reaktionsbetteigenschaften für thermochemische Energiespeicher. CHEM-ING-TECH 2012. [DOI: 10.1002/cite.201250458] [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: 11/12/2022]
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Grönhagen CM, Fored CM, Linder M, Granath F, Nyberg F. Subacute cutaneous lupus erythematosus and its association with drugs: a population-based matched case-control study of 234 patients in Sweden. Br J Dermatol 2012; 167:296-305. [PMID: 22458771 DOI: 10.1111/j.1365-2133.2012.10969.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Numerous case reports about drug-induced (DI) subacute cutaneous lupus erythematosus (SCLE) have been published. Various drug types with different latencies has been proposed as triggers for this autoimmune skin disease. OBJECTIVES To evaluate the association between exposure to certain suspected drugs (previously implicated to induce SCLE) and a subsequent diagnosis of SCLE. METHODS We performed a population-based matched case-control study in which all incident cases of SCLE (n=34) from 2006 to 2009 were derived from the National Patient Register. The control group was selected from the general population, matched (1:10) for gender, age and county of residence. The data were linked to the Prescribed Drug Register. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for the association between exposures to certain suspected drugs and the development of SCLE. RESULTS During the 6 months preceding SCLE diagnosis, 166 (71%) of the patients with SCLE had at least one filled prescription of the suspected drugs. The most increased ORs were found for terbinafine (OR 52.9, 95% CI 6.6-∞), tumour necrosis factor-α inhibitors (OR 8.0, 95% CI 1.6-37.2), antiepileptics (OR 3.4, 95% CI 1.9-5.8) and proton pump inhibitors (OR 2.9, 95% CI 2.0-4.0). CONCLUSIONS We found an association between drug exposure and SCLE. More than one third of the SCLE cases could be attributed to drug exposure. No significant OR was found for thiazides, which might be due to longer latency and therefore missed with this study design. DI-SCLE is reversible once the drug is discontinued, indicating the importance of screening patients with SCLE for potentially triggering drugs. A causal relationship cannot be established from this study and the underlying pathogenesis remains unclear.
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Affiliation(s)
- C M Grönhagen
- Division of Dermatology, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, SE-182 88 Danderyd, Sweden.
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Seiffert M, Baldus S, Conradi L, Diemert P, Linder M, Schirmer J, Kubik M, Blankenberg S, Reichenspurner H, Treede H. Reassessing outcomes after transcatheter aortic valve implantation following the valve academic research consortium definitions. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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