1
|
Fähndrich S, Herr C, Teuteberg S, Alter P, Söhler S, Soriano D, Classen J, Adams J, Weinhold V, Watz H, Waschki B, Zeller T, Eichenlaub M, Trudzinski FC, Michels JD, Omlor A, Seiler F, Moneke I, Biertz F, Stolz D, Welte T, Kauczor HU, Kahnert K, Jörres RA, Vogelmeier CF, Bals R. Midregional proatrial naturetic peptide (MRproANP) and copeptin (COPAVP) as predictors of all-cause mortality in recently diagnosed mild to moderate COPD-results from COSYCONET. Respir Res 2024; 25:56. [PMID: 38267944 PMCID: PMC10809634 DOI: 10.1186/s12931-024-02690-9] [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] [Received: 09/22/2023] [Accepted: 01/12/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND MRproANP and COPAVP are prognostic markers for mortality in chronic obstructive pulmonary disease (COPD). Furthermore, these biomarkers predict mortality due to cardiovascular diseases, which are important prognostically determining comorbidities in patients with COPD. However, less is known about these biomarkers in recently diagnosed mild to moderate COPD. Therefore, we analyzed these biomarkers as potential predictors of mortality in recently diagnosed mild to moderate COPD. METHODS The blood biomarkers considered were copeptin (COPAVP), midregional adrenomedullin (MRproADM), midregional proatrial naturetic peptide (MRproANP), and fibrinogen. Analyses were performed in patients with stable "recently diagnosed mild to moderate COPD" defined by GOLD grades 0-2 and diagnosis of COPD ≤ 5 years prior to inclusion into the COSYCONET cohort (COPD and Systemic Consequences-Comorbidities Network), using Cox regression analysis with stepwise adjustment for multiple COPD characteristics, comorbidities, troponin and NT-proBNP. RESULTS 655 patients with recently diagnosed mild to moderate COPD were included. In the initial regression model, 43 of 655 patients died during the 6-year follow-up, in the final model 27 of 487. Regression analyses with adjustment for confounders identified COPAVP and MRproANP as statistically robust biomarkers (p < 0.05 each) of all-cause mortality, while MRproADM and fibrinogen were not. The fourth quartile of MRproANP (97 pmol/L) was associated with a hazard ratio of 4.5 (95%CI: 1.6; 12.8), and the fourth quartile of COPAVP (9.2 pmol/L) with 3.0 (1.1; 8.0). The results for MRproANP were confirmed in the total cohort of grade 0-4 (n = 1470 finally). CONCLUSION In patients with recently diagnosed mild to moderate COPD, elevated values of COPVP and in particular MRproANP were robust, independent biomarkers for all-cause mortality risk after adjustment for multiple other factors. This suggests that these markers might be considered in the risk assessment of early COPD.
Collapse
Affiliation(s)
- S Fähndrich
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany.
| | - C Herr
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - S Teuteberg
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| | - P Alter
- Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, Philipps University of Marburg (UMR), German Center for Lung Research (DZL), Marburg, Germany
| | - S Söhler
- Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, Philipps University of Marburg (UMR), German Center for Lung Research (DZL), Marburg, Germany
| | - D Soriano
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| | - J Classen
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - J Adams
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - V Weinhold
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - H Watz
- Airway Research Center North (ARCN), Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, DZ, Germany
| | - B Waschki
- LungenClinic Grosshansdorf, Member of the German Center for Lung Research (DZL), Airway Research Center North (ARCN), Grosshansdorf, Germany
- Pneumology, Hospital Itzehoe, Itzehoe, Germany
- University Heart & Vascular Center Hamburg, Department of Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Zeller
- University Heart & Vascular Center Hamburg, Department of Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - M Eichenlaub
- Department of Cardiology and Angiology, Medical Center, University of Freiburg, Freiburg, Germany
| | - F C Trudzinski
- Department of Pneumology and Critical Care, Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany
| | - J D Michels
- Department of Pneumology and Critical Care, Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany
| | - A Omlor
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - F Seiler
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - I Moneke
- Department of Thoracic Surgery, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany
| | - F Biertz
- Institute for Biostatistics, Hannover Medical School, Hannover, Germany
| | - D Stolz
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| | - T Welte
- Department of Respiratory Medicine, Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany
| | - H U Kauczor
- Diagnostic and Interventional Radiology, Member of the German Center of Lung Research, University Hospital Heidelberg, Heidelberg, Germany
| | - K Kahnert
- Department of Internal Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), LMU University Hospital, LMU Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
| | - R A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Munich, Germany
| | - C F Vogelmeier
- Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, Philipps University of Marburg (UMR), German Center for Lung Research (DZL), Marburg, Germany
- Airway Research Center North (ARCN), Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, DZ, Germany
| | - R Bals
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University Campus, Saarbrücken, Germany
| |
Collapse
|
2
|
Quarg C, Jörres RA, Engelhardt S, Alter P, Budweiser S. Characteristics and outcomes of patients hospitalized for infection with influenza, SARS-CoV-2 or respiratory syncytial virus in the season 2022/2023 in a large German primary care centre. Eur J Med Res 2023; 28:568. [PMID: 38053110 DOI: 10.1186/s40001-023-01482-z] [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: 05/31/2023] [Accepted: 10/28/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND In 2022/2023, Influenza A and Respiratory Syncytial Virus (RSV) reappeared in hospitalized patients, which was in parallel to ongoing SARS-CoV-2 infections. The aim of our study was to compare the characteristics and outcomes of these infections during the same time. METHODS We included patients of all ages with a positive polymerase chain reaction (PCR) test for Influenza A/B, RSV, or SARS-CoV-2 virus hospitalized in the neurological, internal or paediatric units of the RoMed Hospital Rosenheim, Germany, between October 1st 2022 and February 28th 2023. RESULTS A total of 906 patients were included (45.6% female; median age 68.0 years; 21.9% Influenza A, 48.2% SARS-CoV-2, 28.3% RSV). Influenza B (0.2%) and co-infections (1.5%) played a minor role. In patients aged ≥ 18 years (n = 637, 71%), Influenza A, SARS-CoV-2 and RSV groups differed in age (median 72, 79, 76 years, respectively; p < 0.001). Comorbidities, particularly asthma and COPD, were most prevalent for RSV. 103 patients were admitted to the intensive care unit (ICU) (16.3% Influenza A, 15.3% SARS-CoV-2, 19.2% RSV; p = 0.649), 56 died (6.8% Influenza A, 9% SARS-CoV-2, 11.1% RSV; p = 0.496). RSV showed the highest frequencies of low-flow oxygen supplementation for admission and stay. Differences in the length of stay were minor (median 7 days). Conversely, in patients aged < 18 years (n = 261, 28,8%), 19.5%, 17.6% and 60.2% were in the Influenza A, SARS-CoV-2 and RSV groups, respectively; 0.4% showed Influenza B and 2.3% co-infections. 17 patients were admitted to ICU (3.9% Influenza A, 9.6% RSV, 0% SARS-CoV-2); none died. RSV showed the highest frequencies of high- and low-flow oxygen supplementation, SARS-CoV-2 the lowest. CONCLUSION When comparing infections with Influenza, SARS-CoV-2 and RSV in the winter 2022/2023 in hospitalized adult patients, rates of ICU admission and mortality were similar. RSV showed the highest frequencies of obstructive airway diseases, and of oxygen supplementation. The latter was also true in children/adolescents, in whom RSV dominated. Thus, in the situation of declining importance of SARS-CoV-2, RSV showed a disease burden that was relatively higher than that from Influenza and SARS-CoV-2 across ages, and this might be relevant for the seasons coming.
Collapse
Affiliation(s)
- C Quarg
- Department of Internal Medicine III, Division of Pneumology and Respiratory Medicine, RoMed Hospital Rosenheim, Ellmaierstraße 23, 83022, Rosenheim, Germany
| | - R A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Member of the German Center for Lung Research (DZL), LMU Hospital, Comprehensive Pneumology Center Munich (CPC-M), Ziemssenstraße 1, 80336, Munich, Germany
| | - S Engelhardt
- Department of Internal Medicine III, Division of Pneumology and Respiratory Medicine, RoMed Hospital Rosenheim, Ellmaierstraße 23, 83022, Rosenheim, Germany
| | - P Alter
- Department of Medicine, Pulmonary and Critical Care Medicine, Germany, Member of the German Center for Lung Research (DZL), University of Marburg (UMR), Baldingerstraße, 35043, Marburg, Germany
| | - S Budweiser
- Department of Internal Medicine III, Division of Pneumology and Respiratory Medicine, RoMed Hospital Rosenheim, Ellmaierstraße 23, 83022, Rosenheim, Germany.
- University Hospital Regensburg, Regensburg, Germany.
| |
Collapse
|
3
|
Kahnert K, Föhrenbach M, Lucke T, Alter P, Trudzinski FT, Bals R, Lutter JI, Timmermann H, Söhler S, Förderreuther S, Nowak D, Watz H, Waschki B, Behr J, Welte T, Vogelmeier CF, Jörres RA. The impact of COPD on polyneuropathy: results from the German COPD cohort COSYCONET. Respir Res 2020; 21:28. [PMID: 31959163 PMCID: PMC6971882 DOI: 10.1186/s12931-020-1293-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/24/2019] [Accepted: 01/14/2020] [Indexed: 11/10/2022] Open
Abstract
Background Peripheral neuropathy is a common comorbidity in COPD. We aimed to investigate associations between alterations commonly found in COPD and peripheral neuropathy, with particular emphasize on the distinction between direct and indirect effects. Methods We used visit 4 data of the COPD cohort COSYCONET, which included indicators of polyneuropathy (repeated tuning fork and monofilament testing), excluding patients with diabetes a/o increased HbA1c. These indicators were analysed for the association with COPD characteristics, including lung function, blood gases, 6-min walk distance (6-MWD), timed-up-and-go-test (TUG), exacerbation risk according to GOLD, C-reactive protein (CRP), and ankle-brachial index (ABI). Based on the results of conventional regression analyses adjusted for age, BMI, packyears and gender, we utilized structural equation modelling (SEM) to quantify the network of direct and indirect relationships between parameters. Results 606 patients were eligible for analysis. The indices of polyneuropathy were highly correlated with each other and related to base excess (BE), ABI and TUG. ABI was linked to neuropathy and 6-MWD, exacerbations depended on FEV1, 6-MWD and CRP. The associations could be summarized into a SEM comprising polyneuropathy as a latent variable (PNP) with three measured indicator variables. Importantly, PNP was directly dependent on ABI and particularly on BE. When also including patients with diabetes and/or elevated values of HbA1c (n = 742) the SEM remained virtually the same. Conclusion We identified BE and ABI as major determinants of peripheral neuropathy in patients with COPD. All other associations, particularly those with lung function and physical capacity, were indirect. These findings underline the importance of alterations of the micromilieu in COPD, in particular the degree of metabolic compensation and vascular status.
Collapse
Affiliation(s)
- K Kahnert
- Department of Internal Medicine V - Pulmonology, University Hospital, LMU Munich, Comprehensive Pneumology Center Munich (CPC-M, member of German Center for Lung Research (DZL), Marchioninisr. 15, 81377 München, and Ziemssenstr. 1, 80336, Munich, Germany.
| | - M Föhrenbach
- Institute and Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M, member of German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - T Lucke
- Institute and Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M, member of German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - P Alter
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany, Member of the German Center for Lung Research (DZL), Baldingerstrasse, 35043, Marburg, Germany.,Department of Internal Medicine V - Pulmonology, Allergology, Intensive Care Medicine, Saarland University Hospital, Kirrberger Straße 1, 66424, Homburg, Germany
| | - F T Trudzinski
- Department of Internal Medicine V - Pulmonology, Allergology, Intensive Care Medicine, Saarland University Hospital, Kirrberger Straße 1, 66424, Homburg, Germany
| | - R Bals
- Department of Internal Medicine V - Pulmonology, Allergology, Intensive Care Medicine, Saarland University Hospital, Kirrberger Straße 1, 66424, Homburg, Germany
| | - J I Lutter
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Ingolstädter Landstr. 1, 85764, Munich, Germany
| | - H Timmermann
- Hamburger Institut für Therapieforschung GmbH, Colonaden 72, 20354, Hamburg, Germany
| | - S Söhler
- ASCONET Study Coordination Office, University of Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - S Förderreuther
- Department of Neurology, Klinikum Innenstadt, Ludwig Maximilian University of Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - D Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M, member of German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - H Watz
- Institute and Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M, member of German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - B Waschki
- LungenClinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany.,Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany
| | - J Behr
- Department of Internal Medicine V - Pulmonology, University Hospital, LMU Munich, Comprehensive Pneumology Center Munich (CPC-M, member of German Center for Lung Research (DZL), Marchioninisr. 15, 81377 München, and Ziemssenstr. 1, 80336, Munich, Germany
| | - T Welte
- Department of Pneumology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - C F Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany, Member of the German Center for Lung Research (DZL), Baldingerstrasse, 35043, Marburg, Germany
| | - R A Jörres
- Institute and Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M, member of German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| |
Collapse
|
4
|
Abstract
For myocarditis and inflammatory cardiomyopathy, an etiologically driven treatment is today the best option beyond heart failure therapy. Prerequisites for this are noninvasive and invasive biomarkers including endomyocardial biopsy and polymerase chain reaction on cardiotropic agents. Imaging by Doppler echocardiography and cardiac magnetic resonance imaging as well as cardiac biomarkers such as C‑reactive protein, N‑terminal pro-B-type natriuretic peptide , and troponins can contribute to the clinical work-up of the syndrome but not toward elucidating the underlying cause or pathogenetic process. This review summarizes the phases and clinical features of myocarditis and gives an up-to-date short overview of the current treatment options starting with heart failure and antiarrhythmic therapy. Although inflammation in myocardial disease can resolve spontaneously, often specific treatment directed against the causative agent is required. For fulminant, acute, and chronic autoreactive myocarditis, immunosuppressive treatment has proven to be beneficial in the TIMIC and ESETCID trials; for viral cardiomyopathy and myocarditis, intravenous immunoglobulin IgG subtype and polyvalent intravenous immunoglobulins IgG, IgA, and IgM can frequently resolve inflammation. However, despite the elimination of inflammation, the eradication of parvovirus B19 and human herpesvirus-6 is still a challenge, for which ivIg treatment can become a future key player.
Collapse
Affiliation(s)
- B Maisch
- Fachbereich Medizin, Philipps-Universität Marburg und Herz- und Gefäßzentrum (HGZ) Marburg, Feldbergstr. 45, 35043, Marburg, Germany.
| | - P Alter
- Klinik für Innere Medizin-Pneumologie und Intensivmedizin, UKGM und Philipps-Universität Marburg, Marburg, Germany
| |
Collapse
|
5
|
Trudzinski FC, Kahnert K, Vogelmeier CF, Alter P, Seiler F, Fähndrich S, Watz H, Welte T, Speer T, Zewinger S, Biertz F, Kauczor HU, Jörres RA, Bals R. Combined effects of lung function, blood gases and kidney function on the exacerbation risk in stable COPD: Results from the COSYCONET cohort. Respir Med 2019; 154:18-26. [PMID: 31203096 DOI: 10.1016/j.rmed.2019.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/26/2019] [Accepted: 06/10/2019] [Indexed: 11/15/2022]
Abstract
RATIONALE Alterations of acid-base metabolism are an important outcome predictor in acute exacerbations of COPD, whereas sufficient metabolic compensation and adequate renal function are associated with decreased mortality. In stable COPD there is, however, only limited information on the combined role of acid-base balance, blood gases, renal and respiratory function on exacerbation risk grading. METHODS We used baseline data of the COPD cohort COSYCONET, applying linear and logistic regression analyses, the results of which were implemented into a comprehensive structural equation model. As most informative parameters it comprised the estimated glomerular filtration rate (eGFR), lung function defined via forced expiratory volume in 1 s (FEV1), intrathoracic gas volume (ITGV) and (diffusing capacity for carbon monoxide (DLCO), moreover arterial oxygen content (CaO2), partial pressure of oxygen (PaCO2), base exess (BE) and exacerbation risk according to GOLD criteria. All measures were adjusted for age, gender, body-mass index, the current smoking status and pack years. RESULTS 1506 patients with stable COPD (GOLD grade 1-4; mean age 64.5 ± 8.1 y; mean FEV1 54 ± 18 %predicted, mean eGFR 82.3 ± 16.9 mL/min/1.73 m2) were included. BE was linked to eGFR, lung function and PaCO2 and played a role as indirect predictor of exacerbation risk via these measures; moreover, eGFR was directly linked to exacerbation risk. These associations remained significant after taking into account medication (diuretics, oral and inhaled corticosteroids), whereby corticosteroids had effects on exacerbation risk and lung function, diuretics on eGFR, BE and lung function. CONCLUSION Even in stable COPD acid-base metabolism plays a key integrative role in COPD risk assessment despite rather small deviations from normality. It partially mediates the effects of impairments in kidney function, which are also directly linked to exacerbation risk.
Collapse
Affiliation(s)
- F C Trudzinski
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany.
| | - K Kahnert
- Department of Internal Medicine V, University Hospital, LMU Munich, Comprehensive Pneumology Center, Member of the German Center for Lung Research, Munich, Germany
| | - C F Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, Philipps University of Marburg (UMR), Member of the German Center for Lung Research (DZL), Marburg, Germany
| | - P Alter
- Department of Medicine, Pulmonary and Critical Care Medicine, Philipps University of Marburg (UMR), Member of the German Center for Lung Research (DZL), Marburg, Germany
| | - F Seiler
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - S Fähndrich
- Department of Pneumology, University Hospital Freiburg, Freiburg, Germany
| | - H Watz
- Pulmonary Research Institute at LungenClinic Grosshansdorf, Airway Research Center North, Member of the German Center for Lung Research, Grosshansdorf, Germany
| | - T Welte
- Clinic for Pneumology, Hannover Medical School, Member of the German Center for Lung Research, Hannover, Germany
| | - T Speer
- Department of Internal Medicine IV - Nephrology, Saarland University Hospital, Homburg, Germany
| | - S Zewinger
- Department of Internal Medicine IV - Nephrology, Saarland University Hospital, Homburg, Germany
| | - F Biertz
- Institute for Biostatistics, Hannover Medical School, Hannover, Germany
| | - H-U Kauczor
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Member of the German Center of Lung Research, Heidelberg, Germany
| | - R A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig Maximilians University (LMU), Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - R Bals
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| |
Collapse
|
6
|
Alter P, Watz H, Kahnert K, Rabe KF, Jung P, Biertz F, Graf J, Bals R, Vogelmeier C, Jörres RA. Einflüsse von Obstruktion und Überblähung bei COPD auf die elektrischen Herzachsen von P-Welle, QRS-Komplex und T-Welle im EKG. Pneumologie 2018. [DOI: 10.1055/s-0037-1619314] [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)
- P Alter
- Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen u. Marburg, Standort Marburg
| | - H Watz
- Pneumologisches Forschungsinstitut an der Lungenclinic Grosshansdorf
| | - K Kahnert
- Medizinische Klinik V, Klinikum der Universität München LMU
| | - KF Rabe
- Zentrum für Pneumologie und Thoraxchirurgie, Lungenclinic Grosshansdorf GmbH
| | - P Jung
- Zentrum für Innere Medizin Dachau
| | - F Biertz
- Institut für Biometrie, Medizinische Hochschule Hannover
| | - J Graf
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der LMU München
| | - R Bals
- Innere Medizin V, Universitätsklinikum des Saarlandes
| | - C Vogelmeier
- Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen u. Marburg, Standort Marburg
| | - RA Jörres
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der LMU München
| |
Collapse
|
7
|
Kahnert K, Alter P, Young D, Lucke T, Heinrich J, Huber RM, Behr J, Wacker M, Biertz F, Watz H, Bals R, Welte T, Wirtz H, Herth FJF, Vestbo J, Wouters EFM, Vogelmeier C, Jörres RA. The revised GOLD 2017 COPD categorization in relation to comorbidities. Pneumologie 2018. [DOI: 10.1055/s-0037-1619396] [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)
- K Kahnert
- Medizinische Klinik V, Klinikum der Universität München LMU
| | - P Alter
- Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | - D Young
- David Young Communications, Horsham, UK
| | - T Lucke
- Klinikum der Universität München
| | - J Heinrich
- Institut für Epidemiologie I, Helmholtz Zentrum München – Deutsches Forschungszentrum für Gesundheit und Umwelt; Comprehensive Pneumology Center Munich (CPC-M), Mitglied des Deutschen Zentrums für Lungenforschung (DZL); German Research Center for Environmental Health
| | - RM Huber
- Division of Respiratory Medicine and Thoracic Oncology, Department of Internal Medicine V, Ludwig Maximilian University of Munich and Thoracic Oncology Centre
| | - J Behr
- Medizinische Klinik und Poliklinik V, Klinikum der LMU München, Comprehensive Pneumology Center
| | - M Wacker
- Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Helmholtz Zentrum München; Comprehensive Pneumology Center Munich (CPC-M), Mitglied des Deutschen Zentrums für Lungenforschung (DZL)
| | - F Biertz
- Institut für Biometrie, Medizinische Hochschule Hannover
| | - H Watz
- Pneumologisches Forschungsinstitut an der Lungenclinic Grosshansdorf
| | - R Bals
- Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes, Homburg
| | - T Welte
- Klinik für Pneumologie, Medizinische Hochschule Hannover
| | - H Wirtz
- Pneumologie, Universitätsklinikum der Universität Leipzig
| | - FJF Herth
- Pneumology, Institute of Internal Medicine III, Thoraxklinik, University Hospital Heidelberg
| | - J Vestbo
- Respiratory Research Group, Manchester Academic Health Sciences Centre
| | | | - C Vogelmeier
- Pulmonary and Critical Care Medicine, Department of Medicine, University Medical Centre Gießen and Marburg, Phillips-University Marburg, Member of the German Centre for Lung Research (DZL)
| | - RA Jörres
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der LMU München
| |
Collapse
|
8
|
Kölpin J, Kaufhold F, Böselt T, Nell C, Herth FJF, Vogelmeier C, Alter P, Kähler CM, Veith M, Greulich T, Spielmanns M, Kenn K, Kreuter M, Koczulla AR. Drei-Center Studie (DZL) zur Untersuchung von Trainingstherapieauswirkungen eines dreimonatigen Ganzkörpervibrationstrainings bei Patienten mit Lungenfibrose auf Muskelkraft, Lungenfunktion, gesundheitsbezogene Lebensqualität und Inflammationsmarker. Pneumologie 2017. [DOI: 10.1055/s-0037-1598477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- J Kölpin
- Pneumologie, Philipps Universität Marburg
| | - F Kaufhold
- Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg, Member of the German Center for Lung Research (Dzl)
| | - T Böselt
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - C Nell
- Pneumologie, Philipps Universität Marburg
| | - FJF Herth
- Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg, Member of the German Center for Lung Research (Dzl)
| | - C Vogelmeier
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - P Alter
- Pneumologie, Philipps Universität Marburg
| | | | - M Veith
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - T Greulich
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - M Spielmanns
- Medizinische Klinik und Ambulante Pneumologische Rehabilitation in Leverkusen (April)
| | - K Kenn
- Schön Klinik Berchtesgadener Land; Philipps Universität Marburg
| | - M Kreuter
- Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg, Member of the German Center for Lung Research (Dzl)
| | - AR Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| |
Collapse
|
9
|
Jimenez Siebert M, Böselt T, Greulich T, Alter P, Herth FJF, Kahn N, Bornitz F, Vogelmeier C, Nell C, Kähler CJ, Hummler S, Koczulla AR. Effects of a 6 week whole-body vibration training (WBVT) in stable COPD patients: a randomized clinical trial. Pneumologie 2017. [DOI: 10.1055/s-0037-1598478] [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 Jimenez Siebert
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - T Böselt
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - T Greulich
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - P Alter
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - FJF Herth
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg; Pulmonology, Thoraxklinik Universitaetsklinikum Heidelberg
| | - N Kahn
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg; Pulmonology, Thoraxklinik Universitaetsklinikum Heidelberg
| | - F Bornitz
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg; Pulmonology, Thoraxklinik Universitaetsklinikum Heidelberg
| | - C Vogelmeier
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - C Nell
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - CJ Kähler
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg; Pulmonology, Fachkliniken Wangen
| | - S Hummler
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg; Pulmonology, Thoraxklinik Universitaetsklinikum Heidelberg
| | - AR Koczulla
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| |
Collapse
|
10
|
Böselt T, Spielmanns M, Nell C, Storre JH, Windisch W, Magerhans L, Beutel B, Kenn K, Greulich T, Alter P, Vogelmeier C, Koczulla AR. Validity and usability of physical activity monitoring in patients with chronic obstructive pulmonary disease (COPD). Pneumologie 2017. [DOI: 10.1055/s-0037-1598310] [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)
- T Böselt
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps Universität Marburg
| | - M Spielmanns
- Medizinische Klinik und Ambulante Pneumologische Rehabilitation in Leverkusen (April)
| | - C Nell
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps Universität Marburg
| | - JH Storre
- Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, University of Witten/Herdecke
| | - W Windisch
- Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, University of Witten/Herdecke
| | - L Magerhans
- Klinik für Innere Medizin, Schwerpunkt Nephrologie, Philipps Universität Marburg
| | - B Beutel
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps Universität Marburg
| | - K Kenn
- Schön Klinik Berchtesgadener Land; Philipps Universität Marburg
| | - T Greulich
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | - P Alter
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | - C Vogelmeier
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | - AR Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| |
Collapse
|
11
|
Alter P, Bircheneder S, Zhou LZ, Schlüter U, Gahrtz M, Sonnewald U, Dresselhaus T. Flowering Time-Regulated Genes in Maize Include the Transcription Factor ZmMADS1. Plant Physiol 2016; 172:389-404. [PMID: 27457125 PMCID: PMC5074603 DOI: 10.1104/pp.16.00285] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 07/23/2016] [Indexed: 05/08/2023]
Abstract
Flowering time (FTi) control is well examined in the long-day plant Arabidopsis (Arabidopsis thaliana), and increasing knowledge is available for the short-day plant rice (Oryza sativa). In contrast, little is known in the day-neutral and agronomically important crop plant maize (Zea mays). To learn more about FTi and to identify novel regulators in this species, we first compared the time points of floral transition of almost 30 maize inbred lines and show that tropical lines exhibit a delay in flowering transition of more than 3 weeks under long-day conditions compared with European flint lines adapted to temperate climate zones. We further analyzed the leaf transcriptomes of four lines that exhibit strong differences in flowering transition to identify new key players of the flowering control network in maize. We found strong differences among regulated genes between these lines and thus assume that the regulation of FTi is very complex in maize. Especially genes encoding MADS box transcriptional regulators are up-regulated in leaves during the meristem transition. ZmMADS1 was selected for functional studies. We demonstrate that it represents a functional ortholog of the central FTi integrator SUPPRESSOR OF OVEREXPRESSION OF CONSTANS1 (SOC1) of Arabidopsis. RNA interference-mediated down-regulation of ZmMADS1 resulted in a delay of FTi in maize, while strong overexpression caused an early-flowering phenotype, indicating its role as a flowering activator. Taken together, we report that ZmMADS1 represents a positive FTi regulator that shares an evolutionarily conserved function with SOC1 and may now serve as an ideal stating point to study the integration and variation of FTi pathways also in maize.
Collapse
Affiliation(s)
- Philipp Alter
- Cell Biology and Plant Biochemistry, Biochemie-Zentrum Regensburg, University of Regensburg, 93040 Regensburg, Germany (P.A., S.B., L.-Z.Z., M.G., T.D.);Institute of Plant Biochemistry, Heinrich Heine University Düsseldorf, 40225 Duesseldorf, Germany (U.Sc.); andBiochemistry, Department of Biology, University of Erlangen-Nürnberg, 91058 Erlangen, Germany (U.So.)
| | - Susanne Bircheneder
- Cell Biology and Plant Biochemistry, Biochemie-Zentrum Regensburg, University of Regensburg, 93040 Regensburg, Germany (P.A., S.B., L.-Z.Z., M.G., T.D.);Institute of Plant Biochemistry, Heinrich Heine University Düsseldorf, 40225 Duesseldorf, Germany (U.Sc.); andBiochemistry, Department of Biology, University of Erlangen-Nürnberg, 91058 Erlangen, Germany (U.So.)
| | - Liang-Zi Zhou
- Cell Biology and Plant Biochemistry, Biochemie-Zentrum Regensburg, University of Regensburg, 93040 Regensburg, Germany (P.A., S.B., L.-Z.Z., M.G., T.D.);Institute of Plant Biochemistry, Heinrich Heine University Düsseldorf, 40225 Duesseldorf, Germany (U.Sc.); andBiochemistry, Department of Biology, University of Erlangen-Nürnberg, 91058 Erlangen, Germany (U.So.)
| | - Urte Schlüter
- Cell Biology and Plant Biochemistry, Biochemie-Zentrum Regensburg, University of Regensburg, 93040 Regensburg, Germany (P.A., S.B., L.-Z.Z., M.G., T.D.);Institute of Plant Biochemistry, Heinrich Heine University Düsseldorf, 40225 Duesseldorf, Germany (U.Sc.); andBiochemistry, Department of Biology, University of Erlangen-Nürnberg, 91058 Erlangen, Germany (U.So.)
| | - Manfred Gahrtz
- Cell Biology and Plant Biochemistry, Biochemie-Zentrum Regensburg, University of Regensburg, 93040 Regensburg, Germany (P.A., S.B., L.-Z.Z., M.G., T.D.);Institute of Plant Biochemistry, Heinrich Heine University Düsseldorf, 40225 Duesseldorf, Germany (U.Sc.); andBiochemistry, Department of Biology, University of Erlangen-Nürnberg, 91058 Erlangen, Germany (U.So.)
| | - Uwe Sonnewald
- Cell Biology and Plant Biochemistry, Biochemie-Zentrum Regensburg, University of Regensburg, 93040 Regensburg, Germany (P.A., S.B., L.-Z.Z., M.G., T.D.);Institute of Plant Biochemistry, Heinrich Heine University Düsseldorf, 40225 Duesseldorf, Germany (U.Sc.); andBiochemistry, Department of Biology, University of Erlangen-Nürnberg, 91058 Erlangen, Germany (U.So.)
| | - Thomas Dresselhaus
- Cell Biology and Plant Biochemistry, Biochemie-Zentrum Regensburg, University of Regensburg, 93040 Regensburg, Germany (P.A., S.B., L.-Z.Z., M.G., T.D.);Institute of Plant Biochemistry, Heinrich Heine University Düsseldorf, 40225 Duesseldorf, Germany (U.Sc.); andBiochemistry, Department of Biology, University of Erlangen-Nürnberg, 91058 Erlangen, Germany (U.So.)
| |
Collapse
|
12
|
Alter P, Jörres RA, Watz H, Welte T, Gläser S, Schulz H, Bals R, Karch A, Wouters E, Vestbo J, Young D, Vogelmeier CF. Lung function impairment is associated with increased left ventricular cardiac wall stress in COPD: The German multicenter COSYCONET study. Pneumologie 2016. [DOI: 10.1055/s-0036-1584656] [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: 10/19/2022]
|
13
|
Böselt T, Nell C, Kehr K, Holland A, Greulich T, Kenn K, Böder J, Klapdor B, Vogelmeier C, Alter P, Koczulla R. Ganzkörpervibrationstherapie bei Intensivpatienten: eine Machbarkeits- und Sicherheitsstudie. Pneumologie 2016. [DOI: 10.1055/s-0036-1583512] [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: 10/21/2022]
|
14
|
Böselt T, Nell C, Kehr K, Holland A, Dresel M, Greulich T, Tackenberg B, Kenn K, Boeder J, Klapdor B, Kirschbaum A, Vogelmeier C, Alter P, Koczulla R. Ganzkörper-Vibrationstherapie bei Intensivpatienten. Pneumologie 2016. [DOI: 10.1055/s-0036-1572255] [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]
|
15
|
Alter P, van des Sand K, Nell C, Figiel JH, Greulich T, Vogelmeier C, Koczulla AR. Lung function in COPD is correlated with increased left ventricular wall stress in coincident heart failure. Pneumologie 2015. [DOI: 10.1055/s-0035-1544768] [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: 10/24/2022]
|
16
|
Alter P, Luetteken L, Nell C, Haid D, Kehr K, Greulich T, Apelt S, Langenhan K, Hohmann C, Vogelmeier CF, Koczulla AR. Exercise training leads to physiological left ventricular hypertrophy in COPD. Int J Cardiol 2014; 174:156-7. [PMID: 24726167 DOI: 10.1016/j.ijcard.2014.03.160] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 03/23/2014] [Indexed: 12/01/2022]
Affiliation(s)
- P Alter
- University of Marburg, Internal Medicine, Cardiology, Germany.
| | - L Luetteken
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - C Nell
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - D Haid
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - K Kehr
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - T Greulich
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - S Apelt
- University of Marburg, Physiotherapy, Germany
| | - K Langenhan
- University of Marburg, Physiotherapy, Germany
| | - C Hohmann
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - C F Vogelmeier
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - A R Koczulla
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany.
| |
Collapse
|
17
|
Colmsee C, Mascher M, Czauderna T, Hartmann A, Schlüter U, Zellerhoff N, Schmitz J, Bräutigam A, Pick TR, Alter P, Gahrtz M, Witt S, Fernie AR, Börnke F, Fahnenstich H, Bucher M, Dresselhaus T, Weber APM, Schreiber F, Scholz U, Sonnewald U. OPTIMAS-DW: a comprehensive transcriptomics, metabolomics, ionomics, proteomics and phenomics data resource for maize. BMC Plant Biol 2012; 12:245. [PMID: 23272737 PMCID: PMC3577462 DOI: 10.1186/1471-2229-12-245] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 12/12/2012] [Indexed: 05/05/2023]
Abstract
BACKGROUND Maize is a major crop plant, grown for human and animal nutrition, as well as a renewable resource for bioenergy. When looking at the problems of limited fossil fuels, the growth of the world's population or the world's climate change, it is important to find ways to increase the yield and biomass of maize and to study how it reacts to specific abiotic and biotic stress situations. Within the OPTIMAS systems biology project maize plants were grown under a large set of controlled stress conditions, phenotypically characterised and plant material was harvested to analyse the effect of specific environmental conditions or developmental stages. Transcriptomic, metabolomic, ionomic and proteomic parameters were measured from the same plant material allowing the comparison of results across different omics domains. A data warehouse was developed to store experimental data as well as analysis results of the performed experiments. DESCRIPTION The OPTIMAS Data Warehouse (OPTIMAS-DW) is a comprehensive data collection for maize and integrates data from different data domains such as transcriptomics, metabolomics, ionomics, proteomics and phenomics. Within the OPTIMAS project, a 44K oligo chip was designed and annotated to describe the functions of the selected unigenes. Several treatment- and plant growth stage experiments were performed and measured data were filled into data templates and imported into the data warehouse by a Java based import tool. A web interface allows users to browse through all stored experiment data in OPTIMAS-DW including all data domains. Furthermore, the user can filter the data to extract information of particular interest. All data can be exported into different file formats for further data analysis and visualisation. The data analysis integrates data from different data domains and enables the user to find answers to different systems biology questions. Finally, maize specific pathway information is provided. CONCLUSIONS With OPTIMAS-DW a data warehouse for maize was established, which is able to handle different data domains, comprises several analysis results that will support researchers within their work and supports systems biological research in particular. The system is available at http://www.optimas-bioenergy.org/optimas_dw.
Collapse
Affiliation(s)
- Christian Colmsee
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), 06466 Stadt Seeland, Corrensstr. 3
| | - Martin Mascher
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), 06466 Stadt Seeland, Corrensstr. 3
| | - Tobias Czauderna
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), 06466 Stadt Seeland, Corrensstr. 3
| | - Anja Hartmann
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), 06466 Stadt Seeland, Corrensstr. 3
| | - Urte Schlüter
- Department of Biology, Friedrich-Alexander University of Erlangen-Nuremberg, 91054 Erlangen, Staudtstr. 5, Germany
| | - Nina Zellerhoff
- University of Cologne, Botanical Institute, 50923 Köln, Albertus-Magnus-Platz, Germany
| | - Jessica Schmitz
- University of Cologne, Botanical Institute, 50923 Köln, Albertus-Magnus-Platz, Germany
| | - Andrea Bräutigam
- Plant Biochemistry, Heinrich-Heine-University, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Thea R Pick
- Plant Biochemistry, Heinrich-Heine-University, Universitätsstr. 1, 40225 Düsseldorf, Germany
- International Graduate Program for Plant Science (iGrad-plant), Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany
| | - Philipp Alter
- Cell Biology and Plant Biochemistry, University of Regensburg, Universitätsstr. 31, 93040 Regensburg, Germany
| | - Manfred Gahrtz
- Cell Biology and Plant Biochemistry, University of Regensburg, Universitätsstr. 31, 93040 Regensburg, Germany
| | - Sandra Witt
- Department of Molecular Physiology, Max Planck Institute of Molecular Plant Physiology, 14476 Potsdam-Golm, Am Mühlenberg 1, Germany
| | - Alisdair R Fernie
- Department of Molecular Physiology, Max Planck Institute of Molecular Plant Physiology, 14476 Potsdam-Golm, Am Mühlenberg 1, Germany
| | - Frederik Börnke
- Department of Biology, Friedrich-Alexander University of Erlangen-Nuremberg, 91054 Erlangen, Staudtstr. 5, Germany
| | | | - Marcel Bucher
- University of Cologne, Botanical Institute, 50923 Köln, Albertus-Magnus-Platz, Germany
| | - Thomas Dresselhaus
- Cell Biology and Plant Biochemistry, University of Regensburg, Universitätsstr. 31, 93040 Regensburg, Germany
| | - Andreas PM Weber
- Plant Biochemistry, Heinrich-Heine-University, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Falk Schreiber
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), 06466 Stadt Seeland, Corrensstr. 3
- Martin Luther University Halle-Wittenberg, Institute of Computer Science, 06120 Halle, Von-Seckendorff-Platz 1, Germany
| | - Uwe Scholz
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), 06466 Stadt Seeland, Corrensstr. 3
| | - Uwe Sonnewald
- Department of Biology, Friedrich-Alexander University of Erlangen-Nuremberg, 91054 Erlangen, Staudtstr. 5, Germany
| |
Collapse
|
18
|
Alter P, Dreissen A, Luo FL, Matsubara S. Acclimatory responses of Arabidopsis to fluctuating light environment: comparison of different sunfleck regimes and accessions. Photosynth Res 2012; 113:221-37. [PMID: 22729524 PMCID: PMC3430843 DOI: 10.1007/s11120-012-9757-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 06/06/2012] [Indexed: 05/20/2023]
Abstract
Acclimation to fluctuating light environment with short (lasting 20 s, at 650 or 1,250 μmol photons m(-2) s(-1), every 6 or 12 min) or long (for 40 min at 650 μmol photons m(-2) s(-1), once a day at midday) sunflecks was studied in Arabidopsis thaliana. The sunfleck treatments were applied in the background daytime light intensity of 50 μmol photons m(-2) s(-1). In order to distinguish the effects of sunflecks from those of increased daily irradiance, constant light treatments at 85 and 120 μmol photons m(-2) s(-1), which gave the same photosynthetically active radiation (PAR) per day as the different sunfleck treatments, were also included in the experiments. The increased daily total PAR in the two higher constant light treatments enhanced photosystem II electron transport and starch accumulation in mature leaves and promoted expansion of young leaves in Columbia-0 plants during the 7-day treatments. Compared to the plants remaining under 50 μmol photons m(-2) s(-1), application of long sunflecks caused upregulation of electron transport without affecting carbon gain in the form of starch accumulation and leaf growth or the capacity of non-photochemical quenching (NPQ). Mature leaves showed marked enhancement of the NPQ capacity under the conditions with short sunflecks, which preceded recovery and upregulation of electron transport, demonstrating the initial priority of photoprotection. The distinct acclimatory responses to constant PAR, long sunflecks, and different combinations of short sunflecks are consistent with acclimatory adjustment of the processes in photoprotection and carbon gain, depending on the duration, frequency, and intensity of light fluctuations. While the responses of leaf expansion to short sunflecks differed among the seven Arabidopsis accessions examined, all plants showed NPQ upregulation, suggesting limited ability of this species to utilize short sunflecks. The increase in the NPQ capacity was accompanied by reduced chlorophyll contents, higher levels of the xanthophyll-cycle pigments, faster light-induced de-epoxidation of violaxanthin to zeaxanthin and antheraxanthin, increased amounts of PsbS protein, as well as enhanced activity of superoxide dismutase. These acclimatory mechanisms, involving reorganization of pigment-protein complexes and upregulation of other photoprotective reactions, are probably essential for Arabidopsis plants to cope with photo-oxidative stress induced by short sunflecks without suffering from severe photoinhibition and lipid peroxidation.
Collapse
Affiliation(s)
- Philipp Alter
- IBG-2: Pflanzenwissenschaften, Forschungszentrum Jülich, 52425 Jülich, Germany
- Aachen University of Applied Sciences, 52066 Aachen, Germany
- Present Address: Cell Biology and Plant Biochemistry, Universität Regensburg, 93053 Regensburg, Germany
| | - Anne Dreissen
- IBG-2: Pflanzenwissenschaften, Forschungszentrum Jülich, 52425 Jülich, Germany
- Aachen University of Applied Sciences, 52066 Aachen, Germany
| | - Fang-Li Luo
- IBG-2: Pflanzenwissenschaften, Forschungszentrum Jülich, 52425 Jülich, Germany
- College of Nature Conservation, Beijing Forestry University, Beijing, 100083 China
| | - Shizue Matsubara
- IBG-2: Pflanzenwissenschaften, Forschungszentrum Jülich, 52425 Jülich, Germany
| |
Collapse
|
19
|
Alter P, Rupp H, Figiel JH, Rominger MB, Maisch B. Assessment of increased left ventricular wall stress with the volume-based wall stress index – prediction of left ventricular hypertrophy and late gadolinium enhancement in dilative heart failure. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0031-1300871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
20
|
Rupp H, Rupp TP, Alter P, Maisch B. Failure of omega-3 fatty acids in atrial fibrillation? No deficiency of highly unsaturated fatty acids in the absence of heart failure. Europace 2011; 13:1357; author reply 1357-8. [DOI: 10.1093/europace/eur149] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
21
|
Rupp H, Rupp TP, Alter P, Jung N, Pankuweit S, Maisch B. Intrapericardial procedures for cardiac regeneration by stem cells: need for minimal invasive access (AttachLifter) to the normal pericardial cavity. Herz 2011; 35:458-65. [PMID: 20941468 DOI: 10.1007/s00059-010-3382-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
In view of the only modest functional and anatomical improvements achieved by bone marrow-derived cell transplantation in patients with heart disease, the question was addressed whether the intracoronary, transcoronary-venous, and intramyocardial delivery routes are adequate. It is hypothesized that an intrapericardial delivery of stem cells or activators of resident cardiac stem cells increases therapeutic benefits. From such an intrapericardial depot, cells or modulating factors, such as thymosin β4 or Ac-SDKP, are expected to reach the myocardium with sustained kinetics. Novel tools which provide access to the pericardial space even in the absence of pericardial effusion are, therefore, described. When the pericardium becomes attached to the suction head (monitored by an increase in negative pressure), the pericardium is lifted from the epicardium ("AttachLifter"). The opening of the suction head ("Attacher") is narrowed by flexible clamps which grab the tissue and improve the vacuum seal in the case of uneven tissue. A ridge, i.e.,"needle guidance", on the suction head excludes injury to the epicardium, whereby the pericardium is punctured by a needle which resides outside the suction head. A fiberscope can be used to inspect the pericardium prior to puncture. Based on these procedures, the role of the pericardial space and the presence of pericardial effusion in cardiac regeneration can be assessed.
Collapse
Affiliation(s)
- H Rupp
- Department of Internal Medicine - Cardiology, Experimental Cardiology Laboratory, Philipps University of Marburg, Marburg, Deutschland.
| | | | | | | | | | | |
Collapse
|
22
|
Alter P, Rupp H, Rominger M, Czerny F, Vollrath A, Klose K, Maisch B. A new method to assess ventricular wall stress in patients with heart failure and its relation to heart rate variability. Int J Cardiol 2010; 139:301-3. [DOI: 10.1016/j.ijcard.2008.09.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Accepted: 09/19/2008] [Indexed: 11/29/2022]
|
23
|
Rupp H, Rupp TP, Alter P, Maisch B. Inverse shift in serum polyunsaturated and monounsaturated fatty acids is associated with adverse dilatation of the heart. Heart 2009; 96:595-8. [DOI: 10.1136/hrt.2009.176560] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
24
|
Alter P, Rupp H, Rominger MB, Vollrath A, Czerny F, Figiel JH, Adams P, Stoll F, Klose KJ, Maisch B. B-type natriuretic peptide and wall stress in dilated human heart. Mol Cell Biochem 2008; 314:179-91. [PMID: 18461428 DOI: 10.1007/s11010-008-9779-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2008] [Accepted: 04/22/2008] [Indexed: 01/20/2023]
Abstract
Background Although B-type natriuretic peptide (BNP) is used as complimentary diagnostic tool in patients with unknown thoracic disorders, many other factors appear to trigger its release. In particular, it remains unresolved to what extent cellular stretch or wall stress of the whole heart contributes to enhanced serum BNP concentration. Wall stress cannot be determined directly, but has to be calculated from wall volume, cavity volume and intraventricular pressure of the heart. The hypothesis was, therefore, addressed that wall stress as determined by cardiac magnetic resonance imaging (CMR) is the major determinant of serum BNP in patients with a varying degree of left ventricular dilatation or dysfunction (LVD). Methods A thick-walled sphere model based on volumetric analysis of the LV using CMR was compared with an echocardiography-based approach to calculate LV wall stress in 39 patients with LVD and 21 controls. Serum BNP was used as in vivo marker of a putatively raised wall stress. Nomograms of isostress lines were established to assess the extent of load reduction that is necessary to restore normal wall stress and related biochemical events. Results Both enddiastolic and endsystolic LV wall stress were correlated with the enddiastolic LV volume (r = 0.54, P < 0.001; r = 0.81, P < 0.001). LV enddiastolic wall stress was related to pulmonary pressure (capillary: r = 0.69, P < 0.001; artery: r = 0.67, P < 0.001). Although LV growth was correlated with the enddiastolic and endsystolic volume (r = 0.73, P < 0.001; r = 0.70, P < 0.001), patients with LVD exhibited increased LV wall stress indicating an inadequately enhanced LV growth. Both enddiastolic (P < 0.05) and endsystolic (P < 0.01) wall stress were increased in patients with increased BNP. In turn, BNP concentration was elevated in individuals with increased enddiastolic wall stress (>8 kPa: 587 +/- 648 pg/ml, P < 0.05; >12 kPa: 715 +/- 661 pg/ml, P < 0.001; normal < or =4 kPa: 124 +/- 203 pg/ml). Analysis of variance revealed LV enddiastolic wall stress as the only independent hemodynamic parameter influencing BNP (P < 0.01). Using nomograms with "isostress" curves, the extent of load reduction required for restoring normal LV wall stress was assessed. Compared with the CMR-based volumetric analysis for wall stress calculation, the echocardiography based approach underestimated LV wall stress particularly of dilated hearts. Conclusions In patients with LVD, serum BNP was increased over the whole range of stress values which were the only hemodynamic predictors. Cellular stretch appears to be a major trigger for BNP release. Biochemical mechanisms need to be explored which appear to operate over this wide range of wall stress values. It is concluded that the diagnostic use of BNP should primarily be directed to assess ventricular wall stress rather than the extent of functional ventricular impairment in LVD.
Collapse
Affiliation(s)
- P Alter
- Internal Medicine, Cardiology, Philipps University, Baldingerstrasse, Marburg, Germany.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Alter P, Rupp H, Rominger MB, Vollrath A, Czerny F, Klose KJ, Maisch B. Relation of B-type natriuretic peptide to left ventricular wall stress as assessed by cardiac magnetic resonance imaging in patients with dilated cardiomyopathy. Can J Physiol Pharmacol 2007; 85:790-9. [PMID: 17901889 DOI: 10.1139/y07-076] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Ventricular loading conditions are crucial determinants of cardiac function and prognosis in heart failure. B-type natriuretic peptide (BNP) is mainly stored in the ventricular myocardium and is released in response to an increased ventricular filling pressure. We examined, therefore, the hypothesis that BNP serum concentrations are related to ventricular wall stress. Cardiac magnetic resonance imaging (MRI) was used to assess left ventricular (LV) mass and cardiac function of 29 patients with dilated cardiomyopathy and 5 controls. Left ventricular wall stress was calculated by using a thick-walled sphere model, and BNP was assessed by immunoassay. LV mass (r = 0.73, p < 0.001) and both LV end-diastolic (r = 0.54, p = 0.001) and end-systolic wall stress (r = 0.66, p < 0.001) were positively correlated with end-diastolic volume. LV end-systolic wall stress was negatively related to LV ejection fraction (EF), whereas end-diastolic wall stress was not related to LVEF. BNP concentration correlated positively with LV end-diastolic wall stress (r = 0.50, p = 0.002). Analysis of variance revealed LV end-diastolic wall stress as the only independent hemodynamic parameter influencing BNP (p < 0.001). The present approach using a thick-walled sphere model permits determination of mechanical wall stress in a clinical routine setting using standard cardiac MRI protocols. A correlation of BNP concentration with calculated LV stress was observed in vivo. Measurement of BNP seems to be sufficient to assess cardiac loading conditions. Other relations of BNP with various hemodynamic parameters (e.g., EF) appear to be secondary. Since an increased wall stress is associated with cardiac dilatation, early diagnosis and treatment could potentially prevent worsening of the outcome.
Collapse
Affiliation(s)
- P Alter
- Philipps University, Internal Medicine - Cardiology, Baldingerstrasse, D-35033 Marburg, Germany.
| | | | | | | | | | | | | |
Collapse
|
26
|
Abstract
The heart can be the primary target for a viral, bacterial or parasitic infection (primary myocarditis/inflammatory cardiomyopathy). It can also participate in the "collateral damage" due to toxins, chemo- and cytokines, autoreactive antibodies or the native and acquired immune response through T- and B-cells, monocytes and macrophages (secondary myocarditis/inflammatory cardiomyopathy), when it is not the dominant organ of the disease. Infective agents show remarkable organ specificity: viral infections, toxic and autoreactive processes affect primarily the myocardium and the pericardium, whereas bacterial infections prefer endothelial surfaces and cause endocarditis and, less frequently, pericarditis. They are even discussed as part of the inflammatory process involved in coronary artery disease. Infective agents and their adequate diagnosis and treatment are discussed for these clinical entities according to current guidelines and clinical pathways.
Collapse
Affiliation(s)
- B Maisch
- Klinik für Innere Medizin, Schwerpunkt Kardiologie, Universitätsklinikum Giessen und Marburg, Baldingerstr. 1, 35033 Marburg, Deutschland.
| | | | | | | | | |
Collapse
|
27
|
Alter P, Rupp H, Rominger MB, Klose KJ, Maisch B. A new methodological approach to assess cardiac work by pressure-volume and stress-length relations in patients with aortic valve stenosis and dilated cardiomyopathy. Pflugers Arch 2007; 455:627-36. [PMID: 17721708 DOI: 10.1007/s00424-007-0323-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [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: 06/07/2007] [Revised: 06/29/2007] [Accepted: 07/06/2007] [Indexed: 01/14/2023]
Abstract
In experimental animals, cardiac work is derived from pressure-volume area and analyzed further using stress-length relations. Lack of methods for determining accurately myocardial mass has until now prevented the use of stress-length relations in patients. We hypothesized, therefore, that not only pressure-volume loops but also stress-length diagrams can be derived from cardiac volume and cardiac mass as assessed by cardiac magnetic resonance imaging (CMR) and invasively measured pressure. Left ventricular (LV) volume and myocardial mass were assessed in seven patients with aortic valve stenosis (AS), eight with dilated cardiomyopathy (DCM), and eight controls using electrocardiogram (ECG)-gated CMR. LV pressure was measured invasively. Pressure-volume curves were calculated based on ECG triggering. Stroke work was assessed as area within the pressure-volume loop. LV wall stress was calculated using a thick-wall sphere model. Similarly, stress-length loops were calculated to quantify stress-length-based work. Taking the LV geometry into account, the normalization with regard to ventricular circumference resulted in "myocardial work." Patients with AS (valve area 0.73+/-0.18 cm(2)) exhibited an increased LV myocardial mass when compared with controls (P<0.05). LV wall stress was increased in DCM but not in AS. Stroke work of AS was unchanged when compared with controls (0.539+/-0.272 vs 0.621+/-0.138 Nm, not significant), whereas DCM exhibited a significant depression (0.367+/-0.157 Nm, P<0.05). Myocardial work was significantly reduced in both AS and DCM when compared with controls (129.8+/-69.6, 200.6+/-80.1, 332.2+/-89.6 Nm/m(2), P<0.05), also after normalization (7.40+/-5.07, 6.27+/-3.20, 14.6+/-4.07 Nm/m(2), P<0.001). It is feasible to obtain LV pressure-volume and stress-length diagrams in patients based on the present novel methodological approach of using CMR and invasive pressure measurement. Myocardial work was reduced in patients with DCM and noteworthy also in AS, while stroke work was reduced in DCM only. Most likely, deterioration of myocardial work is crucial for the prognosis. It is suggested to include these basic physiological procedures in the clinical assessment of the pump function of the heart.
Collapse
MESH Headings
- Aortic Valve Stenosis/complications
- Aortic Valve Stenosis/diagnosis
- Aortic Valve Stenosis/pathology
- Aortic Valve Stenosis/physiopathology
- Blood Pressure
- Cardiac Catheterization
- Cardiomyopathy, Dilated/complications
- Cardiomyopathy, Dilated/diagnosis
- Cardiomyopathy, Dilated/pathology
- Cardiomyopathy, Dilated/physiopathology
- Case-Control Studies
- Electrocardiography
- Feasibility Studies
- Heart Function Tests/methods
- Humans
- Hypertrophy, Left Ventricular/etiology
- Hypertrophy, Left Ventricular/pathology
- Hypertrophy, Left Ventricular/physiopathology
- Magnetic Resonance Imaging, Cine
- Models, Cardiovascular
- Myocardial Contraction
- Predictive Value of Tests
- Prospective Studies
- Stress, Mechanical
- Ventricular Pressure
Collapse
Affiliation(s)
- P Alter
- Internal Medicine--Cardiology, Philipps University, Baldingerstrasse, 35033 Marburg, Germany.
| | | | | | | | | |
Collapse
|
28
|
Abstract
Cardiac side effects of the cytostatic agent 5-fluorouracil (5-FU) have an incidence of 1.2-7.6%. Potentially, arrhythmias, myocardial infarction and sudden cardiac death could occur. Life-threatening cardiotoxicity is rarely observed with a frequency <1%. Cardiotoxicity of 5-FU seems to differ from well known effects of other cytostatics, e.g., anthracyclines. Myocardial ischemia was suggested as potential mechanism due to occasionally observed ECG alterations during 5-FU administration. Experimental studies revealed potential mechanisms of cardiotoxicity ranging from direct toxic effects on vascular endothelium involving endothelial NO synthase leading to coronary spasms and endothelium independent vasoconstriction via protein kinase C. In addition, rheological side effects have to be considered. Coronary artery disease is judged to increase the risk of cardiac side effects. Despite lack of prospective trials, verapamil type calcium antagonists as well as nitrates seem to be useful for treatment of 5-FU induced coronary spasms. In addition, modification of the cytostatic regimen has to be considered in patients who had been symptomatic. It could be assumed that 5-FU toxicity is reversible in the majority of cases when acute complications, e.g., arrhythmias, are resolved.
Collapse
Affiliation(s)
- P Alter
- Philipps University of Marburg/Lahn, Department of Internal Medicine - Cardiology, Baldingerstrasse, 35033 Marburg, Germany.
| | | | | | | | | |
Collapse
|
29
|
Ritter M, Hohenberger K, Alter P, Herzum M, Tebbe J, Maisch M. Caffeine inhibits cytokine expression in lymphocytes. Cytokine 2005; 30:177-81. [PMID: 15863391 DOI: 10.1016/j.cyto.2004.12.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2004] [Revised: 12/17/2004] [Accepted: 12/20/2004] [Indexed: 01/12/2023]
Abstract
Caffeine alters intracellular calcium signalling patterns in lymphocytes which are important for the specific regulation of activation and effector function in lymphocytes. The effect of caffeine on calcium signalling is probably mediated via a ryanodine receptor type 3 dependent intracellular calcium store which releases calcium after exposure to caffeine. Also, caffeine decreases lymphocyte cytotoxicity against allogenic myocyte. Which cytotoxic mechanisms are actually altered by caffeine is unknown. In mouse splenocyte cultures containing about 87% lymphocytes we show that concanavalin A (ConA, 5 microg/ml) stimulated cells increase the expression of TNF-alpha, IL-2 and IFN-gamma (ELISA) significantly. Caffeine (3.75 mM) inhibits cytokine expression of ConA stimulated cells almost completely. Ryanodine (1 microM) specifically blocks ryanodine receptors and thereby prevents caffeine induced calcium release. In our experiments, however, ryanodine has no effect on ConA stimulated IL-2 and IFN-gamma expression and only suppresses TNF-alpha expression by 20%. Furthermore, ryanodine does not prevent the inhibitory effect of caffeine on TNF-alpha, IL-2 and IFN-gamma expression in stimulated effector cells. We postulate that caffeine suppresses cytokine expression and thereby contributes to decreased cytotoxicity of lymphocytes against allogenic myocytes. The ryanodine receptor dependent intracellular calcium store does not seem to play a significant role in this process. Possibly, the blockade of IP3 receptors by caffeine is more important for cytokine suppression.
Collapse
Affiliation(s)
- M Ritter
- Department of Internal Medicine & Cardiology, Philipps-University of Marburg, Germany.
| | | | | | | | | | | |
Collapse
|
30
|
Alter P, Grimm W, Maisch B. Lipomatous hypertrophy of the interatrial septum. Diagnosis by cardiac magnetic resonance imaging. ACTA ACUST UNITED AC 2005; 94:429-30. [PMID: 15997341 DOI: 10.1007/s00392-005-0247-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2005] [Accepted: 02/08/2005] [Indexed: 10/25/2022]
Affiliation(s)
- P Alter
- Philipps University of Marburg/Lahn, Department of Internal Medicine--Cardiology, Baldingerstrasse, 35033 Marburg, Germany.
| | | | | |
Collapse
|
31
|
Grimm W, Ritter M, Alter P, Funck R, Maisch B. Bidirectional ventricular tachycardia due to digitalis intoxication. Z Kardiol 2005; 94:79-80. [PMID: 15674736 DOI: 10.1007/s00392-005-0178-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2004] [Accepted: 10/01/2004] [Indexed: 11/28/2022]
Affiliation(s)
- W Grimm
- Department of Cardiology, Hospital of the Phillips-University Marburg, Baldingerstrasse, 35033 Marburg, Germany.
| | | | | | | | | |
Collapse
|
32
|
Abstract
The frequently used chemotherapeutic drug 5-fluorouracil (5-FU) is known to cause angina pectoris and arrhythmias; myocardial infarction and sudden cardiac death could occur. Potential reasons for these phenomena range from toxic/metabolic disturbances to coronary artery spasms. This report shows angiographically proven spasmophilia of the coronary arteries and contributes to the understanding of angina pectoris occurring during treatment with 5-FU. Thus, verapamil type calcium antagonists as well as nitrates should be administered primarily in patients with coronary artery disease and in all patients who had been symptomatic during 5-FU administration in order to prevent further episodes.
Collapse
Affiliation(s)
- P Alter
- Philipps University of Marburg/Lahn, Department of Internal Medicine-Cardiology, Baldingerstrasse, 35033 Marburg, Germany.
| | | | | | | |
Collapse
|
33
|
Alter P, Maisch B. Escape from cardiomyocyte apoptosis by enterovirus persistence due to elevated soluble Fas-receptors. ACTA ACUST UNITED AC 2004; 93:524-32. [PMID: 15243763 DOI: 10.1007/s00392-004-0092-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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: 10/14/2003] [Accepted: 02/03/2004] [Indexed: 11/29/2022]
Abstract
BACKGROUND Apoptosis causes loss of contractile cardiomyocytes in inflammatory heart disease. Despite recent examinations, the influence of virus infection on apoptosis remained ill-defined. METHODS Apoptosis was assessed in left ventricular endomyocardial biopsies by the TUNEL method frompatients with chronic myocarditis and adeno-, cytomegalo- and enterovirus persistence. Soluble Fas-ligands, sFas-receptors, TNF-alpha, IL-6, IL-10 and IFN-gamma were measured using ELISA technique. RESULTS Elevated (P < 0.05) rates of apoptosis were found in patients with autoimmune myocarditis. Apoptosis was increased (P < 0.05) in the case of cytomegalovirus persistence, but not significantly increased in the presence of adenoviral genome. No evidence for apoptosis, but elevated concentrations of soluble Fas-receptors were found only in the case of enterovirus persistence. In turn, elevated percentages of apoptosis and normal soluble Fas-receptor concentrations were found in patients with chronic myocarditis. Serum levels of soluble Fas-ligands, TNF-alpha, IL-6, IL-10 and IFN-gamma did not predict changes in TUNEL-positivity. CONCLUSIONS Escape mechanisms to protect cardiomyocytes from apoptosis are yet not known for enterovirus infections. Soluble Fas-receptors have to be considered to counteract binding of soluble Fas-ligands that results in the blockade of apoptosis induction. It is a new finding that soluble Fasreceptors were elevated in the presence of enterovirus genome in the heart. Inhibition of apoptosis can impair virus clearing and prolong its replication with a potential worse outcome. In turn, sufficient protection from apoptosis in autoimmune myocarditis should reduce loss of cardiomyocytes. Therefore, the interaction of the Fas components could provide a new therapeutic target in myocarditis.
Collapse
Affiliation(s)
- P Alter
- University of Marburg/Lahn, Department of Internal Medicine Cardiology, Baldingerstrasse, 35033 Marburg, Germany.
| | | |
Collapse
|
34
|
Alter P, Grimm W. [Recurrent syncope in left bundle branch block with normal PQ time]. Internist (Berl) 2002; 43:879-82. [PMID: 12219688 DOI: 10.1007/s00108-002-0555-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- P Alter
- Philipps-Universität Marburg, Klinik für Innere Medizin-Kardiologie, Baldingerstrasse, 35033 Marburg.
| | | |
Collapse
|
35
|
Maisch B, Funcker R, Alter P, Portig I, Pankuweit S. [Dilated cardiomyopathy and myocarditis. Current diagnostic requirements and therapeutic possibilities]. Internist (Berl) 2002; 43 Suppl 1:S45-6, S49-65. [PMID: 11993000 DOI: 10.1007/s00108-002-0590-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- B Maisch
- Klinik für Innere Medizin-Kardiologie, Angiologie, Intensivmedizin und Präventive Kardiologie der Philipps-Universität Marburg, Baldinger Strasse 1, Postfach 23 60, 35033 Marburg.
| | | | | | | | | |
Collapse
|
36
|
Abstract
BACKGROUND Antiarrhythmic therapy with class III drug amiodarone (Cordarex(R)) for supraventricular and ventricular tachycardia is commonly used because of its high efficacy and absent negative inotropy. Pulmonary toxicity of amiodarone possibly leading to lung fibrosis is a rare, but severe side effect of chronic therapy. In contrast to patients with coronary artery disease, there are only a few data about pulmonary toxicity in patients with dilated cardiomyopathy. CASE REPORT We report on two patients with dilated cardiomyopathy who received amiodarone because of symptomatic non-sustained or sustained ventricular tachycardia. After 6 weeks resp. 8 months of treatment with amiodarone both patients developed pulmonary toxicity. Other causes of pulmonary toxicity were ruled out by bronchoscopy, bronchoalveolar lavage and biopsy. Pulmonary function improved in both patients within some weeks after discontinuation of amiodarone. CONCLUSIONS This report deals with two cases of amiodarone induced pulmonary toxicity in dilated cardiomyopathy leading to respiratory insufficiency. Pulmonary toxicity is a rare, but potentially lethal side effect of amiodarone. Reversibility of pulmonary changes in case of an early drug discontinuation is shown. Because of severe reduced left ventricular function in dilated cardiomyopathy, heart failure symptoms could conceal clinical signs of pulmonary amiodarone toxicity. Therefore, pulmonary function should be controlled periodically during amiodarone therapy including bronchoscopy, bronchoalveolar lavage, biopsy and measurement of diffusion capacity.
Collapse
Affiliation(s)
- P Alter
- Zentrum für Innere Medizin - Kardiologie, Philipps-Universität Marburg/Lahn, Germany.
| | | | | |
Collapse
|
37
|
Alter P, Walthers EM, Schaefer JR, Maisch B. Angiography, CT and MR imaging of a high vena cava inferior interruption in a patient with Hirschsprung disease. VASA 2001; 30:299-302. [PMID: 11771218 DOI: 10.1024/0301-1526.30.4.299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We report on a high vena cava inferior interruption immediately at the insertion to the right atrium in a patient with Hirschsprung disease assessed by angiography, CT, and MRI. Hirschsprung disease is frequently associated with Down, Undine, Waardenburg, Bardet-Biedl, Smith-Lemli-Opitz and Goldberg-Sphrintzen syndromes. We suggest that the association of these two malformations are most likely interrelated and should be considered as a new syndrome.
Collapse
Affiliation(s)
- P Alter
- Department of Internal Medicine, Cardiology, Philipps-University Marburg/Lahn, Germany.
| | | | | | | |
Collapse
|
38
|
Affiliation(s)
- D Tontsch
- Department of Medicine, Hospital of the Philipps-University of Marburg, Germany
| | | | | |
Collapse
|
39
|
|
40
|
Abstract
Hemorrhagic fever with renal syndrome (HFRS), caused by different hantaviruses, is a distinct clinical syndrome endemic in several parts of Asia and Europe. However, the clinical picture can sometimes be indistinguishable from that of other infectious or noninfectious diseases. In this report we describe a clinical case, which is a rare occurrence but is a prime example of the difficulties in the diagnosis of HFRS in areas with a low prevalence of the disease.
Collapse
Affiliation(s)
- D Wichmann
- Institut für Virologie, Philipps-Universität, D-35037 Marburg, Germany
| | | | | | | | | |
Collapse
|
41
|
Ritter M, Alter P, Maisch B. [Possibilities and limits of outpatient antibiotic therapy of infective endocarditis]. Herz 2001; 26:418-23. [PMID: 11683072 DOI: 10.1007/pl00002045] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Infective endocarditis has a high morbidity and lethality. Therefore antibiotic treatment has to be intravenous to achieve high blood levels and has to last several weeks without an interruption of treatment at the weekends. PATIENT SELECTION FOR OUTPATIENT THERAPY It is therefore crucial to select the patient group that is suited for an outpatient, antibiotic therapy very carefully. In general only hemodynamically stable patients without complications in whom the responsible organism has been identified should be considered. TREATMENT From a pharmacological point of view intravenous or intramuscular application for the complete duration of therapy is obligatory. Endocarditis caused by penicillin-susceptible streptococci, the biggest group of organisms responsible for endocarditis, can be treated with Ceftriaxon once daily for 4 weeks. For other organisms there are at present no data available which support the feasibility of an outpatient therapy. In particular antibiotic therapy with a complex regimen for those organisms is not practicable for outpatient usage. Possibly, in the near future computer controlled pumps might overcome this disadvantage. LIMITS Every outpatient therapy should be initiated under inpatient conditions and only after an initial response to the antibiotic therapy continued in an outpatient setting. Today reliable outpatient therapy and follow-up 7 days a week under the given outpatient infrastructure is problematic and remains an exception. However, considering cost-effectiveness outpatient as compared to inpatient antibiotic therapy could be an interesting economically advantageous alternative.
Collapse
Affiliation(s)
- M Ritter
- Klinik für Innere Medizin-Kardiologie, Herzzentrum der Philipps-Universität Marburg
| | | | | |
Collapse
|
42
|
Alter P, Jobmann M, Meyer E, Pankuweit S, Maisch B. Apoptosis in myocarditis and dilated cardiomyopathy: does enterovirus genome persistence protect from apoptosis? An endomyocardial biopsy study. Cardiovasc Pathol 2001; 10:229-34. [PMID: 11673061 DOI: 10.1016/s1054-8807(01)00077-1] [Citation(s) in RCA: 27] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
UNLABELLED The purpose of this study was to examine the role of apoptosis in myocarditis and dilated cardiomyopathy. Apoptosis is an active energy-consuming mechanism of cell death in several cardiac diseases in different quality and quantity. METHODS Endomyocardial biopsies from 81 patients with active (1) and chronic myocarditis (10), dilated cardiomyopathy with inflammation (DCMi; 10) and without inflammation (DCM; 20), with borderline myocarditis and positive PCR for cytomegalovirus-DNA (6), adenovirus-DNA, or enterovirus-RNA (7), and controls (17) were analysed. Apoptosis was detected by using the TUNEL method. The highest rate of apoptotic cardiocytes was found in active and chronic myocarditis. One patient with severe active myocarditis demonstrated 6.15% of apoptotic cardiocytes. Mean percentage of apoptotic cardiocytes in chronic myocarditis was significantly increased (0.61+/-1.25%) when compared to controls (0.01+/-0.04%, P<.05). Particularly, patients with cytomegalovirus-DNA persistence in borderline myocarditis had an elevated rate of apoptosis (0.34+/-0.68%, P<.05). Increased rates of apoptosis were found in borderline myocarditis with adenovirus-DNA persistence (0.20+/-0.57%) and in DCM (0.06+/-0.15%). Only a nonsignificant increase of apoptotic cardiocytes was found in DCMi (0.03+/-0.08%). No apoptosis was found in patients with enteroviral genome persistence in borderline myocarditis. CONCLUSIONS Apoptosis of cardiac cells is increased in myocarditis and dilated cardiomyopathy, being highest in severe active myocarditis. Apoptosis thus contributes to cell death in active myocarditis and may play a role not to be neglected in dilated cardiomyopathy. Enteroviruses seem to have anti-apoptotic effects, because no apoptosis at all was found in the myocardium.
Collapse
Affiliation(s)
- P Alter
- Department of Internal Medicine and Cardiology, Philipps-University Marburg/Lahn, Baldingerstrasse, D-35033, Marburg, Germany.
| | | | | | | | | |
Collapse
|
43
|
Affiliation(s)
- P Alter
- Philipps-Universität Marburg, Klinik für Innere Medizin-Kardiologie, Baldingerstrasse, 35033 Marburg.
| | | | | |
Collapse
|
44
|
|
45
|
Abstract
A 24 year old male with varicella myocarditis was admitted with chest pain and fever up to 39 degrees C. The ECG showed J point and ST elevation in leads V2-V4, and inverted T waves in leads V5 and V6. Creatine kinase (CK) was raised to 435 U/l (CK-MB 36 U/l), troponin I was 63.4 microgram/l, and lactate dehydrogenase was 359 U/l, suggesting cardiac involvement of varicella infection. The left ventricle was dilated (58 mm) and left ventricular ejection fraction was globally reduced (ejection fraction 45%). Myocarditis was confirmed by endomyocardial biopsy. The patient was treated with specific varicella hyperimmunoglobulins, aciclovir, and a non-steroidal anti-inflammatory drug. During two months follow up the patient recovered completely. This case report is a reminder that a varicella infection can cause myocarditis in adults. Early diagnosis and appropriate treatment of this rare form of myocarditis may lead to complete recovery.
Collapse
Affiliation(s)
- P Alter
- Department of Internal Medicine-Cardiology, Philipps-University of Marburg, Baldingerstrabetae, D-35033 Marburg/Lahn, Germany.
| | | | | |
Collapse
|
46
|
|
47
|
Alter P, Schaefer JR, Maisch B. [Impediment of cellular immune response under treatment with ticlopidine in a patient with Staphylococcus aureus endocarditis]. Z Kardiol 2000; 89:691-7. [PMID: 11013974 DOI: 10.1007/s003920070197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A 52-year-old male with coronary artery disease was admitted with acute aortic valve endocarditis and a temperature up to 39.5 degrees C caused by Staphylococcus aureus. The patient was treated with ticlopidine (Tiklyd) after percutaneous transluminal coronary angioplasties to reduce restenosis by inhibiting thrombocyte aggregation. Upon admission c-reactive protein (CRP) was 389 mg/l. Interleukin-6 (IL-6) and Interleukin-2-receptor (IL-2-rec) were distinctly increased. Monoclonal antimyocardial antibodies were found. Leukocyte count never exceeded 9.8 G/l; however, transesophageal echocardiography validated a soft vegetation of the aortic valve. Antibiotic therapy was initiated with imipenem, gentamicin and vancomycin; clarithromycin was added after five days. Temperature normalized after 24 days. The c-reactive protein decreased from 389 mg/l to 6 mg/l, and the elevated cytokine levels decreased accordingly. Agranulocytosis or pancytopenia by ticlopidine through a toxic mechanism have been described, which are normally reversible within three weeks; there has not yet been a description of a missing leukocyte response in endocarditis as in this case report. This is a special situation with lack of or impeded immunological response, which limits the use of ticlopidine, especially since a therapeutic alternative with clopidogrel is available.
Collapse
MESH Headings
- Agranulocytosis/chemically induced
- Angioplasty, Balloon, Coronary
- Anti-Bacterial Agents/administration & dosage
- Anti-Bacterial Agents/therapeutic use
- Clarithromycin/administration & dosage
- Clarithromycin/therapeutic use
- Coronary Disease/prevention & control
- Coronary Disease/therapy
- Drug Therapy, Combination/administration & dosage
- Drug Therapy, Combination/therapeutic use
- Echocardiography, Doppler
- Endocarditis, Bacterial/diagnostic imaging
- Endocarditis, Bacterial/drug therapy
- Endocarditis, Bacterial/etiology
- Endocarditis, Bacterial/immunology
- Fibrinolytic Agents/adverse effects
- Gentamicins/administration & dosage
- Gentamicins/therapeutic use
- Humans
- Imipenem/administration & dosage
- Imipenem/therapeutic use
- Immunity, Cellular/drug effects
- Immunity, Cellular/immunology
- Leukocyte Count
- Leukocytes/drug effects
- Leukocytes/immunology
- Leukopenia/chemically induced
- Male
- Middle Aged
- Platelet Aggregation Inhibitors/adverse effects
- Staphylococcal Infections/drug therapy
- Staphylococcal Infections/etiology
- Staphylococcal Infections/immunology
- Thienamycins/administration & dosage
- Thienamycins/therapeutic use
- Ticlopidine/adverse effects
- Time Factors
- Vancomycin/administration & dosage
- Vancomycin/therapeutic use
Collapse
Affiliation(s)
- P Alter
- Abteilung für Innere Medizin-Kardiologie Philipps-Universität Marburg
| | | | | |
Collapse
|
48
|
|
49
|
Alter P, Maisch B. [Endocarditis prophylaxis]. Internist (Berl) 2000; 41:68-9. [PMID: 10712094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- P Alter
- Klinik für Innere Medizin-Kardiologie, Philipps-Universität, Marburg
| | | |
Collapse
|
50
|
Pankuweit S, Jobmann M, Crombach M, Portig I, Alter P, Kruse T, Hufnagel G, Maisch B. [Cell death in inflammatory heart muscle diseases--apoptosis or necrosis?]. Herz 1999; 24:211-8. [PMID: 10412644 DOI: 10.1007/bf03044963] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cell death can be induced by 2 different mechanisms: necrosis and apoptosis. Necrosis, on the one hand, is usually caused by unphysiological stress factors such as hyperthermia or hypoxia, apoptosis, on the other hand, is part of the normal organ development and controls for example immune responses. Morphologically, necrosis is characterized by swelling of cells and their organelles leading to the disruption of the cell membrane, which in turn causes an inflammatory reaction in the surrounding tissue. Morphological and biochemical criteria (Figure 1, Table 1) of apoptosis are the condensation of chromatin leading to the development of apoptotic bodies or membrane-enclosed vesicles containing oligonucleosomal DNA fragments. Important diagnostic tools of cell death (Table 2), such as the TUNEL test (Figure 2) or gel electrophoresis of extracted DNA (Figure 3) are based on the above mentioned biochemical characteristics, but a reliable differentiation of apoptotic versus necrotic processes is not always possible. Experimental studies in animals and studies in various diseases of the cardiovascular system were able to show that apoptosis in myocytes can be induced, an issue that has long been discussed controversially. Ischemia, reperfusion, and myocardial infarction were also shown to lead to apoptosis in cardiomyocytes, whereas cell destruction was caused mainly by necrosis. Several authors (Table 3) demonstrated apoptotic indices in cardiomyocytes of patients with dilatated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy and patients with acute infarction from 0.25 to 35% by the use of the TUNEL test. Others were able to demonstrate an elevated expression of Fas-receptor in cells of atheroslerotic plaques in patients with atherosclerosis and high indices of apoptotic cardiomyocytes in patients with chronic heart failure. We investigated endomyocardial biopsies of patients with inflammatory cardiomyopathy, DCM without inflammatory reaction but the presence of adenoviral or cytomegaloviral genome and idiopathic DCM using the TUNEL test. The percentage of apoptotic cardiomyocytes in biopsies of patients with DCMi was 1.03 and in biopsies of patients with adenoviral genome 0.25, whereas in all other groups no apoptosis was found. If apoptosis plays a major role in myocardial diseases such as heart failure, arrhythmia and others, blocking this mechanism will have to be considered as a therapeutical strategy. Therefore, studies on the extent of apoptotic processes in diseased versus healthy cardiac tissue are of great importance.
Collapse
Affiliation(s)
- S Pankuweit
- Klinik für Innere Medizin und Kardiologie, Philipps-Universität Marburg.
| | | | | | | | | | | | | | | |
Collapse
|