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Penov K, Haugen MA, Radakovic D, Hamouda K, Gorski A, Leyh R, Bening C. Decellularized Pulmonary Xenograft Matrix PplusN versus Cryopreserved Homograft for RVOT Reconstruction during Ross Procedure in Adults. Thorac Cardiovasc Surg 2024; 72:205-213. [PMID: 34972237 DOI: 10.1055/s-0041-1740539] [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: 10/19/2022]
Abstract
BACKGROUND Decellularized pulmonary homografts are being increasingly adopted for right ventricular outflow tract reconstruction in adult patients undergoing the Ross procedure. Few reports presented Matrix PplusN xenograft (Matrix) in a negative light. The objective of this study was to compare our midterm outcomes of Matrix xenograft versus standard cryopreserved pulmonary homograft (CPHG). METHODS Eighteen patients received Matrix xenograft between January 2012 and June 2016, whereas 66 patients received CPHG. Using nonparametric statistical tests and survival analysis, we compared midterm echocardiographic and clinical outcomes between the groups. RESULTS Except for significant age difference (the Matrix group was significantly older with 57 ± 8 years than the CPHG group, 48 ± 9 years, p = 0.02), the groups were similar in all other baseline characteristics. There were no significant differences in cardiopulmonary bypass times (208.3 ± 32.1 vs. 202.8 ± 34.8) or in cross-clamp times (174 ± 33.9 vs. 184.4 ± 31.1) for Matrix and CPHG, respectively. The Matrix group had significantly inferior freedom from reintervention than the CPHG group with 77.8 versus 98.5% (p = 0.02). Freedom from pulmonary valve regurgitation ≥ 2 was not significantly different between the groups with 82.4 versus 90.5% for Matrix versus CPHG, respectively. After median follow-up of 4.9 years, Matrix xenograft developed significantly higher peak pressure gradients compared with CPHG (20.4 ± 15.5 vs. 12.2 ± 9.0 mm Hg; p = 0.04). CONCLUSION After 5 years of clinical and echocardiographic follow-up, the decellularized Matrix xenograft had inferior freedom from reintervention compared with the standard CPHG. Closer follow-up is necessary to avoid progression of valve failure into right ventricular deterioration.
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Affiliation(s)
- Kiril Penov
- Department of Thoracic and Cardiovascular Surgery, University Clinic Würzburg, Julius Maximilians University Würzburg, Würzburg, Bayern, Germany
| | | | - Dejan Radakovic
- Department of Thoracic and Cardiovascular Surgery, University Clinic Würzburg, Julius Maximilians University Würzburg, Würzburg, Bayern, Germany
| | - Khaled Hamouda
- Department of Thoracic and Cardiovascular Surgery, University Clinic Würzburg, Julius Maximilians University Würzburg, Würzburg, Bayern, Germany
| | - Armin Gorski
- Department of Thoracic and Cardiovascular Surgery, University Clinic Würzburg, Julius Maximilians University Würzburg, Würzburg, Bayern, Germany
| | - Rainer Leyh
- Department of Thoracic and Cardiovascular Surgery, University Clinic Würzburg, Julius Maximilians University Würzburg, Würzburg, Bayern, Germany
| | - Constanze Bening
- Department of Thoracic and Cardiovascular Surgery, University Clinic Würzburg, Julius Maximilians University Würzburg, Würzburg, Bayern, Germany
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Bening C, Genser B, Keller D, Müller-Altrock S, Radakovic D, Penov K, Hassan M, Aleksic I, Leyh R, Madrahimov N. Impact of estradiol, testosterone and their ratio on left and right auricular myofilament function in male and female patients undergoing coronary artery bypass grafting. BMC Cardiovasc Disord 2023; 23:538. [PMID: 37925416 PMCID: PMC10625250 DOI: 10.1186/s12872-023-03582-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 10/26/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND The impact of sex hormones on right and left auricular contractile apparatus function is largely unknown. We evaluated the impact of sex hormones on left and right heart contractility at the level of myocardial filaments harvested from left and right auricles during elective coronary artery bypass surgery. METHODS 150 patients (132 male; 18 female) were enrolled. Preoperative testosterone and estradiol levels were measured with Immunoassay. Calcium induced force measurements were performed with left- and right auricular myofilaments in a skinned fiber model. Correlation analysis was used for comparison of force values and levels of sex hormones and their ratio. RESULTS Low testosterone was associated with higher top force values in right-sided myofilaments but not in left-sided myofilaments for both sexes (p = 0.000 in males, p = 0.001 in females). Low estradiol levels were associated with higher top force values in right-sided myofilaments (p 0.000) in females and only borderline significantly associated with higher top force values in males (p 0.056). In females, low estradiol levels correlated with higher top force values in left sided myofilaments (p 0.000). In males, higher Estradiol/Testosterone ratio (E/T ratio) was only associated with higher top force values from right auricular myofilaments (p 0.04) In contrast, in females higher E/T ratio was associated with lower right auricular myofilament top force values (p 0.03) and higher top force values in left-sided myofilaments (p 0.000). CONCLUSIONS This study shows that patients' comorbidities influence left and right sided contractility and may blur results concerning influence of sex hormones if not eliminated. A sex hormone dependent influence is obvious with different effects on the left and right ventricle. The E/T ratio and its impact on myofilament top force showed divergent results between genders, and may partially explain gender differences in patients with cardiovascular disease.
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Affiliation(s)
- C Bening
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg Zentrum Operative Medizin, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany.
| | - B Genser
- Medical Faculty Mannheim, Center for Preventive Medicine, Heidelberg University, Digital Health Baden-Württemberg (CPD-BW), Heidelberg , Germany
| | - D Keller
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg Zentrum Operative Medizin, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - S Müller-Altrock
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg Zentrum Operative Medizin, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - D Radakovic
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg Zentrum Operative Medizin, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - K Penov
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg Zentrum Operative Medizin, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - M Hassan
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg Zentrum Operative Medizin, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - I Aleksic
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg Zentrum Operative Medizin, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - R Leyh
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg Zentrum Operative Medizin, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - N Madrahimov
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg Zentrum Operative Medizin, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
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3
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Ungethüm K, Wiedmann S, Wagner M, Leyh R, Ertl G, Frantz S, Geisler T, Karmann W, Prondzinsky R, Herdeg C, Noutsias M, Ludwig T, Käs J, Klocke B, Krapp J, Wood D, Kotseva K, Störk S, Heuschmann PU. Secondary prevention in diabetic and nondiabetic coronary heart disease patients: Insights from the German subset of the hospital arm of the EUROASPIRE IV and V surveys. Clin Res Cardiol 2023; 112:285-298. [PMID: 36166067 PMCID: PMC9898414 DOI: 10.1007/s00392-022-02093-0] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/25/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Patients with coronary heart disease (CHD) with and without diabetes mellitus have an increased risk of recurrent events requiring multifactorial secondary prevention of cardiovascular risk factors. We compared prevalences of cardiovascular risk factors and its determinants including lifestyle, pharmacotherapy and diabetes mellitus among patients with chronic CHD examined within the fourth and fifth EUROASPIRE surveys (EA-IV, 2012-13; and EA-V, 2016-17) in Germany. METHODS The EA initiative iteratively conducts European-wide multicenter surveys investigating the quality of secondary prevention in chronic CHD patients aged 18 to 79 years. The data collection in Germany was performed during a comprehensive baseline visit at study centers in Würzburg (EA-IV, EA-V), Halle (EA-V), and Tübingen (EA-V). RESULTS 384 EA-V participants (median age 69.0 years, 81.3% male) and 536 EA-IV participants (median age 68.7 years, 82.3% male) were examined. Comparing EA-IV and EA-V, no relevant differences in risk factor prevalence and lifestyle changes were observed with the exception of lower LDL cholesterol levels in EA-V. Prevalence of unrecognized diabetes was significantly lower in EA-V as compared to EA-IV (11.8% vs. 19.6%) while the proportion of prediabetes was similarly high in the remaining population (62.1% vs. 61.0%). CONCLUSION Between 2012 and 2017, a modest decrease in LDL cholesterol levels was observed, while no differences in blood pressure control and body weight were apparent in chronic CHD patients in Germany. Although the prevalence of unrecognized diabetes decreased in the later study period, the proportion of normoglycemic patients was low. As pharmacotherapy appeared fairly well implemented, stronger efforts towards lifestyle interventions, mental health programs and cardiac rehabilitation might help to improve risk factor profiles in chronic CHD patients.
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Affiliation(s)
- K Ungethüm
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Bavaria, Germany.
| | - S Wiedmann
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Bavaria, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Berlin, Germany
| | - M Wagner
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Bavaria, Germany
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Bavaria, Germany
- Kuratorium für Dialyse und Nierentransplantation E.V, Neu-Isenburg, Hesse, Germany
| | - R Leyh
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Bavaria, Germany
- Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Bavaria, Germany
| | - G Ertl
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Bavaria, Germany
- Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Bavaria, Germany
| | - S Frantz
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Bavaria, Germany
- Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Bavaria, Germany
- Department of Internal Medicine III, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Saxony-Anhalt, Halle (Saale), Germany
| | - T Geisler
- Department of Cardiology and Cardiovascular Disease, University Hospital Tübingen, Tübingen, Baden-Württemberg, Germany
| | - W Karmann
- Department of Medicine, Klinik Kitzinger Land, Kitzingen, Bavaria, Germany
| | - R Prondzinsky
- Cardiology/Intensive Care Medicine, Carl Von Basedow Klinikum Merseburg, Merseburg, Saxony-Anhalt, Germany
| | - C Herdeg
- Medius Klinik Ostfildern-Ruit, Klinik für Innere Medizin, Herz- und Kreislauferkrankungen, Ostfildern-Ruit, Baden-Württemberg, Germany
| | - M Noutsias
- Department of Internal Medicine III, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Saxony-Anhalt, Halle (Saale), Germany
- Department of Internal Medicine A, University Hospital Ruppin-Brandenburg (UKRB) of the Medical School of Brandenburg (MHB), Neuruppin, Brandenburg, Germany
| | - T Ludwig
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Bavaria, Germany
| | - J Käs
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Bavaria, Germany
| | - B Klocke
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Bavaria, Germany
| | - J Krapp
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Bavaria, Germany
| | - D Wood
- European Society of Cardiology, Sophia Antipolis, France
- Imperial College Healthcare NHS Trusts, London, UK
- National University of Ireland, Galway, Ireland
| | - K Kotseva
- European Society of Cardiology, Sophia Antipolis, France
- Imperial College Healthcare NHS Trusts, London, UK
- National University of Ireland, Galway, Ireland
| | - S Störk
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Bavaria, Germany
- Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Bavaria, Germany
| | - P U Heuschmann
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Bavaria, Germany
- Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Bavaria, Germany
- Clinical Trial Center, University Hospital Würzburg, Würzburg, Bavaria, Germany
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4
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Penov K, Merz T, Radakovic D, Madrahimov N, Hamouda K, Gorski A, Leyh R, Bening C. 15 Years of Experience with 231 Ross Procedures in Adults: A Single-Center Study. Thorac Cardiovasc Surg 2023. [DOI: 10.1055/s-0043-1761767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- K. Penov
- University Hospital Würzburg, Würzburg, Deutschland
| | - T. Merz
- University Hospital Würzburg, Würzburg, Deutschland
| | - D. Radakovic
- University Hospital Würzburg, Würzburg, Deutschland
| | | | - K. Hamouda
- University Hospital Würzburg, Würzburg, Deutschland
| | - A. Gorski
- University Hospital Würzburg, Würzburg, Deutschland
| | - R. Leyh
- University Hospital Würzburg, Würzburg, Deutschland
| | - C. Bening
- University Hospital Würzburg, Würzburg, Deutschland
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5
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Hassan M, Radakovic D, Berikbol M, Keller D, Madrahimov N, Hamouda K, Leyh R, Bening C. Impact of the Atrial Approach on Atrial Arrhythmia Behavior in Mitral Valve Repair/Replacement Surgery: Do the Ends Justify the Means? Thorac Cardiovasc Surg 2023. [DOI: 10.1055/s-0043-1761824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- M. Hassan
- University Hospital Würzburg, Würzburg, Deutschland
| | - D. Radakovic
- University Hospital Würzburg, Würzburg, Deutschland
| | - M. Berikbol
- Universitiy Clinic Würzburg, Würzburg, Deutschland
| | - D. Keller
- Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Würzburg, Deutschland
| | | | - K. Hamouda
- University Hospital Würzburg, Würzburg, Deutschland
| | - R. Leyh
- University Hospital Würzburg, Würzburg, Deutschland
| | - C. Bening
- Oberdärrbacherstraße 6, Wärzburg, Deutschland
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6
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Madrahimov N, Mutsenko V, Zaiatc E, Makhmetov B, Klapproth A, Hamouda K, Otto C, Leyh R, Bening C. Ex vivo and in situ oxygenated cadaver organ care in murine temperature-controlled organ-preserving machine and ECMO. Cryobiology 2022. [DOI: 10.1016/j.cryobiol.2022.11.054] [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: 12/23/2022]
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7
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Hassan M, Radakovic D, Madrahimov N, Hamouda K, Schimmer C, Leyh R, Bening C. Cerebral Near-Infrared Spectroscopy Monitoring as a Predictor for Postoperative Delirium in Adult Cardiac Surgery Patients: Myth or Reality? Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M. Hassan
- University Hospital Würzburg, Würzburg, Deutschland
| | - D. Radakovic
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - N. Madrahimov
- Department of Thoracic and Cardiovascular Surgery, University Clinic Würzburg, Würzburg, Deutschland
| | - K. Hamouda
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - C. Schimmer
- Oberdürrbacher Str. 6, Würzburg, Deutschland
| | - R. Leyh
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - C. Bening
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Oberdärrbacherstraße 6, Würzburg, Deutschland
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8
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Radakovic D, Penov K, Madrahimov N, Von Bosse F, Keller D, Hassan M, Bening C, Leyh R, Aleksic I. Risk Factors for Perioperative Mortality in Postcardiotomy Patients with Extracorporeal Life Support. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- D. Radakovic
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - K. Penov
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - N. Madrahimov
- Department of Thoracic and Cardiovascular Surgery, University Clinic Würzburg, Würzburg, Deutschland
| | | | - D. Keller
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - M. Hassan
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - C. Bening
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - R. Leyh
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - I. Aleksic
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
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9
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Madrahimov N, Mutsenko V, Makhmetov B, Malikov M, Klapproth A, Cristaldo RB, Hamouda KK, Otto C, Leyh R, Bening C. Real-Time Tissue Oxygenation Monitoring Using Fiberoptic Sensors in Cadaveric Multiorgan Preservation under Mouse ECMO. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- N. Madrahimov
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - V. Mutsenko
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - B. Makhmetov
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - M. Malikov
- Department of Thoracic and Cardiovascular Surgery, University Clinic Würzburg, Würzburg, Deutschland
| | - A. Klapproth
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - R. Benitez Cristaldo
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - K K. Hamouda
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - C. Otto
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - R. Leyh
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
| | - C. Bening
- Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Deutschland
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10
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Walles T, Lichtenberg A, Puschmann C, Leyh R, Wilhelmi M, Kallenbach K, Haverich A, Mertsching H. Corrigendum to 'In vivo model for cross-species porcine endogenous retrovirus transmission using tissue engineered pulmonary arteries'. Eur J Cardiothorac Surg 2021; 61:494. [PMID: 34849702 DOI: 10.1093/ejcts/ezab502] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Thorsten Walles
- Department of Cardiothoracic and Vascular Surgery, Medical School Hannover, Carl-Neuberg-Strasse 1, D-30625, Hannover, Germany
| | - Arthur Lichtenberg
- Department of Cardiothoracic and Vascular Surgery, Medical School Hannover, Carl-Neuberg-Strasse 1, D-30625, Hannover, Germany
| | - Carmen Puschmann
- Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), Medical School Hannover, Podbielskistrasse 380, D-30659, Hannover, Germany
| | - Rainer Leyh
- Department of Cardiothoracic and Vascular Surgery, Medical School Hannover, Carl-Neuberg-Strasse 1, D-30625, Hannover, Germany
| | - Mathias Wilhelmi
- Department of Cardiothoracic and Vascular Surgery, Medical School Hannover, Carl-Neuberg-Strasse 1, D-30625, Hannover, Germany
| | - Klaus Kallenbach
- Department of Cardiothoracic and Vascular Surgery, Medical School Hannover, Carl-Neuberg-Strasse 1, D-30625, Hannover, Germany
| | - Axel Haverich
- Department of Cardiothoracic and Vascular Surgery, Medical School Hannover, Carl-Neuberg-Strasse 1, D-30625, Hannover, Germany.,Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), Medical School Hannover, Podbielskistrasse 380, D-30659, Hannover, Germany
| | - Heike Mertsching
- Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), Medical School Hannover, Podbielskistrasse 380, D-30659, Hannover, Germany
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11
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Yurdadogan T, Malsch C, Kotseva K, Wood D, Leyh R, Ertl G, Karmann W, Müller-Scholden L, Morbach C, Breunig M, Wagner M, Gelbrich G, Bots ML, Heuschmann PU, Störk S. Functional versus morphological assessment of vascular age in patients with coronary heart disease. Sci Rep 2021; 11:18164. [PMID: 34518567 PMCID: PMC8437950 DOI: 10.1038/s41598-021-96998-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 08/04/2021] [Indexed: 01/21/2023] Open
Abstract
Communicating cardiovascular risk based on individual vascular age (VA) is a well acknowledged concept in patient education and disease prevention. VA may be derived functionally, e.g. by measurement of pulse wave velocity (PWV), or morphologically, e.g. by assessment of carotid intima-media thickness (cIMT). The purpose of this study was to investigate whether both approaches produce similar results. Within the context of the German subset of the EUROASPIRE IV survey, 501 patients with coronary heart disease underwent (a) oscillometric PWV measurement at the aortic, carotid-femoral and brachial-ankle site (PWVao, PWVcf, PWVba) and derivation of the aortic augmentation index (AIao); (b) bilateral cIMT assessment by high-resolution ultrasound at three sites (common, bulb, internal). Respective VA was calculated using published equations. According to VA derived from PWV, most patients exhibited values below chronological age indicating a counterintuitive healthier-than-anticipated vascular status: for VAPWVao in 68% of patients; for VAAIao in 52% of patients. By contrast, VA derived from cIMT delivered opposite results: e.g. according to VAtotal-cIMT accelerated vascular aging in 75% of patients. To strengthen the concept of VA, further efforts are needed to better standardise the current approaches to estimate VA and, thereby, to improve comparability and clinical utility.
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Affiliation(s)
- Tino Yurdadogan
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany.
| | - Carolin Malsch
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Kornelia Kotseva
- National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland
| | - David Wood
- Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Rainer Leyh
- Department of Cardiothoracic and Thoracic Vascular Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Georg Ertl
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany.,Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Wolfgang Karmann
- Department of Medicine, Klinik Kitzinger Land, Kitzingen, Germany
| | - Lara Müller-Scholden
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany
| | - Caroline Morbach
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany
| | - Margret Breunig
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany
| | - Martin Wagner
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany.,Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Götz Gelbrich
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Peter U Heuschmann
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany
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Schimmer C, Kühnel RU, Waldow T, Matt P, Leyh R, Grubitzsch H. Diagnostik und Therapie der Poststernotomie-Mediastinitis. Z Herz- Thorax- Gefäßchir 2021. [DOI: 10.1007/s00398-021-00436-z] [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]
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13
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Bakhtiary F, Ahmad AES, Autschbach R, Benedikt P, Bonaros N, Borger M, Dewald O, Feyrer R, Geißler HJ, Grünenfelder J, Lam KY, Leyh R, Liebold A, Czesla M, Mehdiani A, Pollari F, Salamate S, Strauch J, Vötsch A, Weber A, Wendt D, Botta B, Bramlage P, Zierer A. Impact of pre-existing comorbidities on outcomes of patients undergoing surgical aortic valve replacement - rationale and design of the international IMPACT registry. J Cardiothorac Surg 2021; 16:51. [PMID: 33766089 PMCID: PMC7993500 DOI: 10.1186/s13019-021-01434-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/16/2021] [Indexed: 11/18/2022] Open
Abstract
Background Degenerative aortic valve disease accounts for 10–20% of all cardiac surgical procedures. The impact of pre-existing comorbidities on the outcome of patients undergoing surgical aortic valve replacement (SAVR) needs further research. Methods The IMPACT registry is a non-interventional, prospective, open-label, multicenter, international registry with a follow-up of 5 years to assess the impact of pre-existing comorbidities of patients undergoing SAVR with the INSPIRIS RESILIA aortic valve on outcomes. IMPACT will be conducted across 25 sites in Austria, Germany, The Netherlands and Switzerland and intends to enroll approximately 500 patients. Patients will be included if they are at least 18 years of age and are scheduled to undergo SAVR with the INSPIRIS RESILIA Aortic Valve with or without concomitant ascending aortic root replacement and/or coronary bypass surgery. The primary objective is to determine all-cause mortality at 1, 3, and 5 years post SAVR. Secondary objectives include cardiac-related and valve-related mortality and structural valve deterioration including hemodynamics and durability, valve performance and further clinical outcomes in the overall study population and in specific patient subgroups characterized by the presence of chronic kidney disease, hypertension, metabolic syndrome and/or chronic inflammation. Discussion IMPACT is a prospective, multicenter European registry, which will provide much-needed data on the impact of pre-existing comorbidities on patient outcomes and prosthetic valve performance, and in particular the performance of the INSPIRIS RESILIA, in a real-world setting. The findings of this study may help to support and expand appropriate patient selection for treatment with bioprostheses. Trial registration ClinicalTrials.gov identifier: NCT04053088.
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Affiliation(s)
- Farhad Bakhtiary
- Division of Cardiac Surgery, Heart Center Siegburg-Wuppertal, University Witten-Herdecke, Ringstr. 49, 53721, Siegburg, Germany.
| | - Ali El-Sayed Ahmad
- Division of Cardiac Surgery, Heart Center Siegburg-Wuppertal, University Witten-Herdecke, Ringstr. 49, 53721, Siegburg, Germany
| | | | - Peter Benedikt
- Kepler University Hospital Linz, Linz; and Hospital Wels-Grieskirchen, Wels, Austria
| | | | | | | | | | - Hans-Joachim Geißler
- Kepler University Hospital Linz, Linz; and Hospital Wels-Grieskirchen, Wels, Austria
| | | | - Ka Yan Lam
- Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - Rainer Leyh
- University Hospital Wuerzburg, Wuerzburg, Germany
| | | | | | | | - Francesco Pollari
- Cardiac Surgery, Klinikum Nürnberg - Paracelsus Medical University, Nuremberg, Germany
| | - Saad Salamate
- Division of Cardiac Surgery, Heart Center Siegburg-Wuppertal, University Witten-Herdecke, Ringstr. 49, 53721, Siegburg, Germany
| | | | - Andreas Vötsch
- Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University, Salzburg, Austria
| | | | | | - Beate Botta
- Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany
| | - Peter Bramlage
- Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany
| | - Andreas Zierer
- Kepler University Hospital Linz, Linz; and Hospital Wels-Grieskirchen, Wels, Austria
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Bening C, Sales VL, Alhussini K, Radakovic D, Benitez RC, Madrahimov N, Keller D, Leyh R. Clinically inapparent right heart dysfunction is associated with reduced myofilament force development in coronary artery disease. BMC Cardiovasc Disord 2021; 21:125. [PMID: 33663396 PMCID: PMC7934411 DOI: 10.1186/s12872-021-01926-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/15/2021] [Indexed: 11/30/2022] Open
Abstract
Background Right ventricular dysfunction after CABG is associated with poor peri- and postoperative outcomes. We aimed to identify clinical and experimental predictors for preoperative inapparent right ventricular dysfunction and therefore hypothesized that reduced myofilament force development as well as altered levels of biomarkers might predict inapparent right ventricular dysfunction. Methods From 08/2016 to 02/2018, 218 patients scheduled for CABG were divided into two groups (TAPSE ≥ 20 mm, n = 178; TAPSE < 20 mm, n = 40). Baseline serum samples for biomarkers (Galectin, TGFß1, N Acyl-SDMA, Arginine, ADMA and Pentraxin-3), clinical laboratory and transthoracic echocardiographic parameters were evaluated. To examine the myocardial apparatus of the right ventricle intraoperative right auricular tissue was harvested for stepwise skinned fiber force measurements. Results Patients with TAPSE < 20 mm had a higher incidence of DM (55 vs. 34%, p = 0.018), preoperative AFib (43 vs. 16%, p < 0.001), reduced GFR (67 ± 18 vs. 77 ± 24 ml/min/1.73 m2, p = 0.013), larger LA area (22 ± 6 vs. 20 ± 5 cm2, p = 0.005) and reduced LVEF (50 vs. 55%, p = 0.008). Furthermore, higher serum ADMA (0.70 ± 0.13 vs. 0.65 ± 0.15 µmol/l, p = 0.046) and higher serum Pentraxin-3 levels (3371 ± 1068 vs. 2681 ± 1353 pg/dl, p = 0.004) were observed in these patients. Skinned fiber force measurements showed significant lower values at almost every step of calcium concentration (pCa 4.52 to pCa 5.5, p < 0.01 and pCa 5.75–6.0, p < 0.05). Multivariable analysis revealed DM (OR 2.53, CI 1.12–5.73, Euro Score II (OR 1.34, CI 1.02–1.78), preoperative AF (OR 4.86, CI 2.06–11.47), GFR (OR 7.72, CI 1.87–31.96), albumin (OR 1.56, CI 0.52–2.60), Pentraxin-3 (OR 19.68, CI 14.13–25.24), depressed LVEF (OR 8.61, CI 6.37–10.86), lower force values: (pCa 5.4; OR 2.34, CI 0.40–4.29 and pCa 5.2; OR 2.00, CI 0.39–3.60) as predictors for clinical inapparent right heart dysfunction. Conclusions These preliminary data showed that inapparent right heart dysfunction in CAD is already associated with reduced force development of the contractile apparatus.
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Affiliation(s)
- C Bening
- Department of Thoracic and Cardiovascular Surgery, Zentrum Operative Medizin, University of Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany. .,Comprehensive Heart Failure Centre (CHFC) Würzburg, University of Wuerzburg, Wuerzburg, Germany.
| | - V L Sales
- Department of Thoracic and Cardiovascular Surgery, Zentrum Operative Medizin, University of Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - K Alhussini
- Department of Thoracic and Cardiovascular Surgery, Zentrum Operative Medizin, University of Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany.,Comprehensive Heart Failure Centre (CHFC) Würzburg, University of Wuerzburg, Wuerzburg, Germany
| | - D Radakovic
- Department of Thoracic and Cardiovascular Surgery, Zentrum Operative Medizin, University of Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - R Cris Benitez
- Department of Thoracic and Cardiovascular Surgery, Zentrum Operative Medizin, University of Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - N Madrahimov
- Department of Thoracic and Cardiovascular Surgery, Zentrum Operative Medizin, University of Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - D Keller
- Department of Thoracic and Cardiovascular Surgery, Zentrum Operative Medizin, University of Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - R Leyh
- Department of Thoracic and Cardiovascular Surgery, Zentrum Operative Medizin, University of Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany.,Comprehensive Heart Failure Centre (CHFC) Würzburg, University of Wuerzburg, Wuerzburg, Germany
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15
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Madrahimov N, Cristaldo RB, Du S, Keller D, Malikov M, Zaiatc E, Klapproth A, Penov K, Hamouda K, Leyh R, Bening C. Novel Post Mortal Organ Preserving ECMO in Non–Heart‐Beating Mouse. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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16
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Bening C, Alhussini K, Cristaldo RB, Madrahimov N, Radakovic D, Magyar A, Hassan M, Penov K, Leyh R. Correlation of DHEA as a Precursor for Androgens and Estrogens with Echocardiographic Function and Dimensions of the Heart. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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17
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Madrahimov N, Du S, Cristaldo RB, Keller D, Malikov M, Zaiatc E, Klapproth A, Penov K, Hamouda K, Leyh R, Bening C. Mouse Model of Heart Organ Care System to Study Ex Vivo Cardio Protection and Reperfusion in Cadaveric Heart Donation. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Morbach C, Gelbrich G, Tiffe T, Eichner FA, Christa M, Mattern R, Breunig M, Cejka V, Wagner M, Heuschmann PU, Störk S, Frantz S, Maack C, Ertl G, Fassnacht M, Wanner C, Leyh R, Volkmann J, Deckert J, Faller H, Jahns R. Prevalence and determinants of the precursor stages of heart failure: results from the population-based STAAB cohort study. Eur J Prev Cardiol 2020; 28:924-934. [DOI: 10.1177/2047487320922636] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 04/08/2020] [Indexed: 12/16/2022]
Abstract
Abstract
Aims
Prevention of heart failure relies on the early identification and control of risk factors. We aimed to identify the frequency and characteristics of individuals at risk of heart failure in the general population.
Methods and Results
We report cross-sectional data from the prospective Characteristics and Course of Heart Failure Stages A–B and Determinants of Progression (STAAB) cohort study investigating a representative sample of residents of Würzburg, Germany. Sampling was stratified 1:1 for sex and 10:27:27:27:10 for age groups of 30–39/40–49/50–59/60–69/70–79 years. Heart failure precursor stages were defined according to American College of Cardiology/American Heart Association: stage A (risk factors for heart failure), stage B (asymptomatic cardiac dysfunction). The main results were internally validated in the second half of the participants. The derivation sample comprised 2473 participants (51% women) with a distribution of 10%/28%/25%/27%/10% in respective age groups. Stages A and B were prevalent in 42% and 17% of subjects, respectively. Of stage B subjects, 31% had no risk factor qualifying for stage A (group ‘B-not-A’). Compared to individuals in stage B with A criteria, B-not-A were younger, more often women, and had left ventricular dilation as the predominant B qualifying criterion (all P < 0.001). These results were confirmed in the validation sample (n = 2492).
Conclusion
We identified a hitherto undescribed group of asymptomatic individuals with cardiac dysfunction predisposing to heart failure, who lacked established heart failure risk factors and therefore would have been missed by conventional primary prevention. Further studies need to replicate this finding in independent cohorts and characterise their genetic and -omic profile and the inception of clinically overt heart failure in subjects of group B-not-A.
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Affiliation(s)
- Caroline Morbach
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Department of Medicine I, University Hospital Würzburg, Germany
| | - Götz Gelbrich
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
- Clinical Trial Center, University Hospital Würzburg, Germany
| | - Theresa Tiffe
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
| | - Felizitas A Eichner
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
| | - Martin Christa
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Department of Medicine I, University Hospital Würzburg, Germany
| | - Renate Mattern
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Department of Medicine I, University Hospital Würzburg, Germany
| | - Margret Breunig
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Department of Medicine I, University Hospital Würzburg, Germany
| | - Vladimir Cejka
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Department of Medicine I, University Hospital Würzburg, Germany
| | - Martin Wagner
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
| | - Peter U Heuschmann
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
- Clinical Trial Center, University Hospital Würzburg, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Germany
- Department of Medicine I, University Hospital Würzburg, Germany
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Goettler D, Wagner M, Faller H, Kotseva K, Wood D, Leyh R, Ertl G, Karmann W, Heuschmann PU, Störk S. Factors associated with smoking cessation in patients with coronary heart disease: a cohort analysis of the German subset of EuroAspire IV survey. BMC Cardiovasc Disord 2020; 20:152. [PMID: 32228474 PMCID: PMC7106891 DOI: 10.1186/s12872-020-01429-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 02/06/2020] [Accepted: 03/12/2020] [Indexed: 02/07/2023] Open
Abstract
Background Tobacco smoking is one of the most important risk factors of coronary heart disease (CHD). Hence, smoking cessation is considered pivotal in the prevention of CHD. The current study aimed to evaluate smoking cessation patterns and determine factors associated with smoking cessation in patients with established CHD. Methods The fourth European Survey of Cardiovascular Disease Prevention and Diabetes investigated quality of CHD care in 24 countries across Europe in 2012/13. In the German subset, smoking cessation patterns and clinical characteristics were repetitively assessed a) during index event due to CHD by medical record abstraction, b) as part of a face-to-face interview 6 to 36 months after the index event (i.e. baseline visit), and c) by telephone-based follow-up interview two years after the baseline visit. Logistic regression analysis was performed to search for factors determining smoking status at the time of the telephone interview. Results Out of 469 participants available for follow-up, 104 (22.2%) had been classified as current smokers at the index event. Of those, 65 patients (62.5%) had quit smoking at the time of the telephone interview, i.e., after a median observation period of 3.5 years (quartiles 3.0, 4.1). Depressed mood at baseline visit and higher education level were less prevalent amongst quitters vs non-quitters (17.2% vs 35.9%, p = 0.03 and 15.4% vs 33.3%, p = 0.03), cardiac rehabilitation programs were more frequently attended by quitters (83.1% vs 48.7%, p < 0.001), and there was a trend for a higher prevalence of diabetes at baseline visit in quitters (37.5% vs 20.5%, p = 0.07). In the final multivariable model, cardiac rehabilitation was associated with smoking cessation (OR 5.19; 95%CI 1.87 to 14.46; p = 0.002). Discussion Attending a cardiac rehabilitation program after a cardiovascular event was associated with smoking cessation supporting its use as a platform for smoking cessation counseling and relapse prevention.
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Affiliation(s)
- D Goettler
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Haus A15, D-97078, Würzburg, Germany.,Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.,Department of Pediatrics, University Hospital of Würzburg, Würzburg, Germany
| | - M Wagner
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - H Faller
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - K Kotseva
- National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland.,Imperial College Healthcare NHS Trust, London, UK
| | - D Wood
- National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland
| | - R Leyh
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Haus A15, D-97078, Würzburg, Germany.,Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Würzburg, Germany
| | - G Ertl
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Haus A15, D-97078, Würzburg, Germany.,Department of Internal Medicine I, University and University Hospital of Würzburg, Würzburg, Germany
| | - W Karmann
- Department of Medicine, Klinik Kitzinger Land, Kitzingen, Germany
| | - P U Heuschmann
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Haus A15, D-97078, Würzburg, Germany.,Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.,Clinical Trial Center, University Hospital of Würzburg, Würzburg, Germany
| | - S Störk
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Haus A15, D-97078, Würzburg, Germany. .,Department of Internal Medicine I, University and University Hospital of Würzburg, Würzburg, Germany.
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Aboud A, Fujita B, Stierle U, Hemmer W, Lange R, Franke U, Leyh R, Laufer G, Sievers HH, Ensminger S. Long-Term Outcomes for Patients Undergoing the Ross Procedure in 10 European Heart Centers: An Update from the Ross Registry. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Sales V, Wendel J, Gorski A, Alhussini K, Madrahimov N, Penov K, Radakovic D, Magyar A, Leyh R, Bening C. Single Carotid Cannulation for Selective Antegrade Cerebral Perfusion: A Safe and Effective Tailored Approach in Moderate-Risk Patients undergoing Contemporary Minimally Invasive Primary Aortic Arch Repair. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Madrahimov N, Alhussini K, Sales V, Radakovic D, Penov K, Benitez Cristaldo R, Hoffmann J, Hassan M, Leyh R, Bening C. First-Ever Built Magnetically Driven Micropump Using 3D Technology for VAD and ECMO Studies in a Mouse Model. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Madrahimov N, Bening C, Alhussini K, Sales V, Radakovic D, Penov K, Benitez Cristaldo R, Magyar A, Hoffmann J, Leyh R. The Potential Role of Magnetorheological Elastomers as “Smart Materials” in the Future Design of the Artificial Heart and Circulatory Support. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Alhussini K, Sales V, Benitez Cristaldo R, Penov K, Madrahimov N, Radakovic D, Magyar A, Hassan M, Leyh R, Bening C. Comparison of Half Relaxation Time and Peak Force of Intact Muscle Fibers of Elective CABG Patients with Diastolic Dysfunction Grade I–III. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Penov K, Westarp E, Radakovic D, Sales V, Madrahimov N, Alhussini K, Gorski A, Aleksic I, Bening C, Leyh R. Surgery for Aortic and Aortic Valve Pathology in Bicuspid and Tricuspid Valves Has Excellent Short- and Long-Term Outcomes: A Single-Center Experience. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bening C, Alhussini K, Mazalu EA, Yaqub J, Hamouda K, Radakovic D, Schimmer C, Hirnle G, Leyh R. Impact of diabetes mellitus on the contractile properties of the left and right atrial myofilaments. Eur J Cardiothorac Surg 2019; 54:826-831. [PMID: 29659778 DOI: 10.1093/ejcts/ezy154] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 03/14/2018] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES The incidence of diabetes mellitus in patients with ischaemic cardiomyopathy is increasing. To evaluate the impact of diabetes mellitus on contractility, we examined the calcium-induced force in left and right atrial myofilaments of patients with and without diabetes. METHODS We included 149 patients (106 without diabetes, 43 with diabetes), scheduled for elective coronary artery bypass grafting from August 2016 to June 2017. The left and right atria were excised and prepared for skinned fibre measurements (pCa-force curve). The unit for the force measurements is Millinewton (mN). Comprehensive demographic data as well as echocardiographic findings of the patients were collected. RESULTS We observed a significant decrease of left atrial force values in patients with diabetes, averaged over all calcium concentrations (patients with diabetes 0.50 ± 0.19 mN vs 0.68 ± 0.23 mN in patients without diabetes, P = 0.002) as well as in right atrial fibres (patients with diabetes 0.35 ± 0.17 mN vs 0.47 ± 0.21 mN in patients without diabetes, P = 0.005). There was a significant influence of repeated measurements (of the calcium concentrations) on force in left atrial myofilaments (P < 0.001). There was also a significant impact of diabetes on the force values of the different calcium concentrations in left atrial myofilaments (P 0.002). In right atrial myofilaments we also found a significant influence of repeated measurements (of the calcium concentrations) on force (P < 0.001). Additionally the impact of diabetes on the force values was significant (P = 0.005). CONCLUSIONS We demonstrated that diabetes mellitus has a significantly negative impact on calcium-induced force development in left and right atrial myofilaments.
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Affiliation(s)
- Constanze Bening
- Department of Thoracic and Cardiovascular Surgery, University of Wuerzburg, Wuerzburg, Germany.,Comprehensive Heart Failure Centre (CHFC) Würzburg, University of Wuerzburg, Wuerzburg, Germany
| | - Khaled Alhussini
- Department of Thoracic and Cardiovascular Surgery, University of Wuerzburg, Wuerzburg, Germany.,Comprehensive Heart Failure Centre (CHFC) Würzburg, University of Wuerzburg, Wuerzburg, Germany
| | - Elena-Aura Mazalu
- Department of Thoracic and Cardiovascular Surgery, University of Wuerzburg, Wuerzburg, Germany.,Comprehensive Heart Failure Centre (CHFC) Würzburg, University of Wuerzburg, Wuerzburg, Germany
| | - Jonathan Yaqub
- Department of Thoracic and Cardiovascular Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Khaled Hamouda
- Department of Thoracic and Cardiovascular Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Dejan Radakovic
- Department of Thoracic and Cardiovascular Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Christoph Schimmer
- Department of Thoracic and Cardiovascular Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Grzegorz Hirnle
- Department of Thoracic and Cardiovascular Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Rainer Leyh
- Department of Thoracic and Cardiovascular Surgery, University of Wuerzburg, Wuerzburg, Germany.,Comprehensive Heart Failure Centre (CHFC) Würzburg, University of Wuerzburg, Wuerzburg, Germany
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De Backer G, Jankowski P, Kotseva K, Mirrakhimov E, Reiner Ž, Rydén L, Tokgözoğlu L, Wood D, De Bacquer D, De Backer G, Jankowski P, Kotseva K, Mirrakhimov E, Reiner Z, Rydén L, Tokgözoğlu L, Wood D, De Bacquer D, Kotseva K, De Backer G, Abreu A, Aguiar C, Badariene J, Bruthans J, Castro Conde A, Cifkova R, Crowley J, Davletov K, Bacquer DD, De Smedt D, De Sutter J, Deckers J, Dilic M, Dolzhenko M, Druais H, Dzerve V, Erglis A, Fras Z, Gaita D, Gotcheva N, Grobbee D, Gyberg V, Hasan Ali H, Heuschmann P, Hoes A, Jankowski P, Lalic N, Lehto S, Lovic D, Maggioni A, Mancas S, Marques-Vidal P, Mellbin L, Miličić D, Mirrakhimov E, Oganov R, Pogosova N, Reiner Ž, Rydén L, Stagmo M, Störk S, Sundvall J, Tokgözoğlu L, Tsioufis K, Vulic D, Wood D, Wood D, Kotseva K, Jennings C, Adamska A, Adamska S, Rydén L, Mellbin L, Tuomilehto J, Schnell O, Druais H, Fiorucci E, Glemot M, Larras F, Missiamenou V, Maggioni A, Taylor C, Ferreira T, Lemaitre K, Bacquer DD, De Backer G, Raman L, Sundvall J, DeSmedt D, De Sutter J, Willems A, De Pauw M, Vervaet P, Bollen J, Dekimpe E, Mommen N, Van Genechten G, Dendale P, Bouvier C, Chenu P, Huyberechts D, Persu A, Dilic M, Begic A, Durak Nalbantic A, Dzubur A, Hadzibegic N, Iglica A, Kapidjic S, Osmanagic Bico A, Resic N, Sabanovic Bajramovic N, Zvizdic F, Vulic D, Kovacevic-Preradovic T, Popovic-Pejicic S, Djekic D, Gnjatic T, Knezevic T, Kovacevic-Preradovic T, Kos L, Popovic-Pejicic S, Stanetic B, Topic G, Gotcheva N, Georgiev B, Terziev A, Vladimirov G, Angelov A, Kanazirev B, Nikolaeva S, Tonkova D, Vetkova M, Milicic D, Reiner Ž, Bosnic A, Dubravcic M, Glavina M, Mance M, Pavasovic S, Samardzic J, Batinic T, Crljenko K, Delic-Brkljacic D, Dula K, Golubic K, Klobucar I, Kordic K, Kos N, Nedic M, Olujic D, Sedinic V, Blazevic T, Pasalic A, Percic M, Sikic J, Bruthans J, Cífková R, Hašplová K, Šulc P, Wohlfahrt P, Mayer O, Cvíčela M, Filipovský J, Gelžinský J, Hronová M, Hasan-Ali H, Bakery S, Mosad E, Hamed H, Ibrahim A, Elsharef M, Kholef E, Shehata A, Youssef M, Elhefny E, Farid H, Moustafa T, Sobieh M, Kabil H, Abdelmordy A, Lehto S, Kiljander E, Kiljander P, Koukkunen H, Mustonen J, Cremer C, Frantz S, Haupt A, Hofmann U, Ludwig K, Melnyk H, Noutsias M, Karmann W, Prondzinsky R, Herdeg C, Hövelborn T, Daaboul A, Geisler T, Keller T, Sauerbrunn D, Walz-Ayed M, Ertl G, Leyh R, Störk S, Heuschmann P, Ehlert T, Klocke B, Krapp J, Ludwig T, Käs J, Starke C, Ungethüm K, Wagner M, Wiedmann S, Tsioufis K, Tolis P, Vogiatzi G, Sanidas E, Tsakalis K, Kanakakis J, Koutsoukis A, Vasileiadis K, Zarifis J, Karvounis C, Crowley J, Gibson I, Houlihan A, Kelly C, O'Donnell M, Bennati M, Cosmi F, Mariottoni B, Morganti M, Cherubini A, Di Lenarda A, Radini D, Ramani F, Francese M, Gulizia M, Pericone D, Davletov K, Aigerim K, Zholdin B, Amirov B, Assembekov B, Chernokurova E, Ibragimova F, Kodasbayev A, Markova A, Mirrakhimov E, Asanbaev A, Toktomamatov U, Tursunbaev M, Zakirov U, Abilova S, Arapova R, Bektasheva E, Esenbekova J, Neronova K, Asanbaev A, Baigaziev K, Toktomamatov U, Zakirov U, Baitova G, Zheenbekov T, Erglis A, Andrejeva T, Bajare I, Kucika G, Labuce A, Putane L, Stabulniece M, Dzerve V, Klavins E, Sime I, Badariene J, Gedvilaite L, Pečiuraite D, Sileikienė V, Skiauteryte E, Solovjova S, Sidabraite R, Briedis K, Ceponiene I, Jurenas M, Kersulis J, Martinkute G, Vaitiekiene A, Vasiljevaite K, Veisaite R, Plisienė J, Šiurkaitė V, Vaičiulis Ž, Jankowski P, Czarnecka D, Kozieł P, Podolec P, Nessler J, Gomuła P, Mirek-Bryniarska E, Bogacki P, Wiśniewski A, Pająk A, Wolfshaut-Wolak R, Bućko J, Kamiński K, Łapińska M, Paniczko M, Raczkowski A, Sawicka E, Stachurska Z, Szpakowicz M, Musiał W, Dobrzycki S, Bychowski J, Kosior D, Krzykwa A, Setny M, Kosior D, Rak A, Gąsior Z, Haberka M, Gąsior Z, Haberka M, Szostak-Janiak K, Finik M, Liszka J, Botelho A, Cachulo M, Sousa J, Pais A, Aguiar C, Durazzo A, Matos D, Gouveia R, Rodrigues G, Strong C, Guerreiro R, Aguiar J, Abreu A, Cruz M, Daniel P, Morais L, Moreira R, Rosa S, Rodrigues I, Selas M, Gaita D, Mancas S, Apostu A, Cosor O, Gaita L, Giurgiu L, Hudrea C, Maximov D, Moldovan B, Mosteoru S, Pleava R, Ionescu M, Parepa I, Pogosova N, Arutyunov A, Ausheva A, Isakova S, Karpova A, Salbieva A, Sokolova O, Vasilevsky A, Pozdnyakov Y, Antropova O, Borisova L, Osipova I, Lovic D, Aleksic M, Crnokrak B, Djokic J, Hinic S, Vukasin T, Zdravkovic M, Lalic N, Jotic A, Lalic K, Lukic L, Milicic T, Macesic M, Stanarcic Gajovic J, Stoiljkovic M, Djordjevic D, Kostic S, Tasic I, Vukovic A, Fras Z, Jug B, Juhant A, Krt A, Kugonjič U, Chipayo Gonzales D, Gómez Barrado J, Kounka Z, Marcos Gómez G, Mogollón Jiménez M, Ortiz Cortés C, Perez Espejo P, Porras Ramos Y, Colman R, Delgado J, Otero E, Pérez A, Fernández-Olmo M, Torres-LLergo J, Vasco C, Barreñada E, Botas J, Campuzano R, González Y, Rodrigo M, de Pablo C, Velasco E, Hernández S, Lozano C, González P, Castro A, Dalmau R, Hernández D, Irazusta F, Vélez A, Vindel C, Gómez-Doblas J, García Ruíz V, Gómez L, Gómez García M, Jiménez-Navarro M, Molina Ramos A, Marzal D, Martínez G, Lavado R, Vidal A, Rydén L, Boström-Nilsson V, Kjellström B, Shahim B, Smetana S, Hansen O, Stensgaard-Nake E, Deckers J, Klijn A, Mangus T, Peters R, Scholte op Reimer W, Snaterse M, Aydoğdu S, Ç Erol, Otürk S, Tulunay Kaya C, Ahmetoğlu Y, Ergene O, Akdeniz B, Çırgamış D, Akkoyun H Kültürsay S, Kayıkçıoğlu M, Çatakoğlu A, Çengel A, Koçak A, Ağırbaşlı M, Açıksarı G, Çekin M, Tokgözoğlu L, Kaya E, Koçyiğit D, Öngen Z, Özmen E, Sansoy V, Kaya A, Oktay V, Temizhan A, Ünal S, İ Yakut, Kalkan A, Bozkurt E, Kasapkara H, Dolzhenko M, Faradzh C, Hrubyak L, Konoplianyk L, Kozhuharyova N, Lobach L, Nesukai V, Nudchenko O, Simagina T, Yakovenko L, Azarenko V, Potabashny V, Bazylevych A, Bazylevych M, Kaminska K, Panchenko L, Shershnyova O, Ovrakh T, Serik S, Kolesnik T, Kosova H, Wood D, Adamska A, Adamska S, Jennings C, Kotseva K, Hoye P Atkin A, Fellowes D, Lindsay S, Atkinson C, Kranilla C, Vinod M, Beerachee Y, Bennett C, Broome M, Bwalya A, Caygill L, Dinning L, Gillespie A, Goodfellow R, Guy J, Idress T, Mills C, Morgan C, Oustance N, Singh N, Yare M, Jagoda J, Bowyer H, Christenssen V, Groves A, Jan A, Riaz A, Gill M, Sewell T, Gorog D, Baker M, De Sousa P, Mazenenga T, Porter J, Haines F, Peachey T, Taaffe J, Wells K, Ripley D, Forward H, McKie H, Pick S, Thomas H, Batin P, Exley D, Rank T, Wright J, Kardos A, Sutherland SB, Wren L, Leeson P, Barker D, Moreby B, Sawyer J, Stirrup J, Brunton M, Brodison A, Craig J, Peters S, Kaprielian R, Bucaj A, Mahay K, Oblak M, Gale C, Pye M, McGill Y, Redfearn H, Fearnley M. Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries. Atherosclerosis 2019; 285:135-146. [DOI: 10.1016/j.atherosclerosis.2019.03.014] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/22/2019] [Accepted: 03/19/2019] [Indexed: 12/16/2022]
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Leistner M, Sommer S, Kanofsky P, Leyh R, Sommer SP. Ischemia time impacts on respiratory chain functions and Ca 2+-handling of cardiac subsarcolemmal mitochondria subjected to ischemia reperfusion injury. J Cardiothorac Surg 2019; 14:92. [PMID: 31088484 PMCID: PMC6518521 DOI: 10.1186/s13019-019-0911-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 12/20/2018] [Accepted: 04/22/2019] [Indexed: 11/10/2022] Open
Abstract
Background Mitochondrial impairment can result from myocardial ischemia reperfusion injury (IR). Despite cardioplegic arrest, IR-associated cardiodepression is a major problem in heart surgery. We determined the effect of increasing ischemia time on the respiratory chain (RC) function, the inner membrane polarization and Ca2+ homeostasis of rat cardiac subsarcolemmal mitochondria (SSM). Methods Wistar rat hearts were divided into 4 groups of stop-flow induced warm global IR using a pressure-controlled Langendorff system: 0, 15, 30 and 40 min of ischemia with 30 min of reperfusion, respectively. Myocardial contractility was determined from left ventricular pressure records (dP/dt, dPmax) with an intraventricular balloon. Following reperfusion, SSM were isolated and analyzed regarding electron transport chain (ETC) coupling by polarography (Clark-Type electrode), membrane polarization (JC1 fluorescence) and Ca2+-handling in terms of Ca2+-induced swelling and Ca2+-uptake/release (Calcium Green-5 N® fluorescence). Results LV contractility and systolic pressure during reperfusion were impaired by increasing ischemic times. Ischemia reduced ETC oxygen consumption in IR40/30 compared to IR0/30 at complex I-V (8.1 ± 1.2 vs. 18.2 ± 2.0 nmol/min) and II-IV/V (16.4 ± 2.6/14.8 ± 2.3 vs. 2.3 ± 0.6 nmol/min) in state 3 respiration (p < 0.01). Relative membrane potential revealed a distinct hyperpolarization in IR30/30 and IR40/30 (171.5 ± 17.4% and 170.9 ± 13.5%) compared to IR0/30 (p < 0.01), wearing off swiftly after CCCP-induced uncoupling. Excess mitochondrial permeability transition pore (mPTP)-gated Ca2+-induced swelling was recorded in all groups and was most pronounced in IR40/30. Pyruvate addition for mPTP blocking strongly reduced SSM swelling in IR40/30 (relative AUC, ± pyruvate; IR0/30: 1.00 vs. 0.61, IR15/30: 1.68 vs. 1.00, IR30/30: 1.42 vs. 0.75, IR40/30: 1.97 vs. 0.85; p < 0.01). Ca2+-uptake remained unaffected by previous IR. Though Ca2+-release was delayed for ≥30 min of ischemia (p < 0.01), Ca2+ retention was highest in IR15/30 (RFU; IR0/30: 6.3 ± 3.6, IR 15/30 42.9 ± 5.0, IR30/30 15.9 ± 3.8, IR40/30 11.5 ± 6.6; p ≤ 0.01 for IR15/30 against all other groups). Conclusions Ischemia prolongation in IR injury gradually impaired SSM in terms of respiratory chain function and Ca2+-homeostasis. Membrane hyperpolarization appears to be responsible for impaired Ca2+-cycling and ETC function. Ischemia time should be considered an important factor influencing IR experimental data on subsarcolemmal mitochondria. Periods of warm global ischemia should be minimized during cardiac surgery to avoid excessive damage to SSMs.
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Affiliation(s)
- Marcus Leistner
- Department of Thoracic, Cardiac and Vascular Surgery, University Medical Center Goettingen, Goettingen, Germany. .,Department of Cardiothoracic and Thoracic Vascular Surgery, University Hospital Wuerzburg, Wuerzburg, Germany.
| | - Stefanie Sommer
- Institute for Laboratory and Transfusion Medicine, Herz- und Diabeteszentrum Nordrheinwestfalen (HDZ-NRW), Bad Oeynhausen, Germany.,Department of Cardiothoracic and Thoracic Vascular Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Peer Kanofsky
- Department of Cardiothoracic and Thoracic Vascular Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Rainer Leyh
- Department of Cardiothoracic and Thoracic Vascular Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Sebastian-Patrick Sommer
- Department of Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrheinwestfalen (HDZ-NRW), Bad Oeynhausen, Germany.,Department of Cardiothoracic and Thoracic Vascular Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
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Tiffe T, Morbach C, Malsch C, Gelbrich G, Wahl V, Wagner M, Kotseva K, Wood D, Leyh R, Ertl G, Karmann W, Störk S, Heuschmann PU. Physicians' lifestyle advice on primary and secondary cardiovascular disease prevention in Germany: A comparison between the STAAB cohort study and the German subset of EUROASPIRE IV. Eur J Prev Cardiol 2019; 28:1175-1183. [PMID: 37039762 DOI: 10.1177/2047487319838218] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 02/23/2019] [Indexed: 02/02/2023]
Abstract
Abstract
Background
We assessed prevalence and determinants in appropriate physician-led lifestyle advice (PLA) in a population-based sample of individuals without cardiovascular disease (CVD) compared with a sample of CVD patients.
Methods
PLA was assessed via questionnaire in a subsample of the population-based Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) cohort free of CVD (primary prevention sample) and the German subset of the fourth EUROASPIRE survey (EUROASPIRE-IV) comprising CVD patients (secondary prevention sample). PLA was fulfilled if the participant reported having ever been told by a physician to: stop smoking (current/former smokers), reduce weight (overweight/obese participants), increase physical activity (physically inactive participants) or keep to a healthy diet (all participants). Factors associated with receiving at least 50% of the PLA were identified using logistic regression.
Results
Information on PLA was available in 665 STAAB participants (55 ± 11; 55% females) and in 536 EUROASPIRE-IV patients (67 ± 9; 18% females). Except for smoking, appropriate PLA was more frequently given in the secondary compared with the primary prevention sample. Determinants associated with appropriate PLA in primary prevention were: diabetes mellitus (odds ratio (OR) 4.54; 95% confidence interval (CI) 1.88–10.95), hyperlipidaemia (OR 3.12; 95% CI 2.06–4.73) and hypertension (OR 1.74; 95% CI 1.15–2.62); in secondary prevention: age (OR per year 0.96; 95% CI 0.93–0.98) and diabetes mellitus (OR 2.33; 95% CI 1.20–4.54).
Conclusions
In primary prevention, PLA was mainly determined by the presence of vascular risk factors, whereas in secondary prevention the level of PLA was higher in general, but the association between CVD risk factors and PLA was less pronounced.
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Affiliation(s)
- Theresa Tiffe
- Comprehensive Heart Failure Centre, University Hospital and University of Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
| | - Caroline Morbach
- Comprehensive Heart Failure Centre, University Hospital and University of Würzburg, Germany
- Department of Medicine I, University Hospital Würzburg, Germany
| | - Carolin Malsch
- Comprehensive Heart Failure Centre, University Hospital and University of Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
| | - Götz Gelbrich
- Comprehensive Heart Failure Centre, University Hospital and University of Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
| | - Valerie Wahl
- Comprehensive Heart Failure Centre, University Hospital and University of Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
| | - Martin Wagner
- Comprehensive Heart Failure Centre, University Hospital and University of Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
| | - Kornelia Kotseva
- Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, UK
| | - David Wood
- Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, UK
| | - Rainer Leyh
- Comprehensive Heart Failure Centre, University Hospital and University of Würzburg, Germany
- Department of Cardiovascular Surgery, University Hospital Würzburg, Germany
| | - Georg Ertl
- Comprehensive Heart Failure Centre, University Hospital and University of Würzburg, Germany
| | - Wolfgang Karmann
- Department of Medicine, Klinik Kitzinger Land, Kitzingen, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Centre, University Hospital and University of Würzburg, Germany
- Department of Medicine I, University Hospital Würzburg, Germany
| | - Peter U Heuschmann
- Comprehensive Heart Failure Centre, University Hospital and University of Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
- Clinical Trial Centre, University Hospital Würzburg, Germany
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Bening C, Mazalu EA, Yaqub J, Alhussini K, Glanowski M, Kottmann T, Leyh R. Atrial contractility and fibrotic biomarkers are associated with atrial fibrillation after elective coronary artery bypass grafting. J Thorac Cardiovasc Surg 2019; 159:515-523. [PMID: 30929988 DOI: 10.1016/j.jtcvs.2019.02.068] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 02/14/2019] [Accepted: 02/15/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE New-onset postoperative atrial fibrillation is common after cardiac surgery. Less has been reported about the relationship among fibrosis, inflammation, calcium-induced left atrial and right atrial contractile forces, and postoperative atrial fibrillation. We sought to identify predictors of postoperative atrial fibrillation. METHODS From August 2016 to February 2018, we evaluated 229 patients who had preoperative sinus rhythm before elective primary coronary artery bypass grafting. Of 229 patients, 191 maintained sinus rhythm postoperatively, whereas 38 patients developed atrial fibrillation. Preoperative tissue inhibitor of metalloproteinase-1, pentraxin-3, matrix metallopeptidase-9, galectin-3, high-sensitivity C-reactive protein, growth differentiation factor 15, and transforming growth factor-ß were measured. Clinical and echocardiographic findings (tricuspid annular plane systolic excursion for right heart function) and calcium-induced force measurements from left atrial and right atrial-derived skinned myocardial fibers were recorded. RESULTS Patients with atrial fibrillation were older (P = .001), had enlarged left atrial (P = .0001) and right atrial areas (P = .0001), and had decreased tricuspid annular plane systolic excursion (P = .001). Levels of matrix metallopeptidase-9 and pentraxin-3 were decreased (P < .05), whereas growth differentiation factor 15 was increased (P = .001). We detected lower left atrial force values at calcium-induced force measurements 5.5 (P < .05), 5.4 (P < .01), and 5.3 to 4.52 (P = .0001) and right atrial force values at calcium-induced force measurements 5.0 to 4.52 (P < .05) in patients with postoperative atrial fibrillation. Multivariable analysis showed that advanced age (P = .033), decreased left atrial force value at calcium-induced force measurement of 5.5 (P = .033), enlarged left atrial (P = .013) and right atrial (P = .081) areas, and reduced tricuspid annular plane systolic excursion (P = .010) independently predicted postoperative atrial fibrillation. CONCLUSIONS Advanced age, decreased left atrial force value at calcium-induced force measurement of 5.5, enlarged left atrial and right atrial areas, and reduced tricuspid annular plane systolic excursion were identified as independent predictors for postoperative atrial fibrillation.
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Affiliation(s)
- Constanze Bening
- Department of Thoracic and Cardiovascular Surgery, University of Wuerzburg, Wuerzburg, Germany; Comprehensive Heart Failure Centre Würzburg, University of Wuerzburg, Wuerzburg, Germany.
| | - Elena-Aura Mazalu
- Department of Thoracic and Cardiovascular Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Jonathan Yaqub
- Department of Thoracic and Cardiovascular Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Khaled Alhussini
- Department of Thoracic and Cardiovascular Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Michal Glanowski
- Department of Thoracic and Cardiovascular Surgery, University of Wuerzburg, Wuerzburg, Germany
| | | | - Rainer Leyh
- Department of Thoracic and Cardiovascular Surgery, University of Wuerzburg, Wuerzburg, Germany; Comprehensive Heart Failure Centre Würzburg, University of Wuerzburg, Wuerzburg, Germany
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Bening C, Alhussini K, Yaqub J, Mazalu A, Benitez R, Magyar A, Radakovic D, Schade I, Schimmer C, Hamouda K, Leyh R. Correlation of Biomarkers of Endothelial Dysfunction, Inflammation, and Fibrosis and Preserved and Reduced Right Heart Function without Pulmonary Hypertension. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- C. Bening
- Universität Würzburg, Klinik für Thorax,- Herz- und Thorakale Gefäßchirurgie, Würzburg, Germany
| | - K. Alhussini
- Universität Würzburg, Klinik für Thorax,- Herz- und Thorakale Gefäßchirurgie, Würzburg, Germany
| | - J. Yaqub
- Universität Würzburg, Klinik für Thorax,- Herz- und Thorakale Gefäßchirurgie, Würzburg, Germany
| | - A. Mazalu
- Universität Würzburg, Klinik für Thorax,- Herz- und Thorakale Gefäßchirurgie, Würzburg, Germany
| | - R. Benitez
- Universität Würzburg, Klinik für Thorax,- Herz- und Thorakale Gefäßchirurgie, Würzburg, Germany
| | - A. Magyar
- Universität Würzburg, Klinik für Thorax,- Herz- und Thorakale Gefäßchirurgie, Würzburg, Germany
| | - D. Radakovic
- Universität Würzburg, Klinik für Thorax,- Herz- und Thorakale Gefäßchirurgie, Würzburg, Germany
| | - I. Schade
- Universität Würzburg, Klinik für Thorax,- Herz- und Thorakale Gefäßchirurgie, Würzburg, Germany
| | - C. Schimmer
- Universität Würzburg, Klinik für Thorax,- Herz- und Thorakale Gefäßchirurgie, Würzburg, Germany
| | - K. Hamouda
- Universität Würzburg, Klinik für Thorax,- Herz- und Thorakale Gefäßchirurgie, Würzburg, Germany
| | - R. Leyh
- Universität Würzburg, Klinik für Thorax,- Herz- und Thorakale Gefäßchirurgie, Würzburg, Germany
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Penov K, Cordova-Palomera A, Bening C, Pariani M, Zhou Z, Priest J, Leyh R, Fischbein M. Transcriptomic Sequencing of Primary Tissue Improves Genetic Diagnosis in Bicuspid Aortopathy by Identification and Validation of Splicing Variants. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- K. Penov
- University Clinic Wuerzburg, Wuerzburg, Germany
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, United States
| | - A. Cordova-Palomera
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States
| | - C. Bening
- University Clinic Wuerzburg, Wuerzburg, Germany
| | - M. Pariani
- Stanford University School of Medicine, Stanford, California, Stanford Center for Inherited Cardiovascular Disease, Palo Alto, United States
| | - Z. Zhou
- National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China
| | - J. Priest
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States
| | - R. Leyh
- University Clinic Wuerzburg, Wuerzburg, Germany
| | - M. Fischbein
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, United States
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Morbach C, Gelbrich G, Tiffe T, Eichner F, Wagner M, Heuschmann PU, Störk S, Frantz S, Maack C, Ertl G, Fassnacht M, Wanner C, Leyh R, Volkmann J, Deckert J, Faller H, Jahns R. Variations in cardiovascular risk factors in people with and without migration background in Germany - Results from the STAAB cohort study. Int J Cardiol 2018; 286:186-189. [PMID: 30420145 DOI: 10.1016/j.ijcard.2018.10.098] [Citation(s) in RCA: 3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/02/2018] [Accepted: 10/29/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND About 20% of the German population have a migration background which might influence prevalence of preventable cardiovascular risk factors (CVRF). METHODS We report data of the prospective Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) cohort study investigating a representative sample of inhabitants of the City of Würzburg, Germany, aged 30 to 79 years. Individuals without migration background were defined as follows: German as native language, no other native language, and/or born in Germany. All other participants were defined as individuals with migration background. RESULTS Of 2473 subjects (51% female, mean age 54 ± 12 years), 291 (12%) reported a migration background: n = 107 (37%) from a country within the EU, n = 117 (40%) from Russia, and n = 67 (23%) from other countries. Prevalence of hypertension, atherosclerotic disease, and diabetes mellitus was similar in individuals with and without migration background. By contrast, prevalence of obesity and metabolic syndrome was significantly higher in individuals with migration background, with the least favourable profile apparent in individuals from Russia (individuals without vs. with migration background: obesity 19 vs. 24%, p < 0.05; odds ratio: EU: 1.6, Russia: 2.2*, other countries: 0.6; metabolic syndrome 18 vs. 21%, p < 0.05; odds ratio: EU: 1.2, Russia: 1.7*, other countries: 1.5; *p < 0.05). CONCLUSION Individuals with migration background in Germany might exhibit a higher CVRF burden due to a higher prevalence of obesity and metabolic syndrome. Strategies for primary prevention of heart failure may benefit from deliberately considering the migration background.
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Affiliation(s)
- Caroline Morbach
- Comprehensive Heart Failure Center and Dept. of Medicine I, University Hospital and University of Würzburg, Germany
| | - Götz Gelbrich
- Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany
| | - Theresa Tiffe
- Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany
| | - Felizitas Eichner
- Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany
| | - Martin Wagner
- Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany
| | - Peter U Heuschmann
- Institute of Clinical Epidemiology and Biometry, Comprehensive Heart Failure Center, and Clinical Trial Center, University of Würzburg, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center and Dept. of Medicine I, University Hospital and University of Würzburg, Germany.
| | | | - S Frantz
- Dept. of Medicine I, Div. of Cardiology, University Hospital Würzburg, Germany
| | - C Maack
- Comprehensive Heart Failure Center, University Hospital and University of Würzburg, Germany
| | - G Ertl
- University Hospital Würzburg, Germany
| | - M Fassnacht
- Dept. of Medicine I, Div. of Endocrinology, University Hospital Würzburg, Germany
| | - C Wanner
- Dept. of Medicine I, University Hospital Würzburg, Germany
| | - R Leyh
- Dept. of Cardiovascular Surgery, University Hospital Würzburg, Germany
| | - J Volkmann
- Dept. of Neurology, University Hospital Würzburg, Germany
| | - J Deckert
- Dept. of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Germany
| | - H Faller
- Dept. of Medical Psychology, University of Würzburg, Germany
| | - R Jahns
- Interdisciplinary Bank of Biomaterials and Data Würzburg, University Hospital Würzburg, Germany
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Herrmann S, Fries B, Salinger T, Liu D, Hu K, Gensler D, Strotmann J, Christa M, Beer M, Gattenlöhner S, Störk S, Voelker W, Bening C, Lorenz K, Leyh R, Frantz S, Ertl G, Weidemann F, Nordbeck P. Myocardial Fibrosis Predicts 10-Year Survival in Patients Undergoing Aortic Valve Replacement. Circ Cardiovasc Imaging 2018; 11:e007131. [DOI: 10.1161/circimaging.117.007131] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Sebastian Herrmann
- Department of Internal Medicine I, Center of Cardiovascular Diseases, University Hospital, Universitätsklinikum Würzburg, Würzburg, Bayern, Germany (S.H., B.F., T.S., D.L., K.H., D.G., M.C., S.S., W.V., S.F., G.E., P.N.)
- Comprehensive Heart Failure Center (S.H., T.S., D.G., M.C., S.S., W.V., S.F., G.E., F.W., P.N.)
| | - Bastian Fries
- Department of Internal Medicine I, Center of Cardiovascular Diseases, University Hospital, Universitätsklinikum Würzburg, Würzburg, Bayern, Germany (S.H., B.F., T.S., D.L., K.H., D.G., M.C., S.S., W.V., S.F., G.E., P.N.)
| | - Tim Salinger
- Department of Internal Medicine I, Center of Cardiovascular Diseases, University Hospital, Universitätsklinikum Würzburg, Würzburg, Bayern, Germany (S.H., B.F., T.S., D.L., K.H., D.G., M.C., S.S., W.V., S.F., G.E., P.N.)
- Comprehensive Heart Failure Center (S.H., T.S., D.G., M.C., S.S., W.V., S.F., G.E., F.W., P.N.)
| | - Dan Liu
- Department of Internal Medicine I, Center of Cardiovascular Diseases, University Hospital, Universitätsklinikum Würzburg, Würzburg, Bayern, Germany (S.H., B.F., T.S., D.L., K.H., D.G., M.C., S.S., W.V., S.F., G.E., P.N.)
| | - Kai Hu
- Department of Internal Medicine I, Center of Cardiovascular Diseases, University Hospital, Universitätsklinikum Würzburg, Würzburg, Bayern, Germany (S.H., B.F., T.S., D.L., K.H., D.G., M.C., S.S., W.V., S.F., G.E., P.N.)
| | - Daniel Gensler
- Department of Internal Medicine I, Center of Cardiovascular Diseases, University Hospital, Universitätsklinikum Würzburg, Würzburg, Bayern, Germany (S.H., B.F., T.S., D.L., K.H., D.G., M.C., S.S., W.V., S.F., G.E., P.N.)
- Comprehensive Heart Failure Center (S.H., T.S., D.G., M.C., S.S., W.V., S.F., G.E., F.W., P.N.)
| | - Jörg Strotmann
- University Hospital Würzburg, Germany. Department of Internal Medicine II, St Katharinen Hospital Unna, Germany (J.S.)
| | - Martin Christa
- Department of Internal Medicine I, Center of Cardiovascular Diseases, University Hospital, Universitätsklinikum Würzburg, Würzburg, Bayern, Germany (S.H., B.F., T.S., D.L., K.H., D.G., M.C., S.S., W.V., S.F., G.E., P.N.)
- Comprehensive Heart Failure Center (S.H., T.S., D.G., M.C., S.S., W.V., S.F., G.E., F.W., P.N.)
| | - Meinrad Beer
- Department of Internal Medicine, Städtisches Krankenhaus Kiel, Germany (M.B.)
| | | | - Stefan Störk
- Department of Internal Medicine I, Center of Cardiovascular Diseases, University Hospital, Universitätsklinikum Würzburg, Würzburg, Bayern, Germany (S.H., B.F., T.S., D.L., K.H., D.G., M.C., S.S., W.V., S.F., G.E., P.N.)
- Comprehensive Heart Failure Center (S.H., T.S., D.G., M.C., S.S., W.V., S.F., G.E., F.W., P.N.)
| | - Wolfram Voelker
- Department of Internal Medicine I, Center of Cardiovascular Diseases, University Hospital, Universitätsklinikum Würzburg, Würzburg, Bayern, Germany (S.H., B.F., T.S., D.L., K.H., D.G., M.C., S.S., W.V., S.F., G.E., P.N.)
- Comprehensive Heart Failure Center (S.H., T.S., D.G., M.C., S.S., W.V., S.F., G.E., F.W., P.N.)
| | - Constanze Bening
- Institute of Pathology, University Giessen and Marburg, Germany (C.B., R.L.)
| | - Kristina Lorenz
- Department of Heart, Thorax and Thoracovascular Surgery (K.L.)
- ISAS Leibniz Institute for Analytical Sciences, Germany (K.L.)
| | - Rainer Leyh
- Institute of Pathology, University Giessen and Marburg, Germany (C.B., R.L.)
| | - Stefan Frantz
- Department of Internal Medicine I, Center of Cardiovascular Diseases, University Hospital, Universitätsklinikum Würzburg, Würzburg, Bayern, Germany (S.H., B.F., T.S., D.L., K.H., D.G., M.C., S.S., W.V., S.F., G.E., P.N.)
- Comprehensive Heart Failure Center (S.H., T.S., D.G., M.C., S.S., W.V., S.F., G.E., F.W., P.N.)
| | - Georg Ertl
- Department of Internal Medicine I, Center of Cardiovascular Diseases, University Hospital, Universitätsklinikum Würzburg, Würzburg, Bayern, Germany (S.H., B.F., T.S., D.L., K.H., D.G., M.C., S.S., W.V., S.F., G.E., P.N.)
- Comprehensive Heart Failure Center (S.H., T.S., D.G., M.C., S.S., W.V., S.F., G.E., F.W., P.N.)
| | - Frank Weidemann
- Department of Internal Medicine I, Center of Cardiovascular Diseases, University Hospital, Universitätsklinikum Würzburg, Würzburg, Bayern, Germany (S.H., B.F., T.S., D.L., K.H., D.G., M.C., S.S., W.V., S.F., G.E., P.N.)
- Comprehensive Heart Failure Center (S.H., T.S., D.G., M.C., S.S., W.V., S.F., G.E., F.W., P.N.)
| | - Peter Nordbeck
- Department of Internal Medicine I, Center of Cardiovascular Diseases, University Hospital, Universitätsklinikum Würzburg, Würzburg, Bayern, Germany (S.H., B.F., T.S., D.L., K.H., D.G., M.C., S.S., W.V., S.F., G.E., P.N.)
- Comprehensive Heart Failure Center (S.H., T.S., D.G., M.C., S.S., W.V., S.F., G.E., F.W., P.N.)
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Alhussini K, Mazalu E, Jaqub J, Hirnle G, Hamouda K, Radakovic D, Schimmer C, Aleksic I, Leyh R, Bening C. Atrial Fibrillation: Disease of the? Left Atrial Chamber Only. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628081] [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. Alhussini
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - E. Mazalu
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - J. Jaqub
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - G. Hirnle
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - K. Hamouda
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - D. Radakovic
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - C. Schimmer
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - I. Aleksic
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - R. Leyh
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - C. Bening
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
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Oezkur M, Wagner M, Morbach C, Wood D, Kotseva K, Bauer W, Ertl G, Karmann W, Heuschmann P, Leyh R. Acute Kidney Injury in the German EuroAspire IV Cohort: A Risk Factor for Rehospitalization. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627859] [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)
- M. Oezkur
- Department of Cardiac Surgery, University Hospital Halle, Halle, Germany
| | - M. Wagner
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - C. Morbach
- Department of Cardiology, Universitätsklinikum Würzburg, Würzburg, Germany
| | - D. Wood
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - K. Kotseva
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - W. Bauer
- Department of Cardiology, Universitätsklinikum Würzburg, Würzburg, Germany
| | - G. Ertl
- Department of Cardiology, Universitätsklinikum Würzburg, Würzburg, Germany
| | - W. Karmann
- Klinik Kitzinger Land, Kardiologie und Hypertensiologie, Kitzingen, Germany
| | - P. Heuschmann
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - R. Leyh
- Department of Cardiac Surgery, University Hospital Halle, Halle, Germany
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37
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Radakovic D, Hamouda K, Schade I, Magyar A, Bening C, Hirnle G, Leyh R, Aleksic I. The Link between Early Serum Lactate Level Peak and Mortality in Postcardiotomy Patients with Extracorporeal Life Support. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628089] [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)
- D. Radakovic
- Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - K. Hamouda
- Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - I. Schade
- Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - A. Magyar
- Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - C. Bening
- Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - G. Hirnle
- Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - R. Leyh
- Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - I. Aleksic
- Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany
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Jaqub J, Alhussini K, Mazalu E, Hamouda K, Radakovic D, Schimmer C, Aleksic I, Leyh R, Bening C. Correlation of Sex Hormones and Contractile Function of Patients Undergoing CABG Procedure. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628064] [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)
- J. Jaqub
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - K. Alhussini
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - E. Mazalu
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - K. Hamouda
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - D. Radakovic
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - C. Schimmer
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - I. Aleksic
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - R. Leyh
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
| | - C. Bening
- Klinik und Poliklinik für Thorax- Herz- und thorakale Gefäßchirurgie, Universität Würzburg, Würzburg, Germany
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Sayed S, Schimmer C, Shade I, Leyh R, Aleksic I. Combined pulmonary and left ventricular support with veno-pulmonary ECMO and impella 5.0 for cardiogenic shock after coronary surgery. J Cardiothorac Surg 2017; 12:38. [PMID: 28532425 PMCID: PMC5440892 DOI: 10.1186/s13019-017-0594-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 05/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mechanical circulatory support is a common practice nowadays in the management of patients after cardiogenic shock due to myocardial infarction. The single or combined use of one or more devices for mechanical support depends not only on the advantage or disadvantage of these devices but also on the timing of use of these devices before the development of multi organ failure. In our case we used more than one tool for mechanical circulatory support during the prolonged and complicated course of our patient with postcardiotomy cardiogenic shock after coronary artery bypass surgery. CASE PRESENTATION We describe the combined use of Impella 5.0 and veno- pulmonary extra corporeal membrane oxygenation (VP-ECMO) for biventricular failure in a 52 years-old man. He presented with cardiogenic shock after inferior wall ST-elevation myocardial infarction. After emergency coronary artery bypass surgery and failure to wean from extracorporeal circulation we employed V-P ECMO and consecutively Impella 5.0 to manage the primarily failing right and secondarily failing left ventricles. He remained hemodynamically stable on both Impella 5.0 and VP-ECMO until Heart Mate II left ventricular assist device implantation on the 14th postoperative day. Right sided support was weaned on 66th postoperative day. The patient remained in the intensive care unit for 77 days. During his prolonged stay, he underwent renal replacement therapy and tracheostomy with complete recovery. Six months later, he was successfully heart transplanted and has completed three and half years of unremarkable follow up. CONCLUSIONS The combined use of VP ECMO and Impella 5.0 is effective in the management of postcardiotomy biventricular failure as a bridge for further mechanical support or heart transplantation.
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Affiliation(s)
- Sameh Sayed
- Department of Cardiothoracic Surgery, Zentrum Operative Medizine, University of Würzburg, Oberdürrbacher Str.6, 97080, Würzburg, Germany. .,Department of Cardiothoracic Surgery, Assiut University, Assiut, Egypt.
| | - Christoph Schimmer
- Department of Cardiothoracic Surgery, Zentrum Operative Medizine, University of Würzburg, Oberdürrbacher Str.6, 97080, Würzburg, Germany
| | - Ina Shade
- Department of Cardiothoracic Surgery, Zentrum Operative Medizine, University of Würzburg, Oberdürrbacher Str.6, 97080, Würzburg, Germany
| | - Rainer Leyh
- Department of Cardiothoracic Surgery, Zentrum Operative Medizine, University of Würzburg, Oberdürrbacher Str.6, 97080, Würzburg, Germany
| | - Ivan Aleksic
- Department of Cardiothoracic Surgery, Zentrum Operative Medizine, University of Würzburg, Oberdürrbacher Str.6, 97080, Würzburg, Germany
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Bening C, Hamouda K, Oezkur M, Schimmer C, Schade I, Gorski A, Aleksic I, Leyh R. Rapid deployment valve system shortens operative times for aortic valve replacement through right anterior minithoracotomy. J Cardiothorac Surg 2017; 12:27. [PMID: 28511707 PMCID: PMC5434633 DOI: 10.1186/s13019-017-0598-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 05/10/2017] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND There is growing evidence from the literature that right anterior minithoracotomy aortic valve replacement (RAT-AVR) improves clinical outcome. However, increased cross clamp time is the strongest argument for surgeons not performing RAT-AVR. Rapid deployment aortic valve systems have the potential to decrease cross-clamp time and ease this procedure. We assessed clinical outcome of rapid deployment and conventional valves through RAT. METHODS Sixty-eight patients (mean age 76 ± 6 years, 32% females) underwent RAT-AVR between 9/2013 and 7/2015. According to the valve type implanted the patients were divided into two groups. In 43 patients (R-group; mean age 74.1 ± 6.6 years) a rapid deployment valve system (Edwards Intuity, Edwards Lifesciences Corp; Irvine, Calif) and in 25 patients (C-group; mean age 74.2 ± 6.6 years) a conventional stented biological aortic valve was implanted. RESULTS Aortic cross-clamp (42.1 ± 12 min vs. 68.3 ± 20.3 min; p < 0.001) and bypass time (80.4 ± 39.3 min vs. 106.6 ± 23.2 min; p = 0.001) were shorter in the rapid deployment group (R-group). We observed no differences in clinical outcome. Postoperative gradients (R-group: max gradient, 14.3 ± 8 mmHg vs. 15.5 ± 5 mmHg (C-group), mean gradient, 9.2 ± 1.7 mmHg (R-group) vs. 9.1 ± 2.3 mmHg (C-group) revealed no differences. However, larger prostheses were implanted in C-group (25 mm; IQR 23-27 mm vs. 23 mm; IQR 21-25; p = 0.009). CONCLUSIONS Our data suggest that the rapid deployment aortic valve system reduced cross clamp and bypass time in patients undergoing RAT-AVR with similar hemodynamics as with larger size stented prosthesis. However, larger studies and long-term follow-up are mandatory to confirm our findings.
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Affiliation(s)
- Constanze Bening
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg, Wuerzburg, Germany.
| | - Khaled Hamouda
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Mehmet Oezkur
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg, Wuerzburg, Germany.,Institute for Clinical and Biometry, University of Wuerzburg, Wuerzburg, Germany
| | - Christoph Schimmer
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Ina Schade
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Armin Gorski
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Ivan Aleksic
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Rainer Leyh
- Department of Thoracic and Cardiovascular Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
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Morbach C, Wagner M, Güntner S, Malsch C, Oezkur M, Wood D, Kotseva K, Leyh R, Ertl G, Karmann W, Heuschmann PU, Störk S. Heart failure in patients with coronary heart disease: Prevalence, characteristics and guideline implementation - Results from the German EuroAspire IV cohort. BMC Cardiovasc Disord 2017; 17:108. [PMID: 28476146 PMCID: PMC5420109 DOI: 10.1186/s12872-017-0543-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 04/28/2017] [Indexed: 01/10/2023] Open
Abstract
Background Adherence to pharmacotherapeutic treatment guidelines in patients with heart failure (HF) is of major prognostic importance, but thorough implementation of guidelines in routine care remains insufficient. Our aim was to investigate prevalence and characteristics of HF in patients with coronary heart disease (CHD), and to assess the adherence to current HF guidelines in patients with HF stage C, thus identifying potential targets for the optimization of guideline implementation. Methods Patients from the German sample of the European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EuroAspire) IV survey with a hospitalization for CHD within the previous six to 36 months providing valid data on echocardiography as well as on signs and symptoms of HF were categorized into stages of HF: A, prevalence of risk factors for developing HF; B, asymptomatic but with structural heart disease; C, symptomatic HF. A Guideline Adherence Indicator (GAI-3) was calculated for patients with reduced (≤40%) left ventricular ejection fraction (HFrEF) as number of drugs taken per number of drugs indicated; beta-blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers, and mineralocorticoid receptor antagonists (MRA) were considered. Results 509/536 patients entered analysis. HF stage A was prevalent in n = 20 (3.9%), stage B in n = 264 (51.9%), and stage C in n = 225 (44.2%) patients; 94/225 patients were diagnosed with HFrEF (42%). Stage C patients were older, had a longer duration of CHD, and a higher prevalence of arterial hypertension. Awareness of pre-diagnosed HF was low (19%). Overall GAI-3 of HFrEF patients was 96.4% with a trend towards lower GAI-3 in patients with lower LVEF due to less thorough MRA prescription. Conclusions In our sample of CHD patients, prevalence of HF stage C was high and a sizable subgroup suffered from HFrEF. Overall, pharmacotherapy was fairly well implemented in HFrEF patients, although somewhat worse in patients with more reduced ejection fraction. Two major targets were identified possibly suited to further improve the implementation of HF guidelines: 1) increase patients´ awareness of diagnosis and importance of HF; and 2) disseminate knowledge about the importance of appropriately implementing the use of mineralocorticoid receptor antagonists. Trial registration This is a cross-sectional analysis of a non-interventional study. Therefore, it was not registered as an interventional trial.
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Affiliation(s)
- Caroline Morbach
- Comprehensive Heart Failure Center, University of Würzburg, Am Schwarzenberg 15, 97078, Wuerzburg, Germany.,Department of Medicine I, University Hospital of Würzburg, Wuerzburg, Germany
| | - Martin Wagner
- Comprehensive Heart Failure Center, University of Würzburg, Am Schwarzenberg 15, 97078, Wuerzburg, Germany.,Institute of Clinical Epidemiology and Biometry, University of Würzburg, Wuerzburg, Germany
| | - Stefan Güntner
- Comprehensive Heart Failure Center, University of Würzburg, Am Schwarzenberg 15, 97078, Wuerzburg, Germany.,Department of Medicine I, University Hospital of Würzburg, Wuerzburg, Germany
| | - Carolin Malsch
- Comprehensive Heart Failure Center, University of Würzburg, Am Schwarzenberg 15, 97078, Wuerzburg, Germany.,Institute of Clinical Epidemiology and Biometry, University of Würzburg, Wuerzburg, Germany
| | - Mehmet Oezkur
- Comprehensive Heart Failure Center, University of Würzburg, Am Schwarzenberg 15, 97078, Wuerzburg, Germany.,Department of Cardiovascular Surgery, University Hospital Würzburg, Wuerzburg, Germany
| | - David Wood
- Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Kornelia Kotseva
- Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK.,Department of Public Health, University of Ghent, Ghent, Belgium
| | - Rainer Leyh
- Department of Cardiovascular Surgery, University Hospital Würzburg, Wuerzburg, Germany
| | - Georg Ertl
- Comprehensive Heart Failure Center, University of Würzburg, Am Schwarzenberg 15, 97078, Wuerzburg, Germany.,Department of Medicine I, University Hospital of Würzburg, Wuerzburg, Germany
| | - Wolfgang Karmann
- Department of Medicine, Klinik Kitzinger Land, Kitzingen, Germany
| | - Peter U Heuschmann
- Comprehensive Heart Failure Center, University of Würzburg, Am Schwarzenberg 15, 97078, Wuerzburg, Germany.,Institute of Clinical Epidemiology and Biometry, University of Würzburg, Wuerzburg, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center, University of Würzburg, Am Schwarzenberg 15, 97078, Wuerzburg, Germany. .,Department of Medicine I, University Hospital of Würzburg, Wuerzburg, Germany.
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Radakovic D, Leistner M, Schimmer C, Gietzen C, Bening C, Sayed S, Leyh R, Aleksic I. Is Veno-Arterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock Contraindicated in Patients over 75? Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598726] [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)
- D. Radakovic
- Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - M. Leistner
- Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - C. Schimmer
- Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany
| | | | - C. Bening
- Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - S. Sayed
- Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - R. Leyh
- Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - I. Aleksic
- Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany
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Bening C, Hamouda K, Leistner M, Radakovic D, Oezkur M, Leyh R, Schimmer C. Perioperative Results from Left Atrial Appendage Removal during Open Heart Surgery. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598747] [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)
- C. Bening
- Herzchirurgie, Universität Würzburg, Würzburg, Germany
| | - K. Hamouda
- Herzchirurgie, Universität Würzburg, Würzburg, Germany
| | - M. Leistner
- Herzchirurgie, Universität Würzburg, Würzburg, Germany
| | - D. Radakovic
- Herzchirurgie, Universität Würzburg, Würzburg, Germany
| | - M. Oezkur
- Herzchirurgie, Universität Würzburg, Würzburg, Germany
| | - R. Leyh
- Herzchirurgie, Universität Würzburg, Würzburg, Germany
| | - C. Schimmer
- Herzchirurgie, Universität Würzburg, Würzburg, Germany
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Bening C, Hamouda K, Schimmer C, Aleksic I, Radakovic D, Oezkur M, Gorski A, Leyh R. Aortic Root Replacement via A Minimally Invasive Approach is Safe. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598834] [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)
- C. Bening
- Universität Würzburg, Herzchirurgie, Würzburg, Germany
| | - K. Hamouda
- Universität Würzburg, Herzchirurgie, Würzburg, Germany
| | - C. Schimmer
- Universität Würzburg, Herzchirurgie, Würzburg, Germany
| | - I. Aleksic
- Universität Würzburg, Herzchirurgie, Würzburg, Germany
| | - D. Radakovic
- Universität Würzburg, Herzchirurgie, Würzburg, Germany
| | - M. Oezkur
- Universität Würzburg, Herzchirurgie, Würzburg, Germany
| | - A. Gorski
- Universität Würzburg, Herzchirurgie, Würzburg, Germany
| | - R. Leyh
- Universität Würzburg, Herzchirurgie, Würzburg, Germany
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45
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Bening C, Hamouda K, Alhussini K, Radakovic D, Mazalu E, Schimmer C, Aleksic I, Leyh R. Atrial Fibrillation as a Disease of the Left Atrium: Impact on Contractility. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598820] [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)
- C. Bening
- Universität Würzburg, Herzchirurgie, Würzburg, Germany
| | - K. Hamouda
- Universität Würzburg, Herzchirurgie, Würzburg, Germany
| | - K. Alhussini
- Universität Würzburg, Herzchirurgie, Würzburg, Germany
| | - D. Radakovic
- Universität Würzburg, Herzchirurgie, Würzburg, Germany
| | - E.A. Mazalu
- Universität Würzburg, Herzchirurgie, Würzburg, Germany
| | - C. Schimmer
- Universität Würzburg, Herzchirurgie, Würzburg, Germany
| | - I. Aleksic
- Universität Würzburg, Herzchirurgie, Würzburg, Germany
| | - R. Leyh
- Universität Würzburg, Herzchirurgie, Würzburg, Germany
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Hamouda K, Bening C, Özkur M, Aleksic I, Schade I, Alhussini K, Gorski A, Leyh R. Early Failure of Tissue-Engineered Pulmonary Valve Conduits Used for Right Ventricular Outflow Tract Reconstruction in Adult ROSS Patients. A Word of Caution. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598968] [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)
| | - C. Bening
- University of Würzburg, Cardiac and Thoracic Surgery, Würzburg, Germany
| | - M. Özkur
- University of Würzburg, Cardiac and Thoracic Surgery, Würzburg, Germany
| | - I. Aleksic
- University of Würzburg, Cardiac and Thoracic Surgery, Würzburg, Germany
| | - I. Schade
- University of Würzburg, Cardiac and Thoracic Surgery, Würzburg, Germany
| | - K. Alhussini
- University of Würzburg, Cardiac and Thoracic Surgery, Würzburg, Germany
| | - A. Gorski
- University of Würzburg, Cardiac and Thoracic Surgery, Würzburg, Germany
| | - R. Leyh
- University of Würzburg, Cardiac and Thoracic Surgery, Würzburg, Germany
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Kungl MT, Leyh R, Spangler G. Attachment Representations and Brain Asymmetry during the Processing of Autobiographical Emotional Memories in Late Adolescence. Front Hum Neurosci 2017; 10:644. [PMID: 28082880 PMCID: PMC5183619 DOI: 10.3389/fnhum.2016.00644] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 03/11/2016] [Accepted: 12/05/2016] [Indexed: 11/30/2022] Open
Abstract
Frontal and parietal asymmetries have repeatedly been shown to be related to specific functional mechanisms involved in emotion regulation. From a developmental perspective, attachment representations based on experiences with the caregiver are theorized to serve regulatory functions and influence how individuals deal with emotionally challenging situations throughout the life span. This study aimed to investigate neural substrates of emotion regulation by assessing state- and trait dependent EEG asymmetries in secure, insecure-dismissing and insecure-preoccupied subjects. The sample consisted of 40 late adolescents. The Adult Attachment Interview was administered and they were asked to report upon personally highly salient emotional memories related to anger, happiness and sadness. EEG was recorded at rest and during the retrieval of each of these emotional memories, and frontal and parietal hemispheric asymmetry were analyzed. We found attachment representations to differentially affect both the frontal and parietal organization of hemispheric asymmetry at rest and (for parietal region only) during the retrieval of emotional memories. During rest, insecure-dismissing subjects showed an elevated right-frontal brain activity and a reduced right-parietal brain activity. We interpret this finding in light of a disposition to use withdrawal strategies and low trait arousal in insecure-dismissing subjects. Emotional memory retrieval did not affect frontal asymmetry. However, both insecure groups showed an increase in right-sided parietal activity indicating increased arousal during the emotional task as compared to the resting state suggesting that their emotion regulation capability was especially challenged by the retrieval of emotional memories while securely attached subjects maintained a state of moderate arousal. The specific neurophysiological pattern of insecure-dismissing subjects is discussed with regard to a vulnerability to affective disorders.
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Affiliation(s)
- Melanie T Kungl
- Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg Erlangen, Germany
| | - Rainer Leyh
- Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg Erlangen, Germany
| | - Gottfried Spangler
- Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg Erlangen, Germany
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Koschutnik M, Ionin VA, Boeckstaens S, Zakhama L, Hinojar R, Chiu DYY, Kovacs A, Kochmareva EA, Saliba E, Stanojevic D, Aalen J, Chen XH, Zito C, Demerouti E, Smarz K, Krljanac G, Christensen NL, Cavalcante JL, Pal M, Magne J, Giannakopoulos G, Liu D, Chien CY, Moustafa TAMER, Schwaiger M, Zotter-Tufaro C, Aschauer S, Duca F, Kammerlander A, Bonderman D, Mascherbauer J, Zaslavskaya EL, Soboleva AV, Listopad OV, Malikov KN, Baranova EI, Shlyakhto EV, Van Der Hoogstraete M, Coltel N, De Laet N, Beernaerts C, Desmet K, Gillis K, Droogmans S, Cosyns B, Antit S, Herbegue B, Slama I, Belaouer A, Chenik S, Boussabah E, Thameur M, Masmoudi M, Benyoussef S, Fernandez-Golfin C, Gonzalez-Gomez A, Casas E, Garcia Martin A, Pardo A, Del Val D, Ruiz S, Moya JL, Barrios V, Jimenez Nacher JJ, Zamorano JL, Kalra PA, Green D, Hughes J, Sinha S, Abidin N, Muraru D, Lakatos BK, Surkova E, Peluso D, Toser Z, Tokodi M, Merkely B, Badano LP, Volkova AL, Rusina VA, Kokorin VA, Gordeev IG, Baudet M, Chartrand Lefebvre C, Chen-Tournoux A, Hodzic A, Tournoux F, Apostolovic S, Jankovic-Tomasevic R, Djordjevic-Radojkovic D, Salinger-Martinovic S, Kostic T, Tahirovic E, Dungen HD, Andersen OS, Gude E, Andreassen A, Aalen OO, Larsen CK, Remme EW, Smiseth OA, Xu HG, Liu FC, Zha DG, Cui K, Zhang AD, Trio O, Soraci E, Cusma Piccione M, D'amico G, Ioppolo A, Alibani L, Falanga G, Todaro MC, Oreto L, Nucifora G, Vizzari G, Pizzino F, Di Bella G, Carerj S, Boutsikou M, Perreas K, Katselis CH, Samanidis G, Antoniou TH, Karatasakis G, Zaborska B, Jaxa-Chamiec T, Maciejewski P, Bartoszewicz Z, Budaj A, Trifunovic D, Asanin M, Savic L, Matovic D, Petrovic M, Zlatic N, Mrdovic I, Dahl JS, Carter-Storch R, Bakkestroem R, Soendergaard E, Videbaek L, Moeller JE, Rijal S, Abdelkarim I, Althouse AD, Sharbaugh MS, Fridman Y, Han W, Soman P, Forman DE, Schindler JT, Gleason TG, Lee JE, Schelbert EB, Dekany G, Mandzak A, Chaurasia AK, Gyovai J, Hegedus N, Piroth ZS, Szabo GY, Fontos G, Andreka P, Cosyns B, Popescu BA, Carstensen HG, Dahl J, Desai M, Kearney L, Marwick T, Sato K, Takeuchi M, Zito C, Mohty D, Lancellotti P, Habib G, Noble S, Frei A, Mueller H, Hu K, Liebner E, Weidemann F, Herrmann S, Ertl G, Voelker W, Gorski A, Leyh R, Stoerk S, Nordbeck P, Tsai WC, Moustafa TAMER, Aldydamony MOHAMD, Aldydamony MOHAMD. Poster Session 5The imaging examination and quality assessmentP1064The natural course of heart failure with preserved ejection fraction (HFpEF) - insights from an exploratory echocardiographic registryP1065Epicardial fat and effectiveness of catheter radiofrequency ablation in patients with atrial fibrillation and metabolic syndromeP1066Systematic disinfection of echocardiographic probe after each examination to reduce the persistence of pathogens as a potential source of nosocomial infectionsP1067Left atrial mechanical function assessed by two-dimensional echocardiography in hypertensive patientsP1068Real live applications of three-dimensional echocardiographic quantification of the left ventricular volumes and function using an automated adaptive analytics algorithmP10693D echocardiographic left ventricular dyssynchrony indices in end stage kidney disease: associations and outcomesP1070Relative contribution of right ventricular longitudinal shortening and radial displacement to global pump function in healthy volunteersP1071ECHO-parameters, associated with short-term mortality and long-term complications in patients with pulmonary embolism of high and intermediate riskP1072Increased epicardial fat is an independent marker of heart failure with preserved ejection fraction.P1073Influence of optimized beta-blocker therapy on diastolic dysfunction determined echocardiographically in heart failure patientsP1074Early diastolic mitral flow velocity/ annular velocity ratio is a sensitive marker of elevated filling pressure in left ventricular dyssynchronyP1075Left ventricular diastolic function in STEMI patients receiving early and late reperfusion by percutaneous coronary intervention P1076Could anatomical and functional features predict cerebrovascular events in patients with patent foramen ovale?P1077Efficacy of endarterectomy of the left anterior descending artery: evaluation by adenosine echocardiography?P1078Left ventricular diastolic dysfunction after acute myocardial infarction with preserved ejection fraction is related to lower exercise capacityP1079Potentially predictors of ventricular arrhythmia during six months follow up in STEMI patientsP1080Association between left atrial dilatation and invasive haemodynamics at rest and during exercise in asymptimatic aortic stenosisP1081Cardiac amyloidosis and aortic stenosis - the convergence of two aging processes and its association with outcomesP1082Prognostic impact of initial left ventricular dysfunction and mean gradient after transcatheter aortic valve implantationP1083Distribution and prognostic significance of left ventricular global longitudinal strain in asymptomatic significant aortic stenosis: an individual participant data meta-analysisP1084Discrepancies between echocardiographic and invasive assessment of aortic stenosis in multimorbid elderly patientsP1085Echocardiographic determinants and outcome of patients with low-gradient moderate and severe aortic valve stenosis: implications for aortic valve replacementP1086Atrial deformation correlated with functional capacity in mitral stenosisP1087Net atrioventricular compliance can predict reduction of pulmonary artery pressure after percutaneous mitral balloon commissurotomy. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew262] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
Background The impact of sex on cardiac morphology and function in chronic volume overload has been described in detail. However, the relation between sex and contractile properties at the actin-myosin level has not been well defined. Therefore, we evaluated the influence of sex on the contractile capacities of patients with chronic volume overload. Methods In 36 patients (18 males, 65 ± 9 years; 18 females, 65 ± 13 years) scheduled for elective mitral valve surgery due to severe mitral regurgitation (MR) with preserved left ventricular function, right auricle samples were obtained prior to extracorporal circulation. The fibers were prepared and skinned and exposed to a gradual increase in the calcium concentration (from pCa of 6.5–4.0) for calcium-induced force-developing measurements. Calcium sensitivity was also measured and recorded. Results The pCa-force relationship of the fibers obtained from males and females was significantly different, with the force values of the female fibers greater than those of male fibers at maximum calcium concentrations (pCa of 4.0: 3.6 ± 0.3 mN versus 3.2 ± 0.4 mN, p 0.02) and pCa of 4.5 2.6 ± 0.6 versus 2.0 ± 0.5, p 0.002). In contrast, the force values of female fibers were lower at mean calcium concentrations compared to those of male fibers (at 5.5 and pCa of 6.0: 1.0 ± 0.3 mN versus 1.2 ± 0.5 mN, p 0.04; 0.61 ± 0.05 versus 0.88 ± 0.09, p 0.04). Calcium sensitivity was observed at pCa of 5.0 in females and pCa of 4.5 in males. Conclusion This study demonstrated that female fibers from patients exposed to chronic volume overload developed higher force values at a given calcium concentration compared to fibers from male patients. We assume that female patients might tap the full force potential, which is required when exposed to the highest calcium concentrations in our experimental cycle. The calcium sensitivity among genders was significantly different, with the results suggesting that males have higher calcium sensitivity and might compensate for lower force values at maximal calcium concentrations by a higher affinity for calcium. Hence, female patients with MR seem to work more “energy efficient”.
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Affiliation(s)
- C Bening
- Department of Thoracic, Cardiac and Thoracic Vascular Surgery, Medical Centre of the University Hospital Würzburg, Oberdürrbacherstrasse 6, 97080, Würzburg, Germany. .,Department of Cardiothoracic and Vascular Surgery, University Hospital Mainz, Mainz, Germany.
| | - K Hamouda
- Department of Thoracic, Cardiac and Thoracic Vascular Surgery, Medical Centre of the University Hospital Würzburg, Oberdürrbacherstrasse 6, 97080, Würzburg, Germany
| | - R Leyh
- Department of Thoracic, Cardiac and Thoracic Vascular Surgery, Medical Centre of the University Hospital Würzburg, Oberdürrbacherstrasse 6, 97080, Würzburg, Germany
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Schimmer C, Gross J, Ramm E, Morfeld BC, Hoffmann G, Panholzer B, Hedderich J, Leyh R, Cremer J, Petzina R. Prevention of surgical site sternal infections in cardiac surgery: a two-centre prospective randomized controlled study. Eur J Cardiothorac Surg 2016; 51:67-72. [PMID: 27365077 DOI: 10.1093/ejcts/ezw225] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 05/25/2016] [Accepted: 06/01/2016] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Surgical site infection (SSI) of the sternum is a devastating complication in cardiac surgery. The aim of this prospective randomized controlled two-centre clinical study was to compare the use of a gentamicin-collagen sponge (Genta-Coll® resorb) and of a cyanoacrylate-based microbial skin sealant (InteguSeal®) on the SSI rate of the sternum. METHODS We analysed data from 996 consecutive patients following isolated coronary artery bypass grafting between 2012 and 2014. The patients were randomized into three groups: standard group (S-group), Genta-Coll group (G-group) and InteguSeal group (I-group). The primary study end-point was to analyse the incidence of superficial and deep sternal SSI. The secondary study end-point was to determine independent risk factors for an increased SSI rate. RESULTS Of the 996 patients investigated, 332 patients were in S-group, 336 patients in G-group and 328 patients in I-group. The mean age was 67.7 ± 9.4 years, 18.6% were women and the overall SSI rate was 6.2% with 2.2% deep sternal wound infections. SSI rates were 8.3% (S-group), 5.4% (G-group) and 4.9% (I-group) (P 0.16). Multiple regression analysis demonstrated a preoperative body mass index (BMI) of >30 kg/m2 (P 0.047), re-thoracotomy for postoperative bleeding (P < 0.001) and sternum instability (P < 0.001) as independent predictors for an increased SSI rate. CONCLUSIONS The application of InteguSeal® or Genta-Coll® resorb had no significant influence on the incidence of the sternal SSI rate in 996 consecutive cardiac surgery patients but demonstrated a trend towards a benefit from using these prophylactic approaches. Multiple regression analysis demonstrated a preoperative BMI of >30 kg/m2, re-thoracotomy for bleeding and sternum instability as independent predictors for an increased sternal SSI rate.
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Affiliation(s)
- Christoph Schimmer
- Department of Cardiothoracic and Thoracic Vascular Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Justus Gross
- Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Elena Ramm
- Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Björn-Carsten Morfeld
- Department of Cardiothoracic and Thoracic Vascular Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Grischa Hoffmann
- Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Bernd Panholzer
- Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Jürgen Hedderich
- Institute of Medical Informatics and Statistics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Rainer Leyh
- Department of Cardiothoracic and Thoracic Vascular Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Jochen Cremer
- Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Rainer Petzina
- Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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