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Start Over Author "Birner, Christoph" Journal european journal of heart failure
5 results on '"Birner, Christoph"'

2. Angiotensin‐converting enzyme inhibitor/angiotensin II receptor blocker treatment and haemodynamic factors are associated with increased cardiac mRNA expression of angiotensin‐converting enzyme 2 in patients with cardiovascular disease

Author

Lebek, Simon, Tafelmeier, Maria, Messmann, Rebecca, Provaznik, Zdenek, Schmid, Christof, Maier, Lars S., Birner, Christoph, Arzt, Michael, and Wagner, Stefan

Subjects
Male, 610 Medizin, ACE2, Heart failure, Left ventricular assist device, Angiotensin-Converting Enzyme Inhibitors, Coronary Artery Disease, COVID-19 pandemic • SARS-CoV-2 • ACE2 • ACE inhibitor • Heart failure • Left ventricular assist device, SARS‐CoV‐2, Angiotensin Receptor Antagonists, ACE inhibitor, Leukocytes, Humans, cardiovascular diseases, RNA, Messenger, Coronary Artery Bypass, Research Articles, Aged, ddc:610, SARS-CoV-2, Myocardium, Hemodynamics, COVID-19, COVID‐19 pandemic, Middle Aged, Female, Angiotensin-Converting Enzyme 2, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, hormones, hormone substitutes, and hormone antagonists, Research Article, Receptors, Coronavirus
Abstract

Aims Coronavirus disease 2019 (COVID‐19) is a widespread pandemic with an increased morbidity and mortality, especially for patients with cardiovascular diseases. Angiotensin‐converting enzyme 2 (ACE2) has been identified as necessary cell entry point for SARS‐CoV‐2. Previous animal studies have demonstrated an increased ACE2 expression following treatment with either angiotensin‐converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARB) that have led to a massive precariousness regarding the optimal cardiovascular therapy during this pandemic. Methods and results We have measured ACE2 mRNA expression using real‐time quantitative polymerase chain reaction in atrial biopsies of 81 patients undergoing coronary artery bypass grafting and we compared 62 patients that received ACEi/ARB vs. 19 patients that were not ACEi/ARB‐treated. We found atrial ACE2 mRNA expression to be significantly increased in patients treated with an ACEi or an ARB, independent of potential confounding comorbidities. Interestingly, the cardiac ACE2 mRNA expression correlated significantly with the expression in white blood cells of 22 patients encouraging further evaluation if the latter may be used as a surrogate for the former. Similarly, analysis of 18 ventricular biopsies revealed a significant and independent increase in ACE2 mRNA expression in patients with end‐stage heart failure that were treated with ACEi/ARB. On the other hand, cardiac unloading with a left ventricular assist device significantly reduced ventricular ACE2 mRNA expression. Conclusion Treatment with ACEi/ARB is independently associated with an increased myocardial ACE2 mRNA expression in patients with coronary artery disease and in patients with end‐stage heart failure. Further trials are needed to test whether this association is deleterious for patients with COVID‐19, or possibly protective. Nevertheless, haemodynamic factors seem to be equally important for regulation of cardiac ACE2 mRNA expression., Treatment with angiotensin‐converting enzyme inhibitors or angiotensin II receptor blockers increases independently myocardial mRNA expression of the SARS‐CoV‐2 cell entry point ACE2 in high‐risk patients.

Published
2020

5. Kidney injury molecule-1 and N-acetyl-β-D-glucosaminidase in chronic heart failure: possible biomarkers of cardiorenal syndrome.

Author

Jungbauer CG, Birner C, Jung B, Buchner S, Lubnow M, von Bary C, Endemann D, Banas B, Mack M, Böger CA, Riegger G, Luchner A, Jungbauer, Carsten G, Birner, Christoph, Jung, Bettina, Buchner, Stefan, Lubnow, Matthias, von Bary, Christian, Endemann, Dierk, and Banas, Bernhard

Abstract

Aims: Patients with chronic heart failure are often characterized by impaired renal function, also referred to as cardiorenal syndrome (CRS). The aim of this study was to assess whether novel markers of kidney injury are elevated in chronic heart failure and CRS. Methods and Results: The new renal biomarkers kidney injury molecule-1 (KIM-1), N-acetyl-ß-d-glucosaminidase (NAG) and neutrophil gelatinase-associated lipocalin (NGAL) were assessed from urine samples of 173 individuals. Patients with chronic heart failure (n= 150) were characterized by decreased ejection fraction (32 ± 9% vs. controls 62 ± 4%, P < 0.001) and increased plasma N-terminal pro-brain natriuretic peptide (median 1460 pg/mL, interquartile range (IQR) 630-3000 pg/mL vs. controls 56, IQR 25-64l pg/mL, P < 0.001). Urinary analysis showed that KIM-1 was significantly elevated in heart failure patients compared with healthy controls (1100, IQR 620-1920 vs. 550, IQR 320-740 ng/g urinary creatinine, P < 0.001). Further, KIM-1 increased significantly with decreasing left ventricular function (r = -0.37, P < 0.001) and severity of New York Heart Association (NYHA)-class (r = 0.5, P < 0.001). N-acetyl-ß-d-glucosaminidase showed a weaker response but correlated significantly with left ventricular dysfunction (r = -0.18, P= 0.015) and more severe clinical condition (r = 0.22, P= 0.04). In contrast, NGAL showed no significant correlation. Kidney injury molecule-1 and NAG were also predictors of all-cause mortality and the composite of all-cause mortality and rehospitalization for heart failure (all P < 0.05). Conclusions: Kidney injury molecule-1 and NAG are elevated in symptomatic heart failure. This finding may be present in patients with apparently normal kidney function and indicates tubular injury in chronic heart failure. Kidney injury molecule-1 and NAG are potential markers of CRS with additional prognostic value. [ABSTRACT FROM AUTHOR]

Published
2011
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