15 results on '"Carolin Malsch"'
Search Results
2. Functional versus morphological assessment of vascular age in patients with coronary heart disease
- Author
-
Tino Yurdadogan, Carolin Malsch, Kornelia Kotseva, David Wood, Rainer Leyh, Georg Ertl, Wolfgang Karmann, Lara Müller-Scholden, Caroline Morbach, Margret Breunig, Martin Wagner, Götz Gelbrich, Michiel L. Bots, Peter U. Heuschmann, and Stefan Störk
- Subjects
Medicine ,Science - Abstract
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.
- Published
- 2021
- Full Text
- View/download PDF
3. Heart failure in patients with coronary heart disease: Prevalence, characteristics and guideline implementation – Results from the German EuroAspire IV cohort
- Author
-
Caroline Morbach, Martin Wagner, Stefan Güntner, Carolin Malsch, Mehmet Oezkur, David Wood, Kornelia Kotseva, Rainer Leyh, Georg Ertl, Wolfgang Karmann, Peter U Heuschmann, and Stefan Störk
- Subjects
Heart failure ,Coronary heart disease ,Coronary artery disease ,Guideline implementation ,Guideline adherence ,Awareness ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
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.
- Published
- 2017
- Full Text
- View/download PDF
4. Outcome after stroke attributable to baseline factors-The PROSpective Cohort with Incident Stroke (PROSCIS).
- Author
-
Carolin Malsch, Thomas Liman, Silke Wiedmann, Bob Siegerink, Marios K Georgakis, Steffen Tiedt, Matthias Endres, and Peter U Heuschmann
- Subjects
Medicine ,Science - Abstract
BACKGROUND:The impact of risk factors on poor outcome after ischemic stroke is well known, but estimating the amount of poor outcome attributable to single factors is challenging in presence of multimorbidity. We aim to compare population attributable risk estimates obtained from different statistical approaches regarding their consistency. We use a real-life data set from the PROSCIS study to identify predictors for mortality and functional impairment one year after first-ever ischemic stroke and quantify their contribution to poor outcome using population attributable risks. METHODS:The PROSpective Cohort with Incident Stroke (PROSCIS) is a prospective observational hospital-based cohort study of patients after first-ever stroke conducted independently in Berlin (PROSCIS-B) and Munich (PROSCIS-M). The association of baseline factors with poor outcome one year after stroke in PROSCIS-B was analysed using multiple logistic regression analysis and population attributable risks were calculated, which were estimated using sequential population attributable risk based on a multiple generalized additive regression model, doubly robust estimation, as well as using average sequential population attributable risk. Findings were reproduced in an independent validation sample from PROSCIS-M. RESULTS:Out of 507 patients with available outcome information after 12 months in PROSCIS-B, 20.5% suffered from poor outcome. Factors associated with poor outcome were age, pre-stroke physical disability, stroke severity (NIHSS), education, and diabetes mellitus. The order of risk factors ranked by magnitudes of population attributable risk was almost similar for all methods, but population attributable risk estimates varied markedly between the methods. In PROSCIS-M, incidence of poor outcome and distribution of baseline parameters were comparable. The multiple logistic regression model could be reproduced for all predictors, except pre-stroke physical disability. Similar to PROSCIS-B, the order of risk factors ranked by magnitudes of population attributable risk was almost similar for all methods, but magnitudes of population attributable risk differed markedly between the methods. CONCLUSIONS:Ranking of risk factors by population impact is not affected by the different statistical approaches. Thus, for a rational decision on which risk factor to target in disease interventions, population attributable risk is a supportive tool. However, population attributable risk estimates are difficult to interpret and are not comparable when they origin from studies applying different methodology. The predictors for poor outcome identified in PROSCIS-B have a relevant impact on mortality and functional impairment one year after first-ever ischemic stroke.
- Published
- 2018
- Full Text
- View/download PDF
5. Non-Motor Symptoms of Essential Tremor Are Independent of Tremor Severity and Have an Impact on Quality of Life
- Author
-
Thomas Musacchio, Veronika Purrer, Aikaterini Papagianni, Anna Fleischer, Daniel Mackenrodt, Carolin Malsch, Götz Gelbrich, Frank Steigerwald, Jens Volkmann, and Stephan Klebe
- Subjects
Diseases of the musculoskeletal system ,RC925-935 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Background: Several publications have focused on accompanying non-motor symptoms (NMS) in essential tremor (ET) patients; however, it remains unclear if NMS are an intrinsic part of the disease or secondary phenomena. We present the results of several neuropsychiatric tests and their impact on quality of life (QoL) in community-dwelling patients with ET. Methods: Participants were recruited via a newspaper article about ET published in the local media and on the internet. All participants completed several standard neuropsychiatric tests, including those that assess QoL. To compare differences between cases and controls, Student’s t-tests with Bonferroni-Holm post hoc tests were performed. Spearman’s correlation coefficients were also calculated. Results: We enrolled 110 patients with definite or probable ET. Highly significant changes were observed for apathy, anxiety, and cognition and negatively impacted QoL. Most aberrations were independent of tremor severity and duration. Discussion: The significant neuropsychiatric deficits and reduced QoL demonstrate a degree of illness that appears to be a non-motor phenotype rather than a secondary effect of ET. In the future, NMS should carefully be explored in ET patients as they may have an impact on QoL and treatment.
- Published
- 2016
- Full Text
- View/download PDF
6. Performance of Serum microRNAs -122, -192 and -21 as Biomarkers in Patients with Non-Alcoholic Steatohepatitis.
- Author
-
Philip P Becker, Monika Rau, Johannes Schmitt, Carolin Malsch, Christian Hammer, Heike Bantel, Beat Müllhaupt, and Andreas Geier
- Subjects
Medicine ,Science - Abstract
Liver biopsies are the current gold standard in non-alcoholic steatohepatitis (NASH) diagnosis. Their invasive nature, however, still carries an increased risk for patients' health. The development of non-invasive diagnostic tools to differentiate between bland steatosis (NAFL) and NASH remains crucial. The aim of this study is the evaluation of investigated circulating microRNAs in combination with new targets in order to optimize the discrimination of NASH patients by non-invasive serum biomarkers.Serum profiles of four microRNAs were evaluated in two cohorts consisting of 137 NAFLD patients and 61 healthy controls. In a binary logistic regression model microRNAs of relevance were detected. Correlation of microRNA appearance with known biomarkers like ALT and CK18-Asp396 was evaluated. A simplified scoring model was developed, combining the levels of microRNA in circulation and CK18-Asp396 fragments. Receiver operating characteristics were used to evaluate the potential of discriminating NASH.The new finding of our study is the different profile of circulating miR-21 in NASH patients (p
- Published
- 2015
- Full Text
- View/download PDF
7. Off-label-dosing of non-vitamin K-dependent oral antagonists in AF patients before and after stroke: results of the prospective multicenter Berlin Atrial Fibrillation Registry
- Author
-
Daniel Zeise-Wehry, Hans-Christian Koennecke, Manuel C. Olma, Karl Georg Haeusler, Serdar Tütüncü, Andreas Kauert, Martin Honermann, Christian H. Nolte, Carolin Malsch, Georg Hagemann, Joanna Dietzel, Enrico Völzke, Boris Dimitrijeski, Johannes Schurig, Gerhard J. Jungehulsing, Darius G. Nabavi, Robert Stingele, Wolfram Doehner, Cornelia Fiessler, Peter U. Heuschmann, Joschua Mirko Reis, Frank Hamilton, Bruno-Marcel Mackert, Tobias Eberhard Haas, Paul Sparenberg, Ingo Schmehl, Carolin Waldschmidt, Claudia Kunze, and Matthias Endress
- Subjects
medicine.medical_specialty ,therapeutic use [Anticoagulants] ,complications [Atrial Fibrillation] ,Neurology ,Administration, Oral ,Brain Ischemia ,Internal medicine ,Post-hoc analysis ,medicine ,Humans ,drug therapy [Atrial Fibrillation] ,complications [Stroke] ,Dosing ,ddc:610 ,Prospective Studies ,Registries ,NOAC ,Stroke ,Neuroradiology ,Aged, 80 and over ,Under-dosing ,Rivaroxaban ,Original Communication ,Ischemic stroke ,business.industry ,Anticoagulants ,Correction ,Atrial fibrillation ,Off-Label Use ,complications [Brain Ischemia] ,medicine.disease ,drug therapy [Stroke] ,Berlin ,drug therapy [Brain Ischemia] ,Apixaban ,Neurology (clinical) ,business ,medicine.drug - Abstract
Aims We aimed to analyze prevalence and predictors of NOAC off-label under-dosing in AF patients before and after the index stroke. Methods The post hoc analysis included 1080 patients of the investigator-initiated, multicenter prospective Berlin Atrial Fibrillation Registry, designed to analyze medical stroke prevention in AF patients after acute ischemic stroke. Results At stroke onset, an off-label daily dose was prescribed in 61 (25.5%) of 239 NOAC patients with known AF and CHA2DS2-VASc score ≥ 1, of which 52 (21.8%) patients were under-dosed. Under-dosing was associated with age ≥ 80 years in patients on rivaroxaban [OR 2.90, 95% CI 1.05–7.9, P = 0.04; n = 29] or apixaban [OR 3.24, 95% CI 1.04–10.1, P = 0.04; n = 22]. At hospital discharge after the index stroke, NOAC off-label dose on admission was continued in 30 (49.2%) of 61 patients. Overall, 79 (13.7%) of 708 patients prescribed a NOAC at hospital discharge received an off-label dose, of whom 75 (10.6%) patients were under-dosed. Rivaroxaban under-dosing at discharge was associated with age ≥ 80 years [OR 3.49, 95% CI 1.24–9.84, P = 0.02; n = 19]; apixaban under-dosing with body weight ≤ 60 kg [OR 0.06, 95% CI 0.01–0.47, P n = 56], CHA2DS2-VASc score [OR per point 1.47, 95% CI 1.08–2.00, P = 0.01], and HAS-BLED score [OR per point 1.91, 95% CI 1.28–2.84, P Conclusion At stroke onset, off-label dosing was present in one out of four, and under-dosing in one out of five NOAC patients. Under-dosing of rivaroxaban or apixaban was related to old age. In-hospital treatment after stroke reduced off-label NOAC dosing, but one out of ten NOAC patients was under-dosed at discharge. Clinical trial registration NCT02306824.
- Published
- 2022
- Full Text
- View/download PDF
8. Correction to: Off-label-dosing of non-vitamin K-dependent oral antagonists in AF patients before and after stroke: results of the prospective multicenter Berlin Atrial Fibrillation Registry
- Author
-
Serdar Tütüncü, Manuel Olma, Claudia Kunze, Joanna Dietzel, Johannes Schurig, Cornelia Fiessler, Carolin Malsch, Tobias Eberhard Haas, Boris Dimitrijeski, Wolfram Doehner, Georg Hagemann, Frank Hamilton, Martin Honermann, Gerhard Jan Jungehulsing, Andreas Kauert, Hans-Christian Koennecke, Bruno-Marcel Mackert, Darius Nabavi, Christian H. Nolte, Joschua Mirko Reis, Ingo Schmehl, Paul Sparenberg, Robert Stingele, Enrico Völzke, Carolin Waldschmidt, Daniel Zeise-Wehry, Peter U. Heuschmann, Matthias Endres, and Karl Georg Haeusler
- Subjects
Neurology ,Neurology (clinical) ,ddc:610 - Published
- 2022
- Full Text
- View/download PDF
9. Oral anticoagulation in patients with atrial fibrillation and acute ischaemic stroke: design and baseline data of the prospective multicentre Berlin Atrial Fibrillation Registry
- Author
-
Robert Stingele, Peter U. Heuschmann, Ingo Schmehl, Serdar Tütüncü, Bettina Schmitz, Frank Hamilton, Matthias Endres, Martin Honermann, Bruno-Marcel Mackert, Andrea Rocco, Janek Harder, Claudia Kunze, Johannes Schurig, Christoph Leithner, Gerhard J. Jungehulsing, Enrico Völzke, Boris Dimitrijeski, Karl Georg Haeusler, Andreas Kauert, Georg Hagemann, Florian Masuhr, Carolin Malsch, Michael von Brevern, Paul Sparenberg, Joanna Dietzel, Martin Ebinger, Darius G. Nabavi, Silke Wiedmann, and Hans-Christian Koennecke
- Subjects
Male ,prevention & control [Brain Ischemia] ,Administration, Oral ,030204 cardiovascular system & hematology ,Brain Ischemia ,0302 clinical medicine ,Interquartile range ,Atrial Fibrillation ,drug therapy [Atrial Fibrillation] ,Prospective Studies ,Registries ,Stroke ,Aged, 80 and over ,Incidence ,Atrial fibrillation ,Middle Aged ,Vitamin K antagonist ,epidemiology [Berlin] ,Prognosis ,Berlin ,administration & dosage [Anticoagulants] ,Acute Disease ,Female ,Cardiology and Cardiovascular Medicine ,Adult ,complications [Atrial Fibrillation] ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,Young Adult ,03 medical and health sciences ,Physiology (medical) ,Internal medicine ,medicine ,epidemiology [Brain Ischemia] ,Humans ,ddc:610 ,Medical prescription ,Aged ,business.industry ,Anticoagulants ,Odds ratio ,medicine.disease ,etiology [Brain Ischemia] ,Confidence interval ,Heart failure ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Aims The Berlin Atrial Fibrillation Registry was designed to analyse oral anticoagulation (OAC) prescription in patients with atrial fibrillation (AF) and acute ischaemic stroke. Methods and results This investigator-initiated prospective multicentre registry enrolled patients at all 16 stroke units located in Berlin, Germany. The ongoing telephone follow-up is conducted centrally and will cover 5 years per patient. Within 2014 and 2016, 1080 patients gave written informed consent and 1048 patients were available for analysis. Median age was 77 years [interquartile range (IQR) 72–83], 503 (48%) patients were female, and 254 (24%) had a transient ischaemic attack (TIA). Overall, 470 (62%) out of 757 patients with known AF and a (pre-stroke) CHA2DS2-VASc ≥ 1 were anticoagulated at the time of stroke. At hospital discharge, 847 (81.3%) of 1042 patients were anticoagulated. Thereof 710 (68.1%) received a non-vitamin K-dependent oral anticoagulant (NOAC) and 137 (13.1%) a vitamin K antagonist (VKA). Pre-stroke intake of a NOAC [odds ratio (OR) 15.6 (95% confidence interval, 95% CI 1.97–122)] or VKA [OR 0.04 (95% CI 0.02–0.09)], an index TIA [OR 0.56 (95% CI 0.34–0.94)] rather than stroke, heart failure [OR 0.49 (95% CI 0.26–0.93)], and endovascular thrombectomy at hospital admission [OR 12.9 (95% CI 1.59–104)] were associated with NOAC prescription at discharge. Patients’ age or AF type had no impact on OAC or NOAC use, respectively. Conclusion About 60% of all registry patients with known AF received OAC at the time of stroke or TIA. At hospital discharge, more than 80% of AF patients were anticoagulated and about 80% of those were prescribed a NOAC.
- Published
- 2019
- Full Text
- View/download PDF
10. Functional versus morphological assessment of vascular age in patients with coronary heart disease
- Author
-
Tino, Yurdadogan, Carolin, Malsch, Kornelia, Kotseva, David, Wood, Rainer, Leyh, Georg, Ertl, Wolfgang, Karmann, Lara, Müller-Scholden, Caroline, Morbach, Margret, Breunig, Martin, Wagner, Götz, Gelbrich, Michiel L, Bots, Peter U, Heuschmann, and Stefan, Störk
- Subjects
Male ,Aging ,Carotid artery disease ,Arterial stiffening ,Science ,Coronary Disease ,Middle Aged ,Pulse Wave Analysis ,Atherosclerosis ,Carotid Intima-Media Thickness ,Article ,Calcification ,Linear Models ,cardiovascular system ,Blood Vessels ,Humans ,Medicine ,Female ,cardiovascular diseases ,ddc:610 ,Aged - 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 VA(PWVao) in 68% of patients; for VA\(_{AIao}\) in 52% of patients. By contrast, VA derived from cIMT delivered opposite results: e.g. according to VA\(_{total-cIMT}\) 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.
- Published
- 2021
11. Stroke-induced immunodepression and dysphagia independently predict stroke-associated pneumonia – The PREDICT study
- Author
-
Joan Montaner, Frank Hamilton, Hendrik J. Harms, Marcella Hermans, Bruno-Marcel Mackert, Ingo Schmehl, Andreas Meisel, Peter U. Heuschmann, Alejandro Bustamante, Gerhard J. Jungehulsing, Uwe Malzahn, Sarah Hoffmann, Lena Ulm, Carolin Malsch, Darius G. Nabavi, Jos Göhler, and Christian Meisel
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Immune Tolerance ,medicine ,Humans ,Prospective Studies ,cardiovascular diseases ,Risk factor ,Intensive care medicine ,Stroke ,Aged ,Acute stroke ,Aged, 80 and over ,Interleukin-6 ,business.industry ,Macrophages ,HLA-DR Antigens ,Pneumonia ,Original Articles ,Middle Aged ,Prognosis ,medicine.disease ,Dysphagia ,respiratory tract diseases ,030104 developmental biology ,Neurology ,Female ,Neurology (clinical) ,medicine.symptom ,Deglutition Disorders ,Cardiology and Cardiovascular Medicine ,Complication ,business ,030217 neurology & neurosurgery - Abstract
Stroke-associated pneumonia is a frequent complication after stroke associated with poor outcome. Dysphagia is a known risk factor for stroke-associated pneumonia but accumulating evidence suggests that stroke induces an immunodepressive state increasing susceptibility for stroke-associated pneumonia. We aimed to confirm that stroke-induced immunodepression syndrome is associated with stroke-associated pneumonia independently from dysphagia by investigating the predictive properties of monocytic HLA-DR expression as a marker of immunodepression as well as biomarkers for inflammation (interleukin-6) and infection (lipopolysaccharide-binding protein). This was a prospective, multicenter study with 11 study sites in Germany and Spain, including 486 patients with acute ischemic stroke. Daily screening for stroke-associated pneumonia, dysphagia and biomarkers was performed. Frequency of stroke-associated pneumonia was 5.2%. Dysphagia and decreased monocytic HLA-DR were independent predictors for stroke-associated pneumonia in multivariable regression analysis. Proportion of pneumonia ranged between 0.9% in the higher monocytic HLA-DR quartile (≥21,876 mAb/cell) and 8.5% in the lower quartile (≤12,369 mAb/cell). In the presence of dysphagia, proportion of pneumonia increased to 5.9% and 18.8%, respectively. Patients without dysphagia and normal monocytic HLA-DR expression had no stroke-associated pneumonia risk. We demonstrate that dysphagia and stroke-induced immunodepression syndrome are independent risk factors for stroke-associated pneumonia. Screening for immunodepression and dysphagia might be useful for identifying patients at high risk for stroke-associated pneumonia.
- Published
- 2016
- Full Text
- View/download PDF
12. Cognitive Deficits and Related Brain Lesions in Patients With Chronic Heart Failure
- Author
-
Laszlo Solymosi, Peter Kraft, Guido Stoll, Ignaz Gunreben, Peter U. Heuschmann, Stefan Störk, Eric Schmid, Caroline Morbach, György A. Homola, Carolin Malsch, Reinhold Schmidt, Anna Frey, Balint Alkonyi, Georg Ertl, Wolfgang Müllges, Roxane Sell, Edith Hofer, and Isabella Colonna
- Subjects
Male ,medicine.medical_specialty ,Intelligence ,Diastole ,030204 cardiovascular system & hematology ,Neuropsychological Tests ,Vocabulary ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Reaction Time ,Medicine ,Humans ,In patient ,Cognitive Dysfunction ,Aged ,Brain Diseases ,Heart Failure, Diastolic ,Ejection fraction ,business.industry ,Cognition ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Memory, Short-Term ,Stroke prevention ,Heart failure ,Case-Control Studies ,Chronic Disease ,Cardiology ,Brain lesions ,Female ,Verbal memory ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Heart Failure, Systolic - Abstract
This study sought to determine the spectrum of brain lesions seen in heart failure (HF) patients and the extent to which lesion type contributes to cognitive impairment.Cognitive deficits have been reported in patients with HF.A total of 148 systolic and diastolic HF patients (mean age 64 ± 11 years; 16% female; mean left ventricular ejection fraction 43 ± 8%) were extensively evaluated within 2 days by cardiological, neurological, and neuropsychological testing and brain magnetic resonance imaging (MRI). A total of 288 healthy, sex- and age-matched subjects sampled from the Austrian Stroke Prevention Study served as MRI controls.Deficits in reaction times were apparent in 41% of patients and deficits in verbal memory in 46%. On brain MRI, patients showed more advanced medial temporal lobe atrophy (MTA) (Scheltens score) compared to controls (2.1 ± 0.9 vs. 1.0 ± 0.6; p 0.001). The degree of MTA was strongly associated with the severity of cognitive impairment, whereas the extent of white matter hyperintensities was similar in patients and controls. Moreover, patients had a 2.7-fold increased risk for presence of clinically silent lacunes.HF patients exhibit cognitive deficits in the domains of attention and memory. MTA but not white matter lesion load seems to be related to cognitive impairment.
- Published
- 2017
13. Feasibility and Diagnostic Value of Cardiovascular Magnetic Resonance Imaging After Acute Ischemic Stroke of Undetermined Origin
- Author
-
Laura zu Bentheim, Jochen B. Fiebach, Peter U. Heuschmann, Christian Wollboldt, Holger-Carsten Eberle, Heinrich J. Audebert, Claudia Kunze, Oliver Bruder, Matthias Endres, Christoph J Jensen, Juliane Herm, Karl Georg Haeusler, Andreas J. Morguet, Sebastian Jäger, Claudia C. Deluigi, and Carolin Malsch
- Subjects
Male ,medicine.medical_specialty ,complications [Cardiovascular Diseases] ,Aorta, Thoracic ,030204 cardiovascular system & hematology ,Magnetic resonance angiography ,Brain Ischemia ,Brain ischemia ,diagnostic imaging [Aorta, Thoracic] ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,diagnostic imaging [Stroke] ,Humans ,ddc:610 ,Stroke ,Acute ischemic stroke ,Aged ,etiology [Stroke] ,Advanced and Specialized Nursing ,diagnostic imaging [Cardiovascular Diseases] ,standards [Magnetic Resonance Imaging] ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,standards [Magnetic Resonance Angiography] ,Magnetic Resonance Imaging ,etiology [Brain Ischemia] ,standards [Echocardiography, Transesophageal] ,Embolism ,Cardiovascular Diseases ,diagnostic imaging [Brain Ischemia] ,Cardiology ,Feasibility Studies ,Female ,Neurology (clinical) ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Echocardiography, Transesophageal ,Magnetic Resonance Angiography - Abstract
Background and Purpose— Etiology of acute ischemic stroke remains undetermined (cryptogenic) in about 25% of patients after state-of-the-art diagnostic work-up. Methods— One-hundred and three patients with magnetic resonance imaging (MRI)–proven acute ischemic stroke of undetermined origin were prospectively enrolled and underwent 3-T cardiac MRI and magnetic resonance angiography of the aortic arch in addition to state-of-the-art diagnostic work-up, including transesophageal echocardiography (TEE). We analyzed the feasibility, diagnostic accuracy, and added value of cardiovascular MRI (cvMRI) compared with TEE for detecting sources of stroke. Results— Overall, 102 (99.0%) ischemic stroke patients (median 63 years [interquartile range, 53–72], 24% female, median NIHSS (National Institutes of Health Stroke Scale) score on admission 2 [interquartile range, 1–4]) underwent cvMRI and TEE in hospital; 89 (86.4%) patients completed the cvMRI examination. In 93 cryptogenic stroke patients, a high-risk embolic source was found in 9 (8.7%) patients by cvMRI and in 11 (11.8%) patients by echocardiography, respectively. cvMRI and echocardiography findings were consistent in 80 (86.0%) patients, resulting in a degree of agreement of κ=0.24. In 82 patients with cryptogenic stroke according to routine work-up, including TEE, cvMRI identified stroke etiology in additional 5 (6.1%) patients. Late gadolinium enhancement consistent with previous myocardial infarction was found in 13 (14.6%) out of 89 stroke patients completing cvMRI. Only 2 of these 13 patients had known coronary artery disease. Conclusions— Our study demonstrated that cvMRI was feasible in the vast majority of included patients with acute ischemic stroke. The diagnostic information of cvMRI seems to be complementary to TEE but is not replacing echocardiography after acute ischemic stroke. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01917955.
- Published
- 2017
- Full Text
- View/download PDF
14. Associations of circulating plasma microRNAs with age, body mass index and sex in a population-based study
- Author
-
Tim Kacprowski, Elke Hammer, Georg Homuth, Uwe Völker, Nele Friedrich, Sabine Ameling, Maik Pietzner, Volkmar Liebscher, Karsten Suhre, Carolin Malsch, and Ravi Kumar Chilukoti
- Subjects
Oncology ,Adult ,Male ,medicine.medical_specialty ,Aging ,Population ,Biology ,Body Mass Index ,Cohort Studies ,Young Adult ,BMI ,Circulating microRNA ,Plasma ,Age ,Internal medicine ,medicine ,Genetics ,Humans ,Genetics(clinical) ,education ,Genetics (clinical) ,Genetic association ,Aged ,miRNA ,Association studies ,education.field_of_study ,Sex Characteristics ,Blood Cells ,Association Studies ,Blood ,Bmi ,Circulating Microrna ,Mirna ,Sex ,Middle Aged ,Human genetics ,Circulating MicroRNA ,MicroRNAs ,Phenotype ,Study of Health in Pomerania ,Immunology ,Female ,Body mass index ,Cohort study ,Sex characteristics ,Research Article - Abstract
Background Non-cellular blood circulating microRNAs (plasma miRNAs) represent a promising source for the development of prognostic and diagnostic tools owing to their minimally invasive sampling, high stability, and simple quantification by standard techniques such as RT-qPCR. So far, the majority of association studies involving plasma miRNAs were disease-specific case-control analyses. In contrast, in the present study, plasma miRNAs were analysed in a sample of 372 individuals from a population-based cohort study, the Study of Health in Pomerania (SHIP). Methods Quantification of miRNA levels was performed by RT-qPCR using the Exiqon Serum/Plasma Focus microRNA PCR Panel V3.M covering 179 different miRNAs. Of these, 155 were included in our analyses after quality-control. Associations between plasma miRNAs and the phenotypes age, body mass index (BMI), and sex were assessed via a two-step linear regression approach per miRNA. The first step regressed out the technical parameters and the second step determined the remaining associations between the respective plasma miRNA and the phenotypes of interest. Results After regressing out technical parameters and adjusting for the respective other two phenotypes, 7, 15, and 35 plasma miRNAs were significantly (q
- Published
- 2015
15. Performance of Serum microRNAs -122, -192 and -21 as Biomarkers in Patients with Non-Alcoholic Steatohepatitis
- Author
-
Christian Hammer, Monika Rau, Philip P. Becker, Beat Müllhaupt, Heike Bantel, Johannes Schmitt, Carolin Malsch, Andreas Geier, and University of Zurich
- Subjects
Oncology ,Adult ,Male ,medicine.medical_specialty ,Biopsy ,lcsh:Medicine ,Apoptosis ,610 Medicine & health ,1100 General Agricultural and Biological Sciences ,Biology ,Logistic regression ,Sensitivity and Specificity ,digestive system ,Cohort Studies ,Young Adult ,Non-alcoholic Fatty Liver Disease ,1300 General Biochemistry, Genetics and Molecular Biology ,Internal medicine ,medicine ,Humans ,ddc:610 ,Obesity ,lcsh:Science ,1000 Multidisciplinary ,Multidisciplinary ,Receiver operating characteristic ,Gene Expression Profiling ,Fatty liver ,lcsh:R ,Case-control study ,Gold standard (test) ,medicine.disease ,digestive system diseases ,Circulating MicroRNA ,MicroRNAs ,10219 Clinic for Gastroenterology and Hepatology ,Liver ,ROC Curve ,Case-Control Studies ,10076 Center for Integrative Human Physiology ,Immunology ,Regression Analysis ,Female ,lcsh:Q ,Steatohepatitis ,Steatosis ,Biomarkers ,Research Article - Abstract
Objectives Liver biopsies are the current gold standard in non-alcoholic steatohepatitis (NASH) diagnosis. Their invasive nature, however, still carries an increased risk for patients' health. The development of non-invasive diagnostic tools to differentiate between bland steatosis (NAFL) and NASH remains crucial. The aim of this study is the evaluation of investigated circulating microRNAs in combination with new targets in order to optimize the discrimination of NASH patients by non-invasive serum biomarkers. Methods Serum profiles of four microRNAs were evaluated in two cohorts consisting of 137 NAFLD patients and 61 healthy controls. In a binary logistic regression model microRNAs of relevance were detected. Correlation of microRNA appearance with known biomarkers like ALT and CK18-Asp396 was evaluated. A simplified scoring model was developed, combining the levels of microRNA in circulation and CK18-Asp396 fragments. Receiver operating characteristics were used to evaluate the potential of discriminating NASH. Results The new finding of our study is the different profile of circulating miR-21 in NASH patients (p
- Published
- 2015
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.