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1. Edoxaban for Thromboembolism Prevention in Pediatric Patients With Cardiac Disease

Author

Brothers, Matthew, Marino, Bradley, Canter, Charles, Law, Mark, Nguyen, Nguyenvu, Sang, Charlie, Shimano, Kristin, Gupta, Dipankar, Portman, Michael, Williams, Derek, Glass, Lauren, Sperrazza, Charles, Herold, Steven, Garg, Ruchira, Vranicar, Mark, Awad, Sawsan, Asante-Korang, Alfred, Druzgal, Colleen, Ozment, Caroline, Del Toro, Kamill, Roses, Ferran, Jux, Christian, Gravenhorst, Verena, Schweigmann, Ulrich, Bhatt, Mihir, Sabapathy, Christine, Dahdah, Nagib, Bartonicek, Dototea, Tulzer, Gerald, Basargina, Elena, Zvereva, Tatiana, Pertels, Tatiana, Plotnikova, Irina, Pierre-Emmanuel, S.E.G.U.E.L.A., Amedro, Pascal, Yves, Dulac, BONNET, Damien, Saraco, Paola, Rimini, Alessandro, Digtiar, Valerii, Gonchar, Margaryta, Kryuchko, Tetyana, Yablon, Olga, Bedi, Varinder Singh, Patel, Jashvant, Mitra, Monjori, Kusa, Jacek, Domagala, Kowalczyk, KÖRNYEI, László, BERECZKI, Csaba, ABLONCZY, László, Levitas, Vivianne Aviva, Mishali, David, Revel-Vilk, Shoshana, Harlev, Dan, Sasmaz, Hatice Ilgen, Ozbek, Namik Yasar, Unal, Sule, Patıroglu, Türkan, Malbora, Baris, Agin, Hasan, Karakas, Zeynep, Kavakli, Ramazan Kaan, Chalmers, Elizabeth, Bu'Lock, Frances, Daubeney, Piers, Hamza, Hala, Badr, Mohamed, Elalfy, Mohsen, Mansour, Ahmed, Hassab, Hoda, Sabry, Ayman, Daou, Linda, Bitar, Fadi, Portman, Michael A., Jacobs, Jeffrey P., Newburger, Jane W., Berger, Felix, Grosso, Michael A., Duggal, Anil, Tao, Ben, and Goldenberg, Neil A.

Published
2022
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2. Histopathology of congestive nephropathy: a case description and literature review.

Author

Husain‐Syed, Faeq, Rangaswami, Janani, Núñez, Julio, Skrzypek, Susanne, Jux, Christian, Gröne, Hermann‐Josef, and Birk, Horst‐Walter

Subjects
CARDIO-renal syndrome, ACUTE kidney failure, LITERATURE reviews, HEART failure, CELL differentiation, KIDNEY diseases, INTRA-abdominal hypertension
Abstract

Congestive nephropathy is an underappreciated manifestation of cardiorenal syndrome and is characterized by a potentially reversible kidney dysfunction caused by a reduced renal venous outflow secondary to right‐sided heart failure or intra‐abdominal hypertension. To date, the histological diagnostic criteria for congestive nephropathy have not been defined. We herein report a case of acute renal dysfunction following cardiac allograft failure and present a review of the relevant literature to elucidate the current understanding of the disease. Our case demonstrated that congestion‐driven nephropathy may be histopathologically characterized by markedly dilated veins and peritubular capillaries, focally accentuated low‐grade acute tubular damage, small areas of interstitial fibrosis, and tubular atrophy on a background of normal glomeruli and predominantly normal tubular cell differentiation. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Left Ventricular Physiology and Ventricular‐Vascular Interactions in Young Patients After Heart Transplantation

Author

Latus, Heiner, primary, Raap, Ramona, additional, Klingel, Karin, additional, Happel, Christoph, additional, Moysich, Axel, additional, Khalil, Markus, additional, Kerst, Gunter, additional, Milla, Jakob, additional, Skrzypek, Susanne, additional, Thul, Josef, additional, Jux, Christian, additional, Schranz, Dietmar, additional, and Apitz, Christian, additional

Published
2023
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7. Edoxaban for Thromboembolism Prevention in Pediatric Patients With Cardiac Disease

Author

Portman, Michael A., primary, Jacobs, Jeffrey P., additional, Newburger, Jane W., additional, Berger, Felix, additional, Grosso, Michael A., additional, Duggal, Anil, additional, Tao, Ben, additional, Goldenberg, Neil A., additional, Brothers, Matthew, additional, Marino, Bradley, additional, Canter, Charles, additional, Law, Mark, additional, Nguyen, Nguyenvu, additional, Sang, Charlie, additional, Shimano, Kristin, additional, Gupta, Dipankar, additional, Portman, Michael, additional, Williams, Derek, additional, Glass, Lauren, additional, Sperrazza, Charles, additional, Herold, Steven, additional, Garg, Ruchira, additional, Vranicar, Mark, additional, Awad, Sawsan, additional, Asante-Korang, Alfred, additional, Druzgal, Colleen, additional, Ozment, Caroline, additional, Del Toro, Kamill, additional, Roses, Ferran, additional, Jux, Christian, additional, Gravenhorst, Verena, additional, Schweigmann, Ulrich, additional, Bhatt, Mihir, additional, Sabapathy, Christine, additional, Dahdah, Nagib, additional, Bartonicek, Dototea, additional, Tulzer, Gerald, additional, Basargina, Elena, additional, Zvereva, Tatiana, additional, Pertels, Tatiana, additional, Plotnikova, Irina, additional, Pierre-Emmanuel, S.E.G.U.E.L.A., additional, Amedro, Pascal, additional, Yves, Dulac, additional, BONNET, Damien, additional, Saraco, Paola, additional, Rimini, Alessandro, additional, Digtiar, Valerii, additional, Gonchar, Margaryta, additional, Kryuchko, Tetyana, additional, Yablon, Olga, additional, Bedi, Varinder Singh, additional, Patel, Jashvant, additional, Mitra, Monjori, additional, Kusa, Jacek, additional, Domagala, Kowalczyk, additional, KÖRNYEI, László, additional, BERECZKI, Csaba, additional, ABLONCZY, László, additional, Levitas, Vivianne Aviva, additional, Mishali, David, additional, Revel-Vilk, Shoshana, additional, Harlev, Dan, additional, Sasmaz, Hatice Ilgen, additional, Ozbek, Namik Yasar, additional, Unal, Sule, additional, Patıroglu, Türkan, additional, Malbora, Baris, additional, Agin, Hasan, additional, Karakas, Zeynep, additional, Kavakli, Ramazan Kaan, additional, Chalmers, Elizabeth, additional, Bu'Lock, Frances, additional, Daubeney, Piers, additional, Hamza, Hala, additional, Badr, Mohamed, additional, Elalfy, Mohsen, additional, Mansour, Ahmed, additional, Hassab, Hoda, additional, Sabry, Ayman, additional, Daou, Linda, additional, and Bitar, Fadi, additional

Published
2022
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8. Inhibition of mitochondrial respiration has fundamentally different effects on proliferation, cell survival and stress response in immature versus differentiated cardiomyocyte cell lines

Author

Grün, Bent, Tirre, Michaela, Pyschny, Simon, Singh, Vijay, Kehl, Hans-Gerd, Jux, Christian, and Drenckhahn, Jörg-Detlef

Subjects
Cell Biology, Developmental Biology
Abstract

Myocardial tissue homeostasis is critically important for heart development, growth and function throughout the life course. The loss of cardiomyocytes under pathological conditions ultimately leads to cardiovascular disease due to the limited regenerative capacity of the postnatal mammalian heart. Inhibition of electron transport along the mitochondrial respiratory chain causes cellular stress characterized by ATP depletion as well as excessive generation of reactive oxygen species. Adult cardiomyocytes are highly susceptible to mitochondrial dysfunction whereas embryonic cardiomyocytes in the mouse heart have been shown to be resistant towards mitochondrial complex III inhibition. To functionally characterize the molecular mechanisms mediating this stress tolerance, we used H9c2 cells as an in vitro model for immature cardiomyoblasts and treated them with various inhibitors of mitochondrial respiration. The complex I inhibitor rotenone rapidly induced cell cycle arrest and apoptosis whereas the complex III inhibitor antimycin A (AMA) had no effect on proliferation and only mildly increased cell death. HL-1 cells, a differentiated and contractile cardiomyocyte cell line from mouse atrium, were highly susceptible to AMA treatment evident by cell cycle arrest and death. AMA induced various stress response mechanisms in H9c2 cells, such as the mitochondrial unfolded protein response (UPRmt), integrated stress response (ISR), heat shock response (HSR) and antioxidative defense. Inhibition of the UPR, ISR and HSR by siRNA mediated knock down of key components does not impair growth of H9c2 cells upon AMA treatment. In contrast, knock down of NRF2, an important transcriptional regulator of genes involved in detoxification of reactive oxygen species, reduces growth of H9c2 cells upon AMA treatment. Various approaches to activate cell protective mechanisms and alleviate oxidative stress in HL-1 cells failed to rescue them from AMA induced growth arrest and death. In summary, these data show that the site of electron transport interruption along the mitochondrial respiratory chain determines cell fate in immature cardiomyoblasts. The study furthermore points to fundamental differences in stress tolerance and cell survival between immature and differentiated cardiomyocytes which may underlie the growth plasticity of embryonic cardiomyocytes during heart development but also highlight the obstacles of cardioprotective therapies in the adult heart.

Published
2022

10. Impact of Right Ventricular Pressure Load After Repair of Tetralogy of Fallot

Author

Latus, Heiner, primary, Stammermann, Jana, additional, Voges, Inga, additional, Waschulzik, Birgit, additional, Gutberlet, Matthias, additional, Diller, Gerhard‐Paul, additional, Schranz, Dietmar, additional, Ewert, Peter, additional, Beerbaum, Philipp, additional, Kühne, Titus, additional, Sarikouch, Samir, additional, Kerst, Gunter, additional, Kanaan, Majed, additional, Lebherz, Corinna, additional, Rüffer, André, additional, Gkalpakiotis, Dimitrios, additional, Schedifka, Andrea, additional, Buheitel, Gernot, additional, Streble, Joachim, additional, Willing, Rainer, additional, Schubert, Stephan, additional, Laser, Kai Thorsten, additional, Sandica, Eugen, additional, Trusen, Burkhard, additional, Berger, Felix, additional, Miera, Oliver, additional, Ovroutski, Stanislav, additional, Schmitt, Katharina, additional, Photiadis, Joachim, additional, Opgen‐Rhein, Bernd, additional, Weiss, Katja, additional, Klaassen, Sabine, additional, Berns, Christoph, additional, Boeckel, Thomas, additional, Haverkämper, Guido, additional, Kästner, Andreas, additional, Koch, Heike, additional, Peters, Björn, additional, Schmidt, Florian, additional, Timme, Jens, additional, Engel, Konstanze, additional, Franzbach, Birgit, additional, Senft, Gabriela, additional, Beyer, Frank, additional, Winter, Klaus, additional, Breuer, Johannes, additional, Schneider, Martin, additional, Bahlmann, Jens, additional, Griese, Eberhard, additional, Lê, Trong Phi, additional, Hebe, Joachim, additional, Nürnberg, Jan‐Hendrik, additional, Magsaam, Annette, additional, Müller, Ronald, additional, Potthoff, Ludger, additional, Voigt, Renate, additional, Krüger, Tim, additional, Gerleve, Hubert, additional, Kleideiter, Ulrich, additional, Schneider‐Kulla, Dirk, additional, Krülls‐Münch, Jürgen, additional, Menke, Thomas, additional, Lehn, Martin, additional, Heilmann, Antje, additional, Tomczak, Helge, additional, Tarusinov, Gleb, additional, Scheid, Michael, additional, Mayatepek, Ertan, additional, Pillekamp, Frank, additional, Lichtenberg, Artur, additional, Terpeluk, Christiane, additional, Kolterer, Bruno, additional, Dittrich, Sven, additional, Gundlach, Ulrike, additional, Cesnjevar, Robert, additional, Müntjes, Carsten, additional, Morf, Geert, additional, Esmaeili, Anoosh, additional, Backhoff, Stephan, additional, Stiller, Brigitte, additional, Beyersdorf, Friedhelm, additional, Kroll, Johannes, additional, Häffner, Nicole, additional, Siaplaouras, Jannos, additional, Masri‐Zada, Antje, additional, Jux, Christian, additional, Böning, Andreas, additional, Akintürk, Hakan, additional, Paul, Thomas, additional, Sigler, Matthias, additional, Tirilomis, Theodor, additional, Schürer, Gabriele, additional, Hartmann, Johannes, additional, Grabitz, Ralph, additional, Liebaug, Uta, additional, Rotzsch, Claudius, additional, Kozlik‐Feldmann, Rainer, additional, Rickers, Carsten, additional, Mir, Thomas, additional, Hübler, Michael, additional, Sachweh, Jörg, additional, Renz, Stefan, additional, Schemm, Andreas, additional, Friedrich, Bernd, additional, Schlobohm, Otmar, additional, Böthig, Dietmar, additional, Wermter, Burkhard, additional, Kelter‐Klöpping, Andrea, additional, Horke, Alexander, additional, Bauersachs, Johann, additional, Westhoff‐Bleck, Mechthild, additional, Gorenflo, Matthias, additional, Karck, Matthias, additional, Loukanov, Tsvetomir, additional, Schrüfer, Hermann, additional, Wilken, Martin, additional, Abdul‐Khaliq, Hashim, additional, Rädle‐Hurst, Tanja, additional, Rentzsch, Axel, additional, Schäfers, Hans‐Joachim, additional, Reichert, Hagen, additional, Vilser, Daniel, additional, Kriebel, Thomas, additional, Boysen, Arnulf, additional, Uebing, Anselm, additional, Attmann, Tim, additional, Cremer, Joachim Thomas, additional, Scheewe, Jens, additional, Buchholz‐Berdau, Regina, additional, Möller, Peter, additional, Horter, Thorsten, additional, Brockmeier, Konrad, additional, Bennink, Gerardus B. W. E, additional, Baldus, Stephan, additional, Gillor, Alex, additional, Niehues, Tim, additional, Lawrenz, Wolfgang, additional, Leidig, Steffen, additional, Dähnert, Ingo, additional, Riede, Frank‐Thomas, additional, Kostelka, Martin, additional, Kändler, Liane, additional, Bethge, Martin, additional, Köster, Stefan, additional, Schröder, Christoph, additional, Karstedt, Jens, additional, Seitz, Uwe, additional, Kampmann, Christoph, additional, Dohle, Daniel‐Sebastian, additional, Stahl, Frank, additional, Abedini, Mojtaba, additional, Müller‐Scholden, Joachim, additional, Hager, Alfred, additional, Huntgeburth, Michael, additional, Kaemmerer, Harald, additional, Nagdyman, Nicole, additional, Schoetzau, Jörg, additional, Tutarel, Oktay, additional, Lange, Rüdiger, additional, Hörer, Jürgen, additional, Haas, Nikolaus A, additional, Hauser, Michael, additional, Roithmaier, Alexander, additional, Kehl, Hans‐Gerd, additional, Lammers, Astrid, additional, Malec, Edward, additional, Baumgartner, Helmut, additional, Diller, Gerhard, additional, Bahle, Roswitha, additional, Hofner, Gerald, additional, Zink, Stefan, additional, Reif, Roland, additional, Singer, Helmut, additional, Parlasca, Christoph, additional, Freund, Matthias W, additional, Schumacher, Michael, additional, Dewald, Oliver, additional, Darrelmann, Christine, additional, Willmann, Olaf, additional, Schmiedl, Norbert, additional, Quick, Peter, additional, Hillebrand, Dirk, additional, Michele Eiselt, Stephan, additional, Nekarda, Torsten, additional, Eberhard, Michael, additional, Baier, Georg, additional, Uhlemann, Frank, additional, Tzanavaros, Ioannis, additional, Beyer, Alexander, additional, Binz, Gudrun, additional, Hess, Steffen, additional, Teufel, Thomas, additional, Handke, Ronald‐Peter, additional, Hofbeck, Michael, additional, Kaulitz, Renate, additional, Sieverding, Ludger, additional, Schlensak, Christian, additional, Apitz, Christian, additional, Kaestner, Michael, additional, Holtvogt, Jürgen, additional, Wippermann, Carl‐Friedrich, additional, Hinz, Sönke, additional, Heusch, Andreas, additional, Wirbelauer, Johannes, additional, and Brosi, Wolfgang, additional

Published
2022
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12. Medical treatment of pulmonary hypertension in adults with congenital heart disease: updated and extended results from the International COMPERA-CHD Registry

Author

Kaemmerer, Ann-Sophie, primary, Gorenflo, Matthias, additional, Huscher, Dörte, additional, Pittrow, David, additional, Ewert, Peter, additional, Pausch, Christine, additional, Delcroix, Marion, additional, Ghofrani, Hossein A., additional, Hoeper, Marius M., additional, Kozlik-Feldmann, Rainer, additional, Skride, Andris, additional, Stähler, Gerd, additional, Vizza, Carmine Dario, additional, Jureviciene, Elena, additional, Jancauskaite, Dovile, additional, Gumbiene, Lina, additional, Ewert, Ralf, additional, Dähnert, Ingo, additional, Held, Matthias, additional, Halank, Michael, additional, Skowasch, Dirk, additional, Klose, Hans, additional, Wilkens, Heinrike, additional, Milger, Katrin, additional, Jux, Christian, additional, Koestenberger, Martin, additional, Scelsi, Laura, additional, Brunnemer, Eva, additional, Hofbeck, Michael, additional, Ulrich, Silvia, additional, Noordegraaf, Anton Vonk, additional, Lange, Tobias J., additional, Bruch, Leonhard, additional, Konstantinides, Stavros, additional, Claussen, Martin, additional, Löffler-Ragg, Judith, additional, Wirtz, Hubert, additional, Apitz, Christian, additional, Neidenbach, Rhoia, additional, Freilinger, Sebastian, additional, Nemes, Attila, additional, Opitz, Christian, additional, Grünig, Ekkehard, additional, and Rosenkranz, Stephan, additional

Published
2021
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13. Exercise-dependent changes in ventricular–arterial coupling and aortopulmonary collateral flow in Fontan patients: a real-time CMR study.

Author

Latus, Heiner, Hofmann, Lucas, Gummel, Kerstin, Khalil, Markus, Yerebakan, Can, Waschulzik, Birgit, Schranz, Dietmar, Voges, Inga, Jux, Christian, and Reich, Bettina

Subjects
PULMONARY circulation, VENA cava superior, COLLATERAL circulation, MAGNETIC resonance imaging, EXERCISE, RESEARCH funding, EMPLOYEES' workload, AORTA, CARDIOPULMONARY bypass, ERGOMETRY, VENA cava inferior, HEMODYNAMICS, HEART failure
Abstract

Aims Inefficient ventricular–arterial (V–A) coupling has been described in Fontan patients and may result in adverse haemodynamics. A varying amount of aortopulmonary collateral (APC) flow is also frequently present that increases volume load of the single ventricle. The aim of the study was to assess changes in V–A coupling and APC flow during exercise CMR. Methods and results Eighteen Fontan patients (age 24 ± 3 years) and 14 controls (age 23 ± 4 years) underwent exercise CMR using a cycle ergometer. Ventricular volumetry and flow measurements in the ascending aorta (AAO), inferior (IVC), and superior (SVC) vena cava were assessed using real-time sequences during stepwise increases in work load. Measures of systemic arterial elastance Ea, ventricular elastance Ees, and V–A coupling (Ea/Ees) were assessed. APC flow was quantified as AAO − (SVC + IVC). Ea remained unchanged during all levels of exercise in both groups (P = 0.39 and P = 0.11). Ees increased in both groups (P = 0.001 and P < 0.001) with exercise but was lower in the Fontan group (P = 0.04). V–A coupling was impaired in Fontan patients at baseline (P = 0.04). Despite improvement during exercise (P = 0.002) V–A coupling remained impaired compared with controls (P = 0.001). Absolute APC flow in Fontan patients did not change during exercise even at maximum work load (P = 0.98). Conclusions Inefficient V–A coupling was already present at rest in Fontan patients and aggravated during exercise due to a limited increase in ventricular contractility which demonstrates the importance of a limited functional reserve of the single ventricle. APC flow remained unchanged suggesting no further increase in volume load during exercise. [ABSTRACT FROM AUTHOR]

Published
2023
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14. Medical treatment of pulmonary hypertension in adults with congenital heart disease: updated and extended results from the International COMPERA-CHD Registry

Author

Kaemmerer, Ann-Sophie, Gorenflo, Matthias, Huscher, Doerte, Pittrow, David, Ewert, Peter, Pausch, Christine, Delcroix, Marion, Ghofrani, Hossein A., Hoeper, Marius M., Kozlik-Feldmann, Rainer, Skride, Andris, Staehler, Gerd, Vizza, Carmine Dario, Jureviciene, Elena, Jancauskaite, Dovile, Gumbiene, Lina, Ewert, Ralf, Daehnert, Ingo, Held, Matthias, Halank, Michael, Skowasch, Dirk, Klose, Hans, Wilkens, Heinrike, Milger, Katrin, Jux, Christian, Koestenberger, Martin, Scelsi, Laura, Brunnemer, Eva, Hofbeck, Michael, Ulrich, Silvia, Noordegraaf, Anton Vonk, Lange, Tobias J., Bruch, Leonhard, Konstantinides, Stavros, Claussen, Martin, Loeffler-Ragg, Judith, Wirtz, Hubert, Apitz, Christian, Neidenbach, Rhoia, Freilinger, Sebastian, Nemes, Attila, Opitz, Christian, Gruenig, Ekkehard, Rosenkranz, Stephan, Kaemmerer, Ann-Sophie, Gorenflo, Matthias, Huscher, Doerte, Pittrow, David, Ewert, Peter, Pausch, Christine, Delcroix, Marion, Ghofrani, Hossein A., Hoeper, Marius M., Kozlik-Feldmann, Rainer, Skride, Andris, Staehler, Gerd, Vizza, Carmine Dario, Jureviciene, Elena, Jancauskaite, Dovile, Gumbiene, Lina, Ewert, Ralf, Daehnert, Ingo, Held, Matthias, Halank, Michael, Skowasch, Dirk, Klose, Hans, Wilkens, Heinrike, Milger, Katrin, Jux, Christian, Koestenberger, Martin, Scelsi, Laura, Brunnemer, Eva, Hofbeck, Michael, Ulrich, Silvia, Noordegraaf, Anton Vonk, Lange, Tobias J., Bruch, Leonhard, Konstantinides, Stavros, Claussen, Martin, Loeffler-Ragg, Judith, Wirtz, Hubert, Apitz, Christian, Neidenbach, Rhoia, Freilinger, Sebastian, Nemes, Attila, Opitz, Christian, Gruenig, Ekkehard, and Rosenkranz, Stephan

Abstract

Background: Pulmonary arterial hypertension (PAH) is common in congenital heart disease (CHD). Because clinical-trial data on PAH associated with CHD (PAH-CHD) remain limited, registry data on the long-term course are essential. This analysis aimed to update information from the COMPERA-CHD registry on management strategies based on real-world data. Methods: The prospective international pulmonary hypertension registry COMPERA has since 2007 enrolled more than 10,000 patients. COMPERA-CHD is a sub-registry for patients with PAH-CHD Results: A total of 769 patients with PAH-CHD from 62 specialized centers in 12 countries were included into COMPERA-CHD from January 2007 through September 2020. At the last follow-up in 09/2020, patients [mean age 45.3 +/- 16.8 years; 512 (66%) female] had either post-tricuspid shunts (n=359; 46.7%), pre-tricuspid shunts (n=249; 32.4%), complex CHD (n=132; 17.2%), congenital left heart or aortic valve or aortic disease (n=9; 1.3%), or miscellaneous CHD (n=20; 2.6%). The mean 6-minute walking distance was 369 +/- 121 m, and 28.2%, 56.0%, and 3.8% were in WHO functional class I/II, III or IV, respectively (12.0% unknown). Compared with the previously published COMPERA-CHD data, after 21 months of followup, the number of included PAH-CHD patients increased by 91 (13.4%). Within this group the number of Eisenmenger patients rose by 39 (16.3%), the number of Non-Eisenmenger PAH patients by 45 (26.9%). Currently, among the 674 patients from the PAH-CHD group with at least one follow-up, 450 (66.8%) received endothelin receptor antagonists (ERA), 416 (61.7%) PDE-5 inhibitors, 85 (12.6%) prostacyclin analogues, and 36 (5.3%) the sGC stimulator riociguat. While at first inclusion in the COMPERA-CHD registry, treatment was predominantly monotherapy (69.3%), this has shifted to favoring combination therapy in the current group (53%). For the first time, the nature, frequency, and treatment of significant comorbidities requiring supportive care and

Published
2021

15. Single Nuclei Sequencing Reveals Novel Insights Into the Regulation of Cellular Signatures in Children With Dilated Cardiomyopathy

Author

Nicin, Luka, primary, Abplanalp, Wesley T., additional, Schänzer, Anne, additional, Sprengel, Anke, additional, John, David, additional, Mellentin, Hannah, additional, Tombor, Lukas, additional, Keuper, Matthias, additional, Ullrich, Evelyn, additional, Klingel, Karin, additional, Dettmeyer, Reinhard B., additional, Hoffmann, Jedrzej, additional, Akintuerk, Hakan, additional, Jux, Christian, additional, Schranz, Dietmar, additional, Zeiher, Andreas M., additional, Rupp, Stefan, additional, and Dimmeler, Stefanie, additional

Published
2021
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17. Tuberculosis-Associated HLH in an 8-Month-Old Infant: A Case Report and Review

Author

Hauch, Holger, Skrzypek, Susanne, Woessmann, Wilhelm, Lehmberg, Kai, Ehl, Stephan, Speckmann, Carsten, Schneck, Emmanuel, Koerholz, Dieter, Jux, Christian, and Neuhäuser, Christoph

Subjects
tuberculosis, hemophagocytic lymphohistiocytosis, lung failure, case report, extracorporeal membrane oxygenation, ECMO, Pediatrics, infant
Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a rare immunological disease, which can be mistaken for sepsis easily. Among the infectious causes that may trigger secondary HLH, tuberculosis (TBC), a rather rare pathogen nowadays, is typical. To our knowledge, this is the first case report of an infant suffering from TBC-associated HLH-induced acute respiratory failure who was treated successfully using extracorporeal membrane oxygenation. An 8-month-old boy with fever (over the last 8 wk) and pancytopenia was transferred to our institution with acute respiratory failure and for extracorporeal membrane oxygenation therapy. Bone marrow biopsy revealed hemophagocytosis. Immunological work-up for familial HLH was negative. In a desperate search for the cause of secondary HLH, an interferon-gamma release assay for TBC returned positive. However, microscopy for acid-fast bacteria as well as polymerase chain reaction for TBC were initially negative. Despite this, the child was treated with tuberculostatic therapy. TBC was finally confirmed. The child remained on extracorporeal membrane oxygenation for 28 d. Further work-up showed typical lesions of disseminated TBC. The mother was identified as the source of TBC. The boy presents with mild sequelae (fine motor skills). In infants with suspected septicemia, TBC should be considered as differential diagnosis even if the results are initially negative.

Published
2020

23. Interrelationship between hemodynamics, brain volumes and outcome in Hypoplastic Left Heart Syndrome

Author

Reich, Bettina, Heye, Kristina N, O'Gorman Tuura, Ruth; https://orcid.org/0000-0001-5932-7786, Beck, Ingrid, Wetterling, Kristina, Hahn, Andreas, Aktintürk, Hakan, Schranz, Dietmar, Jux, Christian, Kretschmar, Oliver, Hübler, Michael, Latal, Beatrice; https://orcid.org/0000-0003-1309-4790, Knirsch, Walter; https://orcid.org/0000-0002-8741-3929, Reich, Bettina, Heye, Kristina N, O'Gorman Tuura, Ruth; https://orcid.org/0000-0001-5932-7786, Beck, Ingrid, Wetterling, Kristina, Hahn, Andreas, Aktintürk, Hakan, Schranz, Dietmar, Jux, Christian, Kretschmar, Oliver, Hübler, Michael, Latal, Beatrice; https://orcid.org/0000-0003-1309-4790, and Knirsch, Walter; https://orcid.org/0000-0002-8741-3929

Abstract

BACKGROUND The long-term impact of altered hemodynamics after Stage II in children with hypoplastic left heart syndrome (HLHS) and hypoplastic left heart complex (HLHC) on cerebral growth and neurodevelopmental outcome is unknown. We aimed to investigate whether elevated central venous and atrial filling pressures before Fontan procedure may be associated with smaller brain volumes and poorer neurodevelopmental outcome after initial Hybrid procedure. METHODS In a two-center cohort study semi-automated segmentation of cerebral MRI scans was conducted in 25 children with HLHS/HLHC (25 Hybrid) before Fontan procedure (27.6 ± 4.3 months) and in 8 healthy controls (29.7 ± 9.5 months). Study patients were evaluated with the Bayley Scales of Infant and Toddler Development III (Bayley-III) and a neurological examination. Hemodynamic measures after Stage II were assessed with cardiac catheterization at two years of age before Fontan completion. Children with known genetic comorbidities were excluded. RESULTS In HLHS/HLHC patients, higher atrial filling pressures (6 ± 3 mmHg, range 2-14 mmHg) were correlated with reduced brain volumes and lower language composite score, while higher Glenn pressures (10 ± 3 mmHg, range 6-16 mmHg) were related to higher cerebrospinal fluid, reduced brain volumes and lower cognitive, language, and motoric composite scores in the Bayley-III. Compared to controls, white matter volumes were reduced, and cerebrospinal fluid volumes were increased in study patients. CONCLUSIONS These data suggest that altered cardiovascular hemodynamics after stage II influence brain growth and neurodevelopmental outcome in infants with HLHS/HLHC.

Published
2019

24. Interrelationship Between Hemodynamics, Brain Volumes, and Outcome in Hypoplastic Left Heart Syndrome

Author

Reich, Bettina, primary, Heye, Kristina N., additional, O'Gorman Tuura, Ruth, additional, Beck, Ingrid, additional, Wetterling, Kristina, additional, Hahn, Andreas, additional, Aktintürk, Hakan, additional, Schranz, Dietmar, additional, Jux, Christian, additional, Kretschmar, Oliver, additional, Hübler, Michael, additional, Latal, Beatrice, additional, and Knirsch, Walter, additional

Published
2019
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30. Cardiovascular magnetic resonance assessment of ventricular function and myocardial scarring before and early after repair of anomalous left coronary artery from the pulmonary artery

Author

Latus, Heiner, primary, Gummel, Kerstin, additional, Rupp, Stefan, additional, Mueller, Matthias, additional, Jux, Christian, additional, Kerst, Gunter, additional, Akintuerk, Hakan, additional, Bauer, Juergen, additional, Schranz, Dietmar, additional, and Apitz, Christian, additional

Published
2014
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33. Assessment of Pulmonary Endothelial Function During Invasive Testing in Children and Adolescents With Idiopathic Pulmonary Arterial Hypertension

Author

Apitz, Christian, primary, Zimmermann, Rainer, additional, Kreuder, Joachim, additional, Jux, Christian, additional, Latus, Heiner, additional, Pons-Kühnemann, Joern, additional, Kock, Ines, additional, Bride, Peter, additional, Kreymborg, Karsten Grosse, additional, Michel-Behnke, Ina, additional, and Schranz, Dietmar, additional

Published
2012
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35. BioSTAR Evaluation STudy (BEST)

Author

Mullen, Michael J., primary, Hildick-Smith, David, additional, De Giovanni, Joseph V., additional, Duke, Christopher, additional, Hillis, W. Stewart, additional, Morrison, W. Lindsay, additional, and Jux, Christian, additional

Published
2006
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38. Experimental ASD closure using autologous cell-seeded interventional closure devices.

Author

Jux, Christian, Bertram, Harald, Wohlsein, Peter, Brügmann, Michael, Wüboldt, Petra, Fink, Christoph, Paul, Thomas, and Hausdorf, Gerd

Subjects
*ATRIAL septal defects, *PEDIATRICS, *CARDIOLOGY, *HUMAN abnormalities, *BIODEGRADABLE products, *BIOPSY, *FIBROBLASTS
Abstract

Objective: Atrial septal defect (ASD) occluders are permanent implants in paediatric cardiology which serve as mechanical shields until complete overgrowth and incorporation of the occluding device by autologous tissue has occurred. Thereafter, the foreign body material making up the device is dispensable and bears potential long-term adverse effects. Rapid, firm and complete incorporation into the atrial septal wall should be a prerequisite for biodegradable devices. In this study, the feasibility of using autologous cell-seeded devices was investigated by (a) testing the influence of a collagen coating on cellular stress resistance in vitro and (b) comparing the short-term effects between cell-seeded, collagen-coated and acellular ASD occluders in vivo. Methods: Native and collagen-coated Dacon fabrics and Starflex-devices were pre-seeded with autologous fibroblasts (skin biopsy) and evaluated using various mechanical stress tests. In a sheep model interventionally created ASDs were closed using either autologous pre-seeded or conventional (acellular) Starflex-devices. Results: ASD closure devices were successfully pre-seeded with autologous cells. The incubation period needed, the cellular density achieved and the mechanical stability of the cytolayer after mechanical stressing (implantation) were improved by applying a collagen matrix on the fabric. Compared to the thin layer of ingrown tissue seen on conventional occluders after 30 days in vivo, a thicker layer of organising, newly formed granulation tissue on pre-seeded collagen-coated devices embedded not only the Dacron fabric, but also completely covered the spring arms of the device underneath a layer of neo-endothelium. Conclusion: Autologous cell pre-seeding of interventional closure devices is feasible since the cells survive the mechanical stress encountered during implantation. Rapid, firm and complete ingrowth of occluder devices into a thicker layer of young fibrous granulation tissue can be achieved, but an increased thrombogenicity currently limits the in vivo application. [ABSTRACT FROM PUBLISHER]

Published
2002
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39. Interventional Atrial Septal Defect Closure Using a Totally Bioresorbable Occluder Matrix Development and Preclinical Evaluation of the BioSTAR Device

Author

Jux, Christian, Bertram, Harald, Wohlsein, Peter, Bruegmann, Michael, and Paul, Thomas

Abstract

ObjectivesWe sought to test the hypothesis that interventional atrial septal defect (ASD) closure can be performed safely and effectively using a bioresorbable occluder matrix.BackgroundThe ideal septal occluder scaffold should promote the healthiest and most complete healing response while eventually facilitating the full resorption of the material and leaving “native” tissue behind, thus minimizing the potential for future complications from chronic foreign body and maintaining the possibility for later unobstructed transseptal access to the left atrium.MethodsThe STARFlex occluders (NMT Medical Inc., Boston, Massachusetts) were modified by substituting the conventional polyester fabric for a bioengineered, acellular type-I collagen matrix derived from porcine submucosa with a heparin-coated surface (BioSTAR occluder, NMT Medical Inc.). Comparative transcatheter closure of ASDs was performed in young sheep (n = 36). Gross pathology and histopathology were obtained after follow-up periods ranging from 7 days to 2 years.ResultsThe STARFlex (control) devices were encapsulated time-dependently by ingrown fibrous tissue. Histology showed a mild but chronically persisting foreign body reaction. By contrast, BioSTAR devices exhibited a mild-to-moderate transient cellular immune response. Heparin coating of the BioSTAR surface improved the biocompatibility of the device by reducing surface thrombogencity. A remodeling process of the collagen scaffold, starting after 30 days in vivo, resulted in the full replacement of the matrix by host tissue after 2 years of follow-up.ConclusionsThe BioSTAR device is the first septal occluder with a totally bioresorbable matrix that is fully replaced by host tissue during the healing process. The promising results of this study support testing of the BioSTAR device in clinical trials.

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43. Exercise-dependent changes in ventricular-arterial coupling and aortopulmonary collateral flow in Fontan patients: a real-time CMR study.

Author

Latus H, Hofmann L, Gummel K, Khalil M, Yerebakan C, Waschulzik B, Schranz D, Voges I, Jux C, and Reich B

Subjects
Humans, Young Adult, Adult, Arteries, Heart Ventricles, Hemodynamics, Aorta, Fontan Procedure
Abstract

Aims: Inefficient ventricular-arterial (V-A) coupling has been described in Fontan patients and may result in adverse haemodynamics. A varying amount of aortopulmonary collateral (APC) flow is also frequently present that increases volume load of the single ventricle. The aim of the study was to assess changes in V-A coupling and APC flow during exercise CMR., Methods and Results: Eighteen Fontan patients (age 24 ± 3 years) and 14 controls (age 23 ± 4 years) underwent exercise CMR using a cycle ergometer. Ventricular volumetry and flow measurements in the ascending aorta (AAO), inferior (IVC), and superior (SVC) vena cava were assessed using real-time sequences during stepwise increases in work load. Measures of systemic arterial elastance Ea, ventricular elastance Ees, and V-A coupling (Ea/Ees) were assessed. APC flow was quantified as AAO - (SVC + IVC). Ea remained unchanged during all levels of exercise in both groups (P = 0.39 and P = 0.11). Ees increased in both groups (P = 0.001 and P < 0.001) with exercise but was lower in the Fontan group (P = 0.04). V-A coupling was impaired in Fontan patients at baseline (P = 0.04). Despite improvement during exercise (P = 0.002) V-A coupling remained impaired compared with controls (P = 0.001). Absolute APC flow in Fontan patients did not change during exercise even at maximum work load (P = 0.98)., Conclusions: Inefficient V-A coupling was already present at rest in Fontan patients and aggravated during exercise due to a limited increase in ventricular contractility which demonstrates the importance of a limited functional reserve of the single ventricle. APC flow remained unchanged suggesting no further increase in volume load during exercise., Competing Interests: Conflict of interest: none declared., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2022
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