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7. In vitro and in vivo evaluation of biohybrid tissue-engineered vascular grafts with transformative 1H/19F MRI traceable scaffolds

Author

Rama, Elena, Mohapatra, Saurav Ranjan, Sugimura, Yukiharu, Suzuki, Tomoyuki, Siebert, Stefan, Barmin, Roman, Hermann, Juliane, Baier, Jasmin, Rix, Anne, Lemainque, Teresa, Koletnik, Susanne, Elshafei, Asmaa Said, Pallares, Roger Molto, Dadfar, Seyed Mohammadali, Tolba, René H., Schulz, Volkmar, Jankowski, Joachim, Apel, Christian, Akhyari, Payam, Jockenhoevel, Stefan, and Kiessling, Fabian

Published
2024
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9. Durable left ventricular assist devices following temporary circulatory support on a microaxial flow pump with and without extracorporeal life support

Author

Lewin, Daniel, Rojas, Sebastian V., Billion, Michael, Meyer, Anna L., Netuka, Ivan, Kooij, Janajade, Pieri, Marina, Loforte, Antonio, Szymanski, Mariusz K., Moeller, Christian H., Akhyari, Payam, Jawad, Khalil, Krasivskyi, Ihor, Schmack, Bastian, Färber, Gloria, Medina, Marta, Haneya, Assad, Zimpfer, Daniel, Nersesian, Gaik, Oezkur, Mehmet, Djordjevic, Ilija, Saeed, Diyar, Stein, Julia, Kraaijeveld, Adriaan O., Gustafsson, Finn, Scandroglio, Mara, Meyns, Bart, Hofmann, Steffen, Belohlavek, Jan, Gummert, Jan F., Lanmueller, Pia, Bernhardt, Alexander M., and Potapov, Evgenij V.

Published
2024
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13. In-hospital and 6-month outcomes in patients with COVID-19 supported with extracorporeal membrane oxygenation (EuroECMO-COVID): a multicentre, prospective observational study

Author

Lorusso, Roberto, De Piero, Maria Elena, Mariani, Silvia, Di Mauro, Michele, Folliguet, Thierry, Taccone, Fabio Silvio, Camporota, Luigi, Swol, Justyna, Wiedemann, Dominik, Belliato, Mirko, Broman, Lars Mikael, Vuylsteke, Alain, Kassif, Yigal, Scandroglio, Anna Mara, Fanelli, Vito, Gaudard, Philippe, Ledot, Stephane, Barker, Julian, Boeken, Udo, Maier, Sven, Kersten, Alexander, Meyns, Bart, Pozzi, Matteo, Pedersen, Finn M, Schellongowski, Peter, Kirali, Kaan, Barrett, Nicholas, Riera, Jordi, Mueller, Thomas, Belohlavek, Jan, Lo Coco, Valeria, Van der Horst, Iwan C C, Van Bussel, Bas C T, Schnabel, Ronny M, Delnoij, Thijs, Bolotin, Gil, Lorini, Luca, Schmiady, Martin O, Schibilsky, David, Kowalewski, Mariusz, Pinto, Luis F, Silva, Pedro E, Kornilov, Igor, Blandino Ortiz, Aaron, Vercaemst, Leen, Finney, Simon, Roeleveld, Peter P, Di Nardo, Matteo, Hennig, Felix, Antonini, Marta Velia, Davidson, Mark, Jones, Tim J, Staudinger, Thomas, Mair, Peter, Kilo, Juliane, Krapf, Christoph, Erbert, Kathrin, Peer, Andreas, Bonaros, Nikolaos, Kotheletner, Florian, Krenner Mag, Niklas, Shestakova, Liana, Hermans, Greet, Dauwe, Dieter, Meersseman, Philippe, Stockman, Bernard, Nobile, Leda, Lhereux, Olivier, Nrasseurs, Alexandre, Creuter, Jacques, De Backer, Daniel, Giglioli, Simone, Michiels, Gregoire, Foulon, Pierre, Raes, Matthias, Rodrigus, Inez, Allegaert, Matthias, Jorens, Philippe, Debeucklare, Gerd, Piagnerelli, Michael, Biston, Patrick, Peperstraete, Harlinde, Vandewiele, Komeel, Germay, Olivier, Vandeweghe, Dimitri, Havrin, Sven, Bourgeois, Marc, Lagny, Marc-Gilbert, Alois, Genette, Lavios, Nathalie, Misset, Benoit, Courcelle, Romain, Timmermans, Philippe J, Yilmaz, Alaaddin, Vantomout, Michiel, Lehaen, Jerone, Jassen, Ame, Guterman, Herbert, Strauven, Maarten, Lormans, Piet, Verhamme, Bruno, Vandewaeter, catherine, Bonte, Frederik, Vionne, Dominique, Balik, Martin, Blàha, Jan, Lips, Michal, Othal, Michal, Bursa, Filip, Spacek, Radim, Christensen, Steffen, Jorgensen, Vibeke, Sorensen, Marc, Madsen, Soren A, Puss, Severin, Beljantsev, Aleksandr, Saiydoun, gabriel, Fiore, Antonio, Colson, Pascal, Bazalgette, Florian, Capdevila, Xavier, Kollen, Sebastien, Muller, Laurent, Obadia, Jean-Francois, Dubien, Pierre-Yves, Ajrhourh, Lucrezia, Guinot, Pierre G, Zarka, Jonathan, Besserve, Patricia, Malfertheiner, Maximilian V, Dreier, Esther, Heinze, Birgit, Akhyari, Payam, Lichtenberg, Artur, Aubin, Hug, Assman, Alexander, Saeed, Diyar, Thiele, Holger, Baumgaertel, Matthias, Schmitto, Jan D, Ruslan, Natanov, Haverich, Axel, Thielmann, Matthias, Brenner, Thorsten, Ruhpawar, Arjang, Benk, Christoph, Czerny, Martin, Staudacher, Dawid L, Beyersdorf, Fridhelm, Kalbhenn, Johannes, Henn, Philipp, Popov, Aron-Frederik, Iuliu, Torje, Muellenbach, Ralf, Reyher, Christian, Rolfes, Caroline, Lotz, Gosta, Sonntagbauer, Michael, Winkels, Helen, Fichte, Julia, Stohr, Robert, Kalverkamp, Sebastian, Karagiannidis, Christian, Schafer, Simone, Svetlitchny, Alexei, Hopf, Hans-Bernd, Jarczak, Dominik, Groesdonk, Heinirich, Rommer, Magdalena, Hirsch, Jan, Kaehny, Christian, Soufleris, Dimitros, Gavriilidis, Georgios, Pontikis, Kostantinos, Kyriakopoulou, Magdalini, Kyriakoudi, Anna, O'Brien, Serena, Conrick-Martin, Ian, Carton, Edmund, Makhoul, Maged, Ben-Ari, Josef, Hadash, Amir, Kogan, Alexander, Kassif Lerner, Reut, Abu-Shakra, Anas, Matan, Moshe, Balawona, Ahmad, Kachel, Erez, Altshuler, Roman, Galante, Ori, Fuchs, Lior, Almog, Yaniv, Ishay, Yaron S, Lichter, Yael, Gal-oz, Amir, Carmi, Uri, Nini, Asaph, Soroksky, Arie, Dekel, Hagi, Rozman, Ziv, Tayem, Emad, Ilgiyaev, Eduard, Hochman, Yuval, Miltau, daniel, Rapoport, Avigal, Eden, Arieh, Kompanietz, Dmitry, Yousif, Michael, Golos, Miri, Grazioli, Lorenzo, Ghitti, Davide, Loforte, Antonio, Di Luca, Daniela, Baiocchi, Massimo, Pacini, Davide, Cappai, Antioco, Meani, Paolo, Mondino, Michele, Russo, Claudio F, Ranucci, Marco, Fina, Dario, Cotza, Marco, Ballotta, Andrea, Landoni, Giovanni, Nardelli, Pasquale, Fominski, Eygeny V, Brazzi, Luca, Montrucchio, Giorgia, Sales, Gabriele, Simonetti, Umberto, Livigni, Sergio, Silengo, Daniela, Arena, Giulia, Sovatzis, Stefania S, Degani, Antonella, Riccardi, Mariachiara, Milanesi, Elisa, Raffa, Giuseppe, Martucci, Gennaro, Arcadipane, Antonio, Panarello, Giovanna, Chiarini, Giovanni, Cattaneo, Sergio, Puglia, Carmine, Benussi, Stefano, Foti, Giuseppe, Giani, Marco, Bombino, Michela, Costa, Maria Cristina, Rona, Roberto, Avalli, Leonello, Donati, Abele, Carozza, Roberto, Gasparri, Francesco, Carsetti, Andrea, Picichè, Marco, Marinello, Anna, Danzi, Vinicio, Zanin, Anita, Condello, Ignazio, Fiore, Flavio, Moscarelli, Marco, Nasso, Giuseppe, Speziale, Giuseppe, Sandrelli, Luca, Montalto, Andrea, Musumeci, Francesco, Circelli, Alessandro, Russo, Emanuele, Agnoletti, Vanni, Rociola, Ruggero, Milano, Aldo D, Pilato, Emanuele, Comentale, Giuseppe, Montisci, Andrea, Alessandri, Francesco, Tosi, Antonella, Pugliese, Francesco, Giordano, Giovanni, Carelli, Simone, Grieco, Domenico L, Dell'Anna, Antonio M, Antonelli, Massimo, Ramoni, Enrico, Zulueta, Josè, Del Giglio, Mauro, Petracca, Sebastiano, Bertini, Pietro, Guarracino, Fabio, De Simone, Luigi, Angeletti, Paolo M, Forfori, Francesco, Taraschi, Francesco, Quintiliani, Veronica N, Samalavicius, Robertas, Jankuviene, Agne, Scupakova, Nadezda, Urbonas, Karolis, Kapturauskas, Juozas, Soerensen, Gro, Suwalski, Piotr, Linhares Santos, Luis, Marques, Ana, Miranda, Marisa, Teixeira, Sonia, Salgueiro, Andrea, Pereira, Filipe, Ketskalo, Michail, Tsarenko, Sergey, Shilova, Alexandra, Afukov, Ivan, Popugaev, Konstantin, Minin, Sergei, Shelukhin, Daniil, Malceva, Olga, Gleb, Moroz, Skopets, Alexander, Kornelyuk, Roman, Kulikov, Alexandr, Okhrimchuk, Vadim, Turchaninov, Alexandr, Petrushin, Maxim, Sheck, Anastasia, Mekulov, Akhmed, Ciryateva, Svetlana, Urusov, Dmitry, Gorjup, Vojka, Golicnik, Alenka, Goslar, Tomaz, Ferrer, Ricard, Martinez-Martinez, Maria, Argudo, Eduard, Palmer, Neiser, De Pablo Sanchez, Raul, Juan Higuera, Lucas, Arnau Blasco, Lucas, Marquez, Josè A, Sbraga, Fabrizio, Fuset, Mari Paz, De Gopegui, Pablo Ruiz, Claraco, Luis M, De Ayala, Josè A, Peiro, Maranta, Ricart, Pilar, Martinez, Sergio, Chavez, Fernando, Fabra, Marc, Sandoval, elena, Toapanta, David, Carraminana, Albert, Tellez, Adrian, Ososio, Jeysson, Milan, Pablo, Rodriguez, Jorge, Andoni, Garcia, Gutierrez, Carola, Perez de la Sota, Enrique, Eixeres-Esteve, Andrea, Garcia-Maellas, Maria Teresa, Gutierrez-Gutierrez, Judit, Arboleda-Salazar, Rafael, Santa Teresa, Patricia, Jaspe, Alexis, Garrido, Alberto, Castaneda, Galo, Alcantara, Sara, Martinez, Nuria, Perez, Marina, Villanueva, Hector, Vidal Gonzalez, Anxela, Paez, Juan, Santon, Arnoldo, Perez, Cesar, Lopez, Marta, Rubio Lopez, Maria Isabel, Gordillo, Antonio, Naranjo-Izurieta, Jose, Munoz, Javier, Alcalde, Immaculada, Onieva, Fernando, Gimeno Costa, Ricardo, Perez, Francisco, Madrid, Isabel, Gordon, Monica, Albacete Moreno, Carlos L, Perez, Daniel, Lopez, Nayara, Martinenz, Domingo, Blanco-Schweizer, Pablo, Diez, Cristina, Perez, David, Prieto, Ana, Renedo, Gloria, Bustamante, Elena, Cicuendez, Ramon, Citores, Rafael, Boado, Victoria, Garcia, Katherine, Voces, Roberto, Domezain, Monica, Nunez Martinez, Jose Maria, Vicente, Raimundo, Martin, David, Andreu, Antonio, Gomez Casal, Vanesa, Chico, Ignacio, Menor, Eva Maria, Vara, Sabela, Gamacho, Jose, Perez-Chomon, Helen, Javier Gonzales, Francisco, Barrero, Irene, Martin-Villen, Luis, Fernandez, Esperanza, Mendoza, Maria, Navarro, Joaquin, Colomina Climent, Joaquin, Gonzales-Perez, Alfredo, Muniz-Albaceita, Guillermo, Amado, Laura, Rodriguez, Raquel, Ruiz, Emilio, Eiras, Maria, Grins, Edgars, Magnus, Rosen, Kanetoft, Mikael, Eidevald, Marcus, Watson, Pia, Vogt, Paul R, Steiger, Peter, Aigner, Tobias, Weber, Alberto, Grunefelder, Jurg, Kunz, Martin, Grapow, Martin, Aymard, Thierry, Reser, Diana, Agus, Gianluca, Consiglio, Jolanda, Haenggi, Matthias, Hansjoerg, Jenni, Iten, Manuela, Doeble, Thomas, Zenklusen, Urs, Bechtold, Xavier, Faedda, Giovanni, Iafrate, Manuel, Rohjer, Amanda, Bergamaschi, Layla, Maessen, Jos, Reis Miranda, Dinis, Endeman, H, Gommers, D, Meuwese, C, Maas, Jacinta, Van Gijlswijk, MJ, Van Berg, RN, Candura, Dario, Van der Linden, Marcel, Kant, Merijin, Van der Heijden, JJ, Scholten, Eric, Van Belle-van Haren, Nicole, Lagrand, WK, Vlaar, Alexander P, De Jong, Syste, Cander, Basar, Sargin, Murat, Ugur, Murat, Kaygin, Mehmet A, Daly, Kathleen, Agnew, Nicola, Head, Laura, Kelly, Laura, Anoma, Gunawardena, Russell, Clare, Aquino, Verna, Scott, Ian, Flemming, Lucy, Gillon, Stuart, Moore, Olivia, Gelandt, Elton, Auzinger, George, Patel, Sameer, and Loveridge, Robert

Published
2023
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16. Stroke outcomes following durable left ventricular assist device implant in patients bridged with micro‐axial flow pump: Insights from a large registry

Author

Gallone, Guglielmo, primary, Lewin, Daniel, additional, Rojas Hernandez, Sebastian, additional, Bernhardt, Alexander, additional, Billion, Michael, additional, Meyer, Anna, additional, Netuka, Ivan, additional, Kooij, J‐J, additional, Pieri, Marina, additional, Szymanski, Mariusz K., additional, Moeller, Christian H., additional, Akhyari, Payam, additional, Jawad, Khalil, additional, Krasivskyi, Ihor, additional, Schmack, Bastian, additional, Färber, Gloria, additional, Medina, Marta, additional, Haneya, Assad, additional, Zimpfer, Daniel, additional, Nersesian, Gaik, additional, Lanmueller, Pia, additional, Spitaleri, Antonio, additional, Oezkur, Mehmet, additional, Djordjevic, Ilija, additional, Saeed, Diyar, additional, Boffini, Massimo, additional, Stein, Julia, additional, Gustafsson, F., additional, Scandroglio, Anna Mara, additional, De Ferrari, Gaetano Maria, additional, Meyns, Bart, additional, Hofmann, Steffen, additional, Belohlavek, Jan, additional, Gummert, Jan, additional, Rinaldi, Mauro, additional, Potapov, Evgenij V., additional, and Loforte, Antonio, additional

Published
2024
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23. Pioglitazone treatment mitigates cardiovascular bioprosthetic degeneration in a chronic kidney disease model.

Author

Shintaro Katahira, Barth, Mareike, Döpp, Robin, Yukiharu Sugimura, Schmidt, Vera, Selig, Jessica Isabel, Yoshikatsu Saiki, Jankowski, Joachim, Marx, Nikolaus, Jahnen-Dechent, Willi, Lichtenberg, Artur, and Akhyari, Payam

Subjects
DISEASE risk factors, SPRAGUE Dawley rats, PPAR-gamma agonists, AORTIC valve diseases, LABORATORY rats, AORTIC valve, ADENINE, PEROXISOME proliferator-activated receptors
Abstract

Aims: Chronic kidney disease (CKD) is a risk factor for the development of cardiovascular diseases, e.g., atherosclerosis and calcific aortic valve disease, leading inevitably to valve replacement surgery. CKD patients with bioprosthetic cardiovascular grafts, in turn, have a higher risk of premature graft degeneration. Peroxisome proliferator-activated receptor gamma (PPARγ) activation by pioglitazone has cardio-renal protective properties, and research using a heterotopic valve implantation model has shown anti-degenerative effects of PPARγ activation on bioprosthetic valved grafts (BVG) in rats. The present work aims to analyze a potential protective effect of pioglitazone treatment on BVG in an adenine-induced rat model of CKD. Methods and Results: BVG of Sprague Dawley rats were heterotopically implanted in Wistar rats in an infrarenal position for 4 and 8 weeks. Animals were distributed into three groups for each time point: 1) control group receiving standard chow, 2) CKD group receiving 0.25% adenine and 3) CKD + pioglitazone group (300 mg per kg of 0.25% adenine chow). BVG function was analyzed by echocardiography. Plasma analytes were determined and explanted grafts were analyzed by semi-quantitative real-time PCR, Western blot analysis, histology and immunohistology. PPARγ activation significantly reduced CKD-induced calcification of aortic and valvular segments of BVG by 44% and 53%, respectively. Pioglitazone treatment significantly also reduced CKD-induced intima hyperplasia by 60%. Plasma analysis revealed significantly attenuated potassium and phosphate levels after pioglitazone treatment. Moreover, PPARγ activation led to significantly decreased interleukin-6 gene expression (by 57%) in BVG compared to CKD animals. Pioglitazone treatment leads to functional improvement of BVG. Conclusion: This study broadens the understanding of the potential value of PPARγ activation in cardio-renal diseases and delineates pioglitazone treatment as a valuable option to prevent bioprosthetic graft failure in CKD. Further mechanistic studies, e.g., using small molecules activating PPARγ signaling pathways, are necessary for the evaluation of involved mechanisms. Additionally, the translation into pre-clinical studies using large animals is intended as the next research project. [ABSTRACT FROM AUTHOR]

Published
2024
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30. Changes in Therapy and Outcome of Patients Requiring Veno-Venous Extracorporeal Membrane Oxygenation for COVID-19.

Author

Immohr, Moritz Benjamin, Hettlich, Vincent Hendrik, Kindgen-Milles, Detlef, Brandenburger, Timo, Feldt, Torsten, Aubin, Hug, Tudorache, Igor, Akhyari, Payam, Lichtenberg, Artur, Dalyanoglu, Hannan, and Boeken, Udo

Subjects
EXTRACORPOREAL membrane oxygenation, ADULT respiratory distress syndrome, COVID-19, HOSPITAL mortality, PATIENT selection
Abstract

Background Coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome requiring veno-venous extracorporeal membrane oxygenation (vv-ECMO) is related with poor outcome, especially in Germany. We aimed to analyze whether changes in vv-ECMO therapy during the pandemic were observed and lead to changes in the outcome of vv-ECMO patients. Methods All patients undergoing vv-ECMO support for COVID-19 between 2020 and 2021 in a single center (n = 75) were retrospectively analyzed. Weaning from vv-ECMO and in-hospital mortality were defined as primary and peri-interventional adverse events as secondary endpoints of the study. Results During the study period, four infective waves were observed in Germany. Patients were assigned correspondingly to four study groups: ECMO implantation between March 2020 and September 2020: first wave (n = 11); October 2020 to February 2021: second wave (n = 23); March 2021 to July 2021: third wave (n = 25); and August 2021 to December 2021: fourth wave (n = 20). Preferred cannulation technique changed within the second wave from femoro-femoral to femoro-jugular access (p < 0.01) and awake ECMO was implemented. Mean ECMO run time increased by more than 300% from 10.9 ± 9.6 (first wave) to 44.9 ± 47.0 days (fourth wave). Weaning of patients was achieved in less than 20% in the first wave but increased to approximately 40% since the second one. Furthermore, we observed a continuous numerically decrease of in-hospital mortality from 81.8 to 57.9% (p = 0.61). Conclusion Preference for femoro-jugular cannulation and awake ECMO combined with preexisting expertise and patient selection are considered to be associated with increased duration of ECMO support and numerically improved ECMO weaning and in-hospital mortality. [ABSTRACT FROM AUTHOR]

Published
2024
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33. Evaluation of risk factors for cytomegalovirus DNAemia after end of regular prophylaxis after heart transplantation

Author

Immohr, Moritz Benjamin, primary, Oehler, Daniel, additional, Jenkins, Freya Sophie, additional, Kalampokas, Nikolas, additional, Hettlich, Vincent Hendrik, additional, Sigetti, Dennis, additional, Voß, Fabian, additional, Dalyanoglu, Hannan, additional, Aubin, Hug, additional, Akhyari, Payam, additional, Lichtenberg, Artur, additional, and Boeken, Udo, additional

Published
2023
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38. Cytokine Hemoadsorption During Cardiac Surgery Versus Standard Surgical Care for Infective Endocarditis (REMOVE): Results From a Multicenter Randomized Controlled Trial

Author

Diab, Mahmoud, Lehmann, Thomas, Bothe, Wolfgang, Akhyari, Payam, Platzer, Stephanie, Wendt, Daniel, Deppe, Antje-Christin, Strauch, Justus, Hagel, Stefan, Günther, Albrecht, Faerber, Gloria, Sponholz, Christoph, Franz, Marcus, Scherag, André, Velichkov, Ilia, Silaschi, Miriam, Fassl, Jens, Hofmann, Britt, Lehmann, Sven, Schramm, Rene, Fritz, Georg, Szabo, Gabor, Wahlers, Thorsten, Matschke, Klaus, Lichtenberg, Artur, Pletz, Mathias W., Gummert, Jan F., Beyersdorf, Friedhelm, Hagl, Christian, Borger, Michael A., Bauer, Michael, Brunkhorst, Frank M., and Doenst, Torsten

Published
2022
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41. Factors Associated with Early Mortality in Acute Type A Aortic Dissection—A Single-Centre Experience.

Author

Doukas, Panagiotis, Dalibor, Nicola, Keszei, András, Frankort, Jelle, Krabbe, Julia, Zayat, Rachad, Jacobs, Michael J., Gombert, Alexander, Akhyari, Payam, and Mehdiani, Arash

Subjects
AORTIC dissection, DISSECTION, AORTIC stenosis, ACUTE kidney failure, HOSPITAL mortality, ATRIAL fibrillation, SURVIVAL rate
Abstract

Background: Acute aortic dissection type A (AADA) is a surgical emergency with relevant mortality and morbidity despite improvements in current management protocols. Identifying patients at risk of a fatal outcome and controlling the factors associated with mortality remain of paramount importance. Methods: In this retrospective observational study, we reviewed the medical records of 117 patients with AADA, who were referred to our centre and operated on between 2005 and 2021. Preoperative, intraoperative, and postoperative variables were analysed and tested for their correlation with in-hospital mortality. Results: The overall survival rate was 83%. Preoperatively, factors associated with mortality were age (p = 0.02), chronic hypertension (p = 0.02), any grade of aortic valve stenosis in the patient's medical history (p = 0.03), atrial fibrillation (p = 0.04), and oral anticoagulation (p = 0.04). Non-survivors had significantly longer operative times (p = 0.002). During the postoperative phase, mortality was strongly associated with acute kidney injury (AKI) (p < 0.001), acute heart failure (p < 0.001), stroke (p = 0.02), focal neurological deficits (p = 0.02), and sepsis (p = 0.001). In the multivariate regression analysis, the onset of postoperative focal neurological deficits was the best predictor of a fatal outcome after adjusting for ARDS (odds ratio: 5.8, 95%-CI: 1.2–41.7, p = 0.04). Conclusions: In this retrospective analysis, atrial fibrillation, oral anticoagulation, hypertension, and age were significantly correlated with mortality. Postoperatively, acute kidney injury, acute heart failure, sepsis, and focal neurological deficits were correlated with in-hospital mortality, and focal neurological deficit has been identified as a significant predictor of fatal outcomes. Early detection and interdisciplinary management of at-risk patients remain crucial throughout the postoperative phase. [ABSTRACT FROM AUTHOR]

Published
2024
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42. Prevalence, mechanisms, and prognostic impact of dynamic mitral regurgitation assessed by isometric handgrip exercise.

Author

Spieker, Maximilian, Lagarden, Hannah, Sidabras, Jonas, Veulemans, Verena, Christian, Lucas, Bejinariu, Alex, Akhyari, Payam, Rana, Obaida, Polzin, Amin, Horn, Patrick, Kelm, Malte, and Westenfeld, Ralf

Subjects
MITRAL valve insufficiency, GRIP strength, EXERCISE tests, ECHOCARDIOGRAPHY, BLOOD pressure, PULMONARY hypertension, PULMONARY artery, DISEASE prevalence, RESEARCH funding, STROKE volume (Cardiac output), LONGITUDINAL method, DISEASE complications
Abstract

Aims The extent of mitral regurgitation (MR) may vary depending on the haemodynamic situation; thus, exercise testing plays an important role in assessing the haemodynamic relevance of MR. We aim to assess prevalence, mechanisms, and prognostic impact of exercise-induced changes in MR in patients with degenerative MR (DegMR) and functional MR (FMR). Methods and results We enrolled 367 patients with at least mild MR who underwent standardized echocardiography at rest and during handgrip exercise. Handgrip exercise led to an increase in MR by one grade or more in 19% of DegMR and 28% of FMR patients. In FMR, patients with exercise-induced increases in MR, handgrip exercise led to a reduction in left ventricular stroke volume index, being maintained in DegMR patients. Exercise-induced changes in systolic pulmonary artery pressure were linked to changes in effective regurgitant orifice area (DegMR: r = 0.456; P < 0.001; FMR: r = 0.326; P < 0.001). Thus, 26% of patients with DegMR and FMR developed pulmonary hypertension during exercise. In both cohorts, a significant proportion of patients with non-severe MR at rest and exercise-induced severe MR underwent mitral valve surgery/intervention during follow-up. In FMR patients (but not in DegMR patients), early mitral valve surgery/intervention was independently associated with lower event rates during follow-up [0.177 (0.027–0.643); P = 0.025]. Conclusions Handgrip exercise echocardiography provides important information regarding the dynamic nature of MR, exercise-induced changes in left ventricular function, and pulmonary circulation with subsequent consequences for further therapeutic decision making. Thus, it should be considered as a diagnostic tool in symptomatic patients with non-severe MR at rest. [ABSTRACT FROM AUTHOR]

Published
2024
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44. Prevalence, mechanisms, and prognostic impact of dynamic mitral regurgitation assessed by isometric handgrip exercise

Author

Spieker, Maximilian, primary, Lagarden, Hannah, additional, Sidabras, Jonas, additional, Veulemans, Verena, additional, Christian, Lucas, additional, Bejinariu, Alex, additional, Akhyari, Payam, additional, Rana, Obaida, additional, Polzin, Amin, additional, Horn, Patrick, additional, Kelm, Malte, additional, and Westenfeld, Ralf, additional

Published
2023
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45. Clinical outcomes of hundred large Impella implantations in cardiogenic shock patients based on individual clinical scenarios

Author

Sugimura, Yukiharu, primary, Bauer, Sebastian, additional, Immohr, Moritz Benjamin, additional, Mehdiani, Arash, additional, Rellecke, Philipp, additional, Tudorache, Igor, additional, Horn, Patrick, additional, Westenfeld, Ralf, additional, Boeken, Udo, additional, Aubin, Hug, additional, Lichtenberg, Artur, additional, and Akhyari, Payam, additional

Published
2023
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46. Early Postoperative Neurologic Events Are Associated With Worse Outcome and Fatal Midterm Survival After Adult Heart Transplantation

Author

Oehler, Daniel, primary, Oehler, Hannah, additional, Sigetti, Dennis, additional, Immohr, Moritz Benjamin, additional, Böttger, Charlotte, additional, Bruno, Raphael Romano, additional, Haschemi, Jafer, additional, Aubin, Hug, additional, Horn, Patrick, additional, Westenfeld, Ralf, additional, Bönner, Florian, additional, Akhyari, Payam, additional, Kelm, Malte, additional, Lichtenberg, Artur, additional, and Boeken, Udo, additional

Published
2023
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