44 results on '"Vase H"'
Search Results
2. Impella CP implantation during cardiopulmonary resuscitation for cardiac arrest: a multicenter experience
- Author
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Panagides, V, primary, Vase, H, additional, Shah, S, additional, Basir, MB, additional, Mancini, J, additional, Kamran, H, additional, Batra, S, additional, Laine, M, additional, Eiskjaer, H, additional, Karami, K, additional, Paganelli, F, additional, Henriques, JP, additional, and Bonello, L, additional
- Published
- 2022
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3. Prevalence of hereditary transthyretin cardiac amyloidosis (mATTR) in Western Denmark
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Rasmussen, T.B, primary, Vase, H, additional, Ladefoged, B, additional, Dybro, A.M, additional, Clemmensen, T, additional, Terkelsen, A.J, additional, Molgaard, H, additional, Petersen, L.N, additional, and Poulsen, S.H, additional
- Published
- 2020
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4. 479Preoperative global longitudinal strain is the best predictor of mortality following transcatheter aortic valve replacement
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Povlsen, J A, primary, Rasmussen, V G, additional, Vase, H, additional, Jensen, K T, additional, Terkelsen, C J, additional, Christiansen, E H, additional, Mathiassen, O N, additional, and Poulsen, S H, additional
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- 2019
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5. P5689Echocardiographic predictors for successful weaning from veno-arterial extracorporeal membrane oxygenation
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Frederiksen, C A, primary, Nielsen, R, additional, Frederiksen, A S, additional, Christensen, S, additional, Greisen, J, additional, Vase, H, additional, Logstrup, B B, additional, Mellemkjaer, S, additional, Wiggers, H, additional, Molgaard, H, additional, Terkelsen, C J, additional, Poulsen, S H, additional, and Eiskjaer, H, additional
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- 2018
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6. Augmentation of Connexin-43 Conductance Reduces Isehemia-Reperfusion Injury and Myocardial Infarct Size
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Pedersen, C, Lang, N, Venkatasubramanian, S, Vase, H, Hyldebrandt, J, Contractor, H, Barnes, C, Schmidt, MR, Botker, H, Cruden, N, Newby, D, and Kharbanda, R
- Published
- 2012
7. CKD pathophysiology and complications
- Author
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Vlahu, C. A., primary, Vogt, L., additional, Struijk, D. G., additional, Vink, H., additional, Krediet, R. T., additional, Kurita, N., additional, Fujii, A., additional, Kotera, N., additional, Tanaka, M., additional, Tanaka, S., additional, Miyairi, T., additional, Sugimoto, T., additional, Mori, M., additional, Fukuhara, S., additional, Mise, N., additional, Pasch, A., additional, Farese, S., additional, Schlieper, G., additional, Floege, J., additional, Uehlinger, D., additional, Jahnen-Dechent, W., additional, Mose, F. H., additional, Vase, H., additional, Larsen, T., additional, Kancir, A. S. P., additional, Kosierkiewicz, R., additional, Jonczy, B., additional, Hansen, A. B., additional, Oczachowska-Kulik, A. E., additional, Thomsen, I. M., additional, Bech, J. N., additional, Pedersen, E. B., additional, Selim, G., additional, Stojceva-Taneva, O., additional, Tozija, L., additional, Georgievska-Ismail, L., additional, Gelev, S., additional, Dzekova-Vidimliski, P., additional, Trajceska, L., additional, Petronievic, Z., additional, and Sikole, A., additional
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- 2013
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8. Hypertension
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Shin, S. J., primary, Rhee, M.-Y., additional, Lim, C., additional, Lavoz, C., additional, Rodrigues-Di;ez, R., additional, Rayego-Mateos, S., additional, Benito-Martin, A., additional, Rodrigues-Diez, R., additional, Alique, M., additional, Ortiz, A., additional, Mezzano, S., additional, Ruiz-Ortega, M., additional, Axelsson, J., additional, Rippe, A., additional, Sverrisson, K., additional, Rippe, B., additional, Calo, L., additional, Dal Maso, L., additional, Pagnin, E., additional, Caielli, P., additional, Spanos, G., additional, Kalaitzidis, R., additional, Karasavvidou, D., additional, Pappas, K., additional, Balafa, O., additional, Siamopoulos, K., additional, Fang, T.-C., additional, Lee, T. J. F., additional, Pappas, E., additional, Ermeidi, E., additional, Tatsioni, A., additional, Blazquez-Medela, A., additional, Garcia-Sanchez, O., additional, Quiros, Y., additional, Lopez-Hernandez, F. J., additional, Lopez-Novoa, J. M., additional, Martinez-Salgado, C., additional, Wu, H.-Y., additional, Peng, Y.-S., additional, Hung, K.-Y., additional, Tsai, T.-J., additional, Tu, Y.-K., additional, Chien, K.-L., additional, Larsen, T., additional, Mose, F. H., additional, Hansen, A. B., additional, Pedersen, E. B., additional, Quiroz, Y., additional, Rivero, M., additional, Yaguas, K., additional, Rodriguez-Iturbe, B., additional, Xydakis, D., additional, Sfakianaki, M., additional, Petra, C., additional, Maragaki, E., additional, Antonaki, E., additional, Krasoudaki, E., additional, Kostakis, K., additional, Stylianou, K., additional, Papadogiannakis, A., additional, Sagliker, Y., additional, Paylar, N., additional, Heidland, A., additional, Keck, A., additional, Erek, R., additional, Kolasin, P., additional, S Ozkaynak, P., additional, Sagliker, H. S., additional, Gokcay, I., additional, Ritz, E., additional, Koleganova, N., additional, Gross-Weissmann, M.-L., additional, Piecha, G., additional, Reinecke, N., additional, Marquez Cunha, T., additional, M . S. Higa, E., additional, Pfeferman Heilberg, I., additional, Neder, J. A., additional, Nishiura, J. L., additional, Silva Almeida, W., additional, Schor, N., additional, Tapia, E., additional, Sanchez-Lozada, L. G., additional, Cristobal, M., additional, Soto, V., additional, Garci;a-Arroyo, F., additional, Monroy-Sanchez, F., additional, Madero, M., additional, Johnson, R., additional, Kim, S. M., additional, Yang, S. H., additional, Kim, Y. S., additional, Karanovic, S., additional, Fistrek, M., additional, Kos, J., additional, Pecin, I., additional, Premuzic, V., additional, Abramovic, M., additional, Matijevic, V., additional, Cvoriscec, D., additional, Cvitkovic, A., additional, Knezevic, M., additional, Bitunjac, M., additional, Laganovic, M., additional, Jelakovic, B., additional, Liu, F., additional, Wu, M., additional, Fu, P., additional, Klok Matthesen, S., additional, Guldager Lauridsen, T., additional, Vase, H., additional, Gjorup Holland, P., additional, Nykjaer, K. M., additional, Nielsen, S., additional, Bjerregaard Pedersen, E., additional, Montero, M. J., additional, Vink, E., additional, Willemien, V., additional, Michiel, V., additional, Wilko, S., additional, Evert-Jan, V., additional, Blankestijn, P., additional, Zerbi, S., additional, Pedrini, L. A., additional, Zbroch, E., additional, Malyszko, J., additional, Koc-Zorawska, E., additional, Mysliwiec, M., additional, Quelhas-Santos, J., additional, Serrao, P., additional, Soares-Silva, I., additional, Tang, L., additional, Sampaio-Maia, B., additional, Desir, G., additional, Pestana, M., additional, Elsurer, R., additional, Demir, T., additional, Celik, G., additional, Yavas, M., additional, Yavas, O., additional, Murphy, M., additional, Jacquillet, G., additional, Unwin, R. J., additional, Chichger, H., additional, Shirley, D. G., additional, Caraba, A., additional, Andreea, M., additional, Corina, S., additional, Ioan, R., additional, Nowicki, M., additional, Bobik, M., additional, Pawelec, A., additional, Lacisz, J., additional, Zapala, A., additional, Bryc, K., additional, Esposito, C., additional, Scaramuzzi, M. L., additional, Manini, A., additional, Torreggiani, M., additional, Beneventi, F., additional, Spinillo, A., additional, Grosjean, F., additional, Fasoli, G., additional, Dal Canton, A., additional, Christos, C., additional, Bernhard M.W., S., additional, Martin, N., additional, Jan, K., additional, Claus, M., additional, Leyla, R., additional, Jan, B., additional, Ulrich, K., additional, Hermann, H., additional, Menne, J., additional, Pavicevic, M., additional, Markovic, S., additional, and Igrutinovic, Z., additional
- Published
- 2012
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9. EFFECT OF POTASSIUM SUPPLEMENTATION ON RENAL TUBULAR FUNCTION, AMBULATORY BLOOD PRESSURE AND PULSE WAVE VELOCITY IN HEALTHY CONTROL SUBJECTS IN A RANDOMIZED, PLACEBO-CONTROLLED, CROSSOVER STUDY
- Author
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Matthesen, S. K., primary, Gjorup, P. H., additional, Larsen, T., additional, Lauridsen, T. G., additional, Nykjaer, K. M., additional, Vase, H., additional, and Pedersen, E. B., additional
- Published
- 2011
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10. Hypertension & hormones
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Jankowski, V., primary, Patzak, A., additional, Herget-Rosenthal, S., additional, Zidek, W., additional, Jankowski, J., additional, Jankowski, V., additional, Toelle, M., additional, van der Giet, M., additional, Bae, E. H., additional, Ma, S. K., additional, Lee, J., additional, Kim, S. W., additional, Jin, K., additional, Kim, H.-j., additional, Vaziri, N. D., additional, Osaki, K., additional, Suzuki, Y., additional, Sugaya, T., additional, Nishiyama, A., additional, Horikoshi, S., additional, Tomino, Y., additional, Matthesen, S. K., additional, Gjoerup, P. H., additional, Larsen, T., additional, Lauridsen, T. G., additional, Nykjaer, K. M., additional, Vase, H., additional, Pedersen, E. B., additional, Kim, Y. W., additional, Fujimori, A., additional, Yuyama, H., additional, Takakura, K., additional, Tahara, A., additional, Koakutsu, A., additional, Sanagi, M., additional, Sudoh, K., additional, Terada, Y., additional, Mizukami, K., additional, Miura, M., additional, Yokoyama, K., additional, Amano, Y., additional, Furukawa, T., additional, Tomura, Y., additional, Uchida, W., additional, Walkowska, A., additional, Kompanowska-Jezierska, E., additional, Sadowki, J., additional, Ozdemir, Z. N., additional, Sener, G., additional, Ozgur, S., additional, Koc, M., additional, Suleymanoglu, S., additional, Yegen, B., additional, Efrati, S., additional, Berman, S., additional, Abu-Hamad, R., additional, Siman-Tov, Y., additional, Weissgarten, J., additional, Hermida, R. C., additional, Ayala, D. E., additional, Mojon, A., additional, Chayan, L., additional, Dominguez, M. J., additional, Fontao, M. J., additional, Alonso, I., additional, Fernandez, J. R., additional, Zanoli, L., additional, Alivon, M., additional, Estrugo, N., additional, Ketthab, H., additional, Pruny, J.-F., additional, Yanes, S., additional, Bean, K., additional, Empana, J.-P., additional, Jouven, X., additional, Laude, R. D., additional, Laurent, S., additional, Boutouyrie, P., additional, Botticelli, I., additional, Quartagno, R., additional, Venturini, M., additional, Salvioni, M., additional, Lanzani, C., additional, Simonini, M., additional, Delli Carpini, S., additional, Zagato, L., additional, Manunta, P., additional, Blazquez-Medela, A. M., additional, Garcia-Ortiz, L., additional, Gomez-Marcos, M. A., additional, Recio-Rodriguez, J. I., additional, Martin-Hinojal, M., additional, Rodriguez-Martin, C., additional, Castano-Sanchez, C., additional, de Cabo-Laso, A., additional, Sanchez-Salgado, B., additional, Lopez-Novoa, J. M., additional, Martinez-Salgado, C., additional, Villevalde, S., additional, Tyukhmenev, E., additional, Klimenko, A., additional, Kobalava, Z., additional, Shin, S. j., additional, Oh, S. W., additional, Rhee, M.-y., additional, Schneider, M., additional, Janka, R., additional, Raff, U., additional, Ritt, M., additional, Ott, C., additional, Uder, M., additional, Schmieder, R., additional, Golan, E., additional, Bernheim, J., additional, Podjarny, E., additional, Ozturk, K., additional, Bulucu, F., additional, Gezer, M., additional, Kilic, S., additional, Steele, A., additional, Rene de Cotret, P., additional, Hubert, M., additional, Leclerc, J.-M., additional, Tran, L., additional, Rigal, R., additional, Christensen, F. H., additional, Bech, J. N., additional, Raju, B., additional, Nirmala, V. R., additional, Vijayalakshmi, J., additional, Kalaiselvi, M., additional, Rekha, K., additional, Paiva, C. E., additional, Leone Aguiar, A. F., additional, Coelho, E. B., additional, Irzyniec, T., additional, Jez, W., additional, Paterno, J. C., additional, Jara, Z. P., additional, Barrinha, F. F., additional, Freire, A. O., additional, Casarini, D. E., additional, Teixeira, V. d. P. C., additional, Kose, E., additional, Can, E., additional, Alparslan, C., additional, Dogan, A., additional, Bal, A., additional, Demir, B. K., additional, Anil, M., additional, Anil, A. B., additional, Yavascan, O., additional, Aksu, N., additional, Prusek, J., additional, Szypula, M., additional, Grun, O., additional, Jeken, J., additional, Cremers, B., additional, Steimle, C., additional, Kersting, S., additional, Fliser, D., additional, Heine, G., additional, Pillar, R., additional, Lopes, M. G. G., additional, Cuppari, L., additional, Carvalho, A. B., additional, Canziani, M. E. F., additional, Lipkowska, K., additional, Blumczynski, A., additional, Soltysiak, J., additional, Silska, M., additional, Poprawska, A., additional, Musielak, A., additional, Zaniew, M., additional, Zachwieja, J., additional, Labrador, P. J., additional, and Gonzalez Castillo, P. M., additional
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- 2011
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11. Protein-enriched diet increases water absorption via the aquaporin-2 water channels in healthy humans
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Lauridsen, T. G., primary, Vase, H., additional, Starklint, J., additional, Bech, J. N., additional, and Pedersen, E. B., additional
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- 2010
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12. Effect of potassium supplementation on renal tubular function, ambulatory blood pressure and pulse wave velocity in healthy humans.
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Matthesen SK, Larsen T, Vase H, Lauridsen TG, and Pedersen EB
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- 2012
13. Catheter-based renal denervation for treatment of resistant hypertension
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Vase H, On, Mathiassen, Kaltoft A, Eb, Pedersen, Kl, Christensen, Nh, Buus, Lederballe O, Jf, Lassen, Hans Erik Bøtker, and Thuesen L
14. Kateterbaseret renal denervering til behandlingsresistent hypertension
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Vase, H., Mathiassen, O. N., Kaltoft, A., Pedersen, E. B., Christensen, K. L., Buus, N. H., Lederballe, O., Jens Flensted Lassen, Bøtker, H. E., and Thuesen, L.
15. Catheter-based renal denervation for treatment of resistant hypertension
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Vase, H., Mathiassen, O. N., Kaltoft, A., Pedersen, E. B., Christensen, K. L., Buus, N. H., Lederballe, O., Jens Flensted Lassen, Bøtker, H. E., and Thuesen, L.
16. Abnormal increase in urinary aquaporin-2 excretion in response to hypertonic saline in essential hypertension
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Graffe Carolina, Bech Jesper, Lauridsen Thomas, Vase Henrik, and Pedersen Erling
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Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background Dysregulation of the expression/shuttling of the aquaporin-2 water channel (AQP2) and the epithelial sodium channel (ENaC) in renal collecting duct principal cells has been found in animal models of hypertension. We tested whether a similar dysregulation exists in essential hypertension. Methods We measured urinary excretion of AQP2 and ENaC β-subunit corrected for creatinine (u-AQP2CR, u-ENaCβ-CR), prostaglandin E2 (u-PGE2) and cyclic AMP (u-cAMP), fractional sodium excretion (FENa), free water clearance (CH2O), as well as plasma concentrations of vasopressin (AVP), renin (PRC), angiotensin II (Ang II), aldosterone (Aldo), and atrial and brain natriuretic peptide (ANP, BNP) in 21 patients with essential hypertension and 20 normotensive controls during 24-h urine collection (baseline), and after hypertonic saline infusion on a 4-day high sodium (HS) diet (300 mmol sodium/day) and a 4-day low sodium (LS) diet (30 mmol sodium/day). Results At baseline, no differences in u-AQP2CR or u-ENaCβ-CR were measured between patients and controls. U-AQP2CR increased significantly more after saline in patients than controls, whereas u-ENaCβ-CR increased similarly. The saline caused exaggerated natriuretic increases in patients during HS intake. Neither baseline levels of u-PGE2, u-cAMP, AVP, PRC, Ang II, Aldo, ANP, and BNP nor changes after saline could explain the abnormal u-AQP2CR response. Conclusions No differences were found in u-AQP2CR and u-ENaCβ-CR between patients and controls at baseline. However, in response to saline, u-AQP2CR was abnormally increased in patients, whereas the u-ENaCβ-CR response was normal. The mechanism behind the abnormal AQP2 regulation is not clarified, but it does not seem to be AVP-dependent. Clinicaltrial.gov identifier NCT00345124.
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- 2012
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17. Increased renal sodium absorption by inhibition of prostaglandin synthesis during fasting in healthy man. A possible role of the epithelial sodium channels
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Graffe Carolina C, Starklint Jørn, Vase Henrik, Lauridsen Thomas G, Bech Jesper N, Nielsen Søren, and Pedersen Erling B
- Subjects
Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background Treatment with prostaglandin inhibitors can reduce renal function and impair renal water and sodium excretion. We tested the hypotheses that a reduction in prostaglandin synthesis by ibuprofen treatment during fasting decreased renal water and sodium excretion by increased absorption of water and sodium via the aquaporin2 water channels and the epithelial sodium channels. Methods The effect of ibuprofen, 600 mg thrice daily, was measured during fasting in a randomized, placebo-controlled, double-blinded crossover study of 17 healthy humans. The subjects received a standardized diet on day 1, fasted at day 2, and received an IV infusion of 3% NaCl on day 3. The effect variables were urinary excretions of aquaporin2 (u-AQP2), the beta-fraction of the epithelial sodium channel (u-ENaCbeta), cyclic-AMP (u-cAMP), prostaglandin E2 (u-PGE2). Free water clearance (CH2O), fractional excretion of sodium (FENa), and plasma concentrations of vasopressin, angiotensin II, aldosterone, atrial-, and brain natriuretic peptide. Results Ibuprofen decreased u-AQP2, u-PGE2, and FENa at all parts of the study. During the same time, ibuprofen significantly increased u-ENaCbeta. Ibuprofen did not change the response in p-AVP, u-c-AMP, urinary output, and free water clearance during any of these periods. Atrial-and brain natriuretic peptide were higher. Conclusion During inhibition of prostaglandin synthesis, urinary sodium excretion decreased in parallel with an increase in sodium absorption and increase in u-ENaCbeta. U-AQP2 decreased indicating that water transport via AQP2 fell. The vasopressin-c-AMP-axis did not mediate this effect, but it may be a consequence of the changes in the natriuretic peptide system and/or the angiotensin-aldosterone system Trial Registration Clinical Trials Identifier: NCT00281762
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- 2010
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18. Exploring the Noninvasive Evaluation of the Pulmonary Pressure-Flow Relationship During Exercise.
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Andersen MJ, Vase H, and Simon MA
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- Humans, Exercise Test, Pulmonary Circulation physiology, Pulmonary Artery physiopathology, Pulmonary Artery diagnostic imaging, Exercise physiology
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- 2024
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19. Challenges in Noninvasive Cardiac Output Assessment During Exercise.
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Andersen MJ, Møller JE, Vase H, Ersbøll MK, and Poulsen SH
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- Humans, Cardiac Output, Exercise Test, Exercise, Heart
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- 2024
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20. Comparison of chitosan and SLN nano-delivery systems for antibacterial effect of tea tree (Melaleuca alternifolia) oil against P. aeruginosa and S. aureus.
- Author
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Vase H, Nemattalab M, Rohani M, and Hesari Z
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- Staphylococcus aureus, Pseudomonas aeruginosa, Trees, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents chemistry, Microbial Sensitivity Tests, Tea, Methicillin-Resistant Staphylococcus aureus, Melaleuca chemistry, Chitosan pharmacology, Tea Tree Oil pharmacology, Tea Tree Oil chemistry, Anti-Infective Agents pharmacology, Nanoparticles chemistry, Bacterial Infections
- Abstract
Treatment of wounds is challenging due to bacterial infections, including Staphylococcus aureus and Pseudomonas aeruginosa. Using the merits of alternative antimicrobials like tea tree oil (TTO) and nanotechnology, they can be helpful in combatting bacterial infections. Solid lipid nanoparticle (SLN) and chitosan (CS) nanoparticles show great potential as carriers for enhancing the stability and therapeutic benefits of oils. The aim of this study is to compare the influence of nanocarriers in enhancing the antibacterial effects of TTO. The study evaluates the physicochemical and antibacterial properties of TTO-SLN and TTO-CS against P. aeruginosa and S. aureus. The TTO-SLN nanoparticles showed a clear round shape with the average diameter size of 477 nm, while the TTO-CS nanoparticles illustrated very homogeneous morphology with 144 nm size. The encapsulation efficiency for TTO-CS and TTO-SLN was ∼88.3% and 73.5%, respectively. Minimum inhibitory concentration against S. aureus and P. aeruginosa for TTO-CS, TTO-SLN, and pure TTO were 35 and 45 µg ml-1, 130 and 170 µg ml-1, and 380 and 410 µg ml-1, respectively. Since TTO-CS revealed an impressively higher antimicrobial effects in comparison with TTO-SLN and TTO alone, it can be considered as a nanocarrier that produces the same antimicrobial effects with lower required amounts of the active substance., (© The Author(s) 2023. Published by Oxford University Press on behalf of Applied Microbiology International.)
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- 2023
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21. Prognostic implications of residual left ventricular hypertrophy and systolic dysfunction in aortic stenosis following transcatheter aortic valve replacement.
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Pedersen ALD, Povlsen JA, Rasmussen VG, Frederiksen CA, Christiansen EH, Terkelsen CJ, Vase H, and Poulsen SH
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- Humans, Hypertrophy, Left Ventricular diagnostic imaging, Hypertrophy, Left Ventricular etiology, Prognosis, Predictive Value of Tests, Ventricular Function, Left, Aortic Valve diagnostic imaging, Aortic Valve surgery, Treatment Outcome, Severity of Illness Index, Transcatheter Aortic Valve Replacement adverse effects, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Aortic Valve Stenosis complications
- Abstract
The impact of left ventricle (LV) hypertrophy (LVH) regression on contractility-associated measures, the extent of residual cardiac dysfunction and prognostic implications after the initial remodeling process after transcatheter aortic valve replacement (TAVR) has not been investigated. We aimed to assess whether greater LV mass regression from pre-TAVR to 12-months after TAVR was associated with increased systolic function; and assess the prognostic value of residual LVH, systolic function and contractility-associated measures 12-months after TAVR. A total of 439 symptomatic patients were included and examined by echocardiography. LVH regression was assessed as percentage change in LV mass index (LVMi) from baseline to 12-months after TAVR. Midwall fractional shortening (mFS) and stress-corrected (SC-mFS) were used as contractility-associated measures. Primary outcome was all-cause mortality. SC-mFS increased from 0.94 (0.7) at baseline (BS) to 1.22 (0.7) (p < 0.05) 12-months after TAVR for patients with the most LVH regression, compared to patients with no LV regression (BS 1.06 (0.7) to 1.04 (0.5), NS). At 12-months after TAVR, multivariate analysis showed independent prognostic value of LVEF < 50% or GLS < 15% (HR 1.59, p = 0.049) and mFS < 14% (HR 1.99, p = 0.002) for future all cause death. LVH regression in AS after TAVR is associated with significant improvements of LV systolic function in contrast to patients without LV regression. Residual LVH and subsequent LV systolic dysfunction is substantial 12 months after TAVR and are associated with reduced survival. Impaired mFS and the combination of abnormal LVEF or GLS independently predicted all-cause mortality beyond 12 months after TAVR., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)
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- 2023
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22. A systematic approach to weaning from extracorporeal membrane oxygenation in patients with refractory cardiac failure.
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Mørk SR, Frederiksen CA, Nielsen RR, Lichscheidt E, Christensen S, Greisen JR, Tang M, Vase H, Løgstrup BB, Mellemkjaer S, Wiggers HS, Mølgaard H, Poulsen SH, Terkelsen CJ, and Eiskjaer H
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- Echocardiography, Hemodynamics, Humans, Retrospective Studies, Extracorporeal Membrane Oxygenation, Heart Failure therapy
- Abstract
Background: Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is commonly used to provide haemodynamic support for patients with severe cardiac failure. However, timing ECMO weaning remains challenging. We aimed to examine if an integrative weaning approach based on predefined haemodynamic, respiratory and echocardiographic criteria is associated with successful weaning., Methods: All patients weaned from ECMO between April 2017 and April 2019 at Aarhus University Hospital, Denmark, were consecutively enrolled. Predefined haemodynamic, respiratory and echocardiographic criteria were assessed before and during ECMO flow reduction. A weaning attempt was commenced in haemodynamic stable patients and patients remaining stable at minimal flow were weaned from ECMO. Comparisons were made between patients who met the criteria for weaning at first attempt and patients who did not meet these criteria. Patients completing a full weaning attempt with no further need for mechanical support within 24 h were defined as successfully weaned., Results: A total of 38 patients were included in the study, of whom 26 (68%) patients met the criteria for weaning. Among these patients, 25 (96%) could be successfully weaned. Successfully weaned patients were younger and had less need for inotropic support and ECMO duration was shorter. Fulfilling the weaning criteria was associated with successful weaning and both favourable 30-d survival and survival to discharge., Conclusion: An integrative weaning approach based on haemodynamic, respiratory and echocardiographic criteria may strengthen the clinical decision process in predicting successful weaning in patients receiving ECMO for refractory cardiac failure., (© 2021 Acta Anaesthesiologica Scandinavica Foundation.)
- Published
- 2021
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23. Impella CP Implantation during Cardiopulmonary Resuscitation for Cardiac Arrest: A Multicenter Experience.
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Panagides V, Vase H, Shah SP, Basir MB, Mancini J, Kamran H, Batra S, Laine M, Eiskjær H, Christensen S, Karami M, Paganelli F, Henriques JPS, and Bonello L
- Abstract
Background: Impella CP is a left ventricular pump which may serve as a circulatory support during cardiopulmonary resuscitation (CPR) for cardiac arrest (CA). Nevertheless, the survival rate and factors associated with survival in patients undergoing Impella insertion during CPR for CA are unknown., Methods: We performed a retrospective multicenter international registry of patients undergoing Impella insertion during on-going CPR for in- or out-of-hospital CA. We recorded immediate and 30-day survival with and without neurologic impairment using the cerebral performance category score and evaluated the factors associated with survival., Results: Thirty-five patients had an Impella CP implanted during CPR for CA. Refractory ventricular arrhythmias were the most frequent initial rhythm (65.7%). In total, 65.7% of patients immediately survived. At 30 days, 45.7% of patients were still alive. The 30-day survival rate without neurological impairment was 37.1%. In univariate analysis, survival was associated with both an age < 75 years and a time from arrest to CPR ≤ 5 min ( p = 0.035 and p = 0.008, respectively)., Conclusions: In our multicenter registry, Impella CP insertion during ongoing CPR for CA was associated with a 37.1% rate of 30-day survival without neurological impairment. The factors associated with survival were a young age and a time from arrest to CPR ≤ 5 min.
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- 2021
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24. Distribution and prognostic value of left ventricular global longitudinal strain in elderly patients with symptomatic severe aortic stenosis undergoing transcatheter aortic valve replacement.
- Author
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Povlsen JA, Rasmussen VG, Vase H, Jensen KT, Terkelsen CJ, Christiansen EH, Tang M, Pedersen ALD, and Poulsen SH
- Subjects
- Age Factors, Aged, Aged, 80 and over, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis mortality, Aortic Valve Stenosis physiopathology, Denmark, Female, Humans, Male, Prevalence, Recovery of Function, Retrospective Studies, Risk Assessment, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Dysfunction, Left mortality, Aortic Valve Stenosis surgery, Stroke Volume, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement mortality, Ventricular Dysfunction, Left physiopathology, Ventricular Function, Left
- Abstract
Aims: The aim of present study was to examine the preoperative prevalence and distribution of impaired left ventricular global longitudinal strain (LVGLS) in elderly patients with symptomatic aortic stenosis (AS) undergoing transcutaneous aortic valve replacement (TAVR) and to determine the predictive value of LVGLS on survival., Methods: We included 411 patients with symptomatic severe AS treated with TAVR during a 5-year period, where a baseline echocardiography including LVGLS assessment was available., Results: Mean age was 80.1 ± 7.1 years and aortic valve area (AVA) index 0.4 ± 0.1 cm
2 . 78 patients died during a median follow-up of 762 days. Mean left ventricular ejection fraction (LVEF) was 50 ± 13% and mean LVGLS was - 14.0%. LVEF was preserved in 60% of patients, while impaired LVGLS > - 18% was seen in 75% of the patients. Previous myocardial infarction, LVEF < 50%, LVGLS > - 14%, low gradient AS (< 4.0 m/s), tricuspid regurgitant gradient > 30 mmHg were identified as significant univariate predictors of all-cause mortality. On multivariate analysis LVGLS > - 14% (HR 1.79 [1.02-3.14], p = 0.04) was identified as the only independent variable associated with all-cause mortality. Reduced survival was observed with an impaired LVGLS > - 14% in the total population (p < 0.002) but also in patients with high AS gradient with preserved LVEF. LVGLS provided incremental prognostic value with respect to clinical characteristics, AVA and LVEF (χ2 19.9, p = 0.006)., Conclusions: In patients with symptomatic AS undergoing TAVR, impaired LVGLS was highly prevalent despite preserved LVEF. LVGLS > - 14% was an independent predictor of all-cause mortality, and survival was reduced if LVGLS > - 14%.- Published
- 2020
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25. Direct Oral Anticoagulants After Percutaneous Patent Foramen Ovale (PFO) Closure: A Call for Caution.
- Author
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Bovin A, Vase H, Nielsen-Kudsk JE, and Grove EL
- Subjects
- Echocardiography, Female, Humans, Middle Aged, Factor Xa Inhibitors therapeutic use, Foramen Ovale, Patent surgery, Rivaroxaban therapeutic use, Septal Occluder Device, Thrombosis diagnostic imaging
- Abstract
BACKGROUND Transient atrial fibrillation (AF) following percutaneous patent foramen ovale (PFO) closure is common. Anticoagulation therapy should be considered in selected cases of prolonged AF after PFO closure, but guidelines do not provide clear recommendations on indication or choice of anticoagulant therapy for patients with post-procedural AF. CASE REPORT A 45-year-old woman presented with cryptogenic stroke verified by magnetic resonance imaging (MRI). Echocardiography revealed a PFO, which was closed percutaneously using a Gore septal occluder (25 mm). She was discharged on aspirin monotherapy (75 mg oral daily) according to institutional standard. Three weeks later, she presented with atrial fibrillation (AF). A direct oral anticoagulant (DOAC) (rivaroxaban 20 mg once daily) was initiated and aspirin was discontinued. After 4 months of follow-up, a routine echocardiography revealed large thrombi attached to both sides of the PFO occluder. CONCLUSIONS DOACs may be ineffective in preventing thrombus formation on device surfaces. Until more evidence has been provided, we suggest that DOACs are not routinely used for stroke prevention in patients following PFO closure or similar procedures within the first 3 months after device implantation.
- Published
- 2020
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26. Diagnostic delay in wild type transthyretin cardiac amyloidosis - A clinical challenge.
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Ladefoged B, Dybro A, Povlsen JA, Vase H, Clemmensen TS, and Poulsen SH
- Subjects
- Delayed Diagnosis, Echocardiography, Heart Ventricles, Humans, Prealbumin, Amyloid Neuropathies, Familial diagnostic imaging, Cardiomyopathies diagnostic imaging
- Abstract
Aim: To determine the diagnostic delay in patients with wild-type transthyretin cardiac amyloiodosis (ATTRwt). To determine the clinical and echocardiogtraphic characteristics of patients with an early and a late diagnosis and to study the suspected diagnoses and identification of diagnostic "red flags" before the ATTRwt diagnosis was established., Methods: In 50 consecutive patients with ATTRwt diagnosed from 2017 to 2019, clinical and echocardiographic patient characteristics were investigated based on electronic patient charts and echocardiographic database review at Aarhus University Hospital, Denmark., Results: The median diagnostic delay was 13 months (2-47 months) and a diagnostic delay above 3 months was associated with more advanced symptoms and left ventricular (LV) diastolic dysfunction at the time of the diagnosis. Thirty patients (60%) were investigated for at least two non-ATTRwt diagnoses during the time period from the first cardiac examination to the time of the confirmed diagnosis. ATTR red flags were significantly less used in patients with the longest diagnostic delay (p < 0.001). Abormal LV global longitudinal strain (LV-GLS < 18%) and apical sparring ratio (APSR ≥ 1.5) were present in 96% and 94% of the ATTRwt patients, respectively., Conclusion: The diagnostic delay in ATTRwt was substantial and a prolonged diagnostic delay was associated with more advanced symptoms and LV diastolic dysfunction at the time of the diagnosis. Established ATTR red flags are poorly utilized in the diagnostic process. Echocardiographic analysis of LV-GLS and APSR contributes significantly to the evaluation of LV myocardial performance and helps raise the suspicion of ATTRwt., (Copyright © 2020 Elsevier B.V. All rights reserved.)
- Published
- 2020
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27. Effects of renal denervation on coronary flow reserve and forearm dilation capacity in patients with treatment-resistant hypertension. A randomized, double-blinded, sham-controlled clinical trial.
- Author
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Engholm M, Bertelsen JB, Mathiassen ON, Bøtker HE, Vase H, Peters CD, Bech JN, Buus NH, Schroeder AP, Rickers H, Hansen KW, Poulsen PL, Kaltoft A, and Christensen KL
- Subjects
- Adult, Aged, Double-Blind Method, Female, Follow-Up Studies, Humans, Hypertension diagnostic imaging, Hypertension physiopathology, Kidney physiopathology, Male, Middle Aged, Treatment Outcome, Forearm blood supply, Fractional Flow Reserve, Myocardial physiology, Hypertension surgery, Kidney innervation, Sympathectomy trends, Vasodilation physiology
- Abstract
Background: Microvascular impairment is well documented in hypertension. We investigated the effect of renal sympathetic denervation (RDN) on cardiac and peripheral microvasculature in patients with treatment-resistant essential hypertension (TRH)., Methods: A randomized, single centre, double-blinded, sham-controlled clinical trial. Fifty-eight patients with TRH (ambulatory systolic BP (ASBP) ≥ 145mmHg) despite stable treatment were randomized to RDN or SHAM. RDN was performed with the unipolar Medtronic Flex catheter. Coronary flow reserve (CFR) and coronary- and forearm minimum vascular resistance (C-Rmin and F-Rmin) were determined using transthoracic Doppler echocardiography and F-Rmin with venous occlusion plethysmography at baseline and at six-months follow-up., Results: RDN was performed with 5.3±0.2 lesions in the right renal artery and 5.4±0.2 lesions in the left. Baseline ASBP was 152±2mmHg (RDN, n=29) and 154±2mmHg (SHAM, n=29). Similar reductions in MAP were seen at follow up (-3.5±2.0 vs. -3.2±1.8, P=0.92). Baseline CFR was 2.9±0.1 (RDN) and 2.4±0.1 (SHAM), with no significant change at follow-up (0.2±0.2 vs. -0.1±0.2, P=0.57). C-Rmin was 1.9±0.3 (RDN) and 2.7±0.6 (SHAM) (mmHgmin/ml pr. 100g) and did not change significantly (0.3±0.5 vs. -0.4±0.8, P=0.48). F-Rmin was 3.6±0.2 (RDN) and 3.6±0.3 (SHAM) (mmHgmin/ml pr. 100ml tissue) and unchanged at follow-up (4.2±0.4 vs. 3.8±0.2, P=0.17). Left ventricular mass index was unchanged following RDN (-4±7 (RDN) vs. 3±5 (SHAM) (g/m
2 ) P=0.38)., Conclusion: The current study does not support positive effects of RDN on microvascular impairment in TRH., (Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.)- Published
- 2018
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28. The effect of renal denervation on arterial stiffness, central blood pressure and heart rate variability in treatment resistant essential hypertension: a substudy of a randomized sham-controlled double-blinded trial (the ReSET trial).
- Author
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Peters CD, Mathiassen ON, Vase H, Bech Nørgaard J, Christensen KL, Schroeder AP, Rickers HJVH, Opstrup UK, Poulsen PL, Langfeldt S, Andersen G, Hansen KW, Bøtker HE, Engholm M, Bertelsen JB, Pedersen EB, Kaltoft A, and Buus NH
- Subjects
- Double-Blind Method, Essential Hypertension therapy, Female, Humans, Kidney innervation, Male, Middle Aged, Pulse Wave Analysis, Blood Pressure, Denervation methods, Essential Hypertension physiopathology, Essential Hypertension surgery, Heart Rate, Kidney surgery, Vascular Stiffness
- Abstract
Objectives: To investigate, whether renal denervation (RDN) improves arterial stiffness, central blood pressure (C-BP) and heart rate variability (HRV) in patients with treatment resistant hypertension., Methods: ReSET was a randomized, sham-controlled, double-blinded trial (NCT01459900). RDN was performed by a single experienced operator using the Medtronic unipolar Symplicity Flex
TM catheter. C-BP, carotid-femoral pulse wave velocity (PWV), and HRV were obtained at baseline and after six months with the SphygmoCor® -device., Results: Fifty-three patients (77% of the ReSET-cohort) were included in this substudy. The groups were similar at baseline (SHAM/RDN): n = 27/n = 26; 78/65% males; age 59 ± 9/54 ± 8 years (mean ± SD); systolic brachial BP 158 ± 18/154 ± 17 mmHg; systolic 24-hour ambulatory BP 153 ± 14/151 ± 13 mmHg. Changes in PWV (0.1 ± 1.9 (SHAM) vs. -0.6 ± 1.3 (RDN) m/s), systolic C-BP (-2 ± 17 (SHAM) vs. -8 ± 16 (RDN) mmHg), diastolic C-BP (-2 ± 9 (SHAM) vs. -5 ± 9 (RDN) mmHg), and augmentation index (0.7 ± 7.0 (SHAM) vs. 1.0 ± 7.4 (RDN) %) were not significantly different after six months. Changes in HRV-parameters were also not significantly different. Baseline HRV or PWV did not predict BP-response after RDN., Conclusions: In a sham-controlled setting, there were no significant effects of RDN on arterial stiffness, C-BP and HRV. Thus, the idea of BP-independent effects of RDN on large arteries and cardiac autonomic activity is not supported.- Published
- 2017
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29. The Impella CP device for acute mechanical circulatory support in refractory cardiac arrest.
- Author
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Vase H, Christensen S, Christiansen A, Therkelsen CJ, Christiansen EH, Eiskjær H, and Poulsen SH
- Subjects
- Advanced Cardiac Life Support, Aged, Cardiac Catheters, Heart Arrest mortality, Humans, Male, Middle Aged, Assisted Circulation instrumentation, Heart Arrest therapy, Heart-Assist Devices
- Abstract
Introduction: Mechanical circulatory support may be considered as a therapeutic option in selected patients with refractory cardiac arrest (rCA). Animal studies suggest a potential role for the Impella
® left ventricular assist device in this setting, but so far no human data have been published., Methods: Eight patients with rCA were treated with the Impella CP® device at our institution from November 2014 to October 2015. The Impella CP® was used at the discretion of the treating physicians in patients with rCA and pulseless electrical activity with presumed primary left ventricular failure. These patients were compared to 12 patients with cardiogenic shock also treated with the Impella device during the same period., Results: All cardiac arrests were witnessed with a no-flow time of 0min, six in-hospital and two out-of-hospital. Low-flow time was 50±52min (SD). The Impella device was successfully inserted in all patients with rCA and circulation was re-established. Survival rate to hospital discharge with good neurological outcome was similar among patients with rCA and cardiogenic shock treated with the Impella device (50% vs. 58%). Major vascular complications after Impella insertion occurred more frequently among patients with rCA compared to patients with cardiogenic shock (50% vs. 0%, P<0.05)., Conclusion: Mechanical support with the Impella CP® device is a feasible and promising treatment option for selected patients with rCA. Further studies are warranted to determine the full potential and optimal patient selection compared to other modalities of mechanical circulatory support., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)- Published
- 2017
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30. Effects of Renal Denervation on Insulin Sensitivity and Inflammatory Markers in Nondiabetic Patients with Treatment-Resistant Hypertension.
- Author
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Kampmann U, Mathiassen ON, Christensen KL, Buus NH, Bjerre M, Vase H, Møller N, Kaltoft A, and Poulsen PL
- Subjects
- Adult, Aged, Antihypertensive Agents therapeutic use, Biomarkers blood, Drug Resistance, Female, Glycated Hemoglobin metabolism, Humans, Hypertension diagnosis, Hypertension physiopathology, Male, Middle Aged, Sympathectomy adverse effects, Time Factors, Treatment Outcome, Blood Glucose metabolism, Blood Pressure drug effects, Catheter Ablation adverse effects, Hypertension surgery, Inflammation Mediators blood, Insulin blood, Insulin Resistance, Kidney blood supply, Renal Artery innervation, Sympathectomy methods
- Abstract
Increased sympathetic activity is important in the pathogenesis of hypertension and insulin resistance. Afferent signaling from the kidneys elevates the central sympathetic drive. We investigated the effect of catheter-based renal sympathetic denervation (RDN) on glucose metabolism, inflammatory markers, and blood pressure in nondiabetic patients with treatment-resistant hypertension. Eight subjects were included in an open-labelled study. Each patient was studied before and 6 months after RDN. Endogenous glucose production was assessed by a 3-
3 H glucose tracer, insulin sensitivity was examined by hyperinsulinemic euglycemic clamp, hormones and inflammatory markers were analyzed, and blood pressure was measured by office blood pressure readings and 24-hour ambulatory blood pressure monitoring. Insulin sensitivity ( M -value) increased nonsignificantly from 2.68 ± 0.28 to 3.07 ± 0.41 ( p = 0.12). A significant inverse correlation between the increase in M -value and BMI 6 months after RDN ( p = 0.03) was found, suggesting beneficial effects on leaner subjects. Blood pressure decreased significantly, but there were no changes in hormones, inflammatory markers, or endogenous glucose production. Our results indicate that RDN may improve insulin sensitivity in some patients with treatment-resistant hypertension, albeit confirmation of these indications of beneficial effects on leaner subjects awaits the outcome of larger randomized controlled studies.- Published
- 2017
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31. Renal denervation in treatment-resistant essential hypertension. A randomized, SHAM-controlled, double-blinded 24-h blood pressure-based trial.
- Author
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Mathiassen ON, Vase H, Bech JN, Christensen KL, Buus NH, Schroeder AP, Lederballe O, Rickers H, Kampmann U, Poulsen PL, Hansen KW, Btker HE, Peters CD, Engholm M, Bertelsen JB, Lassen JF, Langfeldt S, Andersen G, Pedersen EB, and Kaltoft A
- Subjects
- Aged, Antihypertensive Agents therapeutic use, Blood Pressure Monitoring, Ambulatory, Catheter Ablation methods, Coronary Vasospasm drug therapy, Double-Blind Method, Essential Hypertension, Female, Humans, Hypertension drug therapy, Male, Middle Aged, Blood Pressure, Coronary Vasospasm surgery, Hypertension surgery, Kidney innervation, Sympathectomy methods
- Abstract
Background: Renal denervation (RDN), treating resistant hypertension, has, in open trial design, been shown to lower blood pressure (BP) dramatically, but this was primarily with respect to office BP., Method: We conducted a SHAM-controlled, double-blind, randomized, single-center trial to establish efficacy data based on 24-h ambulatory BP measurements (ABPM). Inclusion criteria were daytime systolic ABPM at least 145 mmHg following 1 month of stable medication and 2 weeks of compliance registration. All RDN procedures were carried out by an experienced operator using the unipolar Medtronic Flex catheter (Medtronic, Santa Rosa, California, USA)., Results: We randomized 69 patients with treatment-resistant hypertension to RDN (n = 36) or SHAM (n = 33). Groups were well balanced at baseline. Mean baseline daytime systolic ABPM was 159 ± 12 mmHg (RDN) and 159 ± 14 mmHg (SHAM). Groups had similar reductions in daytime systolic ABPM compared with baseline at 3 months [-6.2 ± 18.8 mmHg (RDN) vs. -6.0 ± 13.5 mmHg (SHAM)] and at 6 months [-6.1 ± 18.9 mmHg (RDN) vs. -4.3 ± 15.1 mmHg (SHAM)]. Mean usage of antihypertensive medication (daily defined doses) at 3 months was equal [6.8 ± 2.7 (RDN) vs. 7.0 ± 2.5 (SHAM)].RDN performed at a single center and by a high-volume operator reduced ABPM to the same level as SHAM treatment and thus confirms the result of the HTN3 trial., Conclusion: Further, clinical use of RDN for treatment of resistant hypertension should await positive results from double-blinded, SHAM-controlled trials with multipolar ablation catheters or novel denervation techniques.
- Published
- 2016
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32. Rotigaptide protects the myocardium and arterial vasculature from ischaemia reperfusion injury.
- Author
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Pedersen CM, Venkatasubramanian S, Vase H, Hyldebrandt JA, Contractor H, Schmidt MR, Bøtker HE, Cruden NL, Newby DE, Kharbanda RK, and Lang NN
- Subjects
- Acetylcholine pharmacology, Animals, Double-Blind Method, Endothelium, Vascular drug effects, Heart drug effects, Hemodynamics drug effects, Humans, Myocardial Infarction pathology, Nitroprusside pharmacology, Protective Agents pharmacology, Protective Agents therapeutic use, Swine, Vasodilation drug effects, Myocardial Infarction drug therapy, Oligopeptides pharmacology, Oligopeptides therapeutic use, Reperfusion Injury prevention & control
- Abstract
Aim: Ischaemia-reperfusion injury (IRI) causes impaired endothelial function and is a major component of the adverse effects of reperfusion following myocardial infarction. Rotigaptide increases gap junction conductance via connexin-43. We tested the hypothesis that rotigaptide reduces experimental myocardial infarction size and ameliorates endothelial IRI in humans., Methods: Myocardial infarction study: porcine myocardial infarction was achieved by catheter-induced occlusion of the left anterior descending artery. In a randomized double-blind study, rotigaptide (n = 9) or placebo (n = 10) was administered intravenously as a 10 min bolus prior to reperfusion and continuously during 2 h of reperfusion. Myocardial infarction size (IS) was assessed as proportion of the area at risk (AAR). Human translational study: forearm IRI was induced in the presence or absence of intra-arterial rotigaptide. In a randomized double-blind study, forearm arterial blood flow was measured at rest and during intra-arterial infusion of acetylcholine (5-20 μg min(-1) ; n = 11) or sodium nitroprusside (2-8 mg min(-1) ; n = 10) before and after intra-arterial infusion of placebo or rotigaptide, and again following IRI., Results: Myocardial infarction study: Rotigaptide treatment was associated with a reduction of infarct size (IS/AAR[%]: 18.7 ± 4.1 [rotigaptide] vs. 43.6 ± 4.2 [placebo], P = 0.006). Human translational study: Endothelium-dependent vasodilatation to acetylcholine was attenuated after ischaemia-reperfusion in the presence of placebo (P = 0.007), but not in the presence of rotigaptide (P = NS). Endothelium-independent vasodilatation evoked by sodium nitroprusside was unaffected by IRI or rotigaptide (P = NS)., Conclusions: Rotigaptide reduces myocardial infarction size in a porcine model and protects from IRI-related endothelial dysfunction in man. Rotigaptide may have therapeutic potential in the treatment of myocardial infarction., (© 2016 The British Pharmacological Society.)
- Published
- 2016
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33. [Mechanical circulatory treatment of advanced heart failure].
- Author
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Løgstrup BB, Vase H, Gjedsted J, and Eiskjær H
- Subjects
- Assisted Circulation instrumentation, Extracorporeal Membrane Oxygenation instrumentation, Extracorporeal Membrane Oxygenation methods, Humans, Ventricular Dysfunction, Left therapy, Assisted Circulation methods, Heart Failure therapy
- Abstract
Heart failure is one of the most common causes of morbidity and mortality worldwide. When patients cease to respond adequately to optimal medical therapy mechanical circulatory support has been promising. The advent of mechanical circulatory support devices has allowed significant improvements in patient survival and quality of life for those with advanced or end-stage heart failure. We provide a general overview of current mechanical circulatory support devices encompassing options for both short- and long-term ventricular support.
- Published
- 2016
34. Molecular Profiling of Multiplexed Gene Markers to Assess Viability of Ex Vivo Human Colon Explant Cultures.
- Author
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Drew JE, Farquharson AJ, Vase H, Carey FA, Steele RJ, Ross RA, and Bunton DC
- Abstract
Human colon tissue explant culture provides a physiologically relevant model system to study human gut biology. However, the small (20-30 mg) and complex tissue samples used present challenges for monitoring tissue stability, viability, and provision of sufficient tissue for analyses. Combining molecular profiling with explant culture has potential to overcome such limitations, permitting interrogation of complex gene regulation required to maintain gut mucosa in culture, monitor responses to culture environments and interventions. Human ex vivo colon explant gene expression profiles were assayed using an in-house custom-designed hCellMarkerPlex assay at culture time points 0, 1, 2, 4, and 14 h. Characteristic profiles of epithelial cell markers linked to differentiation, cellular polarization, and apoptosis were correlated with visible histochemical changes in explant epithelium during culture and tissue donors. The GenomeLab System provides effective assay of multiple targets not possible from small tissue samples with conventional gene expression technology platforms. This is advantageous to increase the utility of the ex vivo human colon model in applications to interrogate this complex and dynamic tissue environment for use in analytical testing.
- Published
- 2015
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35. Cardiovascular effects of cholecalciferol treatment in dialysis patients--a randomized controlled trial.
- Author
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Mose FH, Vase H, Larsen T, Kancir AS, Kosierkiewic R, Jonczy B, Hansen AB, Oczachowska-Kulik AE, Thomsen IM, Bech JN, and Pedersen EB
- Subjects
- Aged, Blood Pressure drug effects, Double-Blind Method, Female, Heart drug effects, Humans, Male, Middle Aged, Natriuretic Peptide, Brain blood, Placebo Effect, Renal Insufficiency, Chronic complications, Treatment Outcome, Vitamins adverse effects, Vitamins therapeutic use, Cholecalciferol therapeutic use, Heart physiopathology, Renal Dialysis adverse effects, Renal Insufficiency, Chronic drug therapy, Renal Insufficiency, Chronic physiopathology, Vitamin K Deficiency drug therapy, Vitamin K Deficiency physiopathology
- Abstract
Background: Patients on chronic dialysis are at increased risk of vitamin D deficiency. In observational studies plasma 25-hydroxyvitamin D (p-25(OH) D) levels are inversely correlated with plasma BNP and adverse cardiovascular outcomes. Whether a causal relation exists has yet to be established. The aim of this study was to test the hypothesis that cholecalciferol supplementation improves cardiac function and reduces blood pressure (BP) and pulse wave velocity (PWV) in patients on chronic dialysis., Methods: In a randomized, placebo-controlled, double-blind study, we investigated the effect of 75 μg (3000 IU) cholecalciferol daily for 6 months, in patients on chronic dialysis. We performed two-dimensional echocardiography, with doppler and tissue-doppler imaging, 24-h ambulatory BP (24-h BP), PWV, augmentation index (AIx), central BP (cBP) and brain natriuretic peptide (BNP) measurements at baseline and after 6 months., Results: Sixty-four patients were allocated to the study. Fifty dialysis patients with a mean age of 68 years (range: 46-88) and baseline p-25(OH) D of 28 (20;53) nmol/l completed the trial. Cholecalciferol increased left ventricular (LV) volume, but had no impact on other parameters regarding LV structure or left atrial structure. LV systolic function, LV diastolic function, PWV, cBP, AIx and BNP were not changed in placebo or cholecalciferol group at follow-up. 24-h BP decreased significantly in placebo group and tended to decrease in cholecalciferol group without any difference between treatments., Conclusion: Six months of cholecalciferol treatment in patients on chronic dialysis did not improve 24-h BP, arterial stiffness or cardiac function., Trial Registration: NCT01312714, Registration Date: March 9, 2011.
- Published
- 2014
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36. Effect of amiloride and spironolactone on renal tubular function and central blood pressure in patients with arterial hypertension during baseline conditions and after furosemide: a double-blinded, randomized, placebo-controlled crossover trial.
- Author
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Matthesen SK, Larsen T, Vase H, Lauridsen TG, Jensen JM, and Pedersen EB
- Subjects
- Aged, Aldosterone metabolism, Angiotensin II metabolism, Aquaporin 2 metabolism, Blood Pressure drug effects, Blood Pressure physiology, Cross-Over Studies, Double-Blind Method, Epithelial Sodium Channels metabolism, Female, Humans, Hypertension metabolism, Male, Middle Aged, Potassium metabolism, Pulse Wave Analysis, Renin metabolism, Sodium metabolism, Amiloride pharmacology, Diuretics pharmacology, Furosemide pharmacology, Hypertension physiopathology, Kidney Tubules drug effects, Kidney Tubules physiopathology, Spironolactone pharmacology
- Abstract
This study demonstrates that the increased potassium content in the body seems to change both the blood pressure and renal tubular function. We wanted to test the hypotheses that amiloride and spironolactone induced potassium retention reduces ambulatory blood pressure (ABP) and central blood pressure (CBP) during baseline conditions and after furosemide and that the tubular transport via the epithelial sodium channels (ENaCs) and aquaporin-2 (AQP2) water channels was increased by furosemide in arterial hypertension. Each of three 28-day treatment periods (placebo, amiloride, and spironolactone) was completed by a 4-day period with standardized diet regarding calories and sodium and water intake. At the end of each period, we measured pulse wave velocity (PWV), central systolic blood pressure (CSBP), central diastolic blood pressure (CDBP), glomerular filtration rate (GFR), free water clearance (CH2O), fractional excretion of sodium (FENa) and potassium (FEK), urinary excretion of AQP2 (u-AQP2), urinary excretion of γ-fraction of the ENaC (u-ENaCγ), and plasma concentrations of renin (PRC), angiotensin II (p-Ang II), and aldosterone (p-Aldo) at baseline conditions and after furosemide bolus. Ambulatory blood pressure and CBP were significantly lowered by amiloride and spironolactone. During 24-hour urine collection and at baseline, GFR, CH2O, FENa, FEK, u-AQP2 and u-ENaCγ were the same. After furosemide, CH2O, FENa, FEK, u-AQP2, u-ENaCγ, PRC, p-Ang II, p-Aldo, PWV and CDBP increased after all treatments. However, during amiloride treatment, FEK increased to a larger extent than after spironolactone and during placebo after furosemide, and CSBP was not significantly reduced. The increases in water and sodium absorption via AQP2 and ENaC after furosemide most likely are compensatory phenomena to antagonize water and sodium depletion. Amiloride is less effective than spironolactone to reduce renal potassium excretion.
- Published
- 2013
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37. Enzymatic on-chip enhancement for high resolution genotyping DNA microarrays.
- Author
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Schulze H, Barl T, Vase H, Baier S, Thomas P, Giraud G, Crain J, and Bachmann TT
- Subjects
- Bacterial Proteins chemistry, Base Pair Mismatch, Endonucleases metabolism, Fluorescence, Genotype, Klebsiella pneumoniae genetics, Nucleic Acid Hybridization, Oligonucleotide Probes chemistry, Polymorphism, Single Nucleotide, Spectrometry, Fluorescence, Thermodynamics, beta-Lactam Resistance genetics, beta-Lactamases chemistry, Artifacts, Bacterial Proteins genetics, Bacterial Typing Techniques methods, Klebsiella pneumoniae isolation & purification, Oligonucleotide Array Sequence Analysis methods, beta-Lactamases genetics
- Abstract
Antibiotic resistance among pathogenic microorganisms is emerging as a major human healthcare concern. While there are a variety of resistance mechanisms, many can be related to single nucleotide polymorphisms and for which DNA microarrays have been widely deployed in bacterial genotyping. However, genotyping by means of allele-specific hybridization can suffer from the drawback that oligonucleotide probes with different nucleotide composition have varying thermodynamic parameters. This results in unpredictable hybridization behavior of mismatch probes. Consequently, the degree of discrimination between perfect match and mismatch probes is insufficient in some cases. We report here an on-chip enzymatic procedure to improve this discrimination in which false-positive hybrids are selectively digested. We find that the application of CEL1 Surveyor nuclease, a mismatch-specific endonuclease, significantly enhances the discrimination fidelity, as demonstrated here on a microarray for the identification of variants of carbapenem resistant Klebsiella pneumoniae carbapenemases and monitored by end point detection of fluorescence intensity. Further fundamental investigations applying total internal reflection fluorescence detection for kinetic real-time measurements confirmed the enzymatic enhancement for SNP discrimination.
- Published
- 2012
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38. Catheter-based renal denervation for treatment of resistant hypertension.
- Author
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Vase H, Mathiassen ON, Kaltoft A, Pedersen EB, Christensen KL, Buus NH, Lederballe O, Lassen JF, Bøtker HE, and Thuesen L
- Subjects
- Aged, Angiography, Antihypertensive Agents therapeutic use, Blood Pressure, Drug Resistance, Female, Fluoroscopy, Humans, Hypertension drug therapy, Male, Middle Aged, Renal Artery innervation, Catheter Ablation, Hypertension surgery, Renal Artery surgery, Sympathectomy methods
- Abstract
Introduction: Activation of renal sympathetic nerves is associated with the development of hypertension. Catheter-based renal sympathetic denervation with radiofrequency energy ablation is a new promising treatment option for resistant hypertension. We here report the first Danish experiences and results with this technique., Material and Methods: Nine patients with resistant hypertension and a day-time 24-hour ambulatory blood pressure (BP) of 152/89 mmHg ± 10/10 (standard deviation) mmHg despite treatment with 5.4 ± 1.4 anti-hypertensive drugs underwent catheter-based renal sympathetic denervation with the Symplicity catheter., Results: No periprocedural complications or adverse events during follow-up were observed. Seven patients received complete ablation and two patients only partial ablation. Five patients responded to the treatment with a reduction in day-time 24-hour ambulatory BP from 158/94 ± 13/9 mmHg to 139/82 ± 10/8 mmHg (p < 0.05) at the one month follow-up and a reduction in the number of anti-hypertensive drugs from 5.4 ± 1.6 to 3.4 ± 0.9 (p < 0.05). BP in the remaining four patients was not significantly changed and antihypertensive therapy was not changed., Conclusion: Catheter-based renal sympathetic denervation is a feasible and in several cases also effective treatment option for patients with resistant hypertension. Adequately designed controlled trials are needed to assess the long-term safety and the full potential of this treatment.
- Published
- 2012
39. Effect of amiloride and spironolactone on renal tubular function, ambulatory blood pressure, and pulse wave velocity in healthy participants in a double-blinded, randomized, placebo-controlled, crossover trial.
- Author
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Matthesen SK, Larsen T, Lauridsen TG, Vase H, Gjørup PH, Nykjær KM, Nielsen S, and Pedersen EB
- Subjects
- Adolescent, Adult, Algorithms, Aquaporin 2 urine, Biomarkers urine, Cross-Over Studies, Double-Blind Method, Epithelial Sodium Channels drug effects, Female, Humans, Kidney Tubules physiopathology, Male, Renin-Angiotensin System drug effects, Amiloride pharmacology, Blood Pressure drug effects, Blood Pressure Monitoring, Ambulatory methods, Diuretics pharmacology, Glomerular Filtration Rate drug effects, Kidney Tubules drug effects, Pulse Wave Analysis, Spironolactone pharmacology
- Abstract
We wanted to test the hypothesis that treatment with amiloride or spironolactone reduced ambulatory (ABP) and central blood pressure (CBP) and that tubular transport via ENaCγ and AQP2 was increased after furosemide treatment. During baseline conditions, there were no differences in ABP, CBP, renal tubular function, or plasma concentrations of vasoactive hormones. After furosemide treatment, an increase in CBP, CH(2)o, FE(Na), FE(K), u-AQP2/min, u-ENaCγ/min, PRC, p-Ang II, and p-Aldo was observed. The increases in water and sodium absorption via AQP2 and ENaC after furosemide treatment most likely are compensatory phenomena to antagonize water and sodium depletion.
- Published
- 2012
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40. The effect of eprosartan on reflex sympathetic activation in sodium restricted patients with essential hypertension.
- Author
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Vase H, Lauridsen TG, Graffe CC, and Pedersen EB
- Subjects
- Adolescent, Adult, Aged, Blood Pressure drug effects, Cross-Over Studies, Diet, Sodium-Restricted, Double-Blind Method, Female, Heart Rate drug effects, Humans, Hypertension diet therapy, Kidney Function Tests, Male, Middle Aged, Nitroprusside pharmacology, Sympathetic Nervous System physiopathology, Young Adult, Acrylates pharmacology, Angiotensin II Type 2 Receptor Blockers pharmacology, Antihypertensive Agents pharmacology, Hypertension physiopathology, Imidazoles pharmacology, Sympathetic Nervous System drug effects, Thiophenes pharmacology
- Abstract
AT(1) receptor antagonists possess sympathoinhibitory effects in animal experiments, but in human studies the results are conflicting. We tested the hypothesis that very short-term treatment with the AT(1) receptor antagonist eprosartan inhibits reflex activation of the sympathetic nervous system in sodium-restricted patients with essential hypertension. The effect of eprosartan on urinary sodium and lithium excretion, heart rate, blood pressure, and vasoactive hormones was measured during reflex activation of the sympathetic nervous system by a cold pressor test and by a sodium nitroprusside induced 10 mm Hg reduction of the mean arterial pressure. It was a randomized, placebo-controlled, double-blinded, crossover study in 14 patients with essential hypertension. Glomerular filtration rate and renal tubular function were determined with continuous infusion clearance technique and vasoactive hormones with radioimmunoassays. Eprosartan had no effect on the increases in heart rate and plasma levels of noradrenaline during reflex activation of the sympathetic nervous system. However, eprosartan significantly decreased in fractional excretions of sodium (mean ± SD) (0.23 ± 0.22%) and lithium (3.1 ± 1.7%) during the sodium nitroprusside infusion, compared to placebo. Very short-term eprosartan treatment does not seem to have any sympathoinhibitory effects in sodium restricted patients with essential hypertension., (Copyright © 2011 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.)
- Published
- 2011
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41. Increased renal sodium absorption by inhibition of prostaglandin synthesis during fasting in healthy man. A possible role of the epithelial sodium channels.
- Author
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Lauridsen TG, Vase H, Starklint J, Graffe CC, Bech JN, Nielsen S, and Pedersen EB
- Subjects
- Adolescent, Adult, Aged, Albumins drug effects, Aquaporin 2 urine, Arginine Vasopressin blood, Blood Pressure drug effects, Body Weight drug effects, Cross-Over Studies, Cyclic AMP urine, Dinoprostone urine, Fasting, Female, Humans, Male, Middle Aged, Natriuretic Peptide, Brain blood, Natriuretic Peptide, Brain drug effects, Saline Solution, Hypertonic, Young Adult, Aquaporin 2 drug effects, Epithelial Sodium Channels drug effects, Epithelial Sodium Channels urine, Ibuprofen pharmacology, Kidney physiology, Natriuresis drug effects, Prostaglandin Antagonists pharmacology, Prostaglandins metabolism, Sodium pharmacokinetics
- Abstract
Background: Treatment with prostaglandin inhibitors can reduce renal function and impair renal water and sodium excretion. We tested the hypotheses that a reduction in prostaglandin synthesis by ibuprofen treatment during fasting decreased renal water and sodium excretion by increased absorption of water and sodium via the aquaporin2 water channels and the epithelial sodium channels., Methods: The effect of ibuprofen, 600 mg thrice daily, was measured during fasting in a randomized, placebo-controlled, double-blinded crossover study of 17 healthy humans. The subjects received a standardized diet on day 1, fasted at day 2, and received an IV infusion of 3% NaCl on day 3. The effect variables were urinary excretions of aquaporin2 (u-AQP2), the beta-fraction of the epithelial sodium channel (u-ENaCbeta), cyclic-AMP (u-cAMP), prostaglandin E2 (u-PGE2). Free water clearance (CH2O), fractional excretion of sodium (FENa), and plasma concentrations of vasopressin, angiotensin II, aldosterone, atrial-, and brain natriuretic peptide., Results: Ibuprofen decreased u-AQP2, u-PGE2, and FENa at all parts of the study. During the same time, ibuprofen significantly increased u-ENaCbeta. Ibuprofen did not change the response in p-AVP, u-c-AMP, urinary output, and free water clearance during any of these periods. Atrial-and brain natriuretic peptide were higher., Conclusion: During inhibition of prostaglandin synthesis, urinary sodium excretion decreased in parallel with an increase in sodium absorption and increase in u-ENaCbeta. U-AQP2 decreased indicating that water transport via AQP2 fell. The vasopressin-c-AMP-axis did not mediate this effect, but it may be a consequence of the changes in the natriuretic peptide system and/or the angiotensin-aldosterone system, Trial Registration: Clinical Trials Identifier: NCT00281762.
- Published
- 2010
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42. Direct effect of methylprednisolone on renal sodium and water transport via the principal cells in the kidney.
- Author
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Lauridsen TG, Vase H, Bech JN, Nielsen S, and Pedersen EB
- Subjects
- Adolescent, Adult, Aged, Aldosterone blood, Angiotensin II blood, Aquaporin 2 urine, Atrial Natriuretic Factor blood, Blood Pressure drug effects, Cross-Over Studies, Female, Humans, Kidney physiology, Male, Middle Aged, Natriuretic Peptide, Brain blood, Pulse, Renin blood, Epithelial Sodium Channels urine, Kidney drug effects, Methylprednisolone pharmacology, Sodium urine
- Abstract
Background: Glucocorticoids influence renal concentrating and diluting ability. We tested the hypothesis that methylprednisolone treatment increased renal water and sodium absorption by increased absorption via the aquaporin-2 (AQP2) water channels and the epithelial sodium channels (ENaCs) respectively., Methods: The effect of methylprednisolone was measured during fasting in a randomized, placebo-controlled, single-blinded cross-over study of 15 healthy humans. The subjects received a standardized diet on day 1, fasted on day 2, and received 500 mg methylprednisolone intravenously on day 3. The effect variables were urinary excretions of AQP2 (u-AQP2), urinary excretion of the beta-fraction of the ENaC (u-ENaC(beta)), cAMP (u-cAMP), prostaglandin E(2) (u-PGE(2)), free water clearance (C(H2O)), and fractional excretion of sodium (FE(Na)), and plasma vasopressin (p-AVP), angiotensin II (p-Ang II), aldosterone (p-Aldo), atrial natriuretic peptide (p-ANP), and brain natriuretic peptide (p-BNP)., Results: Methylprednisolone treatment increased u-AQP2, u-ENaC(beta), and p-AVP significantly, but did not change u-cAMP, c(H2O), and FE(Na). P-ANP increased during methylprednisolone treatment, but after the increase in u-AQP2 and u-ENaC(beta). U-PGE(2), p-Ang II, and p-BNP were unchanged. Heart rate increased and diastolic blood pressure fell., Conclusions: Methylprednisolone increased u-AQP2 and u-ENaC. Neither the AVP-cAMP axis nor changes in the renin-angiotensin-Aldo system, or the natriuretic peptide system seems to bear a causal relationship with the increase in either u-AQP2 or u-ENaC. Most probably, the effect is mediated via a direct effect of methylprednisolone on the principal cells. The lack of decrease in urinary output and sodium reabsorption most likely can be attributed to the diuretic and natriuretic properties of the increased secretion of ANP.
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- 2010
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43. Effects of dihydralazine on renal water and aquaporin-2 excretion in humans.
- Author
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Vase H, Lauridsen TG, Bech JN, and Pedersen EB
- Subjects
- Adolescent, Adult, Aged, Antihypertensive Agents administration & dosage, Antihypertensive Agents pharmacology, Demography, Dihydralazine administration & dosage, Glomerular Filtration Rate, Health, Hemodynamics drug effects, Hormones blood, Humans, Infusions, Intravenous, Kidney drug effects, Male, Middle Aged, Sodium metabolism, Aquaporin 2 metabolism, Dihydralazine pharmacology, Kidney metabolism, Kidney physiology, Water physiology
- Abstract
Objective: Dihydralazine is a vasodilator that lowers blood pressure, but often also leads to significant water and sodium retention. To characterize the effect of dihydralazine on renal sodium and water handling, we tested the hypothesis that dihydralazine causes water retention parallel with an increase in urinary excretion of aquaporin-2 (u-AQP2) in healthy humans., Material and Methods: The effect of intravenous infusion of dihydralazine in three doses (3.125 mg, 6.250 mg and 9.375 mg) on urinary AQP2, water and sodium excretion, heart rate (HR), blood pressure (BP) and vasoactive hormones was measured in a randomized, placebo-controlled, double-blind, crossover study in 17 healthy subjects. Glomerular filtration rate (GFR) and renal tubular function were determined with the continuous infusion clearance technique and vasoactive hormones with radioimmunoassays., Results: Dihydralazine compared to placebo had no impact of u-AQP2 (effect of dihydralazine versus placebo +/-SE) (-0.074+/-0.048 ng/min versus -0.015+/-0.034 ng/min; p = 0.42), despite significant reductions in urine output and free water clearance after 9.375 mg of dihydralazine. Dihydralazine significantly lowered BP and increased HR, plasma levels of angiotensin II and (except after 3.125 mg) atrial natriuretic peptide, while plasma levels of vasopressin, GFR and fractional excretions of sodium and lithium were not significantly changed., Conclusions: These findings suggest that dihydralazine increases water re-absorption in the distal tubules, independently of vasopressin and of sodium re-absorption. Furthermore, our study does not support an effect of the sympathetic nervous system, the renin-angiotensin system and the natriuretic peptide system on u-AQP2 regulation.
- Published
- 2009
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44. Eprosartan modulates the reflex activation of the sympathetic nervous system in sodium restricted healthy humans.
- Author
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Vase H, Lauridsen TG, Bech JN, and Pedersen EB
- Subjects
- Adult, Blood Pressure physiology, Diet, Sodium-Restricted, Female, Glomerular Filtration Rate physiology, Humans, Male, Sodium, Dietary, Sympathetic Nervous System physiology, Acrylates pharmacology, Angiotensin II Type 1 Receptor Blockers pharmacology, Blood Pressure drug effects, Glomerular Filtration Rate drug effects, Imidazoles pharmacology, Natriuresis drug effects, Sympathetic Nervous System drug effects, Thiophenes pharmacology
- Abstract
What Is Already Known About This Subject: A sympatho-inhibitory effect of ACE-inhibitors and AT(1) receptor antagonists has been widely demonstrated in animal models, but in humans this effect tends only to be present during chronic treatment in conditions with pre-existing high levels of sympathetic activity. Sodium restriction increases renal sympathetic nerve activity and the activity of the renin-angiotensin system and may be a favourable condition to demonstrate sympatho-inhibition as a short-term effect of the AT(1) receptor antagonist eprosartan in healthy humans., What This Study Adds: Results from our study indicate that during sodium restriction eprosartan has a small inhibitory effect on nonbaroreflex mediated activation of the sympathetic nervous system. During arterial baroreflex mediated activation of the sympathetic nervous system this effect is, however, completely overruled by an increased sensitivity of the arterial baroreflex. AIMS To test the hypothesis that eprosartan inhibits both nonbaroreflex and arterial baroreflex mediated activation of the sympathetic nervous system, assessed by renal tubular function, systemic haemodynamics and vasoactive hormones, in sodium restricted healthy humans., Methods: The effect of eprosartan on urinary sodium, lithium and water excretion, heart rate (HR), blood pressure and vasoactive hormones was measured before, during and after a cold pressor test (CPT) and sodium nitroprusside (SNP) infusion in a randomized, placebo controlled, double-blind, crossover study in 17 healthy subjects. Glomerular filtration rate and renal tubular function were determined by a continuous infusion clearance technique and vasoactive hormones by radioimmunoassays., Results: Eprosartan attenuated the impact of the CPT on HR (mean difference from placebo (95% confidence interval) (3.9 (0.7, 7.0) min(-1)) and mean arterial pressure (MAP) (4.7 (0.3, 9.2) mmHg), but no effect of eprosartan was observed on the impact of the CPT on renal tubular function. During a SNP induced reduction in MAP of 10 mmHg eprosartan decreased fractional excretions of sodium (0.46 (0.14, 0.76)%) and lithium (5.1 (2.5, 7.6)%) and tended to increase HR (4.1 (-0.26, 8.4) min(-1)) and plasma concentrations of norepinephrine (33.8 (-5.8, 72.1) pg ml(-1)). CONCLUSIONS; These findings suggest that during mild sodium restriction eprosartan has a small inhibitory effect on nonbaroreflex mediated activation of the sympathetic nervous system. During arterial baroreflex mediated activation of the sympathetic nervous system this effect is, however, completely overruled by an increased sensitivity of the arterial baroreflex.
- Published
- 2008
- Full Text
- View/download PDF
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