Search

Your search keyword '"Schieffer, Bernhard"' showing total 422 results
Start Over Author "Schieffer, Bernhard" Language english
422 results on '"Schieffer, Bernhard"'

8. Microbiological Profiles after Out-of-Hospital Cardiac Arrest: Exploring the Relationship between Infection, Inflammation, and the Potential Effects of Mechanical Circulatory Support.

Author

Kreutz, Julian, Müller, Charlotte, Chatzis, Georgios, Syntila, Styliani, Choukeir, Maryana, Schäfer, Ann-Christin, Betz, Susanne, Schieffer, Bernhard, Patsalis, Nikolaos, and Markus, Birgit

Subjects
ARTIFICIAL blood circulation, CARDIAC arrest, IMPACT (Mechanics), C-reactive protein, GRAM-positive bacteria, CARDIOGENIC shock
Abstract

Background: Cardiogenic shock (CS) following an out-of-hospital cardiac arrest (OHCA) poses significant management challenges, exacerbated by inflammatory responses and infectious complications. This study investigates the microbiological profiles and impacts of mechanical circulatory support (MCS) on inflammation and infection in OHCA patients. Methods: We retrospectively analyzed microbiological data from various specimens of 372 OHCA patients, who were treated at the Cardiac Arrest Center of the University Hospital of Marburg from January 2018 to December 2022. Clinical outcomes were evaluated to investigate the potential impact of MCS on infection and inflammation. Results: Of the study cohort, 115 patients received MCS. The microbiological analysis revealed a higher incidence of positive blood cultures in the MCS group vs. the non-MCS group (39% vs. 27.7%, p = 0.037), with predominantly Gram-positive bacteria. Patients with positive microbiological findings had longer in-hospital stays and prolonged periods of mechanical ventilation. The levels of inflammatory markers such as C-reactive protein (CRP) and procalcitonin (PCT) differed, suggesting a more pronounced inflammatory response in MCS patients, especially in the later ICU stages. Notably, despite the higher infection rate in the MCS group, the survival rates did not significantly differ in the two groups. Conclusions: MCS appears to influence the microbiological and inflammatory landscape in OHCA patients, increasing the susceptibility to certain infections but not affecting the overall mortality. This study underscores the complexity of managing post-resuscitation care and highlights the need for tailored therapeutic strategies to effectively mitigate infectious and inflammatory complications. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

9. Contemporary Management of Severe Symptomatic Aortic Stenosis

Author

Iung, Bernard, Bax, Jeroen, De Bonis, Michele, Delgado, Victoria, Haude, Michael, Hindricks, Gerhard, Maggioni, Aldo P., Pierard, Luc, Popescu, Bogdan A., Prendergast, Bernard, Price, Susanna, Rosenhek, Raphael, Ruschitzka, Frank, Vahanian, Alec, Wendler, Olaf, Windecker, Stephan, Mekhaldi, Souad, Lemaitre, Katell, Authier, Sébastien, Laroche, Cécile, Abdelhamid, Magdy, Apor, Astrid, Bajraktari, Gani, Beleslin, Branko, Bogachev-Prokophiev, Alexander, Demarco, Daniela Cassar, Pasquet, Agnes, Dogan, Sait Mesut, Erglis, Andrejs, Evangelista, Arturo, Goda, Artan, Ihlemann, Nikolaj, Ince, Huseyin, Katsaros, Andreas, Linhartova, Katerina, Mascherbauer, Julia, Mirrakhimov, Erkin, Mizariene, Vaida, Rahman-Haley, Shelley, Ribeiras, Regina, Samadov, Fuad, Saraste, Antti, Simkova, Iveta, Kostovska, Elizabeta Srbinovska, Tomkiewicz-Pajak, Lidia, Tribouilloy, Christophe, Zera, Eliverta, Metalla, Mimoza, Shirka, Ervina, Dado, Elona, Bica, Loreta, Aleksi, Jorida, Knuti, Gerti, Gjyli, Lidra, Pjeci, Rudina, Shuperka, Eritinka, Lleshi, Erviola, Rustemaj, Joana, Qordja, Marsjon, Gina, Mirald, Husi, Senada, Basic, Daniel, Steringer-Mascherbauer, Regina, Huber, Charlotte, Ebner, Christian, Sigmund, Elisabeth, Ploechl, Andrea, Sturmberger, Thomas, Eder, Veronica, Koppler, Tanja, Heger, Maria, Kammerlander, Andreas, Duca, Franz, Binder, Christina, Koschutnik, Matthias, Perschy, Leonard, Puskas, Lisa, Ho, Chen-Yu, Aliyev, Farid, Guluzada, Vugar, Imanov, Galib, Ibrahimov, Firdovsi, Abbasaliyev, Abbasali, Ahmedov, Tahir, Muslumova, Fargana, Babayev, Jamil, Rustamova, Yasmin, Jahangirov, Tofig, Samadov, Rauf, Museyibov, Muxtar, Isayev, Elnur, Musayev, Oktay, Xalilov, Shahin, Huseynov, Saleh, Yuzbashova, Madina, Zamanov, Vuqar, Mammadov, Vusal, Van Camp, Gery, Penicka, Martin, Batjoens, Hedwig, Debonnaire, Philippe, Dendooven, Daniel, Knecht, Sebastien, Duytschaever, Mattias, Vandekerckhove, Yves, Missault, Luc, Muyldermans, Luc, Tavernier, René, De Grande, Tineke, Coussement, Patrick, DeTroyer, Joyce, Derycker, Katrien, De Jaegher, Kelly, Bondue, Antoine, Beauloye, Christophe, Goffinet, Céline, Mirica, Daniela Corina, Eynden, Frédéric Vanden, Van de Borne, Philippe, Van Frachen, Béatrice, Vancraeynest, David, Vanoverschelde, Jean Louis, Pierard, Sophie, Malanca, Mihaela, Sinnaeve, Florence, Tahon, Séverine, De Clippel, Marie, Gayet, Frederic, Loiseau, Jacques, Van de Veire, Nico, Moerman, Veronique, Willems, Anne-Marie, Cosyns, Bernard, Droogmans, Steven, Motoc, Andreea, Kerkhove, Dirk, Plein, Daniele, Roosens, Bram, Weytjens, Caroline, Lancellotti, Patrizio, Dulgheru, Elena Raluca, Parenicova, Ilona, Bedanova, Helena, Tousek, Frantisek, Sindelarova, Stepanka, Canadyova, Julia, Taborsky, Milos, Ostransky, Jiri, Ivona simkova, Vicha, Marek, Jelinek, Libor, Opavska, Irena, Homza, Miroslav, Kvrayola, Miriam, Brat, Radim, Mrozek, Dan, Lichnerova, Eva, Docekalova, Iveta, Zarybnicka, Marta, Peskova, Marketa, Roucka, Patrik, Stastna, Vlasta, Vondrackova, Dagmar Jungwirtova, Hornig, Alfred, Niznansky, Matus, Branny, Marian, Vodzinska, Alexandra, Dorda, Miloslav, Snkouril, Libor, Kluz, Krystyna, Kypusova, Jana, Nezvalova, Radka, Olsen, Niels Thue, Ali, Hosam Hasan, Taha, Salma, Hassan, Mohamed, Afifi, Ahmed, Kabil, Hamza, Mady, Amr, Ebaid, Hany, Ahmed, Yasser, Nour, Mohammad, Talaat, Islam, Sayed, CairoMaiy El, Mostafa, Ahmad Elsayed, Sadek, CairoYasser, Eltobgi, CairoSherif, Bakhoum, Sameh, Doss, Ramy, Sheashea, Mahmoud, Elasry, Abd Allah, Fouad, Ahmed, Baraka, Mahmoud, Samir, Sameh, Roshdy, Alaa, AbdelRazek, Yasmin, Abd Rabou, Mostafa M., Abobakr, Ahmed, Moaaz, Moemen, Mokhtar, Mohamed, Ashry, Mohamed, Elkhashab, Khaled, Ghareeb, Haytham Soliman, Kamal, Mostafa, AbdelRazek, Gomaa, Farag, GizaNabil, Elbarbary, Giza:Ahmed, Wahib, Evette, Kazamel, Ghada, Kamal, Diaa, Tantawy, Mahmoud, Alansary, Adel, Yahia, Mohammed, Mahmoud, Raouf, El Banna, Tamer, Atef, Mohamed, Nasr, Gamela, Ahmed, Salah, El Hefny, Ehab E., Saifelyazal, Islam, El Ghany, Mostafa Abd, El Rahman El Hadary, Abd, Khairy, Ahmed, Lommi, Jyri, Laine, Mika, Kylmala, Minna, Kankanen, Katja, Turpeinen, Anu, Hartikainen, Juha, Kujanen, Lari, Airaksinen, Juhani, Vasankari, Tuija, Szymanski, Catherine, Bohbot, Yohann, Gun, Mesut, Rousseaux, Justine, Biere, Loic, Mateus, Victor, Audonnet, Martin, Rautureau, Jérémy, Cornet, Charles, Sorbets, Emmanuel, Mear, BourgesKarine, Issa, Adi, Jobic, Yannick, Le Ven, Florent, Pouliquen, Marie-Claire, Gilard, Martine, Ohanessian, Alice, Farhat, Ali, Vlase, Alina, Said, Fkhar, Lasgi, Caroline, Sanchez, Carlos, Breil, Romain, Peignon, Marc, Elkaim, Jean-Philippe, Jan-Blin, Virginie, BertrandM'Ban, Sylvain Ropars, Bardet, Hélène, Sawadogo, Samuel, Muschoot, Aurélie, Tchatchoua, Dieudonné, Elhadad, Simon, Maubert, Aline, Lazizi, Tahar, Ourghi, Kais, Bonnet, Philippe, Menager-Gangloff, Clarisse, Gafsi, Sofiene, Mansouri, Djidjiga, Aboyans, Victor, Magne, Julien, Martins, Elie, Karm, Sarah, Mohty, Dania, Briday, Guillaume, David, Amandine, Marechaux, Sylvestre, Le Goffic, Caroline, Binda, Camille, Menet, Aymeric, Delelis, Francois, Ringlé, Anne, Castel, Anne-Laure, Appert, Ludovic, Tristram, Domitille, Trouillet, Camille, Nacer, Yasmine, Ngoy, Lucas, Habib, MarseilleGilbert, Thuny, Franck, Haentjens, Julie, Cautela, Jennifer, Lavoute, Cécile, Robin, Floriane, Armangau, Pauline, Vergeylen, Ugo, Sanhadji, Khalil, Abdallah, Nessim Hamed, Kerzazi, Hassan, Perianu, Mariana, Plurien, François, Oueslati, Chaker, Debauchez, Mathieu, Monin, Jean-Luc, Konstantinos, Zannis, Berrebi, Alain, Dibie, Alain, Lansac, Emmanuel, Veugeois, Aurélie, Diakov, Christelle, Caussin, Christophe, Czitrom, Daniel, Salvi, Suzanna, Amabile, Nicolas, Dervanian, Patrice, Lejeune, Stéphanie, Bagdadi, Imane, Mokrane, Yemmi, Rouault, Gilles, Abalea, Jerome, Leledy, Marion, Horen, Patrice, Donal, Erwan, Bosseau, Christian, Paven, Elise, Galli, Elena, Collette, Edouard, Urien, Jean-Marie, Bridonneau, Valentin, Gervais, Renaud, Bauer, Fabrice, Chopra, Houzefa, Charbonnier, Arthur, Attias, David, Dahouathi, Nesrine, Khounlaboud, Moukda, Daudin, Magalie, Thebault, Christophe, Hamon, Cécile, Couffon, Philippe, Bellot, Catherine, Vomscheid, Maelle, Bernard, Anne, Dion, Fanny, Naudin, Djedjiga, Mouzouri, Mohammed, Rudelin, Mathilde, Berenfeld, Alain, Vanzwaelmen, Thibault, Alloui, Tarik, Radovikj, Marija Gjerakaroska, Jordanova, Slavica, Scholtz, Werner, Liberda-Knoke, Eva, Wiemer, Melanie, Mugge, Andreas, Nickenig, Georg, Sinning, Jan-Malte, Sedaghat, Alexander, Heintzen, Matthias, Ballof, Jan, Frenk, Daniel, Hambrecht, Rainer, Wienbergen, Harm, Seidel, Annemarie, Osteresch, Rico, Kramer, Kirsten, Ziemann, Janna, Schulze, Ramona, Fehske, Wolfgang, Eifler, Clarissa, Wafaisade, Bahram, Kuhn, Andreas, Fischer, Sören, Lichtenberg, Lutz, Brunold, Mareike, Simons, Judith, Balling, Doris, Buck, Thomas, Plicht, Bjoern, Schols, Wolfgang, Ebelt, Henning, Chamieh, Marwan, Anacker, Jelena, Rassaf, Tienush, Janosi, Alexander, Lind, Alexander, Lortz, Julia, Lüdike, Peter, Kahlert, Philipp, Rittger, Harald, Eichinger, Gabriele, Kuhls, Britta, Felix, Stephan B., Lehnert, Kristin, Pedersen, Ann-Louise, Dorr, Marcus, Empen, Klaus, Kaczmarek, Sabine, Busch, Mathias, Baly, Mohammed, Er, Fikret, Duman, Erkan, Gabriel, Linda, Weinbrenner, Christof, Bauersachs, Johann, Wider, Julian, Kempf, Tibor, Bohm, Michael, Schulze, Paul-Christian, Poerner, C. Tudor, Möbius-Winkler, Sven, Lenk, Karsten, Heitkamp, Kerstin, Franz, Marcus, Krauspe, Sabine, Schumacher, Burghard, Windmuller, Volker, Kurwitz, Sarah, Thiele, Holger, Kurz, Thomas, Meyer-Saraei, Roza, Akin, Ibrahim, Fastner, Christian, Lossnitzer, Dirk, Hoffmann, Ursula, Borggrefe, Martin, Baumann, Stefan, Kircher, Brigitte, Foellinger, Claudia, Dietz, Heike, Schieffer, Bernhard, Niroomand, Feraydoon, Mudra, Harald, Maier, Lars, Camboni, Daniele, Birner, Christoph, Debl, Kurt, Paulus, Michael, Seither, Benedikt, El Mokhtari, Nour Eddine, Oner, Alper, Caglayan, Evren, Sherif, Mohammed, Yucel, Seyrani, Custodis, Florian, Schwinger, Robert, Vorpahl, Marc, Seyfarth, Melchior, Nover, Ina, Koehler, Till, Christiani, Sarah, Sanchez, David Calvo, Schanze, Barbel, Sigusch, Holger, Salman, Athir, Hancock, Jane, Chambers, John, Demetrescue, Camelia, Prendergast, Claire, Dalby, Miles, Smith, Robert, Rogers, Paula, Riley, Cheryl, Tousoulis, Dimitris, Kanakakis, Ioannis, Spargias, Konstantinos, Lampropoulos, Konstantinos, Panagiotis, Tolis, Koutsoukis, Athanasios, Michalis, Lampros, Goudevenos, Ioannis, Bellos, Vasileios, Papafaklis, Michail, Lakkas, Lampros, Hahalis, George, Makris, Athanasios, Karvounis, Haralampos, Kamperidis, Vasileios, Ninios, Vlasis, Sachpekidis, Vasileios, Rouskas, Pavlos, Poulimenos, Leonidas, Charalampidis, Georgios, Hamodraka, Eftihia, Manolis, Athanasios, Kiss, Robert Gabor, Borsanyi, Tunde, Jarai, Zoltan, Zsary, Andras, Bartha, Elektra, Kosztin, Annamaria, Doronina, Alexandra, Kovacs, Attila, Imre, Barabas Janos, Chao, Chun, Benke, Kalman, Karoczkai, Istvan, Keltai, Kati, Förchécz, Zsolt, Pozsonyi, Zoltán, Jenei, Zsigmond, Patthy, Adam, Sallai, Laszlo, Majoros, Zsuzsanna, Pál, Tamás, Bencze, Jusztina, Sagi, Ildiko, Molnar, Andrea, Kurczina, Anita, Kolodzey, Gabor, Edes, Istvan, Szatmari, Valeria, Zajacz, Zsuzsanna, Cziraki, Attila, Nemeth, Adam, Faludi, Reka, Vegh, Laszlone, Jebelovszki, Eva, Lupkovics, Geza Karoly, Kovacs, Zsofia, Horvath, Andras, Berisha, Gezim, Ibrahimi, Pranvera, Percuku, Luan, Arapova, Rano, Laahunova, Elmira, Neronova, Kseniia, Zhakypova, Zarema, Naizabekova, Gulira, Muratova, Gulnazik, Sime, Iveta, Sorokins, Nikolajs, Kamzola, Ginta, Cgojeva-Sproge, Irina, Rancane, Gita, Valentinaviciene, Ramune, Rudiene, Laima, Raugaliene, Rasa, Bardzilauske, Aiste, Jonkaitiene, Regina, Petrauskaite, Jurate, Bieseviciene, Monika, Verseckaite, Raimonda, Zvirblyte, Ruta, Kalibatiene, Danute, Radauskaite, Greta, Janaviciute-Matuzeviciene, Gabija, Jancauskaite, Dovile, Balkute, Deimile, Maneikyte, Juste, Mileryte, Ingrida, Vaisvilaite, Monika, Gedvilaite, Lina, Biliukas, Mykolas, Karpaviciene, Vaiva, Xuereb, Robert George, Pllaha, Elton, Djaberi, Roxana, Komor, Klaudiusz, Gorgon-Komor, Agnieszka, Loranc, Beata, Myszor, Jaroslaw, Mizia-Stec, Katarzyna, Berger-Kucza, Adrianna, Mizia, Magdalena, Polak, Mateusz, Bogacki, Piotr, Podolec, Piotr, Komar, Monika, Sedziwy, Ewa, Sliwiak, Dorota, Sobien, Bartosz, Rog, Beata, Hlawaty, Marta, Gancarczyk, Urszula, Libiszewska, Natasza, Sorysz, Danuta, Gackowski, Andrzej, Cieply, Malgorzata, Misiuda, Agnieszka, Racibor, Franciszek, Nytko, Anna, Widenka, Kazimierz, Kolowca, Maciej, Bak, Janusz, Curzytek, Andrzej, Regulski, Mateusz, Kamela, Malgorzata, Wisniowski, Mateusz, Hryniewiecki, Tomasz, Szymanski, Piotr, Rozewicz, Monika, Grabowski, Maciej, Duchnowski, Piotr, Budaj, Andrzej, Zaborska, Beata, Pilichowska-Paskiet, Ewa, Sikora-Frac, Malgorzata, Slomski, Tomasz, Joao, Isabel, Cruz, Ines, Pereira, Hélder, Cale, Rita, Marques, Ana, Pereira, Ana Rita, Morais, Carlos, Freitas, Antonio, Roque, David, Antunes, Nuno, Pereira, Antonio Costeira, Vieira, Catarina, Salome, Nuno, Martins, Juliana, Campos, Isabel, Cardoso, Goncalo, Silva, Claudia, Oliveira, Afonso, Goncalves, Mariana, Martins, Rui, Quintal, Nuno, Mendes, Bruno, Silva, Joseline, Ferreira, Joao, Milner, James, Alves, Patricia, Marinho, Vera, Gago, Paula, Amado, Jose, Bispo, Joao, Bento, Dina, Machado, Inocencia, Oliveira, Margarida, Calvo, Lucy, von Hate, Pedro, Faria, Bebiana, Galrinho, Ana, Branco, Luisa, Goncalves, Antonio, Mendonca, Tiago, Selas, Mafalda, Macedo, Filipe, Sousa, Carla, Cabral, Sofia, Oliveira, Filomena, Trepa, Maria, Fontes-Oliveira, Marta, Nunes, Alzira, Araújo, Paulo, Ribeiro, Vasco Gama, Almeida, Joao, Rodrigues, Alberto, Braga, Pedro, Dias, Sonia, Carvalho, Sofia, Ferreira, Catarina, Ferreira, Alberto, Mateus, Pedro, Moz, Miguel, Leao, Silvia, Margato, Renato, Moreira, Ilidio, Guimanaes, Jose, Ribeiro, Joana, Goncalves, Fernando, Cabral, Jose, Almeida, Ines, Goncalves, Luisa, Tarusi, Mariana, Pop, Calin, Matei, Claudia, Tint, Diana, Barbulescu, Sanziana, Micu, Sorin, Pop, Ioana, Baba, Costica, Dimulescu, Doina, Dorobantu, Maria, Ginghina, Carmen, Onut, Roxana, Popescu, Andreea, Zamfirescu, Brandusa, Aflorii, Raluca, Popescu, Mihaela, Ghilencea, Liviu, Rachieru, Andreeea, Stoian, Monica, Oprescu, Nicoleta, Iancovici, Silvia, Petre, Iona, Mateescu, Anca Doina, Calin, Andreea, Botezatu, Simona, Enache, Roxana, Rosca, Monica, Ciuperca, Daniela, Babalac, Evelyn, Beyer, Ruxandra, Cadis, Laura, Rancea, Raluca, Tomoaia, Raluca, Rosianu, Adela, Kovacs, Emese, Militaru, Constantin, Craciun, Alina, Mirea, Oana, Florescu, Mihaela, Grigorica, Lucica, Dragusin, Daniela, Nechita, Luiza, Marinescu, Mihai, Chiscaneanu, Teodor, Botezatu, Lucia, Corciova, Costela, Petris, Antoniu Octavian, Arsenescu-Georgescu, Catalina, Salaru, Delia, Alexandrescu, Dan Mihai, Plesoianu, Carmjen, Tanasa, Ana, Mitu, Ovidiu, Costache, Irina Iuliana, Tudorancea, Ionut, Usurelu, Catalin, Eminovici, Gabriela, Manitiu, Ioan, Stoia, Oana, Mitre, Adriana, Nistor, Dan-Octavian, Maier, Anca, Lupu, Silvia, Opris, Mihaela, Ionac, Adina, Popescu, Irina, Crisan, Simina, Mornos, Cristian, Goanta, Flavia, Gruescu, Liana, Voinescu, Oana, Petcu, Madalina, Cozlac, Ramona, Damrina, Elena, Khilova, Liliya, Ryazantseva, Irina, Kozmin, Dmitry, Kiseleva, Maria, Goncharova, Marina, Kitalaeva, Kamila, Demetskay, Victoria, Verevetinov, Artem, Fomenko, Mikhail, Skripkina, Elena, Tsoi, Viktor, Antipov, Georgii, Schneider, Yuri, Yazikov, Denis, Makarova, Marina, Cherkes, Aleksei, Ermakova, Natalya, Medvedev, Aleksandr, Sarosek, Anastasia, Isayan, Mikhail, Voronova, Tatyana, Kulumbegov, Oleg, Tuchina, Alina, Stefanov, Sergei, Klimova, Margarita, Smolyaninov, Konstantin, Dandarova, Zhargalma, Magamet, Victoriya, Spiropulos, Natalia, Boldyrev, Sergey, Barbukhatty, Kirill, Buyankov, Dmitrii, Yurin, Vladimir, Gross, Yuriy, Boronin, Maksim, Mikhaleva, Mariya, Shablovskaya, Mariya, Zotov, Alex, Borisov, Daniil, Tereshchenko, Vasily, Zubova, Ekaterina, Kuzmin, A., Tarasenko, Ivan, Gamzaev, Alishir, Borovkova, Natalya, Koroleva, Tatyana, Botova, Svetlana, Pochinka, Ilya, Dunaeva, Vera, Teplitskaya, Victoria, Semenova, Elena I., Korabel'Nikova, Olga V., Simonov, Denis S., Denisenko, Elena, Harina, Natalia, Yarohno, Natalia, Alekseeva, Svetlana, Abydenkova, Julia, Shabalkina, Lyubov, Mayorova, Olga, Tsechanovich, Valeriy, Medvedev, Igor, Lepilin, Michail, Nemchenko, PenzaEvgenii, Karnahin, Vadim, Safina, Vasilya, Slastin, Yaroslav, Gilfanova, Venera, Gorbunov, Roman, Jakubov, Ramis, Fazylova, Aigul, Poteev, Mansur, Vazetdinova, Laysan, Tarasova, Indira, Irgaliyev, Rishat, Moiseeva, Olga, Gordeev, Mikhail, Irtyuga, Olga, Moiseeva, Raisa, Ostanina, Nina, Zverev, Dmitry, Murtazalieva, Patimat, Kuznetsov, Dmitry, Skurativa, Mariya, Polyaeva, Larisa, Mihaiilov, Kirill, Obrenovic-Kircanski, Biljana, Putnik, Svetozar, Simic, Dragan, Petrovic, Milan, Nikolic, Natasa Markovic, Jovovic, Ljiljana, Ostric, Dimitra Kalimanovska, Brajovic, Milan, Manojlovic, Milica Dekleva, Novakovic, Vladimir, Zamaklar-Trifunovic, Danijela, Orbovic, Bojana, Petrovic, Olga, Boricic-Kostic, Marija, Andjelkovic, Kristina, Milanov, Marko, Despotovic-Nikolic, Maja, Budisavljevic, Sreten, Veljkovic, Sanja, Cvetinovic, Nataša, Lepojevic, Daniijela, Todorovic, Aleksandra, Nikolic, Aleksandra, Borzanovic, Branislava, Trkulja, Ljiljana, Tomic, Slobodan, Vukovic, Milan, Milosavljevic, Jelica, Milanovic, Mirjana, Stakic, Vladan, Cvetkovic, Aleksandra, Milutinovic, Suzana, Bozic, Olivera, Miladinovic, Miodrag, Nikolic, Zoran, Despotovic, Dinka, Jovanovic, Dimitrije, Stojsic-Milosavljevic, Anastazija, Ilic, Aleksandra, Sladojevic, Mirjana, Susak, Stamenko, Maletin, Srdjan, Pavlovic, Salvo, Kuzmanovic, Vladimir, Ivanovic, Nikola, Dejanovic, Jovana, Ruzicic, Dusan, Drajic, Dragana, Cvetanovic, Danijel, Mirkovic, Marija, Omoran, Jon, Margoczy, Roman, Sedminova, Katarina, Reptova, Adriana, Baranova, Eva, Valkovicova, Tatiana, Valocik, Gabriel, Kurecko, Marian, Vachalcova, Marianna, Kollarova, Alzbeta, Studencan, Martin, Alusik, Daniel, Kozlej, Marek, Macakova, Jana, Moral, Sergio, Cladellas, Merce, Luiso, Daniele, Calvo, Alicia, Palet, Jordi, Carballo, Juli, Tura, Gisela Teixido, Maldonado, Giuliana, Gutierrez, Laura, Gonzalez-Alujas, Teresa, Jose Fernando, Rodriguez Palomares, Villalva, Nicolas, Molina-Mora, Ma Jose, Paton, Ramon Rubio, Martinez Diaz, Juan Jose, Ruiz, Pablo Ramos, Valle, Alfonso, Rodriguez, Ana, Alania, Edgardo, Galcera, Emilio, Seller, Julia, Valenzuela, Gonzalo de la Morena, Espin, Daniel Saura, Garcia, Dolores Espinosa, Oliva Sandoval, Maria Jose, Gonzalez, Josefa, Navarro, Miguel Garcia, Perez-Martinez, Maria Teresa, Ortega Trujillo, Jose Ramon, Gallego, Irene Menduina, San Roman, Daniel, Perez Nogales, Eliu David, Medina, Olga, Montiel Quintero, Rodolfo Antonio, Bujanda Morun, Pablo Felipe, Perez, Marta Lopez, Huaripata, Jimmy Plasencia, Morales Gonzalez, Juan Jose, Nelson, Veronica Quevedo, Zamorano, Jose Luis, Gomez, Ariana Gonzalez, Fraile, Alfonso, Alberca, Maria Teresa, Martin, Joaquin Alonso, Fernandez-Golfin, Covadonga, Ramos, Javier, Jimenez, Sergio Hernandez, Mitroi, Cristina, Sanchez Fernandez, Pedro L., Diaz-Pelaez, Elena, Garde, Beatriz, Caballero, Luis, Garcia, Fermin Martinez, Cambronero, Francisco, Castro, Noelia, Castro, Antonio, De La Rosa, Alejandro, Gallego, Pastora, Mendez, Irene, Villegas, David Villagomez, Correa, Manuel Gonzalez, Calvo, Roman, Florian, Francisco, Paya, Rafael, Esteban, Esther, Buendia, Francisco, Cubillos, Andrés, Fernandez, Carmen, Cárdenas, Juan Pablo, Pérez-Boscá, José Leandro, Vano, Joan, Belchi, Joaquina, Iglesia-Carreno, Cristina, Iglesias, Francisco Calvo, Escudero-Gonzalez, Aida, Zapateria-Lucea, Sergio, Duarte, Juan Sterling, Perez-Davila, Lara, Cobas-Paz, Rafael, Besada-Montenegro, Rosario, Fontao-Romeo, Maribel, Lopez-Rodriguez, Elena, Paredes-Galan, Emilio, Caneiro-Queija, Berenice, Gonzalez, Alba Guitian, Bozkurt, Abdi, Demir, Serafettin, Unlu, Durmus, Cagliyan, Caglar Emre, Ikikardes, Muslum Firat, Tangalay, Mustafa, Kuloglu, Osman, Ozer, Necla, Canpolat, Ugur, Kemaloglu, Melek Didem, Demirtas, Abdullah Orhan, Akgün, Didar Elif, Avci, Eyup, Taylan, Gokay, Yilmaztepe, Mustafa Adem, Ucar, Fatih Mehmet, Altay, Servet, Gurdogan, Muhammet, Gudul, Naile Eris, Aktas, Mujdat, Buyuklu, Mutlu, Degirmenci, Husnu, Turan, Mehmet Salih, Mert, Kadir Ugur, Mert, Gurbet Ozge, Dural, Muhammet, Arslan, Sukru, Sayar, Nurten, Kanar, Batur, Sadic, Beste Ozben, Sahin, Ahmet Anil, Buyuk, Ahmet, Kilicarslan, Onur, Bostan, Cem, Yildirim, Tarik, Yildirim, Seda Elcim, Cosansu, Kahraman, Varim, Perihan, Ilguz, Ersin, Demirbag, Recep, Yesilay, Asuman, Cirit, Abdullah, Tusun, Eyyup, Erkus, Emre, Sayin, Muhammet Rasit, Kazaz, Zeynep, Kul, Selim, Karabag, Turgut, Kalayci, Belma, Eugène, Marc, and Bax, Jeroen J.

Published
2021
Full Text
View/download PDF

13. Targeting the High-Density Lipoprotein Proteome for the Treatment of Post-Acute Sequelae of SARS-CoV-2.

Author

Grote, Karsten, Schaefer, Ann-Christin, Soufi, Muhidien, Ruppert, Volker, Linne, Uwe, Mukund Bhagwat, Aditya, Szymanski, Witold, Graumann, Johannes, Gercke, Yana, Aldudak, Sümeya, Hilfiker-Kleiner, Denise, Schieffer, Elisabeth, and Schieffer, Bernhard

Subjects
ANGIOTENSIN-receptor blockers, PEPTIDASE, HIGH density lipoproteins, AMYLOID beta-protein precursor, PROTEOMICS, CYTOSKELETAL proteins
Abstract

Here, we target the high-density lipoprotein (HDL) proteome in a case series of 16 patients with post-COVID-19 symptoms treated with HMG-Co-A reductase inhibitors (statin) plus angiotensin II type 1 receptor blockers (ARBs) for 6 weeks. Patients suffering from persistent symptoms (post-acute sequelae) after serologically confirmed SARS-CoV-2 infection (post-COVID-19 syndrome, PCS, n = 8) or following SARS-CoV-2 vaccination (PVS, n = 8) were included. Asymptomatic subjects with corresponding serological findings served as healthy controls (n = 8/8). HDL was isolated using dextran sulfate precipitation and the HDL proteome of all study participants was analyzed quantitatively by mass spectrometry. Clinical symptoms were assessed using questionnaires before and after therapy. The inflammatory potential of the patients' HDL proteome was addressed in human endothelial cells. The HDL proteome of patients with PCS and PVS showed no significant differences; however, compared to controls, the HDL from PVS/PCS patients displayed significant alterations involving hemoglobin, cytoskeletal proteins (MYL6, TLN1, PARVB, TPM4, FLNA), and amyloid precursor protein. Gene Ontology Biological Process (GOBP) enrichment analysis identified hemostasis, peptidase, and lipoprotein regulation pathways to be involved. Treatment of PVS/PCS patients with statins plus ARBs improved the patients' clinical symptoms. After therapy, three proteins were significantly increased (FAM3C, AT6AP2, ADAM10; FDR < 0.05) in the HDL proteome from patients with PVS/PCS. Exposure of human endothelial cells with the HDL proteome from treated PVS/PCS patients revealed reduced inflammatory cytokine and adhesion molecule expression. Thus, HDL proteome analysis from PVS/PCS patients enables a deeper insight into the underlying disease mechanisms, pointing to significant involvement in metabolic and signaling disturbances. Treatment with statins plus ARBs improved clinical symptoms and reduced the inflammatory potential of the HDL proteome. These observations may guide future therapeutic strategies for PVS/PCS patients. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

14. Monitoring a Mystery: The Unknown Right Ventricle during Left Ventricular Unloading with Impella in Patients with Cardiogenic Shock.

Author

Markus, Birgit, Kreutz, Julian, Chatzis, Giorgios, Syntila, Styliani, Choukeir, Maryana, Schieffer, Bernhard, and Patsalis, Nikolaos

Subjects
CARDIOGENIC shock, CENTRAL venous pressure, ARTIFICIAL blood circulation, IMPACT (Mechanics), MYOCARDIAL infarction, OXYGEN saturation
Abstract

Background: Right ventricular (RV) dysfunction or failure occurs in more than 30% of patients in cardiogenic shock (CS). However, the importance of timely diagnosis of prognostically relevant impairment of RV function is often underestimated. Moreover, data regarding the impact of mechanical circulatory support like the Impella on RV function are rare. Here, we investigated the effects of the left ventricular (LV) Impella on RV function. Moreover, we aimed to identify the most optimal and the earliest applicable parameter for bedside monitoring of RV function by comparing the predictive abilities of three common RV function parameters: the pulmonary artery pulsatility index (PAPi), the ratio of right atrial pressure to pulmonary capillary wedge pressure (RA/PCWP), and the right ventricular stroke work index (RVSWI). Methods: The data of 50 patients with CS complicating myocardial infarction, supported with different flow levels of LV Impella, were retrospectively analyzed. Results: Enhancing Impella flow (1.5 to 2.5 L/min ± 0.4 L/min) did not lead to a significant variation in PAPi (p = 0.717), RA/PCWP (p = 0.601), or RVSWI (p = 0.608), indicating no additional burden for the RV. PAPi revealed the best ability to connect RV function with global hemodynamic parameters, i.e., cardiac index (CI; p < 0.001, 95% CI: 0.181–0.663), pulmonary capillary wedge pressure (PCWP; p = 0.005, 95% CI: −6.721–−1.26), central venous pressure (CVP; p < 0.001, 95% CI: −7.89–5.575), and indicators of tissue perfusion (central venous oxygen saturation (SvO2); p = 0.008, 95% CI: 1.096–7.196). Conclusions: LV Impella does not impair RV function. Moreover, PAPi seems to be to the most effective and valid predictor for early bedside monitoring of RV function. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

19. The Impact of Positive Inotropic Therapy on Hemodynamics and Organ Function in Acute Heart Failure: A Differentiated View.

Author

Cheko, Juan, Patsalis, Nikolaos, Kreutz, Julian, Divchev, Dimitar, Chatzis, Georgios, Schieffer, Bernhard, and Markus, Birgit

Subjects
HEART failure, HEMODYNAMICS, ATRIAL fibrillation, DILATED cardiomyopathy, DRUG interactions
Abstract

Background: Little is known about the impact of treatment with inotropic drugs on the interaction of hemodynamics, biomarkers, and end-organ function in patients with acute decompensated heart failure (HF) of different origins and heart rhythms. Methods: Fifty patients with different causes of acute decompensated HF (dilated cardiomyopathy DCM, ischemic cardiomyopathy ICM, atrial fibrillation AF, sinus rhythm/pacemaker lead rhythm SR/PM) were treated with dobutamine or levosimendan. Non-invasive hemodynamics, biomarkers, and parameters of renal organ function were evaluated at hospital admission and after myocardial recompensation (day 5 to 7). Results: Twenty-seven patients with ICM and twenty-three patients with DCM were included. Thirty-nine patients were treated with dobutamine and eleven with levosimendan. Sixteen were accompanied by persistent AF and thirty-four presented either with SR or PM. In the overall cohort, body weight and biomarkers (NT-proBNP/ST2) significantly decreased. GFR significantly increased during therapy with either dobutamine or levosimendan. However, hemodynamic parameters seem to be only improved in patients with DCM, in the levosimendan sub-group, and in patients with SR/PM. Conclusion: Patients with acute decompensated HF benefit from positive inotropic therapy during short-term follow-ups. In particular, patients with DCM, those after levosimendan therapy and those with SR/PM, seem to benefit most from inotropic therapy. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

20. Sex-Specific Disparities in Outcomes of Transcatheter Edge-to-Edge Repair for Mitral Regurgitation: A Multicenter "Real-World" Analysis.

Author

Ausbuettel, Felix, Barth, Sebastian, Chatzis, Georgios, Sassani, Kiarash, Fischer, Dieter, Weyand, Sebastian, Mueller, Julian, Schuett, Harald, Schieffer, Bernhard, Luesebrink, Ulrich, and Waechter, Christian

Subjects
MITRAL valve insufficiency, VENTRICULAR ejection fraction, HEART valve diseases, PATIENTS, ATRIAL flutter, PROPENSITY score matching, ATRIAL fibrillation, PATIENT experience
Abstract

Background: mitral regurgitation (mr) is the most common valvular heart disease (vhd) in the elderly and tends to be more prevalent in women. while relevant sex differences in outcomes are evident in surgically treated collectives, there are very limited and conflicting sex-specific data for the growing cohort of patients undergoing transcatheter edge-to-edge repair (teer). Objective: to investigate whether sex impacts procedural safety and efficacy, and in-hospital- and long-term outcomes, after teer for mr. Methods: in a multicenter observational cohort study, patients who underwent teer were stratified by sex and relevant outcome measures, and analyzed using multivariable cox regression and propensity score matching (psm). Results: a total of 821 patients were analyzed, of whom 37.4% (307/821) were female. compared to male patients, females were significantly older (77 ± 8.5 vs. 80.4 ± 6.7 years, p = 0.03), and had less coronary artery disease (cad, 67.7% vs. 53.1%, p < 0.0001) and a higher proportion of preserved left ventricular function (lvef > 50%, 32.5% vs. 50.5%, p > 0.0001). safety and efficacy of the teer procedure and in-hospital mortality did not differ between the sexes. after psm, women showed significantly better survival 3 years after teer compared to men (60.7% vs. 54.2%, p = 0.04) and a lower risk of all-cause death according to multiple cox regression (hr 0.8, 95% ci 0.6–0.9, p = 0.02). after sex-specific stratification for concomitant atrial fibrillation (af), the most common comorbidity in the present collective, women with af experience significantly worse adjusted survival compared to women without af (53.9% vs. 75.1%, p = 0.042) three years after teer and lose the survival advantage over men. Conclusions: female patients are older and less comorbid than males undergoing TEER. The TEER procedure is equally safe and effective in both sexes. While in-hospital mortality did not differ, female patients experienced a significantly better adjusted long-term survival compared to male patients. Concomitant AF offsets the prognostic advantage of females over males and, in contrast to males, significantly impairs long-term survival in women undergoing TEER. Further research is warranted to elucidate underlying causes for the observed sex disparities and to develop sex-tailored treatment recommendations. [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

24. Comparative analysis of full-length 16s ribosomal RNA genome sequencing in human fecal samples using primer sets with different degrees of degeneracy.

Author

Waechter, Christian, Fehse, Leon, Welzel, Marius, Heider, Dominik, Babalija, Lek, Cheko, Juan, Mueller, Julian, Pöling, Jochen, Braun, Thomas, Pankuweit, Sabine, Weihe, Eberhard, Kinscherf, Ralf, Schieffer, Bernhard, Luesebrink, Ulrich, Soufi, Muhidien, and Ruppert, Volker

Subjects
RIBOSOMAL RNA, HUMAN genome, HUMAN microbiota, COMPARATIVE studies, BACTERIAL communities, NUCLEOTIDE sequencing, SHOTGUN sequencing
Abstract

Next-generation sequencing has revolutionized the field of microbiology research and greatly expanded our knowledge of complex bacterial communities. Nanopore sequencing provides distinct advantages, combining costeffectiveness, ease of use, high throughput, and high taxonomic resolution through its ability to process long amplicons, such as the entire 16s rRNA genome. We examine the performance of the conventional 27F primer (27F-I) included in the 16S Barcoding Kit distributed by Oxford Nanopore Technologies (ONT) and that of a more degenerate 27F primer (27F-II) in the context of highly complex bacterial communities in 73 human fecal samples. The results show striking differences in both taxonomic diversity and relative abundance of a substantial number of taxa between the two primer sets. Primer 27F-I reveals a significantly lower biodiversity and, for example, at the taxonomic level of the phyla, a dominance of Firmicutes and Proteobacteria as determined by relative abundances, as well as an unusually high ratio of Firmicutes/Bacteriodetes when compared to the more degenerate primer set (27F-II). Considering the findings in the context of the gut microbiomes common in Western industrial societies, as reported in the American Gut Project, the more degenerate primer set (27F-II) reflects the composition and diversity of the fecal microbiome significantly better than the 27F-I primer. This study provides a fundamentally relevant comparative analysis of the in situ performance of two primer sets designed for sequencing of the entire 16s rRNA genome and suggests that the more degenerate primer set (27F-II) should be preferred for nanopore sequencing-based analyses of the human fecal microbiome. [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

25. Training one model to detect heart and lung sound events from single point auscultations

Author

Melms, Leander, Ilesan, Robert R., Köhler, Ulrich, Hildebrandt, Olaf, Conradt, Regina, Eckstein, Jens, Atila, Cihan, Matrood, Sami, Schieffer, Bernhard, Schaefer, Jürgen R., Müller, Tobias, Obergassel, Julius, Schlicker, Nadine, and Hirsch, Martin C.

Subjects
FOS: Computer and information sciences, Sound (cs.SD), Audio and Speech Processing (eess.AS), FOS: Electrical engineering, electronic engineering, information engineering, Computer Science - Sound, Electrical Engineering and Systems Science - Audio and Speech Processing
Abstract

Objective: This work proposes a semi-supervised training approach for detecting lung and heart sounds simultaneously with only one trained model and in invariance to the auscultation point. Methods: We use open-access data from the 2016 Physionet/CinC Challenge, the 2022 George Moody Challenge, and from the lung sound database HF_V1. We first train specialist single-task models using foreground ground truth (GT) labels from different auscultation databases to identify background sound events in the respective lung and heart auscultation databases. The pseudo-labels generated in this way were combined with the ground truth labels in a new training iteration, such that a new model was subsequently trained to detect foreground and background signals. Benchmark tests ensured that the newly trained model could detect both, lung, and heart sound events in different auscultation sites without regressing on the original task. We also established hand-validated labels for the respective background signal in heart and lung sound auscultations to evaluate the models. Results: In this work, we report for the first time results for i) a multi-class prediction for lung sound events and ii) for simultaneous detection of heart and lung sound events and achieve competitive results using only one model. The combined multi-task model regressed slightly in heart sound detection and gained significantly in lung sound detection accuracy with an overall macro F1 score of 39.2% over six classes, representing a 6.7% improvement over the single-task baseline models. Conclusion/Significance: To the best of our knowledge, this is the first approach developed to date for measuring heart and lung sound events invariant to both, the auscultation site and capturing device. Hence, our model is capable of performing lung and heart sound detection from any auscultation location., 14 pages, 8 figures

Published
2023

27. Delayed perforation of an atrial pacemaker electrode: Lifelong risk for a rare but serious complication.

Author

Waechter, Christian, Koenig, Alexander M., Chatzis, Georgios, Mueller, Julian, Schieffer, Bernhard, and Luesebrink, Ulrich

Subjects
CARDIAC pacemakers, ARTIFICIAL implants, ELECTRONIC equipment, PERICARDITIS, ELECTRODES, CHEST pain, WOMEN executives
Abstract

Key Clinical Message: Nonspecific symptoms such as pleuritic or pericardial chest pain in cardiovascular implantable electronic devices patients, even with unremarkable ECG or device parameters, should always raise suspicion of electrode perforation, regardless of how long ago the implantation was performed. We report the successful percutaneous management of a 77‐year‐old woman who had a dual‐chamber pacemaker implanted more than 1 year ago and presented with pericarditis pain and compensated pericardial hemorrhagic tamponade. The symptoms were due to very late acute perforation of the atrial lead. This report is intended to raise awareness of procedure‐related complications in the large group of cardiovascular implantable electronic device patients. Pleuritic or pericardial pain in these patients should raise suspicion of electrode perforation, as the risk of perforation is not restricted to the period immediately after implantation and a lifelong risk cannot apparently be excluded. [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

28. New-Onset Atrial Fibrillation in the Setting of COVID-19 Infection Is a Predictor of Mortality in Hospitalized Patients: CovAF-Study.

Author

Parahuleva, Mariana S., Harbaum, Lukas, Patsalis, Nikolaos, Parahuleva, Nikoleta, Arndt, Christian, Lüsebrink, Ulrich, Schieffer, Bernhard, and Kreutz, Julian

Subjects
ATRIAL fibrillation, COVID-19, HOSPITAL patients, ARRHYTHMIA, POLYMERASE chain reaction, COVID-19 pandemic, ATRIAL flutter
Abstract

Recent studies show that hospitalized COVID-19 patients have an increased incidence of arrhythmia, especially atrial fibrillation (AF). This single-center study included 383 hospitalized patients with positive polymerase chain reaction tests for COVID-19 from March 2020 to April 2021. Patient characteristics were documented, and data were analyzed for episodes of AF on admission or during the hospital stay, intrahospital mortality, need for intensive care and/or invasive ventilation, inflammatory parameters (hs-CRP, IL-6, and procalcitonin), and differential blood count. We demonstrated that in the setting of hospitalized cases of COVID-19 infection, there is an incidence of 9.8% (n = 36) for the occurrence of new-onset AF. Furthermore, it was shown that a total of 21% (n = 77) had a history of episodes of paroxysmal/persistent AF. However, only about one-third of patients with pre-existing AF had relevant documented tachycardic episodes during the hospital stay. Patients with new-onset AF had a significantly increased intrahospital mortality compared to the control and the pre-existing AF without rapid ventricular rate (RVR) group. Patients with new-onset AF required intensive care and invasive ventilation more frequently. Further analysis examined patients with episodes of RVR and demonstrated that they had significantly elevated CRP (p < 0.05) and PCT (p < 0.05) levels on the day of hospital admission compared to patients without RVR. [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

29. Management of a severe abdominal compartment complicating fulminant cardiogenic-septic shock: An abdominal arterio-venous single-tube ECMO bypass saved a young patient's life after OHCA.

Author

Kreutz, Julian, Mardini, Amar, Schäfer, Ann-Christin, Schieffer, Bernhard, and Markus, Birgit

Subjects
ANTIBIOTICS, CATECHOLAMINES, COMPARTMENT syndrome, EXTRACORPOREAL membrane oxygenation, BYSTANDER CPR, SEVERITY of illness index, CARDIAC arrest, CARDIOGENIC shock, CARDIOPULMONARY bypass, COMPUTED tomography, SEPTIC shock, FAMILY history (Medicine), DISEASE complications
Abstract

Introduction: In severe cardiogenic shock, for example, following cardiac arrest, the implantation of an extracorporeal hemodynamic assist device often seems to be the last option to save a patient's life. However, even though our guidelines provide a class-IIa-recommendation to implant a veno-arterial extracorporeal membrane oxygenation (vaECMO) device in these patients, the accompanying disease- and device-associated complications and their consequences remain challenging to handle. Case presentation: A 43-year-old patient presented with severe cardiogenic-septic shock with a complicating abdominal compartment due to a prolonged out-of-hospital cardiac arrest (OHCA). A loss of function of the vaECMO, implanted immediately after admission, impended due to increasing intra-abdominal pressure. This dangerous situation was resolved by crafting an experimental "arterio-venous shunt," using the side port of the reinfusion (arterial) vaECMO cannula and a downstream large-volume central access in the right femoral vein toward the abdominal venous system, which led to the patient's full recovery. Conclusion: In patients with cardiogenic shock, the use of catecholamines and implantation of extracorporeal assist devices alone do not ensure successful therapy. To optimize the outcome, device- and disease-associated complications must also be managed in a timely and minimally invasive procedure. [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

34. The Race for ACE: Targeting Angiotensin-Converting Enzymes (ACE) in SARS-CoV-2 Infection

Author

Schieffer, Elisabeth and Schieffer, Bernhard

Subjects
Article Subject
Abstract

The SARS-CoV-2 virus is spreading around the world, and its clinical manifestation COVID-19 is challenging medical, economic, and social systems. With more and more scientific and social media reports on the COVID-19 pandemic appearing, differences in geographical presentations and clinical management occur. Since ACE2 (angiotensin-converting enzyme 2) is the gatekeeper receptor for the SARS-CoV-2 virus in the upper bronchial system, we here focus on the central role of the renin-angiotensin aldosterone system (RAAS) in the SARS-CoV-2 virus infection, the role of pharmacological RAAS inhibitors, and specific genetic aspects, i.e., single nucleotide polymorphisms (SNP) for the clinical outcome of COVID-19. We aimed to bring together clinical, epidemiological, molecular, and pathophysiological and pharmacological data/observations on cardiovascular aspects in the actual SARS-CoV-2 virus pandemic. In detail, we will report controversies about the Yin-Yan between ACE2 and ACE1 and potential implications for the treatment of hypertension, coronary artery disease, and heart failure. Here, we summarize the encouraging and dynamic global effort of multiple biomedical disciplines resulted in astonishing fight against COVID-19 targeting the renin-angiotensin-aldosterone system, yet the race for ACE just begun.

Published
2022
Full Text
View/download PDF

39. Renal Protection and Hemodynamic Improvement by Impella ® Microaxial Pump in Patients with Cardiogenic Shock.

Author

Patsalis, Nikolaos, Kreutz, Julian, Chatzis, Georgios, Syntila, Styliani, Griewing, Sebastian, Pirlet-Grant, Carly, Schlegel, Malte, Schieffer, Bernhard, and Markus, Birgit

Subjects
CARDIOGENIC shock, DOPPLER ultrasonography, HEMODYNAMICS, VASCULAR resistance, ACUTE kidney failure
Abstract

Acute kidney injury is one of the most frequent and prognostically relevant complications in cardiogenic shock. The purpose of this study was to evaluate the potential effect of the Impella® pump on hemodynamics and renal organ perfusion in patients with myocardial infarction complicating cardiogenic shock. Between January 2020 and February 2022 patients with infarct-related cardiogenic shock supported with the Impella® pump were included in this single-center prospective short-term study. Changes in hemodynamics on different levels of Impella® support were documented with invasive pulmonal arterial catheter. As far as renal function is concerned, renal perfusion was assessed by determining the renal resistive index (RRI) using Doppler sonography. A total of 50 patients were included in the analysis. The increase in the Impella® output by a mean of 1.0 L/min improved the cardiac index (2.7 ± 0.86 to 3.3 ± 1.1 p < 0.001) and increased central venous oxygen saturation (62.6 ± 11.8% to 67.4 ± 10.5% p < 0.001). On the other side, the systemic vascular resistance (1035 ± 514 N·s/m5 to 902 ± 371 N·s/m5p = 0.012) and the RRI were significantly reduced (0.736 ± 0.07 to 0.62 ± 0.07 p < 0.001). Furthermore, in the overall cohort, a baseline RRI ≥ 0.8 was associated with a higher frequency of renal replacement therapy (71% vs. 39% p = 0.04), whereas the consequent reduction of the RRI below 0.7 during Impella® support improved the glomerular filtration rate (GFR) during hospital stay (15 ± 3 days; 53 ± 16 mL/min to 83 ± 16 mL/min p = 0.04). Impella® support in patients with cardiogenic shock seems to improve hemodynamics and renal organ perfusion. The RRI, a well-known parameter for the early detection of acute kidney injury, can be directly influenced by the Impella® flow rate. Thus, a targeted control of the RRI by the Impella® pump could mediate renal organ protection. [ABSTRACT FROM AUTHOR]

Published
2022
Full Text
View/download PDF

41. Repetitive Electroencephalography as Biomarker for the Prediction of Survival in Patients with Post-Hypoxic Encephalopathy.

Author

Willems, Laurent M., Rosenow, Felix, Knake, Susanne, Beuchat, Isabelle, Siebenbrodt, Kai, Strüber, Michael, Schieffer, Bernhard, Karatolios, Konstantinos, and Strzelczyk, Adam

Subjects
OVERALL survival, ELECTROENCEPHALOGRAPHY, BRAIN diseases, REGRESSION analysis, BIOMARKERS
Abstract

Predicting survival in patients with post-hypoxic encephalopathy (HE) after cardiopulmonary resuscitation is a challenging aspect of modern neurocritical care. Here, continuous electroencephalography (cEEG) has been established as the gold standard for neurophysiological outcome prediction. Unfortunately, cEEG is not comprehensively available, especially in rural regions and developing countries. The objective of this monocentric study was to investigate the predictive properties of repetitive EEGs (rEEGs) with respect to 12-month survival based on data for 199 adult patients with HE, using log-rank and multivariate Cox regression analysis (MCRA). A total number of 59 patients (29.6%) received more than one EEG during the first 14 days of acute neurocritical care. These patients were analyzed for the presence of and changes in specific EEG patterns that have been shown to be associated with favorable or poor outcomes in HE. Based on MCRA, an initially normal amplitude with secondary low-voltage EEG remained as the only significant predictor for an unfavorable outcome, whereas all other relevant parameters identified by univariate analysis remained non-significant in the model. In conclusion, rEEG during early neurocritical care may help to assess the prognosis of HE patients if cEEG is not available. [ABSTRACT FROM AUTHOR]

Published
2022
Full Text
View/download PDF

46. Case Report: Arterial Wall Inflammation in Atherosclerotic Cardiovascular Disease is Reduced by Olamkicept (sgp130Fc).

Author

Schulte, Dominik M., Waetzig, Georg H., Schuett, Harald, Marx, Marlies, Schulte, Berenice, Garbers, Christoph, Lokau, Juliane, Vlacil, Ann-Kathrin, Schulz, Juliane, Seoudy, Anna K., Schieffer, Bernhard, Rosenstiel, Philip, Seeger, Marcus, Laudes, Matthias, Rose-John, Stefan, Lützen, Ulf, Grote, Karsten, and Schreiber, Stefan

Subjects
LIPIDS, POSITRON emission tomography, CARDIOVASCULAR diseases, CHOLESTEROL metabolism, LDL cholesterol, CHIMERIC proteins, LIPOPROTEIN A
Abstract

Inflammation is a strong driver of atherosclerotic cardiovascular disease (ASCVD). There is a large unmet need for therapies that prevent or reduce excessive inflammation while avoiding systemic immunosuppression. We showed previously that selective inhibition of pro-inflammatory interleukin-6 (IL-6) trans-signalling by the fusion protein olamkicept (sgp130Fc) prevented and reduced experimental murine atherosclerosis in low-density lipoprotein receptor-deficient (Ldlr −/−) mice on a high-fat, high-cholesterol diet independently of low-density lipoprotein (LDL) cholesterol metabolism. Therefore, we allowed compassionate use of olamkicept (600 mg intravenously biweekly for 10 weeks) in a patient with very-high-risk ASCVD. Despite optimal LDL cholesterol under maximum tolerated lipid-lowering treatment, the patient had a remaining very high risk for future cardiovascular events related to significant arterial wall inflammation with lipoprotein (a) [Lp(a)]-cholesterol as the main contributor. 18Fluorodeoxyglucose positron emission tomography/computed tomography (18FDG PET/CT) measurements were performed before and after the treatment period. Olamkicept reduced arterial wall inflammation in this patient without interfering with lipoprotein metabolism. No clinical or laboratory side effects were observed during or after treatment with olamkicept. Our findings in this patient matched the results from our mechanistic study in Ldlr −/− mice, which were extended by additional analyses on vascular inflammation. Olamkicept may be a promising option for treating ASCVD independently of LDL cholesterol metabolism. A Phase II trial of olamkicept in ASCVD is currently being prepared. [ABSTRACT FROM AUTHOR]

Published
2022
Full Text
View/download PDF

48. Extracellular Ribosomal RNA Acts Synergistically with Toll-like Receptor 2 Agonists to Promote Inflammation.

Author

Grote, Karsten, Nicolai, Marina, Schubert, Uwe, Schieffer, Bernhard, Troidl, Christian, Preissner, Klaus T., Bauer, Stefan, and Fischer, Silvia

Subjects
RIBOSOMAL RNA, NF-kappa B, TUMOR necrosis factors, TOLL-like receptors, MONOCYTE chemotactic factor, TUMOR proteins
Abstract

Self-extracellular RNA (eRNA), which is released under pathological conditions from damaged tissue, has recently been identified as a new alarmin and synergistic agent together with toll-like receptor (TLR)2 ligands to induce proinflammatory activities of immune cells. In this study, a detailed investigation of these interactions is reported. The macrophage cell line J774 A.1 or C57 BL/6 J wild-type mice were treated with 18S rRNA and different TLR2 agonists. Gene and protein expression of tumor necrosis factor (Tnf)-α; interleukin (Il)-1β, Il-6; or monocyte chemoattractant protein (Mcp)-1 were analyzed and furthermore in vitro binding studies to TLR2 were performed. The TLR2/TLR6-agonist Pam2 CSK4 (Pam2) together with 18S rRNA significantly increased the mRNA expression of inflammatory genes and the release of TNF-α from macrophages in a TLR2- and nuclear factor kappa B (NF-κB)-dependent manner. The injection of 18S rRNA/Pam2 into mice increased the cytokine levels of TNF-α, IL-6, and MCP-1 in the peritoneal lavage. Mechanistically, 18S rRNA built complexes with Pam2 and thus enhanced the affinity of Pam2 to TLR2. These results indicate that the alarmin eRNA, mainly consisting of rRNA, sensitizes TLR2 to enhance the innate immune response under pathological conditions. Thus, rRNA might serve as a new target for the treatments of bacterial and viral infections. [ABSTRACT FROM AUTHOR]

Published
2022
Full Text
View/download PDF

49. Factor VII Activating Protease Expression in Human Platelets and Accumulation in Symptomatic Carotid Plaque

Author

Parahuleva, Mariana S., Worsch, Michael, Euler, Gerhild, Choukeir, Maryana, Mardini, Amar, Parviz, Behnoush, Kanse, Sandip M., Portig, Irene, Khayrutdinov, Evgeny, Schieffer, Bernhard, and Markus, Birgit

Subjects
Platelets, Blood Platelets, Male, Platelet Membrane Glycoprotein IIb, asymptomatic carotid stenosis, Antigens, Differentiation, Myelomonocytic, Monocytes, Antigens, CD, Humans, Carotid Stenosis, RNA, Messenger, Original Research, symptomatic carotid stenosis, Ischemic Stroke, Aged, platelet, Inflammation, Endarterectomy, Carotid, Macrophages, Transient Ischemic Attack (TIA), Factor VII, Middle Aged, Peptide Fragments, Plaque, Atherosclerotic, Stroke, Carotid Arteries, Case-Control Studies, FSAP, Cerebrovascular Disease/Stroke, Female, atherosclerosis, Peptide Hydrolases
Abstract

Background Factor VII activating protease (FSAP) is of interest as a marker for vascular inflammation and plaque destabilization. The aim of this study was to analyze the expression profile of FSAP in endarterectomy specimens that were taken from patients with asymptomatic and symptomatic carotid atherosclerotic plaques and to compare them with circulating FSAP levels. Methods and Results Plasma FSAP concentration, activity, and mRNA expression were measured in endarterectomy specimens and in monocytes and platelets. Plaque and plasma FSAP levels were higher in symptomatic patients (n=10) than in asymptomatic patients (n=14). Stronger FSAP immunostaining was observed in advanced symptomatic lesions, in intraplaque hemorrhage-related structures, and in lipid-rich areas within the necrotic core. FSAP was also colocalized with monocytes and macrophages (CD11b/CD68-positive cells) and platelets (CD41-positive cells) of the plaques. Moreover, human platelets expressed FSAP in vitro, at both the mRNA and protein levels. Expression is stimulated by thrombin receptor-activating peptide and ADP and reduced by acetylsalicylic acid. Conclusions Plasma FSAP levels were significantly increased in patients with symptomatic carotid stenosis and thus may be involved in plaque development This plaque-associated FSAP may be produced by platelets or macrophages or may be taken up from the circulation. To establish FSAP's utility as a circulating or plaque biomarker in patients with symptomatic carotid atherosclerotic plaques, further studies are needed.

Published
2020

Catalog

Books, media, physical & digital resources
See catalog results