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14 results on '"Ann‐Kathrin Schäfer"'

1. Urinary Dickkopf‐3 as a Potential Marker for Estimated Glomerular Filtration Rate Decline in Patients With Heart Failure

Author

Dennis Pieper, Anja Sandek, Ann‐Kathrin Schäfer, Hassan Dihazi, Gry Helene Dihazi, Andreas Leha, Michael Zeisberg, Stephan Lüders, Michael Koziolek, and Manuel Wallbach

Subjects
cardiorenal syndrome, Dickkopf‐3, estimated glomerular filtration rate, heart failure, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background Patients with chronic heart failure (HF) show an increased risk for the occurrence of chronic kidney disease and cardiorenal syndrome. Urinary Dickkopf‐3 (uDKK3), a stress‐induced, tubular profibrotic glycoprotein, may be elevated in HF as early as in New York Heart Association class I HF and may indicate subsequent decline in estimated glomerular filtration rate (eGFR). Methods and Results uDKK3 levels in patients with HF and controls were measured by enzyme‐linked immunosorbent assay. eGFR was determined up to 5 years in HF. Change in eGFR was assessed with respect to baseline uDKK3 using (mixed‐effect) linear and logistic regression models. A total of 488 patients with chronic HF and 45 control patients were included. Patients with HF showed higher median uDKK3 levels than controls (259.6 pg/mg creatinine [interquartile range (IQR), 119.2–509.4 pg/mg creatinine] versus 107.5 pg/mg creatinine [IQR, 60.5–181.2 pg/mg creatinine], P

Published
2024
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2. Effect of baroreflex activation therapy on dipping pattern in patients with resistant hypertension

Author

Manuel Wallbach, Ellen Born, Ann‐Kathrin Schäfer, and Michael J. Koziolek

Subjects
ambulatory blood pressure monitoring, baroreflex activation therapy, nocturnal dipping, resistant hypertension, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract A relevant number of patients with resistant hypertension do not achieve blood pressure (BP) dipping during nighttime. This inadequate nocturnal BP reduction is associated with elevated cardiovascular risks. The aim of this study was to evaluate whether a nighttime intensification of BAT might improve nocturnal BP dipping. In this prospective observational study, non‐dippers treated with BAT for at least 6 months were included. BAT programming was modified in a two‐step intensification of nighttime stimulation at baseline and week 6. Twenty‐four hours ambulatory BP (ABP) was measured at inclusion and after 3 months. A number of 24 patients with non‐ or inverted dipping pattern, treated with BAT for a median of 44 months (IQR 25–52) were included. At baseline of the study, patients were 66 ± 9 years old, had a BMI of 33 ± 6 kg/m2, showed an office BP of 135 ± 22/72 ± 10 mmHg, and took a median number of antihypertensives of 6 (IQR 4–9). Nighttime stimulation of BAT was adapted by an intensification of pulse width from 237 ± 161 to 267 ± 170 μs (p = .003) while frequency (p = .10) and amplitude (p = .95) remained unchanged. Uptitration of BAT programming resulted in an increase of systolic dipping from 2 ± 6 to 6 ± 8% (p = .03) accompanied with a significant improvement of dipping pattern (p = .02). Twenty four hours ABP, day‐ and nighttime ABP remained unchanged. Programming of an intensified nighttime BAT interval improved dipping profile in patients treated with BAT, while the overall 24 h ABP did not change. Whether the improved dipping response contributes to a reduction of cardiovascular risk beyond the BP‐lowering effects of BAT, however, remains to be shown.

Published
2023
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3. Case Report: High-dose immunoglobulins prior to plasma exchange in severe pulmonary renal syndrome

Author

Ann-Kathrin Schäfer, Sascha Dierks, Moritz Schnelle, Peter Korsten, Samy Hakroush, and Björn Tampe

Subjects
ANCA-associated vasculitis, pulmonary renal syndrome, IVIGs, plasma exchange, ANCA clearance, Immunologic diseases. Allergy, RC581-607
Abstract

Plasma exchange rapidly depletes pathogenic anti-neutrophil cytoplasmic autoantibodies (ANCAs) and is considered for induction therapy in severe ANCA-associated vasculitis. The aim of plasma exchange is to remove putative disease mediators from the circulation, such as toxic macromolecules and pathogenic ANCAs. To our knowledge, we here provide the first report of applying high-dose IVIGs prior to plasma exchange and assessment of ANCA autoantibody elimination in a patient with severe pulmonary renal syndrome due to ANCA-associated vasculitis. After high-dose application of intravenous immunoglobulins (IVIGs) prior to plasma exchange treatment, efficacy of myeloperoxidase (MPO)-ANCA autoantibody elimination was substantially increased, associated with rapid clearance of MPO-ANCA autoantibodies. High-dose IVIGs resulted in marked reduction of MPO-ANCA autoantibody levels and did not directly affect autoantibody clearance by plasma exchange itself, as also confirmed by comparable MPO-ANCAs in the exchange fluid relative to serum levels. Moreover, measurements of serum creatinine and albuminuria confirmed that high-dose IVIGs were well tolerated and did not exacerbate kidney injury.

Published
2023
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4. Eligibility for Baroreflex Activation Therapy and medication adherence in patients with apparently resistant hypertension

Author

Ann‐Kathrin Schäfer, Tim Kuczera, Rebecca Wurm‐Kuczera, Dieter Müller, Ellen Born, Mark Lipphardt, Marlene Plüss, Manuel Wallbach, and Michael Koziolek

Subjects
adherence, antihypertensive medication, baroreflex activation therapy, resistant hypertension, uncontrolled hypertension, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Uncontrolled hypertension is a main risk factor for cardiovascular morbidity. Baroreflex activation therapy (BAT) is an effective therapy option addressing true resistant hypertension. We evaluated patients’ eligibility for BAT in a staged assessment as well as adherence to antihypertensive drug therapy. Therefore, we analyzed files of 345 patients, attending the hypertension clinic at University Medicine Göttingen. Additionally, gas chromatographic‐mass spectrometric urine analyses of selected individuals were performed evaluating their adherence. Most common cause for a revoked BAT recommendation was blood pressure (BP) control by drug adjustment (54.2%). Second leading cause was presence of secondary hypertension (31.6%). Patients to whom BAT was recommended (59 (17.1%)) were significantly more often male (67.8% vs. 43.3%, P = .0063), had a higher body mass index (31.8 ± 5.8 vs. 30.0 ± 5.7 kg/m², P = .0436), a higher systolic office (168.7 ± 24.7 vs. 147.7 ± 24.1 mmHg, P

Published
2021
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5. Effect of baroreflex activation therapy on dipping pattern in patients with resistant hypertension

Author

Manuel Wallbach, Ellen Born, Ann‐Kathrin Schäfer, and Michael J. Koziolek

Subjects
Endocrinology, Diabetes and Metabolism, Internal Medicine, Cardiology and Cardiovascular Medicine
Abstract

A relevant number of patients with resistant hypertension do not achieve blood pressure (BP) dipping during nighttime. This inadequate nocturnal BP reduction is associated with elevated cardiovascular risks. The aim of this study was to evaluate whether a nighttime intensification of BAT might improve nocturnal BP dipping. In this prospective observational study, non-dippers treated with BAT for at least 6 months were included. BAT programming was modified in a two-step intensification of nighttime stimulation at baseline and week 6. Twenty-four hours ambulatory BP (ABP) was measured at inclusion and after 3 months. A number of 24 patients with non- or inverted dipping pattern, treated with BAT for a median of 44 months (IQR 25-52) were included. At baseline of the study, patients were 66 ± 9 years old, had a BMI of 33 ± 6 kg/m

Published
2022

7. Syndecan-4 as a Marker of Endothelial Dysfunction in Patients with Resistant Hypertension

Author

Mark, Lipphardt, Hassan, Dihazi, Jens-Holger, Maas, Ann-Kathrin, Schäfer, Saskia I, Amlaz, Brian B, Ratliff, Michael J, Koziolek, and Manuel, Wallbach

Subjects
Syndecan-4, resistant hypertension, endothelium, baroreflex activation therapy, lcsh:R, lcsh:Medicine, cardiovascular diseases, Article
Abstract

(1) Background: Arterial hypertension (HTN) is one of the most relevant cardiovascular risk factors. Nowadays multiple pharmaceutical treatment options exist with novel interventional methods (e.g., baroreflex activation therapy (BAT)) as a last resort to treat patients with resistant HTN. Although pathophysiology behind resistant HTN is still not fully understood. There is evidence that selected biomarkers may be involved in the pathophysiology of HTN. (2) Methods: We investigated serum SDC4-levels in patients suffering from resistant HTN before and 6 months after BAT implantation. We collected 19 blood samples from patients with resistant HTN and blood pressure above target and measured serum SDC4-levels. (3) Results: Our results showed high serum SDC4-levels in patients with resistant HTN as compared to a healthy population. Patients with both, resistant HTN and diabetes mellitus type II, demonstrated higher serum SDC4-levels. &beta, blockers had lowering effects on serum SDC4-levels, whereas calcium channel blockers were associated with higher levels of serum SDC4. BAT implantation did not lead to a significant difference in serum SDC4-levels after 6 months of therapy. (4) Conclusion: Based on our results we propose SDC4 is elevated in patients suffering from resistant HTN. Thus, SDC4 might be a potential marker for endothelial dysfunction in patients with resistant hypertension.

Published
2020

11. Phenotypical and functional analysis of donor lymphocyte infusion products after long-term cryopreservation

Author

Miguel Waterhouse, Jesus Duque-Afonso, Hartmut Bertz, Jürgen Finke, Ann-Kathrin Schäfer, Marie Follo, and Justus Duyster

Subjects
Cryopreservation, Male, Cell growth, Lymphocyte, Hematology, 030204 cardiovascular system & hematology, Biology, Peripheral blood mononuclear cell, Donor lymphocyte infusion, Andrology, Transplantation, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Phenotype, medicine, Cytotoxic T cell, Humans, Female, Viability assay, Lymphocytes, 030215 immunology, Cell Proliferation
Abstract

Donor lymphocyte infusions, collected from peripheral blood by apheresis, are regularly used to re-establishing disease control in patients with impending or full relapse after allogeneic cell transplantation. The cryopreservation and thawing processes of the cellular products, required for clinical needs, result in a decreased cellular recovery. The aim of this study was to perform an integral analysis of phenotypic and functional characteristics in different cell populations, within cryopreserved products used for therapeutic purposes. A total of 77 cryopreserved products were analysed. Cell viability and subpopulations such as CD3, CD4, CD8, CD14 and CD56 cells were quantified by FACS. Cell proliferation, cytotoxic capacity and CD4 intracellular ATP content were evaluated. A significant loss of cell viability was observed. CD56 cells were significantly reduced when compared with mononuclear cells without cryopreservation. Cell proliferation was also significantly reduced in the cryopreserved products. Cytotoxic capacity was decreased as well although it did not reach statistical significance. However, CD4 intracellular ATP was increased in the cryopreserved products. The analysed functional cell properties showed a wide distribution range although the apheresis, cryopreservation and thawing procedures were similar in all the analysed samples. Our findings may be useful for an improved characterisation of cryopreserved products to be used as donor lymphocyte infusion for therapeutic purposes.

Published
2019

12. Effect of baroreflex activation therapy on renal sodium excretion in patients with resistant hypertension

Author

Ann-Kathrin Schäfer, Michael Koziolek, Stephan Lüders, Mark Lipphardt, Luca-Yves Lehnig, Manuel Wallbach, and Gerhard A. Müller

Subjects
Adult, Male, medicine.medical_specialty, Sympathetic nervous system, 030204 cardiovascular system & hematology, Baroreflex, Kidney, Plasma renin activity, Excretion, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, Antihypertensive Agents, Aged, Polypharmacy, business.industry, Sodium, General Medicine, Middle Aged, Blood pressure, medicine.anatomical_structure, Treatment Outcome, Renal sodium excretion, Ambulatory, Hypertension, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Glomerular Filtration Rate
Abstract

Activation of the sympathetic nervous system increases sodium retention in resistant hypertension. Baroreflex activation therapy (BAT) is an interventional method to reduce sympathetic overactivity in patients with resistant hypertension. This study aimed to assess the effect of BAT on urinary sodium excretion. From 2012 to 2015, consecutive patients with resistant hypertension and blood pressure (BP) above target despite polypharmacy strategies were consecutively included in this observational study. BAT was provided with the individual adaption of programmed parameters over the first months. 24-h urinary sodium excretion (UNa) was estimated at baseline and after 6 months using the Kawasaki formula in patients undergoing BAT. Additionally, the fractional sodium excretion, plasma renin activity, and aldosterone levels were assessed. Forty-two patients completed the 6-month follow-up period. Office systolic and ambulatory 24-h systolic BP at baseline were 169 ± 27 mmHg and 148 ± 16 mmHg despite a median intake of 7(3–9) antihypertensive drugs. After 6 months of BAT, systolic office BP decreased to 150 ± 29 mmHg (p

Published
2019

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