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1. Nicht kodierende Ribonukleinsäure im kardiovaskulären System: Sonderforschungsbereich-Transregio (SFB-TRR 267)

Author

Engelhardt, S., Dimmeler, S., Heim, C., Bär, C., Böttger, T., Boon, R., Brandes, R. P., Braun, T., Dueck, A., Gagneur, J., Grote, P., Holdt, L. M., Jaé, N., Krishnan, J., Kupatt, C., Laugwitz, K.-L., Leisegang, M. S., Maegdefessel, L., Meitinger, T., Moretti, A., Müller-McNicoll, M., Sattler, M., Schnieke, A., Schulz, M., Schunkert, H., Schwalbe, H., Teupser, D., Thum, T., Weber, C., Wittig, I., and Zarnack, K.

Published
2022
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3. Somatic gene editing ameliorates skeletal and cardiac muscle failure in pig and human models of Duchenne muscular dystrophy

Author

Moretti, A., Fonteyne, L., Giesert, F., Hoppmann, P., Meier, A. B., Bozoglu, T., Baehr, A., Schneider, C. M., Sinnecker, D., Klett, K., Fröhlich, T., Rahman, F. Abdel, Haufe, T., Sun, S., Jurisch, V., Kessler, B., Hinkel, R., Dirschinger, R., Martens, E., Jilek, C., Graf, A., Krebs, S., Santamaria, G., Kurome, M., Zakhartchenko, V., Campbell, B., Voelse, K., Wolf, A., Ziegler, T., Reichert, S., Lee, S., Flenkenthaler, F., Dorn, T., Jeremias, I., Blum, H., Dendorfer, A., Schnieke, A., Krause, S., Walter, M. C., Klymiuk, N., Laugwitz, K. L., Wolf, E., Wurst, W., and Kupatt, C.

Published
2020
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6. Man-machine interaction-based phenotyping identifies pathophysiologically and prognostically informative clusters among patients with mitral regurgitation undergoing transcatheter edge-to-edge repair

Author

Lachmann, M, primary, Trenkwalder, T, additional, Covarrubias, H A A, additional, Rippen, E, additional, Schuermann, F, additional, Presch, A, additional, Ruff, C, additional, Mayr, P N, additional, Schunkert, H, additional, Kastrati, A, additional, Kupatt, C, additional, Laugwitz, K L, additional, Joner, M, additional, and Xhepa, E, additional

Published
2022
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10. Sequential defects in cardiac lineage commitment and maturation cause hypoplastic left heart syndrome

Author

Krane, M, Dressen, M, Santamaria, G, My, I, Schneider, C, Dorn, T, Laue, S, Mastantuono, E, Berutti, R, Rawat, H, Gilsbach, R, Schneider, P, Lahm, H, Schwarz, S, Doppler, S, Paige, S, Puluca, N, Doll, S, Neb, I, Brade, T, Zhang, Z, Abou-Ajram, C, Northoff, B, Holdt, L, Sudhop, S, Sahara, M, Goedel, A, Dendorfer, A, Tjong, F, Rijlaarsdam, M, Cleuziou, J, Lang, N, Kupatt, C, Bezzina, C, Lange, R, Bowles, N, Mann, M, Gelb, B, Crotti, L, Hein, L, Meitinger, T, Wu, S, Sinnecker, D, Gruber, P, Laugwitz, K, Moretti, A, Krane M., Dressen M., Santamaria G., My I., Schneider C. M., Dorn T., Laue S., Mastantuono E., Berutti R., Rawat H., Gilsbach R., Schneider P., Lahm H., Schwarz S., Doppler S. A., Paige S., Puluca N., Doll S., Neb I., Brade T., Zhang Z., Abou-Ajram C., Northoff B., Holdt L. M., Sudhop S., Sahara M., Goedel A., Dendorfer A., Tjong F. V. Y., Rijlaarsdam M. E., Cleuziou J., Lang N., Kupatt C., Bezzina C., Lange R., Bowles N. E., Mann M., Gelb B. D., Crotti L., Hein L., Meitinger T., Wu S., Sinnecker D., Gruber P. J., Laugwitz K. -L., Moretti A., Krane, M, Dressen, M, Santamaria, G, My, I, Schneider, C, Dorn, T, Laue, S, Mastantuono, E, Berutti, R, Rawat, H, Gilsbach, R, Schneider, P, Lahm, H, Schwarz, S, Doppler, S, Paige, S, Puluca, N, Doll, S, Neb, I, Brade, T, Zhang, Z, Abou-Ajram, C, Northoff, B, Holdt, L, Sudhop, S, Sahara, M, Goedel, A, Dendorfer, A, Tjong, F, Rijlaarsdam, M, Cleuziou, J, Lang, N, Kupatt, C, Bezzina, C, Lange, R, Bowles, N, Mann, M, Gelb, B, Crotti, L, Hein, L, Meitinger, T, Wu, S, Sinnecker, D, Gruber, P, Laugwitz, K, Moretti, A, Krane M., Dressen M., Santamaria G., My I., Schneider C. M., Dorn T., Laue S., Mastantuono E., Berutti R., Rawat H., Gilsbach R., Schneider P., Lahm H., Schwarz S., Doppler S. A., Paige S., Puluca N., Doll S., Neb I., Brade T., Zhang Z., Abou-Ajram C., Northoff B., Holdt L. M., Sudhop S., Sahara M., Goedel A., Dendorfer A., Tjong F. V. Y., Rijlaarsdam M. E., Cleuziou J., Lang N., Kupatt C., Bezzina C., Lange R., Bowles N. E., Mann M., Gelb B. D., Crotti L., Hein L., Meitinger T., Wu S., Sinnecker D., Gruber P. J., Laugwitz K. -L., and Moretti A.

Abstract

BACKGROUND: Complex molecular programs in specific cell lineages govern human heart development. Hypoplastic left heart syndrome (HLHS) is the most common and severe manifestation within the spectrum of left ventricular outflow tract obstruction defects occurring in association with ventricular hypoplasia. The pathogenesis of HLHS is unknown, but hemodynamic disturbances are assumed to play a prominent role. METHODS: To identify perturbations in gene programs controlling ventricular muscle lineage development in HLHS, we performed whole-exome sequencing of 87 HLHS parent-offspring trios, nuclear transcriptomics of cardiomyocytes from ventricles of 4 patients with HLHS and 15 controls at different stages of heart development, single cell RNA sequencing, and 3D modeling in induced pluripotent stem cells from 3 patients with HLHS and 3 controls. RESULTS: Gene set enrichment and protein network analyses of damaging de novo mutations and dysregulated genes from ventricles of patients with HLHS suggested alterations in specific gene programs and cellular processes critical during fetal ventricular cardiogenesis, including cell cycle and cardiomyocyte maturation. Single-cell and 3D modeling with induced pluripotent stem cells demonstrated intrinsic defects in the cell cycle/unfolded protein response/autophagy hub resulting in disrupted differentiation of early cardiac progenitor lineages leading to defective cardiomyocyte subtype differentiation/ maturation in HLHS. Premature cell cycle exit of ventricular cardiomyocytes from patients with HLHS prevented normal tissue responses to developmental signals for growth, leading to multinucleation/polyploidy, accumulation of DNA damage, and exacerbated apoptosis, all potential drivers of left ventricular hypoplasia in absence of hemodynamic cues. CONCLUSIONS: Our results highlight that despite genetic heterogeneity in HLHS, many mutations converge on sequential cellular processes primarily driving cardiac myogenesis, suggesting n

Published
2021

12. Nicht kodierende Ribonukleinsäure im kardiovaskulären System:Sonderforschungsbereich-Transregio (SFB-TRR 267)

Author

Engelhardt, S., Dimmeler, S., Heim, C., Bär, C., Böttger, T., Boon, R., Brandes, R. P., Braun, T., Dueck, A., Gagneur, J., Grote, P., Holdt, L. M., Jaé, N., Krishnan, J., Kupatt, C., Laugwitz, K. L., Leisegang, M. S., Maegdefessel, L., Meitinger, T., Moretti, A., Müller-McNicoll, M., Sattler, M., Schnieke, A., Schulz, M., Schunkert, H., Schwalbe, H., Teupser, D., Thum, T., Weber, C., Wittig, I., and Zarnack, K.

Abstract

The discovery of regulatory noncoding RNA molecules (ncRNA) revolutionized our previous understanding of gene expression. As shown by extensive sequencing projects from earlier times, ncRNA occurs in the human transcriptome in a previously unforeseen number and diversity, whereas mRNA coding for proteins only makes up a small proportion of the human transcriptome. In addition to structurally important ncRNA, tens of thousands of regulatory ncRNAs were identified in humans, of which microRNAs, long noncoding RNAs and the recently discovered circular RNAs are important groups. Members of this joint project have already contributed essential knowledge on the role, the mechanisms and the target structures of ncRNAs in the cardiovascular (CV) system. Furthermore, they have shown the feasibility of treatment based on the manipulation of ncRNA in cardiovascular diseases. Although a fascinating new field of research has opened up with ncRNAs, the enormous number of RNA transcripts, their different mechanisms of action and the complex methods necessary for their investigation represent major challenges. The tasks are now 1) to determine those ncRNAs which are essential for the development and homeostasis as well as the development and progression of diseases in the cardiovascular system and 2) to mechanistically understand their mode of functioning, with the aim to derive target structures and their manipulation to develop urgently needed new therapies.

Published
2022

13. Will our cardiomyopathy patients accept gene therapy?

Author

Cardiologie, Team Medisch, Circulatory Health, Regenerative Medicine and Stem Cells, Doevendans, P. A., Kupatt, C., Giacca, M., Glijnis, P., Cardiologie, Team Medisch, Circulatory Health, Regenerative Medicine and Stem Cells, Doevendans, P. A., Kupatt, C., Giacca, M., and Glijnis, P.

Published
2022

17. Modifying effect of dual antiplatelet therapy on incidence of stent thrombosis according to implanted drug-eluting stent type

Author

Camenzind, Edoardo, Boersma, Eric, Wijns, William, Mauri, Laura, Rademaker-Havinga, Tessa, Ordoubadi, Farzin Fath, Suttorp, Maarten J., Al Kurdi, Mohammad, Steg, Ph Gabriel, Camenzind, E, Mauri, L, OʼNeill, W, Serruys, P W, Steg, PhG, Wijns, W, Verheugt, FWA, Bertrand, ME, Califf, R, DeMets, D, Wallentin, L, Bocksch, W, Bosmans, J, Garcia, H, Garg, S, Hanet, C, Herrman, J-PR, Kelbaek, H, Mc Fadden, E, Radke, PW, Rutsch, W, Tilsted, HH, Wykrzykowska, J, Alvarez, C, Rodriguez, A, Meredith, I, Muller, D, Whitbourn, R, Worthley, S, Whelan, A, Walters, D, Shetty, S, New, G, Cox, S, Batra, R, van Gaal, W, Bellamy, G, Mayr, H, Heigert, M, Huber, K, Leisch, F, Wijns, W, Desmet, W, Boland, J, Schroeder, E, Chenu, P, Legrand, V, Labinaz, M, Teefy, P, Bertrand, O, Gao, R, Ge, J, Kala, P, Cervinka, P, Ureña, P, Hartikainen, J, Steg, G, Fajadet, J, Carrie, D, Gilard, M, Barragan, P, Lablanche, J-M, Koning, R, Eltchaninoff, H, Darremont, O, Leroy, F, Bertrand, B, Robert, G, Schiele, F, Chassaing, S, Bressollette, E, Brunel, P, Quilliet, L, Brunet, J, Pansieri, M, Sideris, G, Stratiev, V, Teiger, E, Lebreton, H, Bonnet, J-L, Karsenty, B, Delarche, N, Lusson, J-R, Cassagnes, J, Brachmann, J, Kurowski, V, Buerke, M, Schieffer, B, Scholtz, W, Wiemer, M, Fichtlscherer, S, Schächinger, V, Kupatt, C, Boekstegers, P, Genth-Zotz, S, Bode, C, Frey, N, Neumann, F-J, Witzenbichler, B, Pels, K, Strasser, R, Kuck, K-H, Hauptmann, K-E, Baldus, S, Heitzer, T, Haude, M, Hoffmann, E, Jung, W, Hoffmann, S, Schmitt, C, Dissmann, M, Pauschinger, M, Werner, G, Braun-Delleus, R, Burkhardt, D, Manz, M, Voudris, V, Sionis, D, Kang-Yin, M-L, Tse, T-S, Merkely, B, Mehta, A, Parikh, K, Kumar, V, Chandra, P, Rath, P, Hiremath, S, Crean, P, Daly, K, Kornowski, R, Kerner, A, Mosseri, M, Jafari, G, Giudice, P, Trani, C, Manari, A, Prati, F, Pangrazi, A, Bolognese, L, Jeong, M-H, Kim, M-Y, Kim, H-S, Park, S-J, Erglis, A, Kalnins, A, Wagner, D, Zambahari, R, Ong, T-K, Sim, K, den Heijer, P, Appelman, Y, Suttorp, M-J, de Smet, B, Koolen, J, Stella, P, Harding, S, Warwick, J, Maslowski, A, Abernethy, M, Devlin, G, Rotevatn, S, Myreng, Y, Ciecwierz, D, Peruga, J, Reczuch, K, Campante Teles, R, Farto, P, Abreu, E, Leitão-Marques, A, Pereira, H, Vinereanu, D, Alkasab, S, Mhish, H, Al Kurdi, M, Al Turki, F, Wong, P, Teo, S-G, Goicolea Ruigomez, F-J, Valdés Chávarri, M, Bethencourt Gonzalez, A, Iñiguez Romo, A, López Minguez, J, Hernández García, J-M, Diaz Fernández, J, Ruiz Salmeron, R, Martinez Elbal, L, Zueco, J, López-Palop, RF, Melgares, R, Diderholm, E, Kåregren, A, Herterich, O, Olivencrona, G, Fröbert, O, Roffi, M, Verin, V, Girod, G, Vuilliomenet, A, Hsieh, I-C, Wu, C-J, Gershlick, A, Densem, C, Doshi, S, Manoharan, G, McCarthy, P, De Belder, M, Mills, J, Fath-Ordoubadi, F, Simpson, I, Greenwood, J, Chamberlain-Webber, R, Khan, Z, Cotton, J, Gunning, M, Smith, D, Talwar, S, Holmberg, S, Purcell, I, Anderson, R, Alamgir, F, Beatt, K, Kelly, P, Moussavian, M, Aji, J, Prashad, R, Zankar, A, Banerjee, S, Lewis, S, McLaurin, B, Douglas, J, Brener, S, Gupta, A, Walters, L, Driesman, M, Aycock, R, Mego, C, Fisher, D, Frankel, R, and Satler, L

Published
2014
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18. Human Engineered Heart Tissue Patches Remuscularize the Injured Heart in a Dose-Dependent Manner

Author

Querdel, Eva, primary, Reinsch, Marina, additional, Castro, Liesa, additional, Köse, Deniz, additional, Bähr, Andrea, additional, Reich, Svenja, additional, Geertz, Birgit, additional, Ulmer, Bärbel, additional, Schulze, Mirja, additional, Lemoine, Marc D., additional, Krause, Tobias, additional, Lemme, Marta, additional, Sani, Jascha, additional, Shibamiya, Aya, additional, Stüdemann, Tim, additional, Köhne, Maria, additional, Bibra, Constantin von, additional, Hornaschewitz, Nadja, additional, Pecha, Simon, additional, Nejahsie, Yusuf, additional, Mannhardt, Ingra, additional, Christ, Torsten, additional, Reichenspurner, Hermann, additional, Hansen, Arne, additional, Klymiuk, Nikolai, additional, Krane, M., additional, Kupatt, C., additional, Eschenhagen, Thomas, additional, and Weinberger, Florian, additional

Published
2021
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20. The importance of the Heart Team evaluation before transcatheter aortic valve replacement: Results from the BRAVO-3 trial

Author

Camaj, A, Claessen, BE, Mehran, R, Yudi, MB, Power, D, Baber, U, Hengstenberg, C, Lefevre, T, Van Belle, E, Giustino, G, Guedeney, P, Sorrentino, S, Kupatt, C, Webb, JG, Hildick-Smith, D, Hink, HU, Deliargyris, EN, Anthopoulos, P, Sharma, SK, Kini, A, Sartori, S, Chandrasekhar, J, Dangas, GD, Camaj, A, Claessen, BE, Mehran, R, Yudi, MB, Power, D, Baber, U, Hengstenberg, C, Lefevre, T, Van Belle, E, Giustino, G, Guedeney, P, Sorrentino, S, Kupatt, C, Webb, JG, Hildick-Smith, D, Hink, HU, Deliargyris, EN, Anthopoulos, P, Sharma, SK, Kini, A, Sartori, S, Chandrasekhar, J, and Dangas, GD

Abstract

BACKGROUND/OBJECTIVES: Clinicians use validated scores to risk-stratify patients undergoing transcatheter aortic valve replacement (TAVR). However, evaluation by the Heart Team often deems patients to be at higher risk than their formal scores suggest. We sought to assess clinical outcomes of TAVR patients defined as high-risk by the Heart Team's assessment versus the patient's logistic EuroSCORE (LES). METHODS: The BRAVO-3 trial randomized patients at high risk (LES ≥ 18, or deemed inoperable by the Heart Team) to TAVR with periprocedural anticoagulation with unfractionated heparin versus bivalirudin. Endpoints included net adverse cardiac events (NACE: the composite of all-cause mortality, MI, stroke, or bleeding), major adverse cardiovascular events (MACE: death, MI, or stroke), the individual components of MACE, major vascular complications, BARC ≥ 3b bleeding and VARC life-threatening bleeding at 30 days. We compared patients deemed high-risk based on LES ≥ 18 versus high-risk by the Heart Team despite lower LES. RESULTS: A total of 467/800 (58.4%) patients were deemed high-risk by the Heart Team despite LES < 18. After multivariable analysis, there were no differences in the odds of endpoints between groups (NACE, ORLES≥18 : 1.32, 95% CI 0.86-2.02, p = .21; MACE, ORLES≥18 : 1.27, 95% CI 0.72-2.25, p = .41; major vascular complications, ORLES≥18 : 0.97, 95% CI 0.65-1.44, p = .88; BARC ≥3b, ORLES≥18 : 1.38, 95% CI 0.82-2.33, p = .23; and VARC life-threatening bleeding, ORLES≥18 : 0.99, 95% CI 0.69-1.41, p = .95). CONCLUSION: Patients undergoing TAVR and labeled high-risk by LES ≥ 18 or Heart Team assessment despite LES < 18 have comparable short-term outcomes. Assignment of high-risk status to over 50% of patients is attributable to Heart Team's clinical assessment.

Published
2020

36. Everolimus-eluting stents or bypass surgery for left main coronary artery disease

Author

Stone, Gw, Sabik, Jf, Serruys, Pw, Simonton, Ca, Généreux, P, Puskas, J, Kandzari, De, Morice, Mc, Lembo, N, Brown WM 3rd, Taggart, Dp, Banning, A, Merkely, B, Horkay, F, Boonstra, Pw, van Boven AJ, Ungi, I, Bogáts, G, Mansour, S, Noiseux, N, Sabaté, M, Pomar, J, Hickey, M, Gershlick, A, Buszman, P, Bochenek, A, Schampaert, E, Pagé, P, Dressler, O, Kosmidou, I, Mehran, R, Pocock, Sj, Kappetein, Ap, van Es GA, Leon, Mb, Gersh, B, Chaturvedi, S, Kint, Pp, Valgimigli, M, Colombo, A, Costa, M, Di Mario, C, Ellis, S, Fajadet, J, Fearon, W, Kereiakes, D, Makkar, R, Mintz, Gs, Moses, Jw, Teirstein, P, Ruel, M, Sergeant, P, Mack, M, Fontana, G, Mohr, Fw, Nataf, P, Smith, C, Boden, B, Fox, K, Maron, D, Steg, G, Blackstone, E, Juni, P, Parise, H, Wallentin, L, Bertrand, M, Krucoff, M, Turina, M, Ståhle, E, Tijssen, J, Brill, D, Atkins, C, Applegate, B, Argenziano, M, Faly, Rc, Dauerman, H, Davidson, C, Griffith, B, Reisman, M, Rizik, D, Sakwa, M, Shemin, R, Romano, M, Hamm, C, Gummert, J, Tamburino, C, Alfieri, O, Savina, C, de Bruyne, B, Machado, Fp, Uva, S, Moccetti, T, Siclari, F, Hildick Smith, D, Szekely, L, Erglis, A, Stradins, P, Abizaid, A, Bento Sousa LC, Belardi, J, Navia, D, Park, Sj, Lee, Jw, Meredith, I, Smith, J, Yehuda, Ob, Schneijdenberg, R, Ronden, J, Jonk, J, Jonkman, A, van Remortel, E, de Zwart, I, Elshout, L, de Vries, T, Andreae, R, Tol van, J, Teurlings, E, Balachandran, S, Breazna, A, Jenkins, P, Mcandrew, T, Marx, So, Connolly, Mw, Hong, Mk, Weinberger, J, Wong, Sc, Dizon, J, Biviano, A, Morrow, J, Wang, D, Corral, M, Alfonso, M, Sanchez, R, Wright, D, Djurkovic, C, Lustre, M, Jankovic, I, Sanidas, E, Lasalle, L, Maehara, A, Matsumura, M, Sun, E, Iacono, S, Greenberg, T, Jacobson, J, Pullano, A, Gacki, M, Liu, S, Cohen, Dj, Magnuson, E, Baron, Sj, Wang, K, Traylor, K, Worthley, S, Stuklis, R, Barbato, E, Stockman, B, Dubois, C, Meuris, B, Vrolix, M, Dion, R, Bento de Souza LC, Costantini, C, Woitowicz, V, Hueb, W, Stolf, N, Beydoun, H, Baskett, R, Curtis, M, Kieser, T, Doucet, S, Pellerin, M, Hamburger, J, Cook, R, Kutryk, M, Peterson, M, Madan, M, Fremes, S, Mehta, S, Cybulsky, I, Prabhakar, M, Peniston, C, Welsh, R, Macarthur, R, Berland, J, Bessou, Jp, Carrié, D, Glock, Y, Darremont, O, Deville, C, Grimaud, Jp, Soula, P, Lefèvre, T, Maupas, E, Durrleman, N, Silvestri, M, Houel, R, Pratt, A, Francis, J, Van Belle, E, Vicentelli, A, Luchner, A, Hilker, M, Endemann, Dh, Felix, S, Wollert, Hg, Walther, T, Erbel, R, Jacob, H, Kahlert, P, Kupatt, C, Näbauer, M, Schmitz, C, Scholtz, W, Börgermann, J, Schuler, G, Borger, M, Davierwala, P, Fontos, G, Székely, L, Bedogni, F, Panisi, P, Berti, S, Glauber, M, Marzocchi, A, Di Bartolomeo, R, Merlo, M, Guagliumi, G, Fenili, F, Napodano, M, Gerosa, G, Ribichini, F, Faggian, Giuseppe, Saccà, S, Giacomin, A, Mignosa, C, Tumscitz, C, Savini, C, Van Mieghem, N, von Birgelen, C, Grandjean, J, Kubica, J, Anisimowicz, L, Zmudka, K, Sadowski, J, Hernández García, J, Such, M, Macaya, C, Rodríguez Hernández JE, Maroto, L, Serra, A, Padro, J, Tenas, Ms, De Souza, A, Egred, M, Clark, S, Trivedi, U, Jain, A, Uppal, R, Redwood, S, Young, C, Stables, Rh, Pullan, M, Uren, N, Pessotto, R, Abu Fadel, M, Peyton, M, Allaqaband, S, O’Hair, D, Bachinsky, W, Mumtaz, M, Blankenship, J, Casale, A, Brott, B, Davies, J, Brown, D, Cannon, L, Talbott, J, Chang, G, Macheers, S, Choi, J, Henry, C, Cutlip, D, Khabbaz, K, Das, G, Liao, K, Diver, D, Thayer, J, Dobies, D, Fliegner, K, Fischbein, M, Feldman, T, Pearson, P, Foster, M, Briggs, R, Giugliano, G, Engelman, D, Gordon, P, Ehsan, A, Grantham, J, Allen, K, Grodin, J, Jessen, M, Gruberg, L, Taylor JR Jr, Gupta, S, Hermiller J., Jr, Heimansohn, D, Iwaoka, R, Chan, B, Kander, Nh, Duff, S, Brown, W, Karmpaliotis, D, Kini, A, Filsoufi, F, Kong, D, Lin, S, Kutcher, M, Kincaid, E, Leya, F, Bakhos, M, Liberman, H, Halkos, M, Lips, D, Eales, F, Mahoney, P, Rich, J, Barreiro, C, Cheng, W, Metzger, C, Greenfield, T, Moses, J, Palacios, I, Macgillivray, T, Perin, E, Del Prete, J, Pompili, V, Kilic, A, Ragosta, M, Kron, I, Rashid, J, Mueller, D, Riley, R, Reimers, C, Patel, N, Resar, J, Shah, A, Schneider, J, Landvater, L, Reardon, M, Shavelle, D, Baker, C, Singh, J, Maniar, H, Wei, L, Strain, J, Zapolanski, A, Taheri, H, Ad, N, Tannenbaum, M, Prabhakar, G, Waksman, R, Corso, P, Wang, J, Fiocco, M, Wilson, Bh, Steigel, Rm, Chadwick, S, Zidar, F, Oswalt, J., Stone, Gregg W., Sabik, Joseph F., Serruys, Patrick W., Simonton, Charles A., Généreux, Philippe, Puskas, John, Kandzari, David E., Morice, Marie Claude, Lembo, Nichola, Brown, W. Morri, Taggart, David P., Banning, Adrian, Merkely, Béla, Horkay, Ferenc, Boonstra, Piet W., Van Boven, Ad J., Ungi, Imre, Bogáts, Gabor, Mansour, Samer, Noiseux, Nicola, Sabaté, Manel, Pomar, José, Hickey, Mark, Gershlick, Anthony, Buszman, Pawel, Bochenek, Andrzej, Schampaert, Erick, Pagé, Pierre, Dressler, Ovidiu, Kosmidou, Ioanna, Mehran, Roxana, Pocock, Stuart J., Kappetein, A. Pieter, for the EXCEL Trial Investigators:, [. . ., Antonio, Marzocchi, DI BARTOLOMEO, Roberto, ], . ., and Cardiothoracic Surgery

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Coronary Artery Disease, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, law.invention, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Percutaneous Coronary Intervention, Randomized controlled trial, law, Internal medicine, medicine, Clinical endpoint, Drug-Eluting Stent, Humans, Everolimus, 030212 general & internal medicine, cardiovascular diseases, Coronary Artery Bypass, Aged, Female, Middle Aged, Drug-Eluting Stents, business.industry, Coronary Artery Bypa, Medicine (all), Percutaneous coronary intervention, General Medicine, medicine.disease, Surgery, Cardiac surgery, Everolimu, surgical procedures, operative, Bypass surgery, Conventional PCI, Cardiology, business, medicine.drug, Human
Abstract

BACKGROUND: Patients with obstructive left main coronary artery disease are usually treated with coronary-artery bypass grafting (CABG). Randomized trials have suggested that drug-eluting stents may be an acceptable alternative to CABG in selected patients with left main coronary disease. METHODS: We randomly assigned 1905 eligible patients with left main coronary artery disease of low or intermediate anatomical complexity to undergo either percutaneous coronary intervention (PCI) with fluoropolymer-based cobalt-chromium everolimus-eluting stents (PCI group, 948 patients) or CABG (CABG group, 957 patients). Anatomic complexity was assessed at the sites and defined by a Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score of 32 or lower (the SYNTAX score reflects a comprehensive angiographic assessment of the coronary vasculature, with 0 as the lowest score and higher scores [no upper limit] indicating more complex coronary anatomy). The primary end point was the rate of a composite of death from any cause, stroke, or myocardial infarction at 3 years, and the trial was powered for noninferiority testing of the primary end point (noninferiority margin, 4.2 percentage points). Major secondary end points included the rate of a composite of death from any cause, stroke, or myocardial infarction at 30 days and the rate of a composite of death, stroke, myocardial infarction, or ischemia-driven revascularization at 3 years. Event rates were based on Kaplan-Meier estimates in time-to-first-event analyses. RESULTS: At 3 years, a primary end-point event had occurred in 15.4% of the patients in the PCI group and in 14.7% of the patients in the CABG group (difference, 0.7 percentage points; upper 97.5% confidence limit, 4.0 percentage points; P=0.02 for noninferiority; hazard ratio, 1.00; 95% confidence interval, 0.79 to 1.26; P=0.98 for superiority). The secondary end-point event of death, stroke, or myocardial infarction at 30 days occurred in 4.9% of the patients in the PCI group and in 7.9% in the CABG group (P

Published
2017

37. Modifying effect of dual antiplatelet therapy on incidence of stent thrombosis according to implanted drug-eluting stent type

Author

Camenzind, Edoardo, Boersma, Eric, Wijns, William, Mauri, Laura, Rademaker-Havinga, Tessa, Ordoubadi, Farzin Fath, Suttorp, Maarten J., Al Kurdi, Mohammad, Steg, Ph Gabriel, Camenzind, E., Mauri, L., O'Neill, W., Serruys, P W., Steg, PhG, Wijns, W., Verheugt, FWA, Bertrand, ME, Califf, R., DeMets, D., Wallentin, L., Bocksch, W., Bosmans, J., Garcia, H., Garg, S., Hanet, C., Herrman, J-PR, Kelbaek, H., Mc Fadden, E., Radke, PW, Rutsch, W., Tilsted, HH, Wykrzykowska, J., Alvarez, C., Rodriguez, A., Meredith, I., Muller, D., Whitbourn, R., Worthley, S., Whelan, A., Walters, D., Shetty, S., New, G., Cox, S., Batra, R., van Gaal, W., Bellamy, G., Mayr, H., Heigert, M., Huber, K., Leisch, F., Desmet, W., Boland, J., Schroeder, E., Chenu, P., Legrand, V., Labinaz, M., Teefy, P., Bertrand, O., Gao, R., Ge, J., Kala, P., Cervinka, P., Ureña, P., Hartikainen, J., Steg, G., Fajadet, J., Carrie, D., Gilard, M., Barragan, P., Lablanche, J-M, Koning, R., Eltchaninoff, H., Darremont, O., Leroy, F., Bertrand, B., Robert, G., Schiele, F., Chassaing, S., Bressollette, E., Brunel, P., Quilliet, L., Brunet, J., Pansieri, M., Sideris, G., Stratiev, V., Teiger, E., Lebreton, H., Bonnet, J-L, Karsenty, B., Delarche, N., Lusson, J-R, Cassagnes, J., Brachmann, J., Kurowski, V., Buerke, M., Schieffer, B., Scholtz, W., Wiemer, M., Fichtlscherer, S., Schächinger, V., Kupatt, C., Boekstegers, P., Genth-Zotz, S., Bode, C., Frey, N., Neumann, F-J, Witzenbichler, B., Pels, K., Strasser, R., Kuck, K-H, Hauptmann, K-E, Baldus, S., Heitzer, T., Haude, M., Hoffmann, E., Jung, W., Hoffmann, S., Schmitt, C., Dissmann, M., Pauschinger, M., Werner, G., Braun-Delleus, R., Burkhardt, D., Manz, M., Voudris, V., Sionis, D., Kang-Yin, M-L, Tse, T-S, Merkely, B., Mehta, A., Parikh, K., Kumar, V., Chandra, P., Rath, P., Hiremath, S., Crean, P., Daly, K., Kornowski, R., Kerner, A., Mosseri, M., Jafari, G., Giudice, P., Trani, C., Manari, A., Prati, F., Pangrazi, A., Bolognese, L., Jeong, M-H, Kim, M-Y, Kim, H-S, Park, S-J, Erglis, A., Kalnins, A., Wagner, D., Zambahari, R., Ong, T-K, Sim, K., den Heijer, P., Appelman, Y., Suttorp, M-J, de Smet, B., Koolen, J., Stella, P., Harding, S., Warwick, J., Maslowski, A., Abernethy, M., Devlin, G., Rotevatn, S., Myreng, Y., Ciecwierz, D., Peruga, J., Reczuch, K., Campante Teles, R., Farto, P., Abreu, E., Leitão-Marques, A., Pereira, H., Vinereanu, D., Alkasab, S., Mhish, H., Al Kurdi, M., Al Turki, F., Wong, P., Teo, S-G, Goicolea Ruigomez, F-J, Valdés Chávarri, M., Bethencourt Gonzalez, A., Iñiguez Romo, A., López Minguez, J., Hernández García, J-M, Diaz Fernández, J., Ruiz Salmeron, R., Martinez Elbal, L., Zueco, J., López-Palop, RF, Melgares, R., Diderholm, E., Kåregren, A., Herterich, O., Olivencrona, G., Fröbert, O., Roffi, M., Verin, V., Girod, G., Vuilliomenet, A., Hsieh, I-C, Wu, C-J, Gershlick, A., Densem, C., Doshi, S., Manoharan, G., McCarthy, P., De Belder, M., Mills, J., Fath-Ordoubadi, F., Simpson, I., Greenwood, J., Chamberlain-Webber, R., Khan, Z., Cotton, J., Gunning, M., Smith, D., Talwar, S., Holmberg, S., Purcell, I., Anderson, R., Alamgir, F., Beatt, K., Kelly, P., Moussavian, M., Aji, J., Prashad, R., Zankar, A., Banerjee, S., Lewis, S., McLaurin, B., Douglas, J., Brener, S., Gupta, A., Walters, L., Driesman, M., Aycock, R., Mego, C., Fisher, D., Frankel, R., and Satler, L.

Subjects
animal structures, cardiovascular diseases, equipment and supplies
Abstract

Aim To investigate the putative modifying effect of dual antiplatelet therapy (DAPT) use on the incidence of stent thrombosis at 3 years in patients randomized to Endeavor zotarolimus-eluting stent (E-ZES) or Cypher sirolimus-eluting stent (C-SES). Methods and results Of 8709 patients in PROTECT, 4357 were randomized to E-ZES and 4352 to C-SES. Aspirin was to be given indefinitely, and clopidogrel/ticlopidine for ≥3 months or up to 12 months after implantation. Main outcome measures were definite or probable stent thrombosis at 3 years. Multivariable Cox regression analysis was applied, with stent type, DAPT, and their interaction as the main outcome determinants. Dual antiplatelet therapy adherence remained the same in the E-ZES and C-SES groups (79.6% at 1 year, 32.8% at 2 years, and 21.6% at 3 years). We observed a statistically significant (P = 0.0052) heterogeneity in treatment effect of stent type in relation to DAPT. In the absence of DAPT, stent thrombosis was lower with E-ZES vs. C-SES (adjusted hazard ratio 0.38, 95% confidence interval 0.19, 0.75; P = 0.0056). In the presence of DAPT, no difference was found (1.18; 0.79, 1.77; P = 0.43). Conclusion A strong interaction was observed between drug-eluting stent type and DAPT use, most likely prompted by the vascular healing response induced by the implanted DES system. These results suggest that the incidence of stent thrombosis in DES trials should not be evaluated independently of DAPT use, and the optimal duration of DAPT will likely depend upon stent type (Clinicaltrials.gov number NCT00476957)

Published
2017

38. Corrigendum: Regulation of monocyte cell fate by blood vessels mediated by Notch signalling

Author

Gamrekelashvili, J, Giagnorio, R, Jussofie, J, Soehnlein, O, Duchene, J, Briseno, CG, Ramasamy, SK, Krishnasamy, K, Limbourg, A, Hager, C, Kapanadze, T, Ishifune, C, Hinkel, R, Radtke, F, Strobl, LJ, Zimber-Strobl, U, Napp, LC, Bauersachs, J, Haller, H, Yasutomo, K, Kupatt, C, Murphy, KM, Adams, RH, Weber, C, and Limbourg, FP

Subjects
Multidisciplinary Sciences, Science & Technology, MD Multidisciplinary, Science & Technology - Other Topics, Article
Abstract

A population of monocytes, known as Ly6Clo monocytes, patrol blood vessels by crawling along the vascular endothelium. Here we show that endothelial cells control their origin through Notch signalling. Using combinations of conditional genetic deletion strategies and cell-fate tracking experiments we show that Notch2 regulates conversion of Ly6Chi monocytes into Ly6Clo monocytes in vivo and in vitro, thereby regulating monocyte cell fate under steady-state conditions. This process is controlled by Notch ligand delta-like 1 (Dll1) expressed by a population of endothelial cells that constitute distinct vascular niches in the bone marrow and spleen in vivo, while culture on recombinant DLL1 induces monocyte conversion in vitro. Thus, blood vessels regulate monocyte conversion, a form of committed myeloid cell fate regulation., Circulating Ly6Clo monocytes are thought to be derived from Ly6Chi subset. Here the authors show that Notch signalling is activated in Ly6Clo cells and is required for their differentiation, and that Notch ligands that initiate this signalling are provided by a subset of endothelial cells.

Published
2017

46. Single-bolus tenecteplase plus heparin compared with heparin alone for normotensive patients with acute pulmonary embolism who have evidence of right ventricular dysfunction and myocardial injury: rationale and design of the Pulmonary Embolism Thrombolysis (PEITHO) trial

Author

Konstantinides SV, Meyer G, Lang I, Verschuren F, Meneveau N, Charbonnier B, Bouvaist H, Geibel A, Beyer Westendorf J, Dellas C, Empen K, Kupatt C, Giancarlo, Becattini C, Salvi A, Pruszczyk P, Torbicki A, Franca A, Lohmann C, Kozak M, Jiménez D, Kucher N, Goldhaber SZ, Danays T, Bluhmki E, Gallula P., GALIE', NAZZARENO, Konstantinides SV, Meyer G, Lang I, Verschuren F, Meneveau N, Charbonnier B, Bouvaist H, Geibel A, Beyer-Westendorf J, Dellas C, Empen K, Kupatt C, Galiè N, Giancarlo, Becattini C, Salvi A, Pruszczyk P, Torbicki A, Franca A, Lohmann C, Kozak M, Jiménez D, Kucher N, Goldhaber SZ, Danays T, Bluhmki E, and Gallula P.

Subjects
Heparin, Patient Selection, Ventricular Dysfunction, Right, Myocardial Infarction, Blood Pressure, Pulmonary Embolism Thrombolysi, Treatment Outcome, Fibrinolytic Agents, Research Design, Tissue Plasminogen Activator, Injections, Intravenous, Tenecteplase, Humans, Cardiology and Cardiovascular Medicine, Pulmonary Embolism, CLINICAL TRIALS
Abstract

Background: In acute pulmonary embolism (PE), overt right ventricular (RV) failure with cardiogenic shock indicates a poor prognosis. However, normotensive patients with acute RV dysfunction on echocardiography or computed tomography and with myocardial troponin elevation may also have an adverse outcome. Thrombolysis rapidly reverses RV pressure overload in PE, but it remains unclear whether it may improve the early and long-term clinical outcome of selected normotensive patients. Design: The Pulmonary EmbolIsm THrOmbolysis (PEITHO) trial is a prospective, multicenter, international, randomized (1:1), double-blind comparison of thrombolysis with tenecteplase vs placebo in normotensive patients with confirmed PE, an abnormal right ventricle on echocardiography or computed tomography, and a positive troponin I or T test result. Both treatment groups receive standard anticoagulation. The primary efficacy outcome is the composite of death from any cause or hemodynamic collapse within 7 days of randomization. Safety outcomes include ischemic/hemorrhagic strokes and other major bleeding episodes. In addition, 180-day clinical and echocardiographic follow-up will be performed. The study is expected to enroll approximately 1,000 patients. Conclusions: By determining the benefits vs risks of thrombolysis in submassive or intermediate-risk PE, this trial is expected to answer a long-standing query on the management of this patient population

Published
2011

47. Unterschiedliche Aspekte der Menschenwürde in der Intensivmedizin

Author

Kupatt C

Subjects
Pediatrics, medicine.medical_specialty, Life span, business.industry, media_common.quotation_subject, Judgement, Obstetrics and Gynecology, Dignity, Nursing, Patient autonomy, Informed consent, Intensive care, Medicine, In patient, business, media_common
Abstract

Human dignity often is used as an ethical category in medical judgement of current medical and intensive care decisions. The short history of the intensive care medicine, however, demonstrates a certain drift in the use of the term "human dignity". Parallel to the more pronounced patient autonomy, articulated in patient testaments, therapeutic decisions of current intensive care medicine individualize therapeutic approaches, instead of preferentially maximizing life span.

Published
2002

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