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1. Superior vena cava syndrome related to mediastinal lymphoma in late pregnancy: A case report

Author

M.L. Buchholtz, V. Bücklein, M. Brendel, and M. Paal

Subjects
Surgery, RD1-811, Gynecology and obstetrics, RG1-991
Abstract

We report the initial diagnosis in a 28-year-old nulliparous woman of a primary mediastinal B-cell lymphoma in late pregnancy. For several weeks the patient had had symptoms of mediastinal obstruction, such as dyspnea, cough, swelling of the face and upper limbs. However, these symptoms had been misattributed to the pregnancy and a common cold. Due to a rapid decline in the patient's cardiovascular performance, she was transferred to the closest perinatal center in the 34th week of pregnancy, whereupon a cesarean section was performed. The diagnosis of a primary mediastinal B-cell lymphoma was made postpartum from a biopsy. This case emphasizes the importance of timely antenatal investigation in pregnant women with symptoms consistent with mediastinal obstruction. Thoracic ultrasonography can be a valuable tool for the detection of tumor-associated pleural and pericardial effusions. Keywords: Pregnancy, non-Hodgkin lymphoma, primary mediastinal B-cell lymphoma, Ultrasonography, R-CHOEP chemotherapy

Published
2018
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2. Viabahn endoprosthesis for femoropopliteal aneurysm repair: safety, success rates, and long-term patency

Author

Jan M. Brendel, Tobias Mangold, Markus Pfändler, Benedikt Stenzl, Mateja Andic, Jonas Mück, Jörg Schmehl, Patrick Krumm, Christoph Artzner, Gerd Grözinger, and Arne Estler

Subjects
Viabahn, Endoprosthesis, Stent Graft, Aneurysm, Endovascular, Repair, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background The Viabahn endoprosthesis has become a vital option for endovascular therapy, yet there is limited long-term data on its effectiveness for peripheral aneurysm repair. This study aimed to evaluate the safety, technical and clinical success, and long-term patency of the Viabahn endoprosthesis for treating femoropopliteal aneurysms. Methods This retrospective tertiary single-center study analyzed patients who underwent a Viabahn endoprosthesis procedure for femoropopliteal aneurysm repair from 2010 to 2020. Intraoperative complications, technical and clinical success rates, and major adverse events (MAE, including acute thrombotic occlusion, major amputation, myocardial infarction, and device- or procedure-related death) at 30 days were assessed. Incidence of clinically-driven target lesion revascularisation (cdTLR) was noted. Patency rates were evaluated by Kaplan–Meier analysis. Results Among 19 patients (mean age, 72 ± 12 years; 18 male, 1 female) who underwent aneurysm repair using the Viabahn endoprosthesis, there were no intraoperative adverse events, with 100% technical and clinical success rates. At the 30-day mark, all patients (19/19, 100%) were free of MAE. The median follow-up duration was 1,009 days [IQR, 462–1,466]. Popliteal stent graft occlusion occurred in 2/19 patients (10.5%) after 27 and 45 months, respectively. Consequently, the primary patency rates were 100%, 90%, 74% at 12, 24, and 36–72 months, respectively. Endovascular cdTLR was successful in both cases, resulting in sustained secondary patency at 100%. Conclusion The use of Viabahn endoprostheses for femoropopliteal aneurysm repair demonstrated technical and clinical success rates of 100%, a 0% 30-day MAE rate, and excellent long-term patency.

Published
2024
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3. Viabahn stent graft for arterial injury management: safety, technical success, and long-term outcome

Author

Jan M. Brendel, Tobias Mangold, Mario Lescan, Jörg Schmehl, Patrick Ghibes, Antonia Grimm, Simon Greulich, Patrick Krumm, Christoph Artzner, Gerd Grözinger, and Arne Estler

Subjects
Viabahn, Endoprosthesis, Stent, Graft, Injury, Bleeding, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background The Viabahn stent graft has emerged as an integral tool for managing vascular diseases, but there is limited long-term data on its performance in emergency endovascular treatment. This study aimed to assess safety, technical success, and long-term efficacy of the Viabahn stent graft in emergency treatment of arterial injury. Methods We conducted a retrospective single tertiary centre analysis of patients who underwent Viabahn emergency arterial injury treatment between 2015 and 2020. Indication, intraoperative complications, technical and clinical success, and major adverse events at 30 days were evaluated. Secondary efficacy endpoints were the primary and secondary patency rates assessed by Kaplan–Meier analysis. Results Forty patients (71 ± 13 years, 19 women) were analyzed. Indications for Viabahn emergency treatment were extravasation (65.0%), arterio-venous fistula (22.5%), pseudoaneurysm (10.0%), and arterio-ureteral fistula (2.5%). No intraoperative adverse events occurred, technical and clinical success rates were 100%. One acute stent graft occlusion occurred in the popliteal artery on day 9, resulting in a 30-day device-related major-adverse-event rate of 2.5%. Median follow-up was 402 days [IQR, 43–1093]. Primary patency rate was 97% (95% CI: 94–100) in year 1, and 92% (95% CI: 86–98) from years 2 to 6. One stent graft occlusion occurred in the external iliac artery at 18 months; successful revascularization resulted in secondary patency rates of 97% (95% CI: 94–100) from years 1 to 6. Conclusion Using Viabahn stent graft in emergency arterial injury treatment had 100% technical and clinical success rates, a low 30-day major-adverse-event rate of 2.5%, and excellent long-term patency rates.

Published
2024
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4. The eukaryotic Pso2/Snm1/Artemis proteins and their function as genomic and cellular caretakers

Author

D. Bonatto, L.F. Revers, M. Brendel, and J.A.P. Henriques

Subjects
Non-homologous end joining, Double-strand breaks, V(D)J, PSO2, Artemis, Saccharomyces cerevisiae, Medicine (General), R5-920, Biology (General), QH301-705.5
Abstract

DNA double-strand breaks (DSBs) represent a major threat to the genomic stability of eukaryotic cells. DNA repair mechanisms such as non-homologous end joining (NHEJ) are responsible for the maintenance of eukaryotic genomes. Dysfunction of one or more of the many protein complexes that function in NHEJ can lead to sensitivity to DNA damaging agents, apoptosis, genomic instability, and severe combined immunodeficiency. One protein, Pso2p, was shown to participate in the repair of DSBs induced by DNA inter-strand cross-linking (ICL) agents such as cisplatin, nitrogen mustard or photo-activated bi-functional psoralens. The molecular function of Pso2p in DNA repair is unknown, but yeast and mammalian cell line mutants for PSO2 show the same cellular responses as strains with defects in NHEJ, e.g., sensitivity to ICLs and apoptosis. The Pso2p human homologue Artemis participates in V(D)J recombination. Mutations in Artemis induce a variety of immunological deficiencies, a predisposition to lymphomas, and an increase in chromosomal aberrations. In order to better understand the role of Pso2p in the repair of DSBs generated as repair intermediates of ICLs, an in silico approach was used to characterize the catalytic domain of Pso2p, which led to identification of novel Pso2p homologues in other organisms. Moreover, we found the catalytic core of Pso2p fused to different domains. In plants, a specific ATP-dependent DNA ligase I contains the catalytic core of Pso2p, constituting a new DNA ligase family, which was named LIG6. The possible functions of Pso2p/Artemis/Lig6p in NHEJ and V(D)J recombination and in other cellular metabolic reactions are discussed.

Published
2005
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5. Generative Pre-trained Transformer 4 analysis of cardiovascular magnetic resonance reports in suspected myocarditis: A multicenter study

Author

Kenan Kaya, Carsten Gietzen, Robert Hahnfeldt, Maher Zoubi, Tilman Emrich, Moritz C. Halfmann, Malte Maria Sieren, Yannic Elser, Patrick Krumm, Jan M. Brendel, Konstantin Nikolaou, Nina Haag, Jan Borggrefe, Ricarda von Krüchten, Katharina Müller-Peltzer, Constantin Ehrengut, Timm Denecke, Andreas Hagendorff, Lukas Goertz, Roman J. Gertz, Alexander Christian Bunck, David Maintz, Thorsten Persigehl, Simon Lennartz, Julian A. Luetkens, Astha Jaiswal, Andra Iza Iuga, Lenhard Pennig, and Jonathan Kottlors

Subjects
Cardiovascular magnetic resonance, Generative Pre-trained Transformer 4, Artificial intelligence, Large language models, Myocarditis, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

ABSTRACT: Background: Diagnosing myocarditis relies on multimodal data, including cardiovascular magnetic resonance (CMR), clinical symptoms, and blood values. The correct interpretation and integration of CMR findings require radiological expertise and knowledge. We aimed to investigate the performance of Generative Pre-trained Transformer 4 (GPT-4), a large language model, for report-based medical decision-making in the context of cardiac MRI for suspected myocarditis. Methods: This retrospective study includes CMR reports from 396 patients with suspected myocarditis and eight centers, respectively. CMR reports and patient data including blood values, age, and further clinical information were provided to GPT-4 and radiologists with 1 (resident 1), 2 (resident 2), and 4 years (resident 3) of experience in CMR and knowledge of the 2018 Lake Louise Criteria. The final impression of the report regarding the radiological assessment of whether myocarditis is present or not was not provided. The performance of Generative pre-trained transformer 4 (GPT-4) and the human readers were compared to a consensus reading (two board-certified radiologists with 8 and 10 years of experience in CMR). Sensitivity, specificity, and accuracy were calculated. Results: GPT-4 yielded an accuracy of 83%, sensitivity of 90%, and specificity of 78%, which was comparable to the physician with 1 year of experience (R1: 86%, 90%, 84%, p = 0.14) and lower than that of more experienced physicians (R2: 89%, 86%, 91%, p = 0.007 and R3: 91%, 85%, 96%, p

Published
2024
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6. Experimental Performance Comparison of High-Glide Hydrocarbon and Synthetic Refrigerant Mixtures in a High-Temperature Heat Pump

Author

Leon P. M. Brendel, Silvan N. Bernal, Cordin Arpagaus, Dennis Roskosch, André Bardow, and Stefan S. Bertsch

Subjects
glide matching, high-temperature heat pumps, hydrocarbon refrigerants, refrigerant mixtures, Technology
Abstract

Several theoretical studies have predicted that refrigerant mixtures with glides of more than 20 K can yield COP improvements in heat pumps for operating conditions where the temperature difference between the heat source and heat sink is large, but experimental validations and quantifications are scarce. The application of high-glide mixtures (>20 K) in industrial heat pumps in the field is, therefore, still hampered by concerns about the behavior and handling of the mixtures. This study experimentally investigates hydrocarbon (HC) mixtures R-290/600 (propane/butane) and R-290/601 (propane/pentane) and compares them to previously tested mixtures of synthetic refrigerants. Comprehensive evaluations are presented regarding COP, compressor performance, pressure drop, heat transfer, and the possibility of inline composition determination. The mixtures were tested over a range of compositions at a source inlet temperature of 60 °C and a sink outlet temperature of 100 °C, with the heat sink and heat source temperature differences controlled to 35 K. R-290/601 at a mass composition of 70%/30% was found as the best mixture with a COP improvement of 19% over R-600 as the best pure fluid. The overall isentropic compressor efficiency was similar for HC and synthetic refrigerants, given equal suction and discharge pressures. Pressure drops in heat exchangers and connecting lines were equal for synthetic and HC mixtures at equal mass flow rates. This allows higher heating capacities of HC mixtures at a given pressure drop (mass flow rate) due to their wider vapor dome. A previously developed evaporator heat transfer correlation for synthetic refrigerant mixtures was applicable to the HC mixtures. A condenser heat transfer correlation previously fitted for synthetic refrigerants performed significantly worse for HC mixtures. Composition determination during operation and without sampling was possible with a deviation of at most 0.05 mass fraction using simple temperature and pressure measurements and REFPROP for thermodynamic property calculations. Overall, high-glide HC mixtures, just like mixtures of synthetic refrigerants, showed significant COP improvements for specific operating conditions despite a decreased heat transfer coefficient. Potential problems like composition shift or poor compressor performance were not encountered. As a next step, testing high-glide mixtures in pilot-plant installations is recommended.

Published
2024
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7. Genetic engineering of baker's and wine yeasts using formaldehyde hyperresistance-mediating plasmids

Author

M. Schmidt, A. Cömer, M. Grey, and M. Brendel

Subjects
yeast, transformation, hyperresistance to formaldehyde, Medicine (General), R5-920, Biology (General), QH301-705.5
Abstract

Yeast multi-copy vectors carrying the formaldehyde-resistance marker gene SFA have proved to be a valuable tool for research on industrially used strains of Saccharomyces cerevisiae. The genetics of these strains is often poorly understood, and for various reasons it is not possible to simply subject these strains to protocols of genetic engineering that have been established for laboratory strains of S. cerevisiae. We tested our vectors and protocols using 10 randomly picked baker's and wine yeasts all of which could be transformed by a simple protocol with vectors conferring hyperresistance to formaldehyde. The application of formaldehyde as a selecting agent also offers the advantage of its biodegradation to CO2 during fermentation, i.e., the selecting agent will be consumed and therefore its removal during down-stream processing is not necessary. Thus, this vector provides an expression system which is simple to apply and inexpensive to use

Published
1997
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8. Dark-Blood Late Gadolinium Enhancement MRI Is Noninferior to Bright-Blood LGE in Non-Ischemic Cardiomyopathies

Author

Jan M. Brendel, Robert J. Holtackers, Jan N. Geisel, Jens Kübler, Florian Hagen, Meinrad Gawaz, Konstantin Nikolaou, Simon Greulich, and Patrick Krumm

Subjects
magnetic resonance imaging, heart, contrast media, gadolinium, LGE, cardiomyopathies, Medicine (General), R5-920
Abstract

(1) Background and Objectives: Dark-blood late gadolinium enhancement has been shown to be a reliable cardiac magnetic resonance (CMR) method for assessing viability and depicting myocardial scarring in ischemic cardiomyopathy. The aim of this study was to evaluate dark-blood LGE imaging compared with conventional bright-blood LGE for the detection of myocardial scarring in non-ischemic cardiomyopathies. (2) Materials and Methods: Patients with suspected non-ischemic cardiomyopathy were prospectively enrolled in this single-centre study from January 2020 to March 2023. All patients underwent 1.5 T CMR with both dark-blood and conventional bright-blood LGE imaging. Corresponding short-axis stacks of both techniques were analysed for the presence, distribution, pattern, and localisation of LGE, as well as the quantitative scar size (%). (3) Results: 343 patients (age 44 ± 17 years; 124 women) with suspected non-ischemic cardiomyopathy were examined. LGE was detected in 123 of 343 cases (36%) with excellent inter-reader agreement (κ 0.97–0.99) for both LGE techniques. Dark-blood LGE showed a sensitivity of 99% (CI 98–100), specificity of 99% (CI 98–100), and an accuracy of 99% (CI 99–100) for the detection of non-ischemic scarring. No significant difference in total scar size (%) was observed. Dark-blood imaging with mean 5.35 ± 4.32% enhanced volume of total myocardial volume, bright-blood with 5.24 ± 4.28%, p = 0.84. (4) Conclusions: Dark-blood LGE imaging is non-inferior to conventional bright-blood LGE imaging in detecting non-ischemic scarring. Therefore, dark-blood LGE imaging may become an equivalent method for the detection of both ischemic and non-ischemic scars.

Published
2023
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9. T1 Mapping MOLLI 5(3)3 Acquisition Scheme Yields High Accuracy in 1.5 T Cardiac Magnetic Resonance

Author

Patrick Krumm, Petros Martirosian, Alexander Brendel, Jens M. Kübler, Jan M. Brendel, Sebastian Gassenmaier, Arne Estler, Meinrad Gawaz, Konstantin Nikolaou, and Simon Greulich

Subjects
T1 mapping, cardiac magnetic resonance imaging, MOLLI, accuracy, Medicine (General), R5-920
Abstract

Objectives: To systematically compare two modified Look-Locker inversion recovery (MOLLI) T1 mapping sequences and their impact on (1) myocardial T1 values native, (2) post-contrast and (3) extracellular volume (ECV). Methods: 200 patients were prospectively included for 1.5 T CMR for work-up of ischemic or non-ischemic cardiomyopathies. To determine native and post-contrast T1 for ECV calculation, two different T1 mapping MOLLI acquisition schemes, 5(3)3 (designed for native scans with long T1) and 4(1)3(1)2 (designed for post-contrast scans with short T1), were acquired in identical mid-ventricular short-axis slices. Both schemes were acquired in native and post-contrast scans. Results: Datasets from 163 patients were evaluated (age 55 ± 17 years; 38% female). Myocardial T1 native for 5(3)3 was 1017 ± 42 ms vs. 956 ± 40 ms for 4(1)3(1)2, with mean intraindividual difference −61 ms (p < 0.0001). Post-contrast myocardial T1 in patients was similar for both acquisition schemes, with 494 ± 48 ms for 5(3)3 and 490 ± 45 ms for 4(1)3(1)2 and mean intraindividual difference −4 ms. Myocardial ECV for 5(3)3 was 27.6 ± 4% vs. 27 ± 4% for 4(1)3(1)2, with mean difference −0.6 percentage points (p < 0.0001). Conclusions: The T1 MOLLI 5(3)3 acquisition scheme provides a reliable estimation of myocardial T1 for the clinically relevant range of long and short T1 values native and post-contrast. In contrast, the T1 MOLLI 4(1)3(1)2 acquisition scheme may only be used for post-contrast scans according to its designed purpose.

Published
2022
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10. Review of Vapor Compression Refrigeration in Microgravity Environments

Author

Leon P. M. Brendel, Stephen Caskey, Michael K Ewert, Derek Hengeveld, James E. Braun, and Eckhard A. Groll

Subjects
Mechanical Engineering
Abstract

Using a vapor compression cycle for cooling in microgravity environments was already suggested in the 1970s to leverage the high coefficient of performance. Since then, only a few systems have operated in microgravity with scarce documentation of these flights. The lack of measured data and detailed documentation makes identifying the necessary next steps difficult for researchers entering the field of refrigeration in space. This paper provides a review of available literature for vapor compression systems flown in microgravity by outlining the history of vapor compression devices in space and presenting performance data. Moreover, gaps in the literature are highlighted and open questions are posed based on the reviewed material. Next steps of research are suggested to support and ultimately achieve reliable vapor compression refrigeration in space. Calculating equivalent masses for a fair comparison of different microgravity cooling technologies is proposed by capturing both energy consumption and used volume.

Published
2021
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27. T1 Mapping MOLLI 5(3)3 Acquisition Scheme Yields High Accuracy in 1.5 T Cardiac Magnetic Resonance

Author

Greulich, Patrick Krumm, Petros Martirosian, Alexander Brendel, Jens M. Kübler, Jan M. Brendel, Sebastian Gassenmaier, Arne Estler, Meinrad Gawaz, Konstantin Nikolaou, and Simon

Subjects
T1 mapping, cardiac magnetic resonance imaging, MOLLI, accuracy
Abstract

Objectives: To systematically compare two modified Look-Locker inversion recovery (MOLLI) T1 mapping sequences and their impact on (1) myocardial T1 values native, (2) post-contrast and (3) extracellular volume (ECV). Methods: 200 patients were prospectively included for 1.5 T CMR for work-up of ischemic or non-ischemic cardiomyopathies. To determine native and post-contrast T1 for ECV calculation, two different T1 mapping MOLLI acquisition schemes, 5(3)3 (designed for native scans with long T1) and 4(1)3(1)2 (designed for post-contrast scans with short T1), were acquired in identical mid-ventricular short-axis slices. Both schemes were acquired in native and post-contrast scans. Results: Datasets from 163 patients were evaluated (age 55 ± 17 years; 38% female). Myocardial T1 native for 5(3)3 was 1017 ± 42 ms vs. 956 ± 40 ms for 4(1)3(1)2, with mean intraindividual difference −61 ms (p < 0.0001). Post-contrast myocardial T1 in patients was similar for both acquisition schemes, with 494 ± 48 ms for 5(3)3 and 490 ± 45 ms for 4(1)3(1)2 and mean intraindividual difference −4 ms. Myocardial ECV for 5(3)3 was 27.6 ± 4% vs. 27 ± 4% for 4(1)3(1)2, with mean difference −0.6 percentage points (p < 0.0001). Conclusions: The T1 MOLLI 5(3)3 acquisition scheme provides a reliable estimation of myocardial T1 for the clinically relevant range of long and short T1 values native and post-contrast. In contrast, the T1 MOLLI 4(1)3(1)2 acquisition scheme may only be used for post-contrast scans according to its designed purpose.

Published
2022
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28. Five fraction stereotactic radiotherapy after brain metastasectomy: a single-institution experience and literature review

Author

S. Gomez Ordonez, Susanne Rogers, A. Stauffer, M. Brendel, N. Lomax, S. Alonso, T. Lazeroms, Oliver Riesterer, Brigitte Eberle, L. Schwyzer, E. Kessler, University of Zurich, and Rogers, S

Subjects
Cancer Research, medicine.medical_specialty, medicine.medical_treatment, 610 Medicine & health, Radiosurgery, Stereotactic radiotherapy, 10180 Clinic for Neurosurgery, Meningeal Neoplasms, medicine, Humans, 1306 Cancer Research, Fraction (mathematics), Single institution, Radiation Injuries, Retrospective Studies, Brain Neoplasms, business.industry, Incidence (epidemiology), Metastasectomy, Brain, Rate control, Radiation therapy, 2728 Neurology (clinical), Treatment Outcome, Neurology, Oncology, 2808 Neurology, 2730 Oncology, Radiation Dose Hypofractionation, Neurology (clinical), Radiology, business
Abstract

The outcomes of five fraction stereotactic radiotherapy (hfSRT) following brain metastasectomy were evaluated and compared with published series. 30 Gy in 5 fractions HfSRT prescribed to the surgical cavity was reduced to 25 Gy if the volume of ‘brain−GTV’ receiving 20 Gy exceeded 20 cm3. Endpoints were local recurrence, nodular leptomeningeal recurrence, new brain metastases and radionecrosis. The literature was searched for reports of clinical and dosimetric outcomes following postoperative hfSRT in 3–5 fractions. 39 patients with 40 surgical cavities were analyzed. Cavity local control rate at 1 year was 33/40 (82.5%). 3 local failures followed 30 Gy/5 fractions and 4 with 25 Gy/5 fractions. The incidence of leptomeningeal disease (LMD) was 7/40 (17.5%). No grade 3–4 toxicities, particularly no radionecrosis, were reported. The incidence of distant brain metastases was 15/40 (37.5%). The median overall survival was 15 months. Across 13 published series, the weighted mean local control was 83.1% (adjusted for sample size), the mean incidence of LMD was 14.9% (7–34%) and the mean rate of radionecrosis was 10.3% (0–20.6%). Postoperative hfSRT can be delivered with 25–30 Gy in 5 fractions with efficacy in excess of 82% and no significant toxicity when the dose to ‘brain−GTV’ does not exceed 20 cm3.

Published
2021

29. Impact of diabetes on the management and outcomes in atrial fibrillation:an analysis from the ESC-EHRA EORP-AF Long-Term General Registry

Author

Wern Yew Ding, Agnieszka Kotalczyk, Giuseppe Boriani, Francisco Marin, Carina Blomström-Lundqvist, Tatjana S. Potpara, Laurent Fauchier, Gregory.Y.H. Lip, G. Boriani, G.Y.H. Lip, L. Tavazzi, A.P. Maggioni, G.-A. Dan, T. Potpara, M. Nabauer, F. Marin, Z. Kalarus, A. Goda, G. Mairesse, T. Shalganov, L. Antoniades, M. Taborsky, S. Riahi, P. Muda, I. García Bolao, O. Piot, K. Etsadashvili, E. Simantirakis, M. Haim, A. Azhari, J. Najafian, M. Santini, E. Mirrakhimov, K.A. Kulzida, A. Erglis, L. Poposka, M. Burg, H. Crijns, Ö. Erküner, D. Atar, R. Lenarczyk, M. Martins Oliveira, D. Shah, E. Serdechnaya, E. Diker, D. Lane, E. Zëra, U. Ekmekçiu, V. Paparisto, M. Tase, H. Gjergo, J. Dragoti, M. Ciutea, N. Ahadi, Z. el Husseini, M. Raepers, J. Leroy, P. Haushan, A. Jourdan, C. Lepiece, L. Desteghe, J. Vijgen, P. Koopman, G. Van Genechten, H. Heidbuchel, T. Boussy, M. De Coninck, H. Van Eeckhoutte, N. Bouckaert, A. Friart, J. Boreux, C. Arend, P. Evrard, L. Stefan, E. Hoffer, J. Herzet, M. Massoz, C. Celentano, M. Sprynger, L. Pierard, P. Melon, B. Van Hauwaert, C. Kuppens, D. Faes, D. Van Lier, A. Van Dorpe, A. Gerardy, O. Deceuninck, O. Xhaet, F. Dormal, E. Ballant, D. Blommaert, D. Yakova, M. Hristov, T. Yncheva, N. Stancheva, S. Tisheva, M. Tokmakova, F. Nikolov, D. Gencheva, B. Kunev, M. Stoyanov, D. Marchov, V. Gelev, V. Traykov, A. Kisheva, H. Tsvyatkov, R. Shtereva, S. Bakalska-Georgieva, S. Slavcheva, Y. Yotov, M. Kubíčková, A. Marni Joensen, A. Gammelmark, L. Hvilsted Rasmussen, P. Dinesen, S. Krogh Venø, B. Sorensen, A. Korsgaard, K. Andersen, C. Fragtrup Hellum, A. Svenningsen, O. Nyvad, P. Wiggers, O. May, A. Aarup, B. Graversen, L. Jensen, M. Andersen, M. Svejgaard, S. Vester, S. Hansen, V. Lynggaard, M. Ciudad, R. Vettus, A. Maestre, S. Castaño, S. Cheggour, J. Poulard, V. Mouquet, S. Leparrée, J. Bouet, J. Taieb, A. Doucy, H. Duquenne, A. Furber, J. Dupuis, J. Rautureau, M. Font, P. Damiano, M. Lacrimini, J. Abalea, S. Boismal, T. Menez, J. Mansourati, G. Range, H. Gorka, C. Laure, C. Vassalière, N. Elbaz, N. Lellouche, K. Djouadi, F. Roubille, D. Dietz, J. Davy, M. Granier, P. Winum, C. Leperchois-Jacquey, H. Kassim, E. Marijon, J. Le Heuzey, J. Fedida, C. Maupain, C. Himbert, E. Gandjbakhch, F. Hidden-Lucet, G. Duthoit, N. Badenco, T. Chastre, X. Waintraub, M. Oudihat, J. Lacoste, C. Stephan, H. Bader, N. Delarche, L. Giry, D. Arnaud, C. Lopez, F. Boury, I. Brunello, M. Lefèvre, R. Mingam, M. Haissaguerre, M. Le Bidan, D. Pavin, V. Le Moal, C. Leclercq, T. Beitar, I. Martel, A. Schmid, N. Sadki, C. Romeyer-Bouchard, A. Da Costa, I. Arnault, M. Boyer, C. Piat, N. Lozance, S. Nastevska, A. Doneva, B. Fortomaroska Milevska, B. Sheshoski, K. Petroska, N. Taneska, N. Bakrecheski, K. Lazarovska, S. Jovevska, V. Ristovski, A. Antovski, E. Lazarova, I. Kotlar, J. Taleski, S. Kedev, N. Zlatanovik, S. Jordanova, T. Bajraktarova Proseva, S. Doncovska, D. Maisuradze, A. Esakia, E. Sagirashvili, K. Lartsuliani, N. Natelashvili, N. Gumberidze, R. Gvenetadze, N. Gotonelia, N. Kuridze, G. Papiashvili, I. Menabde, S. Glöggler, A. Napp, C. Lebherz, H. Romero, K. Schmitz, M. Berger, M. Zink, S. Köster, J. Sachse, E. Vonderhagen, G. Soiron, K. Mischke, R. Reith, M. Schneider, W. Rieker, D. Boscher, A. Taschareck, A. Beer, D. Oster, O. Ritter, J. Adamczewski, S. Walter, A. Frommhold, E. Luckner, J. Richter, M. Schellner, S. Landgraf, S. Bartholome, R. Naumann, J. Schoeler, D. Westermeier, F. William, K. Wilhelm, M. Maerkl, R. Oekinghaus, M. Denart, M. Kriete, U. Tebbe, T. Scheibner, M. Gruber, A. Gerlach, C. Beckendorf, L. Anneken, M. Arnold, S. Lengerer, Z. Bal, C. Uecker, H. Förtsch, S. Fechner, V. Mages, E. Martens, H. Methe, T. Schmidt, B. Schaeffer, B. Hoffmann, J. Moser, K. Heitmann, S. Willems, C. Klaus, I. Lange, M. Durak, E. Esen, F. Mibach, H. Mibach, A. Utech, M. Gabelmann, R. Stumm, V. Ländle, C. Gartner, C. Goerg, N. Kaul, S. Messer, D. Burkhardt, C. Sander, R. Orthen, S. Kaes, A. Baumer, F. Dodos, A. Barth, G. Schaeffer, J. Gaertner, J. Winkler, A. Fahrig, J. Aring, I. Wenzel, S. Steiner, A. Kliesch, E. Kratz, K. Winter, P. Schneider, A. Haag, I. Mutscher, R. Bosch, J. Taggeselle, S. Meixner, A. Schnabel, A. Shamalla, H. Hötz, A. Korinth, C. Rheinert, G. Mehltretter, B. Schön, N. Schön, A. Starflinger, E. Englmann, G. Baytok, T. Laschinger, G. Ritscher, A. Gerth, D. Dechering, L. Eckardt, M. Kuhlmann, N. Proskynitopoulos, J. Brunn, K. Foth, C. Axthelm, H. Hohensee, K. Eberhard, S. Turbanisch, N. Hassler, A. Koestler, G. Stenzel, D. Kschiwan, M. Schwefer, S. Neiner, S. Hettwer, M. Haeussler-Schuchardt, R. Degenhardt, S. Sennhenn, M. Brendel, A. Stoehr, W. Widjaja, S. Loehndorf, A. Logemann, J. Hoskamp, J. Grundt, M. Block, R. Ulrych, A. Reithmeier, V. Panagopoulos, C. Martignani, D. Bernucci, E. Fantecchi, I. Diemberger, M. Ziacchi, M. Biffi, P. Cimaglia, J. Frisoni, I. Giannini, S. Boni, S. Fumagalli, S. Pupo, A. Di Chiara, P. Mirone, F. Pesce, C. Zoccali, V.L. Malavasi, A. Mussagaliyeva, B. Ahyt, Z. Salihova, K. Koshum-Bayeva, A. Kerimkulova, A. Bairamukova, B. Lurina, R. Zuzans, S. Jegere, I. Mintale, K. Kupics, K. Jubele, O. Kalejs, K. Vanhear, M. Cachia, E. Abela, S. Warwicker, T. Tabone, R. Xuereb, D. Asanovic, D. Drakalovic, M. Vukmirovic, N. Pavlovic, L. Music, N. Bulatovic, A. Boskovic, H. Uiterwaal, N. Bijsterveld, J. De Groot, J. Neefs, N. van den Berg, F. Piersma, A. Wilde, V. Hagens, J. Van Es, J. Van Opstal, B. Van Rennes, H. Verheij, W. Breukers, G. Tjeerdsma, R. Nijmeijer, D. Wegink, R. Binnema, S. Said, S. Philippens, W. van Doorn, T. Szili-Torok, R. Bhagwandien, P. Janse, A. Muskens, M. van Eck, R. Gevers, N. van der Ven, A. Duygun, B. Rahel, J. Meeder, A. Vold, C. Holst Hansen, I. Engset, B. Dyduch-Fejklowicz, E. Koba, M. Cichocka, A. Sokal, A. Kubicius, E. Pruchniewicz, A. Kowalik-Sztylc, W. Czapla, I. Mróz, M. Kozlowski, T. Pawlowski, M. Tendera, A. Winiarska-Filipek, A. Fidyk, A. Slowikowski, M. Haberka, M. Lachor-Broda, M. Biedron, Z. Gasior, M. Kołodziej, M. Janion, I. Gorczyca-Michta, B. Wozakowska-Kaplon, M. Stasiak, P. Jakubowski, T. Ciurus, J. Drozdz, M. Simiera, P. Zajac, T. Wcislo, P. Zycinski, J. Kasprzak, A. Olejnik, E. Harc-Dyl, J. Miarka, M. Pasieka, M. Ziemińska-Łuć, W. Bujak, A. Śliwiński, A. Grech, J. Morka, K. Petrykowska, M. Prasał, G. Hordyński, P. Feusette, P. Lipski, A. Wester, W. Streb, J. Romanek, P. Woźniak, M. Chlebuś, P. Szafarz, W. Stanik, M. Zakrzewski, J. Kaźmierczak, A. Przybylska, E. Skorek, H. Błaszczyk, M. Stępień, S. Szabowski, W. Krysiak, M. Szymańska, J. Karasiński, J. Blicharz, M. Skura, K. Hałas, L. Michalczyk, Z. Orski, K. Krzyżanowski, A. Skrobowski, L. Zieliński, M. Tomaszewska-Kiecana, M. Dłużniewski, M. Kiliszek, M. Peller, M. Budnik, P. Balsam, G. Opolski, A. Tymińska, K. Ozierański, A. Wancerz, A. Borowiec, E. Majos, R. Dabrowski, H. Szwed, A. Musialik-Lydka, A. Leopold-Jadczyk, E. Jedrzejczyk-Patej, M. Koziel, M. Mazurek, K. Krzemien-Wolska, P. Starosta, E. Nowalany-Kozielska, A. Orzechowska, M. Szpot, M. Staszel, S. Almeida, H. Pereira, L. Brandão Alves, R. Miranda, L. Ribeiro, F. Costa, F. Morgado, P. Carmo, P. Galvao Santos, R. Bernardo, P. Adragão, G. Ferreira da Silva, M. Peres, M. Alves, M. Leal, A. Cordeiro, P. Magalhães, P. Fontes, S. Leão, A. Delgado, A. Costa, B. Marmelo, B. Rodrigues, D. Moreira, J. Santos, L. Santos, A. Terchet, D. Darabantiu, S. Mercea, V. Turcin Halka, A. Pop Moldovan, A. Gabor, B. Doka, G. Catanescu, H. Rus, L. Oboroceanu, E. Bobescu, R. Popescu, A. Dan, A. Buzea, I. Daha, G. Dan, I. Neuhoff, M. Baluta, R. Ploesteanu, N. Dumitrache, M. Vintila, A. Daraban, C. Japie, E. Badila, H. Tewelde, M. Hostiuc, S. Frunza, E. Tintea, D. Bartos, A. Ciobanu, I. Popescu, N. Toma, C. Gherghinescu, D. Cretu, N. Patrascu, C. Stoicescu, C. Udroiu, G. Bicescu, V. Vintila, D. Vinereanu, M. Cinteza, R. Rimbas, M. Grecu, A. Cozma, F. Boros, M. Ille, O. Tica, R. Tor, A. Corina, A. Jeewooth, B. Maria, C. Georgiana, C. Natalia, D. Alin, D. Dinu-Andrei, M. Livia, R. Daniela, R. Larisa, S. Umaar, T. Tamara, M. Ioachim Popescu, D. Nistor, I. Sus, O. Coborosanu, N. Alina-Ramona, R. Dan, L. Petrescu, G. Ionescu, C. Vacarescu, E. Goanta, M. Mangea, A. Ionac, C. Mornos, D. Cozma, S. Pescariu, E. Solodovnicova, I. Soldatova, J. Shutova, L. Tjuleneva, T. Zubova, V. Uskov, D. Obukhov, G. Rusanova, N. Isakova, S. Odinsova, T. Arhipova, E. Kazakevich, O. Zavyalova, T. Novikova, I. Riabaia, S. Zhigalov, E. Drozdova, I. Luchkina, Y. Monogarova, D. Hegya, L. Rodionova, V. Nevzorova, O. Lusanova, A. Arandjelovic, D. Toncev, L. Vukmirovic, M. Radisavljevic, M. Milanov, N. Sekularac, M. Zdravkovic, S. Hinic, S. Dimkovic, T. Acimovic, J. Saric, S. Radovanovic, A. Kocijancic, B. Obrenovic-Kircanski, D. Kalimanovska Ostric, D. Simic, I. Jovanovic, I. Petrovic, M. Polovina, M. Vukicevic, M. Tomasevic, N. Mujovic, N. Radivojevic, O. Petrovic, S. Aleksandric, V. Kovacevic, Z. Mijatovic, B. Ivanovic, M. Tesic, A. Ristic, B. Vujisic-Tesic, M. Nedeljkovic, A. Karadzic, A. Uscumlic, M. Prodanovic, M. Zlatar, M. Asanin, B. Bisenic, V. Vasic, Z. Popovic, D. Djikic, M. Sipic, V. Peric, B. Dejanovic, N. Milosevic, S. Backovic, A. Stevanovic, A. Andric, B. Pencic, M. Pavlovic-Kleut, V. Celic, M. Pavlovic, M. Petrovic, M. Vuleta, N. Petrovic, S. Simovic, Z. Savovic, S. Milanov, G. Davidovic, V. Iric-Cupic, D. Djordjevic, M. Damjanovic, S. Zdravkovic, V. Topic, D. Stanojevic, M. Randjelovic, R. Jankovic-Tomasevic, V. Atanaskovic, S. Antic, D. Simonovic, M. Stojanovic, S. Stojanovic, V. Mitic, V. Ilic, D. Petrovic, M. Deljanin Ilic, S. Ilic, V. Stoickov, S. Markovic, A. Mijatovic, D. Tanasic, G. Radakovic, J. Peranovic, N. Panic-Jelic, O. Vujadinovic, P. Pajic, S. Bekic, S. Kovacevic, A. García Fernandez, A. Perez Cabeza, M. Anguita, L. Tercedor Sanchez, E. Mau, J. Loayssa, M. Ayarra, M. Carpintero, I. Roldán Rabadan, M. Gil Ortega, A. Tello Montoliu, E. Orenes Piñero, S. Manzano Fernández, F. Marín, A. Romero Aniorte, A. Veliz Martínez, M. Quintana Giner, G. Ballesteros, M. Palacio, O. Alcalde, I. García-Bolao, V. Bertomeu Gonzalez, F. Otero-Raviña, J. García Seara, J. Gonzalez Juanatey, N. Dayal, P. Maziarski, P. Gentil-Baron, M. Koç, E. Onrat, I.E. Dural, K. Yilmaz, B. Özin, S. Tan Kurklu, Y. Atmaca, U. Canpolat, L. Tokgozoglu, A.K. Dolu, B. Demirtas, D. Sahin, O. Ozcan Celebi, G. Gagirci, U.O. Turk, H. Ari, N. Polat, N. Toprak, M. Sucu, O. Akin Serdar, A. Taha Alper, A. Kepez, Y. Yuksel, A. Uzunselvi, S. Yuksel, M. Sahin, O. Kayapinar, T. Ozcan, H. Kaya, M.B. Yilmaz, M. Kutlu, M. Demir, C. Gibbs, S. Kaminskiene, M. Bryce, A. Skinner, G. Belcher, J. Hunt, L. Stancombe, B. Holbrook, C. Peters, S. Tettersell, A. Shantsila, K. Senoo, M. Proietti, K. Russell, P. Domingos, S. Hussain, J. Partridge, R. Haynes, S. Bahadur, R. Brown, S. McMahon, J. McDonald, K. Balachandran, R. Singh, S. Garg, H. Desai, K. Davies, W. Goddard, G. Galasko, I. Rahman, Y. Chua, O. Payne, S. Preston, O. Brennan, L. Pedley, C. Whiteside, C. Dickinson, J. Brown, K. Jones, L. Benham, R. Brady, L. Buchanan, A. Ashton, H. Crowther, H. Fairlamb, S. Thornthwaite, C. Relph, A. McSkeane, U. Poultney, N. Kelsall, P. Rice, T. Wilson, M. Wrigley, R. Kaba, T. Patel, E. Young, J. Law, C. Runnett, H. Thomas, H. McKie, J. Fuller, S. Pick, A. Sharp, A. Hunt, K. Thorpe, C. Hardman, E. Cusack, L. Adams, M. Hough, S. Keenan, A. Bowring, J. Watts, J. Zaman, K. Goffin, H. Nutt, Y. Beerachee, J. Featherstone, C. Mills, J. Pearson, L. Stephenson, S. Grant, A. Wilson, C. Hawksworth, I. Alam, M. Robinson, S. Ryan, R. Egdell, E. Gibson, M. Holland, D. Leonard, B. Mishra, S. Ahmad, H. Randall, J. Hill, L. Reid, M. George, S. McKinley, L. Brockway, W. Milligan, J. Sobolewska, J. Muir, L. Tuckis, L. Winstanley, P. Jacob, S. Kaye, L. Morby, A. Jan, T. Sewell, C. Boos, B. Wadams, C. Cope, P. Jefferey, N. Andrews, A. Getty, A. Suttling, C. Turner, K. Hudson, R. Austin, S. Howe, R. Iqbal, N. Gandhi, K. Brophy, P. Mirza, E. Willard, S. Collins, N. Ndlovu, E. Subkovas, V. Karthikeyan, L. Waggett, A. Wood, A. Bolger, J. Stockport, L. Evans, E. Harman, J. Starling, L. Williams, V. Saul, M. Sinha, L. Bell, S. Tudgay, S. Kemp, L. Frost, T. Ingram, A. Loughlin, C. Adams, M. Adams, F. Hurford, C. Owen, C. Miller, D. Donaldson, H. Tivenan, H. Button, A. Nasser, O. Jhagra, B. Stidolph, C. Brown, C. Livingstone, M. Duffy, P. Madgwick, P. Roberts, E. Greenwood, L. Fletcher, M. Beveridge, S. Earles, D. McKenzie, D. Beacock, M. Dayer, M. Seddon, D. Greenwell, F. Luxton, F. Venn, H. Mills, J. Rewbury, K. James, K. Roberts, L. Tonks, D. Felmeden, W. Taggu, A. Summerhayes, D. Hughes, J. Sutton, L. Felmeden, M. Khan, E. Walker, L. Norris, L. O'Donohoe, A. Mozid, H. Dymond, H. Lloyd-Jones, G. Saunders, D. Simmons, D. Coles, D. Cotterill, S. Beech, S. Kidd, B. Wrigley, S. Petkar, A. Smallwood, R. Jones, E. Radford, S. Milgate, S. Metherell, V. Cottam, C. Buckley, A. Broadley, D. Wood, J. Allison, K. Rennie, L. Balian, L. Howard, L. Pippard, S. Board, T. Pitt-Kerby, Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia (UNIMORE), Océan du Large et Variabilité Climatique (OLVAC), Laboratoire d'études en Géophysique et océanographie spatiales (LEGOS), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut national des sciences de l'Univers (INSU - CNRS)-Observatoire Midi-Pyrénées (OMP), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National d'Études Spatiales [Toulouse] (CNES)-Centre National de la Recherche Scientifique (CNRS)-Météo-France -Institut de Recherche pour le Développement (IRD)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National d'Études Spatiales [Toulouse] (CNES)-Centre National de la Recherche Scientifique (CNRS)-Météo-France -Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National d'Études Spatiales [Toulouse] (CNES)-Centre National de la Recherche Scientifique (CNRS)-Météo-France -Institut de Recherche pour le Développement (IRD)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National d'Études Spatiales [Toulouse] (CNES)-Centre National de la Recherche Scientifique (CNRS)-Météo-France -Centre National de la Recherche Scientifique (CNRS), Uppsala University, University of Belgrade [Belgrade], CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Éducation Éthique Santé EA 7505 (EES), and Université de Tours (UT)

Subjects
Kardiologi, General Practice, Cohort, Anticoagulants, MACE, Endocrinology and Diabetes, Prognosis, [SHS]Humanities and Social Sciences, Allmänmedicin, Stroke, Risk Factors, Healthcare resource utilisation, Mortality, Prevalence, Endokrinologi och diabetes, Atrial Fibrillation, Internal Medicine, Diabetes Mellitus, Quality of Life, Humans, Cardiac and Cardiovascular Systems, Prospective Studies, Registries, Aged
Abstract

BACKGROUND: The prevalence of atrial fibrillation(AF) and diabetes mellitus is rising to epidemic proportions. We aimed to assess the impact of diabetes on the management and outcomes of patients with AF.METHODS: The EORP-AF General Long-Term Registry is a prospective, observational registry from 250 centres across 27 European countries. Outcomes of interest were as follows: i)rhythm control interventions; ii)quality of life; iii)healthcare resource utilisation; and iv)major adverse events.RESULTS: Of 11,028 patients with AF, the median age was 71 (63-77) years and 2537 (23.0%) had diabetes. Median follow-up was 24 months. Diabetes was related to increased use of anticoagulation but less rhythm control interventions. Using multivariable analysis, at 2-year follow-up, patients with diabetes were associated with greater levels of anxiety (p = 0.038) compared to those without diabetes. Overall, diabetes was associated with worse health during follow-up, as indicated by Health Utility Score and Visual Analogue Scale. Healthcare resource utilisation was greater with diabetes in terms of length of hospital stay (8.1 (±8.2) vs. 6.1 (±6.7) days); cardiology and internal medicine/general practitioner visits; and emergency room admissions. Diabetes was an independent risk factor of major adverse cardiovascular event (MACE; HR 1.26 [95% CI, 1.04-1.52]), all-cause mortality (HR 1.28 [95% CI, 1.08-1.52]), and cardiovascular mortality (HR 1.41 [95% CI, 1.09-1.83]).CONCLUSION: In this contemporary AF cohort, diabetes was present in 1 in 4 patients and it served as an independent risk factor for reduced quality of life, greater healthcare resource utilisation and excess MACE, all-cause mortality and cardiovascular mortality. There was increased use of anticoagulation therapy in diabetes but with less rhythm control interventions.

Published
2022

30. Comprehensive Cardiac Magnetic Resonance to Detect Subacute Myocarditis

Author

Krumm, Jan M. Brendel, Karin Klingel, Jens Kübler, Karin A. L. Müller, Florian Hagen, Meinrad Gawaz, Konstantin Nikolaou, Simon Greulich, and Patrick

Subjects
acute myocarditis, subacute myocarditis, magnetic resonance imaging, CMR, LGE, T1 mapping, T2 mapping, ECV, Lake Louise criteria
Abstract

(1) Background: Compared to acute myocarditis in the initial phase, detection of subacute myocarditis with cardiac magnetic resonance (CMR) parameters can be challenging due to a lower degree of myocardial inflammation compared to the acute phase. (2) Objectives: To systematically evaluate non-invasive CMR imaging parameters in acute and subacute myocarditis. (3) Methods: 48 patients (age 37 (IQR 28–55) years; 52% female) with clinically suspected myocarditis were consecutively included. Patients with onset of symptoms ≤2 weeks prior to 1.5T CMR were assigned to the acute group (n = 25, 52%), patients with symptom duration >2 to 6 weeks were assigned to the subacute group (n = 23, 48%). CMR protocol comprised morphology, function, 3D-strain, late gadolinium enhancement (LGE) imaging and mapping (T1, ECV, T2). (4) Results: Highest diagnostic performance in the detection of subacute myocarditis was achieved by ECV evaluation either as single parameter or in combination with T1 mapping (applying a segmental or global increase of native T1 > 1015 ms and ECV > 28%), sensitivity 96% and accuracy 91%. Compared to subacute myocarditis, acute myocarditis demonstrated higher prevalence and extent of LGE (AUC 0.76) and increased T2 (AUC 0.66). (5) Conclusions: A comprehensive CMR approach allows reliable diagnosis of clinically suspected subacute myocarditis. Thereby, ECV alone or in combination with native T1 mapping indicated the best performance for diagnosing subacute myocarditis. Acute vs. subacute myocarditis is difficult to discriminate by CMR alone, due to chronological connection and overlap of pathologic findings.

Published
2022
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31. Using Multiparametric Cardiac Magnetic Resonance to Phenotype and Differentiate Biopsy-Proven Chronic from Healed Myocarditis and Dilated Cardiomyopathy

Author

Greulich, Patrick Krumm, Jan M. Brendel, Karin Klingel, Karin A. L. Müller, Jens Kübler, Christoph Gräni, Meinrad Gawaz, Konstantin Nikolaou, and Simon

Subjects
myocarditis, dilated cardiomyopathy, DCM, magnetic resonance imaging, CMR, LGE, T1 mapping, T2 mapping, ECV, endomyocardial biopsy
Abstract

(1) Objectives: To discriminate biopsy-proven myocarditis (chronic vs. healed myocarditis) and to differentiate from dilated cardiomyopathy (DCM) using cardiac magnetic resonance (CMR). (2) Methods: A total of 259 consecutive patients (age 51 ± 15 years; 28% female) who underwent both endomyocardial biopsy (EMB) and CMR in the years 2008–2021 were evaluated. According to right-ventricular EMB results, patients were divided into either chronic (n = 130, 50%) or healed lymphocytic myocarditis (n = 60, 23%) or DCM (n = 69, 27%). The CMR protocol included functional, strain, and late gadolinium enhancement (LGE) imaging, T2w imaging, and T2 mapping. (3) Results: Left-ventricular ejection fraction (LV-EF) was higher, and the indexed end-diastolic volume (EDV) was lower in myocarditis patients (chronic: 42%, median 96 mL/m²; healed: 49%, 86 mL/m²) compared to the DCM patients (31%, 120 mL/m²), p < 0.0001. Strain analysis demonstrated lower contractility in DCM patients vs. myocarditis patients, p < 0.0001. Myocarditis patients demonstrated a higher LGE prevalence (68% chronic; 59% healed) than the DCM patients (45%), p = 0.01. Chronic myocarditis patients showed a higher myocardial edema prevalence and ratio (59%, median 1.3) than healed myocarditis (23%, 1.3) and DCM patients (13%, 1.0), p < 0.0001. T2 mapping revealed elevated values more frequently in chronic (90%) than in healed (21%) myocarditis and DCM (23%), p < 0.0001. T2 mapping yielded an AUC of 0.89 (sensitivity 90%, specificity 76%) in the discrimination of chronic from healed myocarditis and an AUC of 0.92 (sensitivity 86%, specificity 91%) in the discrimination of chronic myocarditis from DCM, both p < 0.0001. (4) Conclusions: Multiparametric CMR imaging, including functional parameters, LGE and T2 mapping, may allow differentiation of chronic from healed myocarditis and DCM and therefore help to optimize patient management in this clinical setting.

Published
2022
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35. Review of vapor compression refrigeration in microgravity environments

Author

Derek W. Hengeveld, Michael K. Ewert, Leon P. M. Brendel, Stephen L. Caskey, James E. Braun, and Eckhard A. Groll

Subjects
business.industry, Computer science, 020209 energy, Mechanical Engineering, Refrigeration, 02 engineering and technology, Building and Construction, Energy consumption, Coefficient of performance, 01 natural sciences, 010305 fluids & plasmas, Documentation, 0103 physical sciences, 0202 electrical engineering, electronic engineering, information engineering, Leverage (statistics), Aerospace engineering, Vapor-compression refrigeration, business, Volume (compression)
Abstract

Using a vapor compression cycle for cooling in microgravity environments was already suggested in the 1970s to leverage the high coefficient of performance. Since then, only a few systems have operated in microgravity with scarce documentation of these flights. The lack of measured data and detailed documentation makes identifying the necessary next steps difficult for researchers entering the field of refrigeration in space. This paper provides a review of available literature for vapor compression systems flown in microgravity by outlining the history of vapor compression devices in space and presenting performance data. Moreover, gaps in the literature are highlighted and open questions are posed based on the reviewed material. Next steps of research are suggested to support and ultimately achieve reliable vapor compression refrigeration in space. Calculating equivalent masses for a fair comparison of different microgravity cooling technologies is proposed by capturing both energy consumption and used volume.

Published
2021

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