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(1) Background: Vitamin D, a well-established regulator of calcium and phosphate metabolism, also has immune-modulatory functions. An uncontrolled immune response and cytokine storm are tightly linked to fatal courses of COVID-19. The present retrospective study aimed to inves-tigate vitamin D status markers and vitamin D degradation products in a mixed cohort of 148 hospitalized COVID-19 patients with various clinical courses of COVID-19. (2) Methods: The serum concentrations of 25(OH)D3, 25(OH)D2, 24,25(OH)2D3, and 25,26(OH)2D3 were determined by a validated liquid-chromatography tandem mass-spectrometry method in leftover serum samples from 148 COVID-19 patients that were admitted to the University Hospital of the Medical Uni-versity of Graz between April and November 2020. Anthropometric and clinical data, as well as outcomes were obtained from the laboratory and hospital information systems. (3) Results: From the 148 patients, 34 (23%) died within 30 days after admission. The frequency of fatal outcomes did not differ between males and females. Non-survivors were significantly older than survivors, had higher peak concentrations of IL-6 and CRP, and required mechanical ventilation more frequently. The serum concentrations of all vitamin D metabolites and the vitamin D metabolite ratio (VMR) did not differ significantly between survivors and non-survivors. Additionally, the need for res-piratory support was unrelated to the serum concentrations of 25(OH)D vitamin D and the two vitamin D catabolites, as well as the VMR. (4) Conclusion: The present results do not support a relevant role of vitamin D for the course and outcome of COVID-19.

// Markus Wallner 1, 2, * , Mounir Khafaga 1, * , Ewald Kolesnik 1 , Aris Vafiadis 1 , Gerold Schwantzer 3 , Deborah M. Eaton 2 , Pero Curcic 4 , Martin Kostenberger 5 , Igor Knez 4 , Peter P. Rainer 1 , Martin Pichler 6 , Burkert Pieske 1, 7, 8 and Dirk Von Lewinski 1 1 Division of Cardiology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria 2 Cardiovascular Research Center, Lewis Katz School of Medicine, Temple University, Philadelphia, 19140 PA, United States of America 3 Institute for Medical Informatics, Statistics, and Documentation, Medical University of Graz, 8036 Graz, Austria 4 Division of Cardiac Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria 5 Department of Pediatric Cardiology, Medical University of Graz, 8036 Graz, Austria 6 Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria 7 Department of Internal Medicine and Cardiology, Campus Virchow Klinikum, Charite University Medicine, Berlin, 13353 Berlin, Germany 8 Department of Internal Medicine and Cardiology, German Heart Center, Berlin, 13353 Berlin, Germany * These authors contributed equally to this work Correspondence to: Ewald Kolesnik, email: ewald.kolesnik@medunigraz.at Keywords: prostate cancer, hormone therapy, cardiac disease models, heart failure, istaroxime Received: March 06, 2017 Accepted: April 14, 2017 Published: April 30, 2017 ABSTRACT The current gold standard for prostate cancer treatment is androgen deprivation therapy and antiandrogenic agents. However, adverse cardiovascular events including heart failure can limit therapeutic use. Istaroxime, which combines Na + -K + -ATPase (NKA) inhibition with sarco/endoplasmic reticulum Ca 2+ -ATPase 2a (SERCA2a) stimulation, has recently shown promising anti-neoplastic effects in prostate cancer (PC) models and may also improve cardiac function. Considering the promising anticancer effects of istaroxime, we aimed to assess its functional effects on human myocardium. Results: Istaroxime and strophanthidin elicited dose-dependent positive inotropic effects with a decline in developed force at supraphysiological concentrations in human atrial, nonfailing, and failing ventricular (ToF) myocardium. Diastolic force and RT50% did not change after exposure to both drugs. The maximal developed force in our in-vitro model of heart failure (ToF) was significantly higher after istaroxime administration. Such a difference did not occur in atrial or nonfailing ventricular trabeculae and was not applicable to the diastolic force. Materials and Methods: Human atrial and ventricular trabeculae were isolated from nonfailing hearts and hearts of infants with tetralogy of Fallot (ToF), which were used as an in-vitro model of heart failure. The samples were electrically stimulated and treated with increasing concentrations of istaroxime and strophanthidin (10 nM–1 μM). Systolic and diastolic force development and relaxation parameters (RT50%) were analyzed. Conclusions: Combined NKA inhibition/SERCA2a stimulation increases contractility in atrial, nonfailing, and failing myocardium. Considering that heart failure is a potential side effect of current PC treatments, especially in elderly patients, istaroxime might combine beneficial cardiac and anti-cancer properties.

BACKGROUND: The constantly increasing life-expectancy has led to a high incidence of severe heart diseases in elderly people. The aim of this study was to compare the 30-day morbidity and mortality of octogenarians (group I) with a cohort younger than 60 years (group II). METHODS: Both groups (July 2008 and July 2011) were extracted from the Cardiac database. Demographic data, risk factors, surgical procedures and complications were double-checked. To compare the proportions of patients, Fisher's exact test was performed. RESULTS: In group I (n = 348 patients, 82.6±2.6 years) elective cases (35.3% valvular procedures) were performed in 77.6% and in 67.9% in group II (n = 656 patients, 50±2.4 years). The ICU-stay was 86±108 h (10–1040 h) (median: 51 h) in group I versus 94±256 h (3–4700 h) (median: 46 h). Postoperative renal failure occured in 2.9% in group I. After 17.9 h (1–760 h) (median 4.5 h) patients in group I could be weaned from ventiulation (group II: 26.4 h [1–1230 h] [median 4 h]). The need for blood transfusion was 1.7 units (0–10) in group I (1 unit (0–28) in group II). The 30-day mortality was 5.5% (n = 19) in group I versus 4.7 (n = 31) in group II and was in both groups lower than the expected EuroScore mortality of 16.1 and 6.25%. CONCLUSIONS: It must be argued that the surgical outcome of elderly patients is much better than the individual feeling in the daily routine. We proved that octogenarians should not be excluded from possible benefits of cardiac surgery. As a result of comparing postoperative data of the two different groups we cannot attribute higher costs for our elderly patients.

In this prospective clinical study, we have compared 17 patients with tetralogy of Fallot (TOF) who received mechanical valve substitutes and had concomitant additional right ventricular (RV) volume reduction plasty (aRVVRP, group 1) with seven patients who underwent solitary re-do pulmonary valve replacements (PVR, group 2). All patients were evaluated by magnetic resonance imaging (MRI) two months pre- and four to six months postoperatively for assessment of ventricular geometry. At a mean follow-up of 31.9 months, the RV ejection fraction improved from 39.1 to 48.3% in group 1 vs. from 40.1 to 49% in group 2 (P

Background Literature is controversial whether organs from living donors have a better graft function than brain dead (BD) and non–heart-beating donor organs. Success of transplantation has been correlated with high-energy phosphate (HEP) contents of the graft. Methods HEP contents in heart, liver, kidney, and pancreas from living, BD, and donation after cardiac death in a pig model (n = 6 per donor type) were evaluated systematically. BD was induced under general anesthesia by inflating a balloon in the epidural space. Ten hours after confirmation, organs were retrieved. Cardiac arrest was induced by 9 V direct current. After 10 min of ventricular fibrillation without cardiac output, mechanical and medical reanimation was performed for 30 min before organ retrieval. In living donors, organs were explanted immediately. Freeze-clamped biopsies were taken before perfusion with Celsior solution (heart) or University of Wisconsin solution (abdominal organs) in BD and living donors or with Histidine-Tryptophan-Ketoglutaric solution (all organs) in non–heart-beating donors, after perfusion, and after cold ischemia (4 h for heart, 6 h for liver and pancreas, and 12 h for kidney). HEPs (adenosine triphosphate, adenosine diphosphate, adenosine monophosphate, and phosphocreatine), xanthine, and hypoxanthine were measured by high-performance liquid chromatography. Energy charge and adenosine triphosphate-to-adenosine diphosphate ratio were calculated. Results After ischemia, organs from different donor types showed no difference in energy status. In all organs, a decrease of HEP and an increase in hypoxanthine contents were observed during perfusion and ischemia, irrespective of the donor type. Conclusion Organs from BD or non–heart-beating donors do not differ from living donor organs in their energy status after average tolerable ischemia.

Studies comparing the safety and tolerability of biological therapies for psoriasis in the long-term and in daily clinical practice are lacking. Most published studies are of selected patients with short-term (3-6 months) follow-up. We performed a retrospective cohort study of 103 patients in order to describe the frequency and the clinical features of adverse events, and to evaluate and compare the tolerability and safety of efalizumab, etanercept, infliximab, and adalimumab in clinical practice. A total of 136 courses of biological therapies were administered, with a mean duration of 16 months/patient; 55 patients received efalizumab, 45 etanercept, 33 infliximab, and 3 adalimumab. Infliximab had an incidence rate ratio of suspension due to severe adverse events 5.9 times (95% confidence interval (95% CI) 1.9-18, p 0.001) higher than etanercept and 9.8 times (95% CI 3.2-30.1, p 0.001) higher than efalizumab. Safety profiles for efalizumab and etanercept were more favourable than for infliximab. Concerning tolerability, we found that more patients responded to infliximab, but long-term tolerability was higher for both efalizumab and etanercept due to the better safety profile and a higher compliance to therapy.

Figure 2: Histopathological testing. Left ventricular (LV) myocardial tissue with endocardial fibroelastosis, dilated type. (a) Hypocellular fibrous tissue with multiple lamellae of coarse elastic fibres arranged parallel to the luminal surface (van Gieson’s stain, ×200). (b) The endocardium is extremely thickened extending in the subendocardium (Masson’s trichrome stain, ×200). Note that this myocardial tissue represents the basis of a huge LV papillary muscle.