Publications by authors named "Gregor Poglajen"
Article Synopsis
- The study investigates the significance of cardiac troponin (cTn) levels in predicting mortality in patients with Takotsubo syndrome (TTS), analyzing data from the International Takotsubo Registry.
- It identifies that a cTn increase greater than 28.8 times the upper reference limit signals clinically relevant myocardial injury, correlating with a higher risk of mortality over 5 years (adjusted HR 1.58).
- The findings enhance understanding of patient risk profiles in TTS, emphasizing the need for increased monitoring and follow-up for those with significant troponin elevations.
Article Synopsis
- The study investigated changes in demographics, risk factors, clinical presentations, and outcomes of takotsubo syndrome (TTS) patients from 2004 to 2021, using data from the InterTAK registry.
- Over the years, the proportion of male patients increased, and there was a rise in cases of midventricular TTS as well as significant growth in the incidence of physical triggers.
- There was also a notable increase in 60-day mortality rates, although no significant change in 1-year mortality when excluding early deaths was observed, indicating a complex evolution of TTS and its management in recent years.
Aims: Allogeneic stem cell therapy is more logistically suitable compared with autologous cell therapy for large-scale patient treatment. We aim to investigate the clinical safety and efficacy profile of the allogeneic adipose tissue derived mesenchymal stromal cell product (CSCC_ASC) as an add-on therapy in patients with chronic non-ischaemic heart failure with reduced left ventricular ejection fraction (HFrEF) < 40%.
Methods And Results: This is a single-centre investigator-initiated randomized phase I/II study with direct intra-myocardial injections of 100 million allogeneic CSCC_ASC.
Article Synopsis
- Researchers developed a machine learning model to predict in-hospital death risk in Takotsubo syndrome (TTS) patients using data from over 3,400 individuals.
- The model included 31 clinical variables and achieved strong performance results, with AUC values indicating high accuracy in identifying patients at risk of death.
- Clustering analysis revealed six distinct patient groups with varying in-hospital death rates, demonstrating the model's ability to stratify risk profiles effectively.
Aims: The aim of the SCIENCE trial was to investigate whether a single treatment with direct intramyocardial injections of adipose tissue-derived mesenchymal stromal cells (CSCC_ASCs) was safe and improved cardiac function in patients with chronic ischaemic heart failure with reduced ejection fraction (HFrEF).
Methods And Results: The study was a European multicentre, double-blind, placebo-controlled phase II trial using allogeneic CSCC_ASCs from healthy donors or placebo (2:1 randomization). Main inclusion criteria were New York Heart Association (NYHA) class II-III, left ventricular ejection fraction (LVEF) <45%, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels >300 pg/ml.
It has now been almost 20 years since first clinical trials of stem cell therapy for heart repair were initiated. While initial preclinical data were promising and suggested that stem cells may be able to directly restore a diseased myocardium, this was never unequivocally confirmed in the clinical setting. Clinical trials of cell therapy did show the process to be feasible and safe.
View Article and Find Full Text PDFIdentification of decompensation episodes in chronic heart failure patients based solely on heart sounds.
Front Cardiovasc Med
November 2022
Decompensation episodes in chronic heart failure patients frequently result in unplanned outpatient or emergency room visits or even hospitalizations. Early detection of these episodes in their pre-symptomatic phase would likely enable the clinicians to manage this patient cohort with the appropriate modification of medical therapy which would in turn prevent the development of more severe heart failure decompensation thus avoiding the need for heart failure-related hospitalizations. Currently, heart failure worsening is recognized by the clinicians through characteristic changes of heart failure-related symptoms and signs, including the changes in heart sounds.
View Article and Find Full Text PDFPatients with advanced heart failure (HF) have reduced cardiac output and impaired peripheral blood flow, which diminishes endothelial shear stress and consequently flow-mediated dilatation (FMD). The aim of our study was to find out whether endothelial dysfunction is associated with the number of CD34+ cells and TNF-α levels in patients with ischemic and non-ischemic HF after stimulation with granulocyte colony-stimulating factor (G-CSF). We included 56 patients with advanced HF (LVEF < 35%).
View Article and Find Full Text PDFIntroduction: Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is the fastest way to restore circulation in refractory cardiogenic shock, however it cannot unload the failing left ventricle. There is a lack of consensus regarding optimal approach to left ventricular venting in V-A ECMO patients with severely depressed or absent left ventricular function.
Methods: A computer model was developed in Matlab Simulink R20016b (MathWorks, Inc.
Aims: We investigated the effects of CD34 cell therapy in patients with heart failure with preserved ejection fraction (HFpEF).
Methods And Results: In a prospective pilot study, we enrolled 30 patients with HFpEF. In Phase 1, patients were treated with medical therapy for 6 months.
Background And Aim Of The Study: The aim of this study was to use coronary computed tomography in patients with normal tricuspid aortic valves to perform detailed aortic root and aortic valve geometric analysis with a focus on the asymmetry of the three leaflets.
Methods: Retrospective analysis of anonymized coronary computed tomography angiograms was performed using dedicated software, where manual aortic root segmentation and marking of several points of interest were followed by automated measurements of aortic root and leaflets. Asymmetry of the three leaflets in individual patients was assessed by calculating absolute and relative differences between the largest and the smallest of the three leaflets.
Heart failure with preserved ejection fraction (HFpEF) is the most common cause of hospitalisation for heart failure. However, only limited effective treatments are available. Recent evidence suggests that HFpEF may result from a systemic proinflammatory state, microvascular endothelial inflammation and microvascular rarefaction.
View Article and Find Full Text PDFWe investigated the effects of cell therapy on local mechanical dyssynchrony (LMD) in patients with nonischemic dilated cardiomyopathy (NICM). We analyzed electromechanical data of 30 NICM patients undergoing CD34 cell transplantation. All patients underwent bone marrow stimulation; CD34 cells were collected by apheresis and injected transendocardially.
View Article and Find Full Text PDFBackground Atrial fibrillation (AF) is a major risk factor for mortality. The prevalence, clinical correlates, and prognostic impact of AF in Takotsubo syndrome (TTS) have not yet been investigated in a large patient cohort. This study aimed to investigate the prevalence, clinical correlates, and prognostic impact of AF in patients with TTS.
View Article and Find Full Text PDFArticle Synopsis
- This study investigates ethnic differences in clinical characteristics and in-hospital outcomes of takotsubo syndrome (TTS) patients from Japan and Europe.
- Japanese patients tend to be older, more male, and experience more physical triggers for TTS, along with higher rates of cardiogenic shock and in-hospital mortality compared to European patients.
- Despite worse in-hospital outcomes for Japanese patients, ethnicity itself does not influence mortality rates; rather, the type of physical stressors is the key prognostic factor for both groups.
Aims: Acute pulmonary disorders are known physical triggers of takotsubo syndrome (TTS). This study aimed to investigate prevalence of acute pulmonary triggers in patients with TTS and their impact on outcomes.
Methods And Results: Patients with TTS were enrolled from the International Takotsubo Registry and screened for triggering factors and comorbidities.
Trabecular bone score (TBS) is a textural index that provides indirect evaluation of trabecular microarchitecture. It improves fracture risk assessment in several high-risk populations. We aimed to evaluate the role of TBS assessment in heart transplant recipients (HTR).
View Article and Find Full Text PDFObjective: To investigate the association of left ventricular end-diastolic volume (LVEDV) and the response to cell therapy in patients with nonischemic dilated cardiomyopathy (NICM).
Patients And Methods: Five-year registry data from 133 consecutive patients with NICM who underwent CD34 cell treatment were analyzed. All patients received granulocyte-colony stimulating factor; CD34 cells were collected by apheresis and delivered by transendocardial injections.
Purpose Of Review: The purpose of this review is to discuss recent advances in the field of cell therapy in patients with heart failure with reduced ejection fraction (HFrEF) of ischemic (iCMP) and nonischemic (dCMP) etiology, heart failure with preserved ejection fraction (HFpEF), and in advanced heart failure patients undergoing mechanical circulatory support (LVAD).
Recent Findings: In HFrEF patients (iCMP and dCMP cohorts), autologous and/or allogeneic cell therapy was shown to improve myocardial performance, patients' functional capacity, and neurohumoral activation. In HFpEF patient population, the concept of cell therapy in novel and remains largely unexplored.
Background: We sought to evaluate the long-term effects of angiotensin receptor blocker-neprilysin inhibitor (ARNI) therapy on reverse remodeling of the failing myocardium in HFrEF patients.
Methods: We performed a prospective non-randomized longitudinal study on 228 HFrEF patients treated with ARNI at our center. Prior to ARNI introduction all patients received stable doses of ACEI/ARB for at least six months.
Aims: Takotsubo syndrome (TTS) is an acute heart failure syndrome, which shares many features with acute coronary syndrome (ACS). Although TTS was initially described with angiographically normal coronary arteries, smaller studies recently indicated a potential coexistence of coronary artery disease (CAD) in TTS patients. This study aimed to determine the coexistence, features, and prognostic role of CAD in a large cohort of patients with TTS.
View Article and Find Full Text PDFBackground: Takotsubo syndrome (TTS) occurs predominantly in post-menopausal women but is also found in younger patients.
Objectives: This study aimed to investigate age-related differences in TTS.
Methods: Patients diagnosed with TTS and enrolled in the International Takotsubo Registry between January 2011 and February 2017 were included in this analysis and were stratified by age (younger: ≤50 years, middle-age: 51 to 74 years, elderly: ≥75 years).
Background: Endocrine disorders in patients after heart transplantation (HT) remain understudied. We aimed to assess endocrine profiles and management of HT recipients in the early post- transplant period.
Methods: We conducted a retrospective cohort study on 123 consecutive HT recipients in the Advanced Heart Failure and Transplantation Programme between 2009 and 2018.