Publications by authors named "Rainer P"

Article Synopsis
  • - The study focuses on developing and validating machine learning models to predict major adverse cardiovascular events (MACE) by evaluating their reliability and interpretability across different populations, utilizing data from Brazil and the USA.
  • - Eight machine learning algorithms were trained using a balanced dataset and assessed for their predictive performance based on accuracy and ROC curve metrics, with emphasis on Random Forest, which outperformed the others in both internal and external validations.
  • - Findings indicate that while Random Forest was the most effective model, Shapley values offered more consistent insights for understanding feature importance compared to LIME during exploratory analyses.
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  • Hypertrophic cardiomyopathy (HCM) is a common heart disease that makes the heart muscle thicker, and it can be inherited from family.
  • In Austria, about 20,000 to 40,000 people might have this condition, but it's often hard to diagnose because it shows up in many different ways.
  • Early diagnosis and genetic testing are important to help patients and their families, and new treatments are available that can help without surgery.
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  • * The study revealed that bone morphogenic protein-4 (BMP4) gradients play a crucial role in maintaining cardiac tissue health in both mice and humans with myocarditis.
  • * Enhancing BMP signaling by targeting inhibitors gremlin-1 and gremlin-2 reduced inflammation and fibrosis in mouse models, suggesting that this BMP4-gremlin pathway could be a potential treatment for myocardial inflammation.
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  • * A global survey conducted in 2023 revealed that non-cardiologists and cardiologists were less likely than heart failure specialists to utilize certain diagnostic tools and parameters like natriuretic peptides and specific echocardiographic techniques for diagnosing HFpEF.
  • * While SGLT2 inhibitors and diuretics were commonly preferred medications across specialties, there was a notable variation in the selected first-choice drug for HFpEF, with heart failure specialists favoring SGLT2 inhibitors more than cardiologists
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  • Immune-checkpoint inhibitors (ICIs) can lead to serious heart issues like myocarditis, which can also involve broader muscle-related symptoms, highlighting the need for understanding associated risks.
  • A study conducted across 17 countries from 2014 to 2023 examined data from 748 patients to identify factors that predict severe outcomes related to these heart complications, using a statistical model for analysis.
  • Key findings indicated that certain conditions (like active thymoma) and symptoms (like low heart function) significantly increased the risk of severe heart-related events, and a risk score created from these factors effectively predicted outcomes, validated in multiple cohorts.
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Mounting experimental and clinical evidence has revealed that adaptive immune mechanisms targeting myocardial antigens are triggered by different forms of cardiac injury and impact disease progression. B and T lymphocytes recognize specific antigens via unique adaptive immune receptors generated through a somatic rearrangement process that generates a potential repertoire of 10 unique receptors. While the adaptive immune receptor repertoire diversity provides the basis for immunologic specificity, making sense of it can be a challenging task.

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Cardiovascular disease (CVD) is the leading cause of morbimortality in Europe and worldwide. CVD imposes a heterogeneous spectrum of cardiac remodelling, depending on the insult nature, that is, pressure or volume overload, ischaemia, arrhythmias, infection, pathogenic gene variant, or cardiotoxicity. Moreover, the progression of CVD-induced remodelling is influenced by sex, age, genetic background and comorbidities, impacting patients' outcomes and prognosis.

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  • The study investigates how machine learning (ML) can classify patients with cardiovascular disease or risk factors who are hospitalized with COVID-19, aiming to better predict patient outcomes.
  • A total of 458 patients were analyzed, revealing three distinct clusters: one with mostly women and fewer comorbidities, another mainly with men and less severe symptoms, and a third group of men with severe cardiovascular issues and higher mortality risk.
  • The findings highlight the importance of personalized approaches in treating high-risk COVID-19 patients, particularly identifying those likely to face poorer outcomes due to their cardiovascular conditions.
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Adipose tissue plasticity is orchestrated by molecularly and functionally diverse cells within the stromal vascular fraction (SVF). Although several mouse and human adipose SVF cellular subpopulations have by now been identified, we still lack an understanding of the cellular and functional variability of adipose stem and progenitor cell (ASPC) populations across human fat depots. To address this, we performed single-cell and bulk RNA sequencing (RNA-seq) analyses of >30 SVF/Lin- samples across four human adipose depots, revealing two ubiquitous human ASPC (hASPC) subpopulations with distinct proliferative and adipogenic properties but also depot- and BMI-dependent proportions.

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  • Pulmonary hypertension (PH) linked to left heart failure (PH-LHF) is a common condition that worsens symptoms, reduces physical ability, and harms right heart function, leading to a poor outlook for patients.
  • Despite various drugs being tested, there are currently no specific treatments for PH-LHF, highlighting significant gaps in understanding its pathophysiology and clinical management.
  • The document calls for improved research on pulmonary venous changes, patient categorization for tailored therapies, and rigorous pre-clinical studies to enhance clinical trials and expand treatment options beyond current methods used for pulmonary arterial hypertension.
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In patients with stable chronic heart failure with a reduced ejection fraction (HFrEF), left ventricular ejection fraction (LVEF) provides limited prognostic value, especially in patients with moderately to severely reduced LVEF. Echocardiographic parameters of right ventricular function may be associated with adverse clinical events in these patients. Therefore, we analyzed 164 patients with HFrEF in a prospective single-center cohort study to evaluate whether the parameters of right ventricular function are associated with worsening heart failure (WHF) hospitalizations, cardiovascular and all-cause deaths and combined endpoints.

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Myocarditis has emerged as an immune-related adverse event of immune checkpoint inhibitor (ICI) cancer therapy associated with significant mortality. To ensure patients continue to safely benefit from life-saving cancer therapy, an understanding of fundamental immunological phenomena underlying ICI myocarditis is essential. We recently developed the NOD-cMHCI/II-/-.

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  • Cerebral white matter hyperintensities (WMH) have been linked to early signs of heart issues, particularly coronary artery calcification (CAC), but previous research mostly looked at data from just one point in time.
  • This study specifically examined the relationship between WMH and CAC in older adults, analyzing data at the start and again after 6 years among participants who were initially stroke- and dementia-free.
  • Results showed that while initial CAC levels didn't predict WMH growth, higher WMH volume at the beginning was an indicator of increased CAC over time, particularly in those with severe WMH, suggesting that monitoring heart health could be important for these individuals.
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Irreversible fibrosis is a hallmark of myocardial infarction (MI) and heart failure. Extracellular matrix protein-1 (ECM-1) is up-regulated in these hearts, localized to fibrotic, inflammatory, and perivascular areas. ECM-1 originates predominantly from fibroblasts, macrophages, and pericytes/vascular cells in uninjured human and mouse hearts, and from M1 and M2 macrophages and myofibroblasts after MI.

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  • The study investigates the link between arterial hypertension (HTN) and markers of left ventricular dysfunction and inflammation in patients with hypertrophic cardiomyopathy (HCM).
  • It compares 30 HCM patients with HTN to 30 without, assessing echocardiographic measures and inflammatory markers.
  • Results reveal that while both groups had similar cardiac function, those with HTN showed higher levels of systemic inflammation, suggesting HTN's negative effects on HCM patients stem from overall body inflammation rather than direct heart function decline.
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While chronic heart failure (CHF) treatment has considerably improved patient prognosis and survival, the therapeutic management of acute heart failure (AHF) has remained virtually unchanged in the last decades. This is partly due to the scarcity of pre-clinical models for the pathophysiological assessment and, consequently, the limited knowledge of molecular mechanisms involved in the different AHF phenotypes. This scientific statement outlines the different trajectories from acute to CHF originating from the interaction between aetiology, genetic and environmental factors, and comorbidities.

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Despite the high prevalence of heart failure in the western world, there are few effective treatments. Fibulin-3 is a protein involved in extracellular matrix (ECM) structural integrity, however its role in the heart is unknown. We have demonstrated, using single cell RNA-seq, that fibulin-3 was highly expressed in quiescent murine cardiac fibroblasts, with expression highest prior to injury and late post-infarct (from ~ day-28 to week-8).

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Pivotal outcome trials targeting heart failure with preserved (HFpEF) and mildly-reduced ejection fraction (HFmrEF) may have excluded patients at highest risk of poor outcomes. We aimed to assess eligibility for HFpEF/HFmrEF outcome trials in an unselected heart failure cohort and its association with all-cause mortality. Among 32.

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Background: Several blood biomarkers have been identified as predictors for poor outcome after ischemic stroke. However, recent studies mainly focused on single or experimental biomarkers and considered rather short follow-up intervals limiting their value for daily clinical practice. We, therefore, aimed to compare various clinical routine blood biomarkers for their predictive value on post-stroke mortality over a 5-year follow-up period.

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Importance: Cardiac dysfunction and myocarditis have emerged as serious complications of multisystem inflammatory syndrome in children (MIS-C) and vaccines against SARS-CoV-2. Understanding the role of autoantibodies in these conditions is essential for guiding MIS-C management and vaccination strategies in children.

Objective: To investigate the presence of anticardiac autoantibodies in MIS-C or COVID-19 vaccine-induced myocarditis.

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Normal circulatory function is a key determinant of disease-free life expectancy (healthspan). Indeed, pathologies affecting the cardiovascular system, which are growing in prevalence, are the leading cause of global morbidity, disability and mortality, whereas the maintenance of cardiovascular health is necessary to promote both organismal healthspan and lifespan. Therefore, cardiovascular ageing might precede or even underlie body-wide, age-related health deterioration.

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