Publications by authors named "Schulze P"

Aims: Ischaemic mitral regurgitation (MR) is a dynamic condition influenced by global and regional left ventricular remodelling as well as mitral valvular deformation. Exercise testing plays a substantial role in assessing the haemodynamic relevance of MR and is recommended by current guidelines. We aimed to assess the prevalence, haemodynamic consequences, and prognostic impact of dynamic MR using isometric handgrip exercise.

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Aims: This study aimed to investigate incidence and predictors of weaning failure and in-hospital death after successful weaning from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in patients with cardiogenic shock (CS).

Methods And Results: Overall, 685 patients with CS treated with VA-ECMO from 23 tertiary care centres in 7 countries were analysed (median age 57 [interquartile range 49-66] years, 542 [79.1%] male, median lactate 7.

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Background: Transjugular intrahepatic portosystemic shunt (TIPS) placement leads to a reduction in portal pressure and an improvement in survival in patients with recurrent and refractory ascites and variceal haemorrhage. Prediction of post-TIPS survival is primarily determined by factors identified before the TIPS procedure, as data collected during or after TIPS implantation are limited. The aim of the study was to evaluate the influence of early hemodynamic changes after TIPS placement on survival, in order to refine post TIPS management.

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Background: The timing of coronary angiography in patients with successfully resuscitated out-of-hospital cardiac arrest and missing ST-segment elevations on the electrocardiogram has been investigated in 2 large randomized controlled trials, TOMAHAWK (Angiography After Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation) and COACT (Coronary Angiography After Cardiac Arrest Trial). Both trials found neutral results for immediate vs delayed/selective coronary angiography on short-term all-cause mortality. The TOMAHAWK trial showed a tendency towards harm with immediate coronary angiography, though not statistically significant with traditional frequentist methods.

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Fabry disease (FD, OMIM #301500) is a rare metabolic disorder, X-linked glycosphingolipidosis that is characterized by pathogenic mutations in the GLA (Galactosidase Alpha) gene (OMIM *300644) that result in reduced α-galactosidase A (α-GAL) activity and accumulation of globotriaosylceramide (Gb3) in tissues and organs. Peripheral blood mononuclear cells (PBMCs) were used to generate human induced pluripotent stem cells (hiPSC). UKJi004-A was produced from a healthy donor, whereas UKJi003-A was produced from a patient who had FD with GLA-mutation (IVS6-10G>A).

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Healthcare integrated biobanking describes the annotation and collection of residual samples from hospitalized patients for research purposes. The central idea of the current work is to establish an automated workflow for sample annotation, selection and storage for diabetes mellitus. This is challenging due to incomplete data at the time of sample selection.

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• Depression, as defined by a HADS-D score ≥8 points, is independently associated with long-term mortality in patients with aortic stenosis undergoing transcatheter aortic valve implantation. • The assessment of depression in patients with aortic stenosis is recommended for individual risk stratification and identification of patients that may potentially benefit from psychological interventions.

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Article Synopsis
  • Current guidelines suggest closing a patent foramen ovale (PFO) in patients aged 16-60 who have had a cryptogenic or cardioembolic stroke and have a high-risk PFO, based on strong evidence.
  • The efficacy of PFO closure varies, with studies like the CLOSE and RESPECT trials showing a number needed-to-treat (NNT) of 20 to 44 over five years, while the REDUCE trial indicated an NNT as low as 18 over ten years.
  • Although interventional PFO closure is relatively easy to learn, it requires careful execution to reduce complications; research is ongoing for its use in treating migraines, but closures for non-stroke reasons should be evaluated individually.
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  • This study examines how age influences the effectiveness of microaxial flow pump (mAFP) treatment for patients suffering from ST-elevation myocardial infarction (STEMI) and cardiogenic shock (CS), using data from the DanGer Shock trial involving 355 participants.
  • Findings reveal that mortality rates significantly increase with age, from 31% in the youngest group to 73% in the oldest, showing younger patients (<77 years) benefit more from mAFP treatment (lower mortality), while older patients (≥77 years) do not have the same advantage.
  • The study also notes that complications were more common in the mAFP group, but overall, age significantly impacted survival outcomes, highlighting
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With the increasing age of our population, which is linked to a higher incidence of musculoskeletal diseases, there is a massive clinical need for bone implants. Porous scaffolds, usually offering a lower stiffness and allowing for the ingrowth of blood vessels and nerves, serve as an attractive alternative to conventional implants. Natural porous skeletons from marine sponges represent an array of evolutionarily optimized patterns, inspiring the design of biomaterials.

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Background: In symptomatic high-risk patients with severe mitral valve regurgitation (MR), who are not eligible for surgery, Transcatheter edge-to-edge repair (TEER) or transcatheter mitral valve replacement (TMVR) may be an option, especially when surgical mitral valve repair by annuloplasty has been performed earlier. After TMVR, the appropriate anticoagulation regimen is still matter of debate.

Case Presentation: We here report on a 78-year-old frail lady with heart failure and atrial fibrillation who underwent surgical reconstruction of the mitral valve nine years ago.

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  • Cardiac implantable electronic devices (CIEDs) help treat heart disease, but they can lead to serious infections.
  • The number of CIED patients and the rates of infections, including endocarditis, are on the rise due to potential contamination during implantation or secondary infections.
  • Current guidelines don't recommend preventative antibiotics for CIED patients before dental or invasive procedures unless they have specific risk factors, and any patient showing signs of infection should be treated in specialized centers.
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Background: In DanGer Shock (the Danish-German Cardiogenic Shock trial), use of a microaxial flow pump (mAFP) in patients with ST-segment-elevation myocardial infarction-related cardiogenic shock led to lower all-cause mortality but higher rates of renal replacement therapy (RRT). In this prespecified analysis, rates and predictors of acute kidney injury (AKI) and RRT were assessed.

Methods: In this international, randomized, open-label, multicenter trial, 355 adult patients with ST-segment-elevation myocardial infarction-related cardiogenic shock were randomized to mAFP (n=179) or standard care alone (n=176).

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Importance: Mechanical circulatory support with a microaxial flow pump (MAFP) has been shown to improve survival in ST-elevation myocardial infarction-induced cardiogenic shock (STEMI-CS). Understanding the impact on hemodynamic stability over time is crucial for optimizing patient treatment.

Objective: To determine if an MAFP reduces the need for pharmacological circulatory support without compromising hemodynamics compared with standard care in STEMI-CS.

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Background: Patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) present as a main feature ≤50% stenosis upon angiography despite clinical symptoms and biomarker elevation related to acute coronary syndrome. Due to broad availability of high sensitivity troponin testing as well as invasive and non-invasive imaging, this clinical entity receives increasing clinical awareness.

Objective: We aimed to investigate the in-hospital work flow and economic impact of MINOCA vs.

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  • 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.
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  • Percutaneous active mechanical circulatory support (MCS) devices are increasingly used for treating acute myocardial infarction-related cardiogenic shock (AMICS), but there is mixed evidence on their impact on patients' mortality rates.
  • This study conducted an individual patient data meta-analysis of randomised controlled trials to assess the effect of early routine active MCS versus control treatments on 6-month all-cause mortality in AMICS patients.
  • The analysis included nine studies with a total of 1114 patients and found that four trials evaluated venoarterial extracorporeal membrane oxygenation (VA-ECMO) while five focused on left ventricular unloading devices, contributing valuable insights into their effectiveness in this patient group.
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  • - This study analyzes the effects of mitral transcatheter edge-to-edge repair (M-TEER) on hospitalization rates for patients with functional mitral regurgitation (FMR) and symptomatic heart failure (HF), aiming to clarify conflicting results from previous research.
  • - The results indicate that patients who underwent M-TEER experienced significantly lower rates of recurrent heart failure hospitalizations and cardiovascular (CV) deaths over a 24-month period, as well as an improved quality of life compared to those in the control group.
  • - Specifically, patients in the M-TEER group spent fewer days in the hospital due to HF or CV issues, with a statistically significant reduction in total days lost due to these health complications.
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  • 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.
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  • A study in Germany compared two treatments for heart failure patients with secondary mitral regurgitation: transcatheter edge-to-edge repair and surgical mitral-valve repair or replacement.
  • The trial involved 210 patients and assessed outcomes like death, hospitalizations, and major adverse events, finding that transcatheter repair had similar efficacy but significantly fewer safety issues than surgery.
  • Results showed that transcatheter edge-to-edge repair was noninferior to the surgical approach, indicating it might be a safer alternative for this patient group.
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  • The study examined the effectiveness of transcatheter mitral-valve repair in patients suffering from heart failure and functional mitral regurgitation, comparing it to standard medical therapy.
  • In a trial with 505 patients, results showed that those who received the device had significantly lower rates of hospitalizations for heart failure and cardiovascular death compared to those who only received medical therapy.
  • Additionally, patients in the device group experienced a greater improvement in health status, as measured by the Kansas City Cardiomyopathy Questionnaire, indicating better outcomes with the transcatheter procedure.
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Extracorporeal life support systems (ECLS) are life-sustaining measures for severe cardiovascular diseases, serving as bridging treatment either until cardiovascular function is restored or alternative treatment, such as heart transplantation or the implantation of permanent ventricular assist devices is performed. Given the insufficient evidence and frequent urgency of implantation without initial patient consent, the ethical challenges and psychological burden for patients, relatives and the interprofessional intensive care team are significant. As with any treatment, an appropriate therapeutic goal for ECLS treatment based on the indications and patient informed consent is mandatory.

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Objectives: Inflammatory rheumatic diseases (IRD) are often associated with interstitial lung disease (ILD). The aim of the present study was to establish a correlation between the findings on HRCT and the immunological bronchoalveolar lavage (BAL).

Methods: The study included 74 patients with newly diagnosed IRD and evidence of ILD on HRCT with the following pattern: ground-glass opacities (GGO), non-specific interstitial pneumonia (NSIP) and usual interstitial pneumonia (UIP).

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