Publications by authors named "Walter Speidl"

Article Synopsis
  • This study explores the link between ABO blood groups and the risk of early stent thrombosis in patients who underwent coronary interventions, focusing particularly on non-O blood groups and their association with cardiovascular issues.
  • Among 10,714 patients, only 0.73% experienced early stent thrombosis, and while non-O blood groups weren't significantly linked, those with B-antigens (B and AB blood types) showed a higher risk for early thrombosis compared to O type.
  • The findings suggest that B-antigen presence is a notable factor in early stent thrombosis risk, indicating a need for more research to understand the biological mechanisms behind this relationship.
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Aims: Familial hypercholesterolaemia (FH) is a severely underdiagnosed, inherited disease, causing dyslipidaemia and premature atherosclerotic cardiovascular disease. In order to facilitate screening in a broad clinical spectrum, we aimed to analyse the current yield of routine genetic diagnostics for FH and to evaluate the performance of the Dutch Lipid Clinic Network Score (DLCNS) compared to a single value, the off-treatment LDL-cholesterol exceeding 190 mg/dL.

Methods And Results: We investigated all patients that underwent molecular genotyping routinely performed for FH over a 4-year period in two Austrian specialist lipid clinics.

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: Intra-amniotic infection (IAI) is a rare but serious condition with potential complications such as preterm labor and intrauterine fetal death. Diagnosing IAI is challenging due to varied clinical signs. Oxidative stress and mitochondrial dysfunction have been hypothesized to evolve around IAI.

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: Septic shock is a severe condition with high mortality necessitating precise prognostic tools for improved patient outcomes. This study aimed to evaluate the collective predictive value of the Simplified Acute Physiology Score 3 (SAPS-3) and lactate measurements (initial, peak, last, and clearance rates within the first 24 h) in patients with septic shock. Specifically, it sought to determine how these markers enhance predictive accuracy for 28-day mortality beyond SAPS-3 alone.

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Background: Intravenous administration of azithromycin has been linked to severe hypotension in some case reports in the past. We report a further case of profound shock requiring excessive use of vasopressors and extracorporeal membrane oxygenation (ECMO).

Case Summary: An 18-year-old Caucasian male was admitted due to fulminant myocarditis and signs of cardiogenic shock.

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Fulminant myocarditis (FM) constitutes a severe and life-threatening form of acute cardiac injury associated with cardiogenic shock. The condition is characterised by rapidly progressing myocardial inflammation, leading to significant impairment of cardiac function. Due to the acute and severe nature of the disease, affected patients require urgent medical attention to mitigate adverse outcomes.

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Critical care cardiology (CCC) in the modern era is shaped by a multitude of innovative treatment options and an increasingly complex, ageing patient population. Generating high-quality evidence for novel interventions and devices in an intensive care setting is exceptionally challenging. As a result, formulating the best possible therapeutic approach continues to rely predominantly on expert opinion and local standard operating procedures.

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Article Synopsis
  • VA-ECMO is a type of machine that helps people whose hearts can't pump blood properly, but researchers aren't sure if it's really helpful or safe yet.
  • Some studies show it might help after heart emergencies but others don't agree, especially for certain heart problems.
  • More research is being done to find out who might benefit the most from VA-ECMO and how to use it better.
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Article Synopsis
  • Stent thrombosis is a rare but serious complication that can occur after percutaneous coronary intervention (PCI), especially when patients show signs of acute inflammation.
  • In a study of 6880 patients undergoing PCI, those with elevated inflammatory markers had a nearly threefold increased risk of experiencing early stent thrombosis within 30 days.
  • The findings suggest that if there are indicators of acute inflammation, elective PCI should be postponed, and further research is necessary for those with acute coronary syndrome.
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Critically ill patients admitted to intensive care units (ICUs) experience a broad variety of life-threatening conditions. Irrespective of the initial cause of hospitalization, many experience systemic immune dysregulation. Dendritic cells (DCs) are the most potent antigen-presenting cells and play a pivotal role in regulating the immune response by linking the innate to the adaptive immune system.

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Objective: The low-density lipoprotein cholesterol goals in the 2019 European Society of Cardiology/European Atherosclerosis Society dyslipidaemia guidelines necessitate greater use of combination therapies. We describe a real-world cohort of patients in Austria and simulate the addition of oral bempedoic acid and ezetimibe to estimate the proportion of patients reaching goals.

Methods: Patients at high or very high cardiovascular risk on lipid-lowering treatments (excluding proprotein convertase subtilisin/kexin type 9 inhibitors) from the Austrian cohort of the observational SANTORINI study were included using specific criteria.

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Article Synopsis
  • - The study investigates the role of Toll-like receptor 9 (TLR9) in neutrophil activation and its impact on ischaemia-reperfusion injury (IRI) after a heart attack, linking excessive neutrophil infiltration to increased tissue damage.
  • - Utilizing a rat model, researchers applied a TLR9 antagonist (ODN 2088) during reperfusion and found that TLR9 inhibition resulted in significant left ventricular wall thinning and heightened neutrophil presence, without affecting monocyte levels.
  • - The findings suggest that TLR9 plays a critical role in regulating neutrophil migration, and blocking it may lead to exacerbated tissue damage post-myocardial infarction, highlighting a potential area for therapeutic
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Atherosclerosis is a chronic, inflammatory disease of the vessel wall where triggered immune cells bind to inflamed endothelium, extravasate and sustain local inflammation. Leukocyte adhesion and extravasation are mediated by adhesion molecules expressed by activated endothelial cells, like intercellular adhesion molecule 1 (ICAM-1). Extracellular adherence protein (Eap) from Staphylococcus aureus binds to a plethora of extracellular matrix proteins, including ICAM-1 and its ligands macrophage-1 antigen (Mac-1, αβ) and lymphocyte function-associated antigen 1 (LFA-1, αβ), thereby disrupting the interaction between leukocytes and endothelial cells.

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Background: We aimed to investigate predictors for long-term survival of in-hospital patients with medical emergency team (MET) consultation with or without in-hospital cardiac arrest (IHCA) in Austria's largest medical center.

Methods: Data of patients, who needed an intervention of a MET between 01/2014 and 03/2020 were reviewed for this retrospective analysis.

Results: In total, 708 MET calls were analyzed.

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Interleukin-4 (IL-4) and its receptors (IL-4R) promote the proliferation and polarization of macrophages. However, it is unknown if IL-4R also influences monocyte homeostasis and if steady state IL-4 levels are sufficient to affect monocytes. Employing full IL-4 receptor alpha knockout mice (IL-4Rα ) and mice with a myeloid-specific deletion of IL-4Rα (IL-4Rα LysM ), we show that IL-4 acts as a homeostatic factor regulating circulating monocyte numbers.

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Changes in Ca2 influx during proinflammatory stimulation modulates cellular responses, including the subsequent activation of inflammation. Whereas the involvement of Ca has been widely acknowledged, little is known about the role of Na. Ranolazine, a piperazine derivative and established antianginal drug, is known to reduce intracellular Na as well as Ca2 levels.

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Tachyarrhythmias are common complications of critically ill patients treated on intensive care units. Landiolol is an ultra-short acting beta-blocker with a very high beta1-selectivity. Therefore, landiolol effectively reduces heart rate with only minimal negative effects on blood pressure and inotropy.

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Cardiogenic shock mortality rates remain high despite significant advances in cardiovascular medicine and the widespread uptake of mechanical circulatory support systems. Except for early invasive angiography and percutaneous coronary intervention of the infarct-related artery, all other widely used therapeutic measures are based on low-quality evidence. The grim prognosis and lack of high-quality data warrant further action.

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Cardiogenic shock mortality rates remain high despite significant advances in cardiovascular medicine and the widespread uptake of mechanical circulatory support systems. Except for early invasive angiography and percutaneous coronary intervention of the infarct-related artery, the most widely used therapeutic measures are based on low-quality evidence. The grim prognosis and lack of high-quality data warrant further action.

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Quantitative and functional analysis of mononuclear leukocyte populations is an invaluable tool to understand the role of the immune system in the pathogenesis of a disease. Cryopreservation of mononuclear cells (MNCs) is routinely used to guarantee similar experimental conditions. Immune cells react differently to cryopreservation, and populations and functions of immune cells change during the process of freeze-thawing.

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Background: Critically ill patients admitted to an intensive care unit (ICU) exhibit a high mortality rate irrespective of the initial cause of hospitalization. Neprilysin, a neutral endopeptidase degrading an array of vasoactive peptides became a drug target within the treatment of heart failure with reduced ejection fraction. The aim of this study was to analyse whether circulating levels of neprilysin at ICU admission are associated with 30 day mortality.

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Training of the innate immune system with orally ingested bacterial extracts was demonstrated to have beneficial effects on infection clearance and disease outcome. The aim of our study was to identify cellular and molecular processes responsible for these immunological benefits. We used a murine coronavirus (MCoV) A59 mouse model treated with the immune activating bacterial extract Broncho-Vaxom (BV) OM-85.

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Background: Fabry disease is a hereditary genetic defect resulting in reduced activity of the enzyme α-galactosidase-A and the accumulation of globotriaosylceramide (Gb3) in body fluids and cells. Gb3 accumulation was especially reported for the vascular endothelium in several organs.

Methods: Three Fabry disease patients were screened using a micro-RNA screen.

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