999 results match your criteria: "Comprehensive Heart Failure Center[Affiliation]"

Impaired Intracellular Calcium Buffering Contributes to the Arrhythmogenic Substrate in Atrial Myocytes From Patients With Atrial Fibrillation.

Circulation

August 2024

Cluster of Excellence "Multiscale Bioimaging: From Molecular Machines to Networks of Excitable Cells" (F.E.F., A.L., F.S., F.H., S.E.L., A.E., N.V.), Georg-August-University Göttingen, Germany.

Background: Alterations in the buffering of intracellular Ca, for which myofilament proteins play a key role, have been shown to promote cardiac arrhythmia. It is interesting that although studies report atrial myofibrillar degradation in patients with persistent atrial fibrillation (persAF), the intracellular Ca buffering profile in persAF remains obscure. Therefore, we aimed to investigate the intracellular buffering of Ca and its potential arrhythmogenic role in persAF.

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Pharmacologic interventions to slow chronic kidney disease progression, such as ACE-inhibitors, angiotensin receptor blockers, or sodium glucose co-transporter 2 inhibitors, often produce acute treatment effects on glomerular filtration rate (GFR) that differ from their long-term chronic treatment effects. Observational studies assessing the implications of acute effects cannot distinguish acute effects from GFR changes unrelated to the treatment. Here, we performed meta-regression analysis of multiple trials to isolate acute effects to determine their long-term implications.

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Mitochondrial calcium in cardiac ischemia/reperfusion injury and cardioprotection.

Basic Res Cardiol

August 2024

Department of Translational Research, Comprehensive Heart Failure Center (CHFC), University Clinic Würzburg, Am Schwarzenberg 15, Haus A15, 97078, Würzburg, Germany.

Mitochondrial calcium (Ca) signals play a central role in cardiac homeostasis and disease. In the healthy heart, mitochondrial Ca levels modulate the rate of oxidative metabolism to match the rate of adenosine triphosphate consumption in the cytosol. During ischemia/reperfusion (I/R) injury, pathologically high levels of Ca in the mitochondrial matrix trigger the opening of the mitochondrial permeability transition pore, which releases solutes and small proteins from the matrix, causing mitochondrial swelling and ultimately leading to cell death.

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Perfect Match: Radiomics and Artificial Intelligence in Cardiac Imaging.

Circ Cardiovasc Imaging

June 2024

Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Germany (B.B., A. Hekalo, T.W.).

Cardiovascular diseases remain a significant health burden, with imaging modalities like echocardiography, cardiac computed tomography, and cardiac magnetic resonance imaging playing a crucial role in diagnosis and prognosis. However, the inherent heterogeneity of these diseases poses challenges, necessitating advanced analytical methods like radiomics and artificial intelligence. Radiomics extracts quantitative features from medical images, capturing intricate patterns and subtle variations that may elude visual inspection.

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Background: The incidental finding of a pericardial effusion (PE) poses a challenge in clinical care. PE is associated with malignant conditions or severe cardiac disease but may also be observed in healthy individuals. This study explored the prevalence, determinants, course, and prognostic relevance of PE in a population-based cohort.

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Aims: Cognitive impairment (CI) is a common, yet frequently unrecognized co-morbidity in chronic heart failure (HF). We quantified trajectories of cognitive performance, brain volume, and related clinical outcome over a time course of 6 years.

Methods And Results: The Cognition.

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Article Synopsis
  • Finerenone, a non-steroidal mineralocorticoid receptor antagonist, showed promise in improving kidney and cardiovascular health in patients with chronic kidney disease (CKD) and type 2 diabetes, leading to the FIND-CKD study examining its effects in non-diabetic patients with CKD.
  • The FIND-CKD trial is a Phase 3, randomized, double-blind study involving adults with specific eGFR and urinary albumin-creatinine ratio criteria, focused on the efficacy of finerenone versus a placebo over 32 months.
  • The trial screened over 3,200 patients, with 1,584 participating; the majority had chronic glomerulonephritis or hypertensive nephrop
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In the evolving landscape of precision medicine, NET-targeted radiopharmaceuticals are emerging as pivotal tools for the diagnosis and treatment of a range of conditions, from heart failure and neurodegenerative disorders to neuroendocrine cancers. This review evaluates the advancements offered by F-labeled PET tracers and At alpha-particle therapy, juxtaposed with current I-MIBG SPECT and I-MIBG therapies. The enhanced spatial resolution and capability for quantitative analysis render F-labeled PET tracers potential candidates for improved detection and management of diseases.

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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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The Link Between Heart Failure and Neurodegeneration: Insights From Circulating Biomarkers.

JACC Heart Fail

June 2024

Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany; Department of Clinical Research and Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany.

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Picrosirius red staining constitutes an important and broadly used tool to visualize collagen and fibrosis in various tissues. Although multiple qualitative and quantitative analysis methods to evaluate fibrosis are available, many require specialized devices and software or lack objectivity and scalability. Here, we aimed to develop a versatile and powerful "" macro in the FIJI image processing software capable of automated, robust, and quick collagen quantification in cardiac tissue from light micrographs.

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Cardiac magnetic resonance (CMR) imaging allows precise non-invasive quantification of cardiac function. It requires reliable image segmentation for myocardial tissue. Clinically used software usually offers automatic approaches for this step.

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Background And Aims: Acute ischemic stroke (AIS) outcome prognostication remains challenging despite available prognostic models. We investigated whether a biomarker panel improves the predictive performance of established prognostic scores.

Methods: We investigated the improvement in discrimination, calibration, and overall performance by adding five biomarkers (procalcitonin, copeptin, cortisol, mid-regional pro-atrial natriuretic peptide (MR-proANP), and N-terminal pro-B-type natriuretic peptide (NT-proBNP)) to the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) and age/NIHSS scores using data from two prospective cohort studies (SICFAIL, PREDICT) and one clinical trial (STRAWINSKI).

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Bile acids for diabetic cardiomyopathy.

Nat Metab

June 2024

Department of Translational Research, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany.

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Hypertrophic cardiomyopathy is the most common genetic cardiac disease and is characterized by left ventricular hypertrophy. Although this hypertrophy often associates with sarcomeric gene mutations, nongenetic factors also contribute to the disease, leading to diastolic dysfunction. Notably, this dysfunction manifests before hypertrophy and is linked to hypercontractility, as well as nonuniform contraction and relaxation (myofibril asynchrony) of the myocardium.

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A roadmap for therapeutic discovery in pulmonary hypertension associated with left heart failure. A scientific statement of the Heart Failure Association (HFA) of the ESC and the ESC Working Group on Pulmonary Circulation & Right Ventricular Function.

Eur J Heart Fail

April 2024

Department of Translational Medical Sciences, Interdepartmental Center for Clinical and Translational Research (CIRCET), and Interdepartmental Hypertension Research Center (CIRIAPA), Federico II University, Naples, Italy.

Article Synopsis
  • 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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Acral burning pain triggered by fever, thermal hyposensitivity and skin denervation are hallmarks of small fibre neuropathy in Fabry disease, a life-threatening X-linked lysosomal storage disorder. Variants in the gene encoding alpha-galactosidase A may lead to impaired enzyme activity with cellular accumulation of globotriaosylceramide. To study the underlying pathomechanism of Fabry-associated small fibre neuropathy, we generated a neuronal disease model using patient-derived induced pluripotent stem cells from three Fabry patients and one healthy control.

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Heart failure (HF) is a well-described final common pathway for a broad range of diseases however substantial confusion exists regarding how to describe, study, and track these underlying etiologic conditions. We describe (1) the overlap in HF etiologies, comorbidities, and case definitions as currently used in HF registries led or managed by members of the global HF roundtable; (2) strategies to improve the quality of evidence on etiologies and modifiable risk factors of HF in registries; and (3) opportunities to use clinical HF registries as a platform for public health surveillance, implementation research, and randomized registry trials to reduce the global burden of noncommunicable diseases. Investment and collaboration among countries to improve the quality of evidence in global HF registries could contribute to achieving global health targets to reduce noncommunicable diseases and overall improvements in population health.

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Heart failure (HF) is associated with poor outcome after stroke, but data from large prospective trials are sparse.We assessed the impact of HF on clinical endpoints in patients hospitalized with acute ischemic stroke or transient ischemic attack (TIA) enrolled in the prospective, multicenter Systematic Monitoring for Detection of Atrial Fibrillation in Patients with Acute Ischemic Stroke (MonDAFIS) trial. HF was defined as left ventricular ejection fraction (LVEF) < 55% or a history of HF on admission.

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Fabry disease (FD) is an X-linked multiorgan disorder caused by variants in the alpha-galactosidase A gene (GLA). Depending on the variant, disease phenotypes range from benign to life-threatening. More than 1000 GLA variants are known, but a link between genotype and phenotype in FD has not yet been established for all.

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Cardio-Hepatic Interaction in Cardiac Amyloidosis.

J Clin Med

March 2024

Interdisciplinary Amyloidosis Center of Northern Bavaria, University Hospital Würzburg, 97080 Würzburg, Germany.

Congestion is associated with poor prognosis in cardiac amyloidosis (CA). The cardio-hepatic interaction and the prognostic impact of secondary liver affection by cardiac congestion in CA are poorly understood and require further characterisation. Participants of the amyloidosis cohort study AmyKoS at the Interdisciplinary Amyloidosis Centre of Northern Bavaria with proven transthyretin (ATTR-CA) and light chain CA (AL-CA) underwent serial work-up including laboratory tests, echocardiography, and in-depth hepatic assessment by vibration-controlled transient elastography (VCTE) and C-methacetin breath test.

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Shared decision making (SDM) is a core ideal in the interaction between healthcare providers and patients, but the implementation of the SDM ideal in clinical routines has been a relatively slow process. In a sociological study, 71 interactions between physicians and simulated patients enacting chronic heart failure were video-recorded in China, Germany, the Netherlands, and Turkey as part of a quasi-experimental research design. Participating physicians varied in specialty and level of experience.

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Development and Initial Characterization of the First F-CXCR2-Targeting Radiotracer for PET Imaging of Neutrophils.

J Med Chem

April 2024

Pharmaceutical and Medicinal Chemistry, Institute of Pharmacy and Food Chemistry, University of Würzburg, Würzburg 97074, Germany.

The interleukin-8 receptor beta (CXCR2) is a highly promising target for molecular imaging of inflammation and inflammatory diseases. This is due to its almost exclusive expression on neutrophils. Modified fluorinated ligands were designed based on a squaramide template, with different modification sites and synthetic strategies explored.

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The safety of a low-protein diet in older adults with advanced chronic kidney disease.

Nephrol Dial Transplant

October 2024

Division of Renal Medicine, Department of Clinical Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.

Background: A low-protein diet (LPD) is recommended to patients with advanced chronic kidney disease (CKD), whereas geriatric guidelines recommend a higher amount of protein. The aim of this study was to evaluate the safety of LPD treatment in older adults with advanced CKD.

Methods: The EQUAL study is a prospective, observational study including patients ≥65 years of age with an incident estimated glomerular filtration rate <20 ml/min/1.

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