Institute of Cardiovascular Research

Sankt Pölten, Austria

Institute of Cardiovascular Research

Sankt Pölten, Austria
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PubMed | Institute of Cardiovascular Research, University of Surrey and Fred Hutchinson Cancer Research Center
Type: Journal Article | Journal: Pflugers Archiv : European journal of physiology | Year: 2016

Cardiac arrhythmias are associated with raised intracellular [Ca

Lu Q.,Institute of Cardiovascular Research | Tang S.-L.,Institute of Cardiovascular Research | Tang S.-L.,University of South China | Liu X.-Y.,Institute of Cardiovascular Research | And 12 more authors.
Circulation Journal | Year: 2013

Tert-butylhydroquinone (tBHQ), a synthetic phenolic antioxidant, is commonly used as a food preservative because of its potent antilipid peroxidation activity. Several lines of evidence have demonstrated that dietary supplementation with antioxidants has an antiatherogenic function through reducing cholesterol uptake or promoting reverse cholesterol transport. In this study, we investigated whether tBHQ affects expression of ATP-binding cassette transporter A1 (ABCA1) and the potential subsequent effect on cellular cholesterol homeostasis. Methods and Results: tBHQ increased ABCA1 protein levels and markedly enhanced cholesterol efflux from THP-1 macrophage-derived foam cells. Furthermore, tBHQ reduced calpain-mediated ABCA1 proteolysis via activation of nuclear factor E2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1). Inhibition of HO-1 with a pharmacological inhibitor or siRNA and knockdown of Nrf2 suppressed the stimulatory effects of tBHQ on ABCA1 expression and calpain activity. Conclusions: Nrf2/HO-1 signaling is required for the regulation by tBHQ of ABCA1 expression and cholesterol efflux in macrophage-derived foam cells and an antiatherogenic role of tBHQ is suggested.

Wollmann C.G.,Hospital Of St Polten Lilienfeld | Wollmann C.G.,Institute of Cardiovascular Research | Lawo T.,Berufsgenossenschaftliche Universitatsklinik Bergmannsheil GmbH | Kuhlkamp V.,Herz Zentrum Bodensee | And 6 more authors.
PACE - Pacing and Clinical Electrophysiology | Year: 2014

Background Implantable defibrillators (ICD) are highly effective in reducing arrhythmia-related mortality. ICD shock therapy has been shown to increase psychological distress, health care utilization, and is associated with increased mortality. The Protecta ICDs (Medtronic Inc., Minneapolis, MN, USA) have algorithms designed to reduce unnecessary and inappropriate shock therapy.Methods and Results The PainFree SmartShock™ Technology (PainFree SST) study is a prospective, multicenter, clinical trial with two consecutive phases, a premarket phase safety study and a postmarket phase effectiveness study. We report the results of the PainFree SST safety study. The premarket phase aimed to investigate safety in the first year postimplant, and to determine if the novel algorithms (T-wave discrimination, right ventricular lead noise discrimination and confirmation+) affect appropriate ventricular fibrillation (VF) detection. Patients (total: n = 246 [male 78%, mean age 63 year, primary prevention indication in 76%]) were implanted either with a Protecta XT dual-chamber ICD (n = 114 [46%]) or a defibrillator with cardiac resynchronization therapy (n = 132 [54%]). Appropriate VF detection was measured during VF induction at implantation when the novel algorithms were programmed ON. A two-second delay in VF detection was classified as clinically significant. No delay in VF detection was observed with all algorithms programmed ON. No unanticipated serious adverse device effects occurred during first year postimplant.Conclusion The results of the premarket phase of the PainFree SST trial demonstrate the safety of the Protecta XT defibrillators. Detection of induced VF was not delayed with SmartShock™ algorithms ON. ©2014 Wiley Periodicals, Inc.

Wollmann C.G.,Universitatsklinikum St Polten Lilienfeld | Wollmann C.G.,Institute of Cardiovascular Research
Herzschrittmachertherapie und Elektrophysiologie | Year: 2014

This is the first case report about a patient implanted with a DF4 lead suffering from reel syndrome. The reel syndrome may occur due to a ratchet mechanism where the device generator creates torque on a lead fixed at the fixation sleeve. Theoretically, this is less likely to occur in DF4 connectors due to their higher stiffness. © 2014, Springer-Verlag Berlin Heidelberg.

Cleland J.G.F.,University of Hull | Calvert M.,University of Birmingham | Freemantle N.,University of Birmingham | Arrow Y.,University of Hull | And 6 more authors.
European Journal of Heart Failure | Year: 2011

Aims Revascularization is frequently advocated to improve ventricular function and prognosis for patients with heart failure due to coronary artery disease, especially when there is evidence of extensive myocardial viability. Methods and resultsPatients with heart failure, coronary artery disease, and a left ventricular (LV) ejection fraction ≤35, who had a substantial volume of viable myocardium with contractile dysfunction assessed by any standard imaging technique, were randomly assigned to a strategy of conservative management vs. angiography with the intent of percutaneous or surgical revascularization. Patients requiring revascularization for angina or too frail for surgery were excluded. Only 138 of the planned 800 patients were enrolled because of withdrawal of funding due to slow recruitment. Also, a larger trial (The Surgical Treatment for Ischemic Heart Failure Trial) addressing a similar question became available, which investigators were encouraged to join. Of 69 patients assigned to the invasive strategy, 6 refused angiography, 2 died as a result of the diagnostic procedure, 14 were considered unsuitable for revascularization, 2 refused surgery, and 45 had revascularization. After a median follow-up of 59 (inter-quartile range: 33-63) months, there were 51 (37%) deaths; 25 (37%) in those assigned to the conservative strategy, and 26 (38%) in those assigned to the invasive strategy, 13 (29%) of whom had been revascularized. Conclusion A conservative management strategy may not be inferior to one of coronary arteriography with the intent to revascularize in patients with heart failure, LV systolic dysfunction, and extensive myocardial viability. However, this study was underpowered and, further, larger trials are required to settle this issue.Clinical trials Registration No: ISRCTN86284615. © 2010 The Author.

Wollmann C.G.,Hospital Of St Polten Lilienfeld | Wollmann C.G.,Institute of Cardiovascular Research | Thudt K.,Hospital Of St Polten Lilienfeld | Thudt K.,Institute of Cardiovascular Research | And 6 more authors.
Journal of Cardiovascular Magnetic Resonance | Year: 2014

Background: No published data exist about the safety of diagnostic magnetic resonance (MR) of the heart performed in a larger series of patients implanted with MR conditional pacemakers (PM). The purpose of our study is to analyse safety and potential alterations of electrical lead parameters in patients implanted with the EnRhythm/Advisa MRI SureScan PM with 5086MRI leads (Medtronic Inc.) during and after MR of the heart at 1.5 Tesla. Methods. Patients enrolled in this single center pilot study who underwent non-clinically indicated diagnostic MR of the heart were included in this analysis. Heart MR was performed for analyses of potential changes in right and left ventricular functional parameters under right ventricular pacing at 80 and 110 bpm. Atrial/ventricular sensing, atrial/ventricular pacing capture threshold [PCT], and pacing impedances were assessed immediately before, during, and immediately after MR, as well at 3 and 15 months post MR. Results: Thirty-six patients (mean age 69 ± 13 years; high degree AV block 18 [50%]) underwent MR of the heart. No MR related adverse events occurred during MR or thereafter. Ventricular sensing differed significantly between the FU immediately after MR (10.3 ± 5.3 mV) and the baseline FU (9.8 ± 5.3 mV; p < 0.05). Despite PCT [V/0.4ms] was not significantly different between the FUs (baseline: 0.84 ± 0.27; in-between MR scans: 0.82 ± 0.27; immediately after MR: 0.84 ± 0.24; 3-month: 0.85 ± 0.23; 15-month: 0.90 ± 0.67; p = ns), 7 patients (19%) showed PCT increases by 100% (max. PCT measured: 1.0 V) at the 3-month FU compared to baseline. RV pacing impedance [/5V] differed significantly at the FU in-between MR scans (516 ± 47), and at the 15-month FU (482 ± 58) compared to baseline (508 ± 75). Conclusion: The results of our study suggest MR of the heart to be safe in patients with the MR conditional EnRhythm/Advisa system, albeit although noticeable but clinically irrelevant ventricular PCT changes were observed. © 2014 Wollmann et al.; licensee BioMed Central Ltd.

Wollmann C.G.,Hospital Of St Polten Lilienfeld | Wollmann C.G.,Institute of Cardiovascular Research
Minerva Cardioangiologica | Year: 2011

Twiddler's Syndrome and Reel Syndrome are potentially harmful lead-related complications in patients with implantable defibrillators and pacemakers. Twiddler's Syndrome is caused by device rotations around the devices long axis. A ratchet mechanism, possibly involving lead fixation sleeves and not device rotations around the transverse axis is suggested to be responsible for the Reel Syndrome. No detailed information about the underlying mechanisms of the Reel Syndrome is available. A case of a patient with a CRT-D and Reel Syndrome is reported; the mechanisms making the Reel Syndrome possible are illustrated and discussed.

Wollmann C.G.,Hospital Of St Polten Lilienfeld | Wollmann C.G.,Institute of Cardiovascular Research
Herzschrittmachertherapie und Elektrophysiologie | Year: 2012

Device pocket infections in patients with permanent pacemakers and implantable defibrillators are a common complication, requiring explantation of the entire system if involvement of the leads is evident. We report on a patient with a pocket infection of a cardiac-resynchronization therapy defibrillator (CRT-D), in whom the left ventricular epicardial pacing lead was saved without explantation of the lead. © Springer-Verlag 2012.

Pereira T.,Polytechnic Institute of Coimbra | Maldonado J.,Institute of Cardiovascular Research | Coutinho R.,Polytechnic Institute of Coimbra | Cardoso E.,Polytechnic Institute of Coimbra | And 3 more authors.
Blood Pressure Monitoring | Year: 2014

Introduction: Arteries are the target, the place, and the common denominator of cardiovascular diseases; hence, study of arterial function is of greatest importance in clinical practice. The aim of this study was to evaluate the accuracy of carotid pulse wave analysis using the new version of the Complior device - the Complior Analyse. Methods and results: This was a cross-sectional study that included 15 patients (seven women), mean age 62.07±10.59 years, referenced for cardiac catheterization. Pressure curves were obtained simultaneously in the ascending aorta (invasively) and in the right common carotid artery (using the Complior Analyse). Mean central arterial pressures, augmentation indexes, and wave morphology obtained using both methods were compared. A good concordance between methods was obtained for all the parameters measured, with intraclass correlation coefficients above 0.9. Bland-Altman analysis also indicated a good accuracy profile of the Complior device, with small mean differences observed for all parameters and most values confined within 2 SD of the mean difference. This was further confirmed by the strong Pearson correlation coefficients, with r2 coefficients above 0.92 for all the variables studied. The correlations observed were independent of sex, age, arterial pressure, and BMI. Conclusion: The results presented and available research clearly indicate that the Complior Analyse device measures carotid pressure waves accurately; therefore, it is a simple and reliable noninvasive alternative for pressure wave analysis. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Pereira T.,Polytechnic Institute of Coimbra | Maldonado J.,Institute of Cardiovascular Research | Andrade I.,Polytechnic Institute of Coimbra | Cardoso E.,Polytechnic Institute of Coimbra | And 3 more authors.
Blood Pressure Monitoring | Year: 2014

INTRODUCTION: The aim of this study was to assess the interobserver and intraobserver reproducibility, as well as the temporal variability of the new Complior Analyse assessing aortic pulse wave velocity (PWV). METHODS: Eighty-seven participants (60% men), mean age 34.26±16.58 years, were enrolled in a cross-sectional study. All patients were subjected to sequential measures of aortic PWV by two experienced operators. In a group of 27 participants, PWV was also determined 1 month after the first moment evaluation to assess the temporal stability of the PWV estimations with the device. RESULTS: The analysis of concordance showed a very good agreement for paired PWV values in terms of both the intraobserver and the interobserver variability and also the temporal variability. The intraclass correlation coefficients were above 0.98 for the three conditions (P<0.0001), indicating an excellent strength of agreement. Further evidences in favor of a good overall performance of the device were determined from the Bland-Altman analysis, with small mean differences for intrareproducibility, interreproducibility, and temporal reproducibility (respectively, 0.02±0.38, 0.10±0.45, and 0.07±0.51 m/s), and with differences mainly between 2 SDs of the mean difference. The correlations observed were independent of sex, age, arterial pressure, heart rate, and BMI. CONCLUSION: The data showed an excellent reproducibility of the Complior Analyse for the assessment of aortic PWV when used in ideal conditions and by experienced observers. The technical profile presented shows that this device meets the requirements of quality for its inclusion in integrated clinical follow-up programs. © 2014 Wolters Kluwer Health Lippincott Williams & Wilkins.

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