@article{SahitiMorbachCejkaetal.2022,
  author    = {Sahiti, Floran and Morbach, Caroline and Cejka, Vladimir and Tiffe, Theresa and Wagner, Martin and Eichner, Felizitas A. and Gelbrich, G{\"o}tz and Heuschmann, Peter U. and St{\"o}rk, Stefan},
  title     = {Impact of cardiovascular risk factors on myocardial work-insights from the STAAB cohort study},
  series = {Journal of Human Hypertension},
  volume    = {36},
  journal   = {Journal of Human Hypertension},
  number    = {3},
  issn      = {1476-5527},
  doi       = {10.1038/s41371-021-00509-4},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-271770},
  pages     = {235-245},
  year      = {2022},
  abstract  = {Myocardial work is a new echocardiography-based diagnostic tool, which allows to quantify left ventricular performance based on pressure-strain loops, and has been validated against invasively derived pressure-volume measurements. Myocardial work is described by its components (global constructive work [GCW], global wasted work [GWW]) and indices (global work index [GWI], global work efficiency [GWE]). Applying this innovative concept, we characterized the prevalence and severity of subclinical left ventricular compromise in the general population and estimated its association with cardiovascular (CV) risk factors. Within the Characteristics and Course of Heart Failure STAges A/B and Determinants of Progression (STAAB) cohort study we comprehensively phenotyped a representative sample of the population of W{\"u}rzburg, Germany, aged 30-79 years. Indices of myocardial work were determined in 1929 individuals (49.3\% female, mean age 54 ± 12 years). In multivariable analysis, hypertension was associated with a mild increase in GCW, but a profound increase in GWW, resulting in higher GWI and lower GWE. All other CV risk factors were associated with lower GCW and GWI, but not with GWW. The association of hypertension and obesity with GWI was stronger in women. We conclude that traditional CV risk factors impact selectively and gender-specifically on left ventricular myocardial performance, independent of systolic blood pressure. Quantifying active systolic and diastolic compromise by derivation of myocardial work advances our understanding of pathophysiological processes in health and cardiac disease.},
  language  = {en}
}
@article{RemdeKranzMorelletal.2023,
  author    = {Remde, Hanna and Kranz, Stefanie and Morell, Sarah Maria and Altieri, Barbara and Kroiss, Matthias and Detomas, Mario and Fassnacht, Martin and Deutschbein, Timo},
  title     = {Clinical course of patients with adrenal incidentalomas and cortisol autonomy},
  series = {Frontiers in Endocrinology},
  volume    = {14},
  journal   = {Frontiers in Endocrinology},
  issn      = {1664-2392},
  doi       = {10.3389/fendo.2023.1123132},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-316793},
  year      = {2023},
  abstract  = {Background Adrenal incidentalomas with cortisol autonomy are associated with increased cardiovascular morbidity and mortality. Specific data on the clinical and biochemical course of affected patients are lacking. Methods Retrospective study from a tertiary referral centre in Germany. After exclusion of overt hormone excess, malignancy and glucocorticoid medication, patients with adrenal incidentalomas were stratified according to serum cortisol after 1 mg dexamethasone: autonomous cortisol secretion (ACS), >5.0; possible ACS (PACS), 1.9-5.0; non-functioning adenomas (NFA), ≤1.8 µg/dl. Results A total of 260 patients were enrolled (147 women (56.5\%), median follow-up 8.8 (2.0-20.8) years). At initial diagnosis, median age was 59.5 (20-82) years, and median tumour size was 27 (10-116) mm. Bilateral tumours were more prevalent in ACS (30.0\%) and PACS (21.9\%) than in NFA (8.1\%). Over time, 40/124 (32.3\%) patients had a shift of their hormonal secretion pattern (NFA to PACS/ACS, n=15/53; PACS to ACS, n=6/47; ACS to PACS, n=11/24; PACS to NFA, n=8/47). However, none of the patients developed overt Cushing's syndrome. Sixty-one patients underwent adrenalectomy (NFA, 17.9\%; PACS, 24.0\%; ACS, 39.0\%). When non-operated patients with NFA were compared to PACS and ACS at last follow-up, arterial hypertension (65.3\% vs. 81.9\% and 92.0\%; p<0.05), diabetes (23.8\% vs. 35.6\% and 40.0\%; p<0.01), and thromboembolic events (PACS: HR 3.43, 95\%-CI 0.89-13.29; ACS: HR 5.96, 95\%-CI 1.33-26.63; p<0.05) were significantly less frequent, along with a trend towards a higher rate of cardiovascular events in case of cortisol autonomy (PACS: HR 2.23, 95\%-CI 0.94-5.32; ACS: HR 2.60, 95\%-CI 0.87-7.79; p=0.1). Twenty-five (12.6\%) of the non-operated patients died, with higher overall mortality in PACS (HR 2.6, 95\%-CI 1.0-4.7; p=0.083) and ACS (HR 4.7, 95\%-CI 1.6-13.3; p<0.005) compared to NFA. In operated patients, prevalence of arterial hypertension decreased significantly (77.0\% at diagnosis to 61.7\% at last follow-up; p<0.05). The prevalence of cardiovascular events and mortality did not differ significantly between operated and non-operated patients, whereas thromboembolic events were significantly less frequent in the surgical treatment group. Conclusion Our study confirms relevant cardiovascular morbidity in patients with adrenal incidentalomas (especially those with cortisol autonomy). These patients should therefore be monitored carefully, including adequate treatment of typical cardiovascular risk factors. Adrenalectomy was associated with a significantly decreased prevalence of hypertension. However, more than 30\% of patients required reclassification according to repeated dexamethasone suppression tests. Thus, cortisol autonomy should ideally be confirmed before making any relevant treatment decision (e.g. adrenalectomy).},
  language  = {en}
}
@article{LeistnerBenikLaumeieretal.2012,
  author    = {Leistner, Stefanie and Benik, Steffen and Laumeier, Inga and Ziegler, Annerose and Nieweler, Gabriele and Nolte, Christian H. and Heuschmann, Peter U. and Audebert, Heinrich J.},
  title     = {Secondary Prevention after Minor Stroke and TIA - Usual Care and Development of a Support Program},
  series = {PLoS One},
  volume    = {7},
  journal   = {PLoS One},
  number    = {12},
  doi       = {10.1371/journal.pone.0049985},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-135247},
  pages     = {e49985},
  year      = {2012},
  abstract  = {Background: Effective methods of secondary prevention after stroke or TIA are available but adherence to recommended evidence-based treatments is often poor. The study aimed to determine the quality of secondary prevention in usual care and to develop a stepwise modeled support program. Methods: Two consecutive cohorts of patients with acute minor stroke or TIA undergoing usual outpatient care versus a secondary prevention program were compared. Risk factor control and medication adherence were assessed in 6-month follow-ups (6M-FU). Usual care consisted of detailed information concerning vascular risk factor targets given at discharge and regular outpatient care by primary care physicians. The stepwise modeled support program additionally employed up to four outpatient appointments. A combination of educational and behavioral strategies was employed. Results: 168 patients in the observational cohort who stated their openness to participate in a prevention program (mean age 64.7 y, admission blood pressure (BP): 155/84 mmHg) and 173 patients participating in the support program (mean age 67.6 y, BP: 161/84 mmHg) were assessed at 6 months. Proportions of patients with BP according to guidelines were 50\% in usual-care and 77\% in the support program (p<0.01). LDL<100 mg/dl was measured in 62 versus 71\% (p = 0.12). Proportions of patients who stopped smoking were 50 versus 79\% (p<0.01). 72 versus 89\% of patients with atrial fibrillation were on oral anticoagulation (p = 0.09). Conclusions: Risk factor control remains unsatisfactory in usual care. Targets of secondary prevention were met more often within the supported cohort. Effects on (cerebro-)vascular recurrence rates are going to be assessed in a multicenter randomized trial.},
  language  = {en}
}
@article{KotsevaDeBackerDeBacqueretal.2019,
  author    = {Kotseva, Kornelia and De Backer, Guy and De Bacquer, Dirk and Ryd{\´e}n, Lars and Hoes, Arno and Grobbee, Diederick and Maggioni, Aldo and Marques-Vidal, Pedro and Jennings, Catriona and Abreu, Ana and Aguiar, Carlos and Badariene, Jolita and Bruthans, Jan and Castro Conde, Almudena and Cifkova, Renata and Crowley, Jim and Davletov, Kairat and Deckers, Jaap and De Smedt, Delphine and De Sutter, Johan and Dilic, Mirza and Dolzhenko, Marina and Dzerve, Vilnis and Erglis, Andrejs and Fras, Zlatko and Gaita, Dan and Gotcheva, Nina and Heuschmann, Peter and Hasan-Ali, Hosam and Jankowski, Piotr and Lalic, Nebojsa and Lehto, Seppo and Lovic, Dragan and Mancas, Silvia and Mellbin, Linda and Milicic, Davor and Mirrakhimov, Erkin and Oganov, Rafael and Pogosova, Nana and Reiner, Zeljko and St{\"o}erk, Stefan and Tokg{\"o}zoğlu, L{\^a}le and Tsioufis, Costas and Vulic, Dusko and Wood, David},
  title     = {Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry},
  series = {European Journal of Preventive Cardiology},
  volume    = {26},
  journal   = {European Journal of Preventive Cardiology},
  number    = {8},
  organization    = {EUROASPIRE Investigators},
  issn      = {2047-4873},
  doi       = {10.1177/2047487318825350},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-205526},
  pages     = {824-835},
  year      = {2019},
  abstract  = {Aims The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice. Design A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries. Methods Patients (<80 years old) with verified coronary artery events or interventions were interviewed and examined ≥6 months later. Results A total of 8261 patients (females 26\%) were interviewed. Nineteen per cent smoked and 55\% of them were persistent smokers, 38\% were obese (body mass index ≥30 kg/m2), 59\% were centrally obese (waist circumference: men ≥102 cm; women ≥88 cm) while 66\% were physically active <30 min 5 times/week. Forty-two per cent had a blood pressure ≥140/90 mmHg (≥140/85 if diabetic), 71\% had low-density lipoprotein cholesterol ≥1.8 mmol/L (≥70 mg/dL) and 29\% reported having diabetes. Cardioprotective medication was: anti-platelets 93\%, beta-blockers 81\%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers 75\% and statins 80\%. Conclusion A large majority of coronary patients have unhealthy lifestyles in terms of smoking, diet and sedentary behaviour, which adversely impacts major cardiovascular risk factors. A majority did not achieve their blood pressure, low-density lipoprotein cholesterol and glucose targets. Cardiovascular prevention requires modern preventive cardiology programmes delivered by interdisciplinary teams of healthcare professionals addressing all aspects of lifestyle and risk factor management, in order to reduce the risk of recurrent cardiovascular events.},
  language  = {en}
}
@phdthesis{Fleckenstein2010,
  author    = {Fleckenstein, Bettina},
  title     = {Verhalten von anthropometrischen Parametern, kardiovaskul{\"a}ren Risikofaktoren und kardiopulmonaler Leistungsf{\"a}higkeit von Besch{\"a}ftigten mit Metabolischem Syndrom im Rahmen einer Betrieblichen Gesundheitsf{\"o}rderung},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-46431},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2010},
  abstract  = {An 24 Probanden mit einem Metabolischen Syndrom wurden die Auswirkungen einer dreimonatigen Ern{\"a}hrungs- und Bewegungstherapie sowie deren selbstst{\"a}ndiges Fortsetzen {\"u}ber einen Zeitraum von weiteren sechs Monaten auf anthropometrische Parameter, kardiovaskul{\"a}re Risikofaktoren sowie auf die kardiopulmonale Leistungsf{\"a}higkeit untersucht. Die Teilnehmer durchliefen jeweils drei Untersuchungseinheiten, n{\"a}mlich zu Beginn der Studie (T0), nach Abschluss des Interventionsprogrammes (T1) sowie nach einem Nachbeobachtungszeitraum (T2). Es wurden dabei stets eine k{\"o}rperliche Untersuchung, eine Blutabnahme mit Bestimmung verschiedener Laborparameter, eine Bodyplethysmographie sowie eine Ergospirometrie durchgef{\"u}hrt. Es zeigte sich dabei eine signifikante Reduktion des K{\"o}rpergewichts, des BMIs, des Bauchumfanges, der WHR, der Fett- und Magermasse, des systolischen Blutdruckes sowie des Gesamtcholesterins der Probanden. Von allen erhobenen Parametern der Bodyplethysmographie wies nur das exspiratorische Reservevolumen eine signifikante Erh{\"o}hung im Verlauf auf. Die Ergebnisse der Ergospirometrie zeigten, dass das k{\"o}rperliche Training der Probanden vor allem zu einer Verbesserung der Leistungsparameter im unteren und mittleren Trainingsbereich und weniger zu einer Steigerung der Maximalwerte f{\"u}hrte.},
  subject      = {Metabolisches Syndrom},
  language  = {de}
}