@article{WiedmannHeuschmannHillmannetal.2014,
  author    = {Wiedmann, Silke and Heuschmann, Peter U. and Hillmann, Steffi and Busse, Otto and Wiethoelter, Horst and Walter, Georg M. and Seidel, Guenter and Misselwitz, Bjoern and Janssen, Alfred and Berger, Klaus and Burmeister, Christoph and Matthias, Christine and Kolominsky-Rabas, Peter and Hermanek, Peter},
  title     = {The Quality of Acute Stroke Care-an Analysis of Evidence-Based Indicators in 260 000 Patients},
  series = {Deutsches {\"A}rzteblatt International},
  volume    = {111},
  journal   = {Deutsches {\"A}rzteblatt International},
  number    = {45},
  issn      = {1866-0452},
  doi       = {10.3238/arztebl.2014.0759},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-114747},
  pages     = {759-765},
  year      = {2014},
  abstract  = {Background: Stroke patients should be cared for in accordance with evidence-based guidelines. The extent of implementation of guidelines for the acute care of stroke patients in Germany has been unclear to date. Methods: The regional quality assurance projects that cooperate in the framework of the German Stroke Registers Study Group (Arbeitsgemeinschaft Deutscher Schlaganfall-Register, ADSR) collected data on the care of stroke patients in 627 hospitals in 2012. The quality of the acute hospital care of patients with stroke or transient ischemic attack (TIA) was assessed on the basis of 15 standardized, evidence-based quality indicators and compared across the nine participating regional quality assurance projects. Results: Data were obtained on more than 260 000 patients nationwide. Intravenous thrombolysis was performed in 59.7\% of eligible ischemic stroke patients patients (range among participating projects, 49.7-63.6\%). Dysphagia screening was documented in 86.2\% (range, 74.8-93.1\%). For the following indicators, the defined targets were not reached for all of Germany: antiaggregation within 48 hours, 93.4\% (range, 86.6-96.4\%); anticoagulation for atrial fibrillation, 77.6\% (range, 72.4-80.1\%); standardized dysphagia screening, 86.2\% (range, 74.8-93.1\%); oral and written information of the patients or their relatives, 86.1\% (range, 75.4-91.5\%). The rate of patients examined or treated by a speech therapist was in the target range. Conclusion: The defined targets were reached for most of the quality indicators. Some indicators, however, varied widely across regional quality assurance projects. This implies that the standardization of care for stroke patients in Germany has not yet been fully achieved.},
  language  = {en}
}
@article{KleinschnitzGoebelMeuthetal.2014,
  author    = {Kleinschnitz, Christoph and G{\"o}bel, Kerstin and Meuth, Sven G. and Kraft, Peter},
  title     = {Glatiramer acetate does not protect from acute ischemic stroke in mice},
  doi       = {10.1186/2040-7378-6-4},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-110528},
  year      = {2014},
  abstract  = {Background The role of the immune system in the pathophysiology of acute ischemic stroke is increasingly recognized. However, targeted treatment strategies to modulate immunological pathways in stroke are still lacking. Glatiramer acetate is a multifaceted immunomodulator approved for the treatment of relapsing-remitting multiple sclerosis. Experimental studies suggest that glatiramer acetate might also work in other neuroinflammatory or neurodegenerative diseases apart from multiple sclerosis. Findings We evaluated the efficacy of glatiramer acetate in a mouse model of brain ischemia/reperfusion injury. 60 min of transient middle cerebral artery occlusion was induced in male C57Bl/6 mice. Pretreatment with glatiramer acetate (3.5 mg/kg bodyweight) 30 min before the induction of stroke did not reduce lesion volumes or improve functional outcome on day 1. Conclusions Glatiramer acetate failed to protect from acute ischemic stroke in our hands. Further studies are needed to assess the true therapeutic potential of glatiramer acetate and related immunomodulators in brain ischemia.},
  language  = {en}
}
@article{OezkurGorskiPeltzetal.2014,
  author    = {Oezkur, Mehmet and Gorski, Armin and Peltz, Jennifer and Wagner, Martin and Lazariotou, Maria and Schimmer, Christoph and Heuschmann, Peter U. and Leyh, Rainer G.},
  title     = {Preoperative serum h-FABP concentration is associated with postoperative incidence of acute kidney injury in patients undergoing cardiac surgery},
  doi       = {10.1186/1471-2261-14-117},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-110480},
  year      = {2014},
  abstract  = {Background Fatty acid binding protein (FABP) is an intracellular transport protein associated with myocardial damage size in patients undergoing cardiac surgery. Furthermore, elevated FABP serum concentrations are related to a number of common comorbidities, such as heart failure, chronic kidney disease, diabetes mellitus, and metabolic syndrome, which represent important risk factors for postoperative acute kidney injury (AKI). Data are lacking on the association between preoperative FABP serum level and postoperative incidence of AKI. Methods This prospective cohort study investigated the association between preoperative h-FABP serum concentrations and postoperative incidence of AKI, hospitalization time and length of ICU treatment. Blood samples were collected according to a predefined schedule. The AKI Network definition of AKI was used as primary endpoint. All associations were analysed using descriptive and univariate analyses. Results Between 05/2009 and 09/2009, 70 patients undergoing cardiac surgery were investigated. AKI was observed in 45 patients (64\%). Preoperative median (IQR) h-FABP differed between the AKI group (2.9 [1.7-4.1] ng/ml) and patients without AKI (1.7 [1.1-3.3] ng/ml; p = 0.04), respectively. Patients with AKI were significantly older. No statistically significant differences were found for gender, type of surgery, operation duration, CPB-, or X-Clamp time, preoperative cardiac enzymes, HbA1c, or CRP between the two groups. Preoperative h-FABP was also correlated with the length of ICU stay (rs = 0.32, p = 0.007). Conclusions We found a correlation between preoperative serum h-FABP and the postoperative incidence of AKI. Our results suggest a potential role for h-FABP as a biomarker for AKI in cardiac surgery.},
  language  = {en}
}
@article{DenglerMaldanerGlaeskeretal.2016,
  author    = {Dengler, Julius and Maldaner, Nicolai and Gl{\"a}sker, Sven and Endres, Matthias and Wagner, Martin and Malzahn, Uwe and Heuschmann, Peter U. and Vajkoczy, Peter},
  title     = {Outcome of Surgical or Endovascular Treatment of Giant Intracranial Aneurysms, with Emphasis on Age, Aneurysm Location, and Unruptured Aneuryms - A Systematic Review and Meta-Analysis},
  series = {Cerebrovascular Diseases},
  volume    = {41},
  journal   = {Cerebrovascular Diseases},
  number    = {3-4},
  organization    = {Giant Intracranial Aneurysm Study Group},
  issn      = {1015-9770},
  doi       = {10.1159/000443485},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-196792},
  pages     = {187-198},
  year      = {2016},
  abstract  = {Background: Designing treatment strategies for unruptured giant intracranial aneurysms (GIA) is difficult as evidence of large clinical trials is lacking. We examined the outcome following surgical or endovascular GIA treatment focusing on patient age, GIA location and unruptured GIA. Methods: Medline and Embase were searched for studies reporting on GIA treatment outcome published after January 2000. We calculated the proportion of good outcome (PGO) for all included GIA and for unruptured GIA by meta-analysis using a random effects model. Results: We included 54 studies containing 64 study populations with 1,269 GIA at a median follow-up time (FU-T) of 26.4 months (95\% CI 10.8-42.0). PGO was 80.9\% (77.4-84.4) in the analysis of all GIA compared to 81.2\% (75.3-86.1) in the separate analysis of unruptured GIA. For each year added to patient age, PGO decreased by 0.8\%, both for all GIA and unruptured GIA. For all GIA, surgical treatment resulted in a PGO of 80.3\% (95\% CI 76.0-84.6) compared to 84.2\% (78.5-89.8, p = 0.27) after endovascular treatment. In unruptured GIA, PGO was 79.7\% (95\% CI 71.5-87.8) after surgical treatment and 84.9\% (79.1-90.7, p = 0.54) after endovascular treatment. PGO was lower in high quality studies and in studies presenting aggregate instead of individual patient data. In unruptured GIA, the OR for good treatment outcome was 5.2 (95\% CI 2.0-13.0) at the internal carotid artery compared to 0.1 (0.1-0.3, p < 0.1) in the posterior circulation. Patient sex, FU-T and prevalence of ruptured GIA were not associated with PGO. Conclusions: We found that the chances of good outcome after surgical or endovascular GIA treatment mainly depend on patient age and aneurysm location rather than on the type of treatment conducted. Our analysis may inform future research on GIA.},
  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}
}
@article{SchulerMurauerStangletal.2019,
  author    = {Schuler, Michael and Murauer, Kathrin and Stangl, Stephanie and Grau, Anna and Gabriel, Katharina and Podger, Lauren and Heuschmann, Peter U. and Faller, Hermann},
  title     = {Pre-post changes in main outcomes of medical rehabilitation in Germany: protocol of a systematic review and meta-analysis of individual participant and aggregated data},
  series = {BMJ Open},
  volume    = {9},
  journal   = {BMJ Open},
  number    = {5},
  doi       = {10.1136/bmjopen-2018-023826},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-201929},
  pages     = {e023826},
  year      = {2019},
  abstract  = {Introduction Multidisciplinary, complex rehabilitation interventions are an important part of the treatment of chronic diseases. However, little is known about the effectiveness of routine rehabilitation interventions within the German healthcare system. Due to the nature of the social insurance system in Germany, randomised controlled trials examining the effects of rehabilitation interventions are challenging to implement and scarcely accessible. Consequently, alternative pre-post designs can be employed to assess pre-post effects of medical rehabilitation programmes. We present a protocol of systematic review and meta-analysis methods to assess the pre-post effects of rehabilitation interventions in Germany. Methods and analysis The respective study will be conducted within the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A systematic literature review will be conducted to identify studies reporting the pre-post effects (start of intervention vs end of intervention or later) in German healthcare. Studies investigating the following disease groups will be included: orthopaedics, rheumatology, oncology, pulmonology, cardiology, endocrinology, gastroenterology and psychosomatics. The primary outcomes of interest are physical/mental quality of life, physical functioning and social participation for all disease groups as well as pain (orthopaedic and rheumatologic patients only), blood pressure (cardiac patients only), asthma control (patients with asthma only), dyspnoea (patients with chronic obstructive pulmonary disease only) and depression/anxiety (psychosomatic patients only). We will invite the principal investigators of the identified studies to provide additional individual patient data. We aim to perform the meta-analyses using individual patient data as well as aggregate data. We will examine the effects of both study-level and patient-level moderators by using a meta-regression method. Ethics and dissemination Only studies that have received institutional approval from an ethics committee and present anonymised individual patient data will be included in the meta-analysis. The results will be presented in a peer-reviewed publication and at research conferences. A declaration of no objection by the ethics committee of the University of W{\"u}rzburg is available (number 20180411 01).},
  language  = {en}
}
@article{TiffeMorbachRueckeretal.2019,
  author    = {Tiffe, Theresa and Morbach, Caroline and R{\"u}cker, Viktoria and Gelbrich, G{\"o}tz and Wagner, Martin and Faller, Hermann and St{\"o}rk, Stefan and Heuschmann, Peter U.},
  title     = {Impact of patient beliefs on blood pressure control in the general population: findings from the population-based STAAB cohort study},
  series = {International Journal of Hypertension},
  volume    = {2019},
  journal   = {International Journal of Hypertension},
  doi       = {10.1155/2019/9385397},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-200992},
  pages     = {9385397},
  year      = {2019},
  abstract  = {Background. Effective antihypertensive treatment depends on patient compliance regarding prescribed medications. We assessed the impact of beliefs related towards antihypertensive medication on blood pressure control in a population-based sample treated for hypertension. Methods. We used data from the Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) study investigating 5000 inhabitants aged 30 to 79 years from the general population of W{\"u}rzburg, Germany. The Beliefs about Medicines Questionnaire German Version (BMQ-D) was provided in a subsample without established cardiovascular diseases (CVD) treated for hypertension. We evaluated the association between inadequately controlled hypertension (systolic RR >140/90 mmHg; >140/85 mmHg in diabetics) and reported concerns about and necessity of antihypertensive medication. Results. Data from 293 participants (49.5\% women, median age 64 years [quartiles 56.0; 69.0]) entered the analysis. Despite medication, half of the participants (49.8\%) were above the recommended blood pressure target. Stratified for sex, inadequately controlled hypertension was less frequent in women reporting higher levels of concerns (OR 0.36; 95\%CI 0.17-0.74), whereas no such association was apparent in men. We found no association for specific-necessity in any model. Conclusion. Beliefs regarding the necessity of prescribed medication did not affect hypertension control. An inverse association between concerns about medication and inappropriately controlled hypertension was found for women only. Our findings highlight that medication-related beliefs constitute a serious barrier of successful implementation of treatment guidelines and underline the role of educational interventions taking into account sex-related differences.},
  language  = {en}
}
@article{HermSchurigMartineketal.2019,
  author    = {Herm, Juliane and Schurig, Johannes and Martinek, Martin R. and H{\"o}ltgen, Reinhard and Schirdewan, Alexander and Kirchhof, Paulus and Wieczorek, Marcus and P{\"u}rerfellner, Helmut and Heuschmann, Peter U. and Fiebach, Jochen B. and Haeusler, Karl Georg},
  title     = {MRI-detected brain lesions in AF patients without further stroke risk factors undergoing ablation - a retrospective analysis of prospective studies},
  series = {BMC Cardiovascular Disorders},
  volume    = {19},
  journal   = {BMC Cardiovascular Disorders},
  doi       = {10.1186/s12872-019-1035-1},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-201226},
  pages     = {58},
  year      = {2019},
  abstract  = {Background Atrial fibrillation (AF) without other stroke risk factors is assumed to have a low annual stroke risk comparable to patients without AF. Therefore, current clinical guidelines do not recommend oral anticoagulation for stroke prevention of AF in patients without stroke risk factors. We analyzed brain magnetic resonance imaging (MRI) imaging to estimate the rate of clinically inapparent ("silent") ischemic brain lesions in these patients. Methods We pooled individual patient-level data from three prospective studies comprising stroke-free patients with symptomatic AF. All study patients underwent brain MRI within 24-48 h before planned left atrial catheter ablation. MRIs were analyzed by a neuroradiologist blinded to clinical data. Results In total, 175 patients (median age 60 (IQR 54-67) years, 32\% female, median CHA\(_2\)DS\(_2\)-VASc = 1 (IQR 0-2), 33\% persistent AF) were included. In AF patients without or with at least one stroke risk factor, at least one silent ischemic brain lesion was observed in 4 (8\%) out of 48 and 10 (8\%) out of 127 patients, respectively (p > 0.99). Presence of silent ischemic brain lesions was related to age (p = 0.03) but not to AF pattern (p = 0.77). At least one cerebral microbleed was detected in 5 (13\%) out of 30 AF patients without stroke risk factors and 25 (25\%) out of 108 AF patients with stroke risk factors (p = 0.2). Presence of cerebral microbleeds was related to male sex (p = 0.04) or peripheral artery occlusive disease (p = 0.03). Conclusion In patients with symptomatic AF scheduled for ablation, brain MRI detected silent ischemic brain lesions in approximately one in 12 patients, and microbleeds in one in 5 patients. The prevalence of silent ischemic brain lesions did not differ in AF patients with or without further stroke risk factors.},
  language  = {en}
}
@article{GabrielJirůHillmannKraftetal.2020,
  author    = {Gabriel, Katharina M. A. and J{\´i}rů-Hillmann, Steffi and Kraft, Peter and Selig, Udo and R{\"u}cker, Victoria and M{\"u}hler, Johannes and D{\"o}tter, Klaus and Keidel, Matthias and Soda, Hassan and Rascher, Alexandra and Schneider, Rolf and Pfau, Mathias and Hoffmann, Roy and Stenzel, Joachim and Benghebrid, Mohamed and Goebel, Tobias and Doerck, Sebastian and Kramer, Daniela and Haeusler, Karl Georg and Volkmann, Jens and Heuschmann, Peter U. and Fluri, Felix},
  title     = {Two years' experience of implementing a comprehensive telemedical stroke network comprising in mainly rural region: the Transregional Network for Stroke Intervention with Telemedicine (TRANSIT-Stroke)},
  series = {BMC Neurology},
  volume    = {20},
  journal   = {BMC Neurology},
  doi       = {10.1186/s12883-020-01676-6},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229214},
  year      = {2020},
  abstract  = {Background Telemedicine improves the quality of acute stroke care in rural regions with limited access to specialized stroke care. We report the first 2 years' experience of implementing a comprehensive telemedical stroke network comprising all levels of stroke care in a defined region. Methods The TRANSIT-Stroke network covers a mainly rural region in north-western Bavaria (Germany). All hospitals providing acute stroke care in this region participate in TRANSIT-Stroke, including four hospitals with a supra-regional certified stroke unit (SU) care (level III), three of those providing teleconsultation to two hospitals with a regional certified SU (level II) and five hospitals without specialized SU care (level I). For a two-year-period (01/2015 to 12/2016), data of eight of these hospitals were available; 13 evidence-based quality indicators (QIs) related to processes during hospitalisation were evaluated quarterly and compared according to predefined target values between level-I- and level-II/III-hospitals. Results Overall, 7881 patients were included (mean age 74.6 years +/- 12.8; 48.4\% female). In level-II/III-hospitals adherence of all QIs to predefined targets was high ab initio. In level-I-hospitals, three patterns of QI-development were observed: a) high adherence ab initio (31\%), mainly in secondary stroke prevention; b) improvement over time (44\%), predominantly related to stroke specific diagnosis and in-hospital organization; c) no clear time trends (25\%). Overall, 10 out of 13 QIs reached predefined target values of quality of care at the end of the observation period. Conclusion The implementation of the comprehensive TRANSIT-Stroke network resulted in an improvement of quality of care in level-I-hospitals.},
  language  = {en}
}
@phdthesis{Yurdadogan2020,
  author    = {Yurdadogan, Tino},
  title     = {Endorganschaden und Gef{\"a}ßalter bei Patienten mit koronarer Herzkrankheit},
  doi       = {10.25972/OPUS-21846},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-218469},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2020},
  abstract  = {Die nicht-invasive Gef{\"a}ßdiagnostik stellt einen wichtigen Pfeiler in der Pr{\"a}vention von Herz-Kreislauferkrankungen dar. W{\"a}hrend lange Zeit die sonographische Messung der cIMT, als morphologisches Korrelat der Gef{\"a}ßalterung, als Goldstandard galt, ist in den letzten Jahren in Gestalt der Pulswellenanalyse/PWV-Messung eine Technik weiterentwickelt worden, die, als funktionelles Korrelat der Gef{\"a}ßalterung, aufgrund der leichteren Durchf{\"u}hrbarkeit und geringerer Untersucherabh{\"a}ngigkeit und Kosten vielversprechend ist. So erlaubt die Messung der Pulswelle mittels gew{\"o}hnlicher Blutdruckmanschetten, genau wie die cIMT, die Berechnung des individuellen Gef{\"a}ßalters und die Diagnostik f{\"u}r das Vorliegen eines Endorganschadens der Blutgef{\"a}ße. Um die Messergebnisse der beiden Untersuchungen miteinander zu vergleichen, wurden beide in der EUROASPIRE-IV Studie an Patienten mit koronarer Herzkrankheit durchgef{\"u}hrt. Die Auswertung der Messergebnisse der mit dem Vascular Explorer durchgef{\"u}hrten Pulswellenanalyse/PWV-Messung ergab {\"u}berraschenderweise, dass die Mehrheit der herzkranken Patienten weder eine vaskul{\"a}re Voralterung noch einen Endorganschaden der Blutgef{\"a}ße aufweisen. Im Falle der cIMT-Messung war Gegenteiliges der Fall, was trotz der medikament{\"o}sen Therapie der Patienten so zu erwarten war. Weiterhin zeigte sich lediglich eine geringe Korrelation zwischen den Messergebnissen beider Untersuchungen. Die Determinanten der einzelnen Messwerte aus cIMT und Pulswellenanalyse/PWV-Messung waren deckungsgleich mit den in der Literatur beschriebenen Faktoren, wenn auch viele der sonst signifikanten Regressoren das Signifikanzniveau in unserer Auswertung nicht unterschritten. Eine Limitation der funktionellen Gef{\"a}ßdiagnostik liegt derzeit darin, dass die Messergebnisse stark von dem verwendeten Messger{\"a}t abh{\"a}ngen. Es liegen noch zu wenig Vergleichsstudien vor, um die Messergebnisse, speziell von neueren Ger{\"a}ten wie dem Vascular Explorer, auf andere zu {\"u}bertragen. Bei der Berechnung des Gef{\"a}ßalters sollten daher optimalerweise ger{\"a}tespezifische Normwerte vorliegen, was beim Vascular Explorer nicht der Fall ist. Gleiches gilt f{\"u}r die Verwendung des PWVcf-Grenzwerts f{\"u}r die Diagnose eines Endorganschadens der Blutgef{\"a}ße. Analog hat auch die Messung der cIMT gewisse Einschr{\"a}nkungen. So w{\"a}re eine weitere Standardisierung der Messorte (A. carotis communis vs Bulbus vs A. carotis interna), zwischen denen sich die durchschnittliche cIMT erheblich unterscheidet, sowie der Messparameter (Minimal- vs Maximal- vs Mittelwert) w{\"u}nschenswert. Die universelle Anwendung eines cIMT-Grenzwerts zur Diagnose eines Endorganschadens der Blutgef{\"a}ße ist daher kritisch zu sehen. Dies zeigt sich auch darin, dass in den neuesten Leitlinien der bislang geltende Grenzwert angezweifelt und kein aktuell g{\"u}ltiger Grenzwert mehr genannt wird. Wir interpretieren unsere Ergebnisse dahingehend, dass unsere Messung der cIMT die zu erwartende pathologische Gef{\"a}ßalterung bei Patienten mit koronarer Herzkrankheit besser widerspiegelt als die Messung der Pulswelle mit dem Vascular Explorer. Welche der beiden Untersuchungen hinsichtlich der prognostischen Wertigkeit {\"u}berlegen ist, muss im Rahmen von L{\"a}ngsschnittstudien gekl{\"a}rt werden.},
  subject      = {Arteriosklerose},
  language  = {de}
}