13449
2013
eng
356
108
article
1
2016-06-07
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How can we cure a heart "in flame"? A translational view on inflammation in heart failure
The prevalence of chronic heart failure is still increasing making it a major health issue in the 21st century. Tremendous evidence has emerged over the past decades that heart failure is associated with a wide array of mechanisms subsumed under the term "inflammation". Based on the great success of immuno-suppressive treatments in auto-immunity and transplantation, clinical trials were launched targeting inflammatory mediators in patients with chronic heart failure. However, they widely lacked positive outcomes. The failure of the initial study program directed against tumor necrosis factor-a led to the search for alternative therapeutic targets involving a broader spectrum of mechanisms besides cytokines. We here provide an overview of the current knowledge on immune activation in chronic heart failure of different etiologies, summarize clinical studies in the field, address unresolved key questions, and highlight some promising novel therapeutic targets for clinical trials from a translational basic science and clinical perspective.
Basic Research in Cardiology
10.1007/s00395-013-0356-y
urn:nbn:de:bvb:20-opus-134497
Basic Research in Cardiology (2013) 108:356 DOI 10.1007/s00395-013-0356-y
Ulrich Hofmann
Stefan Frantz
eng
uncontrolled
cytokines
eng
uncontrolled
immuno-modulation
eng
uncontrolled
heart failure
Medizin und Gesundheit
open_access
Medizinische Klinik und Poliklinik I
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/13449/142_Hofmann_Basic_Research_in_Cardiology.pdf
12188
2013
eng
180
14
article
1
2015-11-12
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Recognition of depression and anxiety and their association with quality of life, hospitalization and mortality in primary care patients with heart failure - study protocol of a longitudinal observation study
Background: International disease management guidelines recommend the regular assessment of depression and anxiety in heart failure patients. Currently there is little data on the effect of screening for depression and anxiety on the quality of life and the prognosis of heart failure (HF). We will investigate the association between the recognition of current depression/anxiety by the general practitioner (GP) and the quality of life and the patients' prognosis.
Methods/Design: In this multicenter, prospective, observational study 3,950 patients with HF are recruited by general practices in Germany. The patients fill out questionnaires at baseline and 12-month follow-up. At baseline the GPs are interviewed regarding the somatic and psychological comorbidities of their patients. During the follow-up assessment, data on hospitalization and mortality are provided by the general practice. Based on baseline data, the patients are allocated into three observation groups: HF patients with depression and/or anxiety recognized by their GP (P+/+), those with depression and/or anxiety not recognized (P+/-) and patients without depression and/or anxiety (P-/-). We will perform multivariate regression models to investigate the influence of the recognition of depression and/or anxiety on quality of life at 12 month follow-up, as well as its influences on the prognosis (hospital admission, mortality).
Discussion: We will display the frequency of GP-acknowledged depression and anxiety and the frequency of installed therapeutic strategies. We will also describe the frequency of depression and anxiety missed by the GP and the resulting treatment gap. Effects of correctly acknowledged and missed depression/anxiety on outcome, also in comparison to the outcome of subjects without depression/anxiety will be addressed. In case results suggest a treatment gap of depression/anxiety in patients with HF, the results of this study will provide methodological advice for the efficient planning of further interventional research.
BMC Family Practice
10.1186/1471-2296-14-180
1471-2296
urn:nbn:de:bvb:20-opus-121881
BMC Family Practice 2013, 14:180. doi:10.1186/1471-2296-14-180
Marion Eisele
Eva Blozik
Stefan Störk
Jens-Martin Träder
Christoph Herrmann-Lingen
Martin Scherer
eng
uncontrolled
anxiety
eng
uncontrolled
depression
eng
uncontrolled
health care research
eng
uncontrolled
heart failure
eng
uncontrolled
prevalence
eng
uncontrolled
observational study
eng
uncontrolled
prognosis
eng
uncontrolled
quality of life
eng
uncontrolled
hospitalization
eng
uncontrolled
treatment
eng
uncontrolled
mortality
eng
uncontrolled
task force
eng
uncontrolled
health questionnaire
eng
uncontrolled
cardiovascular care
eng
uncontrolled
validity
eng
uncontrolled
scale
eng
uncontrolled
validation
eng
uncontrolled
outcomes
eng
uncontrolled
standardization
eng
uncontrolled
population
Krankheiten
open_access
Medizinische Klinik und Poliklinik I
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/12188/006_Eisele_BMC_Family_Practice.pdf
13097
2013
eng
e63560
5
8
article
MMKD Study Group
1
2016-03-31
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Homoarginine and Progression of Chronic Kidney Disease: Results from the Mild to Moderate Kidney Disease Study
Background: Homoarginine is an amino acid derivative mainly synthesized in the kidney. It is suggested to increase nitric oxide availability, enhance endothelial function and to protect against cardiovascular diseases. We aimed to investigate the relation between homoarginine, kidney function and progression of chronic kidney disease (CKD).
Methods: We measured plasma homoarginine concentrations in baseline samples of the Mild to Moderate Kidney Disease (MMKD) Study, a prospective cohort study of 227 patients with CKD in Europe. Homoarginine concentrations were available in 182 of the baseline samples and in 139 of the prospectively-followed patients. We correlated homoarginine concentrations to parameters of kidney function. The association between homoarginine and progression of CKD was assessed during a follow-up of up to seven years (median 4.45 years, interquartile range 2.54-5.19) using Cox regression analysis. Progression of CKD was defined as doubling of baseline serum creatinine and/or end-stage renal disease.
Results: Study participants were at baseline on average 47 \(\pm\)13 years old and 65% were male. Mean \(\pm\) standard deviation of homoarginine concentrations were \(2.5 \pm 1.1 \mu mol/L\) and concentrations were incrementally lower at lower levels of GFR with mean concentrations of \(2.90 \pm 1.02 \mu mol/L\) (GFR. 90 ml/min), \(2.64 \pm 1.06 \mu mol/L\) (GFR 60-90 ml/min), \(2.52 \pm 1.24 \mu mol/L\) (GFR 30-60 ml/min) and \(2.05 \pm 0.78 \mu mol/L\) (GFR, 30 ml/min), respectively (p = 0.002). The age-and sex-adjusted risk to reach the renal endpoint was significantly higher by 62% with each decrease by one standard deviation (\(1.1 \mu mol/L\)) of homoarginine (HR 1.62, 95% CI 1.16-2.27, p = 0.005). This association was independent of proteinuria (HR 1.56, 95% CI 1.11-2.20, p = 0.01), and was slightly attenuated when adjusting for GFR (HR 1.40 (95% CI 0.98-1.98, p = 0.06).
Conclusions: Homoarginine concentrations are directly correlated with kidney function and are significantly associated with the progression of CKD. Low homoarginine concentrations might be an early indicator of kidney failure and a potential target for the prevention of disease progression which needs further investigations.
PLoS ONE
10.1371/journal.pone.0063560
urn:nbn:de:bvb:20-opus-130979
PLoS ONE 8(5): e63560. doi:10.1371/journal.pone.0063560
Christiane Drechsler
Barbara Kolleritz
Andreas Meinitzer
Winfried März
Eberhard Ritz
Paul König
Ulrich Neyer
Stefan Pilz
Christoph Wanner
Florian Kronenberg
eng
uncontrolled
risk
eng
uncontrolled
alkaline phosphatase
eng
uncontrolled
cardiovascular events
eng
uncontrolled
nictric-oxide
eng
uncontrolled
induced insulin-release
eng
uncontrolled
creatine synthesis
eng
uncontrolled
renal function
eng
uncontrolled
heart failure
eng
uncontrolled
rat kidney
eng
uncontrolled
L-arginine
Krankheiten
open_access
Medizinische Klinik und Poliklinik I
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/13097/084_Drechsler_Plos_One.pdf