TY  - JOUR
A1  - Leistner, Stefanie
A1  - Benik, Steffen
A1  - Laumeier, Inga
A1  - Ziegler, Annerose
A1  - Nieweler, Gabriele
A1  - Nolte, Christian H.
A1  - Heuschmann, Peter U.
A1  - Audebert, Heinrich J.
T1  - Secondary Prevention after Minor Stroke and TIA - Usual Care and Development of a Support Program
JF  - PLoS One
N2  - 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.
KW  - atherothrombosis
KW  - multifactorial
KW  - clinical trial
KW  - hypertension
KW  - disease
KW  - transient ischemic attack
KW  - randomized controlled trial
KW  - cardiovascular risk factors
KW  - blood pressure
KW  - event rates
Y1  - 2012
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-135247
VL  - 7
IS  - 12
ER  - 
TY  - JOUR
A1  - Biermann, Daniel
A1  - Heilmann, Andreas
A1  - Didié, Michael
A1  - Schlossarek, Saskia
A1  - Wahab, Azadeh
A1  - Grimm, Michael
A1  - Römer, Maria
A1  - Reichenspurner, Hermann
A1  - Sultan, Karim R.
A1  - Steenpass, Anna
A1  - Ergün, Süleyman
A1  - Donzelli, Sonia
A1  - Carrier, Lucie
A1  - Ehmke, Heimo
A1  - Zimmermann, Wolfram H.
A1  - Hein, Lutz
A1  - Böger, Rainer H.
A1  - Benndorf, Ralf A.
T1  - Impact of AT2 Receptor Deficiency on Postnatal Cardiovascular Development
JF  - PLoS One
N2  - Background: The angiotensin II receptor subtype 2 (AT2 receptor) is ubiquitously and highly expressed in early postnatal life. However, its role in postnatal cardiac development remained unclear. 
Methodology/Principal Findings: Hearts from 1, 7, 14 and 56 days old wild-type (WT) and AT2 receptor-deficient (KO) mice were extracted for histomorphometrical analysis as well as analysis of cardiac signaling and gene expression. Furthermore, heart and body weights of examined animals were recorded and echocardiographic analysis of cardiac function as well as telemetric blood pressure measurements were performed. Moreover, gene expression, sarcomere shortening and calcium transients were examined in ventricular cardiomyocytes isolated from both genotypes. KO mice exhibited an accelerated body weight gain and a reduced heart to body weight ratio as compared to WT mice in the postnatal period. However, in adult KO mice the heart to body weight ratio was significantly increased most likely due to elevated systemic blood pressure. At postnatal day 7 ventricular capillarization index and the density of \(\alpha\)-smooth muscle cell actin-positive blood vessels were higher in KO mice as compared to WT mice but normalized during adolescence. Echocardiographic assessment of cardiac systolic function at postnatal day 7 revealed decreased contractility of KO hearts in response to beta-adrenergic stimulation. Moreover, cardiomyocytes from KO mice showed a decreased sarcomere shortening and an increased peak Ca\(^{2+}\) transient in response to isoprenaline when stimulated concomitantly with angiotensin II. 
Conclusion: The AT2 receptor affects postnatal cardiac growth possibly via reducing body weight gain and systemic blood pressure. Moreover, it moderately attenuates postnatal vascularization of the heart and modulates the beta adrenergic response of the neonatal heart. These AT2 receptor-mediated effects may be implicated in the physiological maturation process of the heart.
KW  - mice
KW  - II type-2 receptor
KW  - human endothelial cells
KW  - chronic kidney disease
KW  - angiotensin II
KW  - blood pressure
KW  - in vitro
KW  - cardiac hyperthrophy
KW  - tube formation
KW  - rat heart
Y1  - 2012
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-134902
VL  - 7
IS  - 10
ER  -