Institution
Heart and Diabetes Center North Rhine-Westphalia
Healthcare•Bad Oeynhausen, Germany•
About: Heart and Diabetes Center North Rhine-Westphalia is a healthcare organization based out in Bad Oeynhausen, Germany. It is known for research contribution in the topics: Heart failure & Vitamin D and neurology. The organization has 288 authors who have published 357 publications receiving 9276 citations.
Topics: Heart failure, Vitamin D and neurology, Medicine, Coronary artery disease, Internal medicine
Papers published on a yearly basis
Papers
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TL;DR: Hypoxaemic burden was a robust and independent predictor of all-cause mortality in chronic stable HF-REF patients, and whether or not targeting nocturnal hypoxaemia is associated with beneficial effects on mortality in HF-ref patients remains to be determined.
Abstract: Aim This study investigated the prognostic value of sleep-disordered breathing (SDB) in a large cohort of patients with heart failure with reduced left ventricular function (HF-REF), with focus on the role of nocturnal hypoxaemia.
Methods This single-centre prospective cohort study enrolled patients with chronic stable HF-REF (NYHA ≥II) receiving guideline-based treatment. Unattended in-hospital polygraphy was performed to determine the apnoea–hypopnoea index (AHI). Pulse oximetry was used to determine hypoxaemic burden [time with oxygen saturation <90% (T90)], and all-cause mortality was recorded.
Results Complete data were available for 963 of 1249 patients. At baseline, 58% of patients had moderate-to-severe SDB. The median follow-up was 7.35 years; 480 of 963 (49.8%) patients died. Mortality rate (per 100 person-years) was 8.1 [95% confidence interval (CI) 7.0–9.4] in patients with no or mild SDB, but 12.2 (95% CI 10.9–13.7) in moderate-to-severe SDB. Apnoea–hypopnoea index was significantly associated with time to death from any cause in a simple Cox model [hazard ratio (HR) 1.011, P < 0.001], but was no longer significant after adjustment for confounding factors (HR 1.005, P = 0.085). T90 was significantly ( P < 0.001) associated with time to death from any cause even after adjustment for confounding factors. The risk of death increased by 16.1% (95% CI 8.6–24.2) per hour of T90. Five-year survival probabilities for patients in T90 quartiles 1, 2, 3, and 4 were 70, 63, 60, and 50%, respectively.
Conclusion Hypoxaemic burden was a robust and independent predictor of all-cause mortality in chronic stable HF-REF patients. Whether or not targeting nocturnal hypoxaemia is associated with beneficial effects on mortality in HF-REF patients remains to be determined.
215 citations
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University of Greifswald1, Hannover Medical School2, National Institutes of Health3, Technische Universität München4, Papworth Hospital5, Royal Free Hospital6, Seconda Università degli Studi di Napoli7, University of Zurich8, Heart and Diabetes Center North Rhine-Westphalia9, Ruhr University Bochum10, University Hospital Heidelberg11, Sapienza University of Rome12, Charité13, Dresden University of Technology14, University of Cologne15
TL;DR: Patients with atypical IPAH share features of both typical IPAH and PH-HFpEF, suggesting that there may be a continuum between these conditions.
210 citations
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TL;DR: Male sex, age, body mass index, and the severity of both symptoms and left ventricular dysfunction were clinical predictors for prevalent SDB in a representative population of stable patients with chronic HF receiving contemporary medical management.
Abstract: Objectives This prospective study investigated the prevalence of sleep-disordered breathing (SDB) and its predictors in patients with stable chronic heart failure (HF). Background SDB is increasingly recognized as being important in patients with HF. Methods The multicenter SchlaHF (Sleep-Disordered Breathing in Heart Failure) registry provides demographic and clinical data on chronic, stable, symptomatic patients with HF (New York Heart Association functional class ≥II; left ventricular rejection fraction ≤45%). Moderate-to-severe SDB (apnea-hypopnea index ≥15/h) was determined by a 2-channel screening device (ApneaLink, ResMed, Sydney, Australia). Results Data from 6,876 patients were analyzed. The prevalence of moderate-to-severe SDB was 46%, with a significant sex difference: 36% in women (n = 1,448) versus 49% in men (n = 5,428). Prevalence of SDB rose with increasing age (31%, 39%, 45%, 52%, and 59% in those age ≤50, >50 to 60, >60 to 70, >70 to 80, and >80 years, respectively). Risk factors for SDB were body mass index (per 5 units; odds ratio [OR]: 1.29; 95% confidence interval [CI]: 1.22 to 1.36), left ventricular rejection fraction (per 5% decrement from 45%; OR: 1.10; 95% CI: 1.06 to 1.14), age (per 10-year difference to 60 years; OR: 1.41; 95% CI: 1.34 to 1.49), atrial fibrillation (OR: 1.19; 95% CI: 1.06 to 1.34), and male sex (OR: 1.90; 95% CI: 1.67 to 2.17). Conclusions SchlaHF registry data demonstrate a high prevalence of SDB in a representative population of stable patients with chronic HF receiving contemporary medical management. Male sex, age, body mass index, and the severity of both symptoms and left ventricular dysfunction were clinical predictors for prevalent SDB. (Prevalence, Clinical Characteristics and Type of Sleep-disordered Breathing in Patients With Chronic, Symptomatic, Systolic Heart Failure; NCT01500759)
161 citations
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TL;DR: In this paper, the authors performed a meta-analysis to assess safety and long-term outcome of atrial fibrillation ablation in patients with left ventricular systolic dysfunction.
Abstract: Background— Catheter ablation of atrial fibrillation (AFCA) is an established therapeutic option for rhythm control in symptomatic patients. Its efficacy and safety among patients with left ventricular systolic dysfunction is based on small populations, and data concerning long-term outcome are limited. We performed this meta-analysis to assess safety and long-term outcome of AFCA in patients with left ventricular systolic dysfunction, to evaluate predictors of recurrence and impact on left ventricular function.
Methods and Results— A systematic review was conducted in MEDLINE/PubMed and Cochrane Library. Randomized controlled trials, clinical trials, and observational studies including patients with left ventricular systolic dysfunction undergoing AFCA were included. Twenty-six studies were selected, including 1838 patients. Mean follow-up was 23 (95% confidence interval, 18–40) months. Overall complication rate was 4.2% (3.6%–4.8%). Efficacy in maintaining sinus rhythm at follow-up end was 60% (54%–67%). Meta-regression analysis revealed that time since first atrial fibrillation ( P =0.030) and heart failure ( P =0.045) diagnosis related to higher, whereas absence of known structural heart disease ( P =0.003) to lower incidence of atrial fibrillation recurrences. Left ventricular ejection fraction improved significantly during follow-up by 13% ( P <0.001), with a significant reduction of patients presenting an ejection fraction <35% ( P <0.001). N-terminal pro-brain natriuretic peptide blood levels decreased by 620 pg/mL ( P <0.001).
Conclusions— AFCA efficacy in patients with impaired left ventricular systolic function improves when performed early in the natural history of atrial fibrillation and heart failure. AFCA provides long-term benefits on left ventricular function, significantly reducing the number of patients with severely impaired systolic function.
150 citations
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TL;DR: A systematic review and meta-analysis of propensity score analyses finds off-pump surgery superior to on-p pump surgery in all of the assessed short-term outcomes, especially for mortality, the most valid criterion.
149 citations
Authors
Showing all 303 results
Name | H-index | Papers | Citations |
---|---|---|---|
Jan Gummert | 55 | 290 | 10570 |
Armin Zittermann | 54 | 252 | 12697 |
Dieter Horstkotte | 45 | 457 | 10554 |
Andreas Koster | 41 | 190 | 5602 |
Reiner Körfer | 39 | 240 | 5546 |
Jan D. Schmitto | 38 | 296 | 5560 |
Reiner Koerfer | 38 | 190 | 5844 |
Philipp Beerbaum | 38 | 147 | 4769 |
Jochen Börgermann | 35 | 147 | 3814 |
Jens Dreier | 35 | 114 | 3472 |
Tanja K. Rudolph | 35 | 118 | 3780 |
Joachim Kuhn | 35 | 142 | 4226 |
Christian Götting | 35 | 109 | 4349 |
Aly El-Banayosy | 34 | 142 | 4652 |
Olaf Oldenburg | 34 | 184 | 4736 |