313 research outputs found
Postoperative Atrial Fibrillation Prediction by Left Atrial Size in Coronary Artery Bypass Grafting and Five-Year Survival Outcome
No full textGercek M, Börgermann J, Gummert J, Gercek M. Postoperative Atrial Fibrillation Prediction by Left Atrial Size in Coronary Artery Bypass Grafting and Five-Year Survival Outcome. Journal of Clinical Medicine. 2024;13(13): 3738.Background: Postoperative Atrial Fibrillation (POAF) is a common complication in cardiac surgery. Despite its multifactorial origin, the left atrial (LA) size is closely linked to POAF, raising the question of a valid cut-off value and its impact on the long-term outcome. Methods: Patients without a history of AF who underwent coronary artery bypass grafting between 2014 and 2016 were selected for this retrospective study. LA size was preoperatively assessed using the left atrial anterior-posterior diameter (LAAPd). Correlation and logistic regression analyses were performed, following a receiver-operating characteristic (ROC) analysis. Propensity score matching (PSM) was applied to ensure group comparability, followed by a comparison analysis regarding the primary endpoint of POAF and the secondary endpoints of all-cause mortality and stroke during a five-year follow-up. Results: A total of 933 patients were enrolled in the study eventually revealing a significant correlation between LAAPd and POAF (cor = 0.09, p 38.5 mm was found to be an independent predictor of POAF after coronary artery bypass grafting and resulted in a non-significant tendency towards a worse outcome regarding all-cause mortality in a five-year follow-up
Perioperative outcome of left atrial appendage amputation in coronary artery bypass grafting.
No full textGercek M, Skuljevic T, Borgermann J, Gummert J, Gercek M. Perioperative outcome of left atrial appendage amputation in coronary artery bypass grafting. Clinical research in cardiology : official journal of the German Cardiac Society. 2024.BACKGROUND: Left atrial appendage (LAA) amputation performed alongside cardiac surgery has become an increasingly established procedure to reduce stroke risk in patients with atrial fibrillation. As the recommendation levels for LAA amputation continue to rise, ample evidence assessing its perioperative safety and risk factors is of utmost interest.; METHODS: All patients who underwent isolated coronary artery bypass grafting (CABG) between 2018 and 2021 at two high-volume centers were retrospectively included in the study. Patients were divided into two groups-the CABG and CABG+LAA groups-based on whether they underwent concomitant LAA amputation. Propensity score matching (PS matching) was applied to ensure comparability between the groups. The primary endpoint was defined as a composite outcome comprising of all-cause mortality, stroke, and reoperation. Secondary endpoints included the components of the primary endpoint, perioperative outcome parameters, transfusion rates, and laboratory parameters.; RESULTS: A total of 3904 patients were included with 3038 and 866 in the CABG and CABG+LAA group, respectively. After PS matching each group consisted of 856 patients. The primary endpoint showed no significant differences between the CABG and CABG+LAA group (7.0% vs. 6.5% (OR 0.9 95% CI [0.64; 1.35], p=0.70)). Similarly, there were no notable differences in the individual components of the composite endpoint: all-cause mortality (p=0.84), stroke (p=0.74), and reoperation (p=0.50). Subgroup results did not show any relevant dissimilarity.; CONCLUSION: The concomitant performance of LAA amputation is not associated with worse in-hospital outcomes, as measured by the composite endpoint of all-cause mortality, stroke, and reoperation. © 2024. The Author(s)
Graduate recital, choral conducting. Bleecker, C. V., 1987
No full textRecorded during a live performance at Dalton Center Recital Hall, Western Michigan University, Kalamazoo, Michigan, April 14, 1987, 8:00 p.m., the 355th concert of the School of Music's 1986-1987 season.Mixed choral group, conducted by Catherine V. Bleecker ; Ronald J. Bayer, piano (1st-2nd works) ; Melissa Woodson, organ (8th work) with Scott Hall, Kevin Mossman, trumpets ; Steve Sudduth, Shaw Ross, trombones ; vocal soloists: Corlyn Longer, soprano (1st, 5th-6th works), ; Julie Gummert, alto (5th-6th works) ; Lyle Brown, tenor (1st, 5th-6th works) ; Adam Wurst, bass (5th-6th works).In partial fulfillment of the requirements of the Master of Music degree in choral conducting, Western Michigan University, 1987.Sacred and secular music for mixed chorus with various accompaniments or unaccompanied.Information from performance program.Dixit Dominus, K. 193 (1774) / Wolfgang Amadeus Mozart -- Sehnsucht, op. 112, no. 1 / Johannes Brahms -- Gaudete omnes / Jan Pieterszoon Sweelinck -- Wie lang, O Gott / Hieronymus Praetorius -- Trois chansons de Charles d'Orlean. III. Yver, vous n'estes qu'un villain ; I. Dieu! qu'il la fait bon regarder / Claude Debussy -- Signposts (1968). Signpost I: Psalm 60:2 ; Signpost II: Psalm 73 / Eskil Hemberg -- Nun danket alle Gott (1705) / Johann Pachelbel -- Deep river / Traditional ; arranged by Phil Mattson
The development of LV function upon LVAD-support in human heart failure is linked to the diastolic SR Ca2+leak
No full textEpicardial cavernous haemangioma. A case report of a unique incidental finding
No full textCheaban R, Piran M, Opacic D, Gummert J, Rojas SV. Epicardial cavernous haemangioma. A case report of a unique incidental finding. European heart journal. Case reports. 2024;8(4): ytae146.Background: Primary cardiac tumours are rare, accounting for only 0.002-0.03% at autopsy. Cardiac haemangiomas are benign vascular tumours and constitute for 0.28% of all primary cardiac tumours. Cavernous haemangiomas, capillary haemangiomas, and arteriovenous haemangiomas are three distinct types. Cardiac haemangiomas are often misdiagnosed as myxomas and must be differentiated from malignant angiosarcomas.; Case summary: We present a 44-year-old Mediterranean male patient with a cavernous haemangioma in the inferior vena cava and right atrium, detected on transthoracic echocardiography. The patient experienced palpitations and dyspnoea on exertion. Computed tomography (CT) angiography revealed a 7.5 * 6 * 5 cm mass suspected to be perfused by the distal right coronary artery. A watch-and-wait approach was suggested, leading to a cardiac magnetic resonance imaging (MRI) with contrast 6 months later. T1 mapping exhibited a prolonged relaxation time and isointensity to the myocardium. T2 mapping revealed a homogenous hyperintense mass with heterogenous late enhancement. Surgical excision was performed using a bicaval cannulation technique on cardiopulmonary bypass. Intraoperatively, no connection to the coronaries was noted. At 1 year follow-up, the patient reported restored physical resilience, with no evidence of tumour recurrence.; Discussion: Clinical symptoms of cardiac cavernous haemangiomas are unspecific and become evident once the tumour grows. To investigate the nature and vascular involvement of the tumour, a contrast-enhanced CT angiography or MRI can be performed. Cardiac haemangiomas are often misdiagnosed and must be differentiated from malignant angiosarcomas. Clear guidelines for the treatment of cardiac haemangiomas in adult patients are lacking. Primary cardiac tumours require thorough investigation, and surgical intervention should be tailored to the individual's case. © The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology
The development of LV function upon LVAD-support in human heart failure is linked to the diastolic SR Ca2+leak
No full textSynergistic effects of sirolimus with cyclosporine and tacrolimus: Analysis of immunosuppression on lymphocyte proliferation and activation in rat whole blood
No full textBackground. Whole-blood analysis of lymphocyte function was used to investigate the pharmacodynamic (PD) interaction of sirolimus (SRL) with cyclosporine (CsA) or tacrolimus (TRL) in vitro and to determine the relation between PD and pharmacokinetics (PK) of SRL in an in vivo rat model. Methods. In vitro, experiments involved incubation of increasing concentrations (10(6)-10(9) nM) of SRL with either CsA or TRL in rat whole blood. For the in vivo study, rats were orally treated with different doses of SRL alone (1, 3, 5, or 8 mg/kg) or with a combination of 3 mg/kg SRL plus 2.5 or 5 mg/kg CsA. Blood was obtained before and at different times after dosing. Inhibition of lymphocyte proliferation (proliferating cell nuclear antigen [PCNA]) and activation (CD25, CD71, CD11a, CD134) in mitogen-stimulated blood was determined using fluorescence-activated cell sorter analysis. SRL and CsA blood concentrations were determined at the same time points by light chromatography tandem mass spectrometry (LC-MS). Results. In vitro, concentrations of SRL between 10(6) and 10(8) nM acted synergistically in combination with CsA or TRL at concentrations between 10(6) and 10(8) nM. Higher SRL concentrations did not further increase inhibition of lymphocyte function in these combinations. In vivo, good correlations (r=0.68-0.94) were observed between PD parameters of lymphocyte function and SRL-PK and dose. Increasing SRL doses produced higher blood concentrations, but SRL doses of 8 mg/kg did not further increase inhibition of lymphocyte function. PD effects on lymphocyte function were prolonged, but maximal inhibition was not increased when SRL was applied in combination with CsA as compared to SRL mono therapy. Conclusions. The results suggest that analysis of lymphocyte function in whole blood may be useful to optimize dosing of SRL in combination with CsA or TRL and that PD monitoring of immunosuppressive drugs will enhance the value of PK monitoring
Desensitization and Internalization of Endothelin Receptor A IMPACT OF G PROTEIN-COUPLED RECEPTOR KINASE 2 (GRK2)-MEDIATED PHOSPHORYLATION
No full textGaertner F, Seidel T, Schulz U, Gummert J, Milting H. Desensitization and Internalization of Endothelin Receptor A IMPACT OF G PROTEIN-COUPLED RECEPTOR KINASE 2 (GRK2)-MEDIATED PHOSPHORYLATION. Journal of Biological Chemistry. 2013;288(45):32138-32148.Endothelin receptor A (ETA), a G protein-coupled receptor, mediates endothelin signaling, which is regulated by GRK2. Three Ser and seven Thr residues recently proven to be phosphoacceptor sites are located in the C-terminal extremity (CTE) of the receptor following its palmitoylation site. We created various phosphorylation-deficient ETA mutants. The phospholipase C activity of mutant receptors in HEK-293 cells was analyzed during continuous endothelin stimulation to investigate the impact of phosphorylation sites on ETA desensitization. Total deletion of phosphoacceptor sites in the CTE affected proper receptor regulation. However, proximal and distal phosphoacceptor sites both turned out to be sufficient to induce WT-like desensitization. Overexpression of the G(q) coupling-deficient mutant GRK2-D110A suppressed ETA-WT signaling but failed to decrease phospholipase C activity mediated by the phosphorylation-deficient mutant ETA-6PD. In contrast, GRK2-WT acted on both receptors, whereas the kinase-inactive mutant GRK2-D110A/K220R failed to inhibit signaling of ETA-WT and ETA-6PD. This demonstrates that ETA desensitization involves at least two autonomous GRK2-mediated components: 1) a phosphorylation-independent signal decrease mediated by blocking of G(q) and 2) a mechanism involving phosphorylation of Ser and Thr residues in the CTE of the receptor in a redundant fashion, able to incorporate either proximal or distal phosphoacceptor sites. High level transfection of GRK2 variants influenced signaling of ETA-WT and ETA-6PD and hints at an additional phosphorylation-independent regulatory mechanism. Furthermore, internalization of mRuby-tagged receptors was observed with ETA-WT and the phosphorylation-deficient mutant ETA-14PD (lacking 14 phosphoacceptor sites) and turned out to be based on a phosphorylation-independent mechanism
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