更新于：2024-11-01

Heart and Diabetes Center North Rhine-Westphalia

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更新于：2024-11-01

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项与 Heart and Diabetes Center North Rhine-Westphalia 相关的临床试验

NCT06556485 / Not yet recruitingN/AIIT

Preventive Catheter Ablation for Ventricular arrhythmiaS in Patients With End-sTage Heart faiLure rEfferred for Heart Transplantation eValuaTion (CASTLE-VT)

CASTLE-VT is a randomized evaluation of prophylactic ablative treatment of arrhythmogenic ventricular scar in patients referred for HTx evaluation and diagnosed with ICM. Ablation will be performed with the use of a substrate-based approach in which the myocardial scar is mapped and ablated while the heart remains predominantly in sinus rhythm. The primary end point is the composite of all-cause mortality, worsening of HF requiring prioritized transplantation or LVAD implantation. The main secondary study end points are all-cause mortality, cardiovascular mortality, incidence of implantable cardioverter-defibrillator (ICD) therapy, hospitalizations, Quality of life, time to first ICD therapy, number of device-detected ventricular tachycardia/ventricular fibrillation episodes, LV function, and exercise tolerance. CASTLE-VT will randomize 160 patients with a follow up period of 2 years.

开始日期2024-08-15

申办/合作机构

Heart and Diabetes Center North Rhine-Westphalia

NCT05873920 / RecruitingN/AIIT

Impact of Individual Atrial Arrhythmia Substrate on the Outcome Following Radiofrequency-Guided Catheter Ablation for Atrial Fibrillation in Patients With Diabetes Mellitus

Single center prospective study to analyze the impact of diabetes mellitus on patients' outcome following radiofrequency-guided catheter ablation for atrial fibrillation.

开始日期2023-05-09

申办/合作机构

Heart and Diabetes Center North Rhine-Westphalia

NCT05569317 / CompletedN/AIIT

Patient*Innenbezogene Auswirkungen Prozessverantwortlicher Pflege

After a one-year phase of development, primary nursing (process-responsible nursing; PP) has been practically implemented on a pilot ICU since January 2022 at the Heart and Diabetes Center NRW. PP plan, coordinate and evaluate the nursing carried out. In the further course, an examination between the project ICU and another ICU without PP with a focus on thoracic and cardiovascular surgery (surgical ICU) is to be carried out.
The primary goal of this pilot study is to test the feasibility of a large-scale RCT with patient-related outcomes.

开始日期2023-01-01

申办/合作机构

Heart and Diabetes Center North Rhine-Westphalia

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100 项与 Heart and Diabetes Center North Rhine-Westphalia 相关的临床结果

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0 项与 Heart and Diabetes Center North Rhine-Westphalia 相关的专利（医药）

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290

项与 Heart and Diabetes Center North Rhine-Westphalia 相关的文献（医药）

2024-11-01·The Annals of Thoracic Surgery

Impact of Patient-Prosthesis Mismatch on Long-term Outcomes After Aortic Valve Replacement

Article

作者: Krane, Markus ; Bleiziffer, Sabine ; Puluca, Nazan ; Sideris, Konstantinos ; Graser, Michaela ; Zittermann, Armin ; Mayr, Benedikt ; Prinzing, Anatol

BACKGROUNDPatient-prosthesis mismatch (PPM) after aortic valve replacement potentially affects the outcome after the operation. This study sought to determine whether PPM has an impact on long-term mortality and reoperation rates.METHODSWe included 645 patients who underwent biologic aortic valve replacement between 2000 and 2007. Based on echocardiographic examinations at postoperative month 6, the incidence of PPM was determined according to an indexed effective orifice area <0.85 cm²/m². Survival and reoperation status were analyzed during 15 years of follow-up.RESULTSPPM was present in 256 patients (40%), of whom 175 had moderate PPM and 81 had severe PPM. In multivariable adjusted analysis, survival was not statistically significantly impaired in patients with moderate PPM compared with patients with no PPM, whereas patients with severe PPM showed a marginally significant impairment of survival (hazard ratio [HR], 1.40; 95% CI, 0.99-1.97; P = .054). Risk factors for survival were higher age (HR, 1.12; 95% CI, 1.10-1.14; P < .001), arterial hypertension (HR, 1.78; 95% CI, 1.38-2.31; P < .001), and diabetes mellitus (HR, 1.67; 95% CI, 1.31-2.14; P < .001). In patients with no, moderate, and severe PPM, there were 10.1, 8.5, and 14.8 events of reoperation/1000 patient-years, respectively. The corresponding 10-year cumulative incidence of reoperation was 8.3%, 6.7%, and 12.1%, respectively. In multivariable adjusted analysis, PPM category was not significantly associated with the risk of reoperation (P > .2).CONCLUSIONSIn our study with directly measured effective orifice area, PPM was only marginally related to long-term survival and was not statistically significantly associated with the risk of reintervention.

2024-07-01·JACC: Cardiovascular Interventions

Impact of Intraprocedural Mitral Regurgitation and Gradient Following Transcatheter Edge-to-Edge Repair for Primary Mitral Regurgitation

Article

作者: Makkar, Raj ; Iliadis, Christos ; Kalbacher, Daniel ; Hausleiter, Jörg ; Søndergaard, Lars ; von Stein, Philipp ; Koell, Benedikt ; Lubos, Edith ; Patel, Dhairya ; Adamo, Marianna ; Lavie Badie, Yoan ; Paradis, Jean-Michel ; Chehab, Omar ; Stolz, Lukas ; Schofer, Niklas ; Donal, Erwan ; Gerçek, Muhammed ; Coisne, Augustin ; Metra, Marco ; Dreyfus, Julien ; Trenkwalder, Teresa ; Ludwig, Sebastian ; Granada, Juan F ; Samim, Daryoush ; Primerano, Chiara ; Praz, Fabien ; Modine, Thomas ; Bohbot, Yohann ; Weimann, Jessica ; Rudolph, Felix ; Scotti, Andrea ; Nickenig, Georg ; Xhepa, Erion ; Karam, Nicole ; Redwood, Simon ; Quagliana, Angelo ; Latib, Azeem ; Giannini, Cristina ; Bernard, Anne ; Kessler, Mirjam ; Tanaka, Tetsu ; Melica, Bruno

BACKGROUNDThe impact of intraprocedural results following transcatheter edge-to-edge repair (TEER) in primary mitral regurgitation (MR) is controversial.OBJECTIVESThis study sought to investigate the prognostic impact of intraprocedural residual mitral regurgitation (rMR) and mean mitral valve gradient (MPG) in patients with primary MR undergoing TEER.METHODSThe PRIME-MR (Outcomes of Patients Treated With Mitral Transcatheter Edge-to-Edge Repair for Primary Mitral Regurgitation) registry included consecutive patients with primary MR undergoing TEER from 2008 to 2022 at 27 international sites. Clinical outcomes were assessed according to intraprocedural rMR and mean MPG. Patients were categorized according to rMR (optimal result: ≤1+, suboptimal result: ≥2+) and MPG (low gradient: ≤5 mm Hg, high gradient: > 5 mm Hg). The prognostic impact of rMR and MPG was evaluated in a Cox regression analysis. The primary endpoint was 2-year all-cause mortality or heart failure hospitalization.RESULTSIntraprocedural rMR and mean MPG were available in 1,509 patients (median age = 82 years [Q1-Q3: 76.0-86.0 years], 55.1% male). Kaplan-Meier analysis according to rMR severity showed significant differences for the primary endpoint between rMR ≤1+ (29.1%), 2+ (41.7%), and ≥3+ (58.0%; P < 0.001), whereas there was no difference between patients with a low (32.4%) and high gradient (42.1%; P = 0.12). An optimal result/low gradient was achieved in most patients (n = 1,039). The worst outcomes were observed in patients with a suboptimal result/high gradient. After adjustment, rMR ≥2+ was independently linked to the primary endpoint (HR: 1.87; 95% CI: 1.32-2.65; P < 0.001), whereas MPG >5 mm Hg was not (HR: 0.78; 95% CI: 0.47-1.31; P = 0.35).CONCLUSIONSIntraprocedural rMR but not MPG independently predicted clinical outcomes following TEER for primary MR. When performing TEER in primary MR, optimal MR reduction seems to outweigh the impact of high transvalvular gradients.

2024-06-01·Nuklearmedizin - NuclearMedicine

Diagnostic accuracy of artificial intelligence-enabled vectorcardiography versus myocardial perfusion SPECT in patients with suspected or known coronary heart disease

Article

作者: Knobl, Hermann ; Aydar, Simon ; Burchert, Wolfgang ; Lindner, Oliver

Abstract Aim The present study evaluated with myocardial perfusion SPECT (MPS) the diagnostic accuracy of an artificial intelligence-enabled vectorcardiography system (Cardisiography, CSG) for detection of perfusion abnormalities. Methods We studied 241 patients, 155 with suspected CAD and 86 with known CAD who were referred for MPS. The CSG was performed after the MPS acquisition. The CSG results (1) p-factor (perfusion, 0: normal, 1: mildly, 2: moderately, 3: highly abnormal) and (2) s-factor (structure, categories as p-factor) were compared with the MPS scores. The CSG system was not trained during the study. Results Considering the p-factor alone, a specificity of >78% and a negative predictive value of mostly >90% for all MPS variables were found. The sensitivities ranged from 17 to 56%, the positive predictive values from 4 to 38%. Combining the p- and the s-factor, significantly higher specificity values of about 90% were reached. The s-factor showed a significant correlation (p=0.006) with the MPS ejection fraction. Conclusions The CSG system is able to exclude relevant perfusion abnormalities in patients with suspected or known CAD with a specificity and a negative predictive value of about 90% combining the p- and the s-factor. Since it is a learning system there is potential for further improvement before routine use.

100 项与 Heart and Diabetes Center North Rhine-Westphalia 相关的药物交易

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100 项与 Heart and Diabetes Center North Rhine-Westphalia 相关的转化医学

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