Biomedical subjects

Bodo-Eckehard Strauer

Publications and source records attributed to Bodo-Eckehard Strauer.

7 recordsLinked to original sources

PubMed2006

HFE mutations in idiopathic dilated cardiomyopathy.

BACKGROUND AND PURPOSE: Dilated cardiomyopathy is a typical complication of hereditary hemochromatosis (HH). The present study investigated, whether mutations of the hemochromatosis (HFE) gene might be etiologic and disease-modifying factors in idiopathic dilated cardiomyopathy PATIENTS AND METHODS: Clinical and biochemical assessment and HFE gene analysis were perfomed in 46 patients with IDCM and 350 healthy controls. Cardiomyopathy was angiographically defined according to the criteria of the Collaborative Research Group of the European Human and Capital Mobility Project of Familial Dilated Cardiomyopathy. RESULTS: A higher prevalence of C282Y homozygosity was found among patients with IDCM compared to healthy subjects (4.3% vs. 0.6%; p < 0.02). A total of 6.5% of the patients with IDCM were either C282Y homozygotes or C282Y/H63D compound heterozygotes. The C282Y allele frequency was somewhat higher among patients with IDCM (8.7%) compared to healthy controls (5.4%; p < 0.2), whereas the H63D allele frequency was not increased. No significant differences of serum iron, ferritin or transferrin saturation, cardiac iron loading, NYHA classification, Lown's classification, the history of cardiopulmonary resuscitation, LVEDD (left ventricular end-diastolic diameter), EF (ejection fraction), LADD (left atrial end-diastolic diameter) and CI (cardiac index) were seen between HFE carriers and noncarriers. CONCLUSION: The present study indicates that it is worth screening patients with IDCM for iron parameters given the increased prevalence of disease-predisposing HFE constellations. It remains unclear, to what extent iron or immune-mediated processes contribute to the pathomechanism of IDCM.

Adult↗

PubMed2006

[Transplantation of autologous adult bone marrow stem cells in patients with severe peripheral arterial occlusion disease].

BACKGROUND: For many patients with severe peripheral arterial occlusion disease (PAOD) an interventional or surgical treatment is not feasible. The regenerative potential of adult autologous mononuclear stem cells could contribute to neoangiogenesis. PATIENTS AND METHODS: Ten patients with severe PAOD were included. The walking distance was < 200 m and no interventional or surgical treatment was possible. After harvesting of 80 ml of bone marrow the mononuclear cell fraction was separated. Thereafter, intraarterial (10 ml into the common femoral artery) and intramuscular (5 ml into the muscles of the thigh and the lower leg) transplantation of the cell suspension was performed. RESULTS: After 2 months the walking distance was enhanced significantly in all patients. Furthermore, a significant improvement of ankle-brachial index at rest, capillary-venous oxygen saturation and parameters of venous occlusion plethysmography was seen. No complications or side effects could be monitored. CONCLUSION: These results demonstrate, that the combined intraarterial and intramuscular transplantation of autologous adult bone marrow stem cells leads to a significant improvement of perfusion indices in patients with severe PAOD.

Aged↗

PubMed2005

[Rapid healing of a therapy-refractory diabetic foot after transplantation of autologous bone marrow stem cells].

BACKGROUND: The diabetic foot mainly depends on painless pressure lesions, which are based on diabetic polyneuropathy and microangiopathy. In these cases the regenerative potential of adult autologous mononuclear stem cells could serve as causal therapy. HISTORY AND CLINICAL FINDINGS: A 63-year-old patient with long-lasting type 2 diabetes mellitus suffers from a reduced walking distance of 200 m and a therapy-refractory ulcer at the right ball of the great toe. Therefore, the authors have decided to perform a combined intraarterial and intramuscular transplantation of stem cells into the right limb for the first time on this disease. THERAPY AND RESULTS: After harvesting of bone marrow the mononuclear cell fraction was separated (157 x 10(6) cells). Thereafter, the fractional intraarterial and intramuscular transplantation of the cell suspension was performed (10 ml each). Already 8 weeks later, the ulcer healed completely, after 6 months the walking distance increased by > 100%, on venous occlusion plethysmography the arterial blood circulation at rest increased by 23% and the reactive hyperemia by 56%. CONCLUSION: The combined intraarterial and intramuscular transplantation of autologous bone marrow stem cells could constitute a novel, clinically feasible and safe therapy for patients with diabetic foot syndrome. The success of this approach may be ascribed to microangiogenesis and to an anti-inflammatory effect of the transplanted stem cells.

Bone Marrow Transplantation↗

PubMed2005

[Hypertensive microvascular disease].

Arterial hypertension is a major cardiovascular risk factor and leads to vascular as well as to myocardial manifestations. Particularly hypertensive microvascular disease is of great importance. Major clinical manifestations of hypertensive heart disease are symptoms of coronary insufficiency with typical angina pectoris, but also heart failure (systolic or diastolic dysfunction) and arrhythmia. Different non-invasive and invasive procedures are available for screening. For ultimate quantitative assessment of the coronary reserve, invasive procedures are still required. Beside lowering blood pressure primary therapeutic target is to reverse cardiac manifestations of arterial hypertension using specific therapeutic algorithms.

Clinical Trials as Topic↗

PubMed2003

Management of the hypertensive patient with coronary insufficiency but without atherosclerosis.

Arterial hypertension is a major risk factor for the clinical syndrome of angina pectoris, in which the ECG is abnormal but the coronary arteries are normal. Structural and functional abnormalities in coronary circulation as well as extravascular factors (eg, left-ventricular hypertrophy, fibrosis with diastolic dysfunction) compromise the adequate ratio of coronary blood flow to oxygen demand causing angina, dyspnea, and major cardiac events. Recent studies stress the importance to functional disturbances of coronary microvasculature leading to profound morphologic changes associated with impaired coronary conductance. In patients without epicardial coronary stenosis hypertensive microvascular disease can be qualitatively assessed by noninvasive diagnostic approaches based on new Doppler echocardiography techniques and may also be monitored by widely available stress tests. For ultimate quantitative assessment, invasive procedures are still required. Beyond guidelines to control blood pressure in hypertensive individuals, restoration of functional and structural integrity of the coronary microvasculature represents the ultimate therapeutic goal in hypertensive patients with coronary insufficiency and without angiographic evidence of atherosclerosis. Concomitant factors reducing coronary conductance such as left-ventricular hypertrophy and diastolic dysfunction should be reversed in parallel. Currently, therapeutic intervention in the renin-aldosterone-angiotensin-II-system using ACE inhibitors, angiotensin receptor blockers, and low doses of aldosterone antagonists represent the most promising strategy to achieve these goals. Using the knowledge of these recent results we should refine the overall management of our hypertensive patients with coronary insufficiency but without atherosclerosis.

Antihypertensive Agents↗

PubMed2002

[The current status of noninvasive cardiac diagnosis in women with suspected coronary heart disease].

BACKGROUND AND OBJECTIVE: Coronary artery disease is the leading cause of mortality among women in the industrial countries. Unfortunately, the routinely available noninvasive tests used to screen the presence of coronary artery disease have been relatively insensitive and nonspecific for women. The aim of this study was to evaluate the importance of pretest coronary artery disease probability and to determine whether the evaluation of left ventricular diastolic parameters is a relevant diagnostic tool in women with suspected coronary artery disease. PATIENTS AND METHODS: Electrocardiography at rest and during exercise, echocardiography at rest with evaluation of systolic and diastolic functional parameters, dobutamine stress echocardiography, exercise thallium myocardial scintigraphy, and coronary angiography were performed in 180 consecutive patients with suspected coronary artery disease. RESULTS: Coronary angiography revealed significant coronary artery disease in 104 patients. Angina pectoris, resting and exercise electrocardiography had a very low pretest probability in women. Dobutamine stress echocardiography, myocardial scintigraphy and the evaluation of left ventricular diastolic function showed less relevant gender-related differences and had a significantly better pretest probability. CONCLUSION: Dobutamine stress echocardiography and exercise thallium myocardial scintigraphy are reliable methods of diagnosing coronary artery disease in women. Echocardiographic assessment of diastolic left ventricular function represents another screening test for the evaluation of suspected coronary artery disease in women. All three methods, however, are not able to discriminate between coronary macro- or microangiopathy.

Aged↗

PubMed2002

Evidence for in vivo transport of bioactive nitric oxide in human plasma.

Although hitherto considered as a strictly locally acting vasodilator, results from recent clinical studies with inhaled nitric oxide (NO) indicate that NO can exert effects beyond the pulmonary circulation. We therefore sought to investigate potential remote vascular effects of intra-arterially applied aqueous NO solution and to identify the mechanisms involved. On bolus application of NO into the brachial artery of 32 healthy volunteers, both diameter of the downstream radial artery and forearm blood flow increased in a dose-dependent manner. Maximum dilator responses were comparable to those after stimulation of endogenous NO formation with acetylcholine and bradykinin. Response kinetics and pattern of NO decomposition suggested that despite the presence of hemoglobin-containing erythrocytes, a significant portion of NO was transported in its unbound form. Infusion of NO (36 micromol/min) into the brachial artery increased levels of plasma nitroso species, nitrite, and nitrate in the draining antecubital vein (by < 2-fold, 30-fold, and 4-fold, respectively), indicative of oxidative and nitrosative chemistry. Infused N-oxides were inactive as vasodilators whereas S-nitrosoglutathione dilated conduit and resistance arteries. Our results suggest that NO can be transported in bioactive form for significant distances along the vascular bed. Both free NO and plasma nitroso species contribute to the dilation of the downstream vasculature.

Arteries↗