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Mathias Rauchhaus

Publications and source records attributed to Mathias Rauchhaus.

21 records · Page 2Linked to original sources

The E-selectin SER128ARG gene polymorphism and restenosis after successful coronary angioplasty.

OBJECTIVES: Coronary angioplasty remains plagued by the problem of restenosis. Genetic polymorphisms may contribute to the development of restenosis by mediating exaggerated inflammatory responses of the endothelium to angioplasty-induced injury. BACKGROUND: The serine (Ser)-128-arginine (Arg) gene polymorphism of E-selectin has been implicated in the pathogenesis of coronary artery disease (CAD). We sought to explore whether allelic variants relate to post-angioplasty restenosis. METHODS: The 128Arg allele was analyzed by PCR in 101 (derivation study, age 54+/-1 years, all mean+/-S.E.M.) and 92 (validation study, age 62+/-1 years) patients with CAD who underwent successful angioplasty. RESULTS: Restenosis, defined as >50% luminal diameter reduction at the target lesion at follow-up angiography, was found in 54/101 (53%) and 43/92 (47%) patients during follow-up. The 128Arg allele frequency in the derivation study was 10.39% and was 11.96% in the validation study. The 128Arg allele was more prevalent in the restenosis groups (14.81% and 17.44%, respectively) than in the restenosis-free groups (5.32% and 7.14%, respectively, p=0.027 and p=0.031). In multivariate logistic regression, the 128Arg allele emerged as a predictor of restenosis in both studies (p<0.05). There were no differences in the level of soluble E-selectin according to genotype, gender, age (p>0.20), and between patients with restenosis and those without (43.8+/-3.2 vs. 47.4+/-3.1 ng/ml, p>0.20). CONCLUSIONS: The 128Arg allele of E-selectin may be related to increased endothelial responses to injury, thereby potentially serving as a risk factor for post-angioplasty restenosis in patients with CAD.The development of restenosis remains a problem in patients with CAD. The Ser128Arg polymorphism of E-selectin was analyzed in 101 (derivation) and 92 (validation) CAD patients. Patients with restenosis (54/101 and 43/92) had a higher frequency of the 128Arg allele (14.81 and 17.44%) than those without (5.32%, p=0.027 and 7.14%, p=0.031). In logistic regression, the 128Arg allele emerged as a predictor of restenosis in both studies (p<0.05). The E-selectin 128Arg allele may serve as a risk factor for the development of restenosis.

Angioplasty, Balloon, Coronary↗

The cardiac component of cardiac cachexia.

BACKGROUND: Recent evidence suggests the importance of noncardiac mechanisms in the genesis of the syndrome of cardiac cachexia. This raises the question of the relative role of the heart itself in this syndrome. This study sought to assess the cardiac dimensions, mass, and function and changes in these parameters over time in patients with chronic heart failure with and without cachexia. METHODS: Doppler echocardiography was performed in 28 patients with nonedematous weight loss (>7.5% over a period of >6 months) compared with 56 matched patients without weight loss in a ratio of 1:2 (age 71 +/- 13 vs 67 +/- 8 years, P =.07; New York Heart Association class 2.9 +/- 0.7 vs 2.6 +/- 0.6, P =.08). In 18 cachectic and 35 noncachectic patients with previous echocardiographic recordings, we analyzed the changes in left ventricular (LV) dimensions and mass over time. RESULTS: Cardiac dimensions including LV diastolic (69 +/- 9 mm vs 67 +/- 13 mm) and systolic cavity diameter (58 +/- 11 mm vs 55 +/- 15 mm), LV mass (480 +/- 180 g vs 495 +/- 190 g), and LV systolic and diastolic function including fractional shortening (16% +/- 10% vs 18% +/- 10%), isovolumic relaxation time (29 +/- 22 ms vs 36 +/- 27 ms), and E/A ratio (2.7 +/- 1.6 vs 3.3 +/- 2.9) did not differ between cachectic and noncachectic patients (all P >.1). By analyzing changes in LV mass over time, we found an increase (>20%) in 2 (11%) cachectic and 14 (40%) noncachectic patients and a decrease in LV mass (>20%) in 9 (50%) cachectic and 8 (23%) noncachectic patients (chi2 test, P <.05). CONCLUSIONS: Although no specific cardiac abnormality could be detected echocardiographically in cachectic patients compared with patients with noncachectic chronic heart failure in a cross-sectional study, over time a significant loss of LV mass (>20%) occurs more frequently in patients with cardiac cachexia.

Cachexia↗

Cytokines in chronic heart failure: possible interaction in the neurohormonal and the cytokine system at the cAMP level?

In recent years, the pathophysiological concept of chronic heart failure (CHF) has changed from an isolated hemodynamic view to a more complex concept involving neuroendocrine and inflammatory pathways. New therapeutic strategies, such as beta-blocker therapy, are based on these new concepts and provide clinical evidence for a clinical benefit in patients with CHF. The survival benefit of beta-blocker therapy in CHF has been related to neurohumoral regulation. Thus, evidence evolved showing that following beta-blocker therapy cytokine levels in CHF patients are altered. We have shown that the levels of soluble TNF receptor type 2 correlated well with cAMP in leukocytes. Data from clinical studies in adult and infant CHF patients have demonstrated that beta-blocker therapy is accompanied by altered cytokine, cytokine antagonist, and/or soluble cytokine receptor levels. These alterations may result from a dysregulated interaction of beta-adrenergic pathways and the cytokine system, and are possibly related to cAMP-dependent regulation of the release or shedding of these mediators.

Adrenergic beta-Antagonists↗