Biomedical subjects

Tobias Zeus

Publications and source records attributed to Tobias Zeus.

7 recordsLinked to original sources

PubMed2006

[Therapy of acute decompensated heart failure with levosimendan].

PURPOSE: To determine the short-term hemodynamic and clinical effects of levosimendan, a calcium-sensitizing agent, in patients with decompensated heart failure. PATIENTS AND METHODS: Seven patients with cardiogenic shock requiring catecholamines (two patients with acute myocardial infarction, two patients with decompensated hypertensive heart disease, one patient with low cardiac output with ischemic cardiomyopathy, two patients with dilated cardiomyopathy [ethyl-toxic, polymyositis] with a cardiac index < or = 2.5 ) 1 x min(-1) x m(-2) and a pulmonary wedge pressure > or = 15 mmHg received levosimendan with an initial loading dose of 12 microg/kg over 10 min followed by a continuous infusion of 0.1 microg/kg/min for 24 h. RESULTS: During levosimendan infusion an increase in cardiac index (30% after 6 h and 24 h), a decrease in heart rate (4% after 6 h and 10% after 24 h, respectively), and a decrease in systemic vascular resistance (27% after 6 h and 41% after 24 h, respectively) appeared. In combination with volume resuscitation the pulmonary capillary wedge pressure increased. Under therapy with levosimendan no relevant adverse events occurred; there was no increase in severe cardiac arrhythmias and QT interval duration. CONCLUSION: Levosimendan causes rapid improvement in hemodynamic function in patients with cardiogenic shock. These hemodynamic effects are not associated with relevant adverse events. Levosimendan may be of value in the short-term management of patients with cardiogenic shock.

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↗

PubMed2006

[Effects of exercise training on mobilization of BM-CPCs and migratory capacity as well as LVEF after AMI].

BACKGROUND AND PURPOSE: Bone marrow-derived circulating progenitor cells (BM-CPCs) are mobilized in adult peripheral blood (PB) during the acute myocardial infarction (AMI) period and contribute to the regeneration of infarcted myocardium. In this study, the influence of physical training on the mobilization and the migratory activity of the BM-CPCs as well as on the left ventricular function (LVEF) after AMI was examined. PATIENTS AND METHODS: 26 patients with AMI were analyzed in two groups. The first group comprised 17 patients with standardized exercise training for 3 weeks 14 +/- 4 days after AMI, the second group nine control subjects without exercise training. PB concentrations of CD34/45+ and CD133/45+ were measured by FACS. The migratory activity of BM-CPCs was analyzed by migration assay. B-type natriuretic peptide (BNP) in PB and the functional investigations spiroergometry (VO2 and PaO2) and stress echocardiography (LVEF) were determined in both groups. RESULTS: A significant increase in both concentrations, CD34/45+ and CD133/45+, as well as in migratory capacity of BM-CPCs was found after 3 weeks of exercise training, which was significantly decreased 3 months after completion of exercise training. No significant difference was observed in the control group without exercise training. In the functional investigations a significant increase in VO2 as well as PaO2 was shown spiroergometrically after exercise training. There was no difference in stress echocardiographic LVEF at rest in both groups. On the other hand, interestingly, the findings showed that the increase of LVEF at peak stress was significantly higher after exercise training as compared to the control group. Moreover, a significant decrease in BNP values was found after exercise training as well as 3 months after AMI. No difference was found in the control group. CONCLUSION: This study demonstrates that exercise training for 3 weeks after AMI leads to a significant mobilization as well as increase of functional activation of BM-CPCs in humans. Moreover, regular exercise training might contribute to the positive effects on the regenerative potency after AMI.

Aged↗

PubMed2005

Regeneration of human infarcted heart muscle by intracoronary autologous bone marrow cell transplantation in chronic coronary artery disease: the IACT Study.

OBJECTIVES: Stem cell therapy may be useful in chronic myocardial infarction (MI); this is conceivable, but not yet demonstrated in humans. BACKGROUND: After acute MI, bone marrow-derived cells improve cardiac function. METHODS: We treated 18 consecutive patients with chronic MI (5 months to 8.5 years old) by the intracoronary transplantation of autologous bone marrow mononuclear cells and compared them with a representative control group without cell therapy. RESULTS: After three months, in the transplantation group, infarct size was reduced by 30% and global left ventricular ejection fraction (+15%) and infarction wall movement velocity (+57%) increased significantly, whereas in the control group no significant changes were observed in infarct size, left ventricular ejection fraction, or wall movement velocity of infarcted area. Percutaneous transluminal coronary angioplasty alone had no effect on left ventricular function. After bone marrow cell transplantation, there was an improvement of maximum oxygen uptake (VO2max, +11%) and of regional 18F-fluor-desoxy-glucose uptake into infarct tissue (+15%). CONCLUSIONS: These results demonstrate that functional and metabolic regeneration of infarcted and chronically avital tissue can be realized in humans by bone marrow mononuclear cell transplantation.

Adult↗

PubMed2003

[Stem cell therapy in acute myocardial infarction].

Remodeling of the left ventricle after myocardial infarction represents a major cause of infarct-related heart failure and death. Experimental data suggest that bone marrow-derived cells may contribute to the healing of myocardial infarction. The selective intracoronary transplantation of autologous, mononuclear bone marrow cells is safe and seems to be effective under clinical conditions concerning heart function, myocardial perfusion, and metabolism. The therapeutic effect may be attributed to bone marrow cell-associated myocardial regeneration and neovascularization.

Angioplasty, Balloon, Coronary↗

PubMed2002

Repair of infarcted myocardium by autologous intracoronary mononuclear bone marrow cell transplantation in humans.

BACKGROUND: Experimental data suggest that bone marrow-derived cells may contribute to the healing of myocardial infarction (MI). For this reason, we analyzed 10 patients who were treated by intracoronary transplantation of autologous, mononuclear bone marrow cells (BMCs) in addition to standard therapy after MI. METHODS AND RESULTS: After standard therapy for acute MI, 10 patients were transplanted with autologous mononuclear BMCs via a balloon catheter placed into the infarct-related artery during balloon dilatation (percutaneous transluminal coronary angioplasty). Another 10 patients with acute MI were treated by standard therapy alone. After 3 months of follow-up, the infarct region (determined by left ventriculography) had decreased significantly within the cell therapy group (from 30+/-13 to 12+/-7%, P=0.005) and was also significantly smaller compared with the standard therapy group (P=0.04). Likewise, infarction wall movement velocity increased significantly only in the cell therapy group (from 2.0+/-1.1 to 4.0+/-2.6 cm/s, P=0.028). Further cardiac examinations (dobutamine stress echocardiography, radionuclide ventriculography, and catheterization of the right heart) were performed for the cell therapy group and showed significant improvement in stroke volume index, left ventricular end-systolic volume and contractility (ratio of systolic pressure and end-systolic volume), and myocardial perfusion of the infarct region. CONCLUSIONS: These results demonstrate for the first time that selective intracoronary transplantation of autologous, mononuclear BMCs is safe and seems to be effective under clinical conditions. The marked therapeutic effect may be attributed to BMC-associated myocardial regeneration and neovascularization.

Angioplasty, Balloon, Coronary↗

PubMed2002

Stem cells--clinical application and perspectives.

BACKGROUND: Augmentation of myocardial performance in experimental models of therapeutic infarction and heart failure has been achieved by transplantation of exogenous cells into damaged myocardium. The quest for suitable donor cells has prompted research into the use of both embryonic stem cells and adult somatic stem cells. MULTIPOTENT SOMATIC STEM CELLS: Recently, there has been a growing body of evidence that multipotent somatic stem cells in adult bone marrow exhibit tremendous functional plasticity and can reprogram in a new environmental tissue niche to give rise to cell lineages specific for new organ site. This phenomenon has made huge impact on myocardial biology, while multipotent adult bone marrow hematopoeitic stem cells and mesechymal stem cells can repopulate infarcted rodent myocardium and differentiate into both cardiomyocytes and new blood vessels. CONCLUSION: These data, coupled with the identification of a putative primitive cardiac stem cell population in the adult human heart, may open the way for novel therapeutic modalities for enhancing myocardial performance and treating heart failure.

Adult↗