Steinmetz, Michael

[["dc.bibliographiccitation.firstpage","33"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Clinical Research in Cardiology"],["dc.bibliographiccitation.lastpage","42"],["dc.bibliographiccitation.volume","102"],["dc.contributor.author","Schneider, Heike E."],["dc.contributor.author","Steinmetz, Michael"],["dc.contributor.author","Krause, Ulrich J."],["dc.contributor.author","Kriebel, Thomas"],["dc.contributor.author","Ruschewski, Wolfgang"],["dc.contributor.author","Paul, Thomas"],["dc.date.accessioned","2018-11-07T09:30:45Z"],["dc.date.available","2018-11-07T09:30:45Z"],["dc.date.issued","2013"],["dc.description.abstract","Left cardiac sympathetic denervation (LCSD) may be a therapeutic adjunct for young patients with catecholaminergic polymorphic ventricular tachycardia (CPVT) and long QT syndrome (LQTS) who are not fully protected by beta-blockade. The objective of this analysis was to report our institutional experience with LSCD in young patients for the management of life-threatening ventricular arrhythmias in CPVT and LQTS. Ten young patients with CPVT and LQTS underwent transaxillary LSCD at our institution. Mean age at surgery was 14.0 (range 3.9-42) years, mean body weight was 45.7 (range 15.5-90) kg. Five patients had the clinical diagnosis of CPVT, three were genotype positive for a mutation in the ryanodine-receptor-2-gene. Four of five LQTS patients were genotype positive. Indications for LCSD were recurrent syncope, symptomatic episodes of ventricular tachycardias and/or internal cardioverter-defibrillator (ICD) discharges, and aborted cardiac arrest despite high doses of beta-blockers. LCSD was performed via the transaxillary approach. No significant complications were observed. Two patients already had an ICD, 6 patients received an ICD at the same operation or shortly thereafter. Median length of follow-up after LCSD was 2.3 (range 0.6-3.9) years. After LCSD a marked reduction in arrhythmia burden and cardiac events was observed in all patients while medication was continued. None of the patients had any further ICD discharge for sustained VT. After LCSD, arrhythmia burden could significantly be reduced in all our young patients with CPVT and LQTS."],["dc.identifier.doi","10.1007/s00392-012-0492-7"],["dc.identifier.isi","000313070900004"],["dc.identifier.pmid","22821214"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/8805"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/31382"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.publisher.place","Heidelberg"],["dc.relation.issn","1861-0684"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","Left cardiac sympathetic denervation for the management of life-threatening ventricular tachyarrhythmias in young patients with catecholaminergic polymorphic ventricular tachycardia and long QT syndrome"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","670"],["dc.bibliographiccitation.issue","6"],["dc.bibliographiccitation.journal","European Heart Journal - Cardiovascular Imaging"],["dc.bibliographiccitation.lastpage","675"],["dc.bibliographiccitation.volume","16"],["dc.contributor.author","Hoesch, Olga"],["dc.contributor.author","Thuy-Trang Ngyuen, Thuy-Trang Ngyuen"],["dc.contributor.author","Lauerer, Peter"],["dc.contributor.author","Schuster, Andreas"],["dc.contributor.author","Kutty, Shelby"],["dc.contributor.author","Staab, Wieland"],["dc.contributor.author","Unterberg-Buchwald, Christina"],["dc.contributor.author","Sohns, Jan Martin"],["dc.contributor.author","Paul, Thomas"],["dc.contributor.author","Lotz, Joachim"],["dc.contributor.author","Steinmetz, Michael"],["dc.date.accessioned","2018-11-07T09:56:17Z"],["dc.date.available","2018-11-07T09:56:17Z"],["dc.date.issued","2015"],["dc.description.abstract","Aims Ebstein's anomaly (EA) involves a displaced and dysplastic tricuspid valve resulting in an atrialized portion of the right ventricle and an enlargement of the functional right ventricle and right atrium. Biomarkers targeting heart failure such as brain natriuretic peptide (BNP) or haematological parameters [haemoglobin (Hb) and haematocrit (Hct)] are upregulated in states of pulmonary hypoperfusion. We hypothesized that decreased pulmonary perfusion dependent on the stage of right heart failure is a possible mechanism in EA, and that it can be correlated with cardiac magnetic resonance (CMR) parameters. The aim of this study was to investigate the relationship between BNP and haematological parameters with functional parameters from CMR and exercise testing in patients with EA. Methods and results Twenty-five patients with non-corrected EA were studied prospectively (mean age 26 +/- 14 years). BNP level was increased (74 +/- 127 ng/L), and in 16% markedly above the heart failure cut-off level of 100 ng/L. Hb and Hct were increased above normal levels in 20 and 24% of patients, respectively. BNP and Hct/Hb correlated with CMR [total right/left (R/L)-Volume-Index, right atrium-end-diastolic volume index (EDVi), functional right ventricle (fRV)-EDVi, fRV-ejection fraction (EF), tricuspid regurgitation, pulmonary artery flow, and left ventricular EF] and exercise testing [workload/kg, oxygen uptake (VO2), ventilatory response to carbon dioxide production (VE/VCO2), oxygen (O-2) pulse, and heart rate reserve]. The higher BNP and haematological parameters, the higher was the disease severity and the more limited was the physical exercise capacity. Conclusion In this EA cohort, BNP levels and haematological parameters correlated well with functional data from CMR and exercise testing. The total R/L-Volume-Index and BNP, and to some extent hematological parameters, may be useful as prognostic markers in patients with EA."],["dc.description.sponsorship","Faculty of Medicine, Georg-August-University Gottingen, Germany"],["dc.identifier.doi","10.1093/ehjci/jeu312"],["dc.identifier.isi","000358014000013"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/36927"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Oxford Univ Press"],["dc.relation.issn","2047-2412"],["dc.relation.issn","2047-2404"],["dc.title","BNP and haematological parameters are markers of severity of Ebstein's anomaly: correlation with CMR and cardiopulmonary exercise testing"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.issue","22"],["dc.bibliographiccitation.journal","Circulation"],["dc.bibliographiccitation.volume","128"],["dc.contributor.author","Sohns, Jan Martin"],["dc.contributor.author","Schulte, Christina"],["dc.contributor.author","Zapf, Antonia"],["dc.contributor.author","Unterberg-Buchwald, Christina"],["dc.contributor.author","Staab, Wieland"],["dc.contributor.author","Kowallick, Johannes"],["dc.contributor.author","Preuss, Christoph"],["dc.contributor.author","Fasshauer, Martin"],["dc.contributor.author","Thuy-Trang Nguyen, Thuy-Trang Nguyen"],["dc.contributor.author","Paul, Thomas"],["dc.contributor.author","Lotz, Joachim"],["dc.contributor.author","Steinmetz, Michael"],["dc.date.accessioned","2018-11-07T09:17:27Z"],["dc.date.available","2018-11-07T09:17:27Z"],["dc.date.issued","2013"],["dc.identifier.isi","000332162907028"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/28173"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Lippincott Williams & Wilkins"],["dc.publisher.place","Philadelphia"],["dc.relation.conference","Scientific Sessions and Resuscitation Science Symposium of the American-Heart-Association"],["dc.relation.eventlocation","Dallas, TX"],["dc.relation.issn","1524-4539"],["dc.relation.issn","0009-7322"],["dc.title","Right Atrial Volume in Tetralogy of Fallot Correlates With the Incidence of Supra-Ventricular Arrhythmia: A MRI Study"],["dc.type","conference_abstract"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","601"],["dc.bibliographiccitation.issue","4"],["dc.bibliographiccitation.journal","Circulation Cardiovascular Imaging"],["dc.bibliographiccitation.lastpage","609"],["dc.bibliographiccitation.volume","7"],["dc.contributor.author","Hoesch, Olga"],["dc.contributor.author","Sohns, Jan Martin"],["dc.contributor.author","Thuy-Trang Nguyen, Thuy-Trang Nguyen"],["dc.contributor.author","Lauerer, Peter"],["dc.contributor.author","Rosenberg, Christina"],["dc.contributor.author","Kowallick, Johannes Tammo"],["dc.contributor.author","Kutty, Shelby"],["dc.contributor.author","Unterberg, Christina"],["dc.contributor.author","Schuster, Andreas"],["dc.contributor.author","Fasshauer, Martin"],["dc.contributor.author","Staab, Wieland"],["dc.contributor.author","Paul, Thomas"],["dc.contributor.author","Lotz, Joachim"],["dc.contributor.author","Steinmetz, Michael"],["dc.date.accessioned","2018-11-07T09:38:08Z"],["dc.date.available","2018-11-07T09:38:08Z"],["dc.date.issued","2014"],["dc.description.abstract","Background-The classification of clinical severity of Ebstein anomaly still remains a challenge. The aim of this study was to focus on the interaction of the pathologically altered right heart with the anatomically-supposedly-normal left heart and to derive from cardiac magnetic resonance (CMR) a simple imaging measure for the clinical severity of Ebstein anomaly. Methods and Results-Twenty-five patients at a mean age of 26 +/- 14 years with unrepaired Ebstein anomaly were examined in a prospective study. Disease severity was classified using CMR volumes and functional measurements in comparison with heart failure markers from clinical data, ECG, laboratory and cardiopulmonary exercise testing, and echocardiography. All examinations were completed within 24 hours. A total right/left-volume index was defined from end-diastolic volume measurements in CMR: total right/left-volume index=(RA+aRV+fRV)/(LA+LV). Mean total right/left-volume index was 2.6 +/- 1.7 (normal values: 1.1 +/- 0.1). This new total right/left-volume index correlated with almost all clinically used biomarkers of heart failure: brain natriuretic peptide (r=0.691; P=0.0003), QRS (r=0.432; P=0.039), peak oxygen consumption/kg (r=-0.479; P=0.024), ventilatory response to carbon dioxide production at anaerobic threshold (r=0.426; P=0.048), the severity of tricuspid regurgitation (r=0.692; P=0.009), tricuspid valve offset (r=0.583; P=0.004), and tricuspid annular plane systolic excursion (r=0.554; P=0.006). Previously described severity indices ([RA+aRV]/[fRV+LA+LV]) and fRV/LV end-diastolic volume corresponded only to some parameters. Conclusions-In patients with Ebstein anomaly, the easily acquired index of right-sided to left-sided heart volumes from CMR correlated well with established heart failure markers. Our data suggest that the total right/left-volume index should be used as a new and simplified CMR measure, allowing more accurate assessment of disease severity than previously described scoring systems."],["dc.identifier.doi","10.1161/CIRCIMAGING.113.001467"],["dc.identifier.isi","000339172100006"],["dc.identifier.pmid","24807407"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/33001"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Lippincott Williams & Wilkins"],["dc.relation.issn","1942-0080"],["dc.relation.issn","1941-9651"],["dc.title","The Total Right/Left-Volume Index: A New and Simplified Cardiac Magnetic Resonance Measure to Evaluate the Severity of Ebstein Anomaly of the Tricuspid Valve A Comparison With Heart Failure Markers From Various Modalities"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","459"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","Pediatric Cardiology"],["dc.bibliographiccitation.lastpage","464"],["dc.bibliographiccitation.volume","37"],["dc.contributor.author","Dieks, Jana-Katharina"],["dc.contributor.author","Mueller, Matthias J."],["dc.contributor.author","Schneider, Heike E."],["dc.contributor.author","Krause, Ulrich J."],["dc.contributor.author","Steinmetz, Michael"],["dc.contributor.author","Paul, Thomas"],["dc.contributor.author","Kriebel, Thomas"],["dc.date.accessioned","2018-11-07T10:17:25Z"],["dc.date.available","2018-11-07T10:17:25Z"],["dc.date.issued","2016"],["dc.description.abstract","Experience of catheter ablation of pediatric focal atrial tachycardia (FAT) is still limited. There are data which were gathered prior to the introduction of modern 3D mapping and navigation systems into the clinical routine. Accordingly, procedures were associated with significant fluoroscopy and low success rates. The aim of this study was to present clinical and electrophysiological details of catheter ablation of pediatric FAT using modern mapping systems. Since March 2003, 17 consecutive patients < 20 years underwent electrophysiological study (EPS) for FAT using the NavX(A (R)) system (n = 7), the non-contact mapping system (n = 6) or the LocaLisa(A (R)) system (n = 4), respectively. Radiofrequency was the primary energy source; cryoablation was performed in selected patients with a focus close to the AV node. In 16 patients, a total number of 19 atrial foci (right-sided n = 13, left-sided n = 6) could be targeted. In the remaining patient, FAT was not present/inducible during EPS. On an intention-to-treat basis, acute success was achieved in 14/16 patients (87.5 %) with a median number of 11 (1-31) energy applications. Ablation was unsuccessful in two patients due to an epicardial location of a right atrial focus (n = 1) and a focus close to the His bundle (n = 1), respectively. Median procedure time was 210 (84-332) min, and median fluoroscopy time was 13.1 (4.5-22.5) min. In pediatric patients with FAT, 3D mapping and catheter ablation provided improved clinical quality of care. Catheter ablation may be considered early in the course of treatment of this tachyarrhythmia in symptomatic patients."],["dc.identifier.doi","10.1007/s00246-015-1299-x"],["dc.identifier.isi","000373308800004"],["dc.identifier.pmid","26538211"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/41220"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.relation.issn","1432-1971"],["dc.relation.issn","0172-0643"],["dc.title","Catheter Ablation of Pediatric Focal Atrial Tachycardia: Ten-Year Experience Using Modern Mapping Systems"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","1239"],["dc.bibliographiccitation.issue","6"],["dc.bibliographiccitation.journal","Pediatric Cardiology"],["dc.bibliographiccitation.lastpage","1247"],["dc.bibliographiccitation.volume","36"],["dc.contributor.author","Sohns, Jan Martin"],["dc.contributor.author","Rosenberg, Christina"],["dc.contributor.author","Zapf, Antonia"],["dc.contributor.author","Unterberg-Buchwald, Christina"],["dc.contributor.author","Staab, Wieland"],["dc.contributor.author","Schuster, Andreas"],["dc.contributor.author","Kowallick, Johannes Tammo"],["dc.contributor.author","Hoesch, Olga"],["dc.contributor.author","Thuy-Trang Nguyen, Thuy-Trang Nguyen"],["dc.contributor.author","Fasshauer, Martin"],["dc.contributor.author","Paul, Thomas"],["dc.contributor.author","Lotz, Joachim"],["dc.contributor.author","Steinmetz, Michael"],["dc.date.accessioned","2018-11-07T09:54:12Z"],["dc.date.available","2018-11-07T09:54:12Z"],["dc.date.issued","2015"],["dc.description.abstract","The aim of this study was to evaluate right atrial (RA) volume in corrected Tetralogy of Fallot (cTOF) and assess its correlation with the occurrence of supraventricular (SV) arrhythmia. Cardiac magnetic resonance imaging (CMR) and 24-h Holter were performed in n = 67 consecutive cTOF patients (age 30 +/- A 11.3 years). The CMR protocol included standard HASTE, SSFP cine, and blood flow measurements. Correlations between arrhythmia in ECG, heart volume, and functional parameters were investigated by negative binominal regression. Patients' characteristics (mean +/- A SD) included mean RA volume of 49 +/- A 19 ml/m(2) (HASTE sequence), mean right ventricular (RV) end-diastolic volume of 98 +/- A 27 ml/m(2), mean pulmonary valve regurgitation fraction (PR) of 21 +/- A 19 %, BMI of 25 kg/m(2), and heart rate of 75/min. Twenty-eight out of 67 patients experienced SV arrhythmia including SV couplets or bigeminus or longer non-sustained SV tachycardia (SVT) episodes. RA volume index was identified as an independent risk factor for different degrees of SV arrhythmia (SV couplets/bigeminus p < 0.001, SVT p < 0.001). Further risk factors for SV arrhythmia were male gender (p = 0.023) and decreased left ventricular (LV) ejection fraction (EF) (LV EF p < 0.001). RA volume is increased in adult patients with cTOF with larger RA volumes relating to higher incidence of SV arrhythmia. SV arrhythmia also appeared more often in male patients and those with decreased LV EF. Risk stratification according to these parameters could help to optimize early prevention and adjusted individual therapy to improve patient outcome and quality of life."],["dc.description.sponsorship","DFG [LO 1773/1-1]"],["dc.identifier.doi","10.1007/s00246-015-1152-2"],["dc.identifier.isi","000357683800019"],["dc.identifier.pmid","25862665"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/36485"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.relation.issn","1432-1971"],["dc.relation.issn","0172-0643"],["dc.title","Right Atrial Volume is Increased in Corrected Tetralogy of Fallot and Correlates with the Incidence of Supraventricular Arrhythmia: A CMR Study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","263"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","Basic Research in Cardiology"],["dc.bibliographiccitation.lastpage","269"],["dc.bibliographiccitation.volume","100"],["dc.contributor.author","Steinmetz, M."],["dc.contributor.author","Quentin, Thomas"],["dc.contributor.author","Poppe, Andrea"],["dc.contributor.author","Paul, Thomas"],["dc.contributor.author","Jux, Christian"],["dc.date.accessioned","2018-11-07T11:01:53Z"],["dc.date.available","2018-11-07T11:01:53Z"],["dc.date.issued","2005"],["dc.description.abstract","During neonatal cardiac development, the heart changes its substrate preference from glucose to fatty acids. The aim of this study was to investigate the changes in mRNA expression levels of genes involved in the control of cardiac fatty acid metabolism in the transition from neonatal to adult life. Methods mRNA expression levels for peroxisome proliferator activated receptor (PPAR) alpha, gamma and delta, PPAR gamma co-factor 1 alpha and beta (PGC-1 alpha and beta), 9-cis retinoc-acid-activated receptor alpha, beta and gamma (RXR alpha, beta, gamma), 5'-AMP activated protein kinase (AMPK) alpha 1 and alpha 2, adiponectin receptor 1 and 2 (AR 1 and AR 2) were measured in heart tissue of neonatal 0-day, 7-day and 21-day old rats. Results mRNA expression of all three members of the PPAR family were upregulated significantly from day 0 to day 21 (alpha + 117%, gamma + 133%, delta + 203%). In addition, m-RNA expression of all RXR isoforms increased from day 0 to day 7 (alpha + 125%, beta + 69%; gamma + 41%). AR 2 exhibited a small but significant increase in mRNA expression (+ 46%). Conclusions We were able to demonstrate for the first time that in addition to PPAR alpha, also PPAR gamma and delta, as well as all RXR isoforms and AR 2 are upregulated in the heart during neonatal development."],["dc.identifier.doi","10.1007/s00395-005-0520-0"],["dc.identifier.isi","000228638100010"],["dc.identifier.pmid","15754086"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/51249"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Dr Dietrich Steinkopff Verlag"],["dc.relation.issn","0300-8428"],["dc.title","Changes in expression levels of genes involved in fatty acid metabolism: upregulation of all three members of the PPAR family (alpha, gamma, delta) and the newly described adiponectin receptor 2, but not adiponectin receptor 1 during neonatal cardiac development of the rat"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.issue","9"],["dc.bibliographiccitation.journal","Clinical Research in Cardiology"],["dc.bibliographiccitation.volume","100"],["dc.contributor.author","Schneider, Heike E."],["dc.contributor.author","Kriebel, TA"],["dc.contributor.author","Steinmetz, M."],["dc.contributor.author","Ruschewski, Wolfgang"],["dc.contributor.author","Paul, Thomas"],["dc.date.accessioned","2018-11-07T08:52:34Z"],["dc.date.available","2018-11-07T08:52:34Z"],["dc.date.issued","2011"],["dc.format.extent","823"],["dc.identifier.isi","000294690900032"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/22198"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.publisher.place","Heidelberg"],["dc.relation.issn","1861-0684"],["dc.title","Left cardiac sympathetic denervation for the management of life-threatening ventricular tachyarrhythmias in young patients with catecholaminergic polymorphic ventricular tachycardia and long QT syndrome"],["dc.type","conference_abstract"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","European Journal of Pediatrics"],["dc.bibliographiccitation.volume","167"],["dc.contributor.author","Steinmetz, Michael"],["dc.contributor.author","Quentin, Thomas"],["dc.contributor.author","Krause, Ulrich J."],["dc.contributor.author","Poppe, Andrea"],["dc.contributor.author","Jux, Christian"],["dc.contributor.author","Paul, Thomas"],["dc.date.accessioned","2018-11-07T11:17:33Z"],["dc.date.available","2018-11-07T11:17:33Z"],["dc.date.issued","2008"],["dc.format.extent","367"],["dc.identifier.isi","000252991400040"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/54834"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.publisher.place","New york"],["dc.relation.issn","0340-6199"],["dc.title","Regulation of PPAR alpha activity and expression by metformin in neonatal cardiomyocytes: involvement of the AMP-activated protein kinase"],["dc.type","conference_abstract"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.issue","8"],["dc.bibliographiccitation.journal","Circulation: Cardiovascular Imaging"],["dc.bibliographiccitation.volume","14"],["dc.contributor.author","Steinmetz, Michael"],["dc.contributor.author","Stümpfig, Thomas"],["dc.contributor.author","Seehase, Matthias"],["dc.contributor.author","Schuster, Andreas"],["dc.contributor.author","Kowallick, Johannes"],["dc.contributor.author","Müller, Matthias"],["dc.contributor.author","Unterberg-Buchwald, Christina"],["dc.contributor.author","Kutty, Shelby"],["dc.contributor.author","Lotz, Joachim"],["dc.contributor.author","Uecker, Martin"],["dc.contributor.author","Paul, Thomas"],["dc.date.accessioned","2021-09-01T06:42:57Z"],["dc.date.available","2021-09-01T06:42:57Z"],["dc.date.issued","2021"],["dc.description.abstract","Background: Correction of tetralogy of Fallot (cTOF) often results in pulmonary valve pathology and right ventricular (RV) dysfunction. Reduced exercise capacity in cTOF patients cannot be explained by these findings alone. We aimed to explore why cTOF patients exhibit impaired exercise capacity with the aid of a comprehensive cardiopulmonary exercise testing (CPET) and real-time cardiovascular magnetic resonance exercise testing (CMR-ET) protocol. Methods: Thirty three cTOF patients and 35 matched healthy controls underwent CPET and CMR-ET in a prospective case-control study. Real-time steady-state free precession cine and phase-contrast sequences were obtained during incremental supine in-scanner cycling at 50, 70, and 90 W. RV and left ventricle (LV) volumes and pulmonary blood flow (Qp) were calculated. Differences of CPET and CMR-ET between cTOF versus controls and correlations between CPET and CMR-ET parameters in cTOF were evaluated statistically for all CMR exercise levels using Mann-Whitney U and Spearman rank-order correlation tests. Results: CPET capacity was significantly lower in cTOF than in controls. cTOF patients exhibited not only significantly reduced Qp and RV function but also lower LV function on CMR-ET. Higher CPET values in cTOF correlated with higher Qp (Qp 90 W versus carbon dioxide ventilatory equivalent %: R =−0.519, P <0.05), higher LV–end-diastolic volume indexed to body surface area (LV–end-diastolic volume indexed to body surface area at 50 W versus oxygen uptake in % at maximum exercise on CPET R =0.452, P <0.05), and change in LV ejection fraction (EF; LV-EF at 90 W versus Watt %: r =−0.463, P <0.05). No correlation was found with regard to RV-EF. Significant RV-LV interaction was observed during CMR-ET (RV-EF versus LV-EF at 50 W and 70 W: r =0.66, P <0.02 and r =0.52, P <0.05, respectively). Conclusions: Impaired exercise capacity in cTOF resulted from a reduction in not only RV, but also LV function. cTOF with good exercise capacity on CPET demonstrated higher LV reserve and pulmonary blood flow during incremental CMR-ET. Apart from RV parameters, CMR-ET–derived LV function could be a valuable tool to stratify cTOF patients for pulmonary valve replacement."],["dc.description.abstract","Background: Correction of tetralogy of Fallot (cTOF) often results in pulmonary valve pathology and right ventricular (RV) dysfunction. Reduced exercise capacity in cTOF patients cannot be explained by these findings alone. We aimed to explore why cTOF patients exhibit impaired exercise capacity with the aid of a comprehensive cardiopulmonary exercise testing (CPET) and real-time cardiovascular magnetic resonance exercise testing (CMR-ET) protocol. Methods: Thirty three cTOF patients and 35 matched healthy controls underwent CPET and CMR-ET in a prospective case-control study. Real-time steady-state free precession cine and phase-contrast sequences were obtained during incremental supine in-scanner cycling at 50, 70, and 90 W. RV and left ventricle (LV) volumes and pulmonary blood flow (Qp) were calculated. Differences of CPET and CMR-ET between cTOF versus controls and correlations between CPET and CMR-ET parameters in cTOF were evaluated statistically for all CMR exercise levels using Mann-Whitney U and Spearman rank-order correlation tests. Results: CPET capacity was significantly lower in cTOF than in controls. cTOF patients exhibited not only significantly reduced Qp and RV function but also lower LV function on CMR-ET. Higher CPET values in cTOF correlated with higher Qp (Qp 90 W versus carbon dioxide ventilatory equivalent %: R =−0.519, P <0.05), higher LV–end-diastolic volume indexed to body surface area (LV–end-diastolic volume indexed to body surface area at 50 W versus oxygen uptake in % at maximum exercise on CPET R =0.452, P <0.05), and change in LV ejection fraction (EF; LV-EF at 90 W versus Watt %: r =−0.463, P <0.05). No correlation was found with regard to RV-EF. Significant RV-LV interaction was observed during CMR-ET (RV-EF versus LV-EF at 50 W and 70 W: r =0.66, P <0.02 and r =0.52, P <0.05, respectively). Conclusions: Impaired exercise capacity in cTOF resulted from a reduction in not only RV, but also LV function. cTOF with good exercise capacity on CPET demonstrated higher LV reserve and pulmonary blood flow during incremental CMR-ET. Apart from RV parameters, CMR-ET–derived LV function could be a valuable tool to stratify cTOF patients for pulmonary valve replacement."],["dc.identifier.doi","10.1161/CIRCIMAGING.120.011823"],["dc.identifier.pmid","34384226"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/89183"],["dc.identifier.url","https://mbexc.uni-goettingen.de/literature/publications/427"],["dc.language.iso","en"],["dc.notes.intern","DOI-Import GROB-455"],["dc.relation","EXC 2067: Multiscale Bioimaging"],["dc.relation.eissn","1942-0080"],["dc.relation.issn","1941-9651"],["dc.relation.workinggroup","RG Uecker"],["dc.title","Impaired Exercise Tolerance in Repaired Tetralogy of Fallot Is Associated With Impaired Biventricular Contractile Reserve: An Exercise-Stress Real-Time Cardiovascular Magnetic Resonance Study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dspace.entity.type","Publication"]]