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Edelmann, Frank Thomas
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Edelmann, Frank Thomas
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Edelmann, Frank Thomas
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Edelmann, F. T.
Edelmann, Frank
Edelmann, F.
Edelmann, Frank T.
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2019Journal Article [["dc.bibliographiccitation.journal","ESC Heart Failure"],["dc.contributor.author","Nolte, Kathleen"],["dc.contributor.author","Herrmann-Lingen, Christoph"],["dc.contributor.author","Platschek, Lars"],["dc.contributor.author","Holzendorf, Volker"],["dc.contributor.author","Pilz, Stefan"],["dc.contributor.author","Tomaschitz, Andreas"],["dc.contributor.author","Düngen, Hans-Dirk"],["dc.contributor.author","Angermann, Christiane E"],["dc.contributor.author","Hasenfuß, Gerd"],["dc.contributor.author","Pieske, Burkert"],["dc.contributor.author","Wachter, Rolf"],["dc.contributor.author","Edelmann, Frank"],["dc.date.accessioned","2019-07-09T11:50:12Z"],["dc.date.available","2019-07-09T11:50:12Z"],["dc.date.issued","2019"],["dc.description.abstract","AIMS: Vitamin D deficiency is prevalent in heart failure (HF), but its relevance in early stages of heart failure with preserved ejection fraction (HFpEF) is unknown. We tested the association of 25-hydroxyvitamin D [25(OH)D] serum levels with mortality, hospitalizations, cardiovascular risk factors, and echocardiographic parameters in patients with asymptomatic diastolic dysfunction (DD) or newly diagnosed HFpEF. METHODS AND RESULTS: We measured 25(OH)D serum levels in outpatients with risk factors for DD or history of HF derived from the DIAST-CHF study. Participants were comprehensively phenotyped including physical examination, echocardiography, and 6 min walk test and were followed up to 5 years. Quality of life was evaluated by the Short Form 36 (SF-36) questionnaire. We included 787 patients with available 25(OH)D levels. Median 25(OH)D levels were 13.1 ng/mL, mean E/e' medial was 13.2, and mean left ventricular ejection fraction was 59.1%. Only 9% (n = 73) showed a left ventricular ejection fraction <50%. Fifteen per cent (n = 119) of the recruited participants had symptomatic HFpEF. At baseline, participants with 25(OH)D levels in the lowest tertile (≤10.9 ng/L; n = 263) were older, more often symptomatic (oedema and fatigue, all P ≤ 0.002) and had worse cardiac [higher N-terminal pro-brain natriuretic peptide (NT-proBNP) and left atrial volume index, both P ≤ 0.023], renal (lower glomerular filtration rate, P = 0.012), metabolic (higher uric acid levels, P < 0.001), and functional (reduced exercise capacity, 6 min walk distance, and SF-36 physical functioning score, all P < 0.001) parameters. Increased NT-proBNP, uric acid, and left atrial volume index and decreased SF-36 physical functioning scores were independently associated with lower 25(OH)D levels. There was a higher risk for lower 25(OH)D levels in association with HF, DD, and atrial fibrillation (all P ≤ 0.004), which remained significant after adjusting for age. Lower 25(OH)D levels (per 10 ng/mL decrease) tended to be associated with higher 5 year mortality, P = 0.05, hazard ratio (HR) 1.55 [1.00; 2.42]. Furthermore, lower 25(OH)D levels (per 10 ng/mL decrease) were related to an increased rate of cardiovascular hospitalizations, P = 0.023, HR = 1.74 [1.08; 2.80], and remained significant after adjusting for age, P = 0.046, HR = 1.63 [1.01; 2.64], baseline NT-proBNP, P = 0.048, HR = 1.62 [1.01; 2.61], and other selected baseline characteristics and co-morbidities, P = 0.043, HR = 3.60 [1.04; 12.43]. CONCLUSIONS: Lower 25(OH)D levels were associated with reduced functional capacity in patients with DD or HFpEF and were significantly predictive for an increased rate of cardiovascular hospitalizations, also after adjusting for age, NT-proBNP, and selected baseline characteristics and co-morbidities."],["dc.identifier.doi","10.1002/ehf2.12413"],["dc.identifier.pmid","30784226"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/15880"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/59721"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.relation.issn","2055-5822"],["dc.rights","CC BY-NC 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by-nc/4.0"],["dc.subject.ddc","610"],["dc.title","Vitamin D deficiency in patients with diastolic dysfunction or heart failure with preserved ejection fraction"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]Details DOI PMID PMC2019Journal Article [["dc.bibliographiccitation.artnumber","16478"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Scientific Reports"],["dc.bibliographiccitation.volume","9"],["dc.contributor.author","Tanacli, Radu"],["dc.contributor.author","Hashemi, Djawid"],["dc.contributor.author","Lapinskas, Tomas"],["dc.contributor.author","Edelmann, Frank"],["dc.contributor.author","Gebker, Rolf"],["dc.contributor.author","Pedrizzetti, Gianni"],["dc.contributor.author","Schuster, Andreas"],["dc.contributor.author","Nagel, Eike"],["dc.contributor.author","Pieske, Burkert"],["dc.contributor.author","Düngen, Hans-Dirk"],["dc.contributor.author","Kelle, Sebastian"],["dc.date.accessioned","2019-12-10T14:50:47Z"],["dc.date.accessioned","2021-10-27T13:21:50Z"],["dc.date.available","2019-12-10T14:50:47Z"],["dc.date.available","2021-10-27T13:21:50Z"],["dc.date.issued","2019"],["dc.description.abstract","Heart failure (HF) is associated with progressive ventricular remodeling and impaired contraction that affects distinctly various regions of the myocardium. Our study applied cardiac magnetic resonance (CMR) feature tracking (FT) to assess comparatively myocardial strain at 3 distinct levels: subendocardial (Endo-), mid (Myo-) and subepicardial (Epi-) myocardium across an extended spectrum of patients with HF. 59 patients with HF, divided into 3 subgroups as follows: preserved ejection fraction (HFpEF, N = 18), HF with mid-range ejection fraction (HFmrEF, N = 21), HF with reduced ejection fraction (HFrEF, N = 20) and a group of age- gender- matched volunteers (N = 17) were included. Using CMR FT we assessed systolic longitudinal and circumferential strain and strain-rate at Endo-, Myo- and Epi- levels. Strain values were the highest in the Endo- layer and progressively lower in the Myo- and Epi- layers respectively, this gradient was present in all the patients groups analyzed but decreased progressively in HFmrEF and further on in HFrEF groups. GLS decreased with the severity of the disease in all 3 layers: Normal > HFpEF > HFmrEF > HFrEF (Endo-: -23.0 ± 3.5 > -20.0 ± 3.3 > -16.4 ± 2.2 > -11.0 ± 3.2, p < 0.001, Myo-: -20.7 ± 2.4 > -17.5.0 ± 2.6 > -14.5 ± 2.1 > -9.6 ± 2.7, p < 0.001; Epi-: -15.7 ± 1.9 > -12.2 ± 2.1 > -10.6 ± 2.3 > -7.7 ± 2.3, p < 0.001). In contrast, GCS was not different between the Normal and HFpEF (Endo-: -34.5 ± 6.2 vs -33.9 ± 5.7, p = 0.51; Myo-: -21.9 ± 3.8 vs -21.3 ± 2.2, p = 0.39, Epi-: -11.4 ± 2.0 vs -10.9 ± 2.3, p = 0.54) but was, as well, markedly lower in the systolic heart failure groups: Normal > HFmrEF > HFrEF (Endo-: -34.5 ± 6.2 > -20.0 ± 4.2 > 12.3 ± 4.2, p < 0.001; Myo-: -21.9 ± 3.8 > -13.0 ± 3.4 > -8.0 ± 2.7. p < 0.001; Epi-: -11.4 ± 2.0 > -7.9 ± 2.3 > -4.5 ± 1.9. p < 0.001). CMR feature tracking multilayer strain assessment identifies large range differences between distinct myocardial regions. Our data emphasizes the importance of sub-endocardial myocardium for cardiac contraction and thus, its predilect role in imaging detection of functional impairment. CMR feature tracking offers a convenient, readily available, platform to evaluate myocardial contraction with excellent spatial resolution, rendering further details about discrete areas of the myocardium. Using this technique across distinct groups of patients with heart failure (HF), we demonstrate that subendocardial regions of the myocardium exhibit much higher strain values than mid-myocardium or subepicardial and are more sensitive to detect contractile impairment. We also show comparatively higher values of circumferential strain compared with longitudinal and a higher sensitivity to detect contractile impairment. A newly characterized group of patients, HF with mid-range ejection fraction (EF), shows similar traits of decompensation but has relatively higher strain values as patients with HF with reduced EF."],["dc.identifier.doi","10.1038/s41598-019-52683-8"],["dc.identifier.isbn","31712641"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/16898"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/92048"],["dc.language.iso","en"],["dc.notes.intern","Migrated from goescholar"],["dc.relation.eissn","2045-2322"],["dc.relation.issn","2045-2322"],["dc.relation.orgunit","Universitätsmedizin Göttingen"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.subject.ddc","610"],["dc.title","Range Variability in CMR Feature Tracking Multilayer Strain across Different Stages of Heart Failure"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]Details DOI