Kermer, Pawel

[["dc.bibliographiccitation.artnumber","e0216530"],["dc.bibliographiccitation.issue","5"],["dc.bibliographiccitation.journal","PLoS One"],["dc.bibliographiccitation.volume","14"],["dc.contributor.author","Wasser, Katrin"],["dc.contributor.author","Weber-Krüger, Mark"],["dc.contributor.author","Jürries, Falko"],["dc.contributor.author","Liman, Jan"],["dc.contributor.author","Hamann, Gerhard F."],["dc.contributor.author","Kermer, Pawel"],["dc.contributor.author","Uphaus, Timo"],["dc.contributor.author","Protsenko, Evgeny"],["dc.contributor.author","Seegers, Joachim"],["dc.contributor.author","Mende, Meinhard"],["dc.contributor.author","Gröschel, Klaus"],["dc.contributor.author","Wachter, Rolf"],["dc.date.accessioned","2019-07-09T11:51:30Z"],["dc.date.available","2019-07-09T11:51:30Z"],["dc.date.issued","2019"],["dc.description.abstract","BACKGROUND: The cardiac diagnostic workup of stroke patients, especially the value of echocardiography and enhanced and prolonged Holter-ECG monitoring, is still a matter of debate. We aimed to analyse the impact of pathologies detected by echocardiography and ECG monitoring on therapeutic decisions and prognosis. METHODS: Find-AFRANDOMISED was a prospective multicenter study which randomised 398 acute ischemic stroke patients ≥ 60 years to enhanced and prolonged Holter-ECG monitoring or usual stroke unit care. This substudy compared therapeutic consequences of echocardiography and routine Holter-ECG or enhanced and prolonged Holter-ECG monitoring, respectively, and prognosis of patients with or without pathologic findings in echocardiography or Holter-ECG monitoring. RESULTS: 50.3% received enhanced and prolonged Holter-ECG monitoring and 49.7% routine ECG monitoring. 82.9% underwent transthoracic echocardiography (TTE), 38.9% transesophageal echocardiography (TEE) and 25.6% both procedures. 14/89 TEE pathologies and 1/90 TTE pathology led to a change in therapy, resulting in a number needed to change decision (NNCD) of 12 and 330 (p < 0.001), respectively. In comparison, enhanced and prolonged Holter-ECG monitoring found atrial fibrillation (AF) in 27 of 200 patients, and routine ECG monitoring in twelve of 198 patients, leading to therapeutic changes in all patients (NNCD 8 and 17, respectively, p < 0.001). CONCLUSIONS: Most changes in therapeutic decisions were triggered by enhanced and prolonged Holter-ECG monitoring, which should therefore play a more prominent role in future guidelines. Echocardiography identifies a patient group at high cardiovascular risk, but rarely result in therapeutic changes. Whether this patient group requires further cardiovascular workup remains unknown. This should be further investigated by interdisciplinary neurocardiologic teams and in appropriate future trials."],["dc.identifier.doi","10.1371/journal.pone.0216530"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/16141"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/59961"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.subject.ddc","610"],["dc.title","The cardiac diagnostic work-up in stroke patients—A subanalysis of the Find-AFRANDOMISED trial"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","e34351"],["dc.bibliographiccitation.issue","4"],["dc.bibliographiccitation.journal","PLoS ONE"],["dc.bibliographiccitation.volume","7"],["dc.contributor.author","Wachter, Rolf"],["dc.contributor.author","Lahno, Rosine"],["dc.contributor.author","Haase, Beatrice"],["dc.contributor.author","Weber-Krueger, Mark"],["dc.contributor.author","Seegers, Joachim"],["dc.contributor.author","Edelmann, Frank"],["dc.contributor.author","Wohlfahrt, Janin"],["dc.contributor.author","Gelbrich, Götz"],["dc.contributor.author","Goerlitz, Anke"],["dc.contributor.author","Kermer, Pawel"],["dc.contributor.author","Vollmann, Dirk"],["dc.contributor.author","Hasenfuß, Gerd"],["dc.contributor.author","Groeschel, Klaus"],["dc.contributor.author","Stahrenberg, Raoul"],["dc.date.accessioned","2017-09-07T11:48:54Z"],["dc.date.available","2017-09-07T11:48:54Z"],["dc.date.issued","2012"],["dc.description.abstract","Background and Purpose: Diagnosis of paroxysmal atrial fibrillation (AF) can be challenging, but it is highly relevant in patients presenting with sinus rhythm and acute cerebral ischemia. We aimed to evaluate prospectively whether natriuretic peptide levels and kinetics identify patients with paroxysmal AF. Methods: Patients with acute cerebral ischemia were included into the prospective observational Find-AF study. N-terminal pro brain-type natriuretic peptide (NT-proBNP), brain-type natriuretic peptide (BNP) and N-terminal pro atrial-type natriuretic peptide (NT-proANP) plasma levels were measured on admission, after 6 and 24 hours. Patients free from AF at presentation received 7 day Holter monitoring. We prospectively hypothesized that patients presenting in sinus rhythm with NT-proBNP>median were more likely to have paroxysmal AF than patients with NT-proBNPmedian (239 pg/ml), 17.9% had paroxysmal AF in contrast to 7.4% with NT-proBNP<239 pg/ml (p = 0.025). The ratio of early (0 h) to late (24 h) plasma levels of NT-proBNP showed no difference between both groups. For the detection of paroxysmal atrial fibrillation, BNP, NT-proBNP and NT-proANP at admission had an area under the curve in ROC analysis of 0.747 (0.663-0.831), 0.638 (0.531-0.744) and 0.663 (0.566-0.761), respectively. In multivariate analysis, BNP was the only biomarker to be independently predictive for paroxysmal atrial fibrillation. Conclusions: BNP is independently predictive of paroxysmal AF detected by prolonged ECG monitoring in patients with cerebral ischemia and may be used to effectively select patients for prolonged Holter monitoring."],["dc.description.sponsorship","Open-Access-Publikationsfonds 2012"],["dc.identifier.doi","10.1371/journal.pone.0034351"],["dc.identifier.gro","3142549"],["dc.identifier.isi","000305336600027"],["dc.identifier.pmid","22509292"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/7572"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/8912"],["dc.notes.intern","WoS Import 2017-03-10"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","final"],["dc.notes.submitter","PUB_WoS_Import"],["dc.relation.issn","1932-6203"],["dc.rights","CC BY 2.5"],["dc.rights.uri","https://creativecommons.org/licenses/by/2.5"],["dc.title","Natriuretic Peptides for the Detection of Paroxysmal Atrial Fibrillation in Patients with Cerebral Ischemia - the Find-AF Study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]