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  1. Article ; Online: In Reply.

    Heine, Gunnar H

    Deutsches Arzteblatt international

    2018  Volume 155, Issue 37, Page(s) 606–607

    MeSH term(s) Anticoagulants ; Atrial Fibrillation ; Humans ; Radiation Protection ; Renal Insufficiency, Chronic
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2018-11-26
    Publishing country Germany
    Document type Letter ; Comment
    ZDB-ID 2406159-1
    ISSN 1866-0452 ; 1866-0452
    ISSN (online) 1866-0452
    ISSN 1866-0452
    DOI 10.3238/arztebl.2018.0606b
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Das kardiorenale Syndrom.

    Brandenburg, Vincent / Heine, Gunnar H

    Deutsche medizinische Wochenschrift (1946)

    2019  Volume 144, Issue 6, Page(s) e2

    Title translation The Cardiorenal Syndrome.
    Language German
    Publishing date 2019-03-28
    Publishing country Germany
    Document type Journal Article ; Published Erratum
    ZDB-ID 200446-x
    ISSN 1439-4413 ; 0012-0472
    ISSN (online) 1439-4413
    ISSN 0012-0472
    DOI 10.1055/a-0884-5458
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  3. Article ; Online: Dilemmasituation: Orale Antikoagulation bei Dialysepatienten mit Vorhofflimmern.

    Brandenburg, Vincent / Heine, Gunnar H

    Deutsche medizinische Wochenschrift (1946)

    2020  Volume 145, Issue 17, Page(s) 1277–1279

    Abstract: In patients with intact kidney function and in patients with mild to moderate chronic kidney disease (CKD), strong evidence suggests the use of non-vitamin K dependent oral anticoagulants (NOAC) for preventing ischemic strokes and systemic thromboembolic ...

    Title translation Dilemma situation: Oral anticoagulation in dialysis patients with non-valvular atrial fibrillation.
    Abstract In patients with intact kidney function and in patients with mild to moderate chronic kidney disease (CKD), strong evidence suggests the use of non-vitamin K dependent oral anticoagulants (NOAC) for preventing ischemic strokes and systemic thromboembolic events in patients with non-valvular atrial fibrillation (nvAF) and elevated thromboembolic risk. In contrast, less evidence is available on the risk-benefit ratio of oral anticoagulation (OAC) in patients with nvAF and severe CKD, particularly in dialysis patients. No large randomised study has tested whether OAC will reduce the risk of thromboembolic events in nvAF without prohibitively high bleeding risk, and whether NOACs or vitamin K antagonists are the superior strategy for OAC. Considering absence of strong evidence, the authors suggest that in dialysis patients with nvAF, in whom the treatment team sees the clear need to prevent thromboembolic events, the use of NOACs or left atrial appendage occlusion should be preferred over treatment with vitamin K antagonists. Any OAC treatment for dialysis patients with nvAF is not in-label in most European countries.
    MeSH term(s) Administration, Oral ; Anticoagulants/administration & dosage ; Anticoagulants/adverse effects ; Anticoagulants/therapeutic use ; Atrial Fibrillation/complications ; Humans ; Renal Insufficiency, Chronic/complications ; Stroke/drug therapy ; Stroke/prevention & control ; Thromboembolism/drug therapy ; Thromboembolism/prevention & control
    Chemical Substances Anticoagulants
    Language German
    Publishing date 2020-08-24
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 200446-x
    ISSN 1439-4413 ; 0012-0472
    ISSN (online) 1439-4413
    ISSN 0012-0472
    DOI 10.1055/a-1124-2404
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  4. Article ; Online: Kardiovaskuläre Therapie bei chronischer Nierenerkrankung.

    Brandenburg, Vincent / Saritas, Turgay / Schirmer, Stephan H / Rogacev, Kyrill / Heine, Gunnar Henrik

    Herz

    2023  Volume 48, Issue 5, Page(s) 413–424

    Abstract: Patients with combined cardiac and renal diseases are particularly challenging in the routine clinical practice due to the substantial risk profile for increased morbidity and mortality. As cardiorenal patients have often been underrepresented in ... ...

    Title translation Cardiovascular treatment in chronic kidney disease.
    Abstract Patients with combined cardiac and renal diseases are particularly challenging in the routine clinical practice due to the substantial risk profile for increased morbidity and mortality. As cardiorenal patients have often been underrepresented in randomized, controlled interventional trials, guideline recommendations regarding the choice of treatment are often weaker for these individuals than for cardiovascular patients without chronic kidney disease. Furthermore, there are limitations in the approval of certain medications depending on the kidney function. This review addresses some considerations in crucial treatment areas for patients with cardiovascular diseases, whose treatment is significantly influenced by concomitant chronic kidney disease.
    MeSH term(s) Humans ; Atrial Fibrillation/drug therapy ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/therapy ; Cardiovascular Diseases/therapy ; Cardiovascular Diseases/complications
    Language German
    Publishing date 2023-09-11
    Publishing country Germany
    Document type Review ; English Abstract ; Journal Article
    ZDB-ID 8262-4
    ISSN 1615-6692 ; 0340-9937 ; 0946-1299
    ISSN (online) 1615-6692
    ISSN 0340-9937 ; 0946-1299
    DOI 10.1007/s00059-023-05205-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Therapieresistente und sekundäre Hypertonie.

    Morell, Sarah M / Heine, Gunnar H / Fassnacht, Martin

    Deutsche medizinische Wochenschrift (1946)

    2021  Volume 146, Issue 11, Page(s) 742–746

    Abstract: Resistant hypertension (RH) is defined in patients who do not meet their blood pressure targets despite the daily intake of three antihypertensive drugs in maximally tolerated dosages. This triple treatment should comprise (1) an angiotensin-converting ... ...

    Title translation Update on treatment resistant hypertension and secondary hypertension.
    Abstract Resistant hypertension (RH) is defined in patients who do not meet their blood pressure targets despite the daily intake of three antihypertensive drugs in maximally tolerated dosages. This triple treatment should comprise (1) an angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin receptor blocker (ARB), (2) a calcium channel blocker and (3) a diuretic. RH should also be diagnosed in patients on four or more antihypertensive drug classes. Of note, the diagnosis of RH requires the exclusion of non-adherence, "white coat effect", and incorrect BP-measurement.After diagnosing RH, it is important to recommend lifestyle interventions (e. g. low dietary salt intake, regular physical activity), to pause BP-elevating substances, and to consider the presence of secondary hypertension.Such secondary forms of hypertension primarily include endocrine disorders and renal disease (both acute kidney injury and chronic kidney disease). The leading endocrine cause is primary hyperaldosteronism, the management of which was highlighted in a recent guideline. Other endocrine causes - such as phaeochromocytoma or hypercortisolism - are much less frequent. In contrast, sleep apnoea disorders are now mostly considered as a comorbidity rather than as a cause of secondary hypertension.Treatment options for RH include lifestyle optimisation and escalation of antihypertensive medication. In most patients on triple treatment (ACE-I or ARB plus calcium channel blocker plus diuretic), mineralocorticoid receptor antagonists (MRA) should be the next treatment choice. As MRA may be associated with hyperkalemia (particularly in patients with chronic kidney disease), the concurrent use of potassium-lowering agents such as patiromer may allow a safe long-term treatment. In contrast, novel interventional treatment options in RH such as renal denervation are still controversially discussed.
    MeSH term(s) Antihypertensive Agents/therapeutic use ; Blood Pressure/physiology ; Humans ; Hyperaldosteronism ; Hypertension/drug therapy ; Hypertension/physiopathology
    Chemical Substances Antihypertensive Agents
    Language German
    Publishing date 2021-06-01
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 200446-x
    ISSN 1439-4413 ; 0012-0472
    ISSN (online) 1439-4413
    ISSN 0012-0472
    DOI 10.1055/a-1262-5777
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  6. Article ; Online: Das kardiorenale Syndrom.

    Brandenburg, Vincent / Heine, Gunnar H

    Deutsche medizinische Wochenschrift (1946)

    2019  Volume 144, Issue 6, Page(s) 382–386

    Abstract: In patients with chronic cardio renal syndrome chronic heart disease coexists with chronic kidney disease and poses the patients to a specifically high risk for cardiovascular events and mortality. Treatment recommendations in this condition with a high ... ...

    Title translation The Cardiorenal Syndrome.
    Abstract In patients with chronic cardio renal syndrome chronic heart disease coexists with chronic kidney disease and poses the patients to a specifically high risk for cardiovascular events and mortality. Treatment recommendations in this condition with a high level of evidence are sparse. Mainstay of therapy in cardiorenal syndrome is fluid metabolism control and stabilization of renal and cardiac function, which can basically been achieved by substances modifying the renin-angiotensin-aldosterone-system as well as diuretics. Noteworthy, despite inducing short-term decreases in renal function, inhibition of the RAAS and diuretic medication associate with the long-term improvements of outcome (so-called pseudo-worsening of renal function). The chronic cardiorenal syndrome calls for interdisciplinary care by both nephrologists and cardiologists in order to allow high-end patient care with a maximum of beneficial effect and a minimum of treatment-related side effects.
    MeSH term(s) Cardio-Renal Syndrome ; Humans
    Language German
    Publishing date 2019-03-14
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 200446-x
    ISSN 1439-4413 ; 0012-0472
    ISSN (online) 1439-4413
    ISSN 0012-0472
    DOI 10.1055/a-0661-4456
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  7. Article: Dilemmasituation: Orale Antikoagulation bei Dialysepatienten mit Vorhofflimmern

    Brandenburg, Vincent / Heine, Gunnar H.

    DMW - Deutsche Medizinische Wochenschrift

    2020  Volume 145, Issue 17, Page(s) 1277–1279

    Keywords orale Antikoagulation ; Dialyse ; Vorhofflimmern ; oral anticoagulation ; dialysis ; non-valvular atrial fibrillation
    Language German
    Publishing date 2020-08-01
    Publisher © Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 200446-x
    ISSN 1439-4413 ; 0012-0472
    ISSN (online) 1439-4413
    ISSN 0012-0472
    DOI 10.1055/a-1124-2404
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  8. Article ; Online: Mineral metabolism in heart disease.

    Heine, Gunnar H

    Current opinion in nephrology and hypertension

    2015  Volume 24, Issue 4, Page(s) 310–316

    Abstract: Purpose of review: Strong experimental and clinical evidence points towards a substantial contribution of mineral metabolism disorders to the initiation and progression of cardiovascular disease. Vice versa, recent work suggests that cardiovascular ... ...

    Abstract Purpose of review: Strong experimental and clinical evidence points towards a substantial contribution of mineral metabolism disorders to the initiation and progression of cardiovascular disease. Vice versa, recent work suggests that cardiovascular disease may also cause mineral metabolism alterations.
    Recent findings: Experimental studies suggest that hyperphosphatemia, elevated plasma levels of phosphaturic hormones--parathyroid hormone and fibroblast growth factor-23 (FGF-23)--and hypovitaminosis D exert detrimental effects on vascular tissue and on the myocardium. Accordingly, in longitudinal clinical cohort studies, individuals with high plasma levels of phosphate, parathyroid hormone and FGF-23, and with low vitamin D levels, face worst cardiovascular prognosis.Notably, recent evidence suggests that cardiovascular disease may not only follow but also induce mineral metabolism disorders: severe derangements in mineral metabolism were observed in patients with acute heart failure, who face a tremendous increase in plasma FGF-23. Unfortunately, few prospective studies have been completed hitherto that specifically target components of the mineral metabolism for cardiovascular disease prevention or treatment.
    Summary: A bidirectional interaction exists between mineral metabolism disorders and cardiovascular disease. However, clinical evidence for a cardiovascular benefit of therapeutic interventions into mineral metabolism is outstanding.
    MeSH term(s) Animals ; Fibroblast Growth Factors/metabolism ; Heart Diseases/diagnosis ; Heart Diseases/metabolism ; Humans ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/metabolism ; Metabolic Diseases/metabolism ; Minerals/metabolism ; Parathyroid Hormone/metabolism
    Chemical Substances Minerals ; Parathyroid Hormone ; fibroblast growth factor 23 ; Fibroblast Growth Factors (62031-54-3)
    Language English
    Publishing date 2015-07
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1151092-4
    ISSN 1473-6543 ; 1535-3842 ; 1062-4813 ; 1062-4821
    ISSN (online) 1473-6543 ; 1535-3842
    ISSN 1062-4813 ; 1062-4821
    DOI 10.1097/MNH.0000000000000129
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  9. Article: Das kardiorenale Syndrom

    Brandenburg, Vincent / Heine, Gunnar H.

    DMW - Deutsche Medizinische Wochenschrift

    2019  Volume 144, Issue 06, Page(s) e2–e2

    Language German
    Publishing date 2019-03-01
    Publisher © Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 200446-x
    ISSN 1439-4413 ; 0012-0472
    ISSN (online) 1439-4413
    ISSN 0012-0472
    DOI 10.1055/a-0884-5458
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  10. Article ; Online: Erratum.

    Emrich, Insa E / Heine, Gunnar H

    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

    2017  Volume 32, Issue 1, Page(s) 202

    Language English
    Publishing date 2017-04-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 90594-x
    ISSN 1460-2385 ; 0931-0509
    ISSN (online) 1460-2385
    ISSN 0931-0509
    DOI 10.1093/ndt/gfw435
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