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  1. Article ; Online: Heart Failure After Right Ventricular Myocardial Infarction.

    Nägele, Matthias P / Flammer, Andreas J

    Current heart failure reports

    2022  Volume 19, Issue 6, Page(s) 375–385

    Abstract: Purpose of review: Heart failure (HF) after right ventricular myocardial infarction (RVMI) is common and complicates its clinical course. This review aims to provide a current overview on the characteristic features of RV failure with focus on acute ... ...

    Abstract Purpose of review: Heart failure (HF) after right ventricular myocardial infarction (RVMI) is common and complicates its clinical course. This review aims to provide a current overview on the characteristic features of RV failure with focus on acute management.
    Recent findings: While HF after RVMI is classically seen after acute proximal right coronary artery occlusion, RV dysfunction may also occur after larger infarctions in the left coronary artery. Because of its different anatomy and physiology, the RV appears to be more resistant to permanent infarction compared to the LV with greater potential for recovery of ischemic myocardium. Hypotension and elevated jugular pressure in the presence of clear lung fields are hallmark signs of RV failure and should prompt confirmation by echocardiography. Management decisions are still mainly based on small studies and extrapolation of findings from LV failure. Early revascularization improves short- and long-term outcomes. Acute management should further focus on optimization of preload and afterload, maintenance of sufficient perfusion pressures, and prompt management of arrhythmias and concomitant LV failure, if present. In case of cardiogenic shock, use of vasopressors and/or inotropes should be considered along with timely use of mechanical circulatory support (MCS) in eligible patients. HF after RVMI is still a marker of worse outcome in acute coronary syndrome. Prompt revascularization, careful medical therapy with attention to the special physiology of the RV, and selected use of MCS provide the RV the time it needs to recover from the ischemic insult.
    MeSH term(s) Humans ; Heart Failure/etiology ; Heart Failure/therapy ; Ventricular Dysfunction, Right/etiology ; Ventricular Dysfunction, Right/therapy ; Ventricular Dysfunction, Right/diagnosis ; Myocardial Infarction/complications ; Myocardial Infarction/therapy ; Heart Ventricles/diagnostic imaging ; Myocardium
    Language English
    Publishing date 2022-10-05
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2151202-4
    ISSN 1546-9549 ; 1546-9530
    ISSN (online) 1546-9549
    ISSN 1546-9530
    DOI 10.1007/s11897-022-00577-8
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    Zs.A 5936: Show issues Location:
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  2. Article ; Online: Medication adherence in adults after hospitalization for heart failure: A cross-sectional study.

    Huber, Manuela / Busch, Ada Katrin / Stalder-Ochsner, Irene / Flammer, Andreas J / Schmid-Mohler, Gabriela

    International journal of cardiology. Cardiovascular risk and prevention

    2023  Volume 20, Page(s) 200234

    Abstract: Background: Medication non-adherence in heart failure (HF) leads to increased mortality, morbidity and healthcare costs. However, no study has investigated HF patients' post-hospitalization medication non-adherence in Switzerland.: Objectives: Our ... ...

    Abstract Background: Medication non-adherence in heart failure (HF) leads to increased mortality, morbidity and healthcare costs. However, no study has investigated HF patients' post-hospitalization medication non-adherence in Switzerland.
    Objectives: Our primary aim was to assess the prevalence of post-discharge medication non-adherence in patients with HF. A secondary objective was to identify differences between fully and partially adherent patients regarding selected unplanned therapy-related inpatient/outpatient cardiology visits.
    Methods: A non-experimental cross-sectional study was applied. The prevalence of medication adherence was assessed with a German-translated version of the Medication Adherence Report Scale (MARS-5) and analyzed descriptively. Differences between adherent and partially adherent patients' numbers of medications, dosing per day and 180-day unplanned inpatient stays or cardiology outpatient visits were explored.
    Results: Of 153 recruited patients, 72 participated in the survey. Of these, 26.4 % were not fully adherent. Their most common reason was forgetfulness (23.7 %). There were no significant group differences regarding therapy-related variables or 180-day unplanned cardiology stays/visits.
    Conclusions: Considering that over one-quarter of surveyed HF patients were not fully medication adherent, Swiss cardiology nurses need to be sensitized to this issue and trained in adherence-enhancing interventions. Reaching acceptable adherence levels in patients with HF will require further research and action.
    Language English
    Publishing date 2023-12-24
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2772-4875
    ISSN (online) 2772-4875
    DOI 10.1016/j.ijcrp.2023.200234
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  3. Article ; Online: Sustained Ventricular Tachyarrhythmias are Associated With Increased

    Kovacs, Boldizsar / Giannopoulos, Andreas A / Bogun, Frank / Pazhenkottil, Aju P / Bonetti, Nicole R / Manka, Robert / Medeiros-Domingo, Argelia / Gruner, Christiane / Schmidt, Dörthe / Flammer, Andreas J / Ruschitzka, Frank / Duru, Firat / Kaufmann, Philipp A / Buechel, Ronny R / Saguner, Ardan M

    Circulation. Cardiovascular imaging

    2024  Volume 17, Issue 3, Page(s) e016316

    MeSH term(s) Humans ; Fluorodeoxyglucose F18 ; Tachycardia, Ventricular/diagnostic imaging ; Tachycardia, Ventricular/etiology ; Cardiomyopathies ; Sarcoidosis/diagnosis ; Sarcoidosis/diagnostic imaging ; Positron-Emission Tomography ; Radiopharmaceuticals
    Chemical Substances Fluorodeoxyglucose F18 (0Z5B2CJX4D) ; Radiopharmaceuticals
    Language English
    Publishing date 2024-03-08
    Publishing country United States
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 2435045-X
    ISSN 1942-0080 ; 1941-9651
    ISSN (online) 1942-0080
    ISSN 1941-9651
    DOI 10.1161/CIRCIMAGING.123.016316
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    Zs.A 6743: Show issues Location:
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  4. Article ; Online: Long-distance donor heart procurement using an innovative cold static storage system.

    Schmiady, Martin O / Bec, Leszek P / Shallah, Mohammed / Flammer, Andreas J / Vogt, Paul R / Wilhelm, Markus J

    Perfusion

    2023  , Page(s) 2676591231163018

    Abstract: The global lack of donor shortage poses a major limitation for heart transplantation. New concepts with expanded donor inclusion criteria comprise extended transport distances and prolonged ischemic times with the aim of reaching a larger number of ... ...

    Abstract The global lack of donor shortage poses a major limitation for heart transplantation. New concepts with expanded donor inclusion criteria comprise extended transport distances and prolonged ischemic times with the aim of reaching a larger number of potential donors. Recent developments in cold storage solutions may allow more donor hearts with prolonged ischemic times to be use for transplantation in the future. We present our experience during a long-distance donor heart procurement with the longest reported transport distance and transport time in the current literature. This was made possible through the use of SherpaPak™, an innovative cold storage system which allows for controlled temperatures during transportation.
    Language English
    Publishing date 2023-03-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 645038-6
    ISSN 1477-111X ; 0267-6591
    ISSN (online) 1477-111X
    ISSN 0267-6591
    DOI 10.1177/02676591231163018
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  5. Article ; Online: The use of serotonin reuptake inhibitors increases the risk of bleeding in patients with assist devices.

    Auschra, Bianca / Wilhelm, Markus J / Husung, Claudia / Jenewein, Josef / Flammer, Andreas J / Jellestad, Lena

    BMC cardiovascular disorders

    2022  Volume 22, Issue 1, Page(s) 121

    Abstract: Background: Bleedings are frequent and dreaded complications in heart failure patients with ventricular assist devices (VAD). Serotonin reuptake inhibitor (SRI) antidepressants are widely used to treat depression in these patients, though they are ... ...

    Abstract Background: Bleedings are frequent and dreaded complications in heart failure patients with ventricular assist devices (VAD). Serotonin reuptake inhibitor (SRI) antidepressants are widely used to treat depression in these patients, though they are attributed an increased risk of bleeding due to their modification of hemostasis. Evidence on bleeding risk of VAD patients under SRI medication is scarce and limited. We therefore aimed to assess if SRI use is associated with an elevated bleeding risk in this particularly vulnerable population.
    Methods: We analyzed the medical records of 92 VAD patients at the University Heart Center Zurich between September 2004 and April 2018 for the occurrence of bleedings and the concomitant use of an SRI. Bleeding was defined as any type of post-implantation bleeding requiring medical treatment. We performed univariate analyses and linear mixed-effects models, adjusting for baseline clinical characteristics as potential predictors to identify differences in bleeding rates in patients with vs. without SRI intake.
    Results: The cohort comprised 60.9% of patients with a continuous-flow VAD and 39.1% with a pulsatile-flow VAD. A total of 77.2% of patients experienced at least one bleeding incident. Overall, 28.6% of bleedings occurred under SRI therapy. A generalized linear mixed model showed a predictive effect of SRI medication on bleeding rate, independent of VAD type (z = 2.091, p = 0.037).
    Conclusions: Bleeding events in heart failure patients occur frequently after VAD implantation. Patients with SRI medication were at increased risk of bleeding. The indication and use of SRI, therefore, should be considered carefully.
    MeSH term(s) Heart Failure/diagnosis ; Heart Failure/etiology ; Heart Failure/therapy ; Heart-Assist Devices/adverse effects ; Hemorrhage/epidemiology ; Humans ; Retrospective Studies ; Serotonin Uptake Inhibitors/adverse effects ; Treatment Outcome
    Chemical Substances Serotonin Uptake Inhibitors
    Language English
    Publishing date 2022-03-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2059859-2
    ISSN 1471-2261 ; 1471-2261
    ISSN (online) 1471-2261
    ISSN 1471-2261
    DOI 10.1186/s12872-022-02557-1
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  6. Article: CME-EKG 64: Leistungsintoleranz und Belastungsdyspnoe.

    Parianos, Danaë / Flammer, Andreas J / Brunckhorst, Corinna B

    Praxis

    2019  Volume 108, Issue 13, Page(s) 843–844

    Title translation CME ECG 64: Exercise Intolerance and Dyspnea on Exertion.
    Language German
    Publishing date 2019-09-13
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 209026-0
    ISSN 1661-8165 ; 1661-8157 ; 0369-8394
    ISSN (online) 1661-8165
    ISSN 1661-8157 ; 0369-8394
    DOI 10.1024/1661-8157/a003323
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  7. Article: Arrhythmic Manifestations of Cardiac Amyloidosis: Challenges in Risk Stratification and Clinical Management.

    Laptseva, Natallia / Rossi, Valentina A / Sudano, Isabella / Schwotzer, Rahel / Ruschitzka, Frank / Flammer, Andreas J / Duru, Firat

    Journal of clinical medicine

    2023  Volume 12, Issue 7

    Abstract: Amyloidosis is a systemic disease characterized by extracellular deposits of insoluble amyloid in various tissues and organs. Cardiac amyloidosis is a frequent feature of the disease, causing a progressive, restrictive type of cardiomyopathy, and is ... ...

    Abstract Amyloidosis is a systemic disease characterized by extracellular deposits of insoluble amyloid in various tissues and organs. Cardiac amyloidosis is a frequent feature of the disease, causing a progressive, restrictive type of cardiomyopathy, and is associated with adverse clinical outcomes and increased mortality. The typical clinical presentation in patients with cardiac amyloidosis is heart failure (HF) with preserved ejection fraction. Most patients present with typical symptoms and signs of HF, such as exertional dyspnea, pretibial edema, pleural effusions and angina pectoris due to microcirculatory dysfunction. However, patients may also frequently encounter various arrhythmias, such as atrioventricular nodal block, atrial fibrillation and ventricular tachyarrhythmias. The management of arrhythmias in cardiac amyloidosis patients with drugs and devices is often a clinical challenge. Moreover, predictors of life-threatening arrhythmic events are not well defined. This review intends to give a deepened insight into the arrhythmic features of cardiac amyloidosis by discussing the pathogenesis of these arrhythmias, addressing the challenges in risk stratification and strategies for management in these patients.
    Language English
    Publishing date 2023-03-29
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12072581
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  8. Article ; Online: Open Doors by Fair Means: a quasi-experimental controlled study on the effects of an open-door policy on acute psychiatric wards.

    Schreiber, Lisa K / Metzger, Florian G / Flammer, Erich / Rinke, Heike / Fallgatter, Andreas J / Steinert, Tilman

    BMC health services research

    2022  Volume 22, Issue 1, Page(s) 941

    Abstract: Background: Psychiatric wards treating involuntarily admitted patients are traditionally locked to prevent absconding. However, on the basis of observational evidence, the necessity for locked units in psychiatric hospitals has increasingly been ... ...

    Abstract Background: Psychiatric wards treating involuntarily admitted patients are traditionally locked to prevent absconding. However, on the basis of observational evidence, the necessity for locked units in psychiatric hospitals has increasingly been questioned. Updated Mental Health Laws in several Federal States of Germany legitimate involuntary commitment without generally locked doors.
    Methods: We examined the effects of an open-door policy in a quasi-experimental, prospective design. For the first time, at each of two locations, two identical wards serving as control and intervention could be compared. After a baseline period of three months, one ward at each location started the 12 month intervention period with the implementation of an open-door policy, while the respective control ward, as before, used open doors only facultatively. Primary outcomes were average opening times of the four wards between 8 a.m. and 8 p.m., and the number of involuntary treatment days with the doors open. Secondary outcomes were adverse events including aggressive incidents, absconding, suicide attempts and coercive measures.
    Results: Overall, door-opening times increased significantly at both sites´ intervention wards. The number of adverse events did not increase during intervention period. Frequencies of coercive measures decreased in Friedrichshafen and remained unchanged in Tuebingen. In case of the intervention ward in Friedrichshafen, doors were open in up to 91% of all involuntary treatment days, whereas in the control ward, this was only the case in 67% of all involuntary treatment days (p < .001). In case of the intervention ward in Tuebingen, 45% of involuntary treatment days had open doors, compared to 30% in the control ward (p < .001).
    Conclusions: It is possible to manage psychiatric wards with open doors without taking inappropriate risks. The extent to which open-door policies are achievable is be dependent on staffing and patient characteristics. Further research is necessary to explore the role of staff attitudes.
    Trial registration: Our trial "Open Doors by Fair Means" is retrospectively registered with DRKS ( DRKS00015154 ) on Sept. 10
    MeSH term(s) Coercion ; Hospitals, Psychiatric ; Humans ; Mental Disorders/psychology ; Mental Disorders/therapy ; Policy ; Psychiatric Department, Hospital
    Language English
    Publishing date 2022-07-22
    Publishing country England
    Document type Controlled Clinical Trial ; Journal Article
    ZDB-ID 2050434-2
    ISSN 1472-6963 ; 1472-6963
    ISSN (online) 1472-6963
    ISSN 1472-6963
    DOI 10.1186/s12913-022-08322-6
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  9. Article ; Online: Exercise intolerance in heart failure with preserved ejection fraction: time to scrutinize diuretic therapy?

    Montero, David / Flammer, Andreas J

    European journal of heart failure

    2017  Volume 19, Issue 8, Page(s) 971–973

    MeSH term(s) Diuretics/therapeutic use ; Exercise Tolerance ; Heart Failure/physiopathology ; Heart Failure/therapy ; Humans ; Stroke Volume/physiology ; Ventricular Function, Left/physiology
    Chemical Substances Diuretics
    Language English
    Publishing date 2017-03-29
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1483672-5
    ISSN 1879-0844 ; 1388-9842
    ISSN (online) 1879-0844
    ISSN 1388-9842
    DOI 10.1002/ejhf.811
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    Zs.A 5299: Show issues Location:
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  10. Article ; Online: Impaired retinal micro-vascular function in patients with atrial fibrillation.

    Rossi, Valentina A / Laptseva, Natallia / Nebunu, Delia / Haider, Thomas / Nägele, Matthias P / Ruschitzka, Frank / Sudano, Isabella / Flammer, Andreas J

    International journal of cardiology

    2023  Volume 398, Page(s) 131592

    Abstract: Background: Cardiovascular (CV) risk factors and CV diseases, in particular heart failure, are strongly associated with impaired microvascular retinal endothelial function. Whether atrial fibrillation (AF) contributes to vascular dysfunction is not ... ...

    Abstract Background: Cardiovascular (CV) risk factors and CV diseases, in particular heart failure, are strongly associated with impaired microvascular retinal endothelial function. Whether atrial fibrillation (AF) contributes to vascular dysfunction is not clear. Therefore, the aim of this study was to investigate the impact of AF on retinal microvascular function.
    Methods: In this study, vascular function was measured non-invasively with flicker-light induced vasodilatation of retinal arterioles (FIDart%). Patients with a history of AF and risk factors for heart failure (HF) or heart failure (n = 69; age 67.9 ± 9.2 years, 71% male, 35% HFrEF, 56% paroxysmal, 25% persistent, 19% permanent AF), as well as age, sex and ejection fraction matched patients with absent history of AF (n = 66; age 63.4 ± 10.6 years, 67% male, 47% HFrEF) were included. Patients with AF were further divided into those with paroxysmal AF (in sinus rhythm - AF
    Results: Retinal microvascular function was impaired in patients with AF compared to patients without AF (FIDart% 1.1% [0.3-2.8] vs. 2.7% [1.3-5.1], p < 0.001). Patients currently in AF have poorer retinal microvascular function (FIDart% 0.8% [0.1-1.9) compared to patients with a history of AF but currently in SR at the time of retinal function measurement (1.5% [0.6-4.9] p = 0.017). In patients with AF, impaired retinal vascular function was independently associated with larger left atrial volume (mean 49.8 ± 18.4), even after correction for confounding factors in different models (SCR = -0. 251 to -0.256, p = 0.035-0.01).
    Conclusions: AF in patients with heart failure is associated with impaired vascular function, even if currently in sinus rhythm. The association of retinal microvascular dysfunction with left atrial volume, a surrogate for elevated cardiac filling pressures, may further highlight the important interplay between the vasculature and elevated filling pressures in the development of AF.
    MeSH term(s) Humans ; Male ; Middle Aged ; Aged ; Aged, 80 and over ; Female ; Atrial Fibrillation/diagnostic imaging ; Atrial Fibrillation/epidemiology ; Heart Failure ; Stroke Volume ; Heart Atria ; Risk Factors
    Language English
    Publishing date 2023-11-17
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 779519-1
    ISSN 1874-1754 ; 0167-5273
    ISSN (online) 1874-1754
    ISSN 0167-5273
    DOI 10.1016/j.ijcard.2023.131592
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