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World’s Largest Study Confirms Treatment Success in Minimally Invasive Mitral Valve Surgery

Despite rapidly increasing intervention rates, the complication rate remains consistently low

Scientists at the Center for Cardiology of the Mainz University Medical Center have examined the success of more than 13,575 minimally invasive procedures on the mitral valve in the largest study of their kind to date. Key findings: Although patients grew older during the period from 2011 to 2015 and the number of procedures increased from year to year, mortality and complication rates remained consistently low.

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University Medical Center Mainz is implanting the first motor-controlled heart valves in Europe

Innovative new treatment option for narrowed aortic valves is first used in Mainz

Cardiological patients of the University Medical Center Mainz have recently been able to benefit from a new treatment option for a narrowed aortic valve. Since the beginning of January, cardiologists have implanted a new motor-driven and self-expanding heart valve in three patients across Europe for the first time. The advantage: the flap can be implanted more easily and safely, and leakages after implantation are further minimized.

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Late episodes of childhood cancer: long-term survivors have increased risk of cardiovascular disease

First long-term study results presented: publication in the European Heart Journal

People who have been diagnosed with cancer as a child or adolescent have an increased risk of developing high blood pressure and fat metabolism disorder as adults. In addition, they have an almost double increase in risk for cardiovascular diseases. This is the result of the first long-term study, which systematically investigated the health and especially the long-term cardiovascular consequences of cancer in childhood and adolescence and compared it with the German general population. The results of the Mainz CVSS study were published today in the prestigious European Heart Journal.

On average, hypertension and fat metabolism disorders occurred more frequently and earlier (6 and 8 years) than in the general population. Cardiovascular diseases showed up at 4.5 percent of long-term survivors – most of them already at the age of 40. This is almost eight years earlier than in the rest of the population. In order to reach these results, scientists of the University of Medicine Mainz studied in the framework of the CVSS study ("Cardiac and vascular late sequelae in long-term survivors of childhood cancer") between October 2013 and February 2016 a total of 951 adults who Were diagnosed with cancer as a child or teenager. They conducted clinical investigations, collected information about the then cancer therapy, and asked the subjects whether they smoked and whether there were cardiovascular diseases in the family. The study participants were between 23 and 48 years old at the time of the examination. Their findings were compared with those of 15,000 people from the rest of the population.

Univ.-Prof. Dr. Jörg Faber, head of the Pediatric Oncology Center in the University Center for Tumor Diseases (UCT Mainz), one of three study leaders and first author of the present publication, underlines: "Our results show that earlier Cancer patients have a substantially higher risk of developing classical risk factors for cardiovascular diseases such as hypertension and fat metabolism disorders at a relatively early age, i.e. in young adulthood. " Univ.-Prof. Dr. Philipp Wild, head of the Department of Preventive Cardiology and medical prevention, also CVSS-head of studies and senior author of the work adds: "In addition, with nearly 80 percent of the affected – 207 out of 269 – increased fat levels are only The clinical examinations associated with the study and which had previously been unrecognized. " A similar picture has arisen in hypertension.

On the basis of the lessons learned, it is now necessary to avoid these late consequences as far as possible. "And that is possible," Professor Faber is convinced: "Early screening, which in particular focuses on high blood pressure and increased fat levels, should become an integral part of a structured cancer aftercare – regardless of the cancer ." The fact that a hypertension develops a cardiovascular disease could be prevented at an early stage, for example, by changing lifestyles or using blood pressure medications. The previous aftercare is only for five to ten years – and is mainly aimed at avoiding the recurrence of cancer. In addition, current guidelines recommend regular cardiovascular examinations only for very specific tumor types. "In order to develop an optimal aftercare strategy, however, further studies are needed", emphasizes Univ.-Prof. Dr. Maria Blettner, director of the Institute for Medical Biometrics, Epidemiology and Informatics (IMBEI), also head of the CVSS study and author of this work.

The researchers now want to take a closer look at the precise mechanisms by which former cancer patients develop cardiovascular symptoms. It is known, for example, that chemotherapy or irradiation in the context of a cancer treatment can damage heart cells as well as blood vessels temporarily or even permanently. The assumption is that certain genetic factors also play a role here. The authors of the study said that "this should be further elucidated by means of detailed further investigations at the molecular level."

 

Original Paper

Burden of cardiovascular risk factors and cardiovascular disease in childhood cancer survivors: data from the German CVSS-study

J. Faber, A. Wingerter, M.A.Neu, N. Henninger, S. Eckerle, T.Münzel,K.J. Lackner, M.E. Beutel, M. Blettner,W. Rathmann, A. Peters, C. Meisinger, B. Linkohr, H. Neuhauser, P. Kaatsch, C. Spix, A. Schneider, H. Merzenich, M. Panova-Noeva, J.H. Prochaska and P.S. Wild

European Heart Journal, ehy026

doi.org/10.1093/eurheartj/ehy026

 

 

 

Press Release Public Relations University Medical Center Mainz

 

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Breakthrough in noise research

New study of cardiology of Mainz University identifies mechanisms responsible for vessel damage resulting from aircraft noise

(Mainz, 17 February 2017, ok) Aircraft noise has been shown to be associated with cardiovascular disease and is considered as a novel vascular risk factor. In 2013, the research team of Professor Thomas Münzel has succeeded in proving that simulated night-flying noise increases the stress hormone adrenaline, reduces sleep quality and triggers a vascular damage called endothelial dysfunction. However, the molecular mechanisms of this vascular damage have not been established so far. In a newly developed animal model, the scientists have now been able to detect that aircraft noise leads to a significant increase in stress hormones, vascular dysfunction, increased oxidative stress and a marked change in the expression of genes within the vessel wall. They also decoded the enzymes responsible for vascular damage. The results of this study enable us for the first time to develop specific strategies, which may mitigate the negative consequences for the vasculature caused by noise. The study, published in the European Heart Journal, the most prestigious cardiological journal in Europe, describe the scientists as a breakthrough in (aircraft) noise research. The results were presented today at the University of Mainz.

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Treatment of Thrombosis: Therapeutic benefit of T-Cells

University Medical Center Mainz has achieved new findings about the role of memory cells of the immune defence at dissolving blood clots.

Scientists of the Center for Thrombosis and Hemostasis (CTH), the dermatology clinic and the immunology of the University Medical Center Mainz have achieved new findings about the mechanisms of dissolving blood clots (Thrombus). They were able to Show for the first time, that the Effector-Memory-T-Cells, a specialized subgroup of the so called adaptive immune cells, invade into blood clots and cause inflammations. As a result the resolution of the blood clot delays.
The research findings could lead to an improved therapy of the disrupted cardiovascular system.
The research findings were published in the paper “Innate Effector-Memory T-Cell Activation Regulates Post-Thrombotic Vein Wall Inflammation and Thrombus Resolution” in the renowned Journal „Circulation Research“.

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The Retina of the eye as an indicator of cardio vascular diseases

Promotional Prize of the Hermann-Wacker-Fonds awarded to Dr. Alexander Karl-Georg Schuster

How far can the vascular structure provide Information about the individual risk of cardio vascular diseases? That`s the central question of Dr. Schusters promotional work, for which he was awarded with the Promotional Prize of the Hermann-Wacker-Fonds.  Dr. Schuster was able to show in this work, that it is to be asumed that there is a connection between the vascular structure of the retina and cardio vascular risk factors like high blood pressure or cardiac insufficiency.
The Promotional Prize of the Hermann-Wacker-Fonds includes prize money of €1,000.

Read more...

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Paper of the Month – Oktober 2016

The CTVB Paper of the Month rewards one recent scientific paper of members of the institutions of the research center.

In Oktober  2016 the publication "The role of perivascular adipose tissue in obesity-induced vascular dysfunction" was elected as the Paper of the Month.

 

The perivascular adipose tissue (PVAT) is the tissue surrounding the blood vessels. Long time it was seen as a mechanical  "cushion" for the vessels. It is now known that the PVAT secretes a range of substances, which regulates the vascular function. The PVAT appears to play a very important role in connection with obesity.

Now research results from the research group headed by Professor Li show, that a vessel dysfunction of adipose mice only is verifiable, if the PVAT is intact. When it gets removed, the vascular function remains absolutely normal. This observation points to the fact that the causes of an vessel dysfunction induced by abnormally overweight (adipositas) are located in the vascular wall itself. To explain this phenomenon, it was now possible to show on molecular level, that an enzyme (the NO synthase) in the PVAT of adipose mice was defective; but in the vascular wall it shows an absolute normal activity.
The Enzyme eNOS is known for ist  protective role in the vascular endothelium. Here the produced NO protects against Hypertension, Atherosklerose and Thrombosis. Studies of the research group Li now show that the Enzyme eNOS is also of great importance for the PVAT function. If the eNOS-functionality gets improved by pharmacological measures, the vessel function of adipose mice returns to normal. It also works if the body weight and the fat mass of the adipose mice remain unchanged.

These data suggest that vascular damage under adipose conditions are not per se caused by body weight or fat mass, but arises from a PVAT dysfunction. So the PVAT could be a new therapeutic aim for prevention and therapy of adipositas caused vessel damages.

 

The role of perivascular adipose tissue in obesity-induced vascular dysfunction

British Journal of Pharmacology
doi: 10.1111/bph.13650

Xia N., Li H.

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How alcohol abuse causes damage to the heart

Cardiologists of the University Medical Center Mainz published research findings in  the trade Journal Scientific Reports

Weak hearts are no longer able to sufficiently supply the organism with blood. Approximately 1.8 Million affected People live in Germany. Heart failure caused by alcohol abuse is responsible for more than one fifth of the heart muscle diseases (myocardial diseases) not caused by a circulatory disorder.
A Research Group of the Center of Cardiology at the University Medical Center Mainz now successfully described how Ethanol supports the production of Oxygen radicals with devasting consequences.
These Oxygen radicals again disturb the function of the mitochondria, the power plants of the cell. Heart muscle cells get destroyed and an irreparable heart muscle damage arises.
These findings were published in the renowned Journal Scientific Research, which is published by the Nature Publishing Group.

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Paper of the Month – September 2016

The CTVB Paper of the Month rewards one recent scientific paper of members of the institutions of the research center.

In September 2016 the publication "NOX2 amplifies acetaldehyde-mediated cardiomyocyte mitochondrial dysfunction in alcoholic cardiomyopathy" was elected as the Paper of the Month.

Cardiac insufficiency - commonly heart failure - is the inability of the heart to adequate supply blood to the body. Affected persons perceive this as breathlessness, weariness or water aggregations in the legs. Cardiac insuffieciency is one of the most serious diseases of our time. Approximately 1.8 Million affected People live in Germany. Heart failure caused by alcohol abuse is responsible for more than one fifth of the heart muscle diseases (myocardial diseases) not caused by a circulatory disorder. In case of an alcoholic cardiomyopathy, the regular consumption of alcohol results in an injury of the heart muscle and finally in cardiac insufficiency. Although it was assumed that metabolic products of the potable alcohol Ethanol plays an important role in the development of alcoholic cardiomyopathy, the exact development was unexplained until last.

Scientists of the Research Group around Prof. Wenzel (Center of Cardiology) of the University Medical Center Mainz now successfully described this mechanism for the first time: In the heart muscle cells Ethanol leads with its Degradation product Acetaldehyd via activation of an particular Enzyme (NADPH-Oxidase, NOX2) to an increasing production of Oxygen radicals. These Oxygen radicals again disturb the function of the mitochondria, the power plants of the cell. The lack of chemical energy affect the heart muscle cells ability of contraction. In Addition the cells get destroyed and replaced by scar tissue. An irreparable heart muscle damage and therefore a chronic heart insufficiency arises.

NOX2 amplifies acetaldehyde-mediated cardiomyocyte mitochondrial dysfunction in alcoholic cardiomyopathy

Scientific Reports
DOI: 10.1038/srep32554

Brandt M, Garlapati V, Oelze M, Sotiriou E, Knorr M, Kröller-Schön S, Kossmann S, Schönfelder T, Morawietz H, Schulz E, Schultheiss HP, Daiber A, Münzel T, Wenzel P

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