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Nicolas Verheyen
Division of Cardiology, Department of Internal Medicine Medical University of Graz Auenbruggerplatz 15 Graz A‐8036 Austria

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Case report
Published: 07 May 2021 in ESC Heart Failure
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Amyloid light chain (AL) cardiomyopathy is the most malignant specific cardiomyopathy. According to international recommendations, it should be ruled out non‐invasively using the serum free light chain (FLC) ratio and immunofixation electrophoresis in both serum and urine. Here, we report on a 69‐year‐old female patient with new‐onset heart failure with mid‐range ejection fraction. Cardiac imaging was highly suggestive of cardiac amyloidosis. Amyloid scintigraphy showed faint myocardial tracer uptake according to Perugini Score 1, but immunofixation was negative and the FLC ratio was normal, despite a slight increase in lambda FLCs. Endomyocardial biopsy revealed advanced myocardial lambda immunoglobulin light chain deposition. Clinically relevant extracardiac amyloid organ infiltration could not be detected. Conclusively, non‐invasive testing can in rare cases fail to exclude isolated AL amyloid cardiomyopathy. We suggest that even slight increases in serum lambda or kappa FLCs should be considered abnormal in suspected cardiac amyloidosis if non‐invasive testing delivers discrepant results.

ACS Style

David Zach; Klemens Ablasser; Ewald Kolesnik; Viktoria Hoeller; Friedrich Fruhwald; Florian Prüller; Clemens Reiter; Christine Beham‐Schmid; Rainer Lipp; Peter P. Rainer; Andreas Zirlik; Albert Wölfler; Nicolas Verheyen. Advanced isolated light chain amyloid cardiomyopathy with negative immunofixation and normal free light chain ratio. ESC Heart Failure 2021, 8, 3397 -3402.

AMA Style

David Zach, Klemens Ablasser, Ewald Kolesnik, Viktoria Hoeller, Friedrich Fruhwald, Florian Prüller, Clemens Reiter, Christine Beham‐Schmid, Rainer Lipp, Peter P. Rainer, Andreas Zirlik, Albert Wölfler, Nicolas Verheyen. Advanced isolated light chain amyloid cardiomyopathy with negative immunofixation and normal free light chain ratio. ESC Heart Failure. 2021; 8 (4):3397-3402.

Chicago/Turabian Style

David Zach; Klemens Ablasser; Ewald Kolesnik; Viktoria Hoeller; Friedrich Fruhwald; Florian Prüller; Clemens Reiter; Christine Beham‐Schmid; Rainer Lipp; Peter P. Rainer; Andreas Zirlik; Albert Wölfler; Nicolas Verheyen. 2021. "Advanced isolated light chain amyloid cardiomyopathy with negative immunofixation and normal free light chain ratio." ESC Heart Failure 8, no. 4: 3397-3402.

Journal article
Published: 13 October 2020 in Journal of Clinical Medicine
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Background: Complete real-world data on the indications and outcomes of left atrial appendage closure (LAAC) outside of clinical trials are rare. In this study, we stratified patients undergoing LAAC by indication groups. Methods: This analysis of the national multicentre Austrian LAAC Registry comprised all patients that underwent LAAC up until 2018 at the currently active centres in Austria. The baseline characteristics, procedural details and outcomes between the following indication groups were compared: bleeding as an indication for LAAC (“bleeding” group) vs. thromboembolism despite oral anticoagulation (OAC; “thromboembolism” group) vs. an intolerance to OAC for reasons other than the above (“other” group). Results: The analysis included 186 patients, with 59.7% in the “bleeding” group, 8.1% in the “thromboembolism” group and 32.2% in the “other” group. The CHADS2 score was the highest in the “thromboembolism” group and the HAS-BLED score was the highest in the “bleeding” group. The procedural outcomes were similar between groups (implantation success, 97.3%), with major complications occurring in 7.0% of patients. One-year survival free from stroke, bleeding or LAAC-associated hospitalisation was 83.9%, 90.0% and 81.4% in the “bleeding”, “thromboembolism” and “other” groups, respectively (p = 0.891). Conclusions: In routine clinical practice, LAAC was used in a heterogeneous patient population with atrial fibrillation (AF) and contraindication, inefficacy or intolerance to OAC. The long-term outcome was favourable in all groups.

ACS Style

David Zweiker; Raphael Sieghartsleitner; Lukas Fiedler; Gabor G. Toth; Olev Luha; Guenter Stix; Harald Gabriel; Paul Vock; Brigitte Lileg; Andreas Strouhal; Geort Delle-Karth; Michael Pfeffer; Josef Aichinger; Wolfgang Tkalec; Clemens Steinwender; Kurt Sihorsch; Ronald K. Binder; Martin Rammer; Fabian Barbieri; Silvana Mueller; Nicolas Verheyen; Klemens Ablasser; Andreas Zirlik; Daniel Scherr. Indications and Outcome in Patients Undergoing Left Atrial Appendage Closure—The Austrian LAAC Registry. Journal of Clinical Medicine 2020, 9, 3274 .

AMA Style

David Zweiker, Raphael Sieghartsleitner, Lukas Fiedler, Gabor G. Toth, Olev Luha, Guenter Stix, Harald Gabriel, Paul Vock, Brigitte Lileg, Andreas Strouhal, Geort Delle-Karth, Michael Pfeffer, Josef Aichinger, Wolfgang Tkalec, Clemens Steinwender, Kurt Sihorsch, Ronald K. Binder, Martin Rammer, Fabian Barbieri, Silvana Mueller, Nicolas Verheyen, Klemens Ablasser, Andreas Zirlik, Daniel Scherr. Indications and Outcome in Patients Undergoing Left Atrial Appendage Closure—The Austrian LAAC Registry. Journal of Clinical Medicine. 2020; 9 (10):3274.

Chicago/Turabian Style

David Zweiker; Raphael Sieghartsleitner; Lukas Fiedler; Gabor G. Toth; Olev Luha; Guenter Stix; Harald Gabriel; Paul Vock; Brigitte Lileg; Andreas Strouhal; Geort Delle-Karth; Michael Pfeffer; Josef Aichinger; Wolfgang Tkalec; Clemens Steinwender; Kurt Sihorsch; Ronald K. Binder; Martin Rammer; Fabian Barbieri; Silvana Mueller; Nicolas Verheyen; Klemens Ablasser; Andreas Zirlik; Daniel Scherr. 2020. "Indications and Outcome in Patients Undergoing Left Atrial Appendage Closure—The Austrian LAAC Registry." Journal of Clinical Medicine 9, no. 10: 3274.

Journal article
Published: 10 September 2020 in Kardiologie up2date
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Die linksventrikuläre Non-Compaction-Kardiomyopathie ist eine genetische Erkrankung des Myokards, die durch eine auffällige Hypertrabekularisierung gekennzeichnet ist. Im Einzelfall ist die Abgrenzung zur Hypertrabekularisierung bei anderen Herzerkrankungen schwierig. Dieser Beitrag gibt einen Überblick über die multimodale Diagnostik einschließlich Echokardiografie, kardialer Magnetresonanztomografie sowie Genetik, die zur Diagnosestellung beitragen kann. Publication Date:10 September 2020 (online) © 2020. Thieme. All rights reserved. Georg Thieme Verlag KGStuttgart · New York

ACS Style

Nicolas Verheyen; Herbert Juch; Klemens Ablasser. Linksventrikuläre Non-Compaction-Kardiomyopathie. Kardiologie up2date 2020, 16, 259 -272.

AMA Style

Nicolas Verheyen, Herbert Juch, Klemens Ablasser. Linksventrikuläre Non-Compaction-Kardiomyopathie. Kardiologie up2date. 2020; 16 (03):259-272.

Chicago/Turabian Style

Nicolas Verheyen; Herbert Juch; Klemens Ablasser. 2020. "Linksventrikuläre Non-Compaction-Kardiomyopathie." Kardiologie up2date 16, no. 03: 259-272.

Journal article
Published: 14 July 2020 in Journal of Clinical Medicine
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Background: Hereditary transthyretin amyloidosis (hATTR) is an autosomal dominantly inherited disorder caused by an accumulation of amyloid fibrils in tissues due to mutations in the transthyretin (TTR) gene. The prevalence of hATTR is still unclear and likely underestimated in many countries. In order to apply new therapies in a targeted manner, early diagnosis and knowledge of phenotype-genotype correlations are mandatory. This study aimed to assess the prevalence and phenotypic spectrum of hATTR in Austria. Methods: Within the period of 2014–2019, patients with ATTR-associated cardiomyopathy and/or unexplained progressive polyneuropathies were screened for mutations in the TTR gene. Results: We identified 43 cases from 22 families carrying 10 different TTR missense mutations and confirmed two mutational hot spots at c.323A>G (p.His108Arg) and c.337G>C (p.Val113Leu). Two further patients with late onset ATTR carried TTR variants of unknown significance. The majority of patients initially presented with heart failure symptoms that were subsequently accompanied by progressive polyneuropathy in most cases. A total of 55% had a history of carpal tunnel syndrome before the onset of other organ manifestations. Conclusions: Our study underlined the relevance of hATTR in the pathogenesis of amyloid-driven cardiomyopathy and axonal polyneuropathy and indicated considerable genetic heterogeneity of this disease in the Austrian population. The estimated prevalence of hATTR in Austria based on this study is 1:200,000 but a potentially higher number of unknown cases must be taken into account. With respect to new therapeutic approaches, we strongly propose genetic testing of the TTR gene in an extended cohort of patients with unexplained heart failure and progressive polyneuropathy.

ACS Style

Michaela Auer-Grumbach; Rene Rettl; Klemens Ablasser; Hermine Agis; Christian Beetz; Franz Duca; Martin Gattermeier; Franz Glaser; Markus Hacker; Renate Kain; Birgit Kaufmann; Gabor Kovacs; Christian Lampl; Neira Ljevakovic; Jutta Nagele; Gerhard Pölzl; Stefan Quasthoff; Bernadette Raimann; Helmut Rauschka; Christian Reiter; Volha Skrahina; Othmar Schuhfried; Raute Sunder-Plassmann; Nicolas Verheyen; Julia Wanschitz; Thomas Weber; Reinhard Windhager; Raphael Wurm; Friedrich Zimprich; Wolfgang Löscher; Diana Bonderman. Hereditary ATTR Amyloidosis in Austria: Prevalence and Epidemiological Hot Spots. Journal of Clinical Medicine 2020, 9, 2234 .

AMA Style

Michaela Auer-Grumbach, Rene Rettl, Klemens Ablasser, Hermine Agis, Christian Beetz, Franz Duca, Martin Gattermeier, Franz Glaser, Markus Hacker, Renate Kain, Birgit Kaufmann, Gabor Kovacs, Christian Lampl, Neira Ljevakovic, Jutta Nagele, Gerhard Pölzl, Stefan Quasthoff, Bernadette Raimann, Helmut Rauschka, Christian Reiter, Volha Skrahina, Othmar Schuhfried, Raute Sunder-Plassmann, Nicolas Verheyen, Julia Wanschitz, Thomas Weber, Reinhard Windhager, Raphael Wurm, Friedrich Zimprich, Wolfgang Löscher, Diana Bonderman. Hereditary ATTR Amyloidosis in Austria: Prevalence and Epidemiological Hot Spots. Journal of Clinical Medicine. 2020; 9 (7):2234.

Chicago/Turabian Style

Michaela Auer-Grumbach; Rene Rettl; Klemens Ablasser; Hermine Agis; Christian Beetz; Franz Duca; Martin Gattermeier; Franz Glaser; Markus Hacker; Renate Kain; Birgit Kaufmann; Gabor Kovacs; Christian Lampl; Neira Ljevakovic; Jutta Nagele; Gerhard Pölzl; Stefan Quasthoff; Bernadette Raimann; Helmut Rauschka; Christian Reiter; Volha Skrahina; Othmar Schuhfried; Raute Sunder-Plassmann; Nicolas Verheyen; Julia Wanschitz; Thomas Weber; Reinhard Windhager; Raphael Wurm; Friedrich Zimprich; Wolfgang Löscher; Diana Bonderman. 2020. "Hereditary ATTR Amyloidosis in Austria: Prevalence and Epidemiological Hot Spots." Journal of Clinical Medicine 9, no. 7: 2234.

Randomized controlled trial
Published: 21 October 2019 in Nutrients
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25-hydroxyvitamin D (25(OH)D) is commonly measured to assess vitamin D status. Other vitamin D metabolites such as 24,25-dihydroxyvitamin D (24,25(OH)2D) provide additional insights into vitamin D status or metabolism. Earlier studies suggested that the vitamin D metabolite ratio (VMR), calculated as 24,25(OH)2D/25(OH)D, could predict the 25(OH)D increase after vitamin D supplementation. However, the evidence for this additional value is inconclusive. Therefore, our aim was to assess whether the increase in 25(OH)D after supplementation was predicted by the VMR better than baseline 25(OH)D. Plasma samples of 106 individuals (25(OH)D < 75 nmol/L) with hypertension who completed the Styrian Vitamin D Hypertension Trial (NC.T.02136771) were analyzed. Participants received vitamin D (2800 IU daily) or placebo for 8 weeks. The treatment effect (ANCOVA) for 25(OH)D3, 24,25(OH)2D3 and the VMR was 32 nmol/L, 3.3 nmol/L and 0.015 (all p < 0.001), respectively. Baseline 25(OH)D3 and 24,25(OH)2D3 predicted the change in 25(OH)D3 with comparable strength and magnitude. Correlation and regression analysis showed that the VMR did not predict the change in 25(OH)D3. Therefore, our data do not support routine measurement of 24,25(OH)2D3 in order to individually optimize the dosage of vitamin D supplementation. Our data also suggest that activity of 24-hydroxylase increases after vitamin D supplementation.

ACS Style

Vito Francic; Stan R. Ursem; Niek F. Dirks; Martin H. Keppel; Verena Theiler-Schwetz; Christian Trummer; Marlene Pandis; Valentin Borzan; Martin R. Grübler; Nicolas D. Verheyen; Winfried März; Andreas Tomaschitz; Stefan Pilz; Annemieke C. Heijboer; Barbara Obermayer-Pietsch. The Effect of Vitamin D Supplementation on its Metabolism and the Vitamin D Metabolite Ratio. Nutrients 2019, 11, 2539 .

AMA Style

Vito Francic, Stan R. Ursem, Niek F. Dirks, Martin H. Keppel, Verena Theiler-Schwetz, Christian Trummer, Marlene Pandis, Valentin Borzan, Martin R. Grübler, Nicolas D. Verheyen, Winfried März, Andreas Tomaschitz, Stefan Pilz, Annemieke C. Heijboer, Barbara Obermayer-Pietsch. The Effect of Vitamin D Supplementation on its Metabolism and the Vitamin D Metabolite Ratio. Nutrients. 2019; 11 (10):2539.

Chicago/Turabian Style

Vito Francic; Stan R. Ursem; Niek F. Dirks; Martin H. Keppel; Verena Theiler-Schwetz; Christian Trummer; Marlene Pandis; Valentin Borzan; Martin R. Grübler; Nicolas D. Verheyen; Winfried März; Andreas Tomaschitz; Stefan Pilz; Annemieke C. Heijboer; Barbara Obermayer-Pietsch. 2019. "The Effect of Vitamin D Supplementation on its Metabolism and the Vitamin D Metabolite Ratio." Nutrients 11, no. 10: 2539.

Review
Published: 26 August 2019 in Current Medicinal Chemistry
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Deposition of amyloidogenic proteins leading to the formation of amyloid fibrils in the myocardium causes cardiac amyloidosis. Although any form of systemic amyloidosis can affect the heart, light-chain (AL) or transthyretin amyloidosis (ATTR) account for the majority of diagnosed cardiac amyloid deposition. The extent of cardiac disease independently predicts mortality. Thus, the reversal of arrest of adverse cardiac remodeling is the target of current therapies. Here, we provide a condensed overview on the pathophysiology of AL and ATTR cardiac amyloidoses and describe treatments that are currently used or investigated in clinical or preclinical trials. We also briefly discuss acquired amyloid deposition in cardiovascular disease other than AL or ATTR.

ACS Style

Klemens Ablasser; Nicolas Verheyen; Theresa Glantschnig; Giulio Agnetti; Peter P Rainer. Unfolding Cardiac Amyloidosis –From Pathophysiology to Cure. Current Medicinal Chemistry 2019, 26, 2865 -2878.

AMA Style

Klemens Ablasser, Nicolas Verheyen, Theresa Glantschnig, Giulio Agnetti, Peter P Rainer. Unfolding Cardiac Amyloidosis –From Pathophysiology to Cure. Current Medicinal Chemistry. 2019; 26 (16):2865-2878.

Chicago/Turabian Style

Klemens Ablasser; Nicolas Verheyen; Theresa Glantschnig; Giulio Agnetti; Peter P Rainer. 2019. "Unfolding Cardiac Amyloidosis –From Pathophysiology to Cure." Current Medicinal Chemistry 26, no. 16: 2865-2878.

Clinical trial
Published: 27 June 2019 in Cardiology Journal
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Background: Devices currently used to achieve hemostasis of the femoral artery following percutaneous cardiac catheterization are associated with vascular complications and remnants of artificial materials are retained at the puncture site. The SECURE arterial closure device induces hemostasis by utilizing thermal energy, which causes collagen shrinking and swelling. In comparison to established devices, it has the advantage of leaving no foreign material in the body following closing. This study was designed to evaluate the efficacy and safety of the SECURE device to close the puncture site following percutaneous cardiac catheterization. Methods: The SECURE device was evaluated in a prospective non-randomized single-centre trial with patients undergoing 6 F invasive cardiac procedures. A total of 67 patients were enrolled and the device was utilized in 63 patients. 50 diagnostic and 13 interventional cases were evaluated. Femoral artery puncture closure was performed immediately after completion of the procedure. Time to hemostasis (TTH), time to ambulation (TTA) and data regarding short-term and 30-day clinical follow-up were recorded. Results: Mean TTH was 4:30 ± 2:15 min in the overall observational group. A subpopulation of patients receiving anticoagulants had a TTH of 4:53 ± 1:43 min. There were two access site complications (hematoma > 5 cm). No major adverse events were identified during hospitalization or at the 30 day follow-up. Conclusions: The new SECURE device demonstrates that it is feasible in diagnostic and interventional cardiac catheterization. With respect to safety, the SECURE device was non-inferior to other closure devices as tested in the ISAR closure trial.

ACS Style

Michael Sacherer; Ewald Kolesnik; Friederike Von Lewinski; Nicolas Verheyen; Karin Brandner; Markus Wallner; Deborah M. Eaton; Olev Luha; Robert Zweiker; Dirk Von Lewinski. Thermic sealing in femoral catheterization: First experience with the Secure Device. Cardiology Journal 2019, 26, 233 -240.

AMA Style

Michael Sacherer, Ewald Kolesnik, Friederike Von Lewinski, Nicolas Verheyen, Karin Brandner, Markus Wallner, Deborah M. Eaton, Olev Luha, Robert Zweiker, Dirk Von Lewinski. Thermic sealing in femoral catheterization: First experience with the Secure Device. Cardiology Journal. 2019; 26 (3):233-240.

Chicago/Turabian Style

Michael Sacherer; Ewald Kolesnik; Friederike Von Lewinski; Nicolas Verheyen; Karin Brandner; Markus Wallner; Deborah M. Eaton; Olev Luha; Robert Zweiker; Dirk Von Lewinski. 2019. "Thermic sealing in femoral catheterization: First experience with the Secure Device." Cardiology Journal 26, no. 3: 233-240.

Journal article
Published: 08 May 2018 in Endocrine Abstracts
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ACS Style

Vito Francic; Martin Gaksch; Verena Schwetz; Christian Trummer; Marlene Pandis; Felix Aberer; Martin Grübler; Nicolas D Verheyen; Winfried März; Thomas R Pieber; Andreas Tomaschitz; Stefan Pilz; Barbara Obermayer-Pietsch. Soluble ST2, a promising cardiovascular biomarker, is associated with parameters of glucose and bone metabolism in subjects at cardiovascular risk. Endocrine Abstracts 2018, 1 .

AMA Style

Vito Francic, Martin Gaksch, Verena Schwetz, Christian Trummer, Marlene Pandis, Felix Aberer, Martin Grübler, Nicolas D Verheyen, Winfried März, Thomas R Pieber, Andreas Tomaschitz, Stefan Pilz, Barbara Obermayer-Pietsch. Soluble ST2, a promising cardiovascular biomarker, is associated with parameters of glucose and bone metabolism in subjects at cardiovascular risk. Endocrine Abstracts. 2018; ():1.

Chicago/Turabian Style

Vito Francic; Martin Gaksch; Verena Schwetz; Christian Trummer; Marlene Pandis; Felix Aberer; Martin Grübler; Nicolas D Verheyen; Winfried März; Thomas R Pieber; Andreas Tomaschitz; Stefan Pilz; Barbara Obermayer-Pietsch. 2018. "Soluble ST2, a promising cardiovascular biomarker, is associated with parameters of glucose and bone metabolism in subjects at cardiovascular risk." Endocrine Abstracts , no. : 1.

Endocrine care
Published: 03 May 2018 in Hormone and Metabolic Research
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Current guidelines recommend to withdraw mineralocorticoid receptor (MR) blocker treatment for at least 4 weeks when measuring the aldosterone to renin ratio (ARR) as a screening test for primary aldosteronism (PA). We aimed to evaluate the effect of MR blocker treatment on ARR and its components, plasma aldosterone concentration (PAC), and direct renin concentration (DRC). First, we performed a post-hoc analysis of the effect of eplerenone on parathyroid hormone levels in primary hyperparathyroidism (EPATH) study, a randomized controlled trial (RCT) in 110 patients with primary hyperparathyroidism (pHPT). Patients were 1:1 randomly assigned to receive either 25 mg eplerenone once daily (up-titration after 4 weeks to 50 mg/day) or placebo for 8 weeks. Second, we measured the ARR in 4 PA patients from the Graz Endocrine Causes of Hypertension Study (GECOH) before and after MR blocker treatment. Ninety-seven participants completed the EPATH trial, and the mean treatment effect (95% confidence interval) for log(e)ARR was 0.08 (–0.32 to 0.48) ng/dl/μU/ml (p=0.694). The treatment effect was 0.71 (0.47 to 0.96; p

ACS Style

Stefan Pilz; Christian Trummer; Nicolas Verheyen; Verena Schwetz; Marlene Pandis; Felix Aberer; Martin Grübler; Andreas Meinitzer; Antonia Bachmann; Jakob Voelkl; Ioana Alesutan; Cristiana Catena; Leonardo Sechi; Winfried März; Barbara Obermayer-Pietsch; Andreas Tomaschitz. Mineralocorticoid Receptor Blockers and Aldosterone to Renin Ratio: A Randomized Controlled Trial and Observational Data. Hormone and Metabolic Research 2018, 50, 1 .

AMA Style

Stefan Pilz, Christian Trummer, Nicolas Verheyen, Verena Schwetz, Marlene Pandis, Felix Aberer, Martin Grübler, Andreas Meinitzer, Antonia Bachmann, Jakob Voelkl, Ioana Alesutan, Cristiana Catena, Leonardo Sechi, Winfried März, Barbara Obermayer-Pietsch, Andreas Tomaschitz. Mineralocorticoid Receptor Blockers and Aldosterone to Renin Ratio: A Randomized Controlled Trial and Observational Data. Hormone and Metabolic Research. 2018; 50 (05):1.

Chicago/Turabian Style

Stefan Pilz; Christian Trummer; Nicolas Verheyen; Verena Schwetz; Marlene Pandis; Felix Aberer; Martin Grübler; Andreas Meinitzer; Antonia Bachmann; Jakob Voelkl; Ioana Alesutan; Cristiana Catena; Leonardo Sechi; Winfried März; Barbara Obermayer-Pietsch; Andreas Tomaschitz. 2018. "Mineralocorticoid Receptor Blockers and Aldosterone to Renin Ratio: A Randomized Controlled Trial and Observational Data." Hormone and Metabolic Research 50, no. 05: 1.

Article
Published: 18 April 2018 in International Journal of Peptide Research and Therapeutics
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Glucagon-like peptide 1 (GLP-1) receptor agonists increase the intracellular calcium levels of atrial cardiomyocytes in a protein kinase A dependent manner. This elicits a positive inotropic effect. Furthermore, the translocation of GLUT1 is promoted. The relevance of the latter process is unclear, therefore we assessed the influence of energy substrates. Muscle strips (trabeculae; n = 86) were isolated from human right atrial appendages obtained from patients undergoing heart surgery (n = 34), mounted on hooks, electrically stimulated (1 Hz) and treated with a single dose of exenatide (15 nM), GLP-1(7–36) amide (180 nM), GLP-1(9–36) amide (200 nM), isoproterenol (100 nM), or increasing concentrations of calcium (4.0 and 7.2 mM). Either 11.2 mM glucose or 22.4 mM pyruvate served as the energy substrate. Developed force, diastolic tension and relaxation parameters were recorded and analyzed. Administration of exenatide and GLP-1(7–36) amide, but not GLP-1(9–36) amide, led to a transient positive inotropic effect in the presence of pyruvate and glucose. This effect tended to be more pronounced in glucose-treated muscle strips at maximal developed force and steady state conditions. Both isoproterenol and calcium exerted a strong positive inotropic effect with no difference regarding the energy substrate. In conclusion, the positive inotropic effect of GLP-1 receptor agonists is more pronounced in glucose enriched Tyrode’s solution, which might be linked to the previously reported translocation of GLUT1.

ACS Style

Ewald Kolesnik; Thomas Krainer; Markus Wallner; Natasa Djalinac; Nicolas Verheyen; Klemens Ablasser; Deborah M. Eaton; Peter P. Rainer; Brigitte Pelzmann; Dirk Von Lewinski. Myocardial GLP-1 Receptor Activation in the Presence of Glucose: Strong Partners. International Journal of Peptide Research and Therapeutics 2018, 25, 605 -612.

AMA Style

Ewald Kolesnik, Thomas Krainer, Markus Wallner, Natasa Djalinac, Nicolas Verheyen, Klemens Ablasser, Deborah M. Eaton, Peter P. Rainer, Brigitte Pelzmann, Dirk Von Lewinski. Myocardial GLP-1 Receptor Activation in the Presence of Glucose: Strong Partners. International Journal of Peptide Research and Therapeutics. 2018; 25 (2):605-612.

Chicago/Turabian Style

Ewald Kolesnik; Thomas Krainer; Markus Wallner; Natasa Djalinac; Nicolas Verheyen; Klemens Ablasser; Deborah M. Eaton; Peter P. Rainer; Brigitte Pelzmann; Dirk Von Lewinski. 2018. "Myocardial GLP-1 Receptor Activation in the Presence of Glucose: Strong Partners." International Journal of Peptide Research and Therapeutics 25, no. 2: 605-612.

Journal article
Published: 13 April 2018 in Journal of the American Society of Nephrology
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Background The high cardiovascular morbidity and mortality of patients with CKD may result in large part from medial vascular calcification, a process promoted by hyperphosphatemia and involving osteo-/chondrogenic transdifferentiation of vascular smooth muscle cells (VSMCs). Reduced serum zinc levels have frequently been observed in patients with CKD, but the functional relevance of this remains unclear.

ACS Style

Jakob Voelkl; Rashad Tuffaha; Trang T.D. Luong; Daniel Zickler; Jaber Masyout; Martina Feger; Nicolas Verheyen; Florian Blaschke; Makoto Kuro-O; Andreas Tomaschitz; Stefan Pilz; Andreas Pasch; Kai-Uwe Eckardt; Juergen E. Scherberich; Florian Lang; Burkert Pieske; Ioana Alesutan. Zinc Inhibits Phosphate-Induced Vascular Calcification through TNFAIP3-Mediated Suppression of NF-κB. Journal of the American Society of Nephrology 2018, 29, 1636 -1648.

AMA Style

Jakob Voelkl, Rashad Tuffaha, Trang T.D. Luong, Daniel Zickler, Jaber Masyout, Martina Feger, Nicolas Verheyen, Florian Blaschke, Makoto Kuro-O, Andreas Tomaschitz, Stefan Pilz, Andreas Pasch, Kai-Uwe Eckardt, Juergen E. Scherberich, Florian Lang, Burkert Pieske, Ioana Alesutan. Zinc Inhibits Phosphate-Induced Vascular Calcification through TNFAIP3-Mediated Suppression of NF-κB. Journal of the American Society of Nephrology. 2018; 29 (6):1636-1648.

Chicago/Turabian Style

Jakob Voelkl; Rashad Tuffaha; Trang T.D. Luong; Daniel Zickler; Jaber Masyout; Martina Feger; Nicolas Verheyen; Florian Blaschke; Makoto Kuro-O; Andreas Tomaschitz; Stefan Pilz; Andreas Pasch; Kai-Uwe Eckardt; Juergen E. Scherberich; Florian Lang; Burkert Pieske; Ioana Alesutan. 2018. "Zinc Inhibits Phosphate-Induced Vascular Calcification through TNFAIP3-Mediated Suppression of NF-κB." Journal of the American Society of Nephrology 29, no. 6: 1636-1648.

Editorial
Published: 21 February 2018 in International Journal of Endocrinology
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ACS Style

Nicolas Verheyen; Martin R. Grübler; Cristiana Catena; Astrid Fahrleitner-Pammer; Adriana J. Van Ballegooijen. The Bone-Cardiovascular Axis: Mechanisms and Clinical Relevance. International Journal of Endocrinology 2018, 2018, 1 -2.

AMA Style

Nicolas Verheyen, Martin R. Grübler, Cristiana Catena, Astrid Fahrleitner-Pammer, Adriana J. Van Ballegooijen. The Bone-Cardiovascular Axis: Mechanisms and Clinical Relevance. International Journal of Endocrinology. 2018; 2018 ():1-2.

Chicago/Turabian Style

Nicolas Verheyen; Martin R. Grübler; Cristiana Catena; Astrid Fahrleitner-Pammer; Adriana J. Van Ballegooijen. 2018. "The Bone-Cardiovascular Axis: Mechanisms and Clinical Relevance." International Journal of Endocrinology 2018, no. : 1-2.

Review
Published: 20 January 2018 in Anticancer Research
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Vitamin D is of public health interest because its deficiency is common and is associated with musculoskeletal diseases, as well as extraskeletal diseases, such as cancer, cardiovascular diseases, and infections. Several health authorities have reviewed the existing literature and published nutritional vitamin D guidelines for the general population. There was a wide consensus that serum 25-hydroxyvitamin D [25(OH)D] concentration should be used to assess vitamin D status and intake, and that musculoskeletal, and not extraskeletal, effects of vitamin D should be the basis for nutritional vitamin D guidelines. Recommended target levels for 25(OH)D range from 25 to 50 nmol/l (10 to 20 ng/ml), corresponding to a vitamin D intake of 400 to 800 International Units (10 to 20 μg) per day. It is of concern that significant sections of the general population do not meet these recommended vitamin D levels. This definitely requires action from a public health perspective.

ACS Style

Stefan Pilz; Christian Trummer; Marlene Pandis; Verena Schwetz; Felix Aberer; Martin Grübler; Nicolas Verheyen; Andreas Tomaschitz; Winfried März. Vitamin D: Current Guidelines and Future Outlook. Anticancer Research 2018, 38, 1145 -1151.

AMA Style

Stefan Pilz, Christian Trummer, Marlene Pandis, Verena Schwetz, Felix Aberer, Martin Grübler, Nicolas Verheyen, Andreas Tomaschitz, Winfried März. Vitamin D: Current Guidelines and Future Outlook. Anticancer Research. 2018; 38 (2):1145-1151.

Chicago/Turabian Style

Stefan Pilz; Christian Trummer; Marlene Pandis; Verena Schwetz; Felix Aberer; Martin Grübler; Nicolas Verheyen; Andreas Tomaschitz; Winfried März. 2018. "Vitamin D: Current Guidelines and Future Outlook." Anticancer Research 38, no. 2: 1145-1151.

Randomized controlled trial
Published: 01 December 2017 in Bone
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Mineralocorticoid receptor (MR) antagonism may affect bone turnover via direct and indirect pathways involving parathyroid hormone, but randomized controlled trials are lacking. In a pre-specified analysis of the "Eplerenone in primary hyperparathyroidism" placebo-controlled, randomized trial (ISRCTN 33941607), effects of eight weeks MR-blockade with eplerenone on bone turnover markers in 97 patients with primary hyperparathyroidism were tested. Mean age was 67.5±9.5years, and 76 (78.4%) were females. In analysis of covariance with adjustment for baseline values, eplerenone had no significant effect on isoform 5b of the tartrate-resistant acid phosphatase (TRAP), beta-crosslaps, N-terminal propeptide of procollagen type 1 (P1NP), osteocalcin and bone-specific alkaline phosphatase. There was no significant cross-sectional correlation between plasma aldosterone concentration or the aldosterone-to-renin ratio and markers of bone turnover in multivariate linear regression models at baseline. These data provide first evidence from a randomized and placebo-controlled trial that short-term MR antagonism may not affect bone turnover, at least in patients with primary hyperparathyroidism.

ACS Style

Nicolas Verheyen; Martin R. Grübler; Andreas Meinitzer; Christian Trummer; Verena Schwetz; Karin Amrein; Hans P. Dimai; Winfried März; Cristiana Catena; Dirk Von Lewinski; Jakob Voelkl; Ioana Alesutan; Astrid Fahrleitner-Pammer; Helmut Brussee; Stefan Pilz; Andreas Tomaschitz. Effect of eplerenone on markers of bone turnover in patients with primary hyperparathyroidism – The randomized, placebo-controlled EPATH trial. Bone 2017, 105, 212 -217.

AMA Style

Nicolas Verheyen, Martin R. Grübler, Andreas Meinitzer, Christian Trummer, Verena Schwetz, Karin Amrein, Hans P. Dimai, Winfried März, Cristiana Catena, Dirk Von Lewinski, Jakob Voelkl, Ioana Alesutan, Astrid Fahrleitner-Pammer, Helmut Brussee, Stefan Pilz, Andreas Tomaschitz. Effect of eplerenone on markers of bone turnover in patients with primary hyperparathyroidism – The randomized, placebo-controlled EPATH trial. Bone. 2017; 105 ():212-217.

Chicago/Turabian Style

Nicolas Verheyen; Martin R. Grübler; Andreas Meinitzer; Christian Trummer; Verena Schwetz; Karin Amrein; Hans P. Dimai; Winfried März; Cristiana Catena; Dirk Von Lewinski; Jakob Voelkl; Ioana Alesutan; Astrid Fahrleitner-Pammer; Helmut Brussee; Stefan Pilz; Andreas Tomaschitz. 2017. "Effect of eplerenone on markers of bone turnover in patients with primary hyperparathyroidism – The randomized, placebo-controlled EPATH trial." Bone 105, no. : 212-217.

Observational study
Published: 21 November 2017 in Kidney and Blood Pressure Research
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Atherosclerotic renal artery stenosis (ARAS) is frequently detected in patients with resistant hypertension (RHTN), but the evidence supporting the utility of renal revascularization in these patients is limited. This prospective, observational study investigates the outcomes of renal stenting in patients with RHTN and hemodynamically significant ARAS.Fifty-four patients with RHTN were selected because of angiographic evidence of ARAS >70% and were followed for 4 years after renal stenting. Renal function and echocardiographic variables were assessed at baseline and during follow-up.Blood pressure decreased rapidly after renal stenting and was normalized in 67% of patients at six months, with significant reduction in the number of antihypertensive drugs. Creatinine clearance increased in 39% of patients, decreased in 52%, and remained stable in the remaining 9%, with an average value that had a nonsignificant decrease during follow-up. Urinary albumin excretion did not change throughout the study. After 4 years, left ventricular (LV) wall thickness and concentric geometry decreased significantly and variables of LV diastolic function improved.In patients with RHTN, stenting of hemodynamically significant ARAS decreases blood pressure, preserves renal function in a substantial proportion of patients, and improves LV structure and function, suggesting the opportunity for timely identification of ARAS in these patients.

ACS Style

Cristiana Catena; Gianluca Colussi; Gabriele Brosolo; Nicolas Verheyen; Marileda Novello; Nicole Bertin; Alessandro Cavarape; Leonardo A. Sechi. Long-Term Renal and Cardiac Outcomes after Stenting in Patients with Resistant Hypertension and Atherosclerotic Renal Artery Stenosis. Kidney and Blood Pressure Research 2017, 42, 774 -783.

AMA Style

Cristiana Catena, Gianluca Colussi, Gabriele Brosolo, Nicolas Verheyen, Marileda Novello, Nicole Bertin, Alessandro Cavarape, Leonardo A. Sechi. Long-Term Renal and Cardiac Outcomes after Stenting in Patients with Resistant Hypertension and Atherosclerotic Renal Artery Stenosis. Kidney and Blood Pressure Research. 2017; 42 (5):774-783.

Chicago/Turabian Style

Cristiana Catena; Gianluca Colussi; Gabriele Brosolo; Nicolas Verheyen; Marileda Novello; Nicole Bertin; Alessandro Cavarape; Leonardo A. Sechi. 2017. "Long-Term Renal and Cardiac Outcomes after Stenting in Patients with Resistant Hypertension and Atherosclerotic Renal Artery Stenosis." Kidney and Blood Pressure Research 42, no. 5: 774-783.

Journal article
Published: 20 August 2017 in The Journal of Clinical Hypertension
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Patients with primary hyperparathyroidism are at increased risk for high blood pressure, vascular stiffening, and left ventricular hypertrophy, but previous studies have failed to demonstrate the direct associations with circulating parathyroid hormone (PTH) levels. The authors investigated cross-sectional relationships between PTH and 24-hour pulse wave velocity, nocturnal systolic blood pressure, and left ventricular mass index in patients with primary hyperparathyroidism who were treatment-naive with cinacalcet, renin-angiotensin-aldosterone-system inhibitors, and thiazide or loop diuretics. In 76 patients, mean±SD of pulse wave velocity, nocturnal systolic blood pressure, and left ventricular mass index values were 9.3±1.8 m/s, 116.6±17.0 mm Hg, and 92.8±23.0 g/m². In multivariate linear regression analyses with adjustment for potentially confounding parameters, PTH was independently associated with nocturnal systolic blood pressure (adjusted ß coefficient=.284, P=.040), mean 24-hour pulse wave velocity (ß=.199, P=.001), and left ventricular mass index (ß=.252, P=.025). PTH may promote vascular and cardiac remodeling in primary hyperparathyroidism. Interventional trials are needed to test the antihypertensive and cardioprotective effects of PTH-inhibitory treatment strategies.

ACS Style

Julia Wetzel; Stefan Pilz; Martin R. Grübler; Astrid Fahrleitner-Pammer; Hans P. Dimai; Dirk Von Lewinski; Ewald Kolesnik; Sabine Perl; Christian Trummer; Verena Schwetz; Andreas Meinitzer; Evgeny Belyavskiy; Jakob Völkl; Cristiana Catena; Vincent Brandenburg; Winfried März; Burkert Pieske; Helmut Brussee; Andreas Tomaschitz; Nicolas D. Verheyen. Plasma parathyroid hormone and cardiovascular disease in treatment-naive patients with primary hyperparathyroidism: The EPATH trial. The Journal of Clinical Hypertension 2017, 19, 1173 -1180.

AMA Style

Julia Wetzel, Stefan Pilz, Martin R. Grübler, Astrid Fahrleitner-Pammer, Hans P. Dimai, Dirk Von Lewinski, Ewald Kolesnik, Sabine Perl, Christian Trummer, Verena Schwetz, Andreas Meinitzer, Evgeny Belyavskiy, Jakob Völkl, Cristiana Catena, Vincent Brandenburg, Winfried März, Burkert Pieske, Helmut Brussee, Andreas Tomaschitz, Nicolas D. Verheyen. Plasma parathyroid hormone and cardiovascular disease in treatment-naive patients with primary hyperparathyroidism: The EPATH trial. The Journal of Clinical Hypertension. 2017; 19 (11):1173-1180.

Chicago/Turabian Style

Julia Wetzel; Stefan Pilz; Martin R. Grübler; Astrid Fahrleitner-Pammer; Hans P. Dimai; Dirk Von Lewinski; Ewald Kolesnik; Sabine Perl; Christian Trummer; Verena Schwetz; Andreas Meinitzer; Evgeny Belyavskiy; Jakob Völkl; Cristiana Catena; Vincent Brandenburg; Winfried März; Burkert Pieske; Helmut Brussee; Andreas Tomaschitz; Nicolas D. Verheyen. 2017. "Plasma parathyroid hormone and cardiovascular disease in treatment-naive patients with primary hyperparathyroidism: The EPATH trial." The Journal of Clinical Hypertension 19, no. 11: 1173-1180.

Randomized controlled trial
Published: 17 June 2017 in Nutrients
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Increasing evidence suggests a possible interaction between vitamin D and insulin-like growth factor-1 (IGF-1). We aimed to investigate effects of vitamin D supplementation on IGF-1 (primary outcome) and calcitriol (1,25(OH)2D) concentrations (secondary outcome). This is a post-hoc analysis of the Styrian Vitamin D Hypertension Trial—a single-center, double-blind, randomized, placebo-controlled trial (RCT) conducted from 2011 to 2014 at the Medical University of Graz, Austria. Two-hundred subjects with arterial hypertension and 25(OH)D concentrations <30 ng/mL were randomized to either receive 2800 IU of vitamin D daily or placebo for eight weeks. A total of 175 participants (mean ± standard deviation age, 60 ± 11 years; 49% women) with available IGF-1 concentrations were included in the present analysis. At baseline, IGF-1 concentrations were significantly correlated with 1,25(OH)2D (r = 0.21; p = 0.005) but not with 25(OH)D (r = −0.008; p = 0.91). In the RCT, vitamin D had no significant effect on IGF-1 (mean treatment effect 3.1; 95% confidence interval −5.6 to 11.9 ng/mL; p = 0.48), but it increased 1,25(OH)2D concentrations (mean treatment effect 9.2; 95% confidence interval 4.4 to 13.9 pg/mL; p ≤ 0.001). In this RCT, in hypertensive patients with low 25(OH)D concentrations, there was no significant effect of vitamin D supplementation on IGF-1 concentrations. However, we observed a cross-sectional correlation between 1,25(OH)2D and IGF-1 and an increase of 1,25(OH)2D after vitamin D supplementation.

ACS Style

Christian Trummer; Verena Schwetz; Marlene Pandis; Martin R. Grübler; Nicolas Verheyen; Martin Gaksch; Armin Zittermann; Winfried März; Felix Aberer; Angelika Lang; Claudia Friedl; Andreas Tomaschitz; Barbara Obermayer-Pietsch; Thomas R. Pieber; Stefan Pilz; Gerlies Treiber. Effects of Vitamin D Supplementation on IGF-1 and Calcitriol: A Randomized-Controlled Trial. Nutrients 2017, 9, 623 .

AMA Style

Christian Trummer, Verena Schwetz, Marlene Pandis, Martin R. Grübler, Nicolas Verheyen, Martin Gaksch, Armin Zittermann, Winfried März, Felix Aberer, Angelika Lang, Claudia Friedl, Andreas Tomaschitz, Barbara Obermayer-Pietsch, Thomas R. Pieber, Stefan Pilz, Gerlies Treiber. Effects of Vitamin D Supplementation on IGF-1 and Calcitriol: A Randomized-Controlled Trial. Nutrients. 2017; 9 (6):623.

Chicago/Turabian Style

Christian Trummer; Verena Schwetz; Marlene Pandis; Martin R. Grübler; Nicolas Verheyen; Martin Gaksch; Armin Zittermann; Winfried März; Felix Aberer; Angelika Lang; Claudia Friedl; Andreas Tomaschitz; Barbara Obermayer-Pietsch; Thomas R. Pieber; Stefan Pilz; Gerlies Treiber. 2017. "Effects of Vitamin D Supplementation on IGF-1 and Calcitriol: A Randomized-Controlled Trial." Nutrients 9, no. 6: 623.

Randomized controlled trial
Published: 27 April 2017 in Nutrients
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Bone turnover markers (BTMs) are used to evaluate bone health together with bone mineral density and fracture assessment. Vitamin D supplementation is widely used to prevent and treat musculoskeletal diseases but existing data on vitamin D effects on markers of bone resorption and formation are inconsistent. We therefore examined the effects of vitamin D supplementation on bone-specific alkaline phosphatase (bALP), osteocalcin (OC), C-terminal telopeptide (CTX), and procollagen type 1 N-terminal propeptide (P1NP). This is a post-hoc analysis of the Styrian Vitamin D Hypertension Trial, a single-center, double-blind, randomized, placebo-controlled trial (RCT) performed at the Medical University of Graz, Austria (2011–2014). Two hundred individuals with arterial hypertension and 25-hydroxyvitamin D (25[OH]D) levels <75 nmol/L were randomized to 2800 IU of vitamin D daily or placebo for eight weeks. One hundred ninety-seven participants (60.2 ± 11.1 years; 47% women) were included in this analysis. Vitamin D had no significant effect on bALP (mean treatment effect (MTE) 0.013, 95% CI −0.029 to 0.056 µg/L; p = 0.533), CTX (MTE 0.024, 95% CI −0.163 to 0.210 ng/mL, p = 0.802), OC (MTE 0.020, 95% CI −0.062 to 0.103 ng/mL, p = 0.626), or P1NP (MTE −0.021, 95% CI −0.099 to 0.057 ng/mL, p = 0.597). Analyzing patients with 25(OH)D levels <50 nmol/L separately (n = 74) left results largely unchanged. In hypertensive patients with low 25(OH)D levels, we observed no significant effect of vitamin D supplementation for eight weeks on BTMs.

ACS Style

Verena Schwetz; Christian Trummer; Marlene Pandis; Martin R. Grübler; Nicolas Verheyen; Martin Gaksch; Armin Zittermann; Winfried März; Felix Aberer; Angelika Lang; Gerlies Treiber; Claudia Friedl; Barbara Obermayer-Pietsch; Thomas R. Pieber; Andreas Tomaschitz; Stefan Pilz. Effects of Vitamin D Supplementation on Bone Turnover Markers: A Randomized Controlled Trial. Nutrients 2017, 9, 432 .

AMA Style

Verena Schwetz, Christian Trummer, Marlene Pandis, Martin R. Grübler, Nicolas Verheyen, Martin Gaksch, Armin Zittermann, Winfried März, Felix Aberer, Angelika Lang, Gerlies Treiber, Claudia Friedl, Barbara Obermayer-Pietsch, Thomas R. Pieber, Andreas Tomaschitz, Stefan Pilz. Effects of Vitamin D Supplementation on Bone Turnover Markers: A Randomized Controlled Trial. Nutrients. 2017; 9 (5):432.

Chicago/Turabian Style

Verena Schwetz; Christian Trummer; Marlene Pandis; Martin R. Grübler; Nicolas Verheyen; Martin Gaksch; Armin Zittermann; Winfried März; Felix Aberer; Angelika Lang; Gerlies Treiber; Claudia Friedl; Barbara Obermayer-Pietsch; Thomas R. Pieber; Andreas Tomaschitz; Stefan Pilz. 2017. "Effects of Vitamin D Supplementation on Bone Turnover Markers: A Randomized Controlled Trial." Nutrients 9, no. 5: 432.

Clinical trial
Published: 13 April 2017 in PLOS ONE
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Observational studies suggested a link between bone disease and left ventricular (LV) dysfunction that may be pronounced in hyperparathyroid conditions. We therefore aimed to test the hypothesis that circulating markers of bone turnover correlate with LV function in a cohort of patients with primary hyperparathyroidism (pHPT). Cross-sectional data of 155 subjects with pHPT were analyzed who participated in the “Eplerenone in Primary Hyperparathyroidism” (EPATH) Trial. Multivariate linear regression analyses with LV ejection fraction (LVEF, systolic function) or peak early transmitral filling velocity (e’, diastolic function) as dependent variables and N-terminal propeptide of procollagen type 1 (P1NP), osteocalcin (OC), bone-specific alkaline phosphatase (BALP), or beta-crosslaps (CTX) as the respective independent variable were performed. Analyses were additionally adjusted for plasma parathyroid hormone, plasma calcium, age, sex, HbA1c, body mass index, mean 24-hours systolic blood pressure, smoking status, estimated glomerular filtration rate, antihypertensive treatment, osteoporosis treatment, 25-hydroxy vitamin D and N-terminal pro-brain B-type natriuretic peptide. Independent relationships were observed between P1NP and LVEF (adjusted β-coefficient = 0.201, P = 0.035) and e’ (β = 0.188, P = 0.042), respectively. OC (β = 0.192, P = 0.039) and BALP (β = 0.198, P = 0.030) were each independently related with e’. CTX showed no correlations with LVEF or e’. In conclusion, high bone formation markers were independently and paradoxically related with better LV diastolic and, partly, better systolic function, in the setting of pHPT. Potentially cardio-protective properties of stimulated bone formation in the context of hyperparathyroidism should be explored in future studies.

ACS Style

Nicolas Verheyen; Astrid Fahrleitner-Pammer; Evgeny Belyavskiy; Martin R. Gruebler; Hans Peter Dimai; Karin Amrein; Klemens Ablasser; Johann Martensen; Cristiana Catena; Elisabeth Pieske-Kraigher; Caterina Colantonio; Jakob Voelkl; Florian Lang; Ioana Alesutan; Andreas Meinitzer; Winfried März; Helmut Brussee; Burkert Pieske; Stefan Pilz; Andreas Tomaschitz. Relationship between bone turnover and left ventricular function in primary hyperparathyroidism: The EPATH trial. PLOS ONE 2017, 12, e0173799 .

AMA Style

Nicolas Verheyen, Astrid Fahrleitner-Pammer, Evgeny Belyavskiy, Martin R. Gruebler, Hans Peter Dimai, Karin Amrein, Klemens Ablasser, Johann Martensen, Cristiana Catena, Elisabeth Pieske-Kraigher, Caterina Colantonio, Jakob Voelkl, Florian Lang, Ioana Alesutan, Andreas Meinitzer, Winfried März, Helmut Brussee, Burkert Pieske, Stefan Pilz, Andreas Tomaschitz. Relationship between bone turnover and left ventricular function in primary hyperparathyroidism: The EPATH trial. PLOS ONE. 2017; 12 (4):e0173799.

Chicago/Turabian Style

Nicolas Verheyen; Astrid Fahrleitner-Pammer; Evgeny Belyavskiy; Martin R. Gruebler; Hans Peter Dimai; Karin Amrein; Klemens Ablasser; Johann Martensen; Cristiana Catena; Elisabeth Pieske-Kraigher; Caterina Colantonio; Jakob Voelkl; Florian Lang; Ioana Alesutan; Andreas Meinitzer; Winfried März; Helmut Brussee; Burkert Pieske; Stefan Pilz; Andreas Tomaschitz. 2017. "Relationship between bone turnover and left ventricular function in primary hyperparathyroidism: The EPATH trial." PLOS ONE 12, no. 4: e0173799.

Randomized controlled trial
Published: 01 January 2017 in Clinical Chemistry and Laboratory Medicine (CCLM)
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Background:Primary hyperparathyroidism (pHPT) is associated with low-grade inflammation, left ventricular hypertrophy and increased cardiovascular mortality, but the association between inflammatory markers and parameters of adverse cardiac remodeling is unknown. We investigated the relationship between C-reactive protein (CRP), the essential amino acid tryptophan and its pro-inflammatory derivatives kynurenine and quinolinic acid (QUIN) with echocardiographic parameters.Methods:Cross-sectional baseline data from the “Eplerenone in Primary Hyperparathyroidism” trial were analyzed. Patients with any acute illness were excluded. We assessed associations between CRP, serum levels of tryptophan, kynurenine and QUIN and left ventricular mass index (LVMI), left atrial volume index (LAVI) and E/e′.Results:Among 136 subjects with pHPT (79% females), 100 (73%) had arterial hypertension and the prevalence of left ventricular hypertrophy was 52%. Multivariate linear regression analyses with LVMI, LAVI and E/e′ as respective dependent variables, and C-reactive protein and tryptophan, kynurenine and QUIN as respective independent variables were performed. Analyses were adjusted for age, sex, blood pressure, parathyroid hormone, calcium and other cardiovascular risk factors. LVMI was independently associated with CRP (adjusted β-coefficient=0.193, p=0.030) and QUIN (β=0.270, p=0.007), but not kynurenine. LAVI was related with CRP (β=0.315, p[Correction added after online publication (22 April 2017: The sentence “Among 136 subjects with pHPT (79% females), 100 (73%) had left ventricular hypertrophy.” was corrected to “Among 136 subjects with pHPT (79% females), 100 (73%) had arterial hypertension and the prevalence of left ventricular hypertrophy was 52%.”]Conclusions:Cardiac remodeling is common in pHPT and is associated with low-grade inflammation and activation of the tryptophan-kynurenine pathway. The potential role of kynurenine and QUIN as cardiovascular risk factors may be further investigated in future studies.

ACS Style

Nicolas Verheyen; Andreas Meinitzer; Martin Robert Grübler; Klemens Ablasser; Ewald Kolesnik; Astrid Fahrleitner-Pammer; Evgeny Belyavskiy; Christian Trummer; Verena Schwetz; Elisabeth Pieske-Kraigher; Jakob Voelkl; Ioana Alesutan; Cristiana Catena; Leonardo Alberto Sechi; Helmut Brussee; Dirk Von Lewinski; Winfried März; Burkert Pieske; Stefan Pilz; Andreas Tomaschitz. Low-grade inflammation and tryptophan-kynurenine pathway activation are associated with adverse cardiac remodeling in primary hyperparathyroidism: the EPATH trial. Clinical Chemistry and Laboratory Medicine (CCLM) 2017, 55, 1034 -1042.

AMA Style

Nicolas Verheyen, Andreas Meinitzer, Martin Robert Grübler, Klemens Ablasser, Ewald Kolesnik, Astrid Fahrleitner-Pammer, Evgeny Belyavskiy, Christian Trummer, Verena Schwetz, Elisabeth Pieske-Kraigher, Jakob Voelkl, Ioana Alesutan, Cristiana Catena, Leonardo Alberto Sechi, Helmut Brussee, Dirk Von Lewinski, Winfried März, Burkert Pieske, Stefan Pilz, Andreas Tomaschitz. Low-grade inflammation and tryptophan-kynurenine pathway activation are associated with adverse cardiac remodeling in primary hyperparathyroidism: the EPATH trial. Clinical Chemistry and Laboratory Medicine (CCLM). 2017; 55 (7):1034-1042.

Chicago/Turabian Style

Nicolas Verheyen; Andreas Meinitzer; Martin Robert Grübler; Klemens Ablasser; Ewald Kolesnik; Astrid Fahrleitner-Pammer; Evgeny Belyavskiy; Christian Trummer; Verena Schwetz; Elisabeth Pieske-Kraigher; Jakob Voelkl; Ioana Alesutan; Cristiana Catena; Leonardo Alberto Sechi; Helmut Brussee; Dirk Von Lewinski; Winfried März; Burkert Pieske; Stefan Pilz; Andreas Tomaschitz. 2017. "Low-grade inflammation and tryptophan-kynurenine pathway activation are associated with adverse cardiac remodeling in primary hyperparathyroidism: the EPATH trial." Clinical Chemistry and Laboratory Medicine (CCLM) 55, no. 7: 1034-1042.