Publications by authors named "F Eckstein"

897 Publications

Outcome of right ventricular assist device implantation following left ventricular assist device implantation: Systematic review and meta-analysis.

Perfusion 2021 Jun 11:2676591211024817. Epub 2021 Jun 11.

Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland.

Objectives: The main aim was a systematic evaluation of the current evidence on outcomes for patients undergoing right ventricular assist device (RVAD) implantation following left ventricular assist device (LVAD) implantation.

Methods: This systematic review was registered on PROSPERO (CRD42019130131). Reports evaluating in-hospital as well as follow-up outcome in LVAD and LVAD/RVAD implantation were identified through Ovid Medline, Web of Science and EMBASE. The primary endpoint was mortality at the hospital stay and at follow-up. Pooled incidence of defined endpoints was calculated by using random effects models.

Results: A total of 35 retrospective studies that included 3260 patients were analyzed. 30 days mortality was in favour of isolated LVAD implantation 6.74% (1.98-11.5%) versus 31.9% (19.78-44.02%) p = 0.001 in LVAD with temporary need for RVAD. During the hospital stay the incidence of major bleeding was 18.7% (18.2-19.4%) versus 40.0% (36.3-48.8%) and stroke rate was 5.6% (5.4-5.8%) versus 20.9% (16.8-28.3%) and was in favour of isolated LVAD implantation. Mortality reported at short-term as well at long-term was 19.66% (CI 15.73-23.59%) and 33.90% (CI 8.84-59.96%) in LVAD respectively versus 45.35% (CI 35.31-55.4%) p ⩽ 0.001 and 48.23% (CI 16.01-80.45%) p = 0.686 in LVAD/RVAD group respectively.

Conclusion: Implantation of a temporary RVAD is allied with a worse outcome during the primary hospitalization and at follow-up. Compared to isolated LVAD support, biventricular mechanical circulatory support leads to an elevated mortality and higher incidence of adverse events such as bleeding and stroke.
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http://dx.doi.org/10.1177/02676591211024817DOI Listing
June 2021

Response letter to the Editor.

Semin Arthritis Rheum 2021 May 8. Epub 2021 May 8.

University of Maryland School of Medicine, Baltimore, MD, United States.

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http://dx.doi.org/10.1016/j.semarthrit.2021.05.001DOI Listing
May 2021

Imaging, histopathological degree of degeneration and clinical findings - Do these correlate in patients with temporomandibular joint disorders.

J Stomatol Oral Maxillofac Surg 2021 May 12. Epub 2021 May 12.

Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen Nuremberg, Glückstraße 11, 91054 Erlangen, Germany; Section of Oral and Maxillofacial Surgery, Department of Otorhinolaryngology, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany.

The gold standard for temporomandibular joint imaging is magnetic resonance imaging, although there are still pathological findings that cannot be seen in MRI but in surgery and the subsequent histological analysis only. The main goal of this investigation was to validate the MRI score used by histopathological findings as well as clinical findings. In this retrospective study 39 patients were included; 38 of which underwent unilateral and 1 underwent bilateral discectomy. MRI findings were graded according to the score by Wurm. Histopathological analysis was performed in hematoxylin-eosin staining and graded in accordance with the scores by Krenn and by Leonardi. For valuation of preoperative pain values of the temporomandibular joint operated on the numeric rating scale was utilized. Correlations were verified by Spearman-Rho. The MRI scores on average showed significantly lower scores for the discs of the operated temporomandibular joint than for the discs of the non-operated side(p<.01). No significant correlations between MRI findings, histopathological findings and pain intensities could be observed. Thus unsuspicious morphology of the TMJ and the articular disc in MRI is no guarantee for the absence of cartilage-degeneration. Further investigations utilizing T2 cartilage mapping could possibly show better correlations between the temporomandibular joint's degree of degeneration and imaging results.
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http://dx.doi.org/10.1016/j.jormas.2021.05.002DOI Listing
May 2021

Superficial cartilage transverse relaxation time is associated with osteoarthritis disease progression - data from the FNIH biomarker study of the osteoarthritis initiative.

Arthritis Care Res (Hoboken) 2021 May 10. Epub 2021 May 10.

Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology, Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria.

Objective: To study whether layer-specific cartilage transverse relaxation time (T2), and/or longitudinal change is associated with clinically relevant knee osteoarthritis (OA) disease progression.

Methods: The FNIH biomarker consortium was a nested case-control study on 600 knees from 600 Osteoarthritis Initiative participants. Progressor knees had both medial tibiofemoral radiographic joint space width (JSW) loss (≥0.7 mm) and a persistent increase in WOMAC pain (≥9 on a 0-100 scale) at 24-48 month from baseline (n=194). Multi-echo spin-echo (MESE) MRIs for cartilage T2 analysis had been acquired in the right knees only (97 progressor knees). These were compared to 104 control knees without JSW or pain progression. 53 knees had JSW progression, and 57 pain progression only. Cartilage thickness segmentations obtained from DESS MRI were matched to MESE MRI, to extract superficial and deep femorotibial cartilage T2. Superficial medial femorotibial compartment (MFTC) T2 at baseline was the primary, and change in deep MFTC T2 between baseline and 12 months the secondary analytic outcome of this post-hoc exploratory study.

Results: Baseline superficial MFTC T2 was significantly elevated in progressor knees (adjusted mean 47.2ms [95% confidence interval [CI] 46.5, 48.0]) and JSW progression only knees (adjusted mean 47.3ms [95% confidence interval [CI] 46.3, 48.3]), respectively, vs non-progressor knees (45.8ms [95% CI 45.0, 46.5]) after adjustment for age, sex, BMI, WOMAC pain, and medial JSN grade (ANCOVA). Change in T2 was not significantly associated with case status.

Conclusions: Baseline superficial, but not deep, medial cartilage T2 is associated with clinically relevant disease progression in knee OA.
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http://dx.doi.org/10.1002/acr.24627DOI Listing
May 2021

Long-term structural and symptomatic effects of intra-articular sprifermin in patients with knee osteoarthritis: 5-year results from the FORWARD study.

Ann Rheum Dis 2021 May 7. Epub 2021 May 7.

Rheumatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Objective: The FORWARD (FGF-18 Osteoarthritis Randomized Trial with Administration of Repeated Doses) trial assessed efficacy and safety of the potential disease-modifying osteoarthritis drug (DMOAD) sprifermin in patients with knee osteoarthritis. Here, we report 5-year efficacy and safety results.

Methods: Patients were randomised to intra-articular sprifermin 100 µg or 30 µg every 6 months (q6mo) or 12 months, or placebo, for 18 months. The primary analysis was at year 2, with follow-up at years 3, 4 and 5. Additional post hoc exploratory analyses were conducted in patients with baseline minimum radiographic joint space width 1.5-3.5 mm and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain 40-90, a subgroup at risk (SAR) of progression.

Results: 378 (69%) patients completed the 5-year follow-up. A significant dose-response in total femorotibial joint cartilage thickness with sprifermin (trend test, p<0.001) and a 0.05 mm mean difference with sprifermin 100 µg q6mo versus placebo (95% CI 0.00 to 0.10; p=0.015) were sustained to year 5. WOMAC pain scores improved ~50% from baseline in all groups. No patient in the 100 µg q6mo group had replacement of the treated knee. 96%-98% of patients receiving sprifermin and 98% placebo reported adverse events, most were mild or moderate and deemed unrelated to treatment. Adverse event-related study withdrawals were <10%. Differentiation in WOMAC pain between sprifermin 100 µg q6mo and placebo in the SAR (n=161) at year 3 was maintained to year 5 (-10.08; 95% CI -25.68 to 5.53).

Conclusion: In the longest DMOAD trial reported to date, sprifermin maintained long-term structural modification of articular cartilage over 3.5 years post-treatment. Potential translation to clinical benefit was observed in the SAR.

Trial Registration Number: NCT01919164.
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http://dx.doi.org/10.1136/annrheumdis-2020-219181DOI Listing
May 2021
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