Publications by authors named "M Kranert"

19 Publications

Recurrence of atrial fibrillation after pulmonary vein isolation in dependence of arterial stiffness.

Neth Heart J 2021 Nov 24. Epub 2021 Nov 24.

First Department of Medicine-Cardiology, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.

Background: Arterial stiffness (AS) has emerged as a strong predictor of cardiovascular (CV) diseases. Although increased AS has been described as a predictor of atrial fibrillation (AF), its role as a risk marker for AF recurrence has not yet been elucidated.

Methods: Patients with AF who underwent pulmonary vein isolation (PVI) were included in this study. Presence of AS was evaluated by measuring aortic distensibility (AD) of the descending aorta by transoesophageal echocardiography.

Results: In total, 151 patients (mean ± standard deviation (SD) age 71.9 ± 9.8 years) were enrolled and followed for a median duration of 21 months (interquartile range 15.0-31.0). During follow-up, AF recurred in 94 (62.3%) patients. AF recurrence was seen more frequently in patients with permanent AF (27% vs 46%, p = 0.03) and in those who had undergone prior PVI (9% vs 23%, p = 0.02). AD was significantly reduced in patients with AF recurrence (mean ± SD 2.6 ± 2.3 vs 1.5 ± 0.7 × 10 mm Hg, p < 0.0001), as well as left atrial volume index (LAVI) (mean ± SD 29 ± 12 vs 44 ± 15 ml/m, p < 0.0001). Multivariable analysis revealed LAVI (odds ratio (OR) 2.9, 95% confidence interval (CI) 1.2-3.4) and AS (OR 3.6, 95% CI 2.8-4.1) as independent risk factors of AF recurrence.

Conclusion: Increased AS and left atrial size were independent predictors of AF recurrence after PVI. AD as surrogate marker of AS seemed to reflect the overall CV risk. In addition, AD was significantly correlated with left atrial size, which suggests that increased AS leads to atrial remodelling and thus to AF recurrence.

Trial Registration: German registry for clinical studies (DRKS), DRKS00019007.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12471-021-01644-wDOI Listing
November 2021

Optimizing the co-digestion supply chain of sewage sludge and food waste by the demand oriented biogas supplying mechanism.

Waste Manag Res 2021 Feb 10;39(2):302-313. Epub 2020 Sep 10.

University of Stuttgart, Institute for Sanitary Engineering, Water Quality and Solid Waste Management, Germany.

Co-digestion of sewage sludge with food waste is a beneficial pathway for sewage plants to enhance their biogas yield. This paper employs hybrid programming with system dynamics simulation to optimize such a co-digestion system from the perspective of demand-oriented biogas supply chain, thus to improve the efficiency of the biogas utilization. The optimum operational parameters of the co-digestion system are derived from the simulation model. It is demonstrated that the demand-oriented biogas supply mechanism can be effectively driven under market-oriented incentive policy. For better compensation of the external cost to assist the operations of the co-digestion supply chain, it is suggested that the substrate collection and transportation subsidy should be combined with the renewables portfolio standard to be implemented as the optimum incentives. The limitations of the study are discussed to lay the foundation for future improvements.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0734242X20953491DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874384PMC
February 2021

Arterial Stiffness Is Associated With Increased Symptom Burden in Patients With Atrial Fibrillation.

Can J Cardiol 2020 12 3;36(12):1949-1955. Epub 2020 Sep 3.

First Department of Medicine - Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany. Electronic address:

Background: Increased arterial stiffness (AS) has been described as a predictor of atrial fibrillation (AF). This study was performed to assess whether increased AS leads to a higher symptom burden in patients with AF.

Methods: One hundred sixty-two consecutive patients (104 male, 58 female) with diagnosed AF (paroxysmal or persistent) were enrolled. Symptoms most likely attributable to AF were quantified according to the Canadian Cardiovascular Society Severity of Atrial Fibrillation (SAF) scale. AS indices (aortic distensibility, cyclic circumferential strain, and aortic compliance) were characterized using transoesophageal echocardiography.

Results: The cohort was divided into asymptomatic to oligosymptomatic (SAF scale 0-1, n = 78 [48.1%]) and symptomatic (SAF scale ≥ 2, n = 84 [51.9%]) patients. Symptomatic patients tended to be younger (median, 75 [interquartile range (IQR) 67-80] vs 71 [65-79]; P = 0.047) and were more likely to be female (22 [28.2%] vs 36 [42.9%]; P = 0.052). Hypertension was more frequent in symptomatic patients. Aortic compliance indices each were reduced in symptomatic patients, most pronounced for aortic compliance (median, 0.05 [IQR 0.03-0.06] vs 0.04 [0.03-0.05] cm/mm Hg; P = 0.01) followed by cyclic circumferential strain (median, 0.09 [IQR 0.07-0.11] vs 0.07 [0.04-0.10]; P = 0.02) and aortic distensibility (10 mm Hg, median, 1.74 [IQR 1.34-2.24] vs 1.54 [1.12-2.08]; P = 0.03). Multivariable analysis revealed aortic compliance as an independent predictor for symptoms in patients with AF with an odds ratio of 2.6 (95% confidence interval, 1.2-3.4; P = 0.003).

Conclusions: AS contributes to a high symptom burden in patients with AF, emphasizing the prognostic role of AS in the early detection and prevention in patients with AF.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cjca.2020.08.022DOI Listing
December 2020

Perception of atrial fibrillation in dependence of neuroticism.

J Psychosom Res 2020 11 27;138:110225. Epub 2020 Aug 27.

First Department of Medicine - Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany. Electronic address:

Objective: Atrial fibrillation (AF) is associated with a varying symptom burden, which ranges from completely unawareness to disabling conditions. The present cross-sectional study tried to assess if neuroticism is associated with a greater degree of perception of AF related symptoms.

Methods: 162 patients who were considered for catheter ablation of AF were included. AF related symptom burden was quantified according to the European Heart Rhythm Association (EHRA) score. Personality traits were assessed using the Big Five personality traits (5BT).

Results: Female patients reported higher symptom burden. Higher EHRA scores were furthermore associated with treatment with antiarrhythmic agents, digitalis, direct oral anticoagulants (DOAC), and antidepressant treatment, as well as suffering from heart failure or chronic kidney disease. Neuroticism showed a positive correlation to AF related symptom burden with significantly higher neuroticism scores in patients with higher EHRA scores (Rho = 0.41; 95%CI 0.26 to 0.53; p < .001), while no association was demonstrated for the other four personality traits. Multiple linear regression analysis revealed neuroticism as strongest independent predictor for symptomatic AF, followed by treatment with antiarrhythmic agents and DOAC.

Conclusions: Perception of AF related symptoms is a multifactorial process, which in our cohort was independently associated with neuroticism. Patients with higher symptom burden were also more likely to receive antiarrhythmic agents and DOAC, as well as antidepressants.

Trial Registration: German registry for clinical studies (DRKS), DRKS00019007.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jpsychores.2020.110225DOI Listing
November 2020
-->