Wissenschaftliche Veröffentlichungen von Shiva Shabanian
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Intravenous heme arginate induces HO-1 (heme oxygenase-1) in the Human Heart.
Randomized, placebo-controlled, safety, and feasibility pharmacokinetic study - brief report.
Andreas M, Oeser C, Kainz F-M, Shabanian S, Aref T, Bilban M, Messner B, Heidtmann J, Laufer G, Kocher A, Wolzt M (2018)
Arterioscler Thromb. Vasc. Biol. 38:2755-2762 . DOI: 10.1161/ATVBAHA.118.311832.
-Objective-: HO-1 (heme oxygenase-1) induction may prevent or reduce ischemia-reperfusion injury. We previously evaluated its in vivo induction after a single systemic administration of heme arginate in peripheral blood mononuclear cells. The current trial was designed to assess the pharmacological tissue induction of HO-1 in the human heart with heme arginate in vivo. -Approach and Results-: Patients planned for conventional aortic valve replacement received placebo (n=8), 1 mg/kg (n=7) or 3 mg/kg (n=9) heme arginate infused intravenously 24 hours before surgery. A biopsy of the right ventricle was performed directly before aortic cross-clamping and after cross-clamp release. In addition, the right atrial appendage was partially removed for analysis. HO-1 protein and mRNA concentrations were measured in tissue samples and in peripheral blood mononuclear cells before to and up to 72 hours after surgery. No study medication-related adverse events occurred. A strong, dose-dependent effect on myocardial HO-1 mRNA levels was observed (right ventricle: 7.9 ± 5.0 versus 88.6 ± 49.1 versus 203.6 ± 148.7; p=0.002 and right atrium: 10.8 ± 8.8 versus 229.8 ± 173.1 versus 392.7 ± 195.7; p=0.001). This was paralleled by a profound increase of HO-1 protein concentration in atrial tissue (8401 ± 3889 versus 28?585 ± 10?692 versus 29?022 ± 8583; P<0.001). Surgery and heme arginate infusion significantly increased HO-1 mRNA concentration in peripheral blood mononuclear cells (P<0.001). HO-1 induction led to a significant increase of postoperative carboxyhemoglobin (1.7% versus 1.4%; p=0.041). No effect on plasma HO-1 protein levels could be detected. -Conclusions-: Myocardial HO-1 mRNA and protein can be dose-dependently induced by heme arginate. Protective effects of this therapeutic strategy should be evaluated in upcoming clinical trials. -Clinical Trial Registration-: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02314780
Intermediate-term outcome of 500 consecutive rapid-deployment surgical aortic valve procedures.
Andreas M, Coti I, Rosenhek R, Shabanian S, Mahr S, Uyanık-Ünal K, Wiedemann D, Binder T, Kocher A, Laufer G (2019)
Eur. J. Card.-Thor. Surg. 55:527-533
-OBJECTIVES-: The Edwards INTUITY Valve System is a balloon-expandable bioprosthesis, inspired from the Edwards Magna valve and transcatheter technology, with a subvalvular stent frame to enable rapid deployment. We report a single-centre experience of aortic valve replacement with this novel bioprosthesis. -METHODS-: Five hundred consecutive patients, of whom 45.6% were female with a mean age of 73.5 [standard deviation (SD) 7.9] years, with severe aortic stenosis who received a rapid deployment aortic valve between May 2010 and July 2017 were included in a prospective and ongoing database. The median follow-up time was 12 months, and the total accumulated follow-up time was 818 patient years. Preoperative characteristics, operative parameters, survival, valve-related adverse events and valve haemodynamics were assessed. -RESULTS-: Thirty-day mortality was 0.8% (4/500), and overall survival at 1, 3 and 5 years was 94%, 89% and 81%, respectively. A minimally invasive surgical approach was chosen in 236 patients (47%), of which 122 (24%) were operated on through an anterior right thoracotomy. Cross-clamp and cardiopulmonary bypass times for isolated aortic valve replacement were 53 (SD 17) and 89 (SD 29) min for full sternotomy as well as 75 (SD 23) and 110 (SD 31) min for minimally invasive surgery approaches (p < 0.001). Mean gradients at discharge, 1, 3 and 5 years were 13 (SD 5), 11 (SD 4), 12 (SD 5) and 11 (SD 3) mmHg, respectively. New pacemaker implantation was necessary in 8.6% of patients. A single case (0.2%) of structural degeneration was registered after 6 years. Valve explantation for non-structural dysfunction or endocarditis occurred in 9 patients (1.8%). -CONCLUSIONS-: This rapid deployment aortic valve has shown excellent results concerning haemodynamic performance, durability and safety. Implantation requires specific training, and the rate of pacemaker implantation remains a matter of concern. This novel valve also facilitates minimally invasive approaches and may be beneficial in complex combined procedures.
The VKORC1 polymorphism rs9923231 is associated with aneurysms of the ascending aorta in an Austrian population. (Letter to the Editors-in-Chief)
Andreas M, Panzenboeck A, Shabanian S, Kocher A, Mannhalter C, Petzl A, Hueblauer J, Wolzt M, Ehrlich M, Lang I (2017)
Thromb Res. 152:41-43