Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Herz
Erschienen in: Herz 5/2023

02.02.2023 | Original articles

Effects of hydroxychloroquine on atrial electrophysiology in in silico wild-type and PITX2+/- atrial cardiomyocytes

verfasst von: Euijun Song, MD

Erschienen in: Herz | Ausgabe 5/2023

Einloggen, um Zugang zu erhalten

Abstract

Background

Hydroxychloroquine (HCQ) is commonly used in the treatment of autoimmune diseases and increases the risk of QT interval prolongation. However, it is unclear how HCQ affects atrial electrophysiology and the risk of atrial fibrillation (AF).

Methods

We quantitatively examined the potential atrial arrhythmogenic effects of HCQ on AF using a computational model of human atrial cardiomyocytes. We measured atrial electrophysiological markers after systematically varying HCQ concentrations.

Results

The HCQ concentrations were positively correlated with the action potential duration (APD), resting membrane potential, refractory period, APD alternans threshold, and calcium transient alternans threshold (p < 0.05). By contrast, HCQ concentrations were inversely correlated with the maximum upstroke velocity and calcium transient amplitude (p < 0.05). When the therapeutic concentration (Cmax) of HCQ was applied, HCQ increased APD90 by 1.4% in normal sinus rhythm, 1.8% in wild-type AF, and 2.6% in paired-like homeodomain transcription factor 2 (PITX2)+/- AF, but did not affect the alternans thresholds. The overall in silico results suggest no significant atrial arrhythmogenic effects of HCQ at Cmax, instead implying a potential antiarrhythmic role of low-dose HCQ in AF. However, at an HCQ concentration of fourfold Cmax, a rapid pacing rate of 4 Hz induced prominent APD alternans, particularly in the PITX2+/- AF model.

Conclusion

Our in silico analysis suggests a potential antiarrhythmic role of low-dose HCQ in AF. Concomitant PITX2 mutations and high-dose HCQ treatments may increase the risk of AF, and this potential genotype/dose-dependent arrhythmogenic effect of HCQ should be investigated further.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Nirk EL, Reggiori F, Mauthe M (2020) Hydroxychloroquine in rheumatic autoimmune disorders and beyond. EMBO Mol Med 12:e12476PubMedPubMedCentral
2.
Schrezenmeier E, Dorner T (2020) Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology. Nat Rev Rheumatol 16:155–166PubMed
3.
Group RC, Horby P, Mafham M, Linsell L, Bell JL, Staplin N, Emberson JR, Wiselka M, Ustianowski A, Elmahi E, Prudon B, Whitehouse T, Felton T, Williams J, Faccenda J, Underwood J, Baillie JK, Chappell LC, Faust SN, Jaki T, Jeffery K, Lim WS, Montgomery A, Rowan K, Tarning J, Watson JA, White NJ, Juszczak E, Haynes R, Landray MJ (2020) Effect of hydroxychloroquine in hospitalized patients with Covid-19. N Engl J Med 383:2030–2040
4.
Boulware DR, Pullen MF, Bangdiwala AS, Pastick KA, Lofgren SM, Okafor EC, Skipper CP, Nascene AA, Nicol MR, Abassi M, Engen NW, Cheng MP, LaBar D, Lother SA, MacKenzie LJ, Drobot G, Marten N, Zarychanski R, Kelly LE, Schwartz IS, McDonald EG, Rajasingham R, Lee TC, Hullsiek KH (2020) A randomized trial of hydroxychloroquine as postexposure prophylaxis for Covid-19. N Engl J Med 383:517–525PubMed
5.
Cavalcanti AB, Zampieri FG, Rosa RG, Azevedo LCP, Veiga VC, Avezum A, Damiani LP, Marcadenti A, Kawano-Dourado L, Lisboa T, Junqueira DLM, de Barros ESPGM, Tramujas L, Abreu-Silva EO, Laranjeira LN, Soares AT, Echenique LS, Pereira AJ, Freitas FGR, Gebara OCE, Dantas VCS, Furtado RHM, Milan EP, Golin NA, Cardoso FF, Maia IS, Hoffmann Filho CR, Kormann APM, Amazonas RB, Bocchi de Oliveira MF, Serpa-Neto A, Falavigna M, Lopes RD, Machado FR, Berwanger O, Coalition Covid-19 Brazil I Investigators (2020) Hydroxychloroquine with or without azithromycin in mild-to-moderate Covid-19. N Engl J Med 383:2041–2052PubMed
6.
Sacre K, Criswell LA, McCune JM (2012) Hydroxychloroquine is associated with impaired interferon-alpha and tumor necrosis factor-alpha production by plasmacytoid dendritic cells in systemic lupus erythematosus. Arthritis Res Ther 14:R155PubMedPubMedCentral
7.
Wallace DJ, Linker-Israeli M, Metzger AL, Stecher VJ (1993) The relevance of antimalarial therapy with regard to thrombosis, hypercholesterolemia and cytokines in SLE. Lupus 2(1):S13–15PubMed
8.
Banchereau R, Hong S, Cantarel B, Baldwin N, Baisch J, Edens M, Cepika AM, Acs P, Turner J, Anguiano E, Vinod P, Kahn S, Obermoser G, Blankenship D, Wakeland E, Nassi L, Gotte A, Punaro M, Liu YJ, Banchereau J, Rossello-Urgell J, Wright T, Pascual V (2016) Personalized Immunomonitoring uncovers molecular networks that stratify lupus patients. Cell 165:551–565PubMedPubMedCentral
9.
Ponticelli C, Moroni G (2017) Hydroxychloroquine in systemic lupus erythematosus (SLE). Expert Opin Drug Saf 16:411–419PubMed
10.
Chatre C, Roubille F, Vernhet H, Jorgensen C, Pers YM (2018) Cardiac complications attributed to chloroquine and hydroxychloroquine: a systematic review of the literature. Drug Saf 41:919–931PubMed
11.
Costedoat-Chalumeau N, Hulot JS, Amoura Z, Leroux G, Lechat P, Funck-Brentano C, Piette JC (2007) Heart conduction disorders related to antimalarials toxicity: an analysis of electrocardiograms in 85 patients treated with hydroxychloroquine for connective tissue diseases. Rheumatology 46:808–810PubMed
12.
Jorge A, Ung C, Young LH, Melles RB, Choi HK (2018) Hydroxychloroquine retinopathy—implications of research advances for rheumatology care. Nat Rev Rheumatol 14:693–703PubMed
13.
O’Laughlin JP, Mehta PH, Wong BC (2016) Life threatening severe QTc prolongation in patient with systemic lupus erythematosus due to hydroxychloroquine. Case Rep Cardiol 2016:4626279PubMedPubMedCentral
14.
Jankelson L, Karam G, Becker ML, Chinitz LA, Tsai MC (2020) QT prolongation, torsades de pointes, and sudden death with short courses of chloroquine or hydroxychloroquine as used in COVID-19: a systematic review. Heart Rhythm 17:1472–1479PubMedPubMedCentral
15.
Thomet U, Amuzescu B, Knott T, Mann SA, Mubagwa K, Radu BM (2021) Assessment of proarrhythmogenic risk for chloroquine and hydroxychloroquine using the CiPA concept. Eur J Pharmacol 913:174632PubMedPubMedCentral
16.
Delaunois A, Abernathy M, Anderson WD, Beattie KA, Chaudhary KW, Coulot J, Gryshkova V, Hebeisen S, Holbrook M, Kramer J, Kuryshev Y, Leishman D, Lushbough I, Passini E, Redfern WS, Rodriguez B, Rossman EI, Trovato C, Wu C, Valentin JP (2021) Applying the CiPA approach to evaluate cardiac proarrhythmia risk of some antimalarials used off-label in the first wave of COVID-19. Clin Transl Sci 14:1133–1146PubMedPubMedCentral
17.
Whittaker DG, Capel RA, Hendrix M, Chan XHS, Herring N, White NJ, Mirams GR, Burton RB (2021) Cardiac TdP risk stratification modelling of anti-infective compounds including chloroquine and hydroxychloroquine. R Soc open sci 8:210235PubMedPubMedCentral
18.
Li Z, Ridder BJ, Han X, Wu WW, Sheng J, Tran PN, Wu M, Randolph A, Johnstone RH, Mirams GR, Kuryshev Y, Kramer J, Wu C, Crumb WJ Jr., Strauss DG (2019) Assessment of an in silico mechanistic model for proarrhythmia risk prediction under the CiPA initiative. Clin Pharmacol Ther 105:466–475PubMed
19.
Li Z, Dutta S, Sheng J, Tran PN, Wu W, Chang K, Mdluli T, Strauss DG, Colatsky T (2017) Improving the in silico assessment of proarrhythmia risk by combining hERG (human ether-a-go-go-related gene) channel-drug binding kinetics and multichannel pharmacology. Circ Arrhythm Electrophysiol 10:e4628PubMed
20.
Grandi E, Pandit SV, Voigt N, Workman AJ, Dobrev D, Jalife J, Bers DM (2011) Human atrial action potential and Ca2+ model: sinus rhythm and chronic atrial fibrillation. Circ Res 109:1055–1066PubMedPubMedCentral
21.
Courtemanche M, Ramirez RJ, Nattel S (1998) Ionic mechanisms underlying human atrial action potential properties: insights from a mathematical model. Am J Physiol 275:H301–321PubMed
22.
Boyle PM, Zghaib T, Zahid S, Ali RL, Deng D, Franceschi WH, Hakim JB, Murphy MJ, Prakosa A, Zimmerman SL, Ashikaga H, Marine JE, Kolandaivelu A, Nazarian S, Spragg DD, Calkins H, Trayanova NA (2019) Computationally guided personalized targeted ablation of persistent atrial fibrillation. Nat Biomed Eng 3:870–879PubMedPubMedCentral
23.
24.
Moreno JD, Zhu ZI, Yang PC, Bankston JR, Jeng MT, Kang C, Wang L, Bayer JD, Christini DJ, Trayanova NA, Ripplinger CM, Kass RS, Clancy CE (2011) A computational model to predict the effects of class I anti-arrhythmic drugs on ventricular rhythms. Sci Transl Med 3:98ra83PubMedPubMedCentral
25.
Dasi A, Roy A, Sachetto R, Camps J, Bueno-Orovio A, Rodriguez B (2022) In-silico drug trials for precision medicine in atrial fibrillation: from ionic mechanisms to electrocardiogram-based predictions in structurally-healthy human atria. Front Physiol 13:966046PubMedPubMedCentral
26.
Gupta A, Shields KJ, Manzi S, Wasko MC, Sharma TS (2021) Association of hydroxychloroquine use with decreased incident atrial fibrillation in systemic lupus erythematosus. Arthritis Care Res (Hoboken) 73:828–832PubMed
27.
Syeda F, Holmes AP, Yu TY, Tull S, Kuhlmann SM, Pavlovic D, Betney D, Riley G, Kucera JP, Jousset F, de Groot JR, Rohr S, Brown NA, Fabritz L, Kirchhof P (2016) PITX2 modulates atrial membrane potential and the antiarrhythmic effects of sodium-channel blockers. J Am Coll Cardiol 68:1881–1894PubMedPubMedCentral
28.
Gudbjartsson DF, Arnar DO, Helgadottir A, Gretarsdottir S, Holm H, Sigurdsson A, Jonasdottir A, Baker A, Thorleifsson G, Kristjansson K, Palsson A, Blondal T, Sulem P, Backman VM, Hardarson GA, Palsdottir E, Helgason A, Sigurjonsdottir R, Sverrisson JT, Kostulas K, Ng MC, Baum L, So WY, Wong KS, Chan JC, Furie KL, Greenberg SM, Sale M, Kelly P, MacRae CA, Smith EE, Rosand J, Hillert J, Ma RC, Ellinor PT, Thorgeirsson G, Gulcher JR, Kong A, Thorsteinsdottir U, Stefansson K (2007) Variants conferring risk of atrial fibrillation on chromosome 4q25. Nature 448:353–357PubMed
29.
Lubitz SA, Sinner MF, Lunetta KL, Makino S, Pfeufer A, Rahman R, Veltman CE, Barnard J, Bis JC, Danik SP, Sonni A, Shea MA, Del Monte F, Perz S, Muller M, Peters A, Greenberg SM, Furie KL, van Noord C, Boerwinkle E, Stricker BH, Witteman J, Smith JD, Chung MK, Heckbert SR, Benjamin EJ, Rosand J, Arking DE, Alonso A, Kaab S, Ellinor PT (2010) Independent susceptibility markers for atrial fibrillation on chromosome 4q25. Circulation 122:976–984PubMedPubMedCentral
30.
Syeda F, Kirchhof P, Fabritz L (2017) PITX2-dependent gene regulation in atrial fibrillation and rhythm control. J Physiol 595:4019–4026PubMedPubMedCentral
31.
Vagos MR, Arevalo H, de Oliveira BL, Sundnes J, Maleckar MM (2017) A computational framework for testing arrhythmia marker sensitivities to model parameters in functionally calibrated populations of atrial cells. Chaos 27:93941PubMed
32.
Song E, Lee YS (2022) Interpretable machine learning of action potential duration restitution kinetics in single-cell models of atrial cardiomyocytes. J Electrocardiol 74:137–145PubMed
33.
Lee YS, Hwang M, Song JS, Li C, Joung B, Sobie EA, Pak HN (2016) The contribution of ionic currents to rate-dependent action potential duration and pattern of reentry in a mathematical model of human atrial fibrillation. PLoS ONE 11:e150779PubMedPubMedCentral
34.
Mirams GR, Cui Y, Sher A, Fink M, Cooper J, Heath BM, McMahon NC, Gavaghan DJ, Noble D (2011) Simulation of multiple ion channel block provides improved early prediction of compounds’ clinical torsadogenic risk. Cardiovasc Res 91:53–61PubMedPubMedCentral
35.
Yao X, Ye F, Zhang M, Cui C, Huang B, Niu P, Liu X, Zhao L, Dong E, Song C, Zhan S, Lu R, Li H, Tan W, Liu D (2020) In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome Coronavirus 2 (SARS-coV-2). Clin Infect Dis 71:732–739PubMed
36.
Costedoat-Chalumeau N, Amoura Z, Hulot JS, Hammoud HA, Aymard G, Cacoub P, Frances C, Wechsler B, Huong du LT, Ghillani P, Musset L, Lechat P, Piette JC (2006) Low blood concentration of hydroxychloroquine is a marker for and predictor of disease exacerbations in patients with systemic lupus erythematosus. Arthritis Rheum 54:3284–3290PubMed
37.
Wu TJ, Kim YH, Yashima M, Athill CA, Ting CT, Karagueuzian HS, Chen PS (2001) Progressive action potential duration shortening and the conversion from atrial flutter to atrial fibrillation in the isolated canine right atrium. J Am Coll Cardiol 38:1757–1765PubMed
38.
Franz MR, Jamal SM, Narayan SM (2012) The role of action potential alternans in the initiation of atrial fibrillation in humans: a review and future directions. Europace 14(5):v58–v64PubMedPubMedCentral
39.
Prodromos CC, Rumschlag T, Perchyk T (2020) Hydroxychloroquine is protective to the heart, not harmful: a systematic review. New Microbes New Infect 37:100747PubMedPubMedCentral
40.
Lo CH, Wang YH, Tsai CF, Chan KC, Li LC, Lo TH, Wei JC, Su CH (2021) Association of hydroxychloroquine and cardiac arrhythmia in patients with systemic lupus erythematosus: a population-based case control study. PLoS ONE 16:e251918PubMedPubMedCentral
41.
McGhie TK, Harvey P, Su J, Anderson N, Tomlinson G, Touma Z (2018) Electrocardiogram abnormalities related to anti-malarials in systemic lupus erythematosus. Clin Exp Rheumatol 36:545–551PubMed
42.
Lo CH, Wei JC, Wang YH, Tsai CF, Chan KC, Li LC, Lo TH, Su CH (2021) Hydroxychloroquine does not increase the risk of cardiac arrhythmia in common rheumatic diseases: a nationwide population-based cohort study. Front Immunol 12:631869PubMedPubMedCentral
43.
Morgan ND, Patel SV, Dvorkina O (2013) Suspected hydroxychloroquine-associated QT-interval prolongation in a patient with systemic lupus erythematosus. J Clin Rheumatol 19:286–288PubMed
44.
Park E, Giles JT, Perez-Recio T, Pina P, Depender C, Gartshteyn Y, Askanase AD, Bathon J, Geraldino-Pardilla L (2021) Hydroxychloroquine use is not associated with QTc length in a large cohort of SLE and RA patients. Arthritis Res Ther 23:271PubMedPubMedCentral
45.
Tleyjeh IM, Kashour Z, AlDosary O, Riaz M, Tlayjeh H, Garbati MA, Tleyjeh R, Al-Mallah MH, Sohail MR, Gerberi D, Bin Abdulhak AA, Giudicessi JR, Ackerman MJ, Kashour T (2021) Cardiac toxicity of chloroquine or hydroxychloroquine in patients with COVID-19: a systematic review and meta-regression analysis. Mayo Clin Proc Innov Qual Outcomes 5:137–150PubMed
46.
Saleh M, Gabriels J, Chang D, Soo Kim B, Mansoor A, Mahmood E, Makker P, Ismail H, Goldner B, Willner J, Beldner S, Mitra R, John R, Chinitz J, Skipitaris N, Mountantonakis S, Epstein LM (2020) Effect of chloroquine, hydroxychloroquine, and azithromycin on the corrected QT interval in patients with SARS-coV‑2 infection. Circ Arrhythm Electrophysiol 13:e8662PubMedPubMedCentral
47.
Chorin E, Wadhwani L, Magnani S, Dai M, Shulman E, Nadeau-Routhier C, Knotts R, Bar-Cohen R, Kogan E, Barbhaiya C, Aizer A, Holmes D, Bernstein S, Spinelli M, Park DS, Stefano C, Chinitz LA, Jankelson L (2020) QT interval prolongation and torsade de pointes in patients with COVID-19 treated with hydroxychloroquine/azithromycin. Heart Rhythm 17:1425–1433PubMedPubMedCentral
48.
Mercuro NJ, Yen CF, Shim DJ, Maher TR, McCoy CM, Zimetbaum PJ, Gold HS (2020) Risk of QT interval prolongation associated with use of hydroxychloroquine with or without concomitant azithromycin among hospitalized patients testing positive for Coronavirus disease 2019 (COVID-19). JAMA Cardiol 5:1036–1041PubMed
49.
Rosenberg ES, Dufort EM, Udo T, Wilberschied LA, Kumar J, Tesoriero J, Weinberg P, Kirkwood J, Muse A, DeHovitz J, Blog DS, Hutton B, Holtgrave DR, Zucker HA (2020) Association of treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with COVID-19 in New York state. JAMA 323:2493–2502PubMedPubMedCentral
50.
Kirchhof P, Eckardt L, Franz MR, Monnig G, Loh P, Wedekind H, Schulze-Bahr E, Breithardt G, Haverkamp W (2003) Prolonged atrial action potential durations and polymorphic atrial tachyarrhythmias in patients with long QT syndrome. J Cardiovasc Electrophysiol 14:1027–1033PubMed
51.
Shenthar J, Rachaiah JM, Pillai V, Chakali SS, Balasubramanian V, Chollenhalli Nanjappa M (2017) Incidence of drug-induced torsades de pointes with intravenous amiodarone. Indian Heart J 69:707–713PubMedPubMedCentral
52.
Lim HE, Pak HN, Ahn JC, Song WH, Kim YH (2006) Torsade de pointes induced by short-term oral amiodarone therapy. Europace 8:1051–1053PubMed
53.
Yuan Y, Zhao J, Gong Y, Wang D, Wang X, Yun F, Liu Z, Zhang S, Li W, Zhao X, Sun L, Sheng L, Pan Z, Li Y (2018) Autophagy exacerbates electrical remodeling in atrial fibrillation by ubiquitin-dependent degradation of L‑type calcium channel. Cell Death Dis 9:873PubMedPubMedCentral
54.
Fedai H, Altiparmak IH, Tascanov MB, Tanriverdi Z, Bicer A, Gungoren F, Demirbag R, Koyuncu I (2022) The relationship between oxidative stress and autophagy and apoptosis in patients with paroxysmal atrial fibrillation. Scand J Clin Lab Invest 82:391–397PubMed
55.
Bai J, Lo A, Gladding PA, Stiles MK, Fedorov VV, Zhao J (2020) In silico investigation of the mechanisms underlying atrial fibrillation due to impaired Pitx2. PLoS Comput Biol 16:e1007678PubMedPubMedCentral
56.
Cherry EM, Hastings HM, Evans SJ (2008) Dynamics of human atrial cell models: restitution, memory, and intracellular calcium dynamics in single cells. Prog Biophys Mol Biol 98:24–37PubMedPubMedCentral
57.
Azzolin L, Schuler S, Dossel O, Loewe A (2021) A reproducible protocol to assess arrhythmia vulnerability in silico: pacing at the end of the effective refractory period. Front Physiol 12:656411PubMedPubMedCentral
58.
Song E, Wang RS, Leopold JA, Loscalzo J (2020) Network determinants of cardiovascular calcification and repositioned drug treatments. Faseb J 34:11087–11100PubMed
59.
Lal JC, Mao C, Zhou Y, Gore-Panter SR, Rennison JH, Lovano BS, Castel L, Shin J, Gillinov AM, Smith JD, Barnard J, Van Wagoner DR, Luo Y, Cheng F, Chung MK (2022) Transcriptomics-based network medicine approach identifies metformin as a repurposable drug for atrial fibrillation. Cell Rep Med 3:100749PubMedPubMedCentral
Metadaten
Titel
Effects of hydroxychloroquine on atrial electrophysiology in in silico wild-type and PITX2+/- atrial cardiomyocytes
verfasst von
Euijun Song, MD
Publikationsdatum
02.02.2023
Verlag
Springer Medizin
Erschienen in
Herz / Ausgabe 5/2023
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI
https://doi.org/10.1007/s00059-023-05162-w

Weitere Artikel der Ausgabe 5/2023

Herz 5/2023 Zur Ausgabe

Schwerpunkt

Echokardiographie mit hohen Bildraten in der klinischen Praxis

Original articles

Analysis of risk factors for systemic inflammatory response syndrome in patients after transcatheter aortic valve replacement

Editorial

Kardiale Bildgebung – mehr als reine Diagnostik

Review articles

Overview of pharmacotherapy targeting COVID-19 disease based on ACE-2: current challenges and future directions

CME

Kardiovaskuläre Therapie bei chronischer Nierenerkrankung

Schwerpunkt

Koronare CT-Angiographie und koronare Atherosklerose

Neu im Fachgebiet Kardiologie

Schadet Ärger den Gefäßen?

14.05.2024 Arteriosklerose Nachrichten

In einer Studie aus New York wirkte sich Ärger kurzfristig deutlich negativ auf die Endothelfunktion gesunder Probanden aus. Möglicherweise hat dies Einfluss auf die kardiovaskuläre Gesundheit.

Intervallfasten zur Regeneration des Herzmuskels?

14.05.2024 Herzinfarkt Nachrichten

Die Nahrungsaufnahme auf wenige Stunden am Tag zu beschränken, hat möglicherweise einen günstigen Einfluss auf die Prognose nach akutem ST-Hebungsinfarkt. Darauf deutet eine Studie an der Uniklinik in Halle an der Saale hin.

Shunt-Therapie bei Herzinsuffizienz: Kein Anzug, der allen passt

13.05.2024 Chronische Herzinsuffizienz Nachrichten

Die Anlage eines interatrialen Shunts zur Reduktion des linksatrialen Drucks ist ein neuer Therapieansatz bei Herzinsuffizienz. Viele Patienten sprechen darauf an, andere jedoch nicht. 

Vorsicht, erhöhte Blutungsgefahr nach PCI!

10.05.2024 Koronare Herzerkrankung Nachrichten

Nach PCI besteht ein erhöhtes Blutungsrisiko, wenn die Behandelten eine verminderte linksventrikuläre Ejektionsfraktion aufweisen. Das Risiko ist umso höher, je stärker die Pumpfunktion eingeschränkt ist.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise