@article{KoehlerKoehlerDeckwartetal.2018, author = {Koehler, Friedrich and Koehler, Kerstin and Deckwart, Oliver and Prescher, Sandra and Wegscheider, Karl and Winkler, Sebastian and Vettorazzi, Eik and Polze, Andreas and Stangl, Karl and Hartmann, Oliver and Marx, Almuth and Neuhaus, Petra and Scherf, Michael and Kirwan, Bridget-Anne and Anker, Stefan D.}, title = {Telemedical Interventional Management in Heart Failure II (TIM-HF2), a randomised, controlled trial investigating the impact of telemedicine on unplanned cardiovascular hospitalisations and mortality in heart failure patients}, series = {European Journal of Heart Failure}, volume = {20}, journal = {European Journal of Heart Failure}, number = {10}, publisher = {Wiley}, address = {Hoboken}, issn = {1388-9842}, doi = {10.1002/ejhf.1300}, pages = {1485 -- 1493}, year = {2018}, abstract = {Background Heart failure (HF) is a complex, chronic condition that is associated with debilitating symptoms, all of which necessitate close follow-up by health care providers. Lack of disease monitoring may result in increased mortality and more frequent hospital readmissions for decompensated HF. Remote patient management (RPM) in this patient population may help to detect early signs and symptoms of cardiac decompensation, thus enabling a prompt initiation of the appropriate treatment and care before a manifestation of HF decompensation. Objective The objective of the present article is to describe the design of a new trial investigating the impact of RPM on unplanned cardiovascular hospitalisations and mortality in HF patients. Methods The TIM-HF2 trial is designed as a prospective, randomised, controlled, parallel group, open (with randomisation concealment), multicentre trial with pragmatic elements introduced for data collection. Eligible patients with HF are randomised (1:1) to either RPM + usual care or to usual care only and are followed for 12 months. The primary outcome is the percentage of days lost due to unplanned cardiovascular hospitalisations or all-cause death. The main secondary outcomes are all-cause and cardiovascular mortality. Conclusion The TIM-HF2 trial will provide important prospective data on the potential beneficial effect of telemedical monitoring and RPM on unplanned cardiovascular hospitalisations and mortality in HF patients.}, language = {en} } @article{RokutanSuckowvonHaehlingetal.2012, author = {Rokutan, Hirofumi and Suckow, Christian and von H{\"a}hling, Stephan and Strassburg, Sabine and Bockmeyer, Barbara and D{\"o}hner, Wolfram and Waller, Christiane and Bauersachs, Johann and von Websky, Karoline and Hocher, Berthold and Anker, Stefan D. and Springer, Jochen}, title = {Furosemide induces mortality in a rat model of chronic heart failure}, series = {International journal of cardiology}, volume = {160}, journal = {International journal of cardiology}, number = {1}, publisher = {Elsevier}, address = {Clare}, issn = {0167-5273}, doi = {10.1016/j.ijcard.2011.03.005}, pages = {20 -- 25}, year = {2012}, abstract = {Objectives: In an experimental heart failure model, we tested the hypothesis that furosemide causes excess mortality. Background: Post-hoc analysis of large clinical heart failure trails revealed that furosemide treatment might be associated with worsening of morbidity and even mortality in heart failure patients. Methods and results: Myocardial infarction was induced in 7 +/- 1 week old male Wistar rats by ligation of the left coronary artery. In study 1, animals were randomly assigned to treatment with furosemide (10 mg/kg/d via drinking water, n = 33) or placebo (n = 33) starting 18 days after surgery. In study 2, animals received furosemide from day 18 and were then randomized to ongoing treatment with either furosemide only (n = 38) or furosemide plus ACE-inhibitor Ramipril (1 mg/kg/d, n = 38) starting on day 42. In study 1 survival rate in the furosemide group was lower than in the placebo group (hazard ratio {HR} 3.39, 95\% confidence interval {CI} 1.14 to 10.09, p = 0.028). The furosemide group had a lower body weight (-6\%, p = 0.028) at the end of the study and a higher sclerosis index of the glomeruli (+9\%, p=0.026) than the placebo group. Wet lung weight, infarct size, and cardiac function were similar between the groups. In study 2, the furosemide group had a higher mortality rate than the furosemide + ramipril group (HR 4.55, 95\% CI 2.0 to 10.0, p = 0.0003). Conclusion: In our rat model of heart failure furosemide, provided at a standard dose, was associated with increased mortality. This increased mortality could be prevented by additional administration of an ACE-inhibitor.}, language = {en} }