@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} } @article{FranzOttenMuellerWerdanetal.2019, author = {Franz, Kristina and Otten, Lindsey and M{\"u}ller-Werdan, Ursula and D{\"o}hner, Wolfram and Norman, Kristina}, title = {Severe Weight Loss and Its Association with Fatigue in Old Patients at Discharge from a Geriatric Hospital}, series = {Nutrients}, volume = {11}, journal = {Nutrients}, number = {10}, publisher = {MDPI}, address = {Basel}, issn = {2072-6643}, doi = {10.3390/nu11102415}, pages = {10}, year = {2019}, abstract = {Although malnutrition is frequent in the old, little is known about its association with fatigue. We evaluated the relation of self-reported severe weight loss with fatigue and the predictors for fatigue in old patients at hospital discharge. Severe weight loss was defined according to involuntary weight loss >= 5\% in the last three months. We determined fatigue with the validated Brief Fatigue Inventory questionnaire. The regression analyses were adjusted for age, sex, number of comorbidities, medications/day, and BMI. Of 424 patients aged between 61 and 98 y, 34.1\% had severe weight loss. Fatigue was higher in patients with severe weight loss (3.7 +/- 2.3 vs. 3.2 +/- 2.3 points, p = 0.021). In a multinomial regression model, weight loss was independently associated with higher risk for moderate fatigue (OR:1.172, CI:1.026-1.338, p = 0.019) and with increased risk for severe fatigue (OR:1.209, CI:1.047-1.395, p = 0.010) together with the number of medications/day (OR:1.220, CI:1.023-1.455, p = 0.027). In a binary regression model, severe weight loss predicted moderate-to-severe fatigue in the study population (OR:1.651, CI:1.052-2.590, p = 0.029). In summary, patients with self-reported severe weight loss at hospital discharge exhibited higher fatigue levels and severe weight loss was an independent predictor of moderate and severe fatigue, placing these patients at risk for impaired outcome in the post-hospital period.}, language = {en} } @article{ReibisSalzwedelAbreuetal.2019, author = {Reibis, Rona Katharina and Salzwedel, Annett and Abreu, Ana and Corra, Ugo and Davos, Constantinos and D{\"o}hner, Wolfram and Doherty, Patrick and Frederix, Ines and Hansen, Dominique and Iliou, Marie Christine and Vigorito, Carlo and V{\"o}ller, Heinz}, title = {The importance of return to work}, series = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology}, volume = {26}, journal = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology}, number = {13}, publisher = {Sage Publ.}, address = {London}, organization = {EAPC}, issn = {2047-4873}, doi = {10.1177/2047487319839263}, pages = {1358 -- 1369}, year = {2019}, abstract = {The vocational reintegration of patients after an acute coronary syndrome is a crucial step towards complete convalescence from the social as well as the individual point of view. Return to work rates are determined by medical parameters such as left ventricular function, residual ischaemia and heart rhythm stability, as well as by occupational requirement profile such as blue or white collar work, night shifts and the ability to commute (which is, in part, determined by physical fitness). Psychosocial factors including depression, self-perceived health situation and pre-existing cognitive impairment determine the reintegration rate to a significant extent. Patients at risk of poor vocational outcomes should be identified in the early period of rehabilitation to avoid a reintegration failure and to prevent socio-professional exclusion with adverse psychological and financial consequences. A comprehensive healthcare pathway of acute coronary syndrome patients is initiated by cardiac rehabilitation, which includes specific algorithms and assessment tools for risk stratification and occupational restitution. As the first in its kind, this review addresses determinants and legal aspects of reintegration of patients experiencing an acute coronary syndrome, and offers practical advice on reintegration strategies particularly for vulnerable patients. It presents different approaches and scientific findings in the European countries and serves as a recommendation for action.}, language = {en} }