Pleural Effusions Requiring Thoracocentesis Are Associated With Baseline Lung Allograft Dysfunction and Mortality in Lung Transplant Recipients.

Background: Pleural effusions of unknown etiology have been demonstrated to be associated with poor prognosis in lung allograft recipients. We aimed to identify novel risk factors for pleural effusions after lung transplantation (LTX) and to shed light on their association with allograft function and survival, differentiating early and late pleural effusions after LTX.

Methods: We performed a retrospective study of all LTX recipients transplanted at the LMU Klinikum Munich from 2013 to 2018.

Cardiac autonomic function score: a novel risk stratification tool in the cardiac intensive care unit based on periodic repolarization dynamics and deceleration capacity of heart rate (LMU-eICU study).

Aims: Treatment capacities on intensive care units (ICUs) are a limited resource reserved for high-risk patients. To facilitate risk stratification of ICU patients, several scoring systems have been developed over time. Among them, the Simplified Acute Physiology Score 3 (SAPS3) is the gold standard, but lacks specificity for cardiac ICU patients.

Diagnostic Power of Head-Up Tilt Test Enhanced by Autonomic ECG Parameters and Beat-to-Beat Hemodynamic Monitoring.

The head-up tilt test (HUTT) is a well-established diagnostic procedure used to differentiate between the types of syncope. Since its introduction in 1986, the protocol has undergone several refinements aimed at increasing diagnostic accuracy. Despite growing interest in advanced autonomic ECG parameters and beat-to-beat blood pressure monitoring, their integration into routine HUTT protocols remains limited.

Smartphone-based screening for atrial fibrillation: a pragmatic randomized clinical trial.

Digital smart devices have the capability of detecting atrial fibrillation (AF), but the efficacy of this type of digital screening has not been directly compared to usual care for detection of treatment-relevant AF. In the eBRAVE-AF trial ( NCT04250220 ), we randomly assigned 5,551 policyholders of a German health insurance company who were free of AF at baseline (age 65 years (median; interquartile range (11) years, 31% females)) to digital screening (n = 2,860) or usual care (n = 2,691). In this siteless trial, for digital screening, participants used a certified app on their own smartphones to screen for irregularities in their pulse waves.

Telemedical cardiac risk assessment by implantable cardiac monitors in patients after myocardial infarction with autonomic dysfunction (SMART-MI-DZHK9): a prospective investigator-initiated, randomised, multicentre, open-label, diagnostic trial.

Background: Cardiac autonomic dysfunction after myocardial infarction identifies patients at high risk despite only moderately reduced left ventricular ejection fraction. We aimed to show that telemedical monitoring with implantable cardiac monitors in these patients can improve early detection of subclinical but prognostically relevant arrhythmic events.

Methods: We did a prospective investigator-initiated, randomised, multicentre, open-label, diagnostic trial at 33 centres in Germany and Austria.

Impairment of Cognitive Function in Different Domains Early After Lung Transplantation.

In this prospective observational pilot study patients with the diagnosis of end-stage lung disease and listed for lung transplantation underwent a cognitive function test battery before and after lung transplantation to investigate postoperative cognitive function in three domains (visual and verbal memory, executive functioning, concentration/speed of processing). Additionally we investigated intraoperative risk factors for postoperative cognitive dysfunction. In total, 24 patients were included in this pilot study.

Deceleration Capacity and Periodic Repolarization Dynamics As Predictors of Acute Mountain Sickness.

Hamm, Wolfgang, Sari Kassem, Lukas von Stülpnagel, Florian Maier, Mathias Klemm, Dominik Schüttler, Felix Grabher, Ludwig T. Weckbach, Bruno C. Huber, Axel Bauer, Konstantinos D.

Prediction of mortality benefit based on periodic repolarisation dynamics in patients undergoing prophylactic implantation of a defibrillator: a prospective, controlled, multicentre cohort study.

Background: A small proportion of patients undergoing primary prophylactic implantation of implantable cardioverter defibrillators (ICDs) experiences malignant arrhythmias. We postulated that periodic repolarisation dynamics, a novel marker of sympathetic-activity-associated repolarisation instability, could be used to identify electrically vulnerable patients who would benefit from prophylactic implantation of ICDs by way of a reduction in mortality.

Methods: We did a prespecified substudy of EUropean Comparative Effectiveness Research to Assess the Use of Primary ProphylacTic Implantable Cardioverter Defibrillators (EU-CERT-ICD), a prospective, investigator-initiated, non-randomised, controlled cohort study done at 44 centres in 15 EU countries.

Dynamic Changes of Cardiac Repolarization Instability during Exercise Testing.

Introduction: Physical exercise triggers efferent cardiac sympathetic activation. Here, we tracked the spatiotemporal properties of cardiac repolarization on a beat-to-beat basis throughout a standardized exercise test and hypothesized a detectable change at the point of the anaerobic threshold (AT).

Methods: The study included 20 healthy adults (age 35.

Deceleration Capacity of Heart Rate After Acute Altitude Exposure.

Unlabelled: Hamm, Wolfgang, Lukas von Stülpnagel, Mathias Klemm, Monika Baylacher, Konstantinos D. Rizas, Axel Bauer, and Stefan Brunner. Deceleration capacity of heart rate after acute altitude exposure.