Heart Failure, Ischemic Myocardiopathy, Dilatative Myocardiopathy
Conditions
Brief summary
Project aim is to quantify the influence of a severe therapy-refractory heart failure caused by ischemic or dilative myocardiopathy on the function of the diaphragm, its molecular biological parameters and on the M. vastus lateralis. The control group consists of patients with coronary artery disease (CAD) and normal left ventricular ejection fraction indicated for coronary artery bypass graft surgery (CABG) Differences in the geneses of heart failure (ischemic vs. dilative cardiomyopathy) will be evaluated during analysis. The ubiquitin-proteasome signaling pathway is considered as a central issue for the mechanism of the analyses muscle catabolism.
Interventions
OTHERBiopsy of the diaphragmatic muscle
Sponsors
Norman Mangner
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
40 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
inclusion criteria Group A: * age 40 - 70 years * Restricted left ventricular pump function left ventricular ejection fraction (LVEF) \> 35% on the basis of ischemic cardiomyopathy (ICM) and restricted resting cardiac output (CI\> 2.4 L / min / m²) * or restricted maximal oxygen uptake (VO2max\> 17 ml / min / m²) * Duration of heart failure\> 1 year * Maximum of individual heart failure therapy * Heart team decision to LVAD Implantation inclusion criteria Group B: * age 40 - 70 years * Restricted left ventricular pump function (LVEF) \> 35% on the basis of dilatative cardiomyopathy (DCM) and restricted resting cardiac output (CI\> 2.4 L / min / m²) * or restricted maximal oxygen uptake (VO2max\> 17 ml / min / m²) * Duration of heart failure\> 1 year * Maximum of individual heart failure therapy * Heart team decision to LVAD Implantation inclusion criteria Group C: * age 40 - 70 years * coronary heart disease with indication for elective, coronary artery bypass surgery * normal left ventricle (LV) pumping function LVEF\> 50% * stable clinical situation (no cardiac decompensation within the last 6 months)
Exclusion criteria
* Mechanical ventilation within the last 3 months * Forced Expiratory Pressure (FEV1) \<70% of the norm and / or therapy with α antagonists, β-mimetics or inhaled corticosteroids for the treatment of a lung disease * Pulmonary fibrosis * elevated diaphragm in the ultrasound or X-ray diagnosis or known paresis of the phrenic nerve * chronic kidney disease (CKD) stage 4 and 5, i.e. glomerular filtration rate (GFR) \<30ml / min / 1.73m and / or dialysis * Acute renal failure * Treatment with immunosuppressive agents * Hepatic insufficiency Child-Pugh B and C * Higher grade ventricular arrhythmias (Lown IV b) * Acute myocardial infarction (less than three months) * Decompensated Vitium cordis * Age \<40 years and\> 70 years * Pregnancy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Expression of catabolic E3 ligase Muscle ring finger 1 (MuRF1) | at the time of index procedure (biopsy) |
Secondary
| Measure | Time frame |
|---|---|
| in vitro measurement of the muscle protein - poly ubiquitination of Proteins | at the time of index procedure (biopsy) |
| in vitro measurement of the muscle protein - the proteasome activity | at the time of index procedure (biopsy) |
| in vitro measurement of the muscle protein - fiber typing in the muscle samples | at the time of index procedure (biopsy) |
| in vitro measurement of the force development of skinned muscle fibers | at the time of index procedure (biopsy) |
Countries
Germany
Outcome results
None listed