Jennifer Franke

CardioVasculäres Centrum Frankfurt, Frankfurt, Hesse, Germany

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Publications (70)218.05 Total impact

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    ABSTRACT: We sought to identify prognostic factors of long-term mortality, specific for the underlying etiology of chronic systolic heart failure (CHF).
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    ABSTRACT: Structural heart disease requires a coordinated effort to join echocardiographic and fluoroscopic data. Various methods have been used, including echocardiography, CT, and MRI. We report on the use of EchoNavigator (Philips Inc., Amsterdam, Netherlands), a novel echocardiographic-fluoroscopic fusion system. This new system allows real-time integration and marking of important structures that track on fluoroscopy even with movement of the C-arm. In this article, we describe potential uses for this system in respect to transseptal puncture and left atrial appendage closure. © 2015, Wiley Periodicals, Inc.
    Journal of Interventional Cardiology 02/2015; DOI:10.1111/joic.12170 · 1.50 Impact Factor
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    ABSTRACT: Objectives Aim of this study was to demonstrate the feasibility, safety and short-term outcome of left atrial appendage (LAA) closure with a new generation LAA closure device.Background The Amulet device (AGA, St Jude Medical, Minneapolis, MN, USA) is a new generation of the Amplatzer Cardiac Plug (ACP), specifically designed for LAA closure. This new version is designed to facilitate the implantation process and minimize procedural or device-related complications.Methods The device was implanted in 17 patients with non-valvular atrial fibrillation (AF). Clinical data were obtained at baseline, during the procedure, at discharge, at 30 days and 90 days.ResultsAll devices were implanted successfully. Device sizes ranged from 20 mm to 31 mm. A 12 French (Fr) or 14 Fr delivery sheath was used depending on the selected device size. Full and partial recapture was performed in 1 case and 3 cases respectively. There was 1 procedure-related pericardial effusion successfully managed with pericardiocentesis. There was no device embolization. The mean length of stay was 2.1 ± 0.3 days. At 90 days, there were no deaths, strokes, systemic thromboembolism or bleeding complications. There was no device-related thrombus or pericardial effusion at 90-day TEE. In 2 of the 17 patients minimal peri-device flow (smaller than 2mm) was present.Conclusions The Amulet device, which has new novel features as compared with the first generation ACP, is a feasible option for LAA closure. From our initial experience, implantation of the Amulet is associated with high success rate and good short-term outcome. © 2014 Wiley Periodicals, Inc.
    Catheterization and Cardiovascular Interventions 02/2015; 85(2). DOI:10.1002/ccd.25644 · 2.51 Impact Factor
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    ABSTRACT: To describe the feasibility and safety of transcatheter aortic valve implantation (TAVI) with a visiting on-site cardiac surgery program for surgical back-up. Both European and American guidelines recommend institutional cardiac surgery back-up for TAVI. However, the conversion to cardiac surgery is very rare, many complications of TAVI can be managed by catheter techniques and a visiting team can also provide surgical stand-by. Therefore, the need for institutional cardiac surgery (by a surgeon who routinely performs conventional surgical valve replacement at the institution performing TAVI) has been questioned. A retrospective review of consecutive TAVI cases with visiting on-site cardiac surgery was performed. Key demographic, echocardiographic, and procedural data were collected prospectively. A total of 97 patients (81.9 ± 6.3 years) with high-risk criteria (log Euroscore 21.6 ± 14.4, chronic renal failure 39.2%, severe systolic dysfunction 24.7%) underwent TAVI with visiting on-site cardiac surgery at our institution. Local anesthesia with or without conscious sedation was used in 94.8% of patients. Procedural technical success was 100%, with 2 episodes of tamponade (both treated with pericardiocentesis) and a 16.5% vascular complication rate (all treated conservatively or percutaneously). Thirty-day mortality was 3.1%, with 5.2% rate of stroke and 8.2% rate of major bleeding. There were no conversions to surgery. TAVI can be done safely in the setting of a hospital with visiting on-site cardiac surgery. This requires careful patient selection, experienced operators and surgeons in experienced centers with well-established criteria and processes of care. In this setting, it may be an option for hospitals without institutional cardiac surgery. (J Interven Cardiol 2015;28:76-81). © 2015, Wiley Periodicals, Inc.
    Journal of Interventional Cardiology 02/2015; 28(1):76-81. DOI:10.1111/joic.12176 · 1.50 Impact Factor
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    ABSTRACT: Heart failure is a growing epidemic, with more patients living longer and suffering from this disease. There is a growing segment of patients who have persistent symptoms despite pharmacologic therapy. In an era when transplants are rare, the need for devices and interventions that can assist ventricular function is paramount. This review goes through the devices used in heart failure, including left ventricular reconstruction, aortic counterpulsation, short-term mechanical circulatory support, long-term mechanical circulatory support, and right heart interventions. (Circ J 2015; 79: 237-244).
    Circulation Journal 01/2015; 79(2). DOI:10.1253/circj.CJ-14-1354 · 3.69 Impact Factor
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    ABSTRACT: The German Centre for Cardiovascular Research (DZHK) initiated a standardised scientific infrastructure for clinical research including a centralised data management, harmonised clinical and imaging activities, and a DZHK-wide biobanking. Biobanking includes several processing steps: patient identification, sampling and transport, aliquoting, long-term storage, and withdrawal and re-storage of samples. A standardised and harmonised structure for collection, processing and storage of the data are established. Use and access to biomaterial and data for scientific purposes have been defined in the DZHK use-and-access policy and legal regulations including data privacy protection and ethical aspects have been taken into account.
    Biobanken-Forschung in Deutschland: Vom Konzept zur Realisierung., Berlin; 12/2014
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    ABSTRACT: We performed a prospective multi-center study to assess gender-specific differences in the predictive value of the measured level of NT-proBNP and the calculated Heart Failure Survival Score (HFSS).
    Clinical Research in Cardiology 11/2014; DOI:10.1007/s00392-014-0786-z · 4.17 Impact Factor
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    ABSTRACT: Left ventricular noncompaction (LVNC) is a cardiomyopathy with hypertrabeculation of the LV, often complicated by heart failure, arrhythmia and thromboembolic events. The features of LVNC are still incompletely characterized due to its late recognition as clinically relevant condition. The aims of this study were to describe echocardiographic and electrophysiologic characteristics of LVNC patients and to assess the effects of chronic β-blocker treatment. Study patients (n = 20; 42.5 [36.3; 52.5] years; 12 men) exhibited reduced LV ejection fraction (median LVEF = 32 %) and an increased LV mass of 210 g. Sinus rhythm was present in 19 patients, whereas one patient was in atrial fibrillation. Baseline heart rate was 77.5 beats per minute. Left bundle branch block was detected in five cases. In a subgroup of patients receiving β-blocker therapy (n = 17), LV mass was reduced from 226 [178; 306] g to 220 [169; 254] g (p = 0.007) at 13 ± 6 months follow-up. By contrast, a subgroup of three patients that were not treated with an anti-β-adrenergic agent showed LV mass increase from 180 [169; 197] g to 199 [185; 213] g (p = 0.023). LVEF and electrocardiographic parameters were not significantly modulated during chronic β-blocker treatment. There was no sustained symptomatic ventricular tachyarrhythmia, thromboembolic event or death in either group. In conclusion, this study reveals reduction of LV mass among LVNC patients during β-blocker therapy. Effects of β-blocker treatment in LVNC require validation in prospective controlled studies.
    Clinical Research in Cardiology 10/2014; DOI:10.1007/s00392-014-0778-z · 4.17 Impact Factor
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    ABSTRACT: Objective: To evaluate in-hospital and short-term outcomes of percutaneous mitral valve repair according to patients' logistic EuroSCORE (logEuroSCORE) in a multicenter registry.Background: The logEuroSCORE is an established tool to predict the risk of mortality during cardiac surgery. In high-risk patients percutaneous mitral valve repair with the MitraClip system represents a less-invasive alternative.Methods: Data from 1002 patients, who underwent percutaneous mitral valve repair with the MitraClip system, were analyzed in the German Transcatheter Mitral Valve Interventions (TRAMI) Registry. A logEuroSCORE (mortality risk in %) ≥ 20 was considered high risk.Results: Of all patients, 557 (55.6%) had a logEuroSCORE ≥ 20. Implantation of the MitraClip was successful in 95.5 % (942/986) patients. Moderate residual mitral valve regurgitation was more often detected in patients with a logEuroSCORE ≥ 20 (23.8% vs. 17.1% respectively, p<0.05). In patients with a logEuroSCORE ≥ 20 the procedural complication rate was 8.9% (vs. 6.4, n.s.) and the in-hospital MACCE rate 4.9% (vs. 1.4% p<0.01). The in-hospital mortality rate in patients with a logEuroSCORE ≥ 20 and logEuroSCORE < 20 was 4.3% and 1.1%, respectively (p = <0.01).Conclusion: Percutaneous mitral valve repair with the MitraClip system is feasible in patients with a logEuroSCORE ≥ 20 with similar procedural results compared to patients with lower predicted risk. Although mortality was four times higher than in patients with logEuroSCORE < 20, mortality in high risk patients was lower than predicted. In those with a logEuroSCORE ≥ 20, moderate residual mitral valve regurgitation was more frequent. © 2014 Wiley Periodicals, Inc.
    Catheterization and Cardiovascular Interventions 10/2014; 84(4). DOI:10.1002/ccd.25493 · 2.51 Impact Factor
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    ABSTRACT: To investigate the prognostic impact of left-ventricular (LV) cardiac magnetic resonance (CMR) deformation imaging in patients with non-ischaemic dilated cardiomyopathy (DCM) compared with late-gadolinium enhancement (LGE) quantification and LV ejection fraction (EF).
    European Heart Journal – Cardiovascular Imaging 09/2014; DOI:10.1093/ehjci/jeu181 · 3.67 Impact Factor
  • Catheterization and Cardiovascular Interventions 09/2014; DOI:10.1002/ccd.25654 · 2.51 Impact Factor
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    ABSTRACT: Aim Numerous genes are known to cause dilated cardiomyopathy (DCM). However, until now technological limitations have hindered elucidation of the contribution of all clinically relevant disease genes to DCM phenotypes in larger cohorts. We now utilized next-generation sequencing to overcome these limitations and screened all DCM disease genes in a large cohort. Methods and results In this multi-centre, multi-national study, we have enrolled 639 patients with sporadic or familial DCM. To all samples, we applied a standardized protocol for ultra-high coverage next-generation sequencing of 84 genes, leading to 99.1% coverage of the target region with at least 50-fold and a mean read depth of 2415. In this well characterized cohort, we find the highest number of known cardiomyopathy mutations in plakophilin-2, myosin-binding protein C-3, and desmoplakin. When we include yet unknown but predicted disease variants, we find titin, plakophilin-2, myosin-binding protein-C 3, desmoplakin, ryanodine receptor 2, desmocollin-2, desmoglein-2, and SCN5A variants among the most commonly mutated genes. The overlap between DCM, hypertrophic cardiomyopathy (HCM), and channelopathy causing mutations is considerably high. Of note, we find that >38% of patients have compound or combined mutations and 12.8% have three or even more mutations. When comparing patients recruited in the eight participating European countries we find remarkably little differences in mutation frequencies and affected genes. Conclusion This is to our knowledge, the first study that comprehensively investigated the genetics of DCM in a large-scale cohort and across a broad gene panel of the known DCM genes. Our results underline the high analytical quality and feasibility of Next-Generation Sequencing in clinical genetic diagnostics and provide a sound database of the genetic causes of DCM.
    European Heart Journal 08/2014; DOI:10.1093/eurheartj/ehu301 · 14.72 Impact Factor
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    ABSTRACT: To report procedural outcome of sequential occlusion of the left atrial appendage (LAA) and an interatrial septal communication and discuss possible indications.
    Journal of Interventional Cardiology 08/2014; 27(4):414-22. DOI:10.1111/joic.12138 · 1.32 Impact Factor
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    ABSTRACT: The German Centre for Cardiovascular Research (DZHK) has started to establish a harmonised decentral biobanking. Biobanking is the basis for biomarker research. It will gain even more importance in the future. Biobanking includes several processing steps: patient identification, sampling, transport, aliquoting, long term storage, retrieving of suitable samples, thawing, mixing, analyzing and re-storage, if appropriate. This impacts the biobanking structure. Quality of the samples is mainly affected by processing time and temperature. Aliquoting of samples after thawing for analysis should be avoided, because manual processing requires time and is an additional source of errors; both affecting the quality of biomarker research. The DZHK has seven partner sites including overall 20 university hospitals. One focus of the DZHK is on clinical research. Besides the definition of storage conditions state of the art biobanking needs reliable structures for collection of standardised clinical data. In addition, use & access rules have been defined and legal regulations including data privacy protection and ethical aspects have been taken into account. From all patients recruited within the DZHK a pseudonymised basic-sample-set will be collected independent of scientific questions. Primary and aliquote tubes suitable for robotics and small aliquot sizes with 1D and 2D barcodes are chosen. The tubes will be pre-labeled at the Institute of Clinical Chemistry and Laboratory Medicine of the University Medicine Greifswald and will be sent to all study centres. All samples will be stored in decentral biobanks at -80°C.
    Congress of Clinical Chemistry and Laboratory Medicine/ Clin Chem Lab Med, Mannheim; 08/2014
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    ABSTRACT: Aims: To assess the use of proximal protection devices in consecutive patients as the preferred means of cerebral embolic protection for primary carotid stenting. Methods and results: This was a prospective single-centre study to evaluate the technical and clinical success of proximal protection devices as the first choice for embolic protection in symptomatic (≥50%) and asymptomatic (≥70%) carotid stenosis. Proximal protection devices were used for embolic protection in 124 consecutive patients. No patients were excluded for anatomical reasons. The GORE® Flow Reversal System (W.L. Gore, Flagstaff, AZ, USA) was used in 92 patients, and the Mo.Ma Ultra device (Medtronic, Minneapolis, MN, USA) in 32 patients. Follow-up duration was 30 days. Mean age was 71±8 years. Seventy-five percent of patients were male (n=93). Twenty-six of 124 (21%) treated stenoses were symptomatic. Technical success was achieved in 122 of 124 cases (98%). Due to anatomical conditions, in two patients flow reversal could not be established. In both cases additional distal filter devices were used. Carotid stenting was successful in 124 lesions (100%). Ten patients (8.1%) had contraindications to flow reversal (three high-grade ostial stenoses of the external carotid artery, seven contralateral occlusions of the internal carotid artery) in none of whom complications occurred. There were no procedural neurologic events. Within 30 days of follow-up, one patient had an ischaemic stroke (on day 11). Conclusions: Proximal protection is a safe method as the first choice for embolic protection. It can be used with a high rate of technical success.
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    ABSTRACT: Background: The 6-minute walk test (6WT) is an established tool in the assessment of endurance and prognosis in patients with chronic heart failure (CHF). For these patients there is very limited data on biological variation of 6WT distances. We determined the minimal important difference (MID) for the 6WT in patients with stable systolic CHF. Methods: Two cohorts of patients with stable systolic CHF were included from the outpatients' clinic of the University of Heidelberg. In these cohorts, two 6WT measurements were performed - in cohort 1 (n = 461) 180 days and in cohort 2 (n = 512) 365 days apart. Stability was defined as the absence of clinical events (3 months before the first test, between both tests, and 6 months after the second test) and stability of symptoms (NYHA) between tests. Using a standard error of measurement (SEM)-based approach, we determined the MID for both cohorts. Results: The intraclass correlation coefficient was 0.89 at 180 days and 0.88 at 365 days. The results were consistent for groups stratified for age, gender, etiology of CHF, and individual NYHA class. The MID for the 6WT in stable CHF patients was 35 m and 37 m between presentation and 180 and 365 days, respectively. Conclusion: Submaximal exercise capacity as represented by the 6WT varies little in stable CHF patients for up to 1-year intervals. The MID for changes in 6WT values in patients with stable CHF over a period of 6 to 12 months is similar to 36m.
    International Journal of Cardiology 07/2014; 176(1). DOI:10.1016/j.ijcard.2014.06.035 · 6.18 Impact Factor
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    ABSTRACT: Introduction: Paravalvular leak (PVL) after percutaneous transcatheter aortic valve replacement (TAVR) is associated with significant morbidity and mortality. Percutaneous PVL closure has been reported for balloon-expandable valves but not self-expandable valves. Methods: We conducted a review of cases at our center where patients who received TAVR with self-expandable valves and went on to develop severe PVL underwent percutaneous closure. Baseline demographic, TAVR procedural, PVL procedural, and follow-up data was collected. Results: A total of five patients with severe PVL after TAVR with a self-expanding valve underwent percutaneous PVL closure.. Four of five patients had a trial of balloon postdilatation after valve deployment and had significant persistent PVL. In all five patients, PVL went from moderate-severe to mild-moderate PVL. There were no adverse events. Conclusion: Percutaneous PVL closure for severe PVL self-expanding valve for TAVR is a safe and efficacious procedure. Procedural technique involves transesophageal guidance, a high approach through the valve struts, deployment of an appropriate size device, and careful monitoring. This method may be part of the algorithm for severe PVL after TAVR. © 2013 Wiley Periodicals, Inc.
    Catheterization and Cardiovascular Interventions 07/2014; 84(1). DOI:10.1002/ccd.25176 · 2.51 Impact Factor
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    ABSTRACT: This analysis from the German Mitral Valve Registry investigates the impact of the learning curve with the MitraClip(®) technique on procedural success and complications.
    Clinical Research in Cardiology 06/2014; DOI:10.1007/s00392-014-0734-y · 4.17 Impact Factor
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    ABSTRACT: Background: Patent foramen ovale (PFO) are associated with cryptogenic strokes and transient ischemic attacks (TIAs). This study examined the initial experience with a new PFO occluder, the Nit-Occlud® PFO Occlusion Device (pfm medical ag, Germany). Methods: 63 patients with history of cryptogenic stroke or transient ischemic attack and PFO underwent percutaneous closure of the defect with the Nit-Occlud® PFO Occlusion Device. The primary endpoint was successful implantation without recurrent event, device malfunction, embolization or the need for a replacement device over 6±2 weeks. All patients underwent transesophageal echocardiography (TEE) at 6-weeks, and 42 patients had repeat TEE at 6-months. Clinical follow-up at 18.7 ± 7.4 months was also performed. Results: The device was successfully implanted in 62 (98.4%) patients with no relevant procedural complications. At 6-week follow-up, 60 (95.2%) patients met the primary endpoint. A residual shunt at rest and with Valsalva was noted in 8 (12.7%) and 31 (49.2%) patients respectively at 6-week TEE. At 6-months, one of 42 (2.4%) and 9 of 42 (21.4%) patients had a residual shunt at rest and with Valsava, respectively. At 18 months, 5/63 patients had recurrent events (3 TIAs, 2 strokes). No device-related complications occurred. One patient developed atrial fibrillation. Conclusion: In patients with cryptogenic stroke or transient ischemic attack and a PFO, the Nit-Occlud® PFO Occlusion Device appears to be both a safe and effective means to occlude the PFO. It is associated with high procedural success and favorable rates of complete closure. © 2014 Wiley Periodicals, Inc.
    Catheterization and Cardiovascular Interventions 06/2014; DOI:10.1002/ccd.25580 · 2.51 Impact Factor
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    ABSTRACT: Though distal filter protection during carotid stenting reduces the risk of cerebrovascular events, periprocedural stroke remains a risk despite their broad usage. This observation may be related to the pore size of common filters. The FiberNet distal filter system is unique by its very small pore size (40 micrometers) as well as its low profile and flexibility. Little data is available regarding the clinical performance and safety of this device. The aim was the evaluation of the safety of the Fibernet Embolic Protection System during carotid artery stenting. All consecutive patients treated with carotid stenting at our institution using the FiberNet device were systematically followed. Primary endpoint was the rate of all death and stroke within 30 days of the procedure. Carotid artery stenting using the Fibernet embolic protection system was performed in 54 patients. The procedure was technical successful in all patients. Three patients (5.5%) had a TIA. Amauosis fugax occurred in two patients (3.7%). One patient (1.9%) had a minor stroke with hemiparesis of the left arm and face which resolved completely within 48 hours after the procedure. No patient died or suffered a major stroke. The safety and feasibility of the Fibernet distal protection system appears to be at least equivalent to that reported in studies using conventional distal filter protection. © 2013 Wiley Periodicals, Inc.
    Catheterization and Cardiovascular Interventions 05/2014; 83(6). DOI:10.1002/ccd.25138 · 2.51 Impact Factor

Publication Stats

270 Citations
218.05 Total Impact Points

Institutions

  • 2009–2015
    • CardioVasculäres Centrum Frankfurt
      Frankfurt, Hesse, Germany
  • 2011–2014
    • Universität Heidelberg
      • Department of Cardiology
      Heidelburg, Baden-Württemberg, Germany