M Hennersdorf

SLK-Kliniken, Brackenheim, Baden-Württemberg, Germany

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Publications (124)196.29 Total impact

  • Herz 05/2011; 36(3):265-6. · 0.78 Impact Factor
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    ABSTRACT: Cardiovascular mortality is markedly increased in chronic kidney disease (CKD) and may be explained in part by sympathetic hyperactivity. Impaired hyperoxic chemoreflex sensitivity (CHRS) has been attributed to an increased sympathetic tone. The aim of the present study was to examine whether chemosensor function is altered in patients with CKD. We assessed CHRS in 20 patients with stage 3 CKD [glomerular filtration rate (GFR) 30-59 ml/min/1.73 m(2)], in 15 patients with stage 4 CKD [GFR 15-29 ml/min/1.73 m(2)], as well as in 35 age and gender matched patients without any evidence of CKD. The difference in the R-R intervals divided by the difference in the oxygen pressures before and after deactivation of the chemoreceptors by inhalation of pure oxygen was calculated as the CHRS. A CHRS below 3.0 ms/mmHg was defined as pathological. CHRS was significantly depressed in patients with stage 3 CKD (2.9 ± 0.9 ms/mmHg, P=0.005) and in patients with stage 4 CKD (2.1 ± 0.6 ms/mmHg, P<0.001), as compared with patients without CKD (6.7 ± 0.9 ms/mmHg). There was a negative correlation between serum creatinine and CHRS (r=-0.51; P<0.001). In patients with CKD, chemosensor deactivation decreased mean arterial pressure from 91 ± 4 mmHg to 87 ± 3 mmHg (P=0.03). Multivariate analysis showed that GFR (P=0.001) was the only independent predictor of a pathological CHRS. Using a relatively non-invasive bedside test we provide evidence for a blunted peripheral chemosensor function in chronic kidney disease. We thereby lay the basis for interventional studies assessing chemosensor function in chronic kidney disease.
    International journal of cardiology 10/2010; 155(2):201-5. · 6.18 Impact Factor
  • M Hennersdorf, C M Schannwell, W Motz
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    ABSTRACT: Arterial hypertension often leads to diseases of kidneys, vessels and brain. Besides these end organ damages the changes of the heart are of important role. Substantial consequences of hypertension are microangiopathy, interstitial fibrosis and left ventricular hypertrophy. Hence, as an early stage diastolic dysfunction results. Due to longer persistent hypertension also systolic dysfunction develops. Clinically, patients suffer from angina pectoris, dyspnoea and cardiac arrhythmias (i.e. atrial arrhythmia, atrial fibrillation). The left ventricular hypertrophy also is associated with an increased risk of malignant ventricular arrhythmias. The risk of sudden cardiac death is raised as well, in particular in patients with dilated heart and reduced left ventricular ejection fraction. Well controlled antihypertensive therapy could lead to a regression of left ventricular hypertrophy. Hence, disorders and prognosis of the patients could be improved.
    Der Internist 07/2010; 51(7):815-25. · 0.33 Impact Factor
  • Pneumologie 01/2010; 64.
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    ABSTRACT: Autonomic neuropathy is common in patients suffering from end-stage renal disease (ESRD). This may in part explain the high cardiovascular mortality in these patients. Chemosensory function is involved in autonomic cardiovascular control and is mechanistically linked to the sympathetic tone. The aim of the present study was to assess whether sympathetic hyperactivity contributes to an altered chemosensory function in ESRD. In a randomized, double-masked, placebo controlled crossover design we studied the impact of chemosensory deactivation on heart rate, blood pressure and oxygen saturation in 10 ESRD patients and 10 age and gender matched controls. The difference in the R-R intervals divided by the difference in the oxygen pressures before and after deactivation of the chemoreceptors by 5-min inhalation of 7 L oxygen was calculated as the hyperoxic chemoreflex sensitivity (CHRS). Placebo consisted of breathing room air. Baseline sympathetic activity was characterized by plasma catecholamine levels and 24-h time-domain heart rate variability (HRV) parameters. Plasma norepinephrine levels were increased (1.6 +/- 0.4 vs. 5.8 +/- 0.6; P<0.05) while the SDNN (standard deviation of all normal R-R intervals: 126.4 +/- 19 vs. 100.2 +/- 12 ms), the RMSSD (square root of the mean of the squared differences between adjacent normal R-R intervals: 27.1 +/- 8 vs. 15.7 +/- 2 ms), and the 24-h triangular index (33.6 +/- 4 vs. 25.7 +/- 3; each P<0.05) were decreased in ESRD patients as compared to controls. CHRS was impaired in ESRD patients (2.9 +/- 0.9 ms/mmHg, P<0.05) as compared to controls (7.9 +/- 1.4 ms/mmHg). On multiple regression analysis 24 h-Triangular index, RMSSD, and plasma norepinephrine levels were independent predictors of an impaired hyperoxic CHRS. Sympathetic hyperactivity influences chemosensory function in ESRD resulting in an impaired hyperoxic CHRS.
    European journal of medical research 12/2009; 14 Suppl 4:151-5. · 1.10 Impact Factor
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    ABSTRACT: The occurrence of ventricular arrhythmias in patients with idiopathic dilated cardiomyopathy (DCM) who are treated with an implantable cardioverter-defibrillator (ICD) for primary or secondary prevention is not fully understood. In this nonrandomized, two-centre, observational study we analyzed the occurrence of ventricular arrhythmias in a total of 105 DCM patients (age, 53 +/- 13 years) treated with an ICD. Fifty-one patients with a left ventricular ejection fraction <or= 35% did not have prior sustained ventricular arrhythmias (primary prevention). The secondary prevention group consisted of 54 patients with documented sustained ventricular tachycardia (n = 25) or aborted sudden cardiac death (n = 29). During 32 +/- 7 months follow-up the number of patients with appropriate defibrillator therapies (n = 51) was comparable between the two groups (HR 0.79, 95% CI 0.454 to 1.361, P = 0.389). Importantly, less primary prevention patients experienced appropriate ICD shocks for any arrhythmic event (HR 0.35, 95% CI 0.186 to 0.777, P = 0.008), as well as appropriate ICD shocks for ventricular fibrillation (HR 0.31, 95% CI 0.167 to 0.737, P = 0.006). In contrast, antitachycardia pacing was more often observed in the primary prevention group (HR 2.75, 95% CI 1.031 to 6.238, P = 0.043). Two primary prevention and 6 secondary prevention patients received multiple ICD therapies in consequence of incessant ventricular tachycardia. The characteristics of ventricular arrhythmias in patients with DCM who are treated with an ICD for primary or secondary prevention vary according to the underlying indication. Therefore, different device programming according to the patient's history might improve ventricular tachyarrhythmia management.
    International Heart Journal 11/2009; 50(6):741-51. · 1.23 Impact Factor
  • Per O Schueller, Stephan Steiner, Marcus G Hennersdorf
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    ABSTRACT: Atrial fibrillation is the arrhythmia that most frequently leads to hospital admission. As prevalence of atrial fibrillation increases with age, its epidemiological relevance will increase due to the well-known changes in life expectancy. In the presence of atrial fibrillation the cardiovascular mortality and the risk for a stroke are considerably elevated. Interventional treatment, such as catheter ablation or special pacemaker algorithms, have been improved extensively in the last years as a therapeutic option. Nevertheless drug therapy is still the first choice of treating atrial fibrillation.
    Medizinische Monatsschrift für Pharmazeuten 07/2009; 32(6):204-10; quiz 211-2.
  • International Heart Journal - INT HEART J. 01/2009; 50(6):741-751.
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    P O Schueller, S Steiner, M G Hennersdorf, B E Strauer
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    ABSTRACT: Chemoreflexes are important mechanisms for regulating ventilatory and cardiovascular function. The aim of this study was to determine the meaning of autonomic dysfunction for the pathophysiology and outcome in critical ill patients. For the determination of the chemoreflex sensitivity (ChRS), the ratio of the RR interval shift and the shift of oxygen partial pressure during a 5-min inhalation of oxygen with a nose mask was formed. Pathological chemoreflex sensitivity was predefined as a ChRS below 3.0 ms/mmHg. Out of the 27 critical ill patients included into the study, 17 had a sepsis and 10 a cardiogenic shock. In these patients, chemoreflex sensitivity was significantly reduced compared with a control group (sepsis: 2.1 +/- 1.68, cardiogenic shock: 0.4 +/- 0.27, controls: 5.0 +/- 2.8 ms/mmHg; P<0.05 vs. sepsis or cardiogenic shock). There was a significant negative correlation (r=-0.6; P<0.01) between the chemoreflex sensitivity and the severity of illness described by the SOFA-score. We conclude that cardiac reflex mechanisms are changed toward increased sympathetic activity reflected by reduced chemoreflex sensitivity in critical ill patients. Moreover, there is a close negative correlation between the ChRS and the SOFA-score.
    Journal of physiology and pharmacology: an official journal of the Polish Physiological Society 12/2008; 59 Suppl 6:623-7. · 2.48 Impact Factor
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    S Steiner, P O Schueller, M G Hennersdorf, B E Strauer
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    ABSTRACT: Bradycardia is a common finding in patients with obstructive sleep apnea and might be pronounced in heart failure patients. The aim of the present study was to determine the relationship between nocturnal hypoxemia, apnea-hypopnea index, and electrophysiological parameters of sinus node and atrioventricular conduction properties. Electrophysiological studies were performed in 12 patients with heart failure. Polygraphic studies were done in all of the patients. Patients with an AHI >10/h were classified as sleep apnea patients. Mild sleep apnea was diagnosed in 50% of the patients (AHI 17.8 +/- 4.4 vs. 5.1 +/- 3.6/h). There were no differences with respect to the resting heart rate, PQ interval, or QRS duration between the two groups. Sinus node recovery time was normal in all of the patients (993 +/-291 vs. 1099 +/-62 ms, P=0.45). There was no abnormal atrioventricular conduction. Nevertheless, sleep apnea patients showed decreased atrioventricular conduction time (AH) intervals (134 +/- 42 vs. 102 +/- 25 ms, P=0.1) and infranodal conduction time (HV) intervals (59 +/- 9 vs. 43 +/- 7 ms, P=0.01). We conclude that mild sleep apnea was not associated with abnormal findings in sinus node function or AV conduction properties in patients with heart failure. Decreased AH/HV intervals might be a consequence of apnea associated sympathetic activation.
    Journal of physiology and pharmacology: an official journal of the Polish Physiological Society 12/2008; 59 Suppl 6:669-74. · 2.48 Impact Factor
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    ABSTRACT: In arterial hypertension left ventricular hypertrophy comprises myocyte hypertrophy, interstitial fibrosis and structural alterations of the coronary microcirculation. MRI enables the detection of myocardial fibrosis, infarction and scar tissue by delayed enhancement (DE) after contrast media application. Aim of this study was to investigate patients with arterial hypertension but without known coronary disease or previous myocardial infarction to detect areas of DE. Twenty patients with arterial hypertension with clinical symptoms of myocardial ischemia, but without history of myocardial infarction and normal coronary arteries during coronary angiography were investigated on a 1.0 T superconducting magnet (Gyroscan T10-NT, Intera Release 8.0, Philips). Fast gradient-echo cine sequences and T2-weighted STIR-sequences were acquired. Fifteen minutes after injection of Gadobenate dimeglumine inversion recovery gradient-echo sequences were performed for detection of myocardial DE. Presence or absence of DE on MRI was correlated with clinical data and the results of echocardiography and electrocardiography, respectively. Nine of 20 patients showed DE in the interventricular septum and the anteroseptal left ventricular wall. In 6 patients, DE was localized intramurally and in 3 patients subendocardially. There was a significant correlation between myocardial DE and ST-segment depressions during exercise and between DE and left-ventricular enddiastolic pressure. Patients with intermittent atrial fibrillation showed a myocardial DE more often than patients without atrial fibrillation. In our series, 45% of patients with arterial hypertension showed DE on cardiac MRI. In this clinical setting, delayed enhancement may be due to coronary microangiopathy. The more intramurally localization of DE, however, rather indicates myocardial interstitial fibrosis.
    European journal of radiology 05/2008; 71(1):75-81. · 2.65 Impact Factor
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    ABSTRACT: Intensive care unit (ICU) support following allogeneic peripheral blood stem cell transplantation (PBSCT) is controversial due to the limited prognosis of these patients in case of secondary critical illness. In this retrospective single centre study, we looked for factors predicting survival in patients who needed ICU support after myeloablative (MAC) or non-myeloablative conditioning (non-MAC) therapy and allogeneic PBSCT. Between 1999 and 2006, 64 out of 319 patients following allogeneic PBSCT were admitted to the ICU (24 female and 40 male patients, median age 47 years, range 17-65 years; MAC 49 patients, non-MAC 15 patients). All 64 patients required mechanical ventilation. We looked for variables defining the Sepsis-related Organ Failure Assessment (SOFA) score as well as for baseline characteristics and transplant-associated parameters on the day of ICU admission possibly predictive for poor or good survival prognosis. Nineteen of 49 patients who had received MAC therapy survived the ICU stay for a median time of 9 months (range 2-29 months) and three of 15 patients who had received non-MAC therapy could be discharged from the ICU with a survival time of 4, 5 and 12 months. After univariate and multivariate analysis the SOFA score discriminated survivors and non-survivors of the ICU stay. We conclude that the SOFA score is predictive for survival when applied on the day of ICU admission.
    Annals of Hematology 05/2008; 87(4):299-304. · 2.87 Impact Factor
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    ABSTRACT: Inappropriate sinus tachycardia is a disease which is relatively rarely found and sometimes difficult to treat. Up to now it has been mostly treated with a beta-blocker or verapamil. If this did not work sinus node modulation was considered. Since the relatively new selective IF-stream blocker ivabradine has been approved for the therapy of chronic stable angina pectoris, a new therapeutic option is available. As ivabradine is well tolerated and only few side effects are known, it may become a new therapeutic step between medication and the invasive sinus node modulation. We report the case of a young female patient with inappropriate sinus tachycardia where a sustained therapeutic success was achieved with ivabradine medication as an alternative therapeutic trial after various ineffective medications.
    Cardiology 02/2008; 110(3):206-8. · 1.52 Impact Factor
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    ABSTRACT: At least half of patients with heart failure (HF) suffer from sleep apnea. Growing evidence suggests that there may be a strong pathophysiological link between chronic HF and sleep apnea due to nocturnal oxygen desaturation and sympathetic activation. It seems that sleep apnea contributes to systolic and diastolic HF, reduced left and right ventricular function, and arrhythmia (e.g. atrial fibrillation, bradycardia, or ventricular ectopy). Therefore, treatment of sleep apnea might alleviate cardiac symptoms and improve cardiac function. Nevertheless, the exact role of long-term treatment of sleep apnea in HF patients remains to be elucidated, as important clinical endpoints (e.g mortality) have been assessed in only a few studies. Heart Fail Monit 2008;5(4):106-11.
    Heart failure monitor 02/2008; 5(4):106-11.
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    ABSTRACT: There is growing evidence that obstructive sleep apnea is associated with coronary artery disease. However, there are no data on the course of coronary stenosis after percutaneous coronary intervention in patients with obstructive sleep apnea. To determine whether sleep apnea is associated with increased late lumen loss and restenosis after percutaneous coronary intervention. 78 patients with coronary artery disease who underwent elective percutaneous coronary intervention were divided in 2 groups: 43 patients with an apnea hypopnea - Index < 10/h (group I) and 35 pt. with obstructive sleep apnea and an AHI > 10/h (group II). Late lumen loss, a marker of restenosis, was determined using quantitative coronary angiography after 6.9 +/- 3.1 months. Angiographic restenosis (>50% luminal diameter), was present in 6 (14%) of group I and in 9 (25%) of group II (p = 0.11). Late lumen loss was significant higher in pt. with an AHI > 10/h (0.7 +/- 0.69 mm vs. 0.38 +/- 0.37 mm, p = 0.01). Among these 35 patients, 21(60%) used their CPAP devices regularly. There was a marginally lower late lumen loss in treated patients, nevertheless, this difference did not reach statistical significance (0.57 +/- 0.47 mm vs. 0.99 +/- 0.86 mm, p = 0.08). There was no difference in late lumen loss between treated patients and the group I (p = 0.206). In summary, patients with OSA and coronary artery disease have a higher degree of late lumen loss, which is a marker of restenosis and vessel remodeling after elective percutaneous intervention.
    Respiratory research 01/2008; 9:50. · 3.64 Impact Factor
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    ABSTRACT: Severe pulmonary hypertension (PAH) leads to right ventricular dysfunction and is associated with different atrial arrhythmias. In PAH patients, the echocardiographic Tei-index is used for monitoring right heart function. The P-wave signal-averaged ECG (SA-ECG) has been shown to have a potential role in identifying patients at risk of developing paroxysmal atrial fibrillation and those likely to change from paroxysmal to chronic atrial fibrillation. The aim of the present study was to define the correlation of the Tei-Index with parameters of P-wave triggered and bidirectional P-wave SA-ECG. A total of 18 patients (14 men, 4 women) with normal sinus rhythm and a mean age of 67+/-10 years (BMI 27.6+/-5.1 kg/m2) were included into the study. Right ventricular (RV) Tei-index was calculated from the sum of isovolumetric contraction time and relaxation time divided by ejection time. Furthermore, P-wave triggered P-wave signal averaged ECG was performed from an X, Y, and Z lead system. The results show that there was a statistically significant correlation between Tei-index and filtered P-wave duration (r=0.53; P=0.023). Teiindex did not correlate with the root mean square voltage of the last 20 ms of the P wave (r=-0.16; P=0.52). In conclusion, a correlation of RV Tei index with P-wave duration indicates that this echocardiographic measurement is not only a marker of right heart function, but also an indicator of electrical instability that could be useful to detect patients at risk for atrial arrhythmias.
    Journal of physiology and pharmacology: an official journal of the Polish Physiological Society 12/2007; 58 Suppl 5(Pt 2):627-32. · 2.48 Impact Factor
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    ABSTRACT: Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnea. It is known, that there are beneficial effects on cardiac function, which might be explained by suppression of apnea and specific hemodynamic effects of CPAP. Therefore, CPAP might act as an adjunct therapy in heart failure, even in the absence of sleep apnea. In the present study, 11 patients with congestive heart failure (EF=23.1+/-6.9%) without sleep apnea (AHI 3.0+/-1.2/h) were treated with nocturnal CPAP. Cardiopulmonary exercise testing was performed at baseline and after 8.6 +/-1.3 months. All patients underwent heart catheterization and myocardial biopsy to exclude myocarditis at baseline. Five (46%) of the 11 patients did not complete the study because of poor compliance and irregular use of the CPAP device. Six (54%) of the patients used CPAP regularly (>6 h/night) and completed the study. Cardiopulmonary exercise testing showed an improvement of work load (96+/-36 Watt vs. 112+/-34 Watt; P=0.025) and VO2 peak (1227+/-443 ml vs. 1525+/-470 ml; P=0.01). Oxygen-pulse was increased, although that did not reach significance (11.2+/-4.8 ml/beat vs. 12.6+/-3.9 ml/beat). In conclusion, CPAP might have beneficial effects on exercise capacity in patients with congestive heart failure even in the absence of sleep apnea. Nevertheless, poor compliance seems to be a limiting factor.
    Journal of physiology and pharmacology: an official journal of the Polish Physiological Society 12/2007; 58 Suppl 5(Pt 2):665-72. · 2.48 Impact Factor
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    ABSTRACT: With reference to the EU-Council Directive (1999/30/EC) a discussion in the European Union between basic science, epidemiologic knowledge, and regulatory policies has become of growing public interest. The consequences following particulate matter (PM) exposure on the cardiovascular system, are actually not fully understood. This work reviews latest developments as regards the realization of the mentioned Council Directive and emphasizes the cardiovascular health impairment in this context. PM is assumed to increase the risk for arrhythmia, ischemic cardiovascular events, and worsens heart failure. The importance of the risk factor PM is due to the number of people who are affected, if consequent actions for air pollution prevention are not adequately transposed. Health-care providers can protect especially patients at high risk by informing them about behavior modification to prevent PM exposure and its possible consequences. To promote public health on the health-policy level, several action plans have been established. Forthcoming challenge for PM-associated cardiovascular health promotion remains an interdisciplinary approach to create synergistic effects of several sanctions, which primarily concerns scientific and political decision makers and public consciousness. In conclusion, further investigations are necessary to deepen the understanding of PM exposure and its consequences for the cardiovascular system and evaluate the success of preventive strategies.
    Medizinische Klinik 12/2007; 102(11):899-903. · 0.34 Impact Factor
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    ABSTRACT: Atrial fibrillation (AF) is a very common arrhythmia that often causes the serious complication of a stroke. The aim was to evaluate the utility of pathological chemoreflexsensitivity (PCHRS) and atrial late potentials (ALP) to predict AF in follow-up. We investigated a prospective study on the basis of our observation about a PCHRS and ALP in paroxysmal AF. The PCHRS was predefined as a chemoreflexsensitivity below 3.0 ms/mmHg and ALP were predefined as a filtered P-wave duration > or =120 ms and a root mean square voltage of the last 20 ms of the P-wave < or =3.5 microV. A P-wave triggered P-wave signal averaged electrocardiograph (ECG) and chemoreflexsensitivity was performed on 250 consecutive patients who were divided into four groups. Group I consisted of patients with ALP and PCHRS, patients of group II had only ALP, a PCHRS was only present in group III, and patients of group IV had neither ALP nor PCHRS. During the mean follow-up of 37.8 months AF was observed in 10 patients (4%). The patients of the four groups were similar according to clinical baseline characteristics. The incidence of AF was higher in group I (18% of patients) than in group II (6% of patients, P = 0.229) and significantly higher than in group III (3% of patients, P = 0.034) or group IV (1% of patients, P < 0.0001). Patients with ALP and PCHRS showed a 33-fold risk (P < 0.001) for the onset AF. The results of our study suggest that the probability of AF could be predicted with a P-wave signal averaged ECG and an analysis of chemoreflexsensitivity. The predictive power of the combination of ALP and PCHRS seemed not high enough for risk stratification.
    Pacing and Clinical Electrophysiology 11/2007; 30(10):1254-61. · 1.75 Impact Factor
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    C M Schannwell, M G Hennersdorf, B E Strauer
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    ABSTRACT: Arterial hypertension is the leading cause of mortality and morbidity with a worldwide prevalence of 26%. Aging increases the incidence of arterial hypertension. Arterial hypertension is the prime example for a chronic disease with asymptomatic beginning, creeping course and fatal outcome. Arterial hypertension is a major cardiovascular risk factor and leads to vascular as well as myocardial manifestations: coronary artery disease, hypertensive microvascular disease, concentric left ventricular hypertrophy as well as perivascular and interstitial fibrosis. In the late stages of the disease, hypertrophy and cardiac failure develop. Arterial hypertension is the leading cause of coronary artery disease and cardiac failure, and coronary artery disease is the cause of heart failure in 50% of cases. Various non-invasive and invasive procedures are available for screening and follow-up. The primary therapeutic target is to reverse cardiac manifestations of arterial hypertension using specific therapeutic algorithms as well as lowering blood pressure. This article covers the pathophysiology of arterial hypertension and cardiac failure, clinical symptoms, diagnostic options and therapeutical goals as well as medicinal options.
    Der Internist 10/2007; 48(9):909-20. · 0.33 Impact Factor

Publication Stats

473 Citations
196.29 Total Impact Points

Institutions

  • 2010
    • SLK-Kliniken
      Brackenheim, Baden-Württemberg, Germany
    • SLK Kliniken Heilbronn GmbH
      Heilbronn Neckar, Baden-Württemberg, Germany
  • 1996–2009
    • Heinrich-Heine-Universität Düsseldorf
      • Klinik für Kardiologie, Pneumologie und Angiologie
      Düsseldorf, North Rhine-Westphalia, Germany
  • 2005–2007
    • Universitätsklinikum Düsseldorf
      • Klinik für Kardiologie, Pneumologie und Angiologie
      Düsseldorf, North Rhine-Westphalia, Germany
  • 2005–2006
    • University of Duisburg-Essen
      • Department of Internal and Integrative Medicine
      Essen, North Rhine-Westphalia, Germany