D Tschöpe

Publications (10)9.47 Total impact

• Source

  Available from: Eberhard Standl

  Article: Gemeinsame Stellungnahme zur evidenzbasierten Expertenleitlinie „Diabetes und Herz“ der Deutschen Diabetes Gesellschaft (DDG) sowie den „Empfehlungen zur umfassenden Risikoverringerung für Patienten mit koronarer Herzerkrankung, Gefäßerkrankungen und Diabetes“ der Deutschen Gesellschaft für Kardiologie (DGK)

  H. Gohlke, R. Landgraf, W. A. Scherbaum, P. Schwandt, E. Standl, D. Tschöpe
  Zeitschrift für Kardiologie 04/2012; 91(12):1064-1065. · 0.97 Impact Factor
• Article: [Diabetes mellitus and periodontitis. Bidirectional relationship and clinical implications. A consensus document].

  J Deschner, T Haak, S Jepsen, T Kocher, H Mehnert, J Meyle, P-M Schumm-Draeger, D Tschöpe
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  ABSTRACT: Diabetes and periodontitis are chronic diseases with an increasing prevalence in the German population. There is a bi-directional relationship between both diseases. Diabetes promotes the occurrence, the progression and the severity of periodontitis. Periodontitis complicates the glycemic control of diabetes, increases the risk of diabetes-associated complications and possibly even of its onset. In view of the existing evidence, that is still not sufficiently communicated within the medical community, an expert panel consisting of four diabetologists and four periodontists has addressed the following questions: What is the effect of diabetes mellitus on periodontitis and on periodontal therapy? What is the effect of periodontitis on diabetes mellitus? What are the practical consequences, that result for interdisciplinary treatment strategies? The treatment of periodontal infections should become an integral part of the management of diabetes, whereas glycemic control is a prerequisite for successful periodontal therapy.
  Der Internist 03/2011; 52(4):466-77. · 0.30 Impact Factor
• Article: [Challenge in diabetes therapy: effects of glitazones beyond blood glucose control].

  G Schernthaner, T Forst, D Gulba, W Haberbosch, M Hanefeld, G Linss, W März, H Mehnert, C Rosak, O Schnell, J Seufert, D Tschöpe, E Erdmann
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  ABSTRACT: Not just since the results of ACCORD, ADVANCE and VADT were published, it is clear that lowering blood glucose alone does not reduce the cardiovascular risk of patients with type 2 diabetes. In fact, many studies also indicate that some treatment strategies may even have adverse effects. To treat type 2 diabetes appropriately, the co-morbidities such as diabetic dyslipidaemia, hypertension or nephropathy must also be taken into account. Thiazolidinediones reduce insulin resistance thus allowing to direct the treatment of type 2 diabetes towards its pathophysiologic origin. Due to their mechanism of action, thiazolidinediones not only lower blood glucose but have also beneficial effects on inflammatory and atherogenic parameters, blood pressure and microalbuminuria. Furthermore pioglitazone improves dyslipidaemia and reduces mortality, myocardial infarction and stroke in high risk patients. Effects of rosiglitazone on the cardiovascular risk are yet unclear. Numerous studies document the efficacy and safety of thiazolidinediones and provide a basis for an evidence-based therapeutic approach beyond blood glucose control.
  DMW - Deutsche Medizinische Wochenschrift 05/2009; 134(18):949-54. · 0.53 Impact Factor
• Article: Myocardial sympathetic innervation in diabetic patients with symptomatic coronary artery disease.

  E Fricke, S Eckert, H Fricke, J Körfer, R Weise, O Lindner, D Tschöpe, D Horstkotte, W Burchert
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  ABSTRACT: In non-diabetic patients, sympathetic innervation can be preserved even if there is major impairment of myocardial blood supply. Matters may be more complex in diabetic patients because denervation can be caused by cardiac autonomic neuropathy (CAN) or by ischemic injury. Our aim was to determine whether restrictions in myocardial blood supply have a pronounced influence on sympathetic innervation in diabetics and if this effect can be differentiated from CAN. We analyzed 20 diabetics with advanced coronary artery disease (CAD) and without known CAN. We determined quantitative myocardial blood flow using (13)N-ammonia-PET, myocardial viability with (18)F-FDG, and cardiac innervation with (11)C-HED. We investigated the relationship between regional HED retention, blood flow, and coronary flow reserve (CFR). Attenuated heart rate response to adenosine was taken as indicator for CAN (HR ratio). There was minor correlation of segmental stress flow and HED retention (r(2)=0.063, p<0.0001). Correlation improved when stress flow as well as HED retention were normalized to the individual maximum (r(2)=0.162, p<0.0001). In nine patients, a HR ratio <1.2 implicated subclinical CAN. Duration of diabetic disease or glycaemic control (HbA1c) did not correlate with mean HED retention in the viable segments, but with its variation coefficient. As in non-diabetic patients, a slight correlation exists between CFR and sympathetic innervation. The sensitivity of sympathetic nerves to reductions in CFR does not seem to be increased as compared to the results reported for non-diabetics. Besides impaired blood supply, long duration of diabetic disease and bad glycaemic control also seem to impair sympathetic innervation provoking higher heterogeneity.
  Nuklearmedizin 01/2008; 47(1):24-9. · 1.28 Impact Factor
• Article: [Determining the current position regarding the value of pioglitazone for the therapy of diabetes].

  S Eckert, E Erdmann, R Lundershausen, T Forst, W A Scherbaum, O Schnell, E Standl, P-M Schumm-Draeger, D Tschöpe, H Walter, M Weber
  DMW - Deutsche Medizinische Wochenschrift 01/2008; 132(49):2650-3. · 0.53 Impact Factor
• Article: [Diabetics in secondary prevention].

  D Tschöpe
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  ABSTRACT: It is well known that diabetics live with a significantly higher incidence of a cardiac insufficiency and that acute ischemia is the main cause of death in this group (75%). The risk of suffering a myocardial infarction after ischemic incidences is significantly higher for diabetics than for patients with normal carbohydrate metabolism. Diabetes mellitus is not only responsible for acute incidences, but also for a higher incidence of chronic coronary diseases. Furthermore a disturbed tolerance glucose value was detected in studies for two-thirds of the patients which could even be proven after complete rehabilitation. It has also been shown that the severity of hyperglycemia is in a close inverse relationship to the volume of the brain tissue which can be saved. For this reason hyperglycemia is possibly a therapeutic aim in case of acute ischemic incidences. Therefore the adjustment of blood sugar should be the primary aim to reduce risk in any cases of vascular incidences.
  Clinical Research in Cardiology 02/2006; 95 Suppl 6:VI23-7. · 2.95 Impact Factor
• Article: [Cardiovascular protection in diabetic patients with heart disease in the doctor's office].

  S Eckert, D Tschöpe
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  ABSTRACT: The long-term care of diabetic patients with heart disease poses a particular challenge. Various combinations of risk factors, progression of the coronary heart disease, and complications with further organic damage by the underlying diabetes, frequently necessitate a differentiated diagnostic work-up and management. This can be implemented only by close cooperation between the various specialities. Structured processes may be useful provided they are correctly applied and implemented. Guideline-based treatment of detected cardiovascular risk factors can improve quality of life, reduce morbidity and cardiovascular mortality and thus save costs over the long term.
  MMW Fortschritte der Medizin 11/2005; 147(43):43-6.
• Article: [Glucose metabolism].

  S Eckert, D Tschöpe
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  ABSTRACT: The markedly increased peri-interventional risk (PCI and CABG) in patients with type-2 diabetes mellitus may be reduced by adjusting blood glucose values to a near-normal level. This adjustment should be realized acutely by glucose-insulin-potassium infusions. In long-term therapy, the target value should be achieved independent of the pharmacological principle of blood glucose reduction. Among the available oral antidiabetic agents, metformin, acarbose and glitazones seem to be cardioprotective via pleotropic effects. Given an optimal stent implantation and administration of GP IIb/IIIa inhibitors during coronary interventions, results are similar to those of non-diabetics.
  Zeitschrift für Kardiologie 02/2005; 94 Suppl 3:III/88-91. · 0.97 Impact Factor
• Article: [Diabetic patients after myocardial infarction].

  D Tschöpe
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  ABSTRACT: Diabetes mellitus is not just another risk factor for cardiovascular events; it per se defines maximal risk for target organ damage including the cardiovascular system. Diabetes is one of the main drivers in the race towards a higher incidence in cardiovascular disease worldwide. In addition, it is also one of the often unrecognized predecessors of myocardial infarction and sudden cardiac death. About three quarters of patients post-MI show impaired glucose tolerance or full blown diabetes. The MONICA/KORA data have shown that the higher risk for mortality and morbidity in diabetics is maintained past the first event. However, the STENO-2 trial has shown that consequently managing diabetes and concomitant cardiovascular risk factors can significantly reduce the risk for cardiovascular events in this high-risk group.
  Zeitschrift für Kardiologie 02/2004; 93 Suppl 1:I13-5. · 0.97 Impact Factor
• Article: [Neutral position for the evidence-based expert guidelines "Diabetes and the heart" of the German Diabetes Gesellschaft (DDG) as well as the "Recommendations for comprehensive reduction of risks for patients with coronary heart disease, vascular disease, and diabetes" of the German Cardiac Society (DGK)].

  H Gohlke, R Landgraf, W A Scherbaum, P Schwandt, E Standl, D Tschöpe
  Zeitschrift für Kardiologie 01/2003; 91(12):1064-5. · 0.97 Impact Factor