Franklin Rosenfeldt

Franklin Rosenfeldt
Swinburne University of Technology · Centre for Human Psychopharmacology

Doctor of Medicine

About

314
Publications
27,343
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6,329
Citations
Introduction
Over the years I have had a variety of research interests, mostly centered on the heart and heart surgery. With my colleagues I showed the beneficial effect of multiple metabolic supplements especially coenzyne Q10 and orotic acid on the heart. We improved the quality of grafts for coronary bypass surgery. We demonstrated the beneficial effect of low temperature in heart surgery and transplants . We are still working on improving the preservation of donor hearts for heart transplants.

Publications

Publications (314)
Article
Abstract Background: Donation after circulatory death (DCD) represents an increasing source of organs. However, evaluating the suitability of DCD hearts for transplantation represents a challenge. Contractile function is the ultimate determinant of recovery. We developed a novel technique in an ex vivo rig for measurement of contractility using in...
Article
Background Use of donation after circulatory death (DCD) hearts is becoming more prevalent in cardiac transplantation. However, there is no standardized approach to myocardial preservation, and little data exists on ultrastructural changes in DCD hearts. We have previously identified increased proapoptotic and proinflammatory activity in brain dead...
Article
Heart failure (HF) is one of the most common causes of death in Western society. Recent results underscore the utility of coenzyme Q10 (CoQ10) addition to standard medications in order to reduce mortality and to improve quality of life and functional capacity in chronic heart failure (CHF). The rationale for CoQ10 supplementation in CHF is two-fold...
Article
Full-text available
Introduction: With an aging population there is an important need for the development of effective treatments for the amelioration of cognitive decline. Multiple mechanisms underlie age-related cognitive decline including cerebrovascular disease, oxidative stress, reduced antioxidant capacity and mitochondrial dysfunction. CoQ10 is a novel treatmen...
Article
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Introduction: Statin drugs have become the most highly prescribed drugs for cardiovascular disease. However, there is disagreement as to the existence of adverse effects of statin administration on cognitive function. Therefore, it is important to better understand the effects of statins on cognition and possible mechanisms of these effects. Areas...
Article
Background: Measurements of organ flow and perfusion during cardiopulmonary bypass suggest that perfusion of the splanchnic bed can be impaired by non-pulsatile flow. We postulated that non-pulsatile flow from centrifugal ventricular assist devices might also compromise splanchnic blood flow and cause bowel ischaemia especially in the period of ci...
Article
Background There are limited economic evaluations comparing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for multi-vessel coronary artery disease (MVCAD) in contemporary, routine clinical practice. Objective The aim was to perform a cost-effectiveness analysis comparing CABG and PCI in patients with MVCAD, fro...
Article
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Background: Coronary artery bypass grafting (CABG) performed early after acute myocardial infarction (AMI) carries a high risk of mortality. By avoiding cardioplegic arrest and aortic cross-clamping, on-pump beating heart CABG (ONBEAT) may benefit patients requiring urgent or emergency revascularisation in the setting of AMI. We evaluated the earl...
Article
Background: The aim of this study was to define the status of preoperative zinc levels in patients with heart disease presenting for cardiac surgery and to identify any predictors for and any clinical consequences of low zinc levels. Methods: Adult patients presenting for elective surgery, either coronary artery bypass graft surgery and/or valve...
Article
Background Donation after circulatory death (DCD) represents a potential new source of hearts to increase the donor pool. We showed previously that DCD hearts in Greyhound dogs could be resuscitated and preserved by continuous cold crystalloid perfusion but not by cold static storage and could demonstrate excellent contractile and metabolic functio...
Article
Background: The mechanisms for cognitive impairment in heart failure (HF) are unclear. We investigated the relative contributions of cerebral blood flow velocity (BFV), oxidative stress and inflammation to HF-associated cognitive impairment. Methods and results: Thirty-six HF patients (≥60 years) and 40 healthy controls (68±7 vs 67±5 years, p>0....
Article
Aims The suitability of percutaneous coronary intervention (PCI), compared with coronary artery bypass grafting (CABG), for patients with complex multivessel coronary artery disease (MVCAD) remains a contentious topic. While the body of evidence regarding the clinical effectiveness of these revascularization strategies is growing, there is limited...
Article
Background: We previously showed that donation after circulatory death (DCD) canine hearts can be resuscitated if perfused with warm blood. However, clinical application of this technique is complex and difficult. We have developed a simplified system of cold crystalloid perfusion and compared it with standard cold storage for DCD heart preservati...
Article
This study in five large greyhound dogs implanted with a VentrAssist left ventricular assist device focused on identification of the precise site and physiological changes induced by or underlying the complication of left ventricular suction. Pressure sensors were placed in left and right atria, proximal and distal left ventricle, and proximal aort...
Article
Irreversible electroporation (IRE) uses brief electric pulses to irrecoverably disrupt cell membranes, leading to cell death in a volume of tissue while leaving proteins and the extracellular matrix intact. This enables ablation without damaging blood vessels, ductal systems, and other sensitive structures. IRE has numerous indications, yet clear d...
Chapter
Full-text available
The effect of coenzyme Q10 (CoQ10) supplementation on physical performance has long been a controversial subject. There have been several studies that have demonstrated a beneficial effect of CoQ10 on sports performance whereas many others have been neutral. It has been difficult to interpret the multiple studies due to three main factors: the form...
Article
Preservation of donor hearts for transplantation has traditionally been performed with the use of static cold storage. We have developed and tested a novel gravity-powered system of cold crystalloid perfusion for prolonged donor heart preservation. Greyhounds were anesthetized; their hearts were arrested with cold cardioplegic solution and excised....
Article
Full-text available
Vitamin D deficiency is one of the most common chronic medical conditions in the world and also prevalent in Australia. A growing body of evidence suggests that low vitamin D also has adverse effects on cardiovascular health, including coronary risk factors and adverse cardiovascular outcomes such as myocardial infarction, cardiac failure and strok...
Article
Full-text available
Irreversible electroporation (IRE) ablation uses brief electric pulses to kill a volume of tissue without damaging the structures contraindicated for surgical resection or thermal ablation, including blood vessels and ureters. IRE offers a targeted nephron-sparing approach for treating kidney tumors, but the relevant organ-specific electrical prope...
Article
Full-text available
This randomized controlled multicenter trial evaluated coenzyme Q10 (CoQ10) as adjunctive treatment in chronic heart failure (HF).
Article
Background Currently, the appropriateness of percutaneous coronary intervention (PCI) using drug-eluting stents (DES) versus coronary artery bypass grafting (CABG) for patients with diabetes (DM) and multi-vessel disease (MVD) is uncertain due to limited evidence from few randomised controlled trials (RCTs). We aimed to compare the clinical effecti...
Article
Irreversible electroporation (IRE) delivers brief electric pulses to attain non-thermal focal ablation that spares vasculature and other sensitive systems. It is a promising prostate cancer treatment due to sparing of the tissues associated with morbidity risk from conventional therapies. IRE effects depend on electric field strength and tissue pro...
Article
Full-text available
Objective To evaluate the efficacy of an Integrative Cardiac Wellness Program (ICWP) for cardiothoracic surgery patients on postoperative recovery, bleeding risk, satisfaction and participation in rehabilitation programs. Design An open label study whereby ICWP participants were compared to a historical control group that received usual care at th...
Article
Ventricular assist device (VAD) implantation has become an effective option for patients with severe heart failure. However, device-related infections remain a significant problem. The aim of this study was to describe the incidence and microbiological aetiology of bacteraemia in patients with VADs, and to assess the impact of bacteraemia on clinic...
Article
Despite increasing use of donation after cardiac death (DCD) and encouraging results for non-cardiac transplants, DCD cardiac transplantation has not been widely adopted because, (1) the DCD heart sustains warm ischaemic injury during the death process and (2) conventional static cold storage significantly adds to the ischaemic injury. We have deve...
Article
Full-text available
Electroporation-based therapies deliver brief electric pulses into a targeted volume to destabilize cellular membranes. Nonthermal irreversible electroporation (IRE) provides focal ablation with effects dependent on the electric field distribution, which changes in heterogeneous environments. It should be determined if highly conductive metallic im...
Article
Full-text available
Phrenic nerve injury is a well-recognised complication of cardiac surgery that can lead to disabling effects from diaphragmatic dysfunction, especially in children and patients with a history of chronic obstructive airway disease. Various mechanisms of injury have been recognised including hypothermia, mechanical trauma and possibly ischaemia. A cl...
Article
Background: Xenotransplantation could provide a solution to the donor shortage that is currently the major barrier to solid-organ transplantation. The ability to breed pigs with multiple genetic modifications provides a unique opportunity to explore the immunologic challenges of pulmonary xenotransplantation. Methods: Explanted lungs from wild-t...
Conference Paper
Irreversible electroporation (IRE) is a non-thermal focal ablation technique that uses needle electrodes to deliver a series of brief (100μs duration) electric pulses into the targeted region. These alter cellular transmembrane potentials, destabilizing the membranes in a manner that kills the cells while sparing major vasculature and other sensiti...
Article
Objective Dysfunction of bioenergetics and energy starvation of the myocardium may be a dominant feature of heart failure and attention has been directed towards agents which may stabilise myocardial metabolism and maintain adequate energy stores. The myocardial tissue level of the essential redox component of the respiratory chain Coenzyme Q10 (Co...
Article
Introduction: Multiple agents have been investigated to prevent atrial fibrillation (AF) after cardiac surgery. Several studies have investigated the use of β-blockers such as metoprolol or amiodarone with promising results. We aimed to investigate perioperative pharmacologic prophylaxis against AF using metoprolol, and amiodarone in combination w...
Article
Full-text available
Background: Geographical differences in patient characteristics, management and outcomes in heart failure (HF) trials are well recognized. The aim of this study was to assess the consistency of the treat- ment effect of coenzyme Q10 (CoQ10) in the European sub-population of Q-SYMBIO, a randomized double-blind multinational trial of treatment with...
Article
Background Ventricular assist device (VAD) implantation has become an effective option for patients with severe heart failure. However, device-related infections remain a significant problem. The aim of this study was to describe the incidence and microbiological aetiology of bacteraemia in patients with VADs, and to assess the impact of bacteraemi...
Article
Full-text available
Background: Antihypertensive medicines are to known to cause diverse disturbances to electrolyte homeostasis; however, their potential to affect zinc is less well known. The primary aim was to explore whether antihypertensive medicines have the potential to affect zinc status. Methods: A review of electronic databases was undertaken. Full-length...
Article
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Objectives: To determine whether massage significantly reduces anxiety, pain, and muscular tension and enhances relaxation compared with an equivalent period of rest time after cardiac surgery. The feasibility of delivering the treatment, effects on heart rate, blood pressure, and respiratory rate, and patient satisfaction were also assessed. Met...
Article
Full-text available
Purpose The primary aim of the study was to determine the effects of massage therapy, delivered to post-surgery cardiothoracic patients, on pain, anxiety, relaxation and muscular tension at two different time points and compare it to an equivalent period of rest time. The secondary aims were to explore the effects of massage on heart rate, respirat...
Article
The aims of this study were first to analyze neurocognitive outcomes of patients after open-chamber cardiac surgery to determine whether carbon dioxide pericardial insufflation reduces incidence of neurocognitive decline (primary end point) as measured 6 weeks postoperatively and second to assess the utility of carbon dioxide insufflation in cardia...
Article
Full-text available
Reactive oxygen species (ROS) play both physiological and pathophysiological roles in the body. In clinical practice, oxidative stress and its counterpart, antioxidant capacity, can be measured and can guide remedial therapy. Oxidative stress can make a negative impact in all forms of major surgery including cardiac surgery, general surgery, trauma...
Article
Numerical models, able to simulate the response of the human cardiovascular system (CVS) in the presence of an implantable rotary blood pump (IRBP), have been widely used as a predictive tool to investigate the interaction between the CVS and the IRBP under various operating conditions. The present study investigates the effect of alterations in th...
Article
A heart-pump interaction model has been developed based on animal experimental measurements obtained with a rotary blood pump in situ. Five canine experiments were performed to investigate the interaction between the cardiovascular system and the implantable rotary blood pump over a wide range of operating conditions, including variations in cardia...
Article
To evaluate the effect of negative pressure wound therapy (NPWT) on deep infection rate in open tibial fractures. Retrospective cohort study. Data was collected from medical records and radiographs. Two level-1 trauma centers. Patients who sustained an open tibial fracture which underwent delayed soft tissue coverage between January 2002 and Decemb...
Article
Full-text available
Pain relief remains a major problem in hernia surgery. SABER-Bupivacaine is an investigational extended-release formulation of bupivacaine in a resorbable matrix, which may provide up to 72 h of local pain relief. A double-blinded, randomized controlled trial was undertaken to evaluate the safety and efficacy of SABER-Bupivacaine. Consented patient...
Article
Reactive oxygen species (ROS) play an important role in the regulation of normal cellular function. When ROS are produced in excess they can have detrimental effects, a state known as oxidative stress. Thus ROS play both physiological and pathophysiological roles in the body. In clinical practice oxidative stress and its counterpart, antioxidant ca...
Article
Little is known about the outcome of cardiac surgery in patients with a prior history of malignancy. Our aim was to investigate in our unit the population of patients with a known malignancy and compare their outcomes to a matched population without malignancy. We identified all patients who underwent cardiac surgery at the Alfred Hospital between...
Article
Traditionally, patients presenting with symptoms of coronary artery disease (CAD) were managed medically. If medical treatment proved unsuccessful, patients were referred for coronary artery bypass surgery (CABG). However, in recent years, increasing numbers of patients have received percutaneous coronary intervention (PCI), usually a coronary sten...
Article
Full-text available
Preoperative anxiety and physical unfitness have been shown to have adverse effects on recovery from cardiac surgery. This study involving cardiac surgery patients was primarily aimed at assessing the feasibility of delivering physical conditioning and stress reduction programs within the public hospital setting. Secondary aims were to evaluate the...
Article
Statins are often prescribed for prevention of atherosclerotic outcomes in patients who have chronic heart failure (CHF), if this has an ischaemic etiology. These agents may also possess additional properties, independent of effects on blood lipid levels, which may have an effect on cardiac remodeling. However, beneficial effects were not observed...