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Prognostic impact of acute pulmonary triggers in patients with takotsubo syndrome: new insights from the International Takotsubo Registry

K. Kato, VL. Cammann, LC. Napp, KA. Szawan, J. Micek, S. Dreiding, RA. Levinson, V. Petkova, M. Würdinger, A. Patrascu, R. Sumalinog, S. Gili, CF. Clarenbach, M. Kohler, M. Wischnewsky, R. Citro, C. Vecchione, E. Bossone, M. Neuhaus, J. Franke,...

. 2021 ; 8 (3) : 1924-1932. [pub] 20210313

Language English Country Great Britain

Document type Journal Article, Research Support, Non-U.S. Gov't

Persistent link   https://www.medvik.cz/link/bmc21025655

AIMS: Acute pulmonary disorders are known physical triggers of takotsubo syndrome (TTS). This study aimed to investigate prevalence of acute pulmonary triggers in patients with TTS and their impact on outcomes. METHODS AND RESULTS: Patients with TTS were enrolled from the International Takotsubo Registry and screened for triggering factors and comorbidities. Patients were categorized into three groups (acute pulmonary trigger, chronic lung disease, and no lung disease) to compare clinical characteristics and outcomes. Of the 1670 included patients with TTS, 123 (7%) were identified with an acute pulmonary trigger, and 194 (12%) had a known history of chronic lung disease. The incidence of cardiogenic shock was highest in patients with an acute pulmonary trigger compared with those with chronic lung disease or without lung disease (17% vs. 10% vs. 9%, P = 0.017). In-hospital mortality was also higher in patients with an acute pulmonary trigger than in the other two groups, although not significantly (5.7% vs. 1.5% vs. 4.2%, P = 0.13). Survival analysis demonstrated that patients with an acute pulmonary trigger had the worst long-term outcome (P = 0.002). The presence of an acute pulmonary trigger was independently associated with worse long-term mortality (hazard ratio 2.12, 95% confidence interval 1.33-3.38; P = 0.002). CONCLUSIONS: The present study demonstrates that TTS is related to acute pulmonary triggers in 7% of all TTS patients, which accounts for 21% of patients with physical triggers. The presence of acute pulmonary trigger is associated with a severe in-hospital course and a worse long-term outcome.

1st Department of Cardiology Medical University of Gdansk Gdansk Poland

1st Department of Medicine Faculty of Medicine University Medical Centre Mannheim University of Heidelberg Mannheim Germany

Advanced Heart Failure and Transplantation Center University Medical Center Ljubljana Ljubljana Slovenia

Cardiocenter 3rd Faculty of Medicine Charles University Prague University Hospital Kralovske Vinohrady Prague Czech Republic

Cardiology Department Santa Maria University Hospital Lisbon School of Medicine Universidade de Lisboa Lisbon Portugal

Center for Cardiology Cardiology 1 University Medical Center Mainz Mainz Germany

Center for Molecular Cardiology Schlieren Campus University of Zurich Zurich Switzerland

Centro Cardiologico Monzino IRCCS Milan Italy

Clinic for Cardiology and Pneumology Georg August University of Goettingen Goettingen Germany

Department of Cardiology and Angiology Hannover Medical School Hannover Germany

Department of Cardiology and Cardiac Imaging Center University Hospital of Rangueil Toulouse France

Department of Cardiology Basil Hetzel Institute Queen Elizabeth Hospital University of Adelaide Adelaide Australia

Department of Cardiology Centro Hospitalar Universitário de São João E P E Porto Portugal

Department of Cardiology Charité Campus Rudolf Virchow Berlin Germany

Department of Cardiology Chiba Emergency Medical Center Chiba Japan

Department of Cardiology Christchurch Hospital Christchurch New Zealand

Department of Cardiology Heidelberg University Hospital Heidelberg Germany

Department of Cardiology John Radcliffe Hospital Oxford University Hospitals Oxford UK

Department of Cardiology Kantonsspital Frauenfeld Frauenfeld Switzerland

Department of Cardiology Kantonsspital Lucerne Lucerne Switzerland

Department of Cardiology Kantonsspital St Gallen St Gallen Switzerland

Department of Cardiology Kantonsspital Winterthur Winterthur Switzerland

Department of Cardiology King's College Hospital London UK

Department of Cardiology Leiden University Medical Centre Leiden The Netherlands

Department of Cardiology Medical University of Warsaw Warsaw Poland

Department of Cardiology University Heart Center University Hospital of Zurich Raemistrasse 100 Zurich 8091 Switzerland

Department of Cardiology University Hospital of Basel Basel Switzerland

Department of Cardiovascular Diseases Mayo Clinic Rochester MN USA

Department of Cardiovascular Medicine Chiba University Graduate School of Medicine Chiba Japan

Department of General and Interventional Cardiology University Heart Center Hamburg Hamburg Germany

Department of Internal Medicine 1 Cardiology University Hospital Olomouc Olomouc Czech Republic

Department of Internal Medicine 1 JenaUniversity Hospital Friedrich Schiller University Jena Jena Germany

Department of Internal Medicine 2 Cardiology University of Ulm Medical Center Ulm Germany

Department of Internal Medicine 2 University Medical Center Regensburg Regensburg Germany

Department of Internal Medicine 3 Division of Cardiology Angiology and Intensive Medical Care University Hospital Halle Martin Luther University Halle Wittenberg Halle Germany

Department of Internal Medicine 3 Heart Center University of Cologne Cologne Germany

Department of Internal Medicine B University Medicine Greifswald Greifswald Germany

Department of Internal Medicine Cardiology Heart Center Leipzig University Hospital Leipzig Germany

Deutsches Herzzentrum München Technische Universität München Munich Germany

Division of Cardiology A O U San Luigi Gonzaga Turin Italy

Division of Cardiology Antonio Cardarelli Hospital Naples Italy

Division of Cardiology Department of Medical Sciences AOU Città della Salute e della Scienza University of Turin Turin Italy

Division of Cardiology Heart and Vascular Center University of Iowa Iowa City Iowa USA

Division of Cardiology Kimitsu Central Hospital Kisarazu Japan

Division of Cardiovascular Medicine Department of Medicine College of Medicine University of Florida Gainesville FL USA

Division of Cardiovascular Medicine Keck School of Medicine University of Southern California Los Angeles CA USA

DZHK partner site Greifswald Greifswald Germany

DZHK partner site Hamburg Kiel Luebeck Hamburg Germany

DZHK Partner Site Heidelberg Mannheim Mannheim Germany

DZHK partner site Munich Heart Alliance Munich Germany

FB Mathematics and Computer Science University of Bremen Bremen Germany

Fondazione Policlinico Universitario A Gemelli IRCCS Rome Italy

Heart and Vascular Centre Bad Bevensen Bad Bevensen Germany

Heart Center Turku University Hospital University of Turku Turku Finland

Heart Department University Hospital 'San Giovanni di Dio e Ruggi d'Aragona' Salerno Italy

Intensive Coronary Care Unit Moscow City Hospital 1 named after N Pirogov Moscow Russia

Internal Medicine Cardiology Angiology and Pneumology Magdeburg University Magdeburg Germany

Klinik für Innere Medizin 3 Universitätsklinikum des Saarlandes Homburg Germany

Krankenhaus 'Maria Hilf' Medizinische Klinik Stadtlohn Germany

Local Health Unit n 8 Cardiology Unit Arzignano Vicenza Italy

Pulmonary Division University Hospital of Zurich Zurich Switzerland

Royal Brompton and Harefield Hospitals Trust and Imperial College London UK

Section of Cardiac Electrophysiology Department of Medicine University of California San Francisco San Francisco CA USA

Service de Cardiologie Hôpitaux Universitaires de Genève Geneva Switzerland

Structural Interventional Cardiology Careggi University Hospital Florence Italy

TJ Health Partners Heart and Vascular Glasgow KY USA

University Hospital for Internal Medicine 3 Medical University Innsbruck Innsbruck Austria

References provided by Crossref.org

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$a Prognostic impact of acute pulmonary triggers in patients with takotsubo syndrome: new insights from the International Takotsubo Registry / $c K. Kato, VL. Cammann, LC. Napp, KA. Szawan, J. Micek, S. Dreiding, RA. Levinson, V. Petkova, M. Würdinger, A. Patrascu, R. Sumalinog, S. Gili, CF. Clarenbach, M. Kohler, M. Wischnewsky, R. Citro, C. Vecchione, E. Bossone, M. Neuhaus, J. Franke, B. Meder, M. Jaguszewski, M. Noutsias, M. Knorr, S. Heiner, F. D'Ascenzo, W. Dichtl, C. Burgdorf, B. Kherad, C. Tschöpe, A. Sarcon, J. Shinbane, L. Rajan, G. Michels, R. Pfister, A. Cuneo, C. Jacobshagen, M. Karakas, W. Koenig, A. Pott, P. Meyer, M. Roffi, A. Banning, M. Wolfrum, F. Cuculi, R. Kobza, TA. Fischer, T. Vasankari, KEJ. Airaksinen, M. Budnik, R. Dworakowski, P. MacCarthy, C. Kaiser, S. Osswald, L. Galiuto, C. Chan, P. Bridgman, D. Beug, C. Delmas, O. Lairez, E. Gilyarova, A. Shilova, M. Gilyarov, I. El-Battrawy, I. Akin, M. Kozel, P. Tousek, DE. Winchester, J. Galuszka, C. Ukena, G. Poglajen, P. Carrilho-Ferreira, C. Hauck, C. Paolini, C. Bilato, M. Sano, I. Ishibashi, M. Takahara, T. Himi, Y. Kobayashi, A. Prasad, CS. Rihal, K. Liu, PC. Schulze, M. Bianco, L. Jörg, H. Rickli, G. Pestana, TH. Nguyen, M. Böhm, LS. Maier, FJ. Pinto, P. Widimský, SB. Felix, G. Opolski, RC. Braun-Dullaeus, W. Rottbauer, G. Hasenfuß, BM. Pieske, H. Schunkert, M. Borggrefe, H. Thiele, J. Bauersachs, HA. Katus, JD. Horowitz, C. Di Mario, T. Münzel, F. Crea, JJ. Bax, TF. Lüscher, F. Ruschitzka, JR. Ghadri, C. Templin
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$a AIMS: Acute pulmonary disorders are known physical triggers of takotsubo syndrome (TTS). This study aimed to investigate prevalence of acute pulmonary triggers in patients with TTS and their impact on outcomes. METHODS AND RESULTS: Patients with TTS were enrolled from the International Takotsubo Registry and screened for triggering factors and comorbidities. Patients were categorized into three groups (acute pulmonary trigger, chronic lung disease, and no lung disease) to compare clinical characteristics and outcomes. Of the 1670 included patients with TTS, 123 (7%) were identified with an acute pulmonary trigger, and 194 (12%) had a known history of chronic lung disease. The incidence of cardiogenic shock was highest in patients with an acute pulmonary trigger compared with those with chronic lung disease or without lung disease (17% vs. 10% vs. 9%, P = 0.017). In-hospital mortality was also higher in patients with an acute pulmonary trigger than in the other two groups, although not significantly (5.7% vs. 1.5% vs. 4.2%, P = 0.13). Survival analysis demonstrated that patients with an acute pulmonary trigger had the worst long-term outcome (P = 0.002). The presence of an acute pulmonary trigger was independently associated with worse long-term mortality (hazard ratio 2.12, 95% confidence interval 1.33-3.38; P = 0.002). CONCLUSIONS: The present study demonstrates that TTS is related to acute pulmonary triggers in 7% of all TTS patients, which accounts for 21% of patients with physical triggers. The presence of acute pulmonary trigger is associated with a severe in-hospital course and a worse long-term outcome.
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$a Cammann, Victoria L $u Department of Cardiology, University Heart Center, University Hospital of Zurich, Raemistrasse 100, Zurich, 8091, Switzerland
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$a Napp, L Christian $u Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
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$a Szawan, Konrad A $u Department of Cardiology, University Heart Center, University Hospital of Zurich, Raemistrasse 100, Zurich, 8091, Switzerland
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$a Micek, Jozef $u Department of Cardiology, University Heart Center, University Hospital of Zurich, Raemistrasse 100, Zurich, 8091, Switzerland
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$a Dreiding, Sara $u Department of Cardiology, University Heart Center, University Hospital of Zurich, Raemistrasse 100, Zurich, 8091, Switzerland
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$a Levinson, Rena A $u Department of Cardiology, University Heart Center, University Hospital of Zurich, Raemistrasse 100, Zurich, 8091, Switzerland
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$a Petkova, Vanya $u Department of Cardiology, University Heart Center, University Hospital of Zurich, Raemistrasse 100, Zurich, 8091, Switzerland
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$a Würdinger, Michael $u Department of Cardiology, University Heart Center, University Hospital of Zurich, Raemistrasse 100, Zurich, 8091, Switzerland
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$a Patrascu, Alexandru $u Department of Cardiology, University Heart Center, University Hospital of Zurich, Raemistrasse 100, Zurich, 8091, Switzerland
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$a Sumalinog, Rafael $u Department of Cardiology, University Heart Center, University Hospital of Zurich, Raemistrasse 100, Zurich, 8091, Switzerland
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$a Vecchione, Carmine $u Heart Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
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$a Bossone, Eduardo $u Division of Cardiology, Antonio Cardarelli Hospital, Naples, Italy
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$a Neuhaus, Michael $u Department of Cardiology, Kantonsspital Frauenfeld, Frauenfeld, Switzerland
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$a Franke, Jennifer $u Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany
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$a Meder, Benjamin $u Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany
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$a Jaguszewski, Milosz $u First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
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$a Noutsias, Michel $u Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
700    1_
$a Knorr, Maike $u Center for Cardiology, Cardiology 1, University Medical Center Mainz, Mainz, Germany
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$a Heiner, Susanne $u Center for Cardiology, Cardiology 1, University Medical Center Mainz, Mainz, Germany
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$a D'Ascenzo, Fabrizio $u Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della Scienza, University of Turin, Turin, Italy
700    1_
$a Dichtl, Wolfgang $u University Hospital for Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck, Innsbruck, Austria
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$a Burgdorf, Christof $u Heart and Vascular Centre Bad Bevensen, Bad Bevensen, Germany
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$a Kherad, Behrouz $u Department of Cardiology, Charité, Campus Rudolf Virchow, Berlin, Germany
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$a Tschöpe, Carsten $u Department of Cardiology, Charité, Campus Rudolf Virchow, Berlin, Germany
700    1_
$a Sarcon, Annahita $u Section of Cardiac Electrophysiology, Department of Medicine, University of California-San Francisco, San Francisco, CA, USA
700    1_
$a Shinbane, Jerold $u Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
700    1_
$a Rajan, Lawrence $u TJ Health Partners Heart and Vascular, Glasgow, KY, USA
700    1_
$a Michels, Guido $u Department of Internal Medicine III, Heart Center University of Cologne, Cologne, Germany
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$a Pfister, Roman $u Department of Internal Medicine III, Heart Center University of Cologne, Cologne, Germany
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$a Cuneo, Alessandro $u Krankenhaus 'Maria Hilf' Medizinische Klinik, Stadtlohn, Germany
700    1_
$a Jacobshagen, Claudius $u Clinic for Cardiology and Pneumology, Georg August University of Goettingen, Goettingen, Germany
700    1_
$a Karakas, Mahir $u Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany $u DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
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$a Koenig, Wolfgang $u Deutsches Herzzentrum München, Technische Universität München, Munich, Germany $u DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
700    1_
$a Pott, Alexander $u Department of Internal Medicine II - Cardiology, University of Ulm, Medical Center, Ulm, Germany
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$a Meyer, Philippe $u Service de Cardiologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland
700    1_
$a Roffi, Marco $u Service de Cardiologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland
700    1_
$a Banning, Adrian $u Department of Cardiology, John Radcliffe Hospital, Oxford University Hospitals, Oxford, UK
700    1_
$a Wolfrum, Mathias $u Department of Cardiology, Kantonsspital Lucerne, Lucerne, Switzerland
700    1_
$a Cuculi, Florim $u Department of Cardiology, Kantonsspital Lucerne, Lucerne, Switzerland
700    1_
$a Kobza, Richard $u Department of Cardiology, Kantonsspital Lucerne, Lucerne, Switzerland
700    1_
$a Fischer, Thomas A $u Department of Cardiology, Kantonsspital Winterthur, Winterthur, Switzerland
700    1_
$a Vasankari, Tuija $u Heart Center, Turku University Hospital, University of Turku, Turku, Finland
700    1_
$a Airaksinen, K E Juhani $u Heart Center, Turku University Hospital, University of Turku, Turku, Finland
700    1_
$a Budnik, Monika $u Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
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$a Dworakowski, Rafal $u Department of Cardiology, King's College Hospital, London, UK
700    1_
$a MacCarthy, Philip $u Department of Cardiology, King's College Hospital, London, UK
700    1_
$a Kaiser, Christoph $u Department of Cardiology, University Hospital of Basel, Basel, Switzerland
700    1_
$a Osswald, Stefan $u Department of Cardiology, University Hospital of Basel, Basel, Switzerland
700    1_
$a Galiuto, Leonarda $u Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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$a Chan, Christina $u Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand
700    1_
$a Bridgman, Paul $u Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand
700    1_
$a Beug, Daniel $u Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany $u DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
700    1_
$a Delmas, Clément $u Department of Cardiology and Cardiac Imaging Center, University Hospital of Rangueil, Toulouse, France
700    1_
$a Lairez, Olivier $u Department of Cardiology and Cardiac Imaging Center, University Hospital of Rangueil, Toulouse, France
700    1_
$a Gilyarova, Ekaterina $u Intensive Coronary Care Unit, Moscow City Hospital # 1 named after N. Pirogov, Moscow, Russia
700    1_
$a Shilova, Alexandra $u Intensive Coronary Care Unit, Moscow City Hospital # 1 named after N. Pirogov, Moscow, Russia
700    1_
$a Gilyarov, Mikhail $u Intensive Coronary Care Unit, Moscow City Hospital # 1 named after N. Pirogov, Moscow, Russia
700    1_
$a El-Battrawy, Ibrahim $u First Department of Medicine, Faculty of Medicine, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany $u DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany
700    1_
$a Akin, Ibrahim $u First Department of Medicine, Faculty of Medicine, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany $u DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany
700    1_
$a Kozel, Martin $u Cardiocenter, Third Faculty of Medicine, Charles University in Prague, University Hospital Kralovske Vinohrady, Prague, Czech Republic
700    1_
$a Tousek, Petr $u Cardiocenter, Third Faculty of Medicine, Charles University in Prague, University Hospital Kralovske Vinohrady, Prague, Czech Republic
700    1_
$a Winchester, David E $u Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
700    1_
$a Galuszka, Jan $u Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Olomouc, Czech Republic
700    1_
$a Ukena, Christian $u Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg, Germany
700    1_
$a Poglajen, Gregor $u Advanced Heart Failure and Transplantation Center, University Medical Center Ljubljana, Ljubljana, Slovenia
700    1_
$a Carrilho-Ferreira, Pedro $u Cardiology Department, Santa Maria University Hospital (CHLN), Lisbon Academic Medical Centre and Cardiovascular Centre of the University of Lisbon (CCUL), Lisbon School of Medicine, Universidade de Lisboa, Lisbon, Portugal
700    1_
$a Hauck, Christian $u Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany
700    1_
$a Paolini, Carla $u Local Health Unit n.8, Cardiology Unit, Arzignano, Vicenza, Italy
700    1_
$a Bilato, Claudio $u Local Health Unit n.8, Cardiology Unit, Arzignano, Vicenza, Italy
700    1_
$a Sano, Masanori $u Department of Cardiology, Chiba Emergency Medical Center, Chiba, Japan
700    1_
$a Ishibashi, Iwao $u Department of Cardiology, Chiba Emergency Medical Center, Chiba, Japan
700    1_
$a Takahara, Masayuki $u Division of Cardiology, Kimitsu Central Hospital, Kisarazu, Japan
700    1_
$a Himi, Toshiharu $u Division of Cardiology, Kimitsu Central Hospital, Kisarazu, Japan
700    1_
$a Kobayashi, Yoshio $u Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
700    1_
$a Prasad, Abhiram $u Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
700    1_
$a Rihal, Charanjit S $u Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
700    1_
$a Liu, Kan $u Division of Cardiology, Heart and Vascular Center, University of Iowa, Iowa City, Iowa, USA
700    1_
$a Schulze, P Christian $u Department of Internal Medicine I, JenaUniversity Hospital, Friedrich-Schiller-University Jena, Jena, Germany
700    1_
$a Bianco, Matteo $u Division of Cardiology, A.O.U San Luigi Gonzaga, Turin, Italy
700    1_
$a Jörg, Lucas $u Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
700    1_
$a Rickli, Hans $u Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
700    1_
$a Pestana, Gonçalo $u Department of Cardiology, Centro Hospitalar Universitário de São João, E.P.E, Porto, Portugal
700    1_
$a Nguyen, Thanh H $u Department of Cardiology, Basil Hetzel Institute, Queen Elizabeth Hospital, University of Adelaide, Adelaide, Australia
700    1_
$a Böhm, Michael $u Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg, Germany
700    1_
$a Maier, Lars S $u Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany
700    1_
$a Pinto, Fausto J $u Cardiology Department, Santa Maria University Hospital (CHLN), Lisbon Academic Medical Centre and Cardiovascular Centre of the University of Lisbon (CCUL), Lisbon School of Medicine, Universidade de Lisboa, Lisbon, Portugal
700    1_
$a Widimský, Petr $u Cardiocenter, Third Faculty of Medicine, Charles University in Prague, University Hospital Kralovske Vinohrady, Prague, Czech Republic
700    1_
$a Felix, Stephan B $u Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany $u DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
700    1_
$a Opolski, Grzegorz $u Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
700    1_
$a Braun-Dullaeus, Ruediger C $u Internal Medicine/Cardiology, Angiology, and Pneumology, Magdeburg University, Magdeburg, Germany
700    1_
$a Rottbauer, Wolfgang $u Department of Internal Medicine II - Cardiology, University of Ulm, Medical Center, Ulm, Germany
700    1_
$a Hasenfuß, Gerd $u Clinic for Cardiology and Pneumology, Georg August University of Goettingen, Goettingen, Germany
700    1_
$a Pieske, Burkert M $u Department of Cardiology, Charité, Campus Rudolf Virchow, Berlin, Germany
700    1_
$a Schunkert, Heribert $u Deutsches Herzzentrum München, Technische Universität München, Munich, Germany $u DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
700    1_
$a Borggrefe, Martin $u First Department of Medicine, Faculty of Medicine, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany $u DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany
700    1_
$a Thiele, Holger $u Department of Internal Medicine/Cardiology, Heart Center Leipzig - University Hospital, Leipzig, Germany
700    1_
$a Bauersachs, Johann $u Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
700    1_
$a Katus, Hugo A $u Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany
700    1_
$a Horowitz, John D $u Department of Cardiology, Basil Hetzel Institute, Queen Elizabeth Hospital, University of Adelaide, Adelaide, Australia
700    1_
$a Di Mario, Carlo $u Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
700    1_
$a Münzel, Thomas $u Center for Cardiology, Cardiology 1, University Medical Center Mainz, Mainz, Germany
700    1_
$a Crea, Filippo $u Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
700    1_
$a Bax, Jeroen J $u Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
700    1_
$a Lüscher, Thomas F $u Center for Molecular Cardiology, Schlieren Campus, University of Zurich, Zurich, Switzerland $u Royal Brompton and Harefield Hospitals Trust and Imperial College, London, UK
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700    1_
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700    1_
$a Templin, Christian $u Department of Cardiology, University Heart Center, University Hospital of Zurich, Raemistrasse 100, Zurich, 8091, Switzerland
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