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Articles by S Erbs
Total Records ( 3 ) for S Erbs
  C Walther , L Gaede , V Adams , G Gelbrich , A Leichtle , S Erbs , M Sonnabend , K Fikenzer , A Korner , W Kiess , M Bruegel , J Thiery and G. Schuler
 

Background— The aim of this prospective, randomized study was to examine whether additional school exercise lessons would result in improved peak oxygen uptake (primary end point) and body mass index–standard deviation score, motor and coordinative abilities, circulating progenitor cells, and high-density lipoprotein cholesterol (major secondary end points).

Methods and Results— Seven sixth-grade classes (182 children, aged 11.1±0.7 years) were randomized to an intervention group (4 classes with 109 students) with daily school exercise lessons for 1 year and a control group (3 classes with 73 students) with regular school sports twice weekly. The significant effects of intervention estimated from ANCOVA adjusted for intraclass correlation were the following: increase of peak Vo2 (3.7 mL/kg per minute; 95% confidence interval, 0.3 to 7.2) and increase of circulating progenitor cells evaluated by flow cytometry (97 cells per 1x106 leukocytes; 95% confidence interval, 13 to 181). No significant difference was seen for body mass index–standard deviation score (–0.08; 95% confidence interval, –0.28 to 0.13); however, there was a trend to reduction of the prevalence of overweight and obese children in the intervention group (from 12.8% to 7.3%). No treatment effect was seen for motor and coordinative abilities (4; 95% confidence interval, –1 to 8) and high-density lipoprotein cholesterol (0.03 mmol/L; 95% confidence interval, –0.08 to 0.14).

Conclusions— Regular physical activity by means of daily school exercise lessons has a significant positive effect on physical fitness (Vo2max). Furthermore, the number of circulating progenitor cells can be increased, and there is a positive trend in body mass index–standard deviation score reduction and motor ability improvement. Therefore, we conclude that primary prevention by means of increasing physical activity should start in childhood.

Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Identifier: NCT00176371.

  B Assmus , A Rolf , S Erbs , A Elsasser , W Haberbosch , R Hambrecht , H Tillmanns , J Yu , R Corti , D. G Mathey , C. W Hamm , T Suselbeck , T Tonn , S Dimmeler , T Dill , A. M Zeiher , V Schachinger and for the REPAIR AMI Investigators
 

Background— The aim of this study was to investigate the clinical outcome 2 years after intracoronary administration of autologous progenitor cells in patients with acute myocardial infarction (AMI).

Methods and Results— Using a double-blind, placebo-controlled, multicenter trial design, we randomized 204 patients with successfully reperfused AMI to receive intracoronary infusion of bone marrow–derived progenitor cells (BMC) or placebo medium into the infarct artery 3 to 7 days after successful infarct reperfusion therapy. At 2 years, the cumulative end point of death, myocardial infarction, or necessity for revascularization was significantly reduced in the BMC group compared with placebo (hazard ratio, 0.58; 95% CI, 0.36 to 0.94; P=0.025). Likewise, the combined end point death and recurrence of myocardial infarction and rehospitalization for heart failure, reflecting progression toward heart failure, was significantly reduced in the BMC group (hazard ratio, 0.26; 95% CI, 0.085 to 0.77; P=0.015). Intracoronary administration of BMC remained a significant predictor of a favorable clinical outcome by Cox regression analysis when adjusted for classical predictors of poor outcome after AMI. There was no evidence of increased restenosis or atherosclerotic disease progression after BMC therapy nor any evidence of increased ventricular arrhythmias or neoplasms. In addition, regional left ventricular contractility of infarcted segments, as assessed by MRI in a subgroup of patients at 2-year follow-up, was significantly higher in the BMC group compared with the placebo group (P<0.001).

Conclusions— Intracoronary administration of BMC is associated with a significant reduction of the occurrence of major adverse cardiovascular events maintained for 2 years after AMI. Moreover, functional improvements after BMC therapy may persist for at least 2 years. Larger studies focusing on clinical event rates are warranted to confirm the effects of BMC administration on mortality and progression of heart failure in patients with AMIs.

Clinical Trial Registration— clinicaltrials.gov. Identifier: NCT00279175.

  S Erbs , R Hollriegel , A Linke , E. B Beck , V Adams , S Gielen , S Mobius Winkler , M Sandri , N Krankel , R Hambrecht and G. Schuler
  Background—

Attenuated peripheral perfusion in patients with advanced chronic heart failure (CHF) is partially the result of endothelial dysfunction. This has been causally linked to an impaired endogenous regenerative capacity of circulating progenitor cells (CPC). The aim of this study was to elucidate whether exercise training (ET) affects exercise intolerance and left ventricular (LV) performance in patients with advanced CHF (New York Heart Association class IIIb) and whether this is associated with correction of peripheral vasomotion and induction of endogenous regeneration.

Methods and Results—

Thirty-seven patients with CHF (LV ejection fraction 24±2%) were randomly assigned to 12 weeks of ET or sedentary lifestyle (control). At the beginning of the study and after 12 weeks, maximal oxygen consumption (Vo2max) and LV ejection fraction were determined; the number of CD34+/KDR+ CPCs was quantified by flow cytometry and CPC functional capacity was determined by migration assay. Flow-mediated dilation was assessed by ultrasound. Capillary density was measured in skeletal muscle tissue samples. In advanced CHF, ET improved Vo2max by +2.7±2.2 versus –0.8±3.1 mL/min/kg in control (P=0.009) and LV ejection fraction by +9.4±6.1 versus –0.8±5.2% in control (P<0.001). Flow-mediated dilation improved by +7.43±2.28 versus +0.09±2.18% in control (P<0.001). ET increased the number of CPC by +83±60 versus –6±109 cells/mL in control (P=0.014) and their migratory capacity by +224±263 versus –12±159 CPC/1000 plated CPC in control (P=0.03). Skeletal muscle capillary density increased by +0.22±0.10 versus –0.02±0.16 capillaries per fiber in control (P<0.001).

Conclusions—

Twelve weeks of ET in patients with advanced CHF is associated with augmented regenerative capacity of CPCs, enhanced flow-mediated dilation suggestive of improvement in endothelial function, skeletal muscle neovascularization, and improved LV function.

Clinical Trial Registration—

http://www.clinicaltrials.gov. Unique Identifier: NCT00176384.

 
 
 
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