Cardiac Assist in Clinical Research and Development
This program focuses on the application of cardiac assist and replacement systems in clinical research and development of diagnostic methods and system components. It includes activities in the diagnostics of the interaction between heart and pump, the optimal pump control for physiologically adapted demand and for strategies to train the heart to eventual recovery. Apart from that, studies for development of pump components for minimal invasive implantation and for the safety and usability of the system components are performed. These investigations are done in close cooperation between engineering, experimental, and clinical experts of the LBC.
The Cardiac Regeneration and Protection Program
This program investigates various ways to improve and preserve myocardial function of patients in the acute and chronic phase of myocardial infarction. This research is motivated by the discrepancy between the currently promising experimental success of these therapies (cell transplantation, gene therapy, angiogenesis,..) but the limited clinical experience and relevance. Additionally, the aspect of gender differences is addressed, in order to understand and optimize the post infarct treatment in women. This program involves multiple techniques of the LBC, the cell culture, the isolated heart including in-vivo models of myocardial infarction and remodeling as well as clinical approaches.
Development of Small Diameter Vascular Grafts
This program focuses on the reconstruction of small diameter vessels with bioengineered grafts in patients with vascular disease as well as on the special needs of patients with diabetes, particularly patients with coronary disease and diabetes. Various approaches are investigated. These questions are of particular importance due to the high rate of re-stenosis and occlusion with small conduits in clinical medicine, and are addressed both by using new biomaterials and by surface modification techniques, even with nanotechnology.
Angiogenesis and Inflammation in Adipose Tissue: A link between obesity and cardiovascular disease
Obesity is rapidly increasing worldwide, in particular in Western industrialized countries. Obese patients are at higher risk of developing cardiovascular diseases. A generalized inflammatory state associated with obesity is seen as a link to the development and progression of cardiovascular pathologies such as atherosclerosis in these patients. Angiogenesis is a crucial process in adipose tissue differentiation of preadipocytes into adipocytes and in the growth of adipose tissue mass. In addition crosstalk between adipocytes and inflammatory cells present in adipose tissue such as macrophages seems to be involved also in differentiation and growth of preadipocytes and adipocytes. This project focuses on the regulation of angiogenic and inflammatory mediators in adipose tissue and in inflammatory cells such as adipose tissue macrophages. Based on this approach it is the aim of this project to identify new therapeutic targets for the treatment of cardiovascular diseases in general and in the growing number of obese patients in particular.
Contact: Ao.Univ.-Prof. Dr.Johann Wojta
Impact of Glycemic Control and Insulin Resistance on the Rate of In-stent Restenosis in Diabetic Patient after Drug Eluting Stent Implantation
The drug eluting stent (DES) era brought an improvement in the outcome of patients undergoing coronary stenting. Even in patients with type 2 diabetes mellitus (DM) DES were found to be associated with a better long-term outcome. Several studies compared DES with bare metal stent (BMS) in patients with DM. However these trials have several limitations. A recent published Meta-analysis showed that diabetes is still a risk factor for restenosis after coronary intervention. Several other factors have been demonstrated to influence the pathogenesis and progression of CAD and instent restenosis (IRS). Among these are prothrombotic and fibrinolytic glycopeptides such as plasminogen activator inhibitor type 1 (PAI-1), and tissue type plasminogen activator (t-PA), as well as inflammatory cytokines and peptides such as high sensitive C-reactive protein (hsCRP) and tumor necrosis factor alpha (TNF-a). Moreover, adipocytokines, glycoproteins and hormones such as leptin, adiponectin, resistin, ghrelin, proinsulin, insulin and fetuin-A have recently been introduced in this research area. It is the aim of this project to investigate the impact of the metabolic state (manifest diabetes, impaired glucose tolerance, normal glucose tolerance) on pro-thrombotic, pro-inflammatory and pro-atherosclerotic variables (e.g. PAI-1, t-PA, hsCRP, tumor necrosis TNF-a, insulin, proinsulin, ghrelin, fetuin-A and resistin) on IRS in 400 patients undergoing stent implantation. A pathophysiologic explanation for the role of new pro-inflammatory, pro-thrombotic, and pro-atherogenic variables in IRS and stent-thrombosis formation in patients with or without pathologic glucose metabolism would allow to better identify patients at risk to develop these adverse events.
Contact: Univ. Prof. Dr. Kurt Huber