Universitätsklinik für Kardiologie
Universitätsklinik für Kardiologie / Forschung
Research group of PD Dr. med. Norman Mangner
Scientific projects
1. Molecular alterations elicited by heart failure in the diaphragm - impact of exercise training

Diaphragmatic dysfunction in patients with chronic heart failure (CHF) is associated with poor prognosis. Diaphragm muscle weakness is likely a key mediator in the overall pathogenesis of CHF, but little is still known about its temporal progression and underlying molecular mechanisms.
The goals of our investigations in this area are to answer the following questions:
  1. Does the development of chronic heart failure is associated with a reduction of diaphragm contractility
  2. How fast do we see a force reduction in the diaphragm after an MI-induced chronic heart failure?
  3. What molecular mechanisms are responsible for the CHF-induced loss of diaphragmatic muscle?
  4. Can we influence the loss of muscle function and the related molecular changes by exercise training? If yes, what is the optimal training modality?

2. Childhood Obesity - Impact on Cardiac Geometry and Function

Obesity in children and adolescents has increased over the last decades and is considered a strong risk factor for future cardiovascular morbidity and mortality. Obesity has been associated with myocardial structural alterations that may influence cardiac mechanics.
In a first study we were able to show that, compared to non-obese children, obese subjects were characterized by enlarged left and right sided cardiac chambers, thicker left ventricular walls and, consequently, by elevated left ventricular mass. Despite comparable left ventricular ejection fraction, reduced tissue Doppler derived peak systolic velocity and regional basoseptal strain was found in obese subjects compared to non-obese children. Beyond that, 2D-speckle tracking derived longitudinal and circumferential of the left ventricle was reduced in obese children compared to non-obese children. Diastolic function was also impaired in obese compared to non-obese subjects. Both longitudinal and circumferential strains were independently associated with obesity. The results of this study demonstrate that childhood obesity is associated with significant changes in myocardial geometry and function, indicating an early onset of potentially unfavorable alterations in the myocardium.
The future goals of our investigations in this area are to answer the following questions:
  1. Are the changed values between obese and non-obese children of clinical significance?
  2. Can we use particular values as predictors for future cardiovascular events?
  3. How do the above mentioned results change over time, e.g. childhood to adolescence to adulthood?
  4. Can the alterations found in obese children be reversed by weight loss or are they even aggravated by further weight gain?
This work is in close cooperation with the research group of PD Dr. Sandra Erbs. For further details refer to PD Dr. Sandra Erbs.

3. Transcatheter Aortic Valve Implantation (TAVI)

Transcatheter aortic valve implantation (TAVI) has become a feasible and effective therapeutic option for patients with severe aortic stenosis and high operative risk or relative contraindications for surgical aortic valve replacement (SAVR). As with every new technology, however, a number of potential pitfalls and limitations have to be addressed and future opportunities have to be clarified in well-conducted clinical trials and well-monitored registries.
For this reason a large single center registry, different randomized trials, and industry-supported studies are performed in cooperation with the Department of Cardiac Surgery evaluating different aspects of TAVI, e.g. patient selection, special patient populations, procedural and post-procedural aspects, and outcome.

This work is in close cooperation with the research group of Prof. Dr. Axel Linke. For further details refer to Prof. Dr. Axel Linke.

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Universitätsklinik für Kardiologie