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Short- and long-term outcomes after transcatheter or surgical aortic valve replacement in patients with chronic lung disease : an analysis from the German Aortic Valve Registry
(2025) Böning, Andreas; Balaban, Umniye; Herrmann, Eva; Beckmann, Andreas; Bekeredjian, Raffi; Bleiziffer, Sabine; Ensminger, Stephan; Frerker, Christian; Möllmann, Helge; Walther, Thomas; Bauer, Timm
Objectives: Data from the German Aortic Valve Registry (GARY) were analysed to determine whether there are differences between patients with and without chronic lung disease (CLD) undergoing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) and whether TAVI or SAVR is more beneficial in patients with preexisting CLD. Methods: Follow-up data from GARY registry patients treated from 2014 to 2015 and from 2018 to 2019 were incorporated in the analysis. Demographic results for each of the 2 treatment modalities were evaluated, and patients with and without CLD were compared. In a second step, variables that would have influenced the treatment decision in CLD patients in direction of either SAVR or TAVI were accounted for in the adjusted analysis. This led to a subgroup of 1385 patients with CLD that was subjected to propensity score weighted analysis to compare outcomes of TAVI and SAVR. Results: After exclusion, 11 457 SAVR patients and 2378 TAVI patients were analysed. CLD patients were sicker than patients without CLD, although the observed 30-day mortality was lower than expected by 3 risk scores. Accordingly, long-term survival in CLD patients was lower in both treatment groups than in patients without CLD. Thirty-day mortality was similar in the 2 treatment groups (SAVR 2.3%, TAVI 3.8%, P = .964) in spite of a possible selection bias in favour of SAVR. During a 5-year follow-up, survival after TAVI (44.6%) was significantly lower than after SAVR (56.7%), P = .029. Conclusions: Patients with CLD undergoing SAVR or TAVI are generally at higher risk for complications or death after the procedure than patients without CLD. After 5 years, patient-reported outcomes were similar in TAVI and in SAVR patients.
Correlation between coronary artery disease severity detected by CT coronary angiography and grade of left ventricular diastolic dysfunction detected by echocardiography
(2025) El-Barbary, Ahmed; Elsayed, Mohamed Atef; Yousef Selim, Yousef Ahmed; Elkaffas, Sameh Mohamed Helmy; Sabit, Hussein; Arneth, Borros; Taghiyev, Zulfugar T.; Tantawy, Mahmoud Ahmed
Background: Coronary artery disease (CAD) and left-ventricular (LV) diastolic dysfunction are leading drivers of morbidity and mortality. Clarifying how anatomical CAD burden relates to diastolic impairment may refine diagnosis and risk stratification. Methods: We conducted a cross-sectional analytical study of 200 adults with intermediate pretest probability of CAD who underwent both coronary CT angiography (CCTA) and transthoracic echocardiography (TTE) within ≤1 year. Coronary burden was quantified by Segment Involvement Score (SIS). Diastolic function was graded by contemporary echocardiographic guidelines. Patients were classified as obstructive (≥50% LM or ≥70% in other major epicardial arteries) or non-obstructive CAD. Results: Obstructive CAD was present in 73/200 (36.5%). Diastolic dysfunction occurred in 161/200 (80.5%) and was markedly more prevalent/severe in obstructive vs. non-obstructive CAD (p < 0.001). SIS rose stepwise with higher diastolic dysfunction grades; SIS correlated strongly with diastolic grade (r = 0.809, p < 0.001). Compared with non-obstructive CAD, obstructive CAD showed worse diastolic indices (higher E/e′, larger LAVI, shorter DT and IVRT; all p < 0.001) and a shift toward Grades II–III. Obstructive CAD was also associated with higher total cholesterol, triglycerides, LDL, HbA1c, lower HDL (all p ≤ 0.002), and a greater prevalence of hypertension and diabetes. Discussion: Increasing coronary atherosclerotic burden—captured by SIS, parallels progressive impairment of LV relaxation and elevated filling pressures, supporting a pathophysiologic link between epicardial disease extent and diastolic dysfunction. Conclusions: In symptomatic intermediate-risk patients, greater CAD extent on CCTA is strongly associated with higher grades of LV diastolic dysfunction on echocardiography. Integrating anatomic (SIS) and functional (TTE) metrics may enhance risk assessment and guide management in CAD.
How survey results are reported in the media : a framework on selection mechanisms and a pilot study on reporting practice
(2025) Bethäuser, Jenny; Menold, Natalja; Winker, Peter
Survey results are frequently reported in the media without sufficient background information to assess their methodological quality. This gap may arise from various factors, including a lack of statistical literacy among those involved in generating or disseminating results, time and space constraints in journalistic contexts, or the perception that methodological details may overwhelm or confuse audiences. In addition, economic (dis)incentives in the media landscape can affect how journalists decide what to include or leave out when reporting on survey results. We propose a conceptual framework for these factors and their interactions and outline their expected implications for the communication of survey-based findings in public discourse. This framework serves as the foundation for a subsequent empirical pilot study focused on reporting in DER SPIEGEL and BILD. We collected articles published in the second half of 2023 that include the key word ‘survey’. We performed a manual content analysis to determine the background information provided on the survey methodology when referring to the survey results. We found that the source of the survey is the most frequent and often the only information on survey background provided. The proposed framework could serve as the foundation for a subsequent broader empirical analysis aimed at identifying the main drivers that influence media reporting on survey statistics and guiding improvements in statistical literacy and reporting practices.
Neural networks in catchment hydrology : a comparative study of different algorithms in an ensemble of ungauged basins in Germany
(2025) Weißenborn, Max; Breuer, Lutz; Houska, Tobias
This study presents a comparative analysis of different neural network models, including convolutional neural networks (CNN), long short-term memory (LSTM) and gated recurrent units (GRUs), with regard to predicting discharge within ungauged basins in Hesse, Germany. All models were trained on 54 catchments with 28 years of daily meteorological data, either including or excluding 11 static catchment attributes. The training process for each model scenario combination was repeated 100 times using a Latin hypercube sampler for hyperparameter optimisation with batch sizes of 256 and 2048. The evaluation was carried out using data from 35 additional catchments (6 years) to ensure predictions in basins that were not part of the training data. This evaluation assessed predictive accuracy and computational efficiency concerning varying batch sizes and input configurations and conducted a sensitivity analysis of dynamic input features. The findings indicated that all examined artificial neural networks demonstrated significant predictive capabilities, with a CNN model exhibiting slightly superior performance, closely followed by LSTM and GRU models. The integration of static features was found to improve performance across all models, highlighting the importance of feature selection. Furthermore, models utilising larger batch sizes displayed reduced performance. The analysis of computational efficiency revealed that a GRU model was 41 % faster than the CNN model and 59 % faster than the LSTM model. Despite a modest disparity in performance among the models (<3.9 %), the GRU model's advantageous computational speed rendered it an optimal compromise between predictive accuracy and computational demand.
Serum phospholipids and sphingolipids are linked to early-stage osteoarthritis by lipidomic profiling
(2025) Eichner, Gerrit; Liebisch, Gerhard; Hild, Christiane; Rickert, Markus; Steinmeyer, Juergen
Background: Osteoarthritis (OA) is associated with abnormal lipid metabolism, wherein elevated levels of phospholipids (PLs) and sphingolipids (SLs) in human and canine synovial fluid (SF) have been observed. The aim of this lipidomic study was to evaluate how closely blood lipid levels reflect changes in SF, building on previous findings. Methods: Lipids were extracted from knee SF and serum of 44 joint-healthy donors and 58 early (eOA) or late OA (lOA) patients. By electrospray ionization tandem mass spectrometry (ESI-MS/MS), we quantified the extracted lipids and conducted comprehensive statistical analyses. Results: Human SF and serum had similar PL and SL compositions. Quantifying 91 lipid species from 6 major classes revealed OA-related changes in serum, with the lowest levels in healthy controls and elevated levels already in the eOA cohort. Generally, serum PL and SL levels were 3–12 times higher than in SF. Specific PL species were elevated in both SF and serum of eOA and lOA patients compared to healthy controls, while nearly 10% of the PL species measured were higher exclusively in the serum of OA patients. Conclusions: The significant lipidomic alterations that were detected at an average Outerbridge score of less than 2 suggest that certain serum PLs may serve as indicators for monitoring the early stages of OA even before radiologic detection is possible. With 10% of PL species elevated only in OA serum, our data implicate the existence of a systemic response that parallels the local lipid metabolic response to OA.