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Prof. Dr. Dr. med. habil. Mathias Burgmaier

Faculty of Applied Healthcare Sciences

Professors

Professor

LA 27-2.14

0991/3615-8343

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Journal article
  • P. Petsophonsakul
  • Mathias Burgmaier
  • B. Willems
  • S. Heeneman
  • N. Stadler
  • F. Gremse
  • S. Reith
  • Kathrin Burgmaier
  • F. Kahles
  • N. Marx
  • E. Natour
  • E. Bidar
  • M. Jacobs
  • et al.

Nicotine promotes vascular calcification via intracellular Ca2+-mediated, Nox5-induced oxidative stress, and extracellular vesicle release in vascular smooth muscle cells.

In: Cardiovascular Research vol. 118 pg. 2196-2210

  • (2022)

DOI: 10.1093/cvr/cvab244

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AIMS Smokers are at increased risk of cardiovascular events. However, the exact mechanisms through which smoking influences cardiovascular disease resulting in accelerated atherosclerosis and vascular calcification are unknown. The aim of this study was to investigate effects of nicotine on initiation of vascular smooth muscle cell (VSMC) calcification and to elucidate underlying mechanisms. METHODS AND RESULTS We assessed vascular calcification of 62 carotid lesions of both smoking and non-smoking patients using ex vivo micro-computed tomography (µCT) scanning. Calcification was present more often in carotid plaques of smokers (n = 22 of 30, 73.3%) compared to non-smokers (n = 11 of 32, 34.3%; P < 0.001), confirming higher atherosclerotic burden. The difference was particularly profound for microcalcifications, which was 17-fold higher in smokers compared to non-smokers. In vitro, nicotine-induced human primary VSMC calcification, and increased osteogenic gene expression (Runx2, Osx, BSP, and OPN) and extracellular vesicle (EV) secretion. The pro-calcifying effects of nicotine were mediated by Ca2+-dependent Nox5. SiRNA knock-down of Nox5 inhibited nicotine-induced EV release and calcification. Moreover, pre-treatment of hVSMCs with vitamin K2 ameliorated nicotine-induced intracellular oxidative stress, EV secretion, and calcification. Using nicotinic acetylcholine receptor (nAChR) blockers α-bungarotoxin and hexamethonium bromide, we found that the effects of nicotine on intracellular Ca2+ and oxidative stress were mediated by α7 and α3 nAChR. Finally, we showed that Nox5 expression was higher in carotid arteries of smokers and correlated with calcification levels in these vessels. CONCLUSION In this study, we provide evidence that nicotine induces Nox5-mediated pro-calcific processes as novel mechanism of increased atherosclerotic calcification. We identified that activation of α7 and α3 nAChR by nicotine increases intracellular Ca2+ and initiates calcification of hVSMCs through increased Nox5 activity, leading to oxidative stress-mediated EV release. Identifying the role of Nox5-induced oxidative stress opens novel avenues for diagnosis and treatment of smoking-induced cardiovascular disease.
Journal article
  • Ganesh
  • N.
  • E. van der Vorst
  • J. Spiesshöfer
  • S. He
  • Mathias Burgmaier
  • H. Findeisen
  • M. Lehrke
  • F. Swirski
  • N. Marx
  • F. Kahles

Gut immune cells-A novel therapeutical target for cardiovascular disease?.

In: Frontiers in Cardiovascular Medicine vol. 9 pg. 943214

  • 15.08.2022 (2022)

DOI: 10.3389/fcvm.2022.943214

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Despite scientific and clinical advances during the last 50 years cardiovascular disease continues to be the main cause of death worldwide. Especially patients with diabetes display a massive increased cardiovascular risk compared to patients without diabetes. Over the last two decades we have learned that cardiometabolic and cardiovascular diseases are driven by inflammation. Despite the fact that the gastrointestinal tract is one of the largest leukocyte reservoirs of our bodies, the relevance of gut immune cells for cardiovascular disease is largely unknown. First experimental evidence suggests an important relevance of immune cells in the intestinal tract for the development of metabolic and cardiovascular disease in mice. Mice specifically lacking gut immune cells are protected against obesity, diabetes, hypertension and atherosclerosis. Importantly antibody mediated inhibition of leukocyte homing into the gut showed similar protective metabolic and cardiovascular effects. Targeting gut immune cells might open novel therapeutic approaches for the treatment of cardiometabolic and cardiovascular diseases.
Journal article
  • E. Ferrannini
  • N. Marx
  • D. Andreini
  • B. Campi
  • A. Saba
  • M. Gorini
  • G. Ferrannini
  • A. Milzi
  • M. Magnoni
  • A. Maseri
  • A. Maggioni
  • Mathias Burgmaier

Mannose as a biomarker of coronary artery disease: Angiographic evidence and clinical significance.

In: International Journal of Cardiology vol. 346 pg. 86-92

  • 18.11.2021 (2022)

DOI: 10.1016/j.ijcard.2021.11.038

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BACKGROUND High mannose has previously associated with insulin resistance and cardiovascular disease (CVD). Our objective is to establish whether mannose is associated with anatomical evidence of coronary artery disease (CAD). METHODS Plasma mannose concentrations were measured by liquid chromatography/tandem mass spectrometry in a discovery cohort (n = 513) and a validation cohort (n = 221) of carefully phenotyped individuals. In both cohorts CAD was quantitated using state-of-the-art imaging techniques (coronary computed coronary tomography angiography (CCTA), invasive coronary angiography and optical coherence tomography). Information on subsequent CVD events/death was collected. Associations of mannose with angiographic variables and biomarkers were tested using univariate and multivariate regression models. Survival analysis was performed using the Kaplan-Meier estimator. RESULTS Mannose was related to indices of CAD and features of plaque vulnerability. In the discovery cohort, mannose was a marker of quantity and quality of CCTA-proven CAD and subjects with a mannose level in the top quartile had a significantly higher risk of CVD events/death (p = 3.6e-5). In the validation cohort, mannose was significantly associated with fibrous cap thickness < 65 μm (odds ratio = 1.32 per each 10 μmol/L mannose change [95% confidence interval, 1.05-1.65]) and was an independent predictor of death (hazard ratio for mannose≥vs < 84.6 μmol/L: 4.0(95%CI, 1.4-11.3), p = 0.006). CONCLUSION The current data add novel evidence that high mannose is a signature of CAD with a vulnerable plaque phenotype, consistently across measures of severity of vessel involvement and independent of the traditional correlates of CVD, and that it is an independent predictor of incident adverse outcomes.
Journal article
  • A. Milzi
  • R. Dettori
  • R. Lubberich
  • Kathrin Burgmaier
  • N. Marx
  • S. Reith
  • Mathias Burgmaier

Coronary microvascular dysfunction as assessed by angiography-derived index of microvascular resistance co-localizes with and may explain the presence of ischemia in stress-cardiac magnetic resonance imaging in the absence of coronary artery disease.

In: Frontiers in Cardiovascular Medicine vol. 9 pg. 1060764

  • 24.11.2022 (2022)

DOI: 10.3389/fcvm.2022.1060764

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INTRODUCTION Ischemia with no obstructive coronary disease (INOCA) is a frequent phenomenon in the cath lab. A possible cause is coronary microvascular dysfunction (CMD), which may be assessed by invasive testing with possible complications; therefore, less invasive approaches have emerged, such as the angiography-derived index of microvascular resistance (aIMR). The aim of our study was to investigate the association of single-vessel aIMR as a measure of CMD with areas of INOCA in stress testing. METHODS We measured aIMR in 286 vessels from 102 patients undergoing both stress cMRI and coronary angiography. Groups were (a) INOCA group (93 vessels, 32 patients); (b) coronary artery disease (CAD) control group (116 vessels, 42 patients) with ischemia due to relevant stenosis; and (c) control group (77 vessels, 28 patients) without ischemia or relevant stenosis. RESULTS INOCA patients presented higher mean aIMR (28.3 ± 5.7) compared to both CAD patients (17.4 ± 5.7, p < 0.001) and controls (22.1 ± 5.9, p < 0.001). Furthermore, in INOCA patients aIMR was significantly increased (33.0 ± 8.1 vs. 25.8 ± 6.3, p = 0.021) in vessels with vs. without ischemia. Single vessel aIMR presented a very good diagnostic efficiency in detecting INOCA [AUC 0.865 (0.804-0.925), optimal cut-off 27.1, p < 0.001]. CONCLUSION CMD, as assessed by 3-vessel aIMR, co-localizes with and may explain the presence of ischemia in stress-cMRI in INOCA.
Journal article
  • A. Milzi
  • R. Dettori
  • R. Lubberich
  • Kathrin Burgmaier
  • N. Marx
  • S. Reith
  • Mathias Burgmaier

Quantitative Flow Ratio Is Related to Anatomic Left Main Stem Lesion Parameters as Assessed by Intravascular Imaging.

In: Journal of Clinical Medicine vol. 11

  • 12.10.2022 (2022)

DOI: 10.3390/jcm11206024

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INTRODUCTION Previously, an association between anatomic left main stem (LMS) lesion parameters, as described by intravascular ultrasound (IVUS) and fractional flow reserve (FFR), was shown. Quantitative flow ratio (QFR) is a novel, promising technique which can assess functional stenosis relevance based only on angiography. However, as little is known about the relationship between anatomic LMS parameters and QFR, it was thus investigated in this study. METHODS In 53 patients with LMS disease, we tested the association between anatomic assessment using OCT (n = 28) or IVUS (n = 25) on the one hand and functional assessment as determined by QFR on the other hand. LMS-QFR was measured using a dedicated approach, averaging QFR over left anterior descending (LAD) and circumflex (LCX) and manually limiting segment of interest to LMS. RESULTS The minimal luminal area of the LMS (LMS-MLA) as measured by intravascular imaging showed a consistent correlation with QFR (R = 0.61, p < 0.001). QFR could predict a LMS-MLA < 6 mm2 with very good diagnostic accuracy (AUC 0.919) and a LMS-MLA < 4.5 mm2 with good accuracy (AUC 0.798). Similar results were obtained for other stenosis parameters. CONCLUSIONS QFR might be a valuable tool to assess LMS disease. Further studies focusing on patient outcomes are needed to further validate the effectiveness of this approach.
Journal article
  • A. Milzi
  • R. Dettori
  • R. Lubberich
  • S. Reith
  • M. Frick
  • Kathrin Burgmaier
  • N. Marx
  • Mathias Burgmaier

Coronary microvascular dysfunction is a hallmark of all subtypes of MINOCA.

In: Clinical Research in Cardiology: Official Journal of the German Cardiac Society

  • 02.09.2023 (2023)

DOI: 10.1007/s00392-023-02294-1

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INTRODUCTION Myocardial infarction without obstructive coronary artery disease (MINOCA) is a heterogeneous clinical condition presenting with myocardial necrosis not due to an obstruction of a major coronary artery. Recently, a relevant role of coronary microvascular dysfunction (CMD) in the pathogenesis of MINOCA has been suggested; however, data on this are scarce. Particularly, it is unclear if CMD is equally present in all subtypes of MINOCA or differentially identifies one or more of these conditions. Therefore, the aim of this study was to assess CMD in all three coronary vessels of MINOCA patients, relating it with the clinical subtype. METHODS We retrospectively assessed coronary microvascular function in all three coronary territories by means of angiography-based index of microvascular resistance (aIMR) in 92 patients (64 with working diagnosis of MINOCA, 28 control patients). To further assess the association of CMD with MINOCA subtypes, MINOCA patients were subdivided according to clinical data in coronary cause (n = 13), takotsubo (n = 13), infiltrative or inflammatory cardiomyopathy (n = 9) or unclear (n = 29). RESULTS Patients with working diagnosis of MINOCA showed a significantly elevated average aIMR compared to control patients (30.5 ± 7.6 vs. 22.1 ± 5.9, p < 0.001) as a marker of a relevant CMD; these data were consistent in all vessels. Among MINOCA subtypes, no significant difference in average aIMR could be detected between patients with coronary cause (33.2 ± 6.6), takotsubo cardiomyopathy (29.2 ± 6.9), infiltrative or inflammatory cardiomyopathy (28.1 ± 6.8) or unclear cause (30.6 ± 8.5; p = 0.412). Interestingly, aIMR was significantly elevated in the coronary vessel supplying the diseased myocardium compared with other vessels (31.9 ± 11.4 vs. 27.8 ± 8.2, p = 0.049). CONCLUSION Coronary microvascular dysfunction is a hallmark of all MINOCA subtypes. This study adds to the pathophysiological understanding of MINOCA and sheds light into the role of CMD in MINOCA.
Journal article
  • A. Milzi
  • R. Dettori
  • R. Lubberich
  • S. Reith
  • Kathrin Burgmaier
  • N. Marx
  • Mathias Burgmaier

Quantitative Flow Ratio Is Feasible and Accurate Even at Lower Frame Acquisition Rate.

In: Circulation: Cardiovascular interventions vol. 16 pg. e013266

  • 17.10.2023 (2023)

DOI: 10.1161/CIRCINTERVENTIONS.123.013266

Lecture
  • Mathias Burgmaier

Diabetes mellitus und Herz. Burgmaier M. . . 11.03.2023..

In: Bayerwald Kardio Update

Regen

  • 11.03.2023 (2023)
Journal article
  • A. Milzi
  • A. Landi
  • R. Dettori
  • Kathrin Burgmaier
  • S. Reith
  • Mathias Burgmaier

Multimodal Intravascular Imaging of the Vulnerable Coronary Plaque.

In: Echocardiography vol. 41

  • (2024)

DOI: 10.1111/echo.70035

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Vulnerable coronary plaques are atherosclerotic lesions which, due to their specific phenotype, are prone to plaque rupture and to cause acute coronary syndromes, with subsequent relevant morbidity and mortality. Strategies to break the chain link between plaque vulnerability and adverse clinical events include optimized pharmacologic prevention and potentially also preemptive percutaneous coronary interventions (previously defined as "plaque sealing" or "plaque passivation"). Various morphologic features of the vulnerable plaques have been described, including aspects regarding the large necrotic lipid content, the thin fibrous cap, the presence and extent of the presence of calcifications with small size and calcification angle, and as well as the large macrophage infiltration within the plaque. The detection of these features of plaque vulnerability is possible with intravascular imaging modalities such as intravascular ultrasound (IVUS), near-infrared spectroscopy (NIRS), and optical coherence tomography (OCT). This review explores the peculiarities of these three imaging modalities for the detection of vulnerable coronary plaque features.
Contribution
  • Lydia Bauernfeind
  • Fritz Sterr
  • Christian Rester
  • Mathias Burgmaier

Editorial - Intensivpflege im Wandel.

In: Tagungsband zum 1. Bayerischen Intensivpflegetag am 05. März 2024. pg. 4-6

  • Eds.:
  • Mathias Burgmaier
  • Fritz Sterr
  • Lydia Bauernfeind
  • Christian Rester

  • (2024)

DOI: 10.25929/eqa5-hh46

Contribution
  • Fritz Sterr
  • Christian Rester
  • Mathias Burgmaier

Pflegegeleitete Beatmungsentwöhnung.

In: Tagungsband zum 1. Bayerischen Intensivpflegetag am 05. März 2024. pg. 11-12

  • Eds.:
  • Mathias Burgmaier
  • Fritz Sterr
  • Lydia Bauernfeind
  • Christian Rester

  • (2024)

DOI: 10.25929/eqa5-hh46

ConferenceProceedings

Tagungsband zum 1. Bayerischen Intensivpflegetag am 05. März 2024.

  • Eds.:
  • Mathias Burgmaier
  • Fritz Sterr
  • Lydia Bauernfeind
  • Christian Rester

Deggendorf

  • (2024)

DOI: 10.25929/eqa5-hh46

Contribution
  • Lydia Bauernfeind
  • Fritz Sterr

Die wichtigsten Studien aus der Intensivpflege 2023.

In: Tagungsband zum 1. Bayerischen Intensivpflegetag am 05. März 2024. pg. 20-21

  • Eds.:
  • Mathias Burgmaier
  • Fritz Sterr
  • Lydia Bauernfeind
  • Christian Rester

  • (2024)

DOI: 10.25929/eqa5-hh46

Journal article
  • A. Milzi
  • T. Thomsen
  • A. Landi
  • R. Dettori
  • N. Marx
  • F. Kahles
  • J. Escaned
  • H. Mejía-Rentería
  • Mathias Burgmaier
  • M. Valgimigli

Diagnostic accuracy of quantitative flow ratio in patients with arrhythmias.

In: EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology vol. 20 pg. 1039-1041

  • (2024)

DOI: 10.4244/EIJ-D-24-00144

Journal article
  • Kathrin Burgmaier
  • M. Zeiher
  • A. Weber
  • Z. Cosgun
  • A. Aydin
  • B. Kuehne
  • Mathias Burgmaier
  • M. Hellmich
  • K. Mehler
  • A. Kribs
  • S. Habbig

Low incidence of acute kidney injury in VLBW infants with restrictive use of mechanical ventilation.

In: Pediatric Nephrology vol. 39 pg. 1279-1288

  • 13.11.2023 (2024)

DOI: 10.1007/s00467-023-06182-8

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BACKGROUND We assessed the incidence of and risk factors for acute kidney injury (AKI) in very low birthweight infants (VLBW) in a center with a specific neonatal management protocol focusing on avoidance of early mechanical ventilation (MV). METHODS This retrospective single center analysis includes 128 infants born in 2020 with a gestational age ≥ 22 weeks who were screened for AKI using the nKDIGO criteria. RESULTS AKI was identified in 25/128 patients (19.5%) with eight of them (6.3%) presenting with severe AKI. Low gestational age, birthweight and 10-minute Apgar score as well as high CRIB-1 score were all associated with incidence of AKI. Forty-five percent of the infants with MV developed AKI vs. 8.9% of those without MV (p < 0.001). Early onset of MV and administration of more than 3 dosages of NSAIDs for patent duct were identified as independent risk factors for AKI in a logistic regression analysis. CONCLUSIONS We report a substantially lower frequency of AKI in VLBW infants as compared to previous studies, along with a very low rate of MV. A neonatal protocol focusing on avoidance of MV within the first days of life may be a key factor to decrease the risk of AKI in immature infants. A higher resolution version of the Graphical abstract is available as Supplementary information.
Journal article
  • R. Dettori
  • A. Milzi
  • R. Lubberich
  • Kathrin Burgmaier
  • S. Reith
  • N. Marx
  • M. Frick
  • Mathias Burgmaier

Chronic kidney disease is related to impaired left ventricular strain as assessed by cardiac magnetic resonance imaging in patients with ischemic cardiomyopathy.

In: Clinical Research in Cardiology: Official Journal of the German Cardiac Society vol. 113 pg. 1544-1554

  • 11.12.2023 (2024)

DOI: 10.1007/s00392-023-02346-6

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INTRODUCTION Chronic kidney disease (CKD) is an important cardiovascular risk factor. However, the relationship between CKD and myocardial strain as a parameter of myocardial function is still incompletely understood, particularly in patients with ischemic cardiomyopathy (ICM). Cardiac magnetic resonance imaging (CMR) feature tracking allows to analyze myocardial strain with high reproducibility. Therefore, the aim of the present study was to assess the relationship between CKD and myocardial strain as described by CMR in patients with ICM. METHODS We retrospectively performed CMR-based myocardial strain analysis in 89 patients with ICM and different stages of CKD, classified according to the KDIGO stages. In all patients, global longitudinal strain (GLS), global circumferential strain (GCS) and global radial strain (GRS) analysis of left ventricular myocardium were performed. Furthermore, segmental longitudinal (SLS), circumferential (SCS) and radial strain (SRS) according to the AHA 16/17-segment model was determined. RESULTS Creatinine levels (GLS: r = 0.46, p < 0.001; GCS: r = 0.34, p = 0.001; GRS: r = - 0.4, p < 0.001), urea levels (GLS: r = 0.34, p = 0.001; GCS: r = 0.30, p = 0.005; GRS: r = - 0.31, p = 0.003) as well as estimated glomerular filtration rate (GLS: r = -0.40, p < 0.001; GCS: r = - 0.27, p = 0.012; GRS r = 0.34, p < 0.001) were significantly associated with global strains as determined by CMR. To further investigate the relationship between CKD and myocardial dysfunction, segmental strain analysis was performed: SLS was progressively impaired with increasing severity of CKD (KDIGO-1: - 11.93 ± 0.34; KDIGO-5: - 7.99 ± 0.38; p < 0.001 for KDIGO-5 vs. KDIGO-1; similar data for SCS and SRS). Interestingly, myocardial strain was impaired with CKD in both segments with and without scarring. Furthermore, in a multivariable analysis, eGFR was independently associated with GLS following adjustment for LV-EF, scar burden, diabetes, hypertension, age, gender, LV mass or LV mass index. CONCLUSION CKD is related to impaired LV strain as assessed by CMR in patients with ICM. In our cohort, this relationship is independent of LV-EF, the extent of myocardial scarring, diabetes, hypertension, age, gender, LV mass or LV mass index.
Lecture
  • Mathias Burgmaier

Update Diabetes und Herz.

In: Bayerwald Kardio Update

Regen

  • 02.03.2024 (2024)
Lecture
  • Mathias Burgmaier

Herzinfarkt und die Verkalkung der Herzkranzgefäße – was können wir im Jahr 2025 dagegen tun?.

In: Herzgesundheitstag THD Deggendorf

Deggendorf

  • 25.01.2025 (2025)
Lecture
  • Mathias Burgmaier

Neue Behandlungsmethoden des Diabetes. Ist Metformin out?.

In: Bayerwald Kardio Update

Regen

  • 08.02.2025 (2025)