Universitäts-Herzzentrum Freiburg • Bad Krozingen

Project updates:

 Current enrollment status of the MIRACLE study. 

Cardiogenic shock (CS) is a life-threatening condition characterized by a severe reduction in cardiac output, leading to systemic hypoperfusion, multiorgan failure, and a mortality rate exceeding 30% in hospitalized patients. The primary causes of CS are acute myocardial infarction (AMI) and acutely decompensated heart failure (ADHF), though secondary CS resulting from arrhythmias, valvular dysfunction, right ventricular failure, and septic overlap are increasingly recognized. Beyond the immediate risk of acute mortality, many CS survivors face significant long-term morbidity and an elevated risk of mortality.

To enhance precision phenotyping and risk stratification, we designed the MIRACLE study, a multi-center, prospective, longitudinal cohort study. Our goal is to enable a comprehensive characterization and follow-up of CS patients across all etiologies and severities (SCAI classifications B to E). With a substudy, MIRACLE-SurvivorS, we specifically focus on CS survivors, tracking patient reported outcomes and clinical endpoints longitudinally through the first year.

Biobanking is conducted in collaboration with the Cardiovascular Biobank (CVBB), a hub of the FREEZE-Biobank, during both the acute phase and the long-term follow-up. Thereby, we aim to understand how molecular pathways drive differential recovery from CS.

MIRACLE has received start-up funding from the  Programm Klinische Studien of the Medical Faculty of the University of Freiburg  and is registered at the Deutsches Register Klinischer Studien. 

Project updates:

Recent findings have been published in Circulation and JACC:Advances 

Pregnancy acts as a cardiovascular stress test. Hypertensive disorders of pregnancy (HDPs), including conditions such as preeclampsia, are major causes of maternal morbidity and are strongly linked to an increased risk of future cardiovascular disease. While many studies have demonstrated this association, the underlying causal mechanisms remain unclear, and there is limited understanding of the specific biomarkers and phenotypes during pregnancy that may predict premature cardiovascular disease in women—an area that has not received the attention it deserves until recently.

Through the TWILIGHT project, we aim to leverage pregnancy as an early window to predict short- and long-term cardiovascular health in women. In collaboration with Professor Marianne Andersen, a co-founder of the Danish Odense Child Cohort, and Professor Ralf Dechend, Charité Berlin, we are studying women who were pregnant between 2010 and 2012. By integrating data on their pregnancy outcomes and blood samples drawn during gestation with long-term health data from the The Danish National Patient Register, our goal is to identify biomarkers and mechanisms that may contribute to premature cardiovascular disease in women. We aim to translate these findings into targeted prevention strategies that can be implemented directly postpartum, providing early interventions for women at very high cardiovascular risk.

Project updates:

The PRECARD registry evaluates both clinical outcomes and the long-term cardiovascular impact of pregnancies in women with congenital or acquired heart disease, receiving interdisciplinary care at University Hospital Freiburg. It also explores the perceptions during pregnancy of this patient population, including their experience with care, expectations, and the teamwork among treating physicians, as well as their long-term quality of life. The primary aim is to understand how to improve care and outcomes for this population, with findings guiding future approaches to interdisciplinary patient management.

Project updates: Preliminary findings have been presented at the 9th International Congress on Cardiac Problems in Pregnancy (CPP 2025) and the German Cardiac Society’s annual congress in 2025.

Project updates:

Recent findings have been published in Circulation: Cardiovascular Imaging

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment by enhancing antitumor T-cell activity, leading to significant improvements in outcomes across various cancers. Over the past decade, eligibility for ICI therapy has expanded rapidly. However, concerns about the cardiovascular risks of ICIs have emerged, particularly the potential for accelerated vascular atherosclerosis. ICIs may trigger T-cell autoreactivity against autoantigens, leading to arterial inflammation and an increased risk of long-term cardiovascular events in treated patients.

The ARCTIC project aims to investigate the ability of arterial arterial 2-deoxy-2-[¹⁸F]fluoro-D-glucose ([¹⁸F]FDG) uptake in routine staging positron emission tomography (PET) scans to detect arterial inflammation in cancer patients treated with ICIs. By comparing changes in arterial tracer uptake between ICI-treated patients and non-treated controls across repeated scans, our goal is to assess the impact of ICIs on arterial inflammation and to better understand the mechanisms by which ICIs may increase atherosclerosis.

ARCTIC is a collaborative effort with PD Dr. Dr. Christian Goetz from the Department of Nuclear Medicine and Prof. Dr. Dennis Wolf from the Vascular Immunology Lab.