AG Schnabel

Prof. Dr. Renate Schnabel
Clinic/Institute: Department of Cardiology
Phone: +49 (0) 40 7410 - 53979

Research Focus and Main research questions

Cardiovascular research, epidemiology, biostatistics and data management.
Cardiovascular diseases are the leading cause of death and morbidity worldwide and our research aims to understand the underlining pathophysiology and susceptibility to common cardiovascular diseases in the population. The aim of our research group is to detect the predisposition to cardiovascular disease as well as the detection of early, reversible stages of the disease in order to enable prevention and early intervention. We determine blood and tissue biomarkers and genetics including OMICs analyses of noninvasively assessed cardiovascular function in prospective cohort studies in both, initially healthy individuals and patients with manifest cardiovascular disease.

Integrating data from newly discovered and classical risk factors and association with incident disease will improve current risk algorithms to allow preventive, personalized cardiovascular medicine and identify intervention options. International collaborations in ERACoSysMed-funded consortia, AF-SCREEN International Collaboration , the Framingham Heart Study, MORGAM cohorts, and the BiomarCaRE project, among others, support this effort. Our research projects are integrated in the German Centre for Cardiovascular Research ( Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.: DZHK ) with its mission to rapidly and efficiently transfer results from research into clinical practice (translation). In our Horizon 2020 AFFECT-EU Project including 25 partners we address atrial fibrillation.

Risk prediction of atrial fibrillation
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia with significant comorbidity and mortality. Prevalence is increasing worldwide, with corresponding implications in the clinic and for the health care system. Preventive measures are needed, but relatively little is known about risk factors, except for a handful of established risk factors that we summarized in a risk score. However, these risk factors explain only 60% of the attributable risk in the population. New approaches to improve risk prediction are urgently needed.

AF is diagnosed by electrocardiogram (ECG). In an epidemiological study, we are investigating electrocardiographic changes that may lead to AF. In addition, innovative methods for biomarker determination, genetic and gene expression analyses are performed in cross-sectional studies and also prospectively to identify new risk factors. Prof Schnabel coordinates the international AFFECT-EU consortium that involves 26 partners word wide. Its major goal is to develop an accurate, risk-based and ready for implementation AF screening algorithm using digital devices, for early detection and reduction of AF-related health inequities, morbidity and mortality in Europe. Close cooperation between epidemiologists, electrophysiologists, and cardiac surgeons is essential for this purpose.

Our data will provide new insights into epidemiology and prevention, as well as expand the pathophysiological understanding of the disease and potentially reveal therapeutic pathways.

  • Methods
  • Methods


    • Epidemiologic cohort studies
    • Biobanking
    • Non-invasive vascular function measurements of flow-mediated dilation (FMD) and peripheral arterial tonometry (PAT)
    • Cognitive function testing
    • Sleep apnea monitoring
    • Digital surface electrocardiography, digital rhythm monitoring
    • Advanced statistical analysis methods
    • Blood and tissue OMICs
    • Machine learning algorithms

  • Publications:

    1. Al-Khatib SM, Benjamin EJ, Albert CM, et al. Advancing Research on the Complex Interrelations Between Atrial Fibrillation and Heart Failure. Circulation 2020;141:1915-1926.

    2. Assum I, Krause J, Scheinhardt MO, Müller C, Hammer E, Börschel CS, Völker U, Conradi L, Geelhoed B, Zeller T, Schnabel RB, Heinig M. Tissue-specific multiOMICs analysis of atrial fibrillation. bioRxiv 20202020.2004.2006.021527.

    3. Benjamin EJ, Go AS, Desvigne-Nickens P, et al. Research Priorities in Atrial Fibrillation Screening. Circulation 2021;143:372-388.

    4. Boriani G, Palmisano P, Malavasi VL, Fantecchi E, Vitolo M, Bonini N, Imberti JF, Valenti AC, Schnabel RB, Freedman B. Clinical Factors Associated with Atrial Fibrillation Detection on Single-Time Point Screening Using a Hand-Held Single-Lead ECG Device. Journal of Clinical Medicine 2021;10:729.

    5. Boriani G, Schnabel RB, Healey JS, Lopes RD, Verbiest-van Gurp N, Lobban T, Camm JA, Freedman B. Consumer-led screening for atrial fibrillation using consumer-facing wearables, devices and apps: A survey of health care professionals by AF-SCREEN international collaboration. European Journal of Internal Medicine 2020/12/01/ 2020;82:97-104.

    6. Börschel CS, Ohlrogge AH, Geelhoed B, et al. Risk prediction of atrial fibrillation in the community combining biomarkers and genetics. EP Europace 2021.

    7. Camen S, Ojeda FM, Niiranen T, et al. Temporal relations between atrial fibrillation and ischaemic stroke and their prognostic impact on mortality. EP Europace 2019;22:522-529.

    8. Camen S, Palosaari T, Reinikainen J, et al. Cardiac Troponin I and Incident Stroke in European Cohorts. Stroke 2020;51:2770-2777.

    9. Csengeri D, Sprünker N-A, Di Castelnuovo A, et al. Alcohol consumption, cardiac biomarkers, and risk of atrial fibrillation and adverse outcomes. European Heart Journal 2021;42:1170-1177.

    10. Engler D, Heidbuchel H, Schnabel RB, Investigators ftA-E. Digital, risk-based screening for atrial fibrillation in the European community—the AFFECT-EU project funded by the European Union. European Heart Journal 2021.

    11. Fabritz L, Crijns HJ, Guasch E, Goette A, Häusler KG, Kotecha D, Lewalter T, Meyer C, Potpara TS, Rienstra M. Dynamic risk assessment to improve quality of care in patients with atrial fibrillation: the 7th AFNET/EHRA Consensus Conference. EP Europace 2021.

    12. Freedman B, Kamel H, Van Gelder IC, Schnabel RB. Atrial fibrillation: villain or bystander in vascular brain injury. European Heart Journal Supplements 2020;22:M51-M59.

    13. Geelhoed B, Börschel CS, Niiranen T, et al. Assessment of causality of natriuretic peptides and atrial fibrillation and heart failure: a Mendelian randomization study in the FINRISK cohort. EP Europace 2020;22:1463-1469.

    14. Kornej J, Börschel CS, Benjamin EJ, Schnabel RB. Epidemiology of Atrial Fibrillation in the 21st Century. Circulation Research 2020;127:4-20.

    15. Malavasi VL, Zoccali C, Brandi MC, Micali G, Vitolo M, Imberti JF, Mussi C, Schnabel RB, Freedman B, Boriani G. Cognitive impairment in patients with atrial fibrillation: Implications for outcome in a cohort study. International Journal of Cardiology 2021/01/15/ 2021;323:83-89.

    16. Renda G, Pecen L, Patti G, et al. Antithrombotic management and outcomes of patients with atrial fibrillation treated with NOACs early at the time of market introduction: Main results from the PREFER in AF Prolongation Registry. Internal and Emergency Medicine 2021/04/01 2021;16:591-599.

    17. Rösler A, Schnabel R. Vorhofflimmern und kognitive Störung – Bedeutung für die Geriatrie. Zeitschrift für Gerontologie und Geriatrie 2020/07/05 2020.

    18. Schnabel RB, Benjamin EJ. Diversity 4.0 in the cardiovascular health-care workforce. Nature Reviews Cardiology 2020/12/01 2020;17:751-753.

    19. Schnabel RB, Hasenfuß G, Buchmann S, Kahl KG, Aeschbacher S, Osswald S, Angermann CE. Heart and brain interactions. Herz 2021/03/01 2021;46:138-149.

    20. Schnabel RB, Thomalla G, Kirchhof P. Integrated care in stroke survivors: When and how much? EClinicalMedicine 2020/08/01/ 2020;25:100489.

    21. Schrage B, Geelhoed B, Niiranen TJ, et al. Comparison of Cardiovascular Risk Factors in European Population Cohorts for Predicting Atrial Fibrillation and Heart Failure, Their Subsequent Onset, and Death. Journal of the American Heart Association 2020;9:e015218.

  • Recent Funding:

    Shared expertise Metabolome in Cardiovascular
    Disease Deutsches Zentrum für Herz-Kreislaufforschung (DZHK e.V.)

    EU AFFECT-EU Project, Screening Strategy for Atrial fibrillation (grant agreement no. 847770) Horizon 2020

    PARIS EraCoSysMed, artificial intelligence for stroke prediction in atrial fibrillation using imaging and omics
    Horizon 2020/BMBF

    Shared Expertise Mikrobiome in atrial fibrillation
    Deutsches Zentrum für Herz-Kreislaufforschung (DZHK e.V.)

    Artificial intelligence methods for myocardial infarction prediction from the resting
    ECG Deutsche Herzstiftung, Seefried Projektförderung

    e:Med Summer School COME, Systems Medicine Cardiovascular Disease (Prof. T. Zeller) Bundesministerium für Bildung und Forschung (BMBF)

    BigData@Heart Innovative Medicines Initiative (IMI) Multimodal Approach to Atrial Fibrillation Prediction, ERC consolidator grant
    Horizon 2020

    Shared Expertise Tissue Proteomics
    Deutsches Zentrum für Herz-Kreislaufforschung (DZHK e.V.)

    EU BiomarCaRE Projekt (grant agreement no. HEALTH-F2-2011-278913)
    Framework Programme 7

    e:Med SymAtrial, Junior Research Consortium
    Bundesministerium für Bildung und Forschung (BMBF)

    Biomarkers and Genetics of Noninvasive Vascular Function, Emmy Noether Junior Research Group
    Deutsche Forschungsgemeinschaft (DFG)