Clinical Research in Cardiology最新文献

{"title":"A minimalistic approach for transfemoral transcatheter aortic valve implantation therapy: a prospective \"real-world\" study.","authors":"Marco Barbanti, Giuliano Costa, Valentina Frittitta, Elena Dipietro, Alessandro Comis, Mariachiara Calì, Sofia Sammartino, Wanda Deste, Luigi La Rosa, Valeria Garretto, Cristina Inserra, Maria Teresa Cannizzaro, Carmelo Sgroi, Pierfrancesco Veroux, Davide Capodanno, Corrado Tamburino","doi":"10.1007/s00392-025-02654-z","DOIUrl":"https://doi.org/10.1007/s00392-025-02654-z","url":null,"abstract":"<p><strong>Background: </strong>Optimized pathways for transcatheter aortic valve implantation (TAVI) have been reported over the past decade, but they considered specific devices and selected populations.</p><p><strong>Objectives: </strong>The aim of this study was to assess the safety and efficacy of a comprehensive, minimalistic approach to TAVI utilizing all available devices in all-comers, real-world population.</p><p><strong>Methods: </strong>This is a prospective, single-center, single-arm clinical study. The primary endpoint of the study was a composite of 30-day all-cause mortality, disabling stroke, major bleedings, major vascular complications, stage 3 acute kidney injury (AKI), and permanent pacemaker implantation (PPI). Outcomes were compared to those of an historical cohort of patients undergoing TAVI following a standard approach, by selecting pairs of patients selected through a 1:1 propensity score matching (PSM). A cost analysis of TAVI hospitalization was performed considering costs related to procedural complications and post-procedural length of stay (LoS).</p><p><strong>Results: </strong>Between January 2020 and December 2023, a total of 997 patients underwent TAVI following an optimized, minimalistic pathway. Device success was reported in 88.2% patients, with low procedural complications. The primary endpoint occurred in 21.1% of patients. After PSM, TAVI patients following the minimalistic pathway had higher device success (91.4% vs 84.2%, p = 0.004), and lower major vascular complications (4.5% vs. 10.3%, p = 0.004) compared to those following the standard approach. Median LoS was shorter (1.0 day vs. 2.0 days, p < 0.001) and the rate of next-day discharge was higher (46.7% vs. 19.0%, p < 0.001) in patients following the minimalistic pathway, with lower hospitalization costs (median € 2200 vs. 3150; p < 0.001). At 30-day, the primary endpoint was significantly lower in patients following the minimalistic pathway (17.2% vs 23.9%, p = 0.034).</p><p><strong>Conclusions: </strong>The minimalistic TAVI care pathway was associated with favorable outcomes in an unselected, real-world population. The shorter post-procedural LoS of the minimalistic approach led to a significant cost-saving.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcome after multiple VT ablations in NICM patients.","authors":"Julian Mueller, Ivaylo Chakarov, Philipp Halbfass, Karin Nentwich, Artur Berkovitz, Lena Koch, Martin Eichenlaub, Heiko Lehrmann, Thomas Deneke","doi":"10.1007/s00392-025-02649-w","DOIUrl":"https://doi.org/10.1007/s00392-025-02649-w","url":null,"abstract":"<p><strong>Background: </strong>Data about ventricular tachycardia (VT) ablation in patients with non-ischemic cardiomyopathies (NICM) is limited. This study sought to compare the acute and long-term outcomes of VT ablation in different NICMs.</p><p><strong>Methods: </strong>In this large single-center study consecutive patients presenting with NICM and sustained VTs undergoing VT ablation were included from May 2016 to February 2022. The patients were divided according to underlying NICM and investigated regarding endpoints of VT recurrences and cardiovascular mortality.</p><p><strong>Results: </strong>A total of 206 patients undergoing a total of 323 VT ablations were included (59 ± 16 years; 81% male; LVEF 36 ± 14%; DCM 57%, myocarditis 26%, sarcoidosis 8%, ARVC 9%). The acute procedural success was highest among ARVC (90%) and lowest among DCM patients (74%). 17% showed in-hospital recurrences (4% clinical VTs) with no difference among different NICMs. DCM patients were discharged with highest rates of antiarrhythmic drugs (41%), whereas ARVC patients with lowest (11%). Long-term VT recurrences during mean follow-up of 38 ± 22 months were highest among DCM patients with 61% followed by myocarditis with 56%, ARVC with 41% and sarcoidosis with 35% (log-rank p = 0.148). The recurrences of clinical VT were present in only 5% of all patients. 52 patients with recurrences (51%) underwent a second procedure with recurrences rates of any VT in 50% (highest among DCM patients; log-rank p = 0.259). 20 patients underwent a 3rd VT ablation, 15 a 4th, 6 a 5th and 1 patient a 6th procedure. Freedom from any VT after multiple procedures were different among etiologies (57% DCM vs. 74% myocarditis vs. 71% sarcoidosis vs. 82% ARVC; log-rank p = 0.067). Cardiovascular mortality was 19% with highest rates among DCM patients (log-rank p = 0.001).</p><p><strong>Conclusions: </strong>VT ablation among patients with NICM is highly effective with sufficient rhythm control in 2/3 of all patients, but non-clinical VT recurrences are common, especially in DCM patients. Those patients reveal highest cardiovascular mortality.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The implementation of a streamlined TAVI patient pathway across five European countries: BENCHMARK registry.","authors":"Francesco Saia, Sandra Lauck, Eric Durand, Douglas F Muir, Mark Spence, Mariuca Vasa-Nicotera, David Wood, Cristóbal A Urbano-Carrillo, Damien Bouchayer, Vlad Anton Iliescu, Christophe Saint Etienne, Florence Leclercq, Vincent Auffret, Lluis Asmarats, Carlo Di Mario, Aurelie Veugeois, Jiri Maly, Andreas Schober, Luis Nombela-Franco, Nikos Werner, Joan Antoni Gómez-Hospital, Julia Mascherbauer, Giuseppe Musumeci, Nicolas Meneveau, Thibaud Meurice, Felix Mahfoud, Federico De Marco, Tim Seidler, Florian Leuschner, Patrick Joly, Jean Philippe Collet, Ferdinand Vogt, Emilio Di Lorenzo, Elmar Kuhn, Vicente Peral Disdier, Gemma McCalmont, Radka Rakova, Wilbert Wesselink, Jana Kurucova, Violetta Hachaturyan, Claudia M Lüske, Peter Bramlage, Derk Frank","doi":"10.1007/s00392-025-02638-z","DOIUrl":"https://doi.org/10.1007/s00392-025-02638-z","url":null,"abstract":"<p><strong>Background: </strong>Benchmark best practices have been shown to streamline the clinical pathway for patients undergoing transcatheter aortic valve implantation (TAVI), but the impact in diverse health systems is unknown.</p><p><strong>Aims: </strong>We evaluated the impact of Benchmark best practices implementation in Germany, Austria, France, Spain, and Italy.</p><p><strong>Methods: </strong>International, multicentre registry of severe symptomatic aortic stenosis (AS) patients undergoing TAVI with a balloon-expandable valve, before and after Benchmark best practices implementation. Objectives were to reduce overall and intensive care unit (ICU) length of stay (LoS), and to document 30-day safety.</p><p><strong>Results: </strong>A total of 890 patients were analysed in France, 454 in Spain, 362 in Germany, 300 in Italy, and 176 in Austria. Patients had the highest surgical risk in Germany (EuroSCORE II 6.8 ± 7.3%) and lowest in Spain (3.8 ± 2.6%). Austrian patients reported higher rates of prior myocardial infarction, severe pulmonary hypertension, and aortic valve-related symptoms at baseline. After the implementation of Benchmark best practices, the median hospital LoS was significantly reduced in France (5 vs. 3 days, p < 0.001), Spain (6 vs. 4, p < 0.001), Germany (9 vs. 6, p < 0.001), and Italy (7 vs. 5, p < 0.001); reductions in median ICU LoS were reported in France (1.1 vs. 0 days, p < 0.001), Spain (1.9 vs. 1, p < 0.001), and Germany (1 vs. 0.9, p = 0.004). Across all countries, 30-day safety outcomes were uncompromised and reduced rates of major vascular complications rates were observed in Germany (5.9 vs. 0.0%, p < 0.001).</p><p><strong>Conclusion: </strong>The implementation of Benchmark best practices in diverse European healthcare systems resulted in reduced hospital and ICU LoS without compromising patient safety.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04579445, September 28th, 2020.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical insights on association of aortic root diameter and vascular function with an exaggerated blood pressure response to exercise among elite athletes.","authors":"Muhammad Ibrahim, Fathimathul Henna, Brijesh Sathian, Javed Iqbal","doi":"10.1007/s00392-025-02652-1","DOIUrl":"https://doi.org/10.1007/s00392-025-02652-1","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart failure burden and care among cardiology inpatients: insights from the Hellenic Cardiorenal Morbidity Snapshot (HECMOS) study.","authors":"Ioannis Leontsinis, Sotiria Liori, Dimitrios Farmakis, Aggeliki Valatsou, Panagiotis Vlachakis, Christina Antonia Verikokou, Ioanna Delia Vlad, Vasileios Giannaris, Georgios Giannopoulos, Kyriakos Dimitriadis, Panagiotis Theofilis, Georgios Karakostas, Christoforos Komporozos, Georgios Konstantinides, Stylianos Lambropoulos, Aikaterini Lionti, Athanasios Makris, Panteleimon Makridis, Ioannis Mamarelis, Maria Marketou, Aikaterini Naka, Georgios Nikitas, Periklis Davlouros, Evaggelos Oikonomou, Nikolaos Papaioannou, Athanasios Pipilis, Assaf Sawafta, Pavlos Skantzikas, Michael Siarkos, Theodoros Sinanis, Konstantinos Skordis, Georgios Spiromitros, Ioannis Stamoulopoulos, Konstantinos Tsatiris, Dimitrios Tsiachris, Michael Fosteris, Emmanouel Foukarakis, Chistina Chrysochoou, Gerasimos Filippatos, Konstantinos Tsioufis","doi":"10.1007/s00392-025-02610-x","DOIUrl":"https://doi.org/10.1007/s00392-025-02610-x","url":null,"abstract":"<p><strong>Purpose: </strong>Heart failure (HF) burden and care varies significantly across different countries. We aimed to illustrate the clinical characteristics and HF-related care among cardiology inpatients in Greece.</p><p><strong>Methods: </strong>We collected information about all cardiology inpatients on the 3rd of March 2022. The current analysis focuses on acute or chronic HF.</p><p><strong>Results: </strong>Among a total of 923 participants, 280 (30%) concerned cases of acute HF whereas 351 patients (38%), (median age 79 ± 12 years, male gender 63.8%) had a history of chronic HF, with their majority presenting with multiple comorbidities and previous HF hospitalizations. 173 (49%) of chronic HF participants had reduced LVEF. Ischemic heart disease was the predominant HF etiology (182, 51.9%). Prior to the index admission, chronic HF cases were receiving diuretics, beta blockers, ACEi/ARBs, ARNI, MRAs, and SGLT2i at 79.8%, 74.4%, 43.3%, 10.8%, 40.7%, and 14%, respectively. Independent predictors of lower prescription rates of Guideline Directed Medical Therapy (GDMT) included advanced age (p < 0.001), chronic kidney disease (RASi OR 0.392, p = 0.008, MRA OR 0.523 p = 0.097), and lack of follow-up in dedicated HF clinics (p = 0.006). No regional differences with regards to GDMT were identified.</p><p><strong>Conclusion: </strong>In this nation-wide real-world snapshot study, patients with chronic and acute HF accounted for a significant proportion of cardiology inpatients, while ischemic heart disease was the leading HF cause. GDMT and device therapy can be improved. Follow-up in dedicated HF units was related with increased prescription rates of GDMT, whereas this was not affected by geographical region.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical use and predictors of outcome in venoarterial extracorporeal membrane (VA ECMO): insights from VERGE (VA ECMO Registry of Germany).","authors":"Tobias Wengenmayer, Dawid L Staudacher, Alois Philipp, Eike Tigges, Angela Dettling, Hendrik Busse, Marc Kriege, Jan-Sören Padberg, Ingo Voigt, Clemens Scherer, Tobias Graf, Dominik Scharpf, Peter Noack, Simone Britsch, Guido Michels","doi":"10.1007/s00392-025-02650-3","DOIUrl":"https://doi.org/10.1007/s00392-025-02650-3","url":null,"abstract":"<p><p>The VA ECMO Registry of Germany (VERGE, http://va-ecmo-register.de/ ) is a prospective, multicenter, investigator-driven registry of Venoarterial Extracorporeal Membrane Oxygenation (VA ECMO) all-comers, free from industrial support. VERGE is Germany's first multicenter registry to systematically gather and analyze data from various centers on the clinical use of VA ECMO. This first report compromises data from 581 VA ECMO patients from 2022. Median age was 60 years, hospital survival was 42% and 25% were female. The leading indication for VA ECMO was extracorporeal cardiopulmonary resuscitation (ECPR) followed by VA ECMO in shock (48.9 and 34.9%, respectively). Hospital survival of ECPR was significantly worse compared to shock (28 and 55%, respectively, p < 0.001). Age, pH, and lactate before cannulation all significantly correlated independently with hospital survival (p < 0.001). In VERGE, no patients with pH below 6.7 or lactate above 25 mmol/l survived.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Future directions and challenges in sports cardiology: interplay between blood pressure response and aortic remodeling in athletes.","authors":"Pascal Bauer, Astrid Most","doi":"10.1007/s00392-025-02653-0","DOIUrl":"https://doi.org/10.1007/s00392-025-02653-0","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal atlas on comorbidities in cardiomyopathy: a Mendelian randomization study of European ancestry.","authors":"Mengting Sun, Ming Gao, Peng Huang, Manjun Luo, Tingting Wang, Xiaorui Ruan, Kebin Chen, Jiapeng Tang, Ye Chen, Jiabi Qin","doi":"10.1007/s00392-025-02647-y","DOIUrl":"https://doi.org/10.1007/s00392-025-02647-y","url":null,"abstract":"<p><strong>Background: </strong>Cardiomyopathy (CM) is often accompanied by comorbidities that increase the risk of death. Our aim is to explore the causal association between CM and its subtypes and various related comorbidities.</p><p><strong>Methods: </strong>Bidirectional Mendelian randomization (MR) was used to explore the causal association between 39 comorbidities and CM, 13 comorbidities and hypertrophic cardiomyopathy (HCM), 25 comorbidities and dilated cardiomyopathy (DCM), and 13 comorbidities and restrictive cardiomyopathy (RCM). Besides, we explored the causal associations between systolic, diastolic, and pulse pressure with CM and DCM, respectively. MR Mediation analysis was used to explore whether atrial fibrillation (AF) or hypertension was as mediating variable mediating the causal association between each other and CM.</p><p><strong>Results: </strong>By MR analysis, we found that AF (OR = 1.28) and hypertension (OR = 3.58) were associated with an increased risk of CM, and CM was causally associated with an increased risk of heart failure (OR = 1.40). In addition, hypertension was causally associated with a lower risk of DCM (OR = 0.22). The results of the causal association of systolic, diastolic, and pulse pressure with CM and DCM were consistent with the direction of the causal association of hypertension with CM and DCM. Through MR Mediation analysis, we found AF as a mediating factor mediates the causal association between hypertension and CM, with a mediating proportion of about 16.22%.</p><p><strong>Conclusions: </strong>This study is the first to reveal the causal association between certain comorbidities and CM and DCM, and to find possible mediating effects among them.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-pass perfusion imaging using cardiovascular magnetic resonance in patients with various cardiac implantable electronic devices.","authors":"Claudia Meier, Michael Bietenbeck, Maria Theofanidou, Volker Vehof, Philipp Stalling, Dennis Korthals, Bishwas Chamling, Misael Estepa, Patrick Doeblin, Sebastian Kelle, Ali Yilmaz","doi":"10.1007/s00392-025-02636-1","DOIUrl":"https://doi.org/10.1007/s00392-025-02636-1","url":null,"abstract":"<p><strong>Aims: </strong>The number of patients with cardiac implantable electronic devices (CIEDs) is increasing. However, there is limited experience regarding vasodilator-stress cardiovascular magnetic resonance (CMR) and resulting device artifacts on perfusion images. The aim of this study was to determine CMR image quality in patients with different CIED types for CMR-based perfusion stress testing.</p><p><strong>Methods and results: </strong>A total of 156 patients with active CIEDs underwent CMR on a 1.5-Tesla scanner. Both conventional steady-state-free-precession (SSFP) and modified spoiled gradient-echo (sGE) protocols under stress and resting conditions were used to evaluate image artifacts in a 16-segment segment model of the heart. The study group comprised 39% conventional pacemaker (PM), 4% cardiac resynchronization therapy-pacemaker (CRT-P), 38% conventional implantable cardioverter-defibrillator (ICD), 6% cardiac resynchronization therapy-ICD (CRT-D), and 13% subcutaneous ICD (S-ICD) patients. PM-carriers showed only minor image artifacts in both perfusion protocols. Artifacts caused by ICDs were predominantly located in the left-ventricular (LV) inferolateral and anterior segments. S-ICDs showed the highest extent of artifacts with an anterolateral accentuation. The artifact extent was significantly reduced when sGE-based perfusion was used compared to SSFP-based sequences. 69% of the patients received a stress-perfusion protocol, and elective coronary angiography confirmed the presence of coronary stenosis in three cases. No major safety-relevant issues occurred.</p><p><strong>Conclusion: </strong>Myocardial perfusion imaging by CMR is safe and feasible with moderate-to-high image quality in patients with all types of CIEDs, including non-conditional devices, ICDs, and S-ICDs. A sGE-based perfusion protocol should be preferred in patients with left-sided ICDs, CRT-Ds, or S-ICDs.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"T_peak-T_end interval predicts arrhythmia recurrence in idiopathic ventricular fibrillation and early repolarization syndrome.","authors":"Benjamin Rath, Julian Wolfes, Christian Ellermann, Fatih Güner, Felix Wegner, Julia Köbe, Florian Reinke, Philipp Sebastian Lange, Gerrit Frommeyer, Lars Eckardt","doi":"10.1007/s00392-025-02648-x","DOIUrl":"https://doi.org/10.1007/s00392-025-02648-x","url":null,"abstract":"<p><strong>Background: </strong>In about 8% of survivors of sudden cardiac death, no structural or electrical heart disease can be identified. Some of these patients with idiopathic ventricular fibrillation (IVF) present ECG markers of early repolarization (Early Repolarization Syndrome, ERS). The T_peak-T_end interval has been linked to increased arrhythmic risk in different clinical settings, such as Brugada syndrome or hypertrophic cardiomyopathy. As there is limited data about the relationship of T_peak-T_end and arrhythmogenesis in IVF, respectively, its significance in risk stratification in ERS, the aim of this study was to investigate a possible correlation between sustained ventricular arrhythmia (VA) recurrences in these patients and the T_peak-T_end interval.</p><p><strong>Methods and results: </strong>We retrospectively investigated 56 consecutive IVF patients (64.3% male, mean age 37.8 ± 12.9 years) who received an implantable cardioverter-defibrillator for secondary prevention. Markers of early repolarization were present in 32.1% of cases. During a mean follow-up of 41.2 ± 35.8 months, 11 patients (19.6%) received in total 18 adequate ICD-therapies. Patients with VA recurrence showed longer T_peak-T_end compared to arrhythmia-free patients (105 ± 14 ms vs. 91 ± 14 ms, p = 0.03). The combination of prolonged T_peak-T_end (> 90 ms) and an early repolarization pattern was associated with a 12-fold increased risk of recurrent VA (p = 0.002).</p><p><strong>Conclusion: </strong>Prolonged T_peak-T_end was associated with VA recurrence in patients with survived IVF. This correlation was even more pronounced in IVF patients with early repolarization pattern. The T_peak-T_end interval might play a future role in risk stratification of patients with ERS.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}