Clinical Research in Cardiology最新文献

{"title":"Tribute to Professor Michael Böhm-architect of Clinical Research in Cardiology.","authors":"Norbert Frey","doi":"10.1007/s00392-025-02720-6","DOIUrl":"10.1007/s00392-025-02720-6","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1095"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728450","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":"LipidSnapshot - Treatment gaps in hypercholesterolemia in patients with atherosclerotic cardiovascular disease documented by office-based cardiologists and general practitioners in Germany.","authors":"Oliver Weingärtner, Simon Glück, Karl Werdan, Jessica Schorr, Daniel Thieme, Ana de la Llave, Christian von Vultée, Winfried Haerer","doi":"10.1007/s00392-025-02751-z","DOIUrl":"https://doi.org/10.1007/s00392-025-02751-z","url":null,"abstract":"<p><strong>Aims: </strong>Office-based cardiologists (OBCs) and general practitioners (GPs) follow different approaches for hypercholesterolemia management in atherosclerotic cardiovascular disease (ASCVD). This study evaluates whether differences in clinical practice between OBCs and GPs contribute to existing gaps in low-density lipoprotein cholesterol (LDL-C) control and lipoprotein(a) [Lp(a)] screening in ASCVD care.</p><p><strong>Methods: </strong>LipidSnapshot is a collaborative research initiative comprising a prospective non-interventional study at OBCs and a retrospective analysis of GP records. It evaluates LDL-C target attainment, Lp(a) testing, and lipid-lowering therapies (LLT) in the OBC and the GP setting. Subgroup analyses by gender and age are conducted.</p><p><strong>Results: </strong>The dataset comprises 1,500 ASCVD patients from OBCs and 82,375 patients from GPs. The median LDL-C levels were 68 mg/dL (OBC) vs. 88 mg/dL (GP). LDL-C targets < 55 mg/dL were achieved in 27.4% of patients (OBC) vs. 12.1% of patients (GP). Lp(a) testing rate was 20.3% (OBC) vs. 3.0% (GP). The proportion of patients not receiving any LLT was 1.5% (OBC) vs. 26.6% (GP). LDL-C levels were numerically higher in female patients as well as in younger patients especially in the GP setting. Female patients were less likely to receive LLT compared to their male counterparts and half of the GP patients < 50 years of age remained untreated at all.</p><p><strong>Conclusion: </strong>A large proportion of ASCVD patients in Germany are inadequately treated, with notable differences between GPs and OBCs. Additionally, gender and age-related disparities are evident. There is a clear need for these gaps to be addressed to improve cross-sectional patient care.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945430","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":"Prognostic impact of rheumatic diseases in patients with heart failure with mildly reduced ejection fraction.","authors":"Michelle Goertz, Tobias Schupp, Jonas Dudda, Kathrin Weidner, Felix Lau, Alexander Schmitt, Noah Abel, Mohammad Abumayyaleh, Henning Johann Steffen, Harald F Langer, Daniel Duerschmied, Ibrahim Akin, Michael Behnes","doi":"10.1007/s00392-025-02740-2","DOIUrl":"https://doi.org/10.1007/s00392-025-02740-2","url":null,"abstract":"<p><strong>Background: </strong>Emerging evidence suggests that inflammatory conditions and comorbidities have a prognostic impact on patients with heart failure with mildly reduced ejection fraction (HFmrEF) in particular. This study aims to investigate the influence of rheumatic comorbidities on clinical outcomes in HFmrEF patients.</p><p><strong>Methods: </strong>This retrospective cohort study included patients hospitalized with HFmrEF at a tertiary care center in Germany between January 2016 and December 2022. Patients hospitalized with HFmrEF were divided in two groups - with and without rheumatic diseases - and were compared with regard to the primary endpoint all-cause mortality at 30 months, as well as the key secondary endpoint HF-related rehospitalization.</p><p><strong>Results: </strong>From a total of 2,184 patients with HFmrEF, 47 (2.2%) were diagnosed with a rheumatic disease. There was no significant difference in distribution of age (median 75 years vs. 76 years, p = 0.532), sex (males: 55.3% vs. 64.8%; p = 0.181) and cardiovascular comorbidities between patients with and without rheumatic diseases. The presence of rheumatic disease was not associated with the risk of all-cause mortality at 30 months (HR = 0.765; 95% CI 0.432-1.354; p = 0.358). However, patients with rheumatic diseases were associated with a higher risk of rehospitalization for HF at 30 months (HR = 2.088; 95% CI 1.171-3.723; p = 0.013). This association was still observed after multivariable adjustment (HR = 2.360; p = 0.006).</p><p><strong>Conclusion: </strong>Patients with HFmrEF and coexisting rheumatic diseases did not exhibit increased 30-month all-cause mortality. However, the risk of rehospitalization was significantly higher in patients with rheumatic diseases.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945385","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":"Less intensive lipid-lowering therapy after ST-elevation myocardial infarction is associated with cardiovascular events: 2-year follow-up of \"Jena auf Ziel\".","authors":"Franz Haertel, Umidakhon Makhmudova, Jens-Arndt Geiling, Bernward Lauer, Sven Möbius-Winkler, Sylvia Otto, P Christian Schulze, Oliver Weingärtner","doi":"10.1007/s00392-025-02736-y","DOIUrl":"https://doi.org/10.1007/s00392-025-02736-y","url":null,"abstract":"<p><strong>Background: </strong>\"Jena auf Ziel\" (\"JaZ\") is a prospective cohort study in patients with ST-elevation myocardial infarction (STEMI). Early combination of a statin and ezetimibe was initiated on the day of admission and lipid-lowering therapy (LLT) was escalated during follow-up with bempedoic acid (BA) and PCSK9 inhibitors (PCSK9-I) to reach guideline-recommended LDL-cholesterol (LDL-C) levels. During the initial follow-up period of 12 months, all patients reached the recommended ESC/EAS LDL-C target for very high-risk patients of < 55 mg/dL.</p><p><strong>Methods: </strong>Twelve months after the index event, patients enrolled in \"JaZ\" had the option of either continuing with regular follow-ups in the outpatient lipid clinic of the university hospital Jena or transitioning to standard care by their general practitioners (GPs). Fifty-three patients (62%) stayed with the outpatient lipid clinic and 32 (38%) preferred treatment by their local GP. After 24 months, we analyzed differences in prescribed lipid-lowering drugs, LDL-C target attainment, LDL-C time on target, and major adverse cardiac events (MACEs = nonfatal ischemic cardiovascular events, admission for heart failure, nonfatal stroke) between groups.</p><p><strong>Results: </strong>All 85 patients enrolled in the initial study were followed up for 24 months. The average LDL-C after 24 months was 1.47 ± 0.71 mmol/L in the total study population. Fifty-one patients (60%) of the entire cohort were still on LDL-C target of 1.4 mmol/L or below (outpatient lipid clinic group: 72.5% vs. GP group: 27.5%; p = 0.037). The average LDL-C in patients followed up in the outpatient lipid clinic was significantly lower compared to patients who were treated by GPs (1.2 ± 0.7 mmol/L vs. 2.1 ± 1.04 mmol/L; p < 0.01). Moreover, patients in the outpatient lipid clinic had a longer time on LDL-C targets compared to patients treated by GPs (82.4 ± 29.5% vs. 62.4 ± 36.6%; p < 0.01). The main cause of missed LDL-C targets was deprescribing of LLT by local GPs, surpassing non-adherence (2.1 ± 1.04 mmol/L vs. LDL-C: 1.52 ± 0.53 mmol/L; p < 0.01). Patients with MACE during follow-up were characterized by a shorter time on LDL-C targets compared to patients without MACE (58.1 ± 29.9% vs. 79.1 ± 28.1%; p = 0.048) and higher LDL-C levels at 24 months (2.04 ± 1.26 mmol/L vs. 1.27 ± 0.72 mmol/L; p < 0.01).</p><p><strong>Conclusion: </strong>In this cohort of STEMI patients, a less intensive lipid-lowering strategy during a 2-year follow-up was associated with higher LDL-C levels and a higher incidence of MACE. Therefore, a regular follow-up in a specialized lipid outpatient clinic was superior to standard care treatment by general practitioners.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945437","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":"GLP-1 receptor agonists in atherosclerotic cardiovascular disease and diabetes mellitus or obesity: investigation of the potential role in a German inpatient dataset.","authors":"Vera Oettinger, Constantin von Zur Mühlen, Klaus Kaier, Dennis Wolf, Jonathan Rilinger, Alexander Maier, Markus Jäckel, Dirk Westermann, Ingo Hilgendorf, Dalibor Bockelmann","doi":"10.1007/s00392-025-02735-z","DOIUrl":"https://doi.org/10.1007/s00392-025-02735-z","url":null,"abstract":"<p><strong>Background: </strong>GLP-1 receptor agonists (GLP-1 RA) reduce major adverse cardiovascular events in patients with diabetes mellitus and atherosclerotic cardiovascular disease (ASCVD) or increased cardiovascular risk. Recently, the GLP-1 RA semaglutide was reported to reduce cardiovascular events in ASCVD patients with overweight or obesity even in the absence of diabetes mellitus. Accordingly, this was included in the current European Society of Cardiology guidelines for secondary prevention. We aimed to assess the number of inpatients with ASCVD who could qualify for therapy with GLP-1 RA.</p><p><strong>Methods: </strong>Using nationwide data from the Research Data Centre of the Federal Statistical Office of Germany, a random 10% sample of all adult inpatients in 2022 was analyzed. The proportions of ASCVD, obesity, and diabetes mellitus were examined.</p><p><strong>Results: </strong>The 10% sample included 1,446,420 patients with a mean age of 63.16 years, 52.50% were female. ASCVD was present in 229,619 inpatients (15.87%), including those with coronary artery disease, history of myocardial infarction, peripheral vascular disease or stroke. Among ASCVD patients, 79,516 individuals (34.63% of ASCVD patients) also suffered from type 2 diabetes mellitus and 15,624 individuals were diagnosed with obesity. Approximately half of those (N = 7,256) had ASCVD and obesity without diabetes mellitus (3.16% of ASCVD patients). Overall, 37.79% of ASCVD patients also suffered from type 2 diabetes mellitus or obesity.</p><p><strong>Conclusion: </strong>In this data sampling of German inpatients, more than one-third of ASCVD patients may qualify for GLP-1 RA therapy due to concomitant diabetes mellitus or obesity. That corresponds to about 6% of inpatients in Germany.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945458","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":"Impact of oral nicorandil administration prior to primary percutaneous coronary intervention on no-reflow: a randomized controlled trial.","authors":"Tarek Abdel-Hameed Nagib Ahmed, Shimaa Sayed Khidr, Ahmed Abdelnaser Abdelrady, Salwa Roshdy Demitry, Heba Mahmoud El-Naggar","doi":"10.1007/s00392-025-02734-0","DOIUrl":"https://doi.org/10.1007/s00392-025-02734-0","url":null,"abstract":"<p><strong>Background: </strong>Prior studies and meta-analyses showed cardioprotective benefits of intravenous or intracoronary nicorandil administration in ST-segment elevation myocardial infarction (STEMI). However, little is known about the efficacy of oral nicorandil in this context, especially that parenteral forms are not widely available.</p><p><strong>Aim: </strong>To investigate the impact of oral nicorandil administered before primary percutaneous coronary intervention (PPCI) on no-reflow and to assess the in-hospital and 3-month major adverse cardiac events (MACE).</p><p><strong>Methods: </strong>A total of 302 patients with STEMI undergoing PPCI were randomly assigned in a 1:1 fashion to the Nicorandil-group, who received pre-PPCI oral nicorandil 20 mg followed by maintenance 20 mg b.i.d. for 3 months, and the Control-group. The primary endpoint was no-reflow defined as TIMI flow ≤ 2. Secondary endpoints included myocardial blush grade (MBG), ST-segment resolution, electrocardiographic repolarization dispersion, and in-hospital and 3-month MACE. Baseline and follow-up echocardiography were performed. A 3-month cardiac magnetic resonance (CMR) was performed in a subset of 50 patients.</p><p><strong>Results: </strong>Nicorandil-group showed significantly lower rates of no-reflow (11.9% vs 24.5%, p = 0.005), better MBG, higher rates of complete ST-resolution, and better indices of repolarization dispersion compared to the Control-group. Pre-PPCI nicorandil was among the independent protectors against no-reflow (OR = 0.43, 95%CI = 0.23-0.81, p = 0.01). The Nicorandil-group demonstrated significantly better LV function and lower MACE at follow-up. Three-month CMR data showed microvascular obstruction in two patients among the Control-group and none among the Nicorandil-group (p = 0.14).</p><p><strong>Conclusion: </strong>Oral nicorandil was associated with post-PPCI lower rates of no-reflow and improved myocardial reperfusion. Moreover, it showed improved LVEF and reduced MACE at 3 months.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945389","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":"A novel measure of AV-conduction predicts clinical outcomes and benefit from CRT-D in non-LBBB patients with wide QRS and a low left ventricular ejection fraction.","authors":"Anika Sophie Beierle, Wojciech Zareba, Richard E Auge, Spencer Z Rosero, Scott McNitt, Fabian Knebel, Martin A Stockburger, Valentina Kutyifa","doi":"10.1007/s00392-025-02731-3","DOIUrl":"https://doi.org/10.1007/s00392-025-02731-3","url":null,"abstract":"<p><strong>Background: </strong>PR-interval reflects atrioventricular timing but does not well characterize adverse hemodynamics. Novel ECG parameters of conduction may identify benefit from non-dyssynchronous ventricular pacing to correct long atrioventricular conduction delays.</p><p><strong>Objective: </strong>Evaluating novel ECG parameters to identify risk of heart failure (HF)/death and benefit vs harm by CRT-D in MADIT-CRT non-LBBB patients.</p><p><strong>Methods: </strong>We analyzed intervals from ECGs in 535 non-LBBB patients enrolled in MADIT-CRT, using ImageJ. Onset of atrial activation, P wave zero crossing in V1, latest P offset, earliest QRS onset, and time to the first R peak in V1 and V6 were determined. Endpoints included HF or death. Associations between novel conduction measures and clinical outcomes in ICD patients (n = 209), and CRT-D (n = 326) vs. ICD benefit, were assessed using Kaplan-Meier and multivariable Cox regression analyses.</p><p><strong>Results: </strong>We identified the delay from P zero crossing to the first R peak in V1 (P0PV1) at quintile 5 as the strongest risk predictor in ICD patients (n = 159, 30%), over PR-interval, for all endpoints (p < 0.001), with a more than threefold risk increase. In this group, CRT-D was associated with a 66% lower risk of HF/Death (95% CI: 0.22-0.68, p = 0.001) vs. an ICD. However, in patients with a P0PV1 < 201 ms, CRT-D vs. an ICD was associated with a 64% increased risk of HF/death (95% CI: 1.12-2.55, p = 0.012), with significant bidirectional interaction (p-value < 0.001).</p><p><strong>Conclusions: </strong>We propose a novel variable, P0PV1, to identify risk and benefit vs. harm from CRT-D in HF patients with non-LBBB. Prospective studies are warranted to confirm our findings.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945442","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":"Efficacy of coronary sinus reducer in patients with refractory angina and chronic total occlusion.","authors":"Maayan Konigstein, Alice Moroni, Stefan Verheye, Lior Zornitzki, Ophir Freund, Shmuel Banai","doi":"10.1007/s00392-025-02723-3","DOIUrl":"10.1007/s00392-025-02723-3","url":null,"abstract":"<p><strong>Background: </strong>Coronary chronic total occlusion (CTO) is a common cause of refractory angina, and impaired quality of life. Coronary sinus reducer (CSR) implantation is a safe and effective therapy for patients with refractory angina.</p><p><strong>Aim: </strong>To evaluate the clinical efficacy of reducer implantation to relieve angina in patients with CTO.</p><p><strong>Methods: </strong>Patients with refractory angina and no option for revascularization who underwent Reducer implantation between 2011 and 2023 were included. Angina symptoms, physical capacity, and quality of life were evaluated at baseline, 6 months, and 1 year following reducer implantation. Clinical outcomes were compared between patients with and without CTO.</p><p><strong>Results: </strong>Overall, 262 patients (70 ± 11 years old, 24% female) underwent reducer implantation, and 131 (50%) had CTO. Among the entire population, 77% of patients had improvement of at least 1 CCS class following reducer implantation, and 42% reported improvement of ≥ 2 grades of CCS at 1 year. Median 6MWT increased from 300 m (IQR 218-382) to 358 m (IQR 275-419) 6 months following reducer implantation, and all 5 domains of the SAQ improved (p < 0.001 for all). The degree of improvement in angina severity as well as in quality of life was similar for patients with and without CTO except for better improvement in 6MWT distance among patients without CTO. Patients with CTO of the right coronary artery showed similar improvement following reducer implantation.</p><p><strong>Conclusions: </strong>Reducer implantation is similarly beneficial for patients with refractory angina due to both CTO and non-CTO lesions. Randomized prospective studies are needed to evaluate the optimal therapeutic approach in these patients.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871768","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":"Beyond APACHE II: the role of TAPSE in predicting mortality among septic patients and septic shock; a systematic review and metanalysis Right heart, right prognosis: TAPSE, a new tool for predicting mortality among septic patients and septic shock; a systematic review and metanalysis.","authors":"Alessandro Perencin, Chiara Curreri, Bruno Micael Zanforlini, Anna Bertocco, Chiara Ceolin, Mario Virgilio Papa, Giuseppe Sergi, Marina De Rui","doi":"10.1007/s00392-025-02732-2","DOIUrl":"10.1007/s00392-025-02732-2","url":null,"abstract":"<p><strong>Background: </strong>Bacterial infections are a serious global health problem, especially for older and critically ill patients, who are at increased risk of complications and mortality. Traditional tools like APACHE II and SOFA scores are widely used to predict outcomes in sepsis, but recent attention has focused on the right heart function-specifically, the tricuspid annular plane systolic excursion (TAPSE)-as a simple, bedside marker with potential prognostic value.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to explore the prognostic value of TAPSE in patients with sepsis or septic shock, focusing on its predictive ability compared to established clinical indices such as APACHE II, SOFA and left ventricular ejection fraction (LVEF).</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed, Embase, Cochrane Library and Web of Science up to April 2025. Studies assessing TAPSE in septic patients were included according to predefined criteria. Data on mortality, TAPSE, APACHE II, SOFA and LVEF were extracted and analyzed. Study quality was assessed using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Ten studies with a total of 1812 patients have been included. The analysis revealed that lower TAPSE values were significantly associated with higher mortality (mean difference -0.50 cm; 95% CI: -0.57 to -0.43; p < 0.00001). Similarly, APACHE II scores were higher in non-survivors (mean difference 4.62; 95% CI: 3.17 to 6.07; p < 0.00001). In contrast, LVEF showed no significant correlation with mortality (mean difference -1.46; p = 0.20). Despite variability among studies, the prognostic value of TAPSE remained consistently evident.</p><p><strong>Conclusions: </strong>TAPSE emerges as a practical, non-invasive tool for assessing right ventricular function and predicting mortality in patients with sepsis. Its simplicity and bedside availability make it a valuable complement to traditional severity scores like APACHE II. Unlike LVEF, which appears less informative in this setting, TAPSE could enhance early risk stratification and guide clinical decision-making, particularly in vulnerable populations such as the elderly and critically ill.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871767","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":"Bedside echocardiography in patients with suspected acute myocardial infarction without ST elevation.","authors":"Paul Michael Haller, Alina Schock, Caroline Kellner, Jonas Lehmacher, Betül Toprak, Tau Sarra Hartikainen, Kira Marie Kiss, Gheas Alhaou, Kristin Peifer, Raphael Twerenbold, Tanja Zeller, Dirk Westermann, Johannes Tobias Neumann, Nils Arne Sörensen","doi":"10.1007/s00392-025-02724-2","DOIUrl":"10.1007/s00392-025-02724-2","url":null,"abstract":"<p><strong>Background: </strong>Guidelines recommend using echocardiography in addition to high-sensitivity cardiac troponin (hs-cTn)-based assessment in patients with suspected acute myocardial infarction (MI), although data on its diagnostic and prognostic value is limited.</p><p><strong>Methods: </strong>Patients presenting with suspected MI without ST elevation to a tertiary center were enrolled. Final diagnoses were adjudicated by two cardiologists. Trained cardiology fellows conducted and interpreted bedside echocardiography in the emergency department as standard of care. Diagnostic performance measures (negative and positive predictive values [NPV, PPV] [95% confidence intervals]) to rule-in or rule-out MI were compared for patients with and without any pathological finding (any wall-motion abnormalities [WMA] or systolic left ventricular dysfunction) in patients assigned to the observe group by a 0/1-hs-cTnI-algorithm. Cox regression analysis was conducted to investigate the association of pathological findings with all-cause death.</p><p><strong>Results: </strong>Overall, 2779 patients with available echocardiography were included (median age 63 years, 366 [13.2%] with MI, 2158 [77.6%] with data on WMA, median follow-up 5.2 years). The PPV to identify MI using bedside echocardiography in the observe group was low (PPV 8.9 [6.3, 12.5]), and the NPV was 95.6 [93.9, 96.9]. After adjustment for relevant covariates, patients with any compared to no pathological finding  were at increased risk for all-cause death during follow-up (HR 1.36 [1.06, 1.74], p = 0.014).</p><p><strong>Conclusions: </strong>In this observational study, it could not be shown that bedside echocardiography in the context of suspected acute MI without ST elevation substantially improves diagnostic accuracy beyond hs-cTn-based diagnostic protocols to identify MI in patients assigned to the observe zone. However, findings on echocardiography helped to identify high-risk patients. More prospective evidence on the use of bedside echocardiography is needed to increase the body of evidence. Trial registration ClinicalTrials.gov Identifier: NCT02355457.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871737","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}