European Heart Journal: Acute Cardiovascular Care最新文献

{"title":"Life is worth more than survival: beyond surviving after out of hospital cardiac arrest.","authors":"Emilie P Belley-Côté, Jessica D Spence","doi":"10.1093/ehjacc/zuaf108","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf108","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844982","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":"Catheter Ablation for Refractory Ventricular Tachycardia Early After Acute Myocardial Infarction: Management, electrophysiological characteristics and outcomes.","authors":"Mengmeng Li, Yang Yang, Yujing Cheng, Chenxi Jiang, Wei Wang, Ribo Tang, Caihua Sang, Xin Zhao, Changyi Li, Songnan Li, Xueyuan Guo, Changqi Jia, Man Ning, Li Feng, Dan Wen, Hui Zhu, Yuexin Jiang, Tong Liu, Fang Liu, Deyong Long, Jianzeng Dong, Changsheng Ma","doi":"10.1093/ehjacc/zuaf102","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf102","url":null,"abstract":"<p><strong>Background and aims: </strong>Refractory ventricular tachycardia (VT) is a rare but lethal condition in the early phase of acute myocardial infarction (AMI). Its intracardiac mechanism and role of catheter ablation is under-determined. The current study is to evaluate the feasibility and safety of catheter ablation for refractory ventricular tachycardia in early AMI.</p><p><strong>Methods: </strong>Between 2022 to 2024, 12,835 consecutive patients with AMI were screened and VT/ventricular fibrillation (VF) was developed in 261(2.0%) patients, among them 51 (19.5%) were identified as refractory VT storm necessitating intensive intervention and finally 19 patients received bailout ablation for incessant VT. Their clinical, electrophysiological characteristics and outcomes were collected and analyzed.</p><p><strong>Results: </strong>For these 19 patients underwent rescue ablation, VT was developed at a median of 4 days after the onset of AMI and became incessant two days after the first VT occurrence, despite revascularization, antiarrhythmic agents, sedation and hemodynamic support. Through intracardiac mapping, VT were all identified as scar-related reentry within the territory of the culprit artery. The endocardial mappable cycle length was 65.3±7.6% to total cycle length. Energy delivery at the either component of critical isthmus from endocardium successfully eliminated VT and no foci trigger was observed after VT termination. Subsequent substrate modification was performed around the termination site. After the index procedure, recurrent sustained VT was documented in 2 and one patient received repeated ablation. After a total of 20 procedures, VTs were all well subsided after the index procedure in all except for one patient who died of cerebral hemorrhage. The remaining patients were discharged alive. After a median of 18-month follow-up, one patient developed recurrent VF, and no sudden cardiac death occurred.</p><p><strong>Conclusions: </strong>Scar-related reentry is responsible for refractory VT early after AMI and ablation at critical isthmus is effective in VT suppression. Its indication and optimal timing of catheter ablation should be evaluated in prospective analysis.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844981","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 Association of Early or Late Combined Infection with Clinical Outcomes in Cardiogenic Shock Patients.","authors":"Ji Hyun Cha, Ryoung-Eun Ko, Ki Hong Choi, Chi Ryang Chung, Kyungmin Huh, Jeong Hoon Yang","doi":"10.1093/ehjacc/zuaf104","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf104","url":null,"abstract":"<p><strong>Background: </strong>Infections are common predisposing factors for mixed cardiogenic shock (CS) due to their contribution to systemic vasodilation. However, data on the prognosis of mixed CS complicated by infection remain limited. This study compared the clinical picture and outcomes of isolated CS and mixed CS, stratified by the timing of infection.</p><p><strong>Methods: </strong>We analyzed 878 adult CS patients admitted to a cardiac intensive care unit (CICU) between 2012 and 2020. Patients were classified as isolated CS (non-infected), early mixed CS (infection identified within 48 hours of CICU admission), and late mixed CS (infection identified after 48 hours of CICU admission). The primary outcome was in-hospital mortality.</p><p><strong>Results: </strong>Of 878 patients, 591 (67.3%) had isolated CS, while 287 (32.7%) had mixed CS (early: 18.1%; late: 14.6%). Mixed CS patients experienced prolonged mechanical ventilation (isolated: 2.2 vs. early: 4.7 vs. late: 9.5 days; p < 0.001), and indwelling catheterization (2.0 vs. 7.0 vs. 25.2 days; p < 0.001). In late mixed CS patients, an increasing trend of nosocomial infection was observed with increasing of total catheterization day and CICU length of stay. In-hospital mortalities in both mixed CS groups were higher than in isolated CS (both p < 0.001), with no significant difference between early and late mixed CS. Survival rates were also a similar pattern during the follow-up.</p><p><strong>Conclusions: </strong>Mixed CS complicated by infection showed worse clinical outcomes than isolated CS, irrespective of the infection timing. Further research is needed to develop targeted treatment strategies tailored to this condition.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834536","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":"Answer: Have the remnographic eye: a rare cause of pericardial effusion after myocardial infarction.","authors":"Alexandra Braillon, Thibault Leclercq, Alain Lalande, Kevin Guillen, Charles Guenancia","doi":"10.1093/ehjacc/zuae130","DOIUrl":"10.1093/ehjacc/zuae130","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"499-501"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763471","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":"Role of sub-clinical inflammation and defective cholesterol efflux in myocardial infarction patients without standard modifiable risk factors.","authors":"Vincent Roule, Farzin Beygui, Maryse Guerin, Clément Materne, Niki Procopi, Ghilas Rahoual, Paul Guedeney, Michel Zeitouni, Mathieu Kerneis, Gilles Montalescot, Johanne Silvain","doi":"10.1093/ehjacc/zuaf070","DOIUrl":"10.1093/ehjacc/zuaf070","url":null,"abstract":"<p><strong>Aims: </strong>Sub-clinical inflammation and defective HDL function have emerged as potential risk factors for a first cardiovascular event. We evaluated their role in the pathogenesis of ST-segment elevation myocardial infarction (STEMI) patients with no standard modifiable cardiovascular risk factors (SMuRF).</p><p><strong>Methods and results: </strong>Using our STEMI biobank registry, we compared baseline characteristics and markers of sub-clinical inflammation [interleukin (IL)-1β, high-sensitivity C-reactive protein (hs-CRP), and defective HDL function using serum cholesterol efflux capacity] in patients with and without SMuRF. Determinants of 1-year all-cause mortality were assessed using multivariable Cox regression analyses. Among the 1604 patients included, 178 (11.1%) were SMuRF-less. Compared with patients with SMuRF, SMuRF-less patients had lower serum cholesterol efflux capacity (0.79 ± 0.16 vs. 0.83 ± 0.16, respectively, P < 0.001) and were more often in the highest tertile of IL-1β (28.7 vs. 18.9%, respectively, P = 0.002) with a trend towards more patients within the highest hs-CRP level tertile (24.7 vs. 19.1%, respectively, P = 0.077). Crude rates of mortality were higher in the SMuRF-less group (18.5 vs. 7.7%, P < 0.001). After multivariable adjustment with traditional prognostic risk factors, high tertiles of hs-CRP [hazard ratio, HR 1.83 (1.28-2.63), P = 0.001] or IL-1β [HR 1.54 (1.06-2.24), P = 0.024] and SMuRF-less status [HR 1.56 (1.05-2.38) P = 0.029] were associated with mortality, while higher serum cholesterol efflux capacity was protective [HR 0.27 (0.09-0.87), P = 0.028].</p><p><strong>Conclusion: </strong>Sub-clinical inflammation and defective cholesterol efflux were associated with SMuRF-less status of STEMI patients and had prognostic impact. This highlights the need to explore new therapeutic strategies in this high-risk population.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"466-473"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959429","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":"Machine learning to optimize use of natriuretic peptides in the diagnosis of acute heart failure.","authors":"Dimitrios Doudesis, Kuan Ken Lee, Mohamed Anwar, Adam J Singer, Judd E Hollander, Camille Chenevier-Gobeaux, Yann-Erick Claessens, Desiree Wussler, Dominic Weil, Nikola Kozhuharov, Ivo Strebel, Zaid Sabti, Christopher deFilippi, Stephen Seliger, Evandro Tinoco Mesquita, Jan C Wiemer, Martin Möckel, Joel Coste, Patrick Jourdain, Komukai Kimiaki, Michihiro Yoshimura, Irwani Ibrahim, Shirley Beng Suat Ooi, Win Sen Kuan, Alfons Gegenhuber, Thomas Mueller, Olivier Hanon, Jean-Sébastien Vidal, Peter Cameron, Louisa Lam, Ben Freedman, Tommy Chung, Sean P Collins, Christopher J Lindsell, David E Newby, Alan G Japp, Anoop S V Shah, Humberto Villacorta, A Mark Richards, John J V McMurray, Christian Mueller, James L Januzzi, Nicholas L Mills","doi":"10.1093/ehjacc/zuaf051","DOIUrl":"10.1093/ehjacc/zuaf051","url":null,"abstract":"<p><strong>Aims: </strong>B-type natriuretic peptide (BNP) and mid-regional pro-atrial natriuretic peptide (MR-proANP) testing are guideline-recommended to aid in the diagnosis of acute heart failure. Nevertheless, the diagnostic performance of these biomarkers is uncertain.</p><p><strong>Methods and results: </strong>We performed a systematic review and individual patient-level data meta-analysis to evaluate the diagnostic performance of BNP and MR-proANP. We subsequently developed and externally validated a decision-support tool called CoDE-HF that combines natriuretic peptide concentrations with clinical variables using machine learning to report the probability of acute heart failure. Fourteen studies from 12 countries provided individual patient-level data in 8493 patients for BNP and 3899 patients for MR-proANP, in whom, 48.3% (4105/8493) and 41.3% (1611/3899) had an adjudicated diagnosis of acute heart failure, respectively. The negative predictive value (NPV) of guideline-recommended thresholds for BNP (100 pg/mL) and MR-proANP (120 pmol/L) was 93.6% (95% confidence interval 88.4-96.6%) and 95.6% (92.2-97.6%), respectively, whilst the positive predictive value (PPV) was 68.8% (62.9-74.2%) and 64.8% (56.3-72.5%). Significant heterogeneity in the performance of these thresholds was observed across important subgroups. CoDE-HF was well calibrated with excellent discrimination in those without prior acute heart failure for both BNP and MR-proANP [area under the curve of 0.914 (0.906-0.921) and 0.929 (0.919-0.939), and Brier scores of 0.110 and 0.094, respectively]. CoDE-HF with BNP and MR-proANP identified 30% and 48% as low-probability [NPV of 98.5% (97.1-99.3%) and 98.5% (97.7-99.0%)], and 30% and 28% as high-probability [PPV of 78.6% (70.4-85.0%) and 75.1% (70.9-78.9%)], respectively, and performed consistently across subgroups.</p><p><strong>Conclusion: </strong>The diagnostic performance of guideline-recommended BNP and MR-proANP thresholds for acute heart failure varied significantly across patient subgroups. A decision-support tool that combines natriuretic peptides and clinical variables was more accurate and supports more individualized diagnosis.</p><p><strong>Study registration: </strong>PROSPERO number, CRD42019159407.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"474-488"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Targeted proteomic profiling of cardiogenic shock in the cardiac intensive care unit.","authors":"","doi":"10.1093/ehjacc/zuaf033","DOIUrl":"10.1093/ehjacc/zuaf033","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"507"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical ventilation in acute pulmonary embolism: a randomized, experimental, crossover study.","authors":"Cecilie Dahl Baltsen, Mark Stoltenberg Ellegaard, Casper Nørholt, Simone Juel Dragsbaek, Christopher Kabrhel, Asger Andersen, Asger Granfeldt, Mads Dam Lyhne","doi":"10.1093/ehjacc/zuaf036","DOIUrl":"10.1093/ehjacc/zuaf036","url":null,"abstract":"<p><strong>Aims: </strong>Acute intermediate-high-risk pulmonary embolism (PE) causes a pathological increase in pulmonary artery pressure and right ventricle afterload that may progress to right ventricle failure and cardiopulmonary collapse. Patients may require mechanical ventilation, further increasing pulmonary vascular resistance (PVR) and artery pressure. We aimed to investigate the ability of ventilator settings adjustments to reduce pulmonary artery pressure in a porcine model.</p><p><strong>Methods and results: </strong>Eleven Danish female pigs (Landrace/Yorkshire/Duroc) of ≈60 kg were used to perform a randomized, blinded, cross-over, experimental study. Following induction of acute PE, the animals were subject to four randomized interventions with wash-out periods in between: (1) changes in positive end-expiratory pressure (PEEP) (from 5 to 0, 10 and 15 cmH2O), (2) 50 and 100% increase in minute ventilation (hypocapnia), (3) increase in fraction of inspired oxygen (FiO2, from 21 to 40%), and (4) infusion of sodium bicarbonate to induce alkalosis. The main outcome was mean pulmonary artery pressure (mPAP). mPAP was reduced by a reduction in PEEP (28 ± 6 vs. 26 ± 5 mmHg, P = 0.011), hypocapnia (27 ± 6 vs. 23 ± 5 mmHg, P = 0.0004), alkalosis (27 ± 4 vs. 25 ± 5 mmHg, P = 0.003), and increased fraction of inspired oxygen (28 ± 6 vs. 23 ± 5 mmHg, P < 0.0001). Changes in PVR showed similar patterns (P < 0.05 for all).</p><p><strong>Conclusion: </strong>In a porcine model of acute PE reduction of PEEP, permissive hypocapnia through hyperventilation, alkalosis, and increased fraction of inspired oxygen can reduce mPAP.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"455-462"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566335","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 ACVC certification programme: gaining competencies in Acute CardioVascular Care.","authors":"Alessandro Galluzzo, Janine Pöss","doi":"10.1093/ehjacc/zuaf090","DOIUrl":"10.1093/ehjacc/zuaf090","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"502-503"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526937","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":"Fifty shades of paediatric heart failure with systolic dysfunction.","authors":"Thomas Salaets, Alexander Van De Bruaene, Bjorn Cools","doi":"10.1093/ehjacc/zuaf083","DOIUrl":"10.1093/ehjacc/zuaf083","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"453-454"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247061","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}