European Heart Journal: Acute Cardiovascular Care最新文献_第5页

Implications of a new clinical classification of acute myocardial infarction. 急性心肌梗死新临床分类的意义。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-04-30 DOI: 10.1093/ehjacc/zuaf065

Alexander J F Thurston, Jasper Boeddinghaus, Andrew R Chapman, Bertil Lindahl, Nicholas L Mills

引用次数: 0

Early Repolarization Pattern in Post-Resuscitation ECG and Outcomes in Cardiac Arrest Survivors: A Propensity Score Matching Analysis. 复苏后心电图早期复极模式和心脏骤停幸存者的预后：倾向评分匹配分析。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-04-29 DOI: 10.1093/ehjacc/zuaf066

Dongju Kim, Dong Hun Lee, Hanna Park, Yong Hun Jung, Byung Kook Lee, Won Young Kim

{"title":"Early Repolarization Pattern in Post-Resuscitation ECG and Outcomes in Cardiac Arrest Survivors: A Propensity Score Matching Analysis.","authors":"Dongju Kim, Dong Hun Lee, Hanna Park, Yong Hun Jung, Byung Kook Lee, Won Young Kim","doi":"10.1093/ehjacc/zuaf066","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf066","url":null,"abstract":"Background: Early repolarization patterns (ERP) are a known risk factor for sudden cardiac death; however, their prognostic significance in cardiac arrest survivors remains unclear. This study aimed to investigate the clinical characteristics and outcomes of ERP in post-cardiac arrest survivors.Methods: This observational cohort study included adult out-of-hospital cardiac arrest survivors (aged ≥18 years) who underwent targeted temperature management at two South Korean tertiary care centers between February 2018 and May 2023. Clinical, ECG, and outcome characteristics were compared between patients with and without ERP. Propensity score matching (PSM) was used to minimize confounding, followed by logistic regression analysis. The primary outcome was survival until the hospital discharge.Results: Among the 693 post-resuscitation patients, 127 (18.3%) had ERP. The ERP cohort was characterized by a younger average age (59.0 years vs. 64.1 years) and had lower peak levels of troponin I (1.7 vs. 4.5) and creatinine (1.2 vs. 1.4). Multivariable logistic regression analysis revealed that the ERP pattern independently predicted decreased mortality at discharge (Odds Ratio: 1.68; 95% Confidence Interval: 1.04-2.72; p=0.034) after adjusting for potential confounders. However, the difference in achieving favorable neurological outcomes was not statistically significant. These results were consistent within the matched cohort. After matching, groups showed no significant differences in post-resuscitation care variables or adverse events, except for maximum vasopressor doses.Conclusions: The presence of ERP in post-resuscitation ECG was associated with a greater likelihood of survival until hospital discharge.","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973759","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}

引用次数: 0

The intersection of obesity and acute heart failure: Cardiac structure and function and congestion across BMI categories. 肥胖和急性心力衰竭的交叉：跨BMI类别的心脏结构和功能和充血。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-04-28 DOI: 10.1093/ehjacc/zuaf067

Sofie Bøgh-Sørensen, Ross T Campbell, Brian L Claggett, Eldrin F Lewis, Kieran F Docherty, Matthew M Y Lee, Moritz Lindner, Tor Biering-Sørensen, Scott D Solomon, Elke Platz

{"title":"The intersection of obesity and acute heart failure: Cardiac structure and function and congestion across BMI categories.","authors":"Sofie Bøgh-Sørensen, Ross T Campbell, Brian L Claggett, Eldrin F Lewis, Kieran F Docherty, Matthew M Y Lee, Moritz Lindner, Tor Biering-Sørensen, Scott D Solomon, Elke Platz","doi":"10.1093/ehjacc/zuaf067","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf067","url":null,"abstract":"Background: Overweight/obesity are important risk factors for heart failure (HF), however, the pathophysiologic consequences of obesity in patients with acute HF (AHF) are incompletely understood.Methods: We examined cardiac structure and function, and congestion-related markers in adults hospitalized for AHF across 3 body mass index (BMI) groups: 18.5-24.9 kg/m2 (normal weight), 25-29.9 kg/m2 (overweight), ≥30 kg/m2 (obese), and based on left ventricular ejection fraction (LVEF) >40% (HF with mildly reduced/preserved EF (HFmrEF/HFpEF)) vs. ≤40% (HF with reduced EF (HFrEF)). Echocardiography, 4-zone lung ultrasound, and patient-reported symptoms were assessed at baseline, and 6-month outcomes (HF hospitalizations and all-cause death) were collected.Results: Among 354 participants (median age 75, 59% men), 36% were normal weight, 29% overweight and 35% obese. Higher BMI was associated with younger age, more comorbidities, a higher proportion of prior HF, and worse patient-reported symptoms. Patients with HFmrEF/HFpEF were older, more likely female, had a higher BMI and higher proportions of hypertension and atrial fibrillation. Both patients with HFmrEF/HFpEF and HFrEF had greater biventricular volumes/area and LV mass, similar degrees of elevated LV filling pressure and lower degrees of pulmonary congestion with higher BMI. The risk of the composite outcome was similar across BMI groups both in the overall cohort and when stratified by LVEF.Conclusions: Among patients with AHF, those with overweight/obesity had greater biventricular volumes/area and LV mass, similar sonographic evidence of hemodynamic congestion and less pulmonary congestion than those with normal weight. The risk of 6-month HF hospitalization or death was similar across BMI groups.","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986914","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}

引用次数: 0

Cracking the clot: the RIVAWAR trial challenges warfarin's reign in left ventricular thrombus post-acute coronary syndrome. 破裂血栓：RIVAWAR试验挑战华法林在急性冠状动脉综合征后左室血栓中的统治地位。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-04-26 DOI: 10.1093/ehjacc/zuaf052

Pascal Vranckx, Sigrun Halvorsen

引用次数: 0

Early left ventricular unloading after venoarterial extracorporeal membrane oxygenation: 1-year outcomes of the EARLY-UNLOAD randomized clinical trial. 静脉体外膜氧合后早期左心室卸载：早期卸载随机临床试验的一年结果。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-04-26 DOI: 10.1093/ehjacc/zuae150

Yongwhan Lim, Min Chul Kim, Seung Hun Lee, Seongho Park, Joon Ho Ahn, Dae Young Hyun, Kyung Hoon Cho, Yong Hun Jung, In-Seok Jeong, Youngkeun Ahn

{"title":"Early left ventricular unloading after venoarterial extracorporeal membrane oxygenation: 1-year outcomes of the EARLY-UNLOAD randomized clinical trial.","authors":"Yongwhan Lim, Min Chul Kim, Seung Hun Lee, Seongho Park, Joon Ho Ahn, Dae Young Hyun, Kyung Hoon Cho, Yong Hun Jung, In-Seok Jeong, Youngkeun Ahn","doi":"10.1093/ehjacc/zuae150","DOIUrl":"10.1093/ehjacc/zuae150","url":null,"abstract":"Aims: The long-term effects of early left ventricular (LV) unloading after venoarterial extracorporeal membrane oxygenation (VA-ECMO) remain unclear.Methods and results: The EARLY-UNLOAD trial was a single-centre, investigator-initiated, open-label, randomized clinical trial involving 116 patients with cardiogenic shock (CS) undergoing VA-ECMO. The patients were randomly assigned to undergo either early routine LV unloading by transseptal left atrial cannulation within 12 h after randomization or the conventional approach, which permitted rescue transseptal cannulation in case of an increased LV afterload. The pre-specified secondary endpoints at 1 year included all-cause mortality, cardiac mortality, non-cardiac mortality, rehospitalization for heart failure (HF), and the composite of all-cause mortality or rehospitalization for HF. At 1 year, data for 114 of 116 patients (98.3%) were available for analysis. All-cause death had occurred in 33 of 58 patients (56.9%) in early group and 32 of 56 patients (57.1%) in conventional group {hazard ratio [HR], 0.97 [95% confidence interval (CI), 0.60 to 1.58], P = 0.887}. There was no significant difference in cardiac or non-cardiac mortality. Among 61 survivors at 30 days, the incidence of rehospitalization for HF at 1 year was comparable between two groups [HR, 1.17 (95% CI 0.43 to 3.24), P = 0.758]. The incidence of the composite outcome of all-cause mortality or rehospitalization for HF also did not differ between the groups [HR, 1.01 (95% CI 0.69 to 1.76), P = 0.692].Conclusion: Among patients with CS undergoing VA-ECMO, early routine LV unloading did not improve clinical outcomes at 1 year of follow-up.Registration: ClinicalTrials.gov: NCT04775472.","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"203-211"},"PeriodicalIF":3.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921284","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}

引用次数: 0

Ten-year prognosis of acute atrial fibrillation in ST-elevation myocardial infarction: recurrence and risk stroke. ST段抬高型心肌梗死急性心房颤动的十年预后：复发和中风风险。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-04-26 DOI: 10.1093/ehjacc/zuae072

María José Martínez Membrive, Isaac Subirana, Edgar Fadeuilhe, Ferran Rueda, José Carreras-Mora, Teresa Oliveras, Teresa Giralt, Carlos Labata, Marc Ferrer, Nabil El Ouaddi, Santiago Montero, Roberto Elosúa, Núria Ribas, Antoni Bayés-Genís, Cosme García-García

{"title":"Ten-year prognosis of acute atrial fibrillation in ST-elevation myocardial infarction: recurrence and risk stroke.","authors":"María José Martínez Membrive, Isaac Subirana, Edgar Fadeuilhe, Ferran Rueda, José Carreras-Mora, Teresa Oliveras, Teresa Giralt, Carlos Labata, Marc Ferrer, Nabil El Ouaddi, Santiago Montero, Roberto Elosúa, Núria Ribas, Antoni Bayés-Genís, Cosme García-García","doi":"10.1093/ehjacc/zuae072","DOIUrl":"10.1093/ehjacc/zuae072","url":null,"abstract":"Aims: Atrial fibrillation (AF) often complicates ST-elevation acute myocardial infarction (STEMI), with associated risks including stroke and mortality. Anticoagulation therapy for these patients and AF prognosis remain controversial. The aim was to evaluate long-term prognosis of STEMI patients complicated with AF in the acute phase.Methods and results: We performed a retrospective analysis on a prospective register involving 4184 patients admitted for STEMI to the intensive cardiac care unit of two tertiary centres from 2007 to 2015. Patients with pre-existing permanent AF were excluded. Out of these, 269 (6.4%) patients developed AF within the first 48 h after STEMI and were matched with a control group based on age and left ventricular ejection fraction. After matching, a total of 470 patients were included (n = 235, AF-STEMI; n = 235, control group). Mean age was 69.0 years, and 31.7% were women. No differences were found in gender, cardiovascular risk factors, or ischaemic heart disease. AF-STEMI patients experienced more sustained ventricular tachycardia, advanced atrioventricular block, heart failure, and cardiogenic shock. In-hospital mortality was also higher in AF-STEMI patients (11.9% vs. 7.2%, P = 0.008). After a 10-year follow-up, the AF-STEMI group had remained with higher mortality (50.5% vs. 36.2%; P = 0.003) and a greater recurrence of AF (44.2% vs. 14.7%; P < 0.001), without differences in stroke incidence (10.1% vs. 9.3%).Conclusion: As a conclusion, patients with AF complicating STEMI have higher rates of heart failure, cardiogenic shock, and in-hospital mortality. After a 10-year follow-up, they exhibit a high risk of AF recurrence and mortality, with no significant differences in stroke incidence.","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"214-222"},"PeriodicalIF":3.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199934","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}

引用次数: 0

Answer: Diagnostic dilemma in a critical extracorporeal membrane oxygenation patient: a case of uncertain aortic pathology. 回答：诊断困境的关键体外膜氧合病人：一个病例不确定的主动脉病理。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-04-26 DOI: 10.1093/ehjacc/zuaf016

Catarina Gregório, José António Duarte, Fausto J Pinto, Doroteia Silva

引用次数: 0

Intra-aortic balloon pump in patients with heart failure-related cardiogenic shock: the Altshock-2 trial in perspective. 主动脉内球囊泵在心力衰竭相关心源性休克患者中的应用：Altshock-2试验

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-04-26 DOI: 10.1093/ehjacc/zuaf056

Uwe Zeymer, David A Morrow

引用次数: 0

Association between air pollutants and out-of-hospital cardiac arrest: a 5-year time series analysis. 空气污染物与院外心脏骤停的关系：5年时间序列分析

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-04-26 DOI: 10.1093/ehjacc/zuaf013

Jingjing Wang, Qiang Zhou, Song Ni, Jie Li, Chongzhen Qin, Wangsheng Deng, Zhe Deng

{"title":"Association between air pollutants and out-of-hospital cardiac arrest: a 5-year time series analysis.","authors":"Jingjing Wang, Qiang Zhou, Song Ni, Jie Li, Chongzhen Qin, Wangsheng Deng, Zhe Deng","doi":"10.1093/ehjacc/zuaf013","DOIUrl":"10.1093/ehjacc/zuaf013","url":null,"abstract":"Aims: We aimed to analyse the yet unclear correlation between air pollutant concentrations and out-of-hospital cardiac arrest (OHCA) in Shenzhen, China.Methods and results: A 5-year time series analysis of all OHCA events reported to the Shenzhen Emergency Center was conducted. Quasi-Poisson regression, controlling for meteorological variables (daily mean relative temperature and humidity) with multivariable fractional polynomial and using Fourier series to adjust for long-term trends and account for periodic patterns, was used to assess the association among particulate matter of 2.5 μm (PM2.5), ozone (O3), particulate matter of ≥10 μm (PM10), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and OHCA. Data from 16 769 patients who experienced OHCA were analysed. An increase of 10 μg/m3 in PM2.5 was associated with a higher risk of OHCA (relative risk (RR): 1.026 [95% confidence interval [CI]: 1.001-1.053]) on lag Day 1. A similar increase in PM10 was linked to an immediate risk of OHCA on the onset day (RR: 1.02 [95% CI: 1.005-1.036]) and a cumulative risk on lag Day 1 (RR: 1.021 [95% CI: 1.003-1.039]). An increased risk of OHCA was associated with NO2 and O3 exposure, while a reduced risk of OHCA was associated with SO2 and CO exposure in the subsequent 5 days. The relationship between PM2.5 and OHCA varied by gender and arrest rhythm. A reduction in the average daily PM2.5 concentration by 1 µg/m³ could decrease the incidence of OHCA attributable to PM2.5 exposure by 4.60%, while a reduction by 3 µg/m³ could decrease it by 18.41% on lag Day 1. PM2.5 was significantly associated with the occurrence of OHCA on lag Day 1. This association was modulated by gender and arrest rhythm.Conclusion: Improving the levels of PM2.5, NO2, and O3 could decrease the risk of OHCA and the demand for emergency medical service related to PM2.5 exposure.","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"223-231"},"PeriodicalIF":3.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022624","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}

引用次数: 0

Prevalence and prognostic impact of ST-segment elevation in lead aVR among patients with cardiac arrest. 心脏骤停患者aVR导联ST段抬高的患病率及对预后的影响。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-04-26 DOI: 10.1093/ehjacc/zuaf018

Soumya Banna, Christopher Schenck, Noah Kim, Tariq Ali, Emily J Gilmore, David M Greer, Rachel Beekman, P Elliott Miller

{"title":"Prevalence and prognostic impact of ST-segment elevation in lead aVR among patients with cardiac arrest.","authors":"Soumya Banna, Christopher Schenck, Noah Kim, Tariq Ali, Emily J Gilmore, David M Greer, Rachel Beekman, P Elliott Miller","doi":"10.1093/ehjacc/zuaf018","DOIUrl":"10.1093/ehjacc/zuaf018","url":null,"abstract":"Aims: In acute coronary syndrome, ST-segment elevation in lead aVR (STE-aVR) indicates global myocardial ischaemia, often related to multivessel or severe left main disease, and correlates with increased mortality. The prevalence and prognostic significance of STE-aVR in cardiac arrest (CA) patients is unknown.Methods and results: We identified patients (≥18 years) with CA between 2011 and 2022 who achieved return of spontaneous circulation (ROSC). The first electrocardiogram post-ROSC was assessed for STE-aVR, defined as ≥1 mm ST-segment elevation at the J point, measured by two trained assessors. Multivariable logistic regression was used to analyse the association between STE-aVR and outcomes (in-hospital mortality and poor neurologic outcome), adjusted for patient and arrest characteristics. Including 443 CA patients, the median (interquartile range) age was 61 years (50-72 years), with 60.5% (n = 268) male, 65.7% (n = 291) presenting with out-of-hospital CA (OHCA), and 29.8% (n = 132) with shockable rhythms. ST-segment elevation in lead aVR was observed in 18.3% (n = 81) of patients. Those with STE-aVR were more likely to present with OHCA and less likely to have a shockable rhythm (both, P < 0.05). ST-segment elevation in lead aVR was associated with higher in-hospital mortality (86.4% vs. 65.8%, P < 0.001) and poor neurologic outcomes (90.1% vs. 72.9%, P = 0.001). After multivariable adjustment, STE-aVR remained associated with higher in-hospital mortality [odds ratio (OR) 2.23; 95% confidence interval (CI): 1.02-4.84, P = 0.04], but not a poor neurologic outcome (OR 2.12; 95% CI: 0.90-4.98, P = 0.09).Conclusion: ST-segment elevation in lead aVR was present in one in five CA survivors and was independently associated with higher in-hospital mortality.","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"232-236"},"PeriodicalIF":3.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052048","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}

引用次数: 0