European Heart Journal: Acute Cardiovascular Care最新文献_第6页

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

Question: Diagnostic dilemma in a critical extracorporeal membrane oxygenation patient: a case of uncertain aortic pathology. 问题：诊断困境在一个关键的体外膜氧合病人：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/zuaf015

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

引用次数: 0

Spring into innovation: connecting minds, transforming care, saving lives. 进入创新：连接思想，改变护理，拯救生命。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-04-26 DOI: 10.1093/ehjacc/zuaf040

Pascal Vranckx, David Morrow, Sean van Diepen, Frederik H Verbrugge

引用次数: 0

Moving forward one loss at a time. 从一次失败中走出来。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-04-26 DOI: 10.1093/ehjacc/zuaf028

Jonas Sundermeyer, Benedikt Schrage

引用次数: 0

Myocardial ischaemic syndromes: time for a new nomenclature? 心肌缺血综合征-新的命名时间？

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-04-26 DOI: 10.1093/ehjacc/zuaf026

Alessandro Galluzzo, Anna Juliane Buch, Janine Pöss

引用次数: 0