European Heart Journal: Acute Cardiovascular Care最新文献

{"title":"Delving in the troponin fragmentation and takotsubo syndrome: pathophysiologic implications.","authors":"John E Madias","doi":"10.1093/ehjacc/zuae138","DOIUrl":"10.1093/ehjacc/zuae138","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"55"},"PeriodicalIF":3.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846256","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":"Looking back, moving forward: a bold start to 2025.","authors":"Pascal Vranckx, David Morrow, Sean van Diepen, Frederik H Verbrugge","doi":"10.1093/ehjacc/zuaf009","DOIUrl":"10.1093/ehjacc/zuaf009","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"1-2"},"PeriodicalIF":3.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002578","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":"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":"https://doi.org/10.1093/ehjacc/zuaf018","url":null,"abstract":"<p><strong>Background: </strong>In acute coronary syndrome, ST-segment elevation in lead aVR (STE-aVR) indicates global myocardial ischemia, 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.</p><p><strong>Methods: </strong>We identified patients (≥18 years) with CA between 2011 to 2022 who achieved return of spontaneous circulation (ROSC). The first electrocardiogram (ECG) 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 analyze the association between STE-aVR and outcomes (in-hospital mortality and poor neurologic outcome), adjusted for patient and arrest characteristics.</p><p><strong>Results: </strong>Including 443 CA patients, the median (IQR) age was 61 years (50-72 years), with 60.5% (n=268) male, 65.7% (n=291) presenting with out-of-hospital cardiac arrest (OHCA) and 29.8% (n=132) with shockable rhythms. STE-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). STE-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).</p><p><strong>Conclusions: </strong>STE-aVR was present in 1 in 5 CA survivors and was independently associated with higher in-hospital mortality.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-28","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}

{"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":"https://doi.org/10.1093/ehjacc/zuaf013","url":null,"abstract":"<p><strong>Background: </strong>We aimed to analyze the yet unclear correlation between air pollutant concentrations (AP) and out-of-hospital cardiac arrest (OHCA) in Shenzhen, China.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>Data from 16,769 patients who experienced OHCA were analyzed. 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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-23","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}

{"title":"End-of-life issues in the ITU - 10 important points to remember.","authors":"Jean-Louis Vincent","doi":"10.1093/ehjacc/zuaf011","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf011","url":null,"abstract":"<p><p>End-of-life (EOL) issues have become increasingly common in intensive therapy units (ITUs), largely due to advances in critical care that enable patients to be kept alive for extended periods. Death in the ITU now generally follows an EOL decision, which can pose ethical, emotional, and practical challenges. Our approach to such issues should be based on adherence to the four bioethical principles -autonomy, beneficence, nonmaleficence, and distributive justice- as well as the concept of proportionate care, and requires careful and effective communication with the whole ITU team, including the patient and their family. In this article, we discuss 10 key considerations related to EOL care in the ITU, in an attempt to highlight some critical aspects of EOL decision-making for intensivists navigating this sensitive and multifaceted area of practice.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002573","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":"ACVC New Year's Dispatch 2025 Prospects, thoughts and visions from ACVC Board members and Committee Chairs.","authors":"Janine Pöss, Milica Aleksic","doi":"10.1093/ehjacc/zuae151","DOIUrl":"https://doi.org/10.1093/ehjacc/zuae151","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946672","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":"Early Left Ventricular Unloading after Venoarterial Extracorporeal Membrane Oxygenation: One-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":"https://doi.org/10.1093/ehjacc/zuae150","url":null,"abstract":"<p><strong>Background: </strong>The long-term effects of early left ventricular unloading after venoarterial extracorporeal membrane oxygenation (VA-ECMO) remain unclear.</p><p><strong>Methods: </strong>The EARLY-UNLOAD trial was a single-center, 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 left ventricular unloading by transseptal left atrial cannulation within 12 hours after randomization or the conventional approach, which permitted rescue transseptal cannulation in case of an increased left ventricular afterload. The prespecified secondary endpoints at 1 year included all-cause mortality, cardiac mortality, non-cardiac mortality, rehospitalization for heart failure, and the composite of all-cause mortality or rehospitalization for heart failure.</p><p><strong>Results: </strong>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 (HR, 0.97 [95% 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 heart failure at 1 year was comparable between 2 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 heart failure also did not differ between the groups (HR, 1.01 [95% CI 0.69 to 1.76], P=0.692).</p><p><strong>Conclusions: </strong>Among patients with CS undergoing VA-ECMO, early routine left ventricular unloading did not improve clinical outcomes at 1-year of follow-up.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT04775472.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-03","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}

{"title":"A New Year's resolution for the editors of the European Heart Journal: a resolution on not making big resolutions.","authors":"Pascal Vranckx, David Morrow, Sean van Diepen, Frederik H Verbrugge","doi":"10.1093/ehjacc/zuae137","DOIUrl":"https://doi.org/10.1093/ehjacc/zuae137","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914018","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":"Echocardiographic assessment of right ventricular adaptation and pulmonary embolism: a perfect couple?","authors":"Samuel B Brusca, Jessica N Holtzman","doi":"10.1093/ehjacc/zuae133","DOIUrl":"10.1093/ehjacc/zuae133","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"826-827"},"PeriodicalIF":3.9,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638602","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":"Context is key: ethical considerations related to consent and study design in acute cardiac care research.","authors":"Neal W Dickert, Madeline Meer","doi":"10.1093/ehjacc/zuae125","DOIUrl":"10.1093/ehjacc/zuae125","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"845-850"},"PeriodicalIF":3.9,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738870","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}