European Heart Journal: Acute Cardiovascular Care最新文献

{"title":"Right ventricular-pulmonary artery coupling for prognostication in acute pulmonary embolism.","authors":"Mads Dam Lyhne, Behnood Bikdeli, David Jiménez, Christopher Kabrhel, David M Dudzinski, Jorge Moisés, José Luis Lobo, Fernando Armestar, Leticia Guirado, Aitor Ballaz, Manuel Monreal","doi":"10.1093/ehjacc/zuae120","DOIUrl":"10.1093/ehjacc/zuae120","url":null,"abstract":"<p><strong>Aims: </strong>Acute pulmonary embolism (PE) increases pulmonary pressure and impair right ventricular (RV) function. Echocardiographic investigation can quantify this mismatch as the tricuspid annular plane systolic excursion (TAPSE) to pulmonary arterial systolic pressure (PASP) ratio. The aim of the study was to investigate the prognostic capabilities of TAPSE/PASP ratio in patients with acute PE.</p><p><strong>Methods and results: </strong>We utilized the Registro Informatizado Enfermedad TromboEmbolica registry to analyse consecutive haemodynamically stable PE patients. We used multi-variable logistic regression analyses to assess the association between the TAPSE/PASP ratio and 30-day all-cause mortality across the strata of European Society of Cardiology (ESC) risk categories. We included 4478 patients, of whom 1326 (30%) had low-risk, 2425 (54%) intermediate-low risk and 727 (16%) intermediate-high risk PE. Thirty-day mortality rates were 0.7%, 2.3% and 3.4%, respectively. Mean TAPSE/PASP ratio was 0.65 ± 0.29 in low-risk patients, 0.46 ± 0.30 in intermediate-low risk and 0.33 ± 0.19 in intermediate-high risk patients. In multi-variable analyses, there was an inverse association between TAPSE/PASP ratio and 30-day mortality (adjusted OR 1.32 [95% CI 1.14-1.52] per 0.1 decrease in TAPSE/PASP). TAPSE/PASP ratio below optimal cut-points was associated with increased mortality in low- (<0.40, aOR: 5.88; 95% CI: 1.63-21.2), intermediate-low (<0.43, aOR: 2.96; 95% CI: 1.54-5.71) and intermediate-high risk patients (<0.34, aOR: 4.37; 95% CI: 1.27-15.0). TAPSE/PASP <0.44 showed net reclassification improvement of 18.2% (95% CI: 0.61-35.8) vs. RV/LV ratio >1, and 27.7% (95% CI: 10.2-45.1) vs. ESC risk strata.</p><p><strong>Conclusion: </strong>Decreased TAPSE/PASP ratio was associated with increased mortality. The ratio may aid in clinical decision-making, particularly for intermediate-risk patients for whom the discriminatory capability of the current risk stratification tools is limited.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"817-825"},"PeriodicalIF":3.9,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497393","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":"Heartfelt discoveries for winter nights: December's game-changers in acute cardiovascular care.","authors":"Pascal Vranckx, David Morrow, Sean van Diepen, Frederik H Verbrugge","doi":"10.1093/ehjacc/zuae136","DOIUrl":"10.1093/ehjacc/zuae136","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"815-816"},"PeriodicalIF":3.9,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750301","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":"Short- and long-term effects of beta-blockers on symptoms of anxiety and depression in patients with myocardial infarction and preserved left ventricular function: a pre-specified quality of life sub-study from the REDUCE-AMI trial.","authors":"Philip Leissner, Katarina Mars, Sophia Humphries, Patric Karlström, Troels Yndigegn, Tomas Jernberg, Robin Hofmann, Claes Held, Erik M G Olsson","doi":"10.1093/ehjacc/zuae112","DOIUrl":"10.1093/ehjacc/zuae112","url":null,"abstract":"<p><strong>Aims: </strong>Among patients with myocardial infarction (MI) with preserved left ventricular ejection fraction (LVEF), the REDUCE-AMI trial did not demonstrate a benefit of beta-blocker vs. no beta-blocker treatment on all-cause mortality and recurrent myocardial infarction. The aim of this pre-specified sub-study was to investigate effects of beta-blockers on self-reported symptoms of anxiety and depression.</p><p><strong>Methods and results: </strong>In this parallel-group, open-label, registry-based randomized trial, assessments with the Hospital Anxiety and Depression Scale were obtained at hospitalization and two follow-up points (6-10 weeks and 12-14 months) after MI. Analyses were based on the intention-to-treat principle using linear mixed models, calculating both short- and long-term effects. From August 2018 through June 2022, 806 patients were enrolled. At baseline, 27% of patients were possible cases of anxiety (m, 5.6; SD, 3.9) and 14% were possible cases of depression (m, 3.9; SD, 3.2). Beta-blocker treatment had a negative effect on depressive symptoms at both follow-ups 1 (β = 0.48; 95% CI 09-0.86; P = 0.015) and 2 (β = 0.41; 95% CI = 0.01-0.81; P = 0.047), but no effect on anxiety.</p><p><strong>Conclusion: </strong>Beta-blocker treatment led to a modest increase in depressive symptoms among MI patients with preserved LVEF. This observed effect was most pronounced in individuals with prior beta-blocker treatment. In routine initiation and continuation of beta-blocker treatment, a risk of slightly increased depressive symptoms should be considered.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"789-797"},"PeriodicalIF":3.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460949","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":"Efficacy of early use of percutaneous stellate ganglion block for electrical storms.","authors":"Enrico Baldi, Veronica Dusi, Roberto Rordorf, Alessia Currao, Sara Compagnoni, Antonio Sanzo, Francesca Romana Gentile, Simone Frea, Carol Gravinese, Filippo Angelini, Filippo Maria Cauti, Gianmarco Iannopollo, Francesco De Sensi, Edoardo Gandolfi, Laura Frigerio, Pasquale Crea, Domenico Zagari, Matteo Casula, Giulio Binaghi, Giuseppe Sangiorgi, Lucy Barone, Simone Persampieri, Gabriele Dell'Era, Giuseppe Patti, Claudia Colombo, Giacomo Mugnai, Domenico Tavella, Francesco Notaristefano, Alberto Barengo, Roberta Falcetti, Giulia Girardengo, Giuseppe D'Angelo, Nikita Tanese, Vito Sgromo, Gaetano Maria De Ferrari, Simone Savastano","doi":"10.1093/ehjacc/zuae109","DOIUrl":"10.1093/ehjacc/zuae109","url":null,"abstract":"<p><strong>Aims: </strong>Electrical storm (ES) is a life-threatening condition requiring a rapid management. Percutaneous stellate ganglion block (PSGB) is proved to be safe and effective on top of standard therapy, but no data are available about its early use.</p><p><strong>Methods and results: </strong>We considered all patients enrolled from 1 July 2017 to 30 April 2024 in the STAR registry (STellate ganglion block for Arrhythmic stoRm), a multicentre, international, observational, prospective registry. We aimed to assess the effectiveness of the first PSGB only. Patients were divided into two groups depending on whether they received PSGB before [early PSGB, often due to antiarrhythmic drug (AAD) contraindication] or after (delayed PSGB) intravenous AADs (AADs other than beta-blockers). We considered 180 PSGB (26 early PSGB and 154 AAD first). In the early PSGB group, we observed a statistically significant reduction of treated arrhythmic events in the hour after PSGB compared with the hour before: 0 (0-0) vs. 4.5 (1-10), P < 0.001, and the extent of the reduction was similar in the early PSGB and delayed PSGB groups [-4.5 (-7 to -2) vs. -2.5 (-3.5 to -1.5), P = ns]. The percentage of patients free from arrhythmias was similar in the two groups up to 12 h after PSGB (81 vs. 84%, P = 0.6, after 1 h; 77 vs. 79%, P = 0.8, at 3 h; and 65 vs. 69%, P = 0.7, after 12 h).</p><p><strong>Conclusion: </strong>Percutaneous stellate ganglion block is proved to be effective also when used early in the treatment of ES. Due to its rapidity of action, our results may suggest its early use to reduce the number of defibrillations and possibly to reduce the likelihood of a refractory ES.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"757-765"},"PeriodicalIF":3.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344002","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":"FACTT-checking pulmonary vascular physiology in the acute respiratory distress syndrome.","authors":"Thomas S Metkus","doi":"10.1093/ehjacc/zuae122","DOIUrl":"10.1093/ehjacc/zuae122","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"779-781"},"PeriodicalIF":3.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497381","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":"Frontloading the fight: early vs. delayed percutaneous sympathetic blockade in cardiac electrical storm.","authors":"Kamen Vlassakov, Usha Tedrow","doi":"10.1093/ehjacc/zuae123","DOIUrl":"10.1093/ehjacc/zuae123","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"766-767"},"PeriodicalIF":3.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564086","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 warm November rain: illuminating new approaches in cardiogenic shock management.","authors":"Pascal Vranckx, David Morrow, Sean van Diepen, Frederik H Verbrugge","doi":"10.1093/ehjacc/zuae116","DOIUrl":"10.1093/ehjacc/zuae116","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"755-756"},"PeriodicalIF":3.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564084","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":"Question: Syncope and chest discomfort on flecainide: a diagnostic dilemma.","authors":"Sedhupathi Shanmugam, Sudipta Mondal, Jyothi Vijay","doi":"10.1093/ehjacc/zuae090","DOIUrl":"10.1093/ehjacc/zuae090","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"810-811"},"PeriodicalIF":3.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709293","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 microcirculation in cardiogenic shock.","authors":"Mara Schemmelmann, Malte Kelm, Christian Jung","doi":"10.1093/ehjacc/zuae124","DOIUrl":"10.1093/ehjacc/zuae124","url":null,"abstract":"<p><p>Cardiogenic shock is a life-threatening condition characterized by inadequate cardiac output, leading to end-organ hypoperfusion and associated mortality rates ranging between 40 and 50%. The critical role of microcirculatory impairments in the progression of organ failure during shock has been highlighted in several studies. Traditional therapies have often focused on stabilizing macrocirculation, neglecting microcirculatory dysfunction, which can result in persistent tissue hypoxia and poor outcomes. This review highlights the importance of assessing microcirculation in cardiogenic shock, including parameters such as skin perfusion, sublingual microcirculation, and lactate dynamics. Integrating microcirculatory assessments into clinical practice remains challenging due to the complexity of the methods and limited therapeutic options targeting microvascular perfusion. While advances in microcirculation-guided therapies hold promise for improving outcomes in cardiogenic shock, further research is needed to establish effective protocols.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"802-809"},"PeriodicalIF":3.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590262","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: Syncope and chest discomfort on flecainide: a diagnostic dilemma.","authors":"Sedhupathi Shanmugam, Sudipta Mondal, Jyothi Vijay","doi":"10.1093/ehjacc/zuae091","DOIUrl":"https://doi.org/10.1093/ehjacc/zuae091","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":"13 11","pages":"812-813"},"PeriodicalIF":3.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817320","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}