European Heart Journal: Acute Cardiovascular Care最新文献

{"title":"Question: A mysterious cause of myocardial infarction: look beyond his coronary vessels.","authors":"Grace H T Kwok, Kevin K H Kam","doi":"10.1093/ehjacc/zuae117","DOIUrl":"10.1093/ehjacc/zuae117","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"123-125"},"PeriodicalIF":3.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046056","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":"Deep learning model for identifying acute heart failure patients using electrocardiography in the emergency room.","authors":"Jose Moon, Jong-Ho Kim, Soon Jun Hong, Cheol Woong Yu, Yong Hyun Kim, Eung Ju Kim, Jung-Joon Cha, Hyung Joon Joo","doi":"10.1093/ehjacc/zuaf001","DOIUrl":"10.1093/ehjacc/zuaf001","url":null,"abstract":"<p><strong>Aims: </strong>Acute heart failure (AHF) poses significant diagnostic challenges in the emergency room (ER) because of its varied clinical presentation and limitations of traditional diagnostic methods. This study aimed to develop and evaluate a deep learning model using electrocardiogram (ECG) data to enhance AHF identification in the ER.</p><p><strong>Methods and results: </strong>In this retrospective cohort study, we analysed the ECG data of 19 285 patients who visited ERs of three hospitals between 2016 and 2020; 9119 with available left ventricular ejection fraction and N-terminal prohormone of brain natriuretic peptide level data and who were diagnosed with AHF were included in the study. We extracted morphological and clinical parameters from ECG data to train and validate four machine learning models: baseline linear regression and more advanced models including XGBoost, Light GBM, and CatBoost. The CatBoost algorithm outperformed other models, showing superior area under the receiver operating characteristic and area under the precision-recall curve diagnostic accuracy across both internal (0.89 ± 0.01 and 0.89 ± 0.01) and external (0.90 and 0.89) validation data sets, respectively. The model demonstrated high accuracy, precision, recall, and f1 score, indicating robust performance in AHF identification.</p><p><strong>Conclusion: </strong>The developed machine learning model significantly enhanced AHF detection in the ER using conventional 12-lead ECGs combined with clinical data. These findings suggest that ECGs, a common tool in the ER, can effectively help screen for AHF.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"74-82"},"PeriodicalIF":3.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946763","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":"Current state in acute aortic syndromes: year in review 2024.","authors":"David A Morrow, Milica Aleksic","doi":"10.1093/ehjacc/zuaf008","DOIUrl":"10.1093/ehjacc/zuaf008","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"104-106"},"PeriodicalIF":3.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002571","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":"C-reactive protein levels and outcomes in infarct-related cardiogenic shock: data from the ECLS-SHOCK trial.","authors":"Tobias Schupp, Holger Thiele, Tienush Rassaf, Amir Abbas Mahabadi, Ralf Lehmann, Ingo Eitel, Carsten Skurk, Peter Clemmensen, Marcus Hennersdorf, Ingo Voigt, Axel Linke, Eike Tigges, Peter Nordbeck, Christian Jung, Philipp Lauten, Hans-Josef Feistritzer, Maria Buske, Janine Pöss, Taoufik Ouarrak, Steffen Schneider, Michael Behnes, Daniel Duerschmied, Steffen Desch, Anne Freund, Uwe Zeymer, Ibrahim Akin","doi":"10.1093/ehjacc/zuae148","DOIUrl":"10.1093/ehjacc/zuae148","url":null,"abstract":"<p><strong>Aims: </strong>The impact of systemic inflammation in acute myocardial infarction complicated by cardiogenic shock (AMI-CS) is still a matter of debate. The present ECLS-SHOCK sub-study investigates the association of C-reactive protein (CRP) levels with short-term outcomes in patients with AMI-CS.</p><p><strong>Methods and results: </strong>Patients with AMI-CS enrolled in the multicentre, randomized ECLS-SHOCK trial between 2019 and 2022 were included. The prognostic impact of CRP levels on admission, as well as the effect of extracorporeal life support (ECLS), stratified by CRP levels, was tested with regard to the primary endpoint of 30-day all-cause mortality. In 371 patients with AMI-CS and available CRP level on baseline, the median CRP level was 18.0 mg/L. Patients with CRP levels in the highest tertile were older and less often resuscitated from cardiac arrest. The highest tertile (i.e. CRP >61.0 mg/L) was associated with an increased risk of 30-day all-cause mortality compared with patients with lower CRP levels (lowest tertile: ≤5.0 mg/L) [adjusted odds ratio: 3.54; 95% confidence interval (CI) 1.88-6.68; P = 0.001]. The use of ECLS did not reduce 30-day all-cause mortality, irrespective of CRP levels on admission. The additional inclusion of CRP to the IABP-SHOCK II score was associated with a slight improvement of the prediction of 30-days all-cause mortality (area under the curve: 0.74; 95% CI 0.68-0.79).</p><p><strong>Conclusion: </strong>Higher CRP levels were independently associated with the risk of 30-day all-cause mortality in AMI-CS. The additional inclusion of CRP to a validated CS risk score may further improve the prediction of short-term prognosis.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"59-70"},"PeriodicalIF":3.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946743","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":"Effect of low-dose administration of carperitide for acute heart failure: the LASCAR-AHF trial.","authors":"Satoshi Honda, Toshiyuki Nagai, Yasuyuki Honda, Hiroki Nakano, Takanori Kawabata, Hirotada Maeda, Koko Asakura, Naotsugu Iwakami, Sakae Takenaka, Yoshiya Kato, Yusuke Tokuda, Takafumi Yamane, Yutaka Furukawa, Takeshi Kitai, Yasuhide Asaumi, Shuzo Nishihara, Atsushi Mizuno, Tetsuo Yamaguchi, Teruo Noguchi, Satoshi Yasuda, Toshihisa Anzai","doi":"10.1093/ehjacc/zuae140","DOIUrl":"10.1093/ehjacc/zuae140","url":null,"abstract":"<p><strong>Aims: </strong>The effects of low-dose carperitide on long-term clinical outcomes of patients with acute heart failure (AHF) have not yet been fully elucidated. This study aimed to evaluate the effects of low-dose intravenous carperitide on the long-term clinical outcomes of patients with AHF.</p><p><strong>Methods and results: </strong>In this multicentre, open-label, randomized controlled trial, 247 patients with AHF received low-dose carperitide intravenously with standard treatment or matching standard treatment for 72 h from November 2014 to March 2021 across nine sites in Japan. The primary endpoint was a composite of all-cause death and heart failure hospitalization within 2 years. The primary endpoint was observed in 36 of 122 patients (29.5%) and 35 of 125 patients (28.0%) in the carperitide group and standard treatment groups, respectively [hazard ratio 1.26; 95% confidence interval (CI) 0.78-2.06, P = 0.827]. No significant differences were observed in the secondary endpoints, including cumulative urine volume at 72 h; change in the degree of dyspnoea over 72 h; and changes in brain natriuretic peptide, cystatin C, renin, aldosterone, and catecholamine levels at 72 h post-randomization between the groups. A greater decrease in the estimated glomerular filtration rate was observed in the carperitide group compared with the standard treatment group (inter-group difference -3.9 mL/min/1.73 m2; 95% CI -7.0 to -0.8).</p><p><strong>Conclusion: </strong>In patients with AHF, low-dose carperitide did not reduce long-term mortality or hospitalization events when combined with standard treatment. Because patient enrolment was terminated prematurely, the study was underpowered and inconclusive.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"83-92"},"PeriodicalIF":3.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827815","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":"Ischaemic cardiogenic shock: should we consider basal inflammation-and how? An editorial on the manuscript entitled: 'C-reactive protein levels and outcomes in infarct-related cardiogenic shock: data from the ECLS-SHOCK trial'.","authors":"François Roubille","doi":"10.1093/ehjacc/zuae149","DOIUrl":"10.1093/ehjacc/zuae149","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"71-73"},"PeriodicalIF":3.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893125","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: A mysterious cause of myocardial infarction: look beyond his coronary vessels.","authors":"Grace H T Kwok, Kevin K H Kam","doi":"10.1093/ehjacc/zuae118","DOIUrl":"10.1093/ehjacc/zuae118","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"126-127"},"PeriodicalIF":3.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079060","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":"Device-related adverse events and flow capacity of percutaneous ventricular assist devices.","authors":"Yuki Ikeda, Shunsuke Ishii, Shohei Nakahara, Saeko Iikura, Teppei Fujita, Yuichiro Iida, Takeru Nabeta, Nobuhiro Sato, Junya Ako","doi":"10.1093/ehjacc/zuae132","DOIUrl":"10.1093/ehjacc/zuae132","url":null,"abstract":"<p><strong>Aims: </strong>Complication management is crucial in patients receiving mechanical circulatory devices. However, there are limited data on the association between the risks of complications and device type in patients with percutaneous ventricular assist devices (PVAD).</p><p><strong>Methods and results: </strong>The Japanese registry for PVAD (J-PVAD) is a nationwide ongoing registry that enrols consecutive patients with cardiogenic shock treated with PVAD. We analysed 5717 patients in the J-PVAD from 1 February 2020 to 31 December 2022, to compare the incident risks of device-related problems and all-cause mortality within 30 days after PVAD introduction based on flow capacities of first-line PVAD (low: Impella 2.5/CP, n = 5375; high: Impella 5.0/5.5, n = 342). The overall incidence of major device-related problems, including haemolysis, major bleeding, kidney injury, sepsis, and pump stop, was 13%, 21%, 7%, 3%, and 1%, respectively. The all-cause mortality rate was 34%. The incident risks of haemolysis [hazard ratio (HR) 0.38, 95% confidence interval (CI) 0.24-0.58], kidney injury (HR 0.32, 95% CI 0.18-0.57), and pump stop (HR 0.38, 95% CI 0.16-0.91) were lower in patients with high-flow PVAD compared with those with low-flow PVAD. The risks of major bleeding or sepsis did not differ significantly between groups. The risk of all-cause mortality was lower in patients with high-flow PVAD compared with those with low-flow PVAD (HR 0.79, 95% CI 0.65-0.96).</p><p><strong>Conclusion: </strong>Compared with those with low-flow PVAD, patients with high-flow PVAD had lower incident risks of device-related problems, including haemolysis, kidney injury, and pump stop, as well as lower risk of all-cause mortality.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"93-103"},"PeriodicalIF":3.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667609","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":"Weakness acquired in the cardiac intensive care unit: still the elephant in the room?","authors":"Nathalie Van Aerde, Greet Hermans","doi":"10.1093/ehjacc/zuae146","DOIUrl":"10.1093/ehjacc/zuae146","url":null,"abstract":"<p><p>Over the past two decades, the cardiac critical care population has shifted to increasingly comorbid and elderly patients often presenting with nonprimary cardiac conditions that exacerbate underlying advanced cardiac disease. Consequently, the modern cardiac intensive care unit (CICU) patient has poor outcome regardless of left ventricular ejection fraction. Importantly, delayed liberation from organ support, independent from premorbid health status and admission severity of illness, has been associated with increased morbidity and mortality up to years post-general critical care. Although a constellation of several acquired morbidities is at play, the most prominent enactor of poor long-term outcome in this population appears to be intensive care unit acquired weakness. Although the specific burden of ICU-acquired morbidities in CICU patients is yet to be clearly defined, it seems unfathomable that patients will not accrue some sort of ICU-related morbidity. There is hence an urgent need to better establish the exact benefit and cost of resource-intensive strategies in both short- and long-term survival of the CICU patient. Consequent and standardized documentation of admission comorbidities, severity of illness indicators, relevant ICU-related complications including weakness, and long-term post-ICU morbidity outcomes can help our understanding of the disease continuum and how to better care for the CICU survivor and their families and caregivers. Given increasing budgetary pressure on healthcare systems worldwide, interventions targeting CICU patients should focus on improving patient-centred long-term outcomes in a cost-effective manner. It will require a holistic and transmural continuity of care model to meet the challenges associated with treating critically ill cardiac patients in the future.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"107-119"},"PeriodicalIF":3.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885068","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 top 10 European Heart Journal: Acute Cardiovascular Care papers in cardiogenic shock and resuscitation of 2024.","authors":"Sean van Diepen, Janine Pöss, Venu Menon","doi":"10.1093/ehjacc/zuae144","DOIUrl":"10.1093/ehjacc/zuae144","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"48-50"},"PeriodicalIF":3.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846307","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}