Piergiuseppe Agostoni, Mattia Chiesa, Elisabetta Salvioni, Michele Emdin, Massimo Piepoli, Gianfranco Sinagra, Michele Senni, Alice Bonomi, Stamatis Adamopoulos, Dimitris Miliopoulos, Massimo Mapelli, Jeness Campodonico, Umberto Attanasio, Anna Apostolo, Emanuele Pestrin, Agostino Rossoni, Damiano Magrì, Stefania Paolillo, Ugo Corrà, Rosa Raimondo, Antonio Cittadini, Annamaria Iorio, Andrea Salzano, Rocco Lagioia, Carlo Vignati, Roberto Badagliacca, Pasquale Perrone Filardi, Michele Correale, Enrico Perna, Marco Metra, Gaia Cattadori, Marco Guazzi, Giuseppe Limongelli, Gianfranco Parati, Fabiana De Martino, Maria Vittoria Matassini, Francesco Bandera, Maurizio Bussotti, Federica Re, Carlo M Lombardi, Angela B Scardovi, Susanna Sciomer, Andrea Passantino, Caterina Santolamazza, Davide Girola, Claudio Passino, Marlus Karsten, Savina Nodari, Giulio Pompilio
{"title":"The chronic heart failure evolutions: Different fates and routes.","authors":"Piergiuseppe Agostoni, Mattia Chiesa, Elisabetta Salvioni, Michele Emdin, Massimo Piepoli, Gianfranco Sinagra, Michele Senni, Alice Bonomi, Stamatis Adamopoulos, Dimitris Miliopoulos, Massimo Mapelli, Jeness Campodonico, Umberto Attanasio, Anna Apostolo, Emanuele Pestrin, Agostino Rossoni, Damiano Magrì, Stefania Paolillo, Ugo Corrà, Rosa Raimondo, Antonio Cittadini, Annamaria Iorio, Andrea Salzano, Rocco Lagioia, Carlo Vignati, Roberto Badagliacca, Pasquale Perrone Filardi, Michele Correale, Enrico Perna, Marco Metra, Gaia Cattadori, Marco Guazzi, Giuseppe Limongelli, Gianfranco Parati, Fabiana De Martino, Maria Vittoria Matassini, Francesco Bandera, Maurizio Bussotti, Federica Re, Carlo M Lombardi, Angela B Scardovi, Susanna Sciomer, Andrea Passantino, Caterina Santolamazza, Davide Girola, Claudio Passino, Marlus Karsten, Savina Nodari, Giulio Pompilio","doi":"10.1002/ehf2.14966","DOIUrl":"https://doi.org/10.1002/ehf2.14966","url":null,"abstract":"<p><strong>Aims: </strong>Individual prognostic assessment and disease evolution pathways are undefined in chronic heart failure (HF). The application of unsupervised learning methodologies could help to identify patient phenotypes and the progression in each phenotype as well as to assess adverse event risk.</p><p><strong>Methods and results: </strong>From a bulk of 7948 HF patients included in the MECKI registry, we selected patients with a minimum 2-year follow-up. We implemented a topological data analysis (TDA), based on 43 variables derived from clinical, biochemical, cardiac ultrasound, and exercise evaluations, to identify several patients' clusters. Thereafter, we used the trajectory analysis to describe the evolution of HF states, which is able to identify bifurcation points, characterized by different follow-up paths, as well as specific end-stages conditions of the disease. Finally, we conducted a 5-year survival analysis (composite of cardiovascular death, left ventricular assist device, or urgent heart transplant). Findings were validated on internal (n = 527) and external (n = 777) populations. We analyzed 4876 patients (age = 63 [53-71], male gender n = 3973 (81.5%), NYHA class I-II n = 3576 (73.3%), III-IV n = 1300 (26.7%), LVEF = 33 [25.5-39.9], atrial fibrillation n = 791 (16.2%), peak VO<sub>2</sub>% pred = 54.8 [43.8-67.2]), with a minimum 2-year follow-up. Nineteen patient clusters were identified by TDA. Trajectory analysis revealed a path characterized by 3 bifurcation and 4 end-stage points. Clusters survival rate varied from 44% to 100% at 2 years and from 20% to 100% at 5 years, respectively. The event frequency at 5-year follow-up for each study cohort cluster was successfully compared with those in the validation cohorts (R = 0.94 and R = 0.84, P < 0.001, for internal and external cohort, respectively). Finally, we conducted a 5-year survival analysis (composite of cardiovascular death, left ventricular assist device, or urgent heart transplant observed in 22% of cases).</p><p><strong>Conclusions: </strong>Each HF phenotype has a specific disease progression and prognosis. These findings allow to individualize HF patient evolutions and to tailor assessment.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344018","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}
Bahadır Açıktepe, Sevval Nil Esirgun, Mehmet Kocak
{"title":"Association of environmental and behavioural factors with cardiovascular disease mortality.","authors":"Bahadır Açıktepe, Sevval Nil Esirgun, Mehmet Kocak","doi":"10.1002/ehf2.14976","DOIUrl":"https://doi.org/10.1002/ehf2.14976","url":null,"abstract":"<p><strong>Aims: </strong>Recognizing the rising concern of environmental impacts on health, the study aims to explore how specific environmental factors such as air pollution, humidity, and temperature variations contribute to the prevalence of cardiovascular disease (CVD) mortality, emphasizing the role of air quality, climate variables, and lifestyle factors in the disease mortality specifically.</p><p><strong>Methods and results: </strong>Analysis of province-level data on CVD mortality in Turkey from 2010 to 2019, assessing the correlations with environmental and lifestyle factors like particulate matter, sulfur dioxide, meteorological variables, and smoking and alcohol consumption. The study employs the SAS TRAJ procedure and Ordinal Logistic Regression for statistical analysis. The multiplicity correction was done through Benjamini-Hoechberg false discovery rate (FDR) approach. As expected, both smoking and alcohol consumption were found to be significantly associated with CVD mortality (odds ratio (OR): 1.10, 95% CI: 1.08, 1.11, P-value < 0.0001). While median Air Pressure and Humidity were among the most significant markers with OR of 1.10 indicating an increasing CVD mortality, their variability metrics such as coefficient of variation (CV) showed significant protective effects with OR of 0.37 and 0.89, respectively. Temperature and its variability seemed to be protective overall.</p><p><strong>Conclusions: </strong>Our research highlights the significant influence of environmental factors on cardiovascular health, especially air pressure and humidity, beyond the known factors such as smoking and alcohol consumption. These findings suggest the need for comprehensive public health strategies that address both environmental and lifestyle risk factors to effectively reduce the burden of cardiovascular diseases.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307449","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":"Prognostic impact of being underweight in patients undergoing mitral TEER: The OCEAN-Mitral registry.","authors":"Ryosuke Higuchi, Masaki Izumo, Yuki Izumi, Mike Saji, Mitsuaki Isobe, Yoshihiro Akashi, Masanori Yamamoto, Masahiko Asami, Yusuke Enta, Masaki Nakashima, Shinichi Shirai, Shingo Mizuno, Yusuke Watanabe, Makoto Amaki, Kazuhisa Kodama, Junichi Yamaguchi, Toru Naganuma, Hiroki Bota, Yohei Ohno, Masahiro Yamawaki, Hiroshi Ueno, Kazuki Mizutani, Shunsuke Kubo, Toshiaki Otsuka, Kentaro Hayashida","doi":"10.1002/ehf2.15047","DOIUrl":"https://doi.org/10.1002/ehf2.15047","url":null,"abstract":"<p><strong>Aims: </strong>Mitral transcatheter edge-to-edge repair (M-TEER) is a valid treatment option for severe mitral regurgitation (MR), necessitating accurate risk stratification of M-TEER candidates for effective patient selection, optimal periprocedural care and improved long-term outcomes. The body mass index (BMI) is a simple and practical prognostic index, and the obesity paradox has been widely reported.</p><p><strong>Methods and results: </strong>Between April 2018 and June 2021, 2149 patients undergoing M-TEER were registered in the prospective multicentre registry and classified into three groups: underweight (BMI < 18.5 kg/m<sup>2</sup>), normal weight (18.5 ≦ BMI < 25 kg/m<sup>2</sup>) and overweight and obese (25 kg/m<sup>2</sup> ≦ BMI). The impact of underweight on the all-cause, cardiovascular and non-cardiovascular mortality following M-TEER was evaluated [follow-up duration: 436 (363-733) days]. The participants (median BMI: 21.1 kg/m<sup>2</sup>) were categorized as underweight (n = 450, 20.9%), normal weight (n = 1409, 65.6%) and overweight and obese (n = 290, 13.5%). Compared with the other two groups, the underweight group exhibited several negative prognostic factors, including older age, frailty, no dyslipidaemia, hypoalbuminaemia, residual MR and non-home discharge. Underweight patients had the highest rate of all-cause, cardiovascular and non-cardiovascular mortality, whereas those in the other two groups were similar. As per the multivariate analysis, underweight itself was associated with all-cause mortality (hazard ratio: 1.52, 95% confidence interval: 1.17-1.97, P = 0.009) and cardiovascular mortality (hazard ratio: 1.45, 95% confidence interval: 1.04-2.01, P = 0.028).</p><p><strong>Conclusions: </strong>Underweight patients had the highest mortality rate after M-TEER. Comorbidities, residual MR, discharge disposition and underweight status were correlated with postprocedural outcome.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282350","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":"Importance of non-cardiovascular comorbidities in atrial fibrillation and heart failure with preserved ejection fraction.","authors":"Yasuhiro Hamatani, Moritake Iguchi, Takao Kato, Yasutaka Inuzuka, Yodo Tamaki, Neiko Ozasa, Tetsuma Kawaji, Masahiro Esato, Hikari Tsuji, Hiromichi Wada, Koji Hasegawa, Mitsuru Abe, Takeshi Kimura, Koh Ono, Masaharu Akao","doi":"10.1002/ehf2.15093","DOIUrl":"https://doi.org/10.1002/ehf2.15093","url":null,"abstract":"<p><strong>Aims: </strong>Atrial fibrillation (AF) and heart failure (HF) with preserved ejection fraction (HFpEF) are interlinked and frequently coexisting conditions. To date, patients with AF and HFpEF have limited evidence guiding their management. This study aimed to investigate the predictors of adverse outcomes among patients with AF and HFpEF.</p><p><strong>Methods: </strong>The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto, Japan. From the registry, we explored predictors for a composite of cardiac death or HF hospitalization among AF patients with HFpEF (defined as having a prior HF hospitalization or New York Heart Association class ≥2 in association with heart disease and left ventricular ejection fraction ≥50%). Besides, we investigated whether the scoring using the predictors identified by the Fushimi AF Registry could stratify the outcomes in patients with AF and HFpEF registered in another independent Kyoto Congestive Heart Failure Registry.</p><p><strong>Results: </strong>Of 755 patients with AF and HFpEF [mean age: 77.5 ± 9.9 years; female: 391 (52%); paroxysmal AF: 258 (34%); and mean CHA<sub>2</sub>DS<sub>2</sub>-VASc score: 4.5 ± 1.5], cardiac death or HF hospitalization occurred in 246 patients (33%) during the median follow-up period of 4.4 years in the Fushimi AF Registry. Using multivariate Cox regression analysis, age ≥75 years [hazard ratio (HR): 1.72, 95% confidence interval (CI): 1.26-2.36] and non-cardiovascular comorbidities such as anaemia (HR: 1.83, 95% CI: 1.37-2.46), chronic kidney disease (HR: 1.69, 95% CI: 1.27-2.26), diabetes mellitus (HR: 1.55, 95% CI: 1.15-2.09) and chronic obstructive pulmonary disease (HR: 1.87, 95% CI: 1.08-3.22) were independent predictors of adverse outcomes. Meanwhile, cardiovascular comorbidities including coronary artery disease, valvular heart disease or cardiomyopathy were not significantly associated with adverse outcomes. These results were also the case when analysed for patients with AF and HFpEF who registered in the Kyoto Congestive Heart Failure registry (N = 878). The score assigning 1 point for each five predictors (age, anaemia, chronic kidney disease, diabetes mellitus and chronic obstructive pulmonary disease; ranging 0-5 points) stratified the incidence of adverse outcomes among patients with AF and HFpEF registered in the Kyoto Congestive Heart Failure Registry as well as among those in the Fushimi AF Registry (both log-rank; P < 0.001).</p><p><strong>Conclusions: </strong>Non-cardiovascular comorbidities such as anaemia, diabetes mellitus and kidney or pulmonary disease in addition to advanced age were independent predictors of adverse outcomes in patients with AF and HFpEF. Our study suggests the importance of focusing on these non-cardiovascular comorbidities for individualized risk stratification and optimal management in patients with AF and HFpEF.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282348","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}
Giacomo Tini, Beatrice Musumeci, Paolo Milani, Mattia Zampieri, Angelo Giuseppe Caponetti, Francesca Fabris, Andrea Foli, Alessia Argirò, Carlotta Mazzoni, Christian Gagliardi, Simone Longhi, Giulia Saturi, Giuseppe Vergaro, Alberto Aimo, Ludovica De Fazio, Guerino Giuseppe Varrà, Matteo Serenelli, Gioele Fabbri, Laura De Michieli, Giuseppe Palmiero, Giuseppe Ciliberti, Samuela Carigi, Margherita Zanoletti, Giulia Elena Mandoli, Giulia Ricci Lucchi, Valeria Rella, Enrico Monti, Elisa Gardini, Michela Bartolotti, Lia Crotti, Elisa Merli, Roberta Mussinelli, Pier Filippo Vianello, Matteo Cameli, Francesca Marzo, Federico Guerra, Giuseppe Limongelli, Alberto Cipriani, Stefano Perlini, Laura Obici, Federico Perfetto, Emanuele Barbato, Italo Porto, Gianfranco Sinagra, Marco Merlo, Michele Emdin, Elena Biagini, Francesco Cappelli, Giovanni Palladini, Marco Canepa
{"title":"Early diagnosis, disease stage and prognosis in wild-type transthyretin amyloid cardiomyopathy: The DIAMOND study.","authors":"Giacomo Tini, Beatrice Musumeci, Paolo Milani, Mattia Zampieri, Angelo Giuseppe Caponetti, Francesca Fabris, Andrea Foli, Alessia Argirò, Carlotta Mazzoni, Christian Gagliardi, Simone Longhi, Giulia Saturi, Giuseppe Vergaro, Alberto Aimo, Ludovica De Fazio, Guerino Giuseppe Varrà, Matteo Serenelli, Gioele Fabbri, Laura De Michieli, Giuseppe Palmiero, Giuseppe Ciliberti, Samuela Carigi, Margherita Zanoletti, Giulia Elena Mandoli, Giulia Ricci Lucchi, Valeria Rella, Enrico Monti, Elisa Gardini, Michela Bartolotti, Lia Crotti, Elisa Merli, Roberta Mussinelli, Pier Filippo Vianello, Matteo Cameli, Francesca Marzo, Federico Guerra, Giuseppe Limongelli, Alberto Cipriani, Stefano Perlini, Laura Obici, Federico Perfetto, Emanuele Barbato, Italo Porto, Gianfranco Sinagra, Marco Merlo, Michele Emdin, Elena Biagini, Francesco Cappelli, Giovanni Palladini, Marco Canepa","doi":"10.1002/ehf2.15091","DOIUrl":"https://doi.org/10.1002/ehf2.15091","url":null,"abstract":"<p><strong>Aims: </strong>Disease staging and prognostic scoring in wild-type transthyretin-related cardiac amyloidosis (ATTRwt-CA) can be captured by two systems (NAC and Columbia scores). However, uncertainty remains as epidemiology of the disease is evolving rapidly. We evaluated features associated with staging systems across ATTRwt-CA patients from different diagnostic pathways, and their association with prognosis.</p><p><strong>Methods: </strong>We performed an analysis on DIAMOND patients with available data to evaluate NAC and Columbia score. DIAMOND was a retrospective study from 17 Italian referral centres for CA, enrolling 1281 patients diagnosed between 2016 and 2021, and aimed at describing characteristics of pathways leading to ATTRwt-CA diagnosis. Of the original cohort, 811 patients were included in this analysis. Each patient had NAC and Columbia score calculated. Patients were grouped according to NAC and Columbia scoring classes. We described characteristics of patients according to staging classes and diagnostic pathways at diagnosis. Prevalence of early diagnoses, defined as NAC Ia, NYHA class I, no use of diuretics, no history of heart failure (HF) hospitalizations nor of atrial fibrillation prior to diagnosis, was investigated. Finally, prognostic variables were tested alone and grouped as NAC or Columbia scores in Cox univariate and multivariate regression analyses. Prognosis was investigated as all-cause mortality, in the whole population and dividing patients in HF versus other diagnostic pathways.</p><p><strong>Results: </strong>Only 1% of the study population had an early ATTRwt-CA diagnosis. Distribution of prognostic variables and of NAC and Columbia classes was heterogeneous across diagnostic pathways. The prevalence of NAC III and Columbia III was higher in the HF diagnostic pathway, but all NAC and Columbia classes were present in all pathways. Both NAC and Columbia scores were associated with all-cause mortality at univariate Cox regression analysis in the whole population, in patients from the HF diagnostic pathway and in those from other pathways. At multivariate analysis, Columbia score remained significantly associated with the outcome, together with age at diagnosis, left ventricular ejection fraction and maximal wall thickness.</p><p><strong>Conclusions: </strong>In this contemporary nationwide cohort, an ATTRwt-CA early diagnosis was very rare. Disease staging with NAC and Columbia scoring systems determined classes of patients with heterogeneous features. Both scores were significantly associated with mortality, but other variables also had prognostic significance.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282345","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}
Athanasios Saplaouras, Konstantinos Vlachos, Panagiotis Mililis, Athena Batsouli, George Bazoukis, Sotirios Xydonas, Panagioula Niarchou, Antonio Frontera, Stylianos Dragasis, Ourania Kariki, Ilias G Patsiotis, Aggeliki Gkouziouta, Panagiotis Stachteas, Panagiotis Korantzopoulos, Stylianos Tzeis, Nikolaos Fragakis, Michael Efremidis, Konstantinos P Letsas
{"title":"Cardiac resynchronization therapy in heart failure based on Strauss criteria for left bundle branch block.","authors":"Athanasios Saplaouras, Konstantinos Vlachos, Panagiotis Mililis, Athena Batsouli, George Bazoukis, Sotirios Xydonas, Panagioula Niarchou, Antonio Frontera, Stylianos Dragasis, Ourania Kariki, Ilias G Patsiotis, Aggeliki Gkouziouta, Panagiotis Stachteas, Panagiotis Korantzopoulos, Stylianos Tzeis, Nikolaos Fragakis, Michael Efremidis, Konstantinos P Letsas","doi":"10.1002/ehf2.15028","DOIUrl":"https://doi.org/10.1002/ehf2.15028","url":null,"abstract":"<p><strong>Aims: </strong>The left bundle branch block (LBBB) is a strong predictor of response to cardiac resynchronization therapy (CRT). However, a significant number of patients do not respond to the treatment. The study sought to evaluate the impact of the stricter Strauss criteria for left bundle branch block (St-LBBB) on CRT response, hospitalizations, ventricular arrhythmia (VA) events and mortality.</p><p><strong>Methods: </strong>This study is a retrospective analysis of prospectively collected data on heart failure (HF) patients with LBBB admitted for CRT implantation. Patients were divided into two groups according to the fulfilment or not of St-LBBB criteria.</p><p><strong>Results: </strong>The study included 82 patients with ischaemic (ICM) and non-ischaemic (NICM) cardiomyopathy [46 (56%) with St-LBBB and 36 (44%) with non-St-LBBB]. Patients with St-LBBB showed higher CRT response rates compared with those with non-St-LBBB (P < 0.01), while the group with NICM exhibited the greatest benefit (P < 0.01). St-LBBB CRT responders displayed significantly lower rates of HF hospitalization (P < 0.0001) compared with the non-St-LBBB group. According to Kaplan-Meier time curves, this was primarily evident in patients with NICM (P < 0.0001). CRT responders displayed significantly fewer VA events (P < 0.001) and lower mortality rates (P < 0.0001) than non-responders. Kaplan-Meier estimates demonstrated a significantly lower incidence of VAs in NICM patients with St-LBBB (P = 0.049) compared with ICM patients with St-LBBB (P = 0.25). Lower mortality rates were observed in CRT responders than non-responders (P < 0.0001), with the group of NICM with St-LBBB criteria exhibiting the greatest benefit (P = 0.0238).</p><p><strong>Conclusions: </strong>Patients with NICM and St-LBBB present the greatest benefit concerning CRT response, HF hospitalizations, VA events and mortality. Although St-LBBB criteria seem to improve patient selection for CRT, more data are needed to elucidate the role of St-LBBB criteria in this setting.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282344","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":"Benefit of implantable cardioverter defibrillator use in Japanese patients based on modified MADIT-ICD benefit score.","authors":"Toshinori Chiba, Yusuke Kondo, Yuki Shiko, Masahiro Nakano, Kajiyama Takatsugu, Miyo Nakano, Ryo Ito, Masafumi Sugawara, Yutaka Yoshino, Satoko Ryuzaki, Yukiko Takanashi, Yuya Komai, Yoshio Kobayashi","doi":"10.1002/ehf2.15081","DOIUrl":"https://doi.org/10.1002/ehf2.15081","url":null,"abstract":"<p><strong>Aims: </strong>The MADIT-ICD benefit score is used to stratify the risk of life-threatening arrhythmia and non-arrhythmic mortality. We sought to develop an implantable cardioverter defibrillator (ICD) benefit-prediction score for Japanese patients with ICDs.</p><p><strong>Methods: </strong>Patients who underwent ICD implantation as primary prophylaxis were retrospectively enrolled. Based on their MADIT-ICD benefit scores, we developed a modified MADIT-ICD benefit score adapted to the Japanese population. The primary endpoints were appropriate ICD therapy and all-cause death without appropriate ICD therapy (non-arrhythmic death). We used the Fine and Gray multivariate model and Cox proportional hazard regression to identify factors for adjusting the MADIT-ICD benefit-risk score specifically for the Japanese population. The scoring points for the original MADIT-ICD benefit score were adjusted to optimal points based on the multivariate analysis results in the population.</p><p><strong>Results: </strong>The study enrolled 167 patients [age, 61.9 ± 12.3 years; male individuals, 138 (82.6%); cardiac resynchronization therapy, 73 (43.7%); ischaemic cardiomyopathy, 53 (31.7%)]. Fourteen patients received anti-tachycardia pacing (ATP) therapy, and 23 received shock therapy as the initial appropriate ICD therapy. Non-arrhythmic deaths occurred in 37 patients. The original MADIT-ICD benefit score could not stratify non-arrhythmic mortality in the Japanese population. The patients were reclassified into three groups according to the modified MADIT-ICD benefit score. The modified MADIT-ICD benefit score could effectively stratify the incidence of appropriate ICD therapy and non-arrhythmic mortality. In the highest-benefit group, the 10 year cumulative rates of appropriate ICD therapy and non-arrhythmic mortality were 56.8% and 12.9%, respectively (P < 0.01). In the intermediate-benefit group, these rates were 20.2% and 40.2% (P = 0.01). In the lowest-benefit group, the incidence of non-arrhythmic deaths was 68.1%, and no patient received appropriate ICD therapy.</p><p><strong>Conclusions: </strong>The modified MADIT-ICD benefit score may be useful for stratifying ICD candidates in the Japanese population.</p>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282343","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":"Clinical characteristics, diagnosis and short-term outcomes of COVID-19-associated acute myocarditis in China.","authors":"Huihui Liu,Ping Zhou,Yan Huang,Sulan Yan,Lei Zhou,Chuanyu Gao,Lian Wang,Jianjun Tang,Qiong Zhou,Xinqing Li,Xiaofeng Zhuang,Mei Zhai,Liyan Huang,Xuemei Zhao,Barry Greenberg,David H Hsi,Yuhui Zhang,Jian Zhang","doi":"10.1002/ehf2.15048","DOIUrl":"https://doi.org/10.1002/ehf2.15048","url":null,"abstract":"AIMSAcute myocarditis (AM) has been recognized as a rare complication of coronavirus disease 2019 (COVID-19) infection. This study was conducted to present the clinical characteristics, disease courses and short-term prognoses of Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induced AM in China, which has been unavailable so far.METHODS AND RESULTSData from 28 patients diagnosed with definite COVID-19-associated AM from 6 hospitals in China between 1 December 2022 and 30 June 2023 were collected and analysed. The diagnosis of AM was based on increased troponin level plus typical findings of AM on cardiac magnetic resonance (CMR) imaging and/or endomyocardial biopsy. Among 28 patients with definite COVID-19-related AM, median age was 37 years (Q1-Q3: 22-52) and 53.6% were men. Twenty-three patients occurred within 2 weeks of the onset of COVID-19 infection, 10 patients underwent endomyocardial biopsy and CMR was performed in all patients. Seven (25.0%) patients developed fulminant myocarditis that required inotropic agents or temporary mechanical circulatory support. Of the nine patients (32.1%) with left ventricular ejection fraction (LVEF) below 50% on admission, five had fully recovered LVEF and two demonstrated improvement but to levels below normal at discharge. The comparison of CMR parameters between the baseline and first follow-up showed that ECV was decreased at the first follow-up [28.95 (25.38, 32.55)% vs. 33.65 (31.58, 37.55)%, P = 0.028), while other CMR parameters had no significant changes. Eighteen patients (64.3%) were prescribed with corticosteroids, and seven patients (25.0%) underwent temporary mechanical circulatory support. Only two patients died during hospitalization.CONCLUSIONSThe majority of COVID-19-associated AM occurred within 2 weeks of Omicron variant infection. Fulminant myocarditis complicated by hemodynamic instability requiring temporary mechanical circulatory support was not uncommon. However, short-term outcome was generally good and most AM patients fully recovered.","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"16 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255934","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}