European Heart Journal Supplements最新文献

{"title":"Triggers, characteristics, and hospital outcome of patients with Takotsubo syndrome: 10 years experience in a large university hospital centre.","authors":"Karolina Polednikova,&nbsp;Martin Kozel,&nbsp;Hana Linkova,&nbsp;Marketa Novackova,&nbsp;Minh Duc Trinh,&nbsp;Petr Tousek","doi":"10.1093/eurheartjsupp/suad105","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suad105","url":null,"abstract":"<p><p>A unique clinical feature of Takotsubo syndrome (TTS) is the stress trigger factor. Different types of triggers exist, generally divided into emotional and physical stressor. The aim was to create long-term registry of all consecutive patients with TTS across all disciplines in our large university hospital. We enrolled patients on the basis of meeting the diagnostic criteria of the international InterTAK Registry. We aimed to determine type of triggers, clinical characteristics, and outcome of TTS patients during 10 years period. In our prospective, academic, single centre registry, we enrolled 155 consecutive patients with diagnoses of TTS between October 2013 and October 2022. The patients were divided into three groups, those having unknown (<i>n</i> = 32; 20.6%), emotional (<i>n</i> = 42; 27.1%), or physical (<i>n</i> = 81; 52.3%) triggers. Clinical characteristics, cardiac enzyme levels, echocardiographic findings, including ejection fraction, and TTS type did not differ among the groups. Chest pain was less common in the group of patients with a physical trigger. On the other hand, arrhythmogenic disorders such as prolonged QT intervals, cardiac arrest requiring defibrillation, and atrial fibrillation were more common among the TTS patients with unknown triggers compared with the other groups. The highest in-hospital mortality was observed between patients having physical trigger (16% vs. 3.1% in TTS with emotional trigger and 4.8% in TTS with unknown trigger; <i>P</i> = 0.060). <b>Conclusion:</b> More than half of the patients with TTS diagnosed in a large university hospital had a physical trigger as a stress factor. An essential part of caring for these types of patients is the correct identification of TTS in the context of severe other conditions and the absence of typical cardiac symptoms. Patients with physical trigger have a significantly higher risk of acute heart complications. Interdisciplinary cooperation is essential in the treatment of patients with this diagnosis.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"25 Suppl E","pages":"E10-E16"},"PeriodicalIF":1.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/d9/suad105.PMC10206857.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9897478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-hospital delay, clinical characteristics, angiographic findings, and in-hospital mortality in young and middle-aged adults with acute coronary syndrome: a single-centre registry analysis.","authors":"Dávid Bauer,&nbsp;Marek Neuberg,&nbsp;Markéta Nováčková,&nbsp;Viktor Kočka,&nbsp;Petr Toušek","doi":"10.1093/eurheartjsupp/suad102","DOIUrl":"10.1093/eurheartjsupp/suad102","url":null,"abstract":"<p><p>There are several differences between younger and older adults with acute coronary syndrome (ACS). However, few studies have evaluated these differences. We analysed the pre-hospital time interval [symptom onset to first medical contact (FMC)], clinical characteristics, angiographic findings, and in-hospital mortality in patients aged ≤50 (group A) and 51-65 (group B) years hospitalised for ACS. We retrospectively collected data from 2010 consecutive patients hospitalised with ACS between 1 October 2018 and 31 October 2021 from a single-centre ACS registry. Groups A and B included 182 and 498 patients, respectively. ST-segment elevation myocardial infarction (STEMI) was more common in group A than group B (62.6 and 45.6%, respectively; <i>P</i> < 0.001). The median time from symptom onset to FMC in STEMI patients did not significantly differ between groups A and B [74 (40-198) and 96 (40-249) min, respectively; <i>P</i> = 0.369]. There was no difference in the rate of sub-acute STEMI (symptom onset to FMC > 24 h) between groups A and B (10.4% and 9.0%, respectively; <i>P</i> = 0.579). Among patients with non-ST elevation acute coronary syndrome (NSTE-ACS), 41.8 and 50.2% of those in groups A and B, respectively, presented to the hospital within 24 h of symptom onset (<i>P</i> = 0.219). The prevalence of previous myocardial infarction was 19.2% in group A and 19.5% in group B (<i>P</i> = 1.00). Hypertension, diabetes, and peripheral arterial disease were more common in group B than group A. Active smoking was more common in group A than group B (67 and 54.2%, respectively; <i>P</i> = 0.021). Single-vessel disease was present in 52.2 and 37.1% of participants in groups A and B, respectively (<i>P</i> = 0.002). Proximal left anterior descending artery was more commonly the culprit lesion in group A compared with group B, irrespective of the ACS type (STEMI, 37.7 and 24.2%, respectively; <i>P</i> = 0.009; NSTE-ACS, 29.4 and 21%, respectively; <i>P</i> = 0.140). The hospital mortality rate for STEMI patients was 1.8 and 4.4% in groups A and B, respectively (<i>P</i> = 0.210), while for NSTE-ACS patients it was 2.9 and 2.6% in groups A and B, respectively (<i>P</i> = 0.873). No significant differences in pre-hospital delay were found between young (≤50 years) and middle-aged (51-65 years) patients with ACS. Although clinical characteristics and angiographic findings differ between young and middle-aged patients with ACS, the in-hospital mortality rate did not differ between the groups and was low for both of them.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"25 Suppl E","pages":"E33-E39"},"PeriodicalIF":1.6,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ec/5f/suad102.PMC10206810.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9527081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of interdisciplinary research.","authors":"Petr Widimsky, Ivana Stetkarova, Petr Tousek","doi":"10.1093/eurheartjsupp/suad108","DOIUrl":"10.1093/eurheartjsupp/suad108","url":null,"abstract":"","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"25 Suppl E","pages":"E1-E2"},"PeriodicalIF":1.7,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/64/suad108.PMC10207137.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9897480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ANMCO position paper: guide to the appropriate use of the wearable cardioverter defibrillator in clinical practice for patients at high transient risk of sudden cardiac death.","authors":"Giancarlo Casolo, Michele Massimo Gulizia, Daniela Aschieri, Alessandra Chinaglia, Marco Corda, Daniele Nassiacos, Salvatore Ivan Caico, Cristina Chimenti, Marzia Giaccardi, Enrico Gotti, Stefano Maffé, Roberta Magnano, Gianluca Solarino, Domenico Gabrielli, Fabrizio Oliva, Furio Colivicchi","doi":"10.1093/eurheartjsupp/suad101","DOIUrl":"10.1093/eurheartjsupp/suad101","url":null,"abstract":"<p><p>Extended risk stratification and optimal management of patients with a permanently increased risk of sudden cardiac death (SCD) are becoming increasingly important. There are several clinical conditions where the risk of arrhythmic death is present albeit only transient. As an example, patients with depressed left ventricular function have a high risk of SCD that may be only transient if there will be a significant recovery of function. It is important to protect the patients while receiving and titrating to the optimal dose the recommended drugs that may lead to an improved left ventricular function. In several other conditions, a transient risk of SCD can be observed even if the left ventricular function is not compromised. Examples are patients with acute myocarditis, during the diagnostic work-up of some arrhythmic conditions or after extraction of infected catheters while eradicating the associated infection. In all these conditions, it is important to offer a protection to these patients. The wearable cardioverter defibrillator (WCD) is of particular importance as a temporary non-invasive technology for both arrhythmia monitoring and therapy in patients with increased risk of SCD. Previous studies have shown the WCD to be an effective and safe therapy for the prevention of SCD caused by ventricular tachycardia/fibrillation. The aim of this ANMCO position paper is to provide a recommendation for clinical utilization of the WCD in Italy, based upon current data and international guidelines. In this document, we will review the WCD functionality, indications, clinical evidence, and guideline recommendations. Finally, a recommendation for the utilization of the WCD in routine clinical practice will be presented, in order to provide physicians with a practical guidance for SCD risk stratification in patients who may benefit from this device.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"25 Suppl D","pages":"D294-D311"},"PeriodicalIF":1.7,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/31/suad101.PMC10194821.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9502799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spotlight on Italian Association of Hospital Cardiologists (ANMCO) activity in the 2-year period 2021-2023.","authors":"Stefania Angela Di Fusco, Furio Colivicchi","doi":"10.1093/eurheartjsupp/suad112","DOIUrl":"10.1093/eurheartjsupp/suad112","url":null,"abstract":"","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"25 Suppl D","pages":"D251-D254"},"PeriodicalIF":1.7,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/36/suad112.PMC10194820.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9508050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Italian Association of Hospital Cardiologists practical guidance for sodium-glucose cotransporter 2 inhibitors use in patients with heart failure.","authors":"Stefania Angela Di Fusco, Antonella Spinelli, Stefano Aquilani, Nunzia Borrelli, Gianmarco Iannopollo, Michele Massimo Gulizia, Domenico Gabrielli, Fabrizio Oliva, Furio Colivicchi","doi":"10.1093/eurheartjsupp/suad107","DOIUrl":"10.1093/eurheartjsupp/suad107","url":null,"abstract":"<p><p>Sodium-glucose cotransporter 2 inhibitors (SGLT2-is) have recently been included among the first-line drugs for the treatment of heart failure with reduced ejection fraction. International guidelines recommend SGLT2-i use in association with neuro-hormonal modulators (renin-angiotensin blockers, beta blockers, and aldosterone antagonists). Although SGLT2-is are well tolerated, it is important to know potential side effects and conditions that may lead to an increased risk of adverse events in order to maximize clinical benefits. The aim of this Italian Association of Hospital Cardiologists document is to briefly report clinical evidence that supports SGLT2-i use in patients with heart failure and provide practical indications for clinical implementation.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"25 Suppl D","pages":"D287-D293"},"PeriodicalIF":1.7,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/30/suad107.PMC10194818.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9502795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ANMCO position paper on vericiguat use in heart failure: from evidence to place in therapy.","authors":"Stefania Angela Di Fusco, Alessandro Alonzo, Alberto Aimo, Andrea Matteucci, Rita Cristina Myriam Intravaia, Stefano Aquilani, Manlio Cipriani, Leonardo De Luca, Alessandro Navazio, Serafina Valente, Michele Massimo Gulizia, Domenico Gabrielli, Fabrizio Oliva, Furio Colivicchi","doi":"10.1093/eurheartjsupp/suad106","DOIUrl":"10.1093/eurheartjsupp/suad106","url":null,"abstract":"<p><p>In the growing therapeutic armamentarium for heart failure (HF) management, vericiguat represents an innovative therapeutic option. The biological target of this drug is different from that of other drugs for HF. Indeed, vericiguat does not inhibit neuro-hormonal systems overactivated in HF or sodium-glucose co-transporter 2 but stimulates the biological pathway of nitric oxide and cyclic guanosine monophosphate, which is impaired in patients with HF. Vericiguat has recently been approved by international and national regulatory authorities for the treatment of patients with HF and reduced ejection fraction who are symptomatic despite optimal medical therapy and have worsening HF. This ANMCO position paper summarises key aspects of vericiguat mechanism of action and provides a review of available clinical evidence. Furthermore, this document reports use indications based on international guideline recommendations and local regulatory authority approval at the time of writing.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"25 Suppl D","pages":"D278-D286"},"PeriodicalIF":1.7,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2e/44/suad106.PMC10194817.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9502801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bempedoic acid: what prospective uses?","authors":"Ilaria Jacomelli,&nbsp;Luca Monzo,&nbsp;Germana Panattoni,&nbsp;Chiara Lanzillo,&nbsp;Marco Rebecchi,&nbsp;Leonardo Calò","doi":"10.1093/eurheartjsupp/suad012","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suad012","url":null,"abstract":"<p><p>There is still the need to lower LDL-c, although the use of statins, ezetimibe and proprotein convertase subtilisin/kexin type 9. Patients with atherosclerotic cardiovascular disease and/or familial hypercholesterolaemia are treated with statins at maximum tolerated dose, with or without further lipid-lowering drugs, but very often, we can't reach the goal, so bempedoic acid treatment lead to a significant reduction in low-density lipoprotein cholesterol, in different groups of patients, with a favourable safety profile.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"25 Suppl C","pages":"C109-C111"},"PeriodicalIF":1.6,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6a/1e/suad012.PMC10132602.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9450983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of interventional imaging in structural heart disease.","authors":"Eustachio Agricola,&nbsp;Giacomo Ingallina,&nbsp;Francesco Ancona,&nbsp;Federico Biondi,&nbsp;Davide Margonato,&nbsp;Monica Barki,&nbsp;Annamaria Tavernese,&nbsp;Martina Belli,&nbsp;Stefano Stella","doi":"10.1093/eurheartjsupp/suad044","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suad044","url":null,"abstract":"<p><p>Treatments for structural heart diseases (SHD) have been considerably evolved by the widespread of transcatheter approach in the last decades. The progression of transcatheter treatments for SHD was feasible due to the improvement of devices and the advances in imaging techniques. In this setting, the cardiovascular imaging is pivotal not only for the diagnosis but even for the treatment of SHD. With the aim of fulfilling these tasks, a multimodality imaging approach with new imaging tools for pre-procedural planning, intra-procedural guidance, and follow-up of SHD was developed. This review will describe the current state-of-the-art imaging techniques for the most common percutaneous interventions as well as the new imaging tools. The imaging approaches will be addressed describing the use in pre-procedural planning, intra-procedural guidance, and follow-up.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"25 Suppl C","pages":"C189-C199"},"PeriodicalIF":1.6,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6e/64/suad044.PMC10132629.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9450988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P272 ROLE OF 3D TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN DIANOSIS OF DYSFUNCTION OF MECHANICAL PROSTHESES","authors":"V. Scollo, G. Fede, G. Abate, P. Belluardo, N. Guccione, G. Sulsenti, S. Ficili","doi":"10.1093/eurheartjsupp/suad111.346","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suad111.346","url":null,"abstract":"\u0000 Infections with endocardial vegetation or the exuberant growth of neoendothelialization tissue (cloth –tissue overgrowth) in heart valve prostheses lead, among other complications, to the malfunction of the prostheses themselves due to obstruction. Among the diagnostic methods available to us, to achieve the diagnosis of prosthetic dysfunction, in recent years three–dimensional transesophageal echocardiography (3D TTE) has become increasingly imposed. We present two clinical cases of patients admitted to our Cardiology department Case 1: Patient of 62 years old, hospitalized for established congestive heart failure. In 2006 he underwent ascending aorta replacement with Dacron 28 prosthesis and aortic valve replacement with mechanical prosthesis (Sorin 25) for aortic bicuspid and ascending aortic aneurysm. During the last follow–up was observed a slight increase in the value of intraprosthetic gradients, as well as a variability in INR values. Physical examination showed signs of heart failure (NT–ProBNP >1000 pg/ml); normal inflammation indices (PCR <2.9 mg/l); ECG: sinus rhythm at 85 bpm with left ventricular overload; trans–thoracic echocardiography showed severe intraprosthetic aortic gradient (Gmax 132mmHg–Gmed 72mmHg), doubtful for cloth adhered to prosthetic discs; 3D TTE shoved hyperechoreflective image adhered to the posterior mobile element (5x9mm) which was fixed in semi–closure. Subsequently, the patient underwent prosthetic replacement surgery with biological prosthesis. Case 2: Patient of 67 years old, heavy smoker, hypertensive, with aortic mechanical prosthesis, a few weeks before hospitalized for Corynebacterium Jeikeium infection. Hospitalized again for fever with increased inflammation indices (CRP 202mg/l). A first TTE concluded for suspected endocarditis of the prosthesis; this doubt was also dissolved by 3D TTE which showed a soft protruding image of the posterior mobile element, preventing the opening and determining severe stenosis (Gmax 160mmHg–Gmed of 80 mmHg), so this patients was transferred to the cardiac surgery department.\u0000 \u0000 \u0000 3D TTE is a method of rapid and safe execution that can be exploited not only pre– or intraoperatively but also to settle diagnostic suspicions not clarified by traditional 2d methods, even managing to distinguish cloth deposits from vegetation / abscesses.\u0000","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"51 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90281794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}