European Heart Journal Supplements最新文献

{"title":"Left atrial appendage occlusion: behind the bleeding risk.","authors":"Giovanni Lorenzoni, Pierluigi Merella, Gavino Casu","doi":"10.1093/eurheartjsupp/suae094","DOIUrl":"10.1093/eurheartjsupp/suae094","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is the most common arrhythmia in adults and is associated with an increased risk of embolic stroke. The main prevention strategy for cerebral embolic events is based on the use of oral anticoagulant therapy (OAT). Left atrial appendage occlusion (LAAO) has demonstrated non-inferiority to OAT in clinical trials for prevention of stroke in non-valvular atrial fibrillation (NVAF). Patients with NVAF may still suffer ischemic strokes despite receiving adequate OAT.The physiopathological substrate remains unclear and only few theories can be proposed to explain the phenomenon and the approach to secondary prevention in these 'resistant strokes' remains largely empirical.Several therapeutic strategies have been proposed. Among these, LAAO should be taken into consideration. The procedure requires special planning in well selected patients, but can be performed successfully in most cases.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"27 Suppl 1","pages":"i12-i15"},"PeriodicalIF":1.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467426","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 clinical and pharmacoeconomic impact of established and novel heart failure therapies.","authors":"Mauro Acquaro, Annalisa Turco, Leonardo De Luca","doi":"10.1093/eurheartjsupp/suae118","DOIUrl":"10.1093/eurheartjsupp/suae118","url":null,"abstract":"<p><p>Chronic heart failure (HF) is a prevalent condition associated with significant morbidity, mortality, and economic burden worldwide. The pharmacological management of HF has evolved over time with various drug classes demonstrating efficacy in improving patient outcomes. This review examines the pharmacoeconomic aspects of these therapies, including common and newer HF therapies as angiotensin receptor-neprilysin inhibitors, sodium-glucose co-transporter-2 inhibitors, iron supplementation, and vericiguat, a novel soluble guanylate cyclase stimulator. By analysing cost-effectiveness studies and their implications on healthcare resource utilization, this paper aims to inform clinicians and policymakers on HF management optimization from both clinical and economic perspectives.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"27 Suppl 1","pages":"i132-i136"},"PeriodicalIF":1.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467315","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 era of interventional imaging has arrived: what role for computed tomography and magnetic resonance?","authors":"Saima Mushtaq, Fabio Fazzari, Maria Elisabetta Mancini, Gianluca Pontone","doi":"10.1093/eurheartjsupp/suae112","DOIUrl":"10.1093/eurheartjsupp/suae112","url":null,"abstract":"<p><p>Coronary computed tomography angiography (CCTA) is the first-line investigation test to 'rule out' significant coronary artery disease in low-risk patients. By performing blood flow simulations using computational fluid dynamics, it is possible to derive fractional flow reserve (FFR) from CCTA (FFRCT) images. Coronary computed tomography angiography and FFRCT are now utilized in higher-risk patients to choose the revascularization mode. Furthermore, new applications of CCTA and FFRCT include a planning tool for percutaneous coronary intervention (PCI), which allows the cardiologist to assess lesion-specific ischaemia, plan stent locations and sizes, and use virtual remodelling of the lumen (virtual stenting) to assess the functional impact of PCI. Moreover, CCTA can assist in planning surgical and percutaneous revascularization by determining the disease complexity, vessel size, lesion length, and tissue composition of the atherosclerotic plaque, as well as the best fluoroscopic viewing angle; it may also help in selecting adjunctive percutaneous devices (e.g. rotational atherectomy) and in determining the best landing zone for stents or bypass grafts. Coronary computed tomography angiography has become also the gold standard for pre-procedural annular assessment, device sizing, risk determination of annular injury, coronary occlusion or left ventricular outflow tract obstruction, calcification visualization and quantification of the target structure, and prediction of a co-planar fluoroscopic angulation for transcatheter interventions in patients with structural heart disease. Coronary computed tomography angiography and cardiac magnetic resonance could be used also in electrophysiology procedures of atrial fibrillation and ventricular arrhythmias ablation (imaging during clinical evaluation and pre-procedural evaluation and intra-procedural live integration). The era of interventional imaging has arrived, and it is based on the cooperation of different figures with specific competences (cardio-imagers, electrophysiologists, cardiac surgeons, and invasive cardiologists).</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"27 Suppl 1","pages":"i22-i26"},"PeriodicalIF":1.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467338","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":"From thick walls to clear answers: approaches to diagnosing hypertrophic cardiomyopathy and its mimics.","authors":"Filippo Angelini, Pier Paolo Bocchino, Veronica Dusi, Stefano Pidello, Gaetano Maria De Ferrari, Claudia Raineri","doi":"10.1093/eurheartjsupp/suae099","DOIUrl":"10.1093/eurheartjsupp/suae099","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy (HCM) is a genetic condition primarily caused by mutations in sarcomeric proteins, leading to abnormal thickening of the left ventricular wall. Although HCM is the most common genetic cardiovascular disorder, other conditions-such as cardiac amyloidosis, Fabry disease, and mitochondrial myopathies-can mimic its phenotype, complicating diagnosis. Accurate differentiation between HCM and its phenocopies is crucial, as these conditions differ in treatment, prognosis, and inheritance. This paper reviews the clinical, imaging, and laboratory tools essential for diagnosing HCM and its mimics, emphasizing the role of advanced diagnostics like cardiac magnetic resonance, genetic testing, and tissue characterization in guiding personalized management strategies.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"27 Suppl 1","pages":"i40-i46"},"PeriodicalIF":1.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467360","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":"Oral semaglutide: an innovative paradigm in the management of cardiovascular risk in patients with Type 2 diabetes.","authors":"Pier Luigi Temporelli","doi":"10.1093/eurheartjsupp/suae086","DOIUrl":"10.1093/eurheartjsupp/suae086","url":null,"abstract":"<p><p>Cardiovascular (CV) diseases (CVDs) remain a leading global health issue, causing about one-third of all deaths worldwide. Among modifiable CV risk factors (systolic blood pressure, non-HDL cholesterol, diabetes, body mass index, and smoking), diabetes is a leading one, accounting for established CVDs in 34.8% of diabetic patients, with an increasing prevalence of disease. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), like exenatide, liraglutide, albiglutide, dulaglutide, and semaglutide, initially developed for treatment of Type 2 diabetes, have shown CV benefits, and international guidelines recommend now GLP-1 RAs as preferred drugs for CV prevention in diabetic patients regardless of baseline HbA1c or metformin use. Among GLP-1 RAs, subcutaneous semaglutide has demonstrated cardio-metabolic risk factors reduction and efficacy in CV prevention. Development of oral semaglutide represents the evolution of the molecule. The PIONEER study programme confirmed the efficacy of oral semaglutide in reducing HbA1c, body weight, and cardio-metabolic risk factors as well as CV safety. Notably, independently by route of administration, semaglutide showed early CV benefits, suggesting mechanisms beyond glycaemic control or weight reduction. Semaglutide, combining potent cardio-metabolic effects with oral route, emerges as a pivotal treatment for high-risk Type 2 diabetes patients, offering comprehensive CV protection independent of HbA1c levels.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"27 Suppl 1","pages":"i1-i5"},"PeriodicalIF":1.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466637","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":"Remote monitoring and heart failure.","authors":"Nicola Pierucci, Domenico Laviola, Marco Valerio Mariani, Alessio Nardini, Francesco Adamo, Karim Mahfouz, Carlo Colaiaco, Fabrizio Ammirati, Luca Santini, Carlo Lavalle","doi":"10.1093/eurheartjsupp/suae116","DOIUrl":"10.1093/eurheartjsupp/suae116","url":null,"abstract":"<p><p>Heart failure (HF) represents one of the leading causes of morbidity and mortality worldwide. In recent years, remote monitoring (RM) and telemedicine have emerged as a promising strategy to improve the management of patients with HF, reducing hospitalizations and enhancing the quality of life. Through the integration of technologies such as implantable sensors, home monitoring devices, and mobile applications, it is possible to detect clinical changes early, enabling timely interventions. This article provides an overview of available technologies for RM in HF, analyses the clinical benefits observed in various studies, and addresses the remaining challenges, such as the need for standardization, long-term sustainability, and widespread adoption. Remote monitoring offers significant potential to improve clinical outcomes but requires further research and development to optimize its use in clinical practice.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"27 Suppl 1","pages":"i126-i131"},"PeriodicalIF":1.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467148","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":"Endocardial gaglionated plexi ablation in different vagally-mediated clinical settings: From cardioneuroablation to cardio-neuromodulation.","authors":"Marco Rebecchi, Ermenegildo De Ruvo, Antonella Sette, Domenico Grieco, Lucia De Luca, Stefano Strano, Marco Tomaino, Domenico Giamundo, Stefano Sasso, Chiara Carabotta, Pietro Desimone, Alessandro Fagagnini, Cinzia Crescenzi, Annamaria Martino, Germana Panattoni, Fabiana Romeo, Marianna Sgueglia, Francesco Barillà, Michele Brignole, Leonardo Calò","doi":"10.1093/eurheartjsupp/suae109","DOIUrl":"10.1093/eurheartjsupp/suae109","url":null,"abstract":"<p><p>Cardioneuroablation (CNA) is now recognized as a safe and effective method in patients with cardioinhibitory neurocardiogenic syncope (CNCS), especially in young patients in order to avoid or prolong, as much as possible, the timing of definitive cardiac pacing. Several investigations have shown beneficial and very satisfactory results with a standard non-extensive endocardial ablation, aimed at identifying high-amplitude fragmented signals in the right and left atria. Despite this, the current scientific debate is focused about a proposal on an ablative method, even more individualized than CNA (at least as a first approach), considering that a standardized approach, especially in the left atrium, could expose CNCS patients with a good prognosis to an excessive risk of complications. These findings, moving from the concept of CNA to a new concept of 'cardioneuromodulation', opened a new era, aimed at a non-extensive and individualized treatment of different clinical CNCS scenarios or vagally-mediated atrioventricular block or sinus-atrial node dysfunction.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"27 Suppl 1","pages":"i171-i176"},"PeriodicalIF":1.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467359","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":"Over 10 years of non-vitamin K antagonist oral anticoagulants: highlights, challenges, and future developments.","authors":"Raffaele De Caterina, Simona Chiusolo","doi":"10.1093/eurheartjsupp/suae087","DOIUrl":"10.1093/eurheartjsupp/suae087","url":null,"abstract":"<p><p>Over the past decade, non-vitamin K antagonist oral anticoagulants have revolutionized anticoagulation therapy, offering substantial benefits over traditional vitamin K antagonists. Non-vitamin K antagonist oral anticoagulants offer reduced bleeding risks, fixed dosing without frequent monitoring, and fewer drug and dietary interactions. Their effectiveness has been demonstrated in preventing stroke in atrial fibrillation, managing venous thromboembolism, and offering new options for patients with coronary artery disease and cancer-associated thrombosis. However, challenges remain, including bleeding risks, high costs, and limited efficacy in certain patient populations. Current research is focused on addressing these limitations, with Factor XI inhibitors emerging as a promising advancement for safer anticoagulation. This review provides an overview of the clinical highlights, challenges, and future directions of anticoagulation therapy.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"27 Suppl 1","pages":"i6-i11"},"PeriodicalIF":1.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467109","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":"Pacing of the specialized His Purkinje conduction system: 'HOW and FOR WHOM'.","authors":"Emanuele Chiarazzo, Paolo Golia, Edoardo Bressi, Domenico Grieco, Ermenegildo De Ruvo, Leonardo Calò","doi":"10.1093/eurheartjsupp/suae113","DOIUrl":"10.1093/eurheartjsupp/suae113","url":null,"abstract":"<p><p>The human heart's conduction system consists of specialized cardiomyocytes that generate and transmit electrical impulses, leading to the rhythmic and synchronized contraction of the atria and ventricles, which is crucial for the normal cardiac cycle. In conduction system pacing (CSP), pacing leads are placed in the His bundle region and the left bundle branch area to achieve physiological cardiac activation. This method offers a more natural alternative to the myocardial stimulation provided by conventional right ventricular pacing and biventricular pacing. In this review, we describe the implantation techniques for CSP and discuss the current recommendations for their use.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"27 Suppl 1","pages":"i141-i148"},"PeriodicalIF":1.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467139","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 role of antiarrhythmic drugs and stellate ganglion block in the acute management of electrical storm.","authors":"Veronica Dusi, Filippo Angelini, Carol Gravinese, Simone Frea, Gaetano Maria De Ferrari","doi":"10.1093/eurheartjsupp/suae084","DOIUrl":"10.1093/eurheartjsupp/suae084","url":null,"abstract":"<p><p>Electrical storm (ES) is a life-threatening condition characterized by at least three separate episodes of ventricular arrhythmia (VAs) over 24 h, each one requiring intervention. Early recognition and prompt treatment are crucial to improving outcomes. In addition to identifying and correcting potential reversible causes, performing acute cardiac life support if required, and interrogating/reprogramming the implantable cardioverter defibrillator in present, the acute management of ES (within 12-24 h upon presentation) nowadays mostly relies on antiarrhythmic drugs and percutaneous left ganglion sympathetic block (PLSGB), that will be the focus of the present review. The choice of the drug should consider several factors, including the aetiology and mechanism of VAs, the underlying cardiac function, and the potential risk of adverse events. Intravenous amiodarone, the most used and recommended drug in the setting of high burden VAs and structural heart disorders, mostly exerts dose and rate infusion dependent antiadrenergic effects in the first hours, and may lead to severe hypotension. PLSGB has an excellent safety-efficacy profile and can be easily performed by trained cardiologists at bedside.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"27 Suppl 1","pages":"i154-i161"},"PeriodicalIF":1.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467279","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}