European Heart Journal Supplements最新文献_第4页

Vasovagal syncope: the role of 24 h ambulatory blood pressure monitoring. 血管迷走神经性晕厥：24小时动态血压监测的作用。

IF 2.7 4区医学

European Heart Journal Supplements Pub Date : 2026-03-11 eCollection Date: 2026-05-01 DOI: 10.1093/eurheartjsupp/suag025

Michele Brignole, Giulia Rivasi

{"title":"Vasovagal syncope: the role of 24 h ambulatory blood pressure monitoring.","authors":"Michele Brignole, Giulia Rivasi","doi":"10.1093/eurheartjsupp/suag025","DOIUrl":"10.1093/eurheartjsupp/suag025","url":null,"abstract":"The haemodynamic mechanisms underlying vasovagal (reflex) syncope include hypotension and extrinsic asystole/bradycardia, corresponding to two distinct haemodynamic phenotypes of syncope, that is, the hypotensive and the bradycardic phenotypes. The hypotensive phenotype is the most prevalent, being observed in the 83% of patients. Twenty-four hours ambulatory blood pressure monitoring (ABPM) demonstrated high effectiveness in identifying the hypotensive phenotype in patients with suspected reflex syncope. The diagnosis of a hypotensive mechanism of syncope is supported by ABPM when one or more of the following criteria are present:. Constitutional hypotension: 24-h systolic blood pressure (SBP) < 105 mmHg in men and <98 in women. Drug-related hypotension: 24-h SBP <120 mmHg. Hypotensive episodes: ≥1 daytime SBP <90 mmHg or ≥2 daytime SBP <100 mmHg. Postprandial hypotension: symptomatic SBP fall >20 mmHg or absolute value <90 mmHg within 75 min of meals. ABPM also plays a key role in guiding therapy. In hypertensive patients with hypotensive syncope, deprescribing antihypertensive medications is indicated with the goal of increasing 24-h average SBP to ≥ 134 mmHg and/or by at least ≥12 mmHg, without exceeding 140 mmHg (or <160 mmHg in frail older patients). In patients with drug-unrelated hypotension, lower-body elastic garments, fludrocortisone, or midodrine-prescribed singularly or in combination-may be considered and targeted to achieve a 24-h average SBP ≥116 mmHg and/or an increase of at least ≥9 mmHg.","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"28 Suppl 5","pages":"v48-v51"},"PeriodicalIF":2.7,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835334","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}

引用次数: 0

The ODYSSEY-HCM and MAPLE-HCM studies: the role of cardiac myosin inhibitors in hypertrophic cardiomyopathy (obstructive and non-obstructive). ODYSSEY-HCM和MAPLE-HCM研究：心肌球蛋白抑制剂在肥厚性心肌病（阻塞性和非阻塞性）中的作用。

IF 2.7 4区医学

European Heart Journal Supplements Pub Date : 2026-03-11 eCollection Date: 2026-05-01 DOI: 10.1093/eurheartjsupp/suag022

Elena Biagini, Maria Alessandra Schiavo

{"title":"The ODYSSEY-HCM and MAPLE-HCM studies: the role of cardiac myosin inhibitors in hypertrophic cardiomyopathy (obstructive and non-obstructive).","authors":"Elena Biagini, Maria Alessandra Schiavo","doi":"10.1093/eurheartjsupp/suag022","DOIUrl":"10.1093/eurheartjsupp/suag022","url":null,"abstract":"Hypertrophic cardiomyopathy (HCM) is an inherited heart disease characterized by unexplained left ventricular hypertrophy with or without outflow tract obstruction. Conventional therapies may relieve symptoms associated with left ventricular outflow tract (LVOT) obstruction; however, they do not act directly on the contractile cell, and refractory patients may require septal reduction therapy. Allosteric cardiac myosin inhibitors (CMIs) represent a novel therapeutic approach directly targeting sarcomeric hypercontractility. Mavacamten and aficamten have demonstrated significant clinical and haemodynamic benefits in obstructive HCM (oHCM). The MAPLE-HCM trial revealed that aficamten significantly improved peak oxygen uptake, NYHA functional class, quality of life, and reduced LVOT gradients compared with metoprolol, with a favourable safety profile. Encouraged by these findings, CMIs have been investigated in non-obstructive HCM (nHCM). The ODYSSEY-HCM trial evaluated mavacamten in patients with symptomatic nHCM. While the primary endpoints of exercise capacity and patient-reported health status were not met, secondary analyses showed favourable effects on NT-proBNP, high-sensitivity troponin I, left ventricular diastolic function, and hypertrophy parameters. In conclusion, CMIs offer substantial benefits in oHCM, improving symptoms and cardiac haemodynamics. In nHCM, despite limited impact on functional capacity, CMIs demonstrate biological activity and favourable cardiac remodelling, supporting further research into their potential role in modulating disease pathophysiology.","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"28 Suppl 5","pages":"v18-v21"},"PeriodicalIF":2.7,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835083","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}

引用次数: 0

PCSK9 inhibitors conquer primary prevention: the VESALIUS-CV study. PCSK9抑制剂征服一级预防：VESALIUS-CV研究

IF 2.7 4区医学

European Heart Journal Supplements Pub Date : 2026-03-11 eCollection Date: 2026-05-01 DOI: 10.1093/eurheartjsupp/suag032

Laura Gatto, Maria Pia Di Bitonto, Lorenzo Scalia, Flavio Giuseppe Biccirè, Francesco Prati

{"title":"PCSK9 inhibitors conquer primary prevention: the VESALIUS-CV study.","authors":"Laura Gatto, Maria Pia Di Bitonto, Lorenzo Scalia, Flavio Giuseppe Biccirè, Francesco Prati","doi":"10.1093/eurheartjsupp/suag032","DOIUrl":"10.1093/eurheartjsupp/suag032","url":null,"abstract":"Elevated low-density lipoprotein cholesterol (LDL-C) represents a key causal factor in atherosclerotic cardiovascular disease. Robust evidence demonstrates that early, marked, and sustained reduction of LDL-C is associated with a significant decrease in the risk of major adverse cardiovascular events. However, a substantial proportion of high-risk patients fail to achieve guideline-recommended LDL-C targets with statin therapy alone, thus requiring additional lipid-lowering treatments. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, particularly the monoclonal antibodies evolocumab and alirocumab, have been shown to reduce LDL-C levels by ∼60% and to provide clear cardiovascular outcome benefits in secondary prevention. More recently, the VESALIUS-CV trial extended these findings to the setting of primary prevention in high cardiovascular risk patients without prior major cardiovascular events. In this trial, evolocumab achieved a significant and sustained reduction in LDL-C levels and significantly reduced the risk of a first cardiovascular event, including myocardial infarction and ischaemia-driven revascularization, while maintaining a safety profile comparable to placebo. Overall, the available evidence supports the role of evolocumab as an effective and safe strategy for cardiovascular risk reduction across the entire risk continuum, from secondary to primary prevention, underscoring the importance of a personalized therapeutic approach based on the patient's global cardiovascular risk profile.","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"28 Suppl 5","pages":"v111-v115"},"PeriodicalIF":2.7,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835356","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}

引用次数: 0

The comeback of digitalis (digitoxin): the DIGIT-HF trial. 洋地黄（地黄毒素）的回归：DIGIT-HF试验。

IF 2.7 4区医学

European Heart Journal Supplements Pub Date : 2026-03-11 eCollection Date: 2026-05-01 DOI: 10.1093/eurheartjsupp/suag031

Edoardo Sciatti, Emilia D'Elia, Mauro Gori, Luca Fazzini, Salvatore D'Isa, Luca Antonio Felice Di Odoardo, Ottavio Zucchetti, Attilio Iacovoni, Michele Senni, Antonello Gavazzi

{"title":"The comeback of digitalis (digitoxin): the DIGIT-HF trial.","authors":"Edoardo Sciatti, Emilia D'Elia, Mauro Gori, Luca Fazzini, Salvatore D'Isa, Luca Antonio Felice Di Odoardo, Ottavio Zucchetti, Attilio Iacovoni, Michele Senni, Antonello Gavazzi","doi":"10.1093/eurheartjsupp/suag031","DOIUrl":"10.1093/eurheartjsupp/suag031","url":null,"abstract":"Cardiac glycosides represent one of the oldest therapeutic pillars in medicine, although their role has progressively diminished in the modern era of neurohormonal therapy for heart failure (HF). Following publication of the Digitalis Investigation Group (DIG) trial in 1997, no randomized clinical trials evaluating this drug class were conducted for almost three decades, while observational studies and meta-analyses accumulated, often yielding conflicting results. The DIGIT-HF randomized clinical trial (2025) addressed a major unmet need by evaluating digitoxin in patients with HF with reduced ejection fraction in the contemporary era of guideline-directed medical therapy. Treatment with digitoxin was associated with favourable outcomes, including a reduction in the composite endpoint of all-cause mortality and hospitalizations for HF, thereby reopening a long-standing debate on the role of digitalis, which had remained marginal for many years. This article reviews the history of digitalis, the main evidence generated over recent decades, the evolution of clinical guidelines from 1997 to 2022, and the conceptual and clinical implications of the DIGIT-HF trial.","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"28 Suppl 5","pages":"v116-v121"},"PeriodicalIF":2.7,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835056","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}

引用次数: 0

Applications of coronary computed tomography angiography: a clinical cardiologist's point of view. 冠状动脉计算机断层造影的应用：临床心脏病专家的观点。

IF 2.7 4区医学

European Heart Journal Supplements Pub Date : 2026-03-11 eCollection Date: 2026-05-01 DOI: 10.1093/eurheartjsupp/suag030

Leonardo Bolognese, Marco Chioccioli, Matteo Rocco Reccia

引用次数: 0

New frontiers in the treatment of hypercholesterolaemia: oral inhibition of PCSK9. 治疗高胆固醇血症的新领域：口服抑制PCSK9。

IF 2.7 4区医学

European Heart Journal Supplements Pub Date : 2026-03-11 eCollection Date: 2026-05-01 DOI: 10.1093/eurheartjsupp/suag035

Lorenzo Arnaboldi, Zixiong Tang, Nicola Ferri, Alberto Corsini

{"title":"New frontiers in the treatment of hypercholesterolaemia: oral inhibition of PCSK9.","authors":"Lorenzo Arnaboldi, Zixiong Tang, Nicola Ferri, Alberto Corsini","doi":"10.1093/eurheartjsupp/suag035","DOIUrl":"10.1093/eurheartjsupp/suag035","url":null,"abstract":"PCSK9 inhibitors represent a cornerstone of lipid-lowering therapy; however, the need for cost containment and simplified routes of administration has stimulated the development of oral small molecules and peptidomimetics capable of modulating or blocking the PCSK9-LDL receptor (LDL-R) interaction, inhibiting PCSK9 mRNA transcription, or preventing lysosomal degradation of the LDL-R. Agents in advanced development include enlicitide (MK-0616) and laroprovstat (AZD0780), while DC371739, NNC0385-0434 (development currently suspended), and CVI-LM001 should also be considered. Enlicitide decanoate, owing to improved intestinal permeability, significantly reduces free PCSK9 (>90%) and LDL-cholesterol (C) (≈60%) in Phase I-II studies, with excellent tolerability. Phase III trials (CORALreef-Lipids and CORALreef-HeFH) have confirmed LDL-C reductions of 55-60%, along with favourable effects on non-HDL-C, apolipoprotein B (apoB), and Lipoprotein(a) Lp(a), comparable to those achieved with monoclonal antibodies. AZD0780 demonstrates dose-dependent reductions in LDL-C (up to 50%) and potential synergism with rosuvastatin, whereas NNC0385-0434-despite documenting significant decreases in LDL-C and Lp(a)-has been discontinued. DC371739 (a dual PCSK9/ANGPTL3 inhibitor) and CVI-LM001 (a transcriptional modulator) may represent additional therapeutic perspectives. Overall, oral PCSK9 inhibitors show consistent efficacy and favourable safety profiles, positioning them as next-generation lipid-lowering therapies, pending cardiovascular outcome data from ongoing studies.","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"28 Suppl 5","pages":"v95-v99"},"PeriodicalIF":2.7,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835371","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}

引用次数: 0

Worsening tricuspid regurgitation following a successful mitral valve procedure: how to manage. 二尖瓣手术成功后三尖瓣返流恶化：如何处理。

IF 2.7 4区医学

European Heart Journal Supplements Pub Date : 2026-03-11 eCollection Date: 2026-05-01 DOI: 10.1093/eurheartjsupp/suag046

Francesco Maisano, Marco Metra

引用次数: 0

Tirzepatide and semaglutide: different twins? 替西帕肽和西马鲁肽：不同的双胞胎？

IF 2.7 4区医学

European Heart Journal Supplements Pub Date : 2026-03-11 eCollection Date: 2026-05-01 DOI: 10.1093/eurheartjsupp/suag028

Arturo Cesaro, Vincenzo Acerbo, Paolo Calabrò

{"title":"Tirzepatide and semaglutide: different twins?","authors":"Arturo Cesaro, Vincenzo Acerbo, Paolo Calabrò","doi":"10.1093/eurheartjsupp/suag028","DOIUrl":"10.1093/eurheartjsupp/suag028","url":null,"abstract":"Incretin-based therapies currently represent one of the cornerstones in the management of type 2 diabetes mellitus and obesity, owing to their ability to integratively modulate cardiometabolic risk. Semaglutide, a selective agonist of the glucagon-like peptide-1 (GLP-1) receptor, has consolidated its clinical role through an efficacy profile that combines marked improvement in glycaemic control, substantial body weight reduction, and well-established cardiovascular and renal benefits. Tirzepatide, the first dual agonist of the glucose-dependent insulinotropic polypeptide and GLP-1 receptors, has introduced a new generation of incretin-based agents, characterized by a superior impact on weight loss and insulin sensitivity, with a potential expansion of therapeutic indications. Although both molecules share a remarkable ability to reduce body weight and HbA1c levels, they differ in their mechanisms of action, current therapeutic indications, and the robustness of available evidence on cardiovascular outcomes. Their integration into clinical practice therefore requires a personalized approach that balances metabolic efficacy, safety, and individual patient risk profiles. Within this context, the incretin revolution offers new perspectives for cardio-reno-metabolic prevention.","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"28 Suppl 5","pages":"v57-v61"},"PeriodicalIF":2.7,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835338","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}

引用次数: 0

Heart Failure and Moderate Aortic Stenosis: is Early TAVI the Better Strategy? 心力衰竭和中度主动脉瓣狭窄：早期TAVI是更好的策略吗？

IF 2.7 4区医学

European Heart Journal Supplements Pub Date : 2026-03-11 eCollection Date: 2026-05-01 DOI: 10.1093/eurheartjsupp/suag016

Michele Legati, Luca Branca, Angelica Cersosimo, Marianna Adamo

{"title":"Heart Failure and Moderate Aortic Stenosis: is Early TAVI the Better Strategy?","authors":"Michele Legati, Luca Branca, Angelica Cersosimo, Marianna Adamo","doi":"10.1093/eurheartjsupp/suag016","DOIUrl":"10.1093/eurheartjsupp/suag016","url":null,"abstract":"Aortic stenosis (AS) is the most common valvular heart disease in Western countries. Current clinical guidelines recommend intervention exclusively for severe AS, given its association with poor short-term prognosis. However, accumulating evidence over recent years suggests that even moderate AS may be associated with adverse outcomes, particularly in patients with heart failure with reduced ejection fraction (HFrEF). Consequently, an early aortic valve replacement (AVR) strategy could potentially improve survival and reduce heart-failure-related hospitalizations. Moreover, treating moderate AS in patients with HFrEF may reduce left ventricular afterload and improve haemodynamic status, thereby facilitating the initiation and/or up-titration of guideline-directed medical therapy (GDMT), especially when such therapy is poorly tolerated due to hypotension or other hypoperfusion-related factors. Nevertheless, the available evidence is derived predominantly from retrospective observational studies. The only published randomized controlled trial to date (the TAVR UNLOAD trial) failed to demonstrate a prognostic benefit of transcatheter aortic valve implantation (TAVI) in patients with moderate AS and HFrEF or heart failure with mildly reduced ejection fraction (HFmrEF). Two additional ongoing randomized trials may ultimately provide more definitive evidence. In summary, although the pathophysiological rationale is sound and the available data are encouraging, an early AVR strategy in moderate AS cannot currently be regarded as evidence-based.","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"28 Suppl 5","pages":"v1-v4"},"PeriodicalIF":2.7,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835347","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}

引用次数: 0

Forgotten tricuspid valve? In cases of severe regurgitation, I prefer early surgery. 忘记三尖瓣了吗？对于严重的反流，我更倾向于早期手术。

IF 2.7 4区医学

European Heart Journal Supplements Pub Date : 2026-03-11 eCollection Date: 2026-05-01 DOI: 10.1093/eurheartjsupp/suag019

Nicola Buzzatti, Francesco Maisano, Ottavio Alfieri

引用次数: 0