European Heart Journal Supplements最新文献_第6页

Brugada syndrome: identification of subjects at risk and therapy Brugada 综合征：高危人群的识别与治疗

IF 1.6 4区医学

European Heart Journal Supplements Pub Date : 2024-04-01 DOI: 10.1093/eurheartjsupp/suae021

F. Gaita, N. Cerrato, C. Giustetto, L. Garberoglio, L. Calò

{"title":"Brugada syndrome: identification of subjects at risk and therapy","authors":"F. Gaita, N. Cerrato, C. Giustetto, L. Garberoglio, L. Calò","doi":"10.1093/eurheartjsupp/suae021","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suae021","url":null,"abstract":"\u0000 Brugada syndrome mainly affects young subjects with structurally normal heart and can cause x syncope or sudden death due to ventricular arrhythmias, even as the first manifestation, in approximately 5–10% of cases. To date, two questions remain open: how to recognize subjects who will experience arrhythmic events and how to treat them. The guidelines suggest treating subjects with a previous history of cardiac arrest or arrhythmogenic syncope, while they are unconclusive about the management of asymptomatic patients, who represent ∼90% of Brugada patients. We recently demonstrated that in asymptomatic patients, the presence of spontaneous Brugada type 1 electrocardiogram (ECG) pattern and inducibility of ventricular arrhythmias at electrophysiological study allows us to identify a group of patients at greater risk who deserve treatment. Regarding treatment, there are three options: implantable cardioverter defibrillator, drugs, and epicardial transcatheter ablation. Recent studies have shown that the latter is effective and free from serious side effects, thus opening a new scenario in the treatment of Brugada patients at risk. Subjects who present drug-induced-only type 1 Brugada ECG pattern, in whom a spontaneous type 1 pattern has been ruled out with repeated ECGs and 12-lead 24-h Holter monitoring, represent a very low-risk group, provided they adhere to behavioural recommendations and undergo regular follow-up.","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140765064","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}

引用次数: 0

Cerebral haemorrhage in the patient with atrial fibrillation: do we employ the direct oral anticoagulants without waiting too long? 心房颤动患者脑出血：直接口服抗凝剂是否无需等待太久？

IF 1.6 4区医学

European Heart Journal Supplements Pub Date : 2024-04-01 DOI: 10.1093/eurheartjsupp/suae020

Gloria Vassiliki’ Coutsoumbas, G. Di Pasquale

{"title":"Cerebral haemorrhage in the patient with atrial fibrillation: do we employ the direct oral anticoagulants without waiting too long?","authors":"Gloria Vassiliki’ Coutsoumbas, G. Di Pasquale","doi":"10.1093/eurheartjsupp/suae020","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suae020","url":null,"abstract":"\u0000 Intracranial haemorrhage (ICH) is the most feared haemorrhagic complication of oral anticoagulant therapy (OAT), although the risk is significantly lower with direct oral anticoagulants (DOACs) compared with warfarin. Intracranial haemorrhage is generally considered, by clinicians, to be an absolute contraindication to starting or resuming OAT in patients with atrial fibrillation (AF). On the other hand, the pivotal trials with DOACs excluded patients with previous ICH. Observational studies actually indicate a net clinical benefit in favour of DOAC in patients with AF and previous ICH. This benefit is confirmed by randomized clinical trials which, however, have the limitation of the small number of cases, but larger clinical trials comparing DOACs vs. aspirin or no therapy are underway. While OAT is certainly contraindicated in patients with lobar ICH and cerebral amyloid angiopathy, in other cases, the decision must be made in the individual patient through an accurate balance between thromboembolic risk and haemorrhagic risk and a multidisciplinary cardio-neurological evaluation.","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140793116","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}

引用次数: 0

Immediate multivessel revascularization after myocardial infarction: change of strategy? 心肌梗死后立即进行多血管血运重建：改变策略？

IF 1.6 4区医学

European Heart Journal Supplements Pub Date : 2024-04-01 DOI: 10.1093/eurheartjsupp/suae015

P. Capranzano, Luca Lombardo

{"title":"Immediate multivessel revascularization after myocardial infarction: change of strategy?","authors":"P. Capranzano, Luca Lombardo","doi":"10.1093/eurheartjsupp/suae015","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suae015","url":null,"abstract":"\u0000 Multivessel coronary artery disease (MVD) is a frequently encountered condition in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) of the culprit vessel. Several studies have demonstrated the benefit of complete coronary revascularization compared with the treatment of the culprit lesion only in patients with STEMI. Based on this evidence, the current European guidelines recommend that in haemodynamically stable patients with STEMI and MVD, routine complete revascularization should be achieved either during the same procedure in concomitance with the treatment of the culprit lesion (immediate multivessel PCI) or with a subsequent intervention within 45 days from the index PCI of the culprit lesion (deferred multivessel PCI). However, the guidelines do not express a preference for immediate vs. delayed multivessel PCI. Therefore, the optimal timing of the treatment of non-culprit lesions in patients with STEMI and haemodynamic stability is still debated and has been evaluated in recent studies that showed the non-inferiority of immediate vs. delayed multivessel PCI. The article discusses the results and clinical implications of these studies on the timing of complete revascularization of non-culprit lesions in haemodynamically stable patients with STEMI.","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140765495","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}

引用次数: 0

Abnormal conduction-induced cardiomyopathy: a poorly explored entity 传导异常诱发的心肌病：一个探索不足的实体

IF 1.6 4区医学

European Heart Journal Supplements Pub Date : 2024-04-01 DOI: 10.1093/eurheartjsupp/suae028

A. Lalario, M. Rossi, Valentina Allegro, G. Gagno, Maria Perotto, A. de Luca, Marco Merlo, G. Sanna, G. Sinagra

{"title":"Abnormal conduction-induced cardiomyopathy: a poorly explored entity","authors":"A. Lalario, M. Rossi, Valentina Allegro, G. Gagno, Maria Perotto, A. de Luca, Marco Merlo, G. Sanna, G. Sinagra","doi":"10.1093/eurheartjsupp/suae028","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suae028","url":null,"abstract":"\u0000 A dyssynchronous biventricular activation, which can be determined by left bundle branch block, chronic right ventricular pacing, frequent premature ventricular complexes, or pre-excitation, can cause a global abnormal contractility, thus leading to systolic dysfunction and left ventricular remodelling in a unique nosological entities: abnormal conduction-induced cardiomyopathies. In this clinical scenario, the mainstay therapy is eliminating or improving LV dyssynchrony, removing the trigger. This usually ensures the improvement and even recovery of cardiac geometry and left ventricular function, especially in the absence of genetic background. A multidisciplinary approach, integrating advanced multimodal imaging, is essential for the systematic aetiological definition and the subsequent evaluation and aetiology-guided therapies of patients and their families. This review aims to describe mechanisms, prevalence, risk factors, and diagnostic and therapeutic approach to the various abnormal conduction-induced cardiomyopathies, starting from reasonable certainties and then analysing the grey areas requiring further studies.","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794969","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}

引用次数: 0

Ablation of the epicardial substrate in patients with long-QT syndrome at risk of sudden death 消融有猝死风险的长 QT 综合征患者的心外膜基质

IF 1.6 4区医学

European Heart Journal Supplements Pub Date : 2024-04-01 DOI: 10.1093/eurheartjsupp/suae009

Carlo Pappone, A. Boccellino, G. Ciconte, Luigi Anastasia

引用次数: 0

Eliminate LDL cholesterol after heart attack … but only for a while 心脏病发作后消除低密度脂蛋白胆固醇......但只是暂时的

IF 1.6 4区医学

European Heart Journal Supplements Pub Date : 2024-04-01 DOI: 10.1093/eurheartjsupp/suae010

Francesco Prati, F. Biccirè, E. Sammartini, L. Gatto

{"title":"Eliminate LDL cholesterol after heart attack … but only for a while","authors":"Francesco Prati, F. Biccirè, E. Sammartini, L. Gatto","doi":"10.1093/eurheartjsupp/suae010","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suae010","url":null,"abstract":"\u0000 There is a clear demonstration of the inverse linear correlation between LDL cholesterol levels and clinical benefit. However, the timing of the action of lipid-lowering drugs is not clear. According to animal studies with recombinant lipoprotein A-1, the composition of atherosclerosis changes within 40 h (with variations in lipid and inflammatory contents). Progression–regression studies of atherosclerosis in humans confirm the data, highlighting a rapid change in the plaque over 5 weeks. The data are also in line with what emerges from the survival curves of the old study comparing atorvastatin 80 mg vs. placebo (Myocardial Ischaemia Reduction with Aggressive Cholesterol Lowering). The spacing of the curves occurs after only 4 weeks, indicating the precociousness of the favourable effects of powerful statins. Finally, a recent Odyssey post hoc analysis compared the risk of cardiac death and coronary revascularization between a group in which alirocumab lowered LDL cholesterol to below 15 mg (Group 1 and in which the drug was therefore stopped) against the subjects in the placebo group (Group 2), applying a propensity score matching. The primary endpoint occurred in a lower percentage of patients in Group 1 (6.4 vs. 8.4%). Furthermore, patients in Group 1 had a significantly lower hazard ratio (HR) for major adverse cardiovascular events [0.72; 95% confidence interval (CI) 0.51–0.997; P = 0.047] compared with the entire alirocumab group vs. placebo (HR 0.85; 95% CI 0.78–0.93; P < 0.001). According to these preliminary observations, aggressive and early treatment of hypercholesterolaemia in subjects with acute coronary syndrome translates into improved clinical results compared with a strategy that provides for more gradual control. These data will need to be confirmed through further prospective clinical studies and ideally with early conducted atherosclerosis regression studies.","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140770276","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}

引用次数: 0

Percutaneous repair of tricuspid regurgitation 经皮修复三尖瓣反流

IF 1.6 4区医学

European Heart Journal Supplements Pub Date : 2024-04-01 DOI: 10.1093/eurheartjsupp/suae018

A. Mangieri, Antonio Colombo

引用次数: 0

There are those who would like zero LDL cholesterol 有些人希望低密度脂蛋白胆固醇为零

IF 1.6 4区医学

European Heart Journal Supplements Pub Date : 2024-04-01 DOI: 10.1093/eurheartjsupp/suae012

Claudio Borghi, Alessio Bragagni

引用次数: 0

Efficacy of cryoablation in atrial fibrillation: comparison with antiarrhythmic therapy 低温消融术治疗心房颤动的疗效：与抗心律失常疗法的比较

IF 1.6 4区医学

European Heart Journal Supplements Pub Date : 2024-04-01 DOI: 10.1093/eurheartjsupp/suae014

Silvia Magnani, R. Cappato

{"title":"Efficacy of cryoablation in atrial fibrillation: comparison with antiarrhythmic therapy","authors":"Silvia Magnani, R. Cappato","doi":"10.1093/eurheartjsupp/suae014","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suae014","url":null,"abstract":"\u0000 Atrial fibrillation (AF) represents the most common arrhythmia in clinical practice, characterized by irregular atrial electrical activity originating mainly in and around the pulmonary veins. This condition can manifest itself symptomatically or silently but still dangerously. Complications associated with AF include stroke, heart failure, worst clinical outcome in patients with underlying conditions, increased emergency room visits, hospitalizations, and cardiovascular mortality. Currently, according to the main international guidelines, antiarrhythmic therapy is considered the first choice for rhythm control in patients with AF despite modest efficacy and non-negligible side effects. In recent decades, radiofrequency catheter ablation has emerged as an alternative to antiarrhythmic drugs for rhythm control. Cryoablation was developed with the aim of reducing procedural times and reducing complications related to the ablative procedure with radiofrequency without losing efficacy. Recent studies conducted with rigour and scientific solidity have demonstrated on the one hand that the results of this technique are not inferior compare with radiofrequency. This study aims to compare data on the safety and efficacy of cryoablation with those obtained from antiarrhythmic drugs through a review of the most recent scientific evidence.","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794055","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}

引用次数: 0

Myocardial viability on trial 试验中的心肌活力

IF 1.6 4区医学

European Heart Journal Supplements Pub Date : 2024-04-01 DOI: 10.1093/eurheartjsupp/suae005

Leonardo Bolognese, M. Reccia

引用次数: 0