European Heart Journal Supplements最新文献

{"title":"Strategies for preventing arrhythmic sudden death in adult congenital heart disease.","authors":"Berardo Sarubbi, Victor Waldmann, Giovanni Domenico Ciriello, Tom Wong, Óscar Cano","doi":"10.1093/eurheartjsupp/suaf090","DOIUrl":"10.1093/eurheartjsupp/suaf090","url":null,"abstract":"<p><p>Arrhythmic sudden cardiac death (SCD) remains a major cause of late mortality in adults with congenital heart disease (ACHD), second only to heart failure. Risk prediction is challenging due to the heterogeneity of underlying defects and surgical histories. This review summarizes contemporary evidence on arrhythmic SCD prevention in ACHD, focusing on lesion-specific risk stratification, device-based therapies, and emerging technologies. Traditional markers-ventricular dysfunction, QRS prolongation, and prior arrhythmias-show limited predictive value. Recent models such as PREVENTION-ACHD and the Spanish ACHD Network score offer structured but evolving approaches to individualized risk assessment. Cardiac MRI-derived fibrosis quantification, electro-anatomical mapping, and machine-learning-based tools hold promise for refined prediction. Implantable cardioverter-defibrillators (ICDs) remain the cornerstone of secondary prevention, while subcutaneous ICDs and emerging extravascular systems mitigate lead-related complications. The wearable cardioverter-defibrillator offers a temporary protective option in high-risk patients awaiting definitive therapy. Catheter ablation-particularly in repaired Tetralogy of Fallot-can modify arrhythmic substrates, whereas bradyarrhythmias require vigilant monitoring and timely pacing interventions. In conclusion, effective prevention of arrhythmic SCD in ACHD demands a multidisciplinary, lesion-specific approach integrating advanced imaging, device innovation, and personalized risk modelling. Ongoing refinement of predictive tools and interventional strategies will be crucial to reduce mortality in this growing population.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"28 Suppl 1","pages":"i25-i32"},"PeriodicalIF":1.7,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104470","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":"Clinical and imaging phenotypes.","authors":"Giovanni Benfari, Davide Margonato, Marco Metra, Antoni Bayes-Genis, Raffi Bekeredjian, Denisa Muraru, Maurice Enriquez-Sarano","doi":"10.1093/eurheartjsupp/suaf096","DOIUrl":"10.1093/eurheartjsupp/suaf096","url":null,"abstract":"<p><p>Functional/Secondary tricuspid regurgitation (STR) accounts for over 85% of clinically significant tricuspid regurgitation (TR) and is associated with adverse prognosis and impaired quality of life. Advances in percutaneous tricuspid valve (TV) interventions underscore the need to differentiate TR aetiologies, mechanisms, and phenotypes. STR is subdivided into atrial (A-STR), caused by right atrial dilation and tricuspid annular enlargement without significant leaflet tethering, and ventricular (V-STR), resulting from right ventricular dilation/dysfunction with leaflet tethering. A-STR, increasingly prevalent with ageing and atrial fibrillation, typically presents with preserved right ventricular function, whereas V-STR reflects more advanced disease, is associated with RV dysfunction and, often, left ventricular systolic dysfunction and remodelling and/or left-sided valve disease, carrying higher mortality, compared with A-STR. Cardiac implantable electronic device (CIED) related TR is emerging as a distinct entity, while organic-TR arises from intrinsic structural abnormalities of the valve apparatus. Echocardiography, particularly three-dimensional imaging, is essential for accurate phenotyping and helps in procedural planning. Medical therapy remains primarily symptomatic, with diuretics as first-line therapy and targeted treatment of underlying cardiac pathology. In A-STR, rhythm control strategies, including catheter ablation for atrial fibrillation, may reverse annular remodelling. Surgical repair, preferably annuloplasty, is recommended in selected patients, often when concomitant left-sided surgery is needed. Transcatheter edge-to-edge repair offers a safe and increasingly used alternative, providing symptomatic improvement. The effects on outcomes are likely dependent on the time of intervention and the STR phenotype.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"28 Suppl 4","pages":"iv39-iv47"},"PeriodicalIF":2.7,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812719","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":"Reframing tricuspid regurgitation in Europe: from marker of risk to therapeutic target.","authors":"Erwan Donal, Prayuth Rasmeehirun, Marina Petersen Saadi, Emma Bajeux","doi":"10.1093/eurheartjsupp/suaf094","DOIUrl":"10.1093/eurheartjsupp/suaf094","url":null,"abstract":"<p><p>Tricuspid regurgitation (TR), once considered a passive marker of advanced cardiac disease, is increasingly recognized as an independent contributor to morbidity, mortality, and healthcare burden. Recent evidence, including the pivotal TRILUMINATE trial and Tri-FR, together with supporting cost-effectiveness models, suggest that the correction of TR with T-TEER systems may improve patient outcomes and offer good value for money in European healthcare settings. This article explores the clinical rationale and economic imperative for considering TR as a modifiable and actionable target in modern cardiology ([Adamo M, Chioncel O, Pagnesi M, Bayes-Genis A, Abdelhamid M, Anker SD <i>et al.</i> Epidemiology, pathophysiology, diagnosis and management of chronic right-sided heart failure and tricuspid regurgitation. A clinical consensus statement of the Heart Failure Association (HFA) and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC. <i>Eur J Heart Fail</i> 2024;<b>26</b>:18-33.]).</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"28 Suppl 4","pages":"iv16-iv20"},"PeriodicalIF":2.7,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812792","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":"Why we need treatment? Prognosis of tricuspid regurgitation.","authors":"Josè Luis Zamorano, Pieter van der Bijl, Ariana González Gómez, Covadonga Fernández-Golfìn, Giorgia Benzoni, Maurizio Taramasso, Angel Sanchez-Recalde, Jeroen J Bax","doi":"10.1093/eurheartjsupp/suaf093","DOIUrl":"10.1093/eurheartjsupp/suaf093","url":null,"abstract":"<p><p>Tricuspid regurgitation (TR) has historically been under-recognized in clinical practice, yet growing evidence highlights its significant impact on prognosis, particularly in its severe forms. Severe TR is indeed associated with increased mortality and heart failure hospitalizations, with prognostic deterioration further stratified by emerging classifications such as 'massive' and 'torrential' TR. Accurate assessment of TR severity is essential for timely referral and management decisions. Traditional echocardiographic parameters-such as tricuspid annular plane systolic excursion and right ventricular (RV) fractional area change-are limited by their load-dependence, prompting growing interest in advanced imaging modalities such as strain imaging and cardiac magnetic resonance for more precise evaluation of RV function. In this setting, medical management remains only supportive, with diuretics and neurohormonal modulation forming the cornerstone of therapy, especially in patients with heart failure. However, evidence for pharmacological interventions specific to TR is limited. Surgical treatment is indicated in select patients, though associated with high perioperative risk, necessitating careful patient selection. In recent years, transcatheter tricuspid valve interventions have emerged as promising alternatives for high-risk patients, including edge-to-edge repair (T-TEER) and orthotopic tricuspid valve replacement, and also caval valve implantation is being explored for anatomically complex or high-risk cases. Early recognition, comprehensive risk assessment, and individualized therapeutic planning-including consideration of timely intervention-are crucial to improving outcomes in this often-neglected valvular condition.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"28 Suppl 4","pages":"iv2-iv15"},"PeriodicalIF":2.7,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812763","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":"Transcatheter tricuspid valve treatment: a growing armamentarium of devices.","authors":"Rodrigo Estevez-Loureiro, Julio Echarte-Morales, Nicole Karam, Axel Linke, Henryk Dreger, Xavier Freixa, Thomas Modine, Philip Lurz","doi":"10.1093/eurheartjsupp/suaf098","DOIUrl":"10.1093/eurheartjsupp/suaf098","url":null,"abstract":"<p><p>Tricuspid regurgitation is a frequent and undertreated condition associated with poor outcomes. Over the past decade, transcatheter tricuspid valve interventions have emerged as a valuable alternative for high-risk patients. Edge-to-edge repair is the most widely adopted approach, while replacement technologies are advancing rapidly and offer the potential for near-complete elimination of regurgitation. In parallel, annuloplasty, spacers, and caval devices are broadening the therapeutic spectrum across diverse anatomies. This review outlines the expanding device armamentarium and the key opportunities and challenges in this evolving field.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"28 Suppl 4","pages":"iv56-iv69"},"PeriodicalIF":2.7,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812779","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":"Aetiology, prevalence, and prognosis.","authors":"Marianna Adamo, Mauro Massussi, Gianluigi Savarese, Erwan Donal, Fabien Praz, Francesco Maisano","doi":"10.1093/eurheartjsupp/suaf097","DOIUrl":"10.1093/eurheartjsupp/suaf097","url":null,"abstract":"<p><p>Tricuspid regurgitation (TR) is a common yet often overlooked valvular disorder that carries a substantial impact on morbidity and mortality. It is increasingly recognized as a heterogeneous entity with different phenotypes identified (primary, atrial secondary, ventricular secondary, and cardiac implantable electronic device-related). Contemporary population studies and disease-specific registries reveal that secondary TR is highly prevalent in elderly patients, those with heart failure of any phenotype, and in candidates for transcatheter aortic or mitral interventions. Prognosis varies widely according to aetiology, with atrial secondary TR consistently associated with better survival than ventricular secondary TR. Across diverse settings, TR severity is an independent predictor of mortality, and several clinical scores, including the TRI-SCORE, Wang score, and TRIO score, have been developed to refine risk stratification. Recent staging models integrating ventricular function, renal status, and biomarkers suggest that intervention during an intermediate disease phase, before irreversible end-organ damage, may optimize outcomes. Together, these advances underscore the need for accurate phenotyping, structured prognostic assessment, and timely intervention to improve the care of patients with TR.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"28 Suppl 4","pages":"iv48-iv55"},"PeriodicalIF":2.7,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812732","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":"Retraction and removal of: May Measurement Month 2022: an analysis of blood pressure screening results from Malawi.","authors":"","doi":"10.1093/eurheartjsupp/suaf084","DOIUrl":"10.1093/eurheartjsupp/suaf084","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.1093/eurheartjsupp/suaf043.].</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"27 Suppl 7","pages":"vii111"},"PeriodicalIF":1.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112279","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":"Expression of Concern: May Measurement Month 2022: an analysis of blood pressure screening results from Malawi.","authors":"","doi":"10.1093/eurheartjsupp/suaf080","DOIUrl":"10.1093/eurheartjsupp/suaf080","url":null,"abstract":"","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"27 Suppl 7","pages":"vii110"},"PeriodicalIF":1.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112278","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":"Correction to: Optimizing outcomes in heart transplantation: multidisciplinary Heart Teams and mechanical circulatory support for primary graft dysfunction.","authors":"","doi":"10.1093/eurheartjsupp/suaf081","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suaf081","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/eurheartjsupp/suaf003.].</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"27 Suppl 4","pages":"iv61"},"PeriodicalIF":1.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257621","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: functional reorganization of Intensive Cardiac Care Units (ICCUs) in Italy: Evolution of ICCUs: Growing Needs and the Necessity of a Network With Varying Levels of Care Complexity.","authors":"Serafina Valente, Paolo Trambaiolo, Gianni Casella, Alice Sacco, Carlotta Sorini Dini, Andrea Farina, Leonardo De Luca, Giovanna Geraci, Emanuele Tizzani, Maddalena Lettino, Fortunato Scotto di Uccio, Roberta Rossini, Gaetano Maria De Ferrari, Alberto Genovesi Ebert, Marco Marini, Rita Camporotondo, Michela Barisone, Francesco Paparoni, Francesca Maria Righini, Claudio Bilato, Marco Corda, Massimo Di Marco, Attilio Iacovoni, Massimo Milli, Alessandro Navazio, Vittorio Pascale, Carmine Riccio, Pietro Scicchitano, Michele Massimo Gulizia, Federico Nardi, Domenico Gabrielli, Furio Colivicchi, Massimo Grimaldi, Fabrizio Oliva","doi":"10.1093/eurheartjsupp/suaf075","DOIUrl":"10.1093/eurheartjsupp/suaf075","url":null,"abstract":"<p><p>Recently, intensive cardiac care units (ICCUs) have undergone a significant transformation related to the evolution in management of acute coronary syndrome and influenced by other factors such as the epidemiological transition, the increasing complexity of clinical cases, the technological advancement, and the growth of clinical and scientific expertise of cardiologists. In the context of this evolution, a functional reorganization of ICCUs in Italy has to be implemented in order to meet the changing needs of the population with cardiovascular disease requiring critical care. Therefore, the Italian Association of Hospital Cardiologists (ANMCO) proposes this position paper for the reorganization of CICUs into three levels with increasing functional complexity, based on the hospital characteristics, the available technology, and the clinical cases treated. The system would be functionally integrated into a regional ICCU organization modelled on a time-dependent care network. This proposed network aims to standardize diagnostic and therapeutic protocols and establish unified data collection registries to facilitate self-assessment and support clinical research. The document delineates specific requirements for each ICCU level, including the management of clinical cases, the expertise of intensive care cardiologists, the technological facilities, and the medical and nursing staff needed to ensure optimal care delivery.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"27 Suppl 5","pages":"v205-v215"},"PeriodicalIF":1.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092950","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}