European Heart Journal Supplements最新文献

{"title":"The development of a free and user-friendly health education website targeting Egyptians with cardiovascular diseases","authors":"Mohamed El-Khatib, Mahmoud Eltayyeb, Nevin Mohamed, Saber Mostafa","doi":"10.1093/eurheartjsupp/suad113.016","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suad113.016","url":null,"abstract":"Abstract Background Health care provider’s patient education promotes patients’ comprehension and adherence to medical instructions, hence improving patient health. Various obstacles exist in providing successful patient education to patients with multiple chronic diseases, such as providing the appropriate time, variety, and types of learning materials, as well as assessing the level of comprehension. To assist in overcoming these obstacles, it is essential to investigate new electronic tools for patient education, such as mobile devices, interactive media, and multimedia educational content in healthcare facilities. Aim Determine the steps that need to be taken to develop a user-friendly, cost-free website for health education. Process and Steps Create a specialized team to manage the process of creating educational resources and a website; in MYF, the team comprised of nurses who moderate the website, create the leaflets and films, and an external supporter who edited and directed the videos. Choose the appropriate website and design templates. The MYF nurses use (Google Site), which is a free, easy-to-use website design tool, and for leaflets, the team uses (Ai illustrator), which is an easy-to-use software application for writing, sketching, and adding attractive images. Identify the patient education needs based on patient-centeredness and the most prevalent cardiac diseases, procedures, and preventative measures via the educational council. The offered leaflets are written in Arabic and English. The videos presented have Arabic voiceovers and subtitles. Using the most up-to-date evidence-based resources, identify the appropriate evidence-based resources. Determine the appropriate presenting techniques using electronic leaflets and educational videos. Materials design, including leaflet and video design, script, and voiceover development. Revision of instructional materials through the educational council. Following admission to the hospital, the nurses in charge conduct a health awareness session about the health education website and provide the link/QR code for accessing the website after discharge. Challenges Patients have barriers to using the free website due to economic circumstances and tocology illiteracy, such as a lack of access to a cellphone or internet, or an inability to utilise the associated technology. Additionally, MYF provide printed materials or invent other family members who can access the website for. Conclusion Clinicians can reduce patient apprehension and confusion and enhance the related knowledge by directing them to credible, up-to-date, and comprehensible sources of knowledge provided on a user-friendly health education website on a variety of internet platforms is regarded as a valuable cost-effective and expense-reduction strategy. Recommendation Health care facilities should develop free and user-friendly educational websites which will enhance patient knowledge and awareness.","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298867","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}

{"title":"Utility of residual SYNTAX score to predict clinical outcome after acute myocardial infarction","authors":"Ahmad Samir, Mai Elshinawi, Hesham Yehia, Mohamed Mahjouri, Mohamed Elhafy, Ahmed Shehata, Bassem Zarif, Azza Farrag","doi":"10.1093/eurheartjsupp/suad113.017","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suad113.017","url":null,"abstract":"Abstract Aims Acute myocardial infarction (AMI) represents a huge health burden and a growing economical challenge, particularly with recurrent major adverse cardiovascular events (MACE). Large attention is critically mandated to identify population at higher risk for recurrent MACE to maximize secondary preventive measures. This study aimed to evaluate the utility of residual SYNTAX Score (RSS) after percutaneous coronary intervention (PCI) to the culprit vessel(s) in patients with AMI (STEMI or NSTEMI) to predict 6-months clinical outcomes. Methods and results A total of 492 eligible AMI patients were recruited through a period of 12 months. The RSS was systematically calculated after the PCI procedures. Median RSS was 4 (minimum 0–maximum 47.5). RSS showed excellent association to mid-term clinical outcomes. At cut-off value of RSS 3 had robust prediction for subsequent heart failure (HF), recurrent AMI, unplanned revascularization and the composite of MACE (P < 0.001). A significantly higher RSS was found in those who developed heart failure through the 6-months follow up period compared to those who did not (10 vs. 3, P < 0.001). Similar significant difference was found for recurrent ACS (11.5 vs. 3, P < 0.001), unplanned revascularization (15 vs. 3, P < 0.001) and occurrence of MACE (12 vs. 3, P < 0.001). Conclusions RSS is a sensitive predictor for 6-months adverse clinical outcomes after AMI. Calculating RSS at the end of PCI can guide intensification of secondary preventive measures. Ability of RSS- tailored management to impact clinical outcomes in high-risk patients is to be evaluated.Improvement, with subsequent amelioration of LV diastolic function. The Dapa group had a significantly greater improvement in LVEF at four months and six months compared to the Empa group. While the Empa group showed a significant improvement in HbA1C at six months compared to the Dapa group. Additional Content An author video to accompany this abstract is available on https://academic.oup.com/eurheartjsupp. Please click on the arrow next to ‘More Content’ and then click on ‘Author videos’.","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298875","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}

{"title":"Effect of Newly Approved Medications Sacubitril/Valsartan, Empagliflozin and Dapagliflozin on the Quality of Life in Patients with Heart Failure with Reduced Ejection Fraction","authors":"Amr Setouhi, Asmaa Taha, Hazem M A Farrag, Hany T Asklany","doi":"10.1093/eurheartjsupp/suad113.005","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suad113.005","url":null,"abstract":"ABSTRACT Background Per the guidelines established by the European Society of Cardiology (ESC) guidelines for diagnosing and managing chronic and acute heart failure, Sacubitril/Valsartan, Empagliflozin, and Dapagliflozin are suggested to replace an angiotensin-converting enzyme (ACE) inhibitor to significantly minimize the heart failure (HF) associated risks including hospitalization and possible death of HF ambulatory patients with reduced ejection fraction that remain symptomatic. Objective This work aimed to evaluate the health-related quality of life (HRQOL) changes in HFrEF patients throughout treatment with newly approved medications sacubitril/valsartan, Dapagliflozin, and empagliflozin using Minnesota living with heart failure questionnaire (MLHFQ) and Kansas City Cardiomyopathy Questionnaire (KCCQ) -12 at baseline, 3 months, and 6 months of treatment. Methods This prospective study was conducted on 500 patients with chronic HF with 35% or less LVEF, New York Heart Association class III or IV symptoms who visited Minia university cardiothorasic hospital, cardiology outpatient clinic from period of March 2022 to May 2023. Patients were treated using maximum tolerated doses of guideline-directed medical therapy; angiotensin-converting enzyme inhibitors (ACEIs), ß-blocker (BB), mineralocorticoid receptor antagonist (MRA), and systolic blood pressure greater than 105 mmHg. A total of 3 visits were done (baseline visit, months 3 and 6). At the baseline visit, patients were on ACEIs, BB, MRA, and diuretics and quality of life (QOL) was assessed for this regimen by MLHFQ and KCCQ.12 Then dapagliflozin or empagliflozin was added to the previous regimen, and a reevaluation of patients' QOL was done at 3 months. The ACEI or ARBs was replaced by sacubitril/valsartan, and the reevaluation of QOL was evaluated at 6 months. Results Systolic blood pressure (SBP), diastolic blood pressure (DBP), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), E/e′ ratio, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were remarkably decreased at 6 months compared to baseline (P value <0.001), at 6 months compared to 3 months (P value <0.001), and at 3 months compared to baseline (P value <0.001). Left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), and potassium were significantly increased at 6 months compared to baseline (P value <0.001), at 6 months compared to 3 months (P value <0.001), and at 3 months compared to baseline (P value <0.001). MLHFQ and KCCQ-23 scores were significantly improved at 6 months compared to baseline (P value <0.001), compared to 3 months (P value <0.001), and at 3 months compared to baseline (P value <0.001). 28 (5.6%) patients had stopped the medications due to adverse events (AEs). Conclusions Treatment of HFrEF patients with sodium-glucose Co-transporter-2 inhibitors (SGLT2i) and/or sacubitril/val","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298361","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}

{"title":"Moodle as online platform for cardiac nurses’ competency: nursing staff experiences","authors":"Mohamed El-Khatib, Ibrahim Helmy, Mahmoud Eltayyeb","doi":"10.1093/eurheartjsupp/suad113.011","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suad113.011","url":null,"abstract":"Abstract Background Aswan Heart Centre competency project were started in 2017, nurse’s competency were tillered and implemented within the nursing units. Self-assessment and preceptor grading ideationally to constrictive comment should be documented in the competency tool for every staff, was no unified way to keep tracking these documentations and very hard to secure the hard copy. Aim Is to establish an online platform where the competencies are accessible and high secured that also controls and facilitates the use of nursing competencies. Process Moodle as a cloud-based learning management system (LMS) selected to be the new Online competency platform. Moodle expert were contacted by the nursing education department to assist and support the process. Online could server to host and upload the platform were established by the information technology department. After competencies and users uploaded pilot phase were started to identify the gap in the Moodle platform. After 4 months of use survey were conducted to get a clear view from the staff. Data analysis Most of the staff were satisfied about Moodle use, but the form still need farther support from the information technology department to host the Moodle cloud in stable server to avoid the browser render. Recommendation The use of cloud-based learning management system like Moodle will maintain the easy accessibility and the high security of the data also will facilitate the data audit for further plans.","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135299075","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}

{"title":"Evaluation of left atrial function by two-dimensional speckle tracking echocardiography in patients with cryptogenic stroke","authors":"Amr Setouhi, Ahmed M Ali, Tarek A Rahman, Mohamed A Kader A. Wahab","doi":"10.1093/eurheartjsupp/suad113.007","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suad113.007","url":null,"abstract":"Abstract Cryptogenic cerebro-vascular stroke is defined as ischemic stroke without definite etiology in spite of complete work up. It differs from embolic stroke of undetermined source (ESUS) which is a subgroup including the cardio-embolic sources.We aimed to evaluate the left atrial function using two-dimensional speckle tracking echocardiography (2D-STE) as a possible cause for cryptogenic stroke or a predictor for subclinical AF.TEE has an important role in the work up of cryptogenic stroke and ESUS searching for a possible cardio-embolic source including PFO, left atrial appendage thrombi and atheromatous plaques in aortic arch. Patients and methods Our retrospective cohort study included 62 patients of both sexes with unexplained cerebro-vascular stroke or TIA in stroke unit of Minia University.After performing TEE, 22 patients were excluded as they were proven to have a possible source for cardio-embolism.So, Participants were divided into two groups, group I which included 40 patients with cryptogenic stroke and group II which included 40 healthy participants with no medical history of significance as a control group.Two-dimensional trans-thoracic echocardiography and speckle tracking echocardiography were performed in both groups. We used LA diameter in PLAX, LA volume index (LAVI), LA ejection fraction (LAEF), LA strain rate during reservoir phase (LASr) and LV diastolic dysfunction as parameters of LA dysfunction.48 hours ECG rhythm monitoring during hospitalization was used in participants of group I for detection of more than 30 s episodes of subclinical or paroxysmal atrial fibrillation.Bilateral carotid duplex ultrasonography was also performed for exclusion of significant carotid artery stenosis as a possible cause for stroke. Results The parameters of LA dysfunction were significantly affected in group I than group II with P-value < 0.0001 for LV diastolic dysfunction, LAVI, LAEF and LASr, and 0.001 for LA diameter in PLAX. Episodes of AF were noticed in 14 patients of group I (group Ia, 35%) and the other 26 patients were called (group Ib, 65%).We compared LA dysfunction parameters in Group Ib and group II (healthy controls). There was significant affection of LV diastolic dysfunction in group Ib than group II with P-value < 0.011. LAVI, LAEF and LASr were significantly affected in group Ib than group II with P-value < 0.0001. While, there is no significant difference in LA diameter between both groups with P-value = 0.053.We found that left atrial strain rate during reservoir phase (LASr) is the most sensitive and specific parameter of left atrial cardiopathy in prediction of AF with cut-off point ≤24.5 % and P-value < 0.0001, then LAEF with cut-off point ≤40.5 % and P-value = 0.011. The LAVI is the least sensitive and specific parameter with cut-off point ≥38.5 ml/m2 and P-value = 0.003. Conclusion 2D-STE has an important role in the evaluation of LA dysfunction as a possible cause for cryptogenic s","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298220","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}

{"title":"A Cross sectional descriptive study to investigate the different effects of using approved therapeutic regimens options on the quality of life for chronic heart disease patients with reduced ejection fraction","authors":"Mohamed Metwally, Enas Abd Elaziz, Rasha Wafaie, Fakhr AlAyoubi, Engy M Emam, Rabab Y Kosba, Ahmed Abd Elaaty","doi":"10.1093/eurheartjsupp/suad113.001","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suad113.001","url":null,"abstract":"Abstract Aim Investigate the different effects on the quality of life (QOL) between the approved regimens used for Heart failure patients with reduced ejection fraction (HFrEF) treatment in clinical practice. Methods Cross Sectional descriptive study on (HFrEF) patients was conducted from December 2021 to Mars 2023 at governmental and private hospitals in Egypt and Saudi Arabia, the 118 patients were receiving different treatment regimens divided into 4 groups, all groups have B-blockers and mineralocorticoid receptor antagonist (MRA); 1.Conventional therapy group of 33 patients: angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEi/ARBs), 2. Group of 22 patients: Sacubitril/Valsartan as an angiotensin receptor-neprilysin inhibitor (ARNI), 3. Group of 33 patients (ACEi/ARBs) + Sodium−glucose co-transporter 2 inhibitors (SGLT2i), 4. Group of 30 patients (ARNI) with SGLT2i. Their quality of life assessment was done using validated questionnaire MLHFQ (Minnesota Living with Heart Failure Questionnaire) as face to face interviews and data were collected from hospital records. Statistical software IBM SPSS package version 27.0, a one-way ANOVA test was conducted to compare the difference between 4 groups normally distributed quantitative variables. Post hoc pairwise multiple comparisons were executed using the Tukey HSD test. A multiple linear regression analysis was conducted to assess the ability of the independent variables (Platelets count, Ejection Fraction EF%, Hemoglobin, S.Cr, Gender, WBCs and Urea) to predict the value of MLHFQ score. Significance was judged at the 5% level. Results There was a statistically significant difference In MLHFQ Score for the four groups: F (3, 114) = 8.135, P = 0.000. The actual difference in mean scores was relatively high and this was approved by a large effect size, calculated using eta squared (0.176). Post hoc comparisons indicated that the mean score for Conventional regimen group (M = 68.06, SD = 19.77, CI95% 11.92–38.67, P < 0.05) and SGLT2i containing regimen group (M = 56.88, SD = 22.21, CI95% 0.74–27.48, P = 0.034) both were significantly different from that of ARNI + SGLT2i combination containing regimen group (M = 42.77, SD = 19.04). By comparing the EF% between the 4 groups, There was a statistically significant difference: F (3, 114) = 2.725, P = 0.047. Post hoc comparisons indicated that the mean score for Conventional containing regimen (M = 33, SD = 8.746, CI95% 0.1–10.43, P = 0.044) was significantly different from that of ARNI + SGLT2i combination regimen (M = 27.73, SD = 7.497). The linear regression analysis for variables showed statistical significance (F Change (7,110) = 5.234, P = .000).The statistically significant affected predicted variables are (S.Cr, P = 0.01), (B.urea, P = 0.003), (Hb, P = 0.011), while R2 = 0.25 explained only 25% of the variance in the dependent variable (MLHFQ score). Conclusions The early beginning of ARNI + SGLT2i with B-blocker + MRA","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298539","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}

{"title":"Does speckle tracking transthorasic echocardiography show subtle changes in left ventricular function in patient with heart failure with reduced ejection fraction treated by Sacubitril-Valsartan","authors":"Amr Setouhi, Hazem M A Farrag, Nasser M Taha, Hany T Askalany","doi":"10.1093/eurheartjsupp/suad113.004","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suad113.004","url":null,"abstract":"Abstract Introduction Pathophysiology of HF involves a maladaptive response during which the (RAAS) is activated. RAAS activation leads to VC, HT, increased aldosterone levels, increased sympathetic tone, and eventually, cardiac remodeling, all of which are detrimental to the progression of the disease. By blocking these maladaptive elements, ACEIs or ARBs play a major role in reducing morbidity and mortality due to HF, Simultaneously, the NP system is also activated, hence the elevated BNP and NT-pro BNP seen in HF exacerbations. This is a Compensatory mechanism that leads to VD, natriuresis and diuresis, lowers BP, lowers sympathetic tone, and reduces aldosterone levels. The NP system works antagonistically to the RAAS and has favorable effects on the pathogenesis of HF NP are broken down by an enzyme called neprilysin and blocking of its action by neprilysin inhibitor prevent the breakdown of NP leading to prolonged duration of the favorable effects of these peptides. Sacubitril/valsartan is a first-in-class medicine that contains a neprilysin (NEP) inhibitor (sacubitril) and (Ang-II) receptor blocker (valsartan). STE is a sensitive tool for assessing ventricular function, even subclinical myocardial alterations that traditional imaging techniques are not able to detect. Sub endocardial function is powered mostly by longitudinal contraction, it is impaired earlier than circumferential or radial component's. Therefore, Longitudinal function is in most cases the best early marker of LV dysfunction. Objective The aim of our study is to retrospectively detect if the patients treated by sacubitril/valsartan showed no improvement in LVEF assessed by TTE, is the same patient will shows improvement in LVEF assessed by 2D STE? Methods Our study will include 200 patients with HFrEF. All participants were subjected to the following: History taking, Physical examination, Serial 12-lead ECG, 2D echo to assess: -LVEDD, LVESD and LVEF%, LVEDVI (ml/m2), LVESVI (ml/m2), (LAVI) ml/m2, E/e′ ratio. 2D STE was done before and after 6 months of sacubitril/valsartan. Results Age 48 ± 9 years, 63% females, 9 (4.5%) were in NYHA FC I, 120 (60%) NYHA FC II, 64 (32%) of patients were in NYHA FC III & 7 (3.5%) were in FC IV. improved to NYHA FC I, 82 (41%) NYHA FC II 118 (59%), LVEDV, LVESV, LVEF, E/e′ were 139.3 ± 7.3, 89.7 ± 4.7, 34.9 ± 2.8, 11.2 ± 2.7, that all improved to 139.1 ± 10.5, 89.0 ± 4.4, 35.6 ± 2.6, 9.1 ± 2.3. 82 (41%) patient showed improvement in LVEF either by traditional TTE or STE, 118 (59%) patients showed no improvement of EF by traditional TTE, of them 74 (37%) patients was improved detected by STE while 44 (22%) patients showed no improvement in EF neither by TTE nor by STE. Conclusion STE is more accurate diagnostic tool for detecting early improvment in LVEF that not detected by traditional TTE in patient with HFREF treated by scubitril/valsartan. Additional Content An author video to accompany this abstract is available on https://academic.o","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"120 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135299050","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}

{"title":"Prevalence of myocardial injury in patients after acute ischaemic stroke according to standard criteria.","authors":"Michal Mihalovic,&nbsp;Petr Mikulenka,&nbsp;Hana Línková,&nbsp;Marek Neuberg,&nbsp;Ivana Štětkářová,&nbsp;Tomáš Peisker,&nbsp;David Lauer,&nbsp;Petr Tousek","doi":"10.1093/eurheartjsupp/suad104","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suad104","url":null,"abstract":"<p><p>This study examined the prevalence of acute and chronic myocardial injury according to standard criteria in patients after acute ischaemic stroke (AIS) and its relation to stroke severity and short-term prognosis. Between August 2020 and August 2022, 217 consecutive patients with AIS were enrolled. Plasma levels of high-sensitive cardiac troponin I (hs-cTnI) were measured in blood samples obtained at the time of admission and 24 and 48 h later. The patients were divided into three groups according to the Fourth Universal Definition of Myocardial Infarction: no injury, chronic injury, and acute injury. Twelve-lead ECGs were obtained at the time of admission, 24 and 48 h later, and on the day of hospital discharge. A standard echocardiographic examination was performed within the first 7 days of hospitalization in patients with suspected abnormalities of left ventricular function and regional wall motion. Demographic characteristics, clinical data, functional outcomes, and all-cause mortality were compared between the three groups. The National Institutes of Health Stroke Scale (NIHSS) at the time of admission and the modified Rankin Scale (mRS) 90 days following hospital discharge were used to assess stroke severity and outcome. Elevated hs-cTnI levels were measured in 59 patients (27.2%): 34 patients (15.7%) had acute myocardial injury and 25 patients (11.5%) had chronic myocardial injury within the acute phase after ischaemic stroke. An unfavourable outcome, evaluated based on the mRS at 90 days, was associated with both acute and chronic myocardial injury. Myocardial injury was also strongly associated with all-cause death, with the strongest association in patients with acute myocardial injury, at 30 days and at 90 days. Kaplan-Meier survival curves showed that all-cause mortality was significantly higher in patients with acute and chronic myocardial injury than in patients without myocardial injury (<i>P</i> < 0.001). Stroke severity, evaluated with the NIHSS, was also associated with acute and chronic myocardial injury. A comparison of the ECG findings between patients with and without myocardial injury showed a higher occurrence in the former of T-wave inversion, ST segment depression, and QTc prolongation. In echocardiographic analysis, a new abnormality in regional wall motion of the left ventricle was identified in six patients. Chronic and acute myocardial injury with hs-cTnI elevation after AIS are associated with stroke severity, unfavourable functional outcome, and short-term mortality.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"25 Suppl E","pages":"E3-E9"},"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/17/45/suad104.PMC10206909.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9897475","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":"Previous antithrombotic therapy does not have an impact on the in-hospital mortality of patients with upper gastrointestinal bleeding.","authors":"Marek Hozman,&nbsp;Sabri Hassouna,&nbsp;Lukas Grochol,&nbsp;Petr Waldauf,&nbsp;Tomas Hracek,&nbsp;Blanka Zborilova Pazdiorova,&nbsp;Stanislav Adamec,&nbsp;Pavel Osmancik","doi":"10.1093/eurheartjsupp/suad103","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suad103","url":null,"abstract":"<p><p>The association between antithrombotics (ATs) and the risk of gastrointestinal bleeding is well known; however, data regarding the influence of ATs on outcomes are scarce. The goals of this study are: (i) to assess the impact of prior AT therapy on in-hospital and 6-month outcomes and (ii) to determine the re-initiation rate of the ATs after a bleeding event. All patients with upper gastrointestinal bleeding (UGB) who underwent urgent gastroscopy in three centres from 1 January 2019 to 31 December 2019 were retrospectively analysed. Propensity score matching (PSM) was used. Among 333 patients [60% males, mean age 69.2 (±17.3) years], 44% were receiving ATs. In multivariate logistic regression, no association between AT treatment and worse in-hospital outcomes was observed. Development of haemorrhagic shock led to worse survival [odds ratio (OR) 4.4, 95% confidence interval (CI) 1.9-10.2, <i>P</i> < 0.001; after PSM: OR 5.3, 95% CI 1.8-15.7, <i>P</i> = 0.003]. During 6-months follow-up, higher age (OR 1.0, 95% CI 1.0-1.1, <i>P</i> = 0.002), higher comorbidity (OR 1.4, 95% CI 1.2-1.7, <i>P</i> < 0.001), a history of cancer (OR 3.6, 95% CI 1.6-8.1, <i>P</i> < 0.001) and a history of liver cirrhosis (OR 2.2, 95% CI 1.0-4.4, <i>P</i> = 0.029) were associated with higher mortality. After a bleeding episode, ATs were adequately re-initiated in 73.8%. Previous AT therapy does not worsen in-hospital outcomes in after UGB. Development of haemorrhagic shock predicted poor prognosis. Higher 6-month mortality was observed in older patients, patients with more comorbidities, with liver cirrhosis and cancer.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"25 Suppl E","pages":"E25-E32"},"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/07/80/suad103.PMC10206644.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9897481","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":"Left bundle branch area pacing results in more physiological ventricular activation than biventricular pacing in patients with left bundle branch block heart failure.","authors":"Ondrej Sussenbek,&nbsp;Leonard Rademakers,&nbsp;Petr Waldauf,&nbsp;Pavel Jurak,&nbsp;Radovan Smisek,&nbsp;Petr Stros,&nbsp;Lukas Poviser,&nbsp;Jana Vesela,&nbsp;Filip Plesinger,&nbsp;Josef Halamek,&nbsp;Pavel Leinveber,&nbsp;Dalibor Herman,&nbsp;Pavel Osmancik,&nbsp;Karol Curila","doi":"10.1093/eurheartjsupp/suad109","DOIUrl":"https://doi.org/10.1093/eurheartjsupp/suad109","url":null,"abstract":"<p><p>Biventricular pacing (Biv) and left bundle branch area pacing (LBBAP) are methods of cardiac resynchronization therapy (CRT). Currently, little is known about how they differ in terms of ventricular activation. This study compared ventricular activation patterns in left bundle branch block (LBBB) heart failure patients using an ultra-high-frequency electrocardiography (UHF-ECG). This was a retrospective analysis including 80 CRT patients from two centres. UHF-ECG data were obtained during LBBB, LBBAP, and Biv. Left bundle branch area pacing patients were divided into non-selective left bundle branch pacing (NSLBBP) or left ventricular septal pacing (LVSP) and into groups with V6 R-wave peak times (V6RWPT) < 90 ms and ≥ 90 ms. Calculated parameters were: e-DYS (time difference between the first and last activation in V1-V8 leads) and Vdmean (average of V1-V8 local depolarization durations). In LBBB patients (<i>n</i> = 80) indicated for CRT, spontaneous rhythms were compared with Biv (39) and LBBAP rhythms (64). Although both Biv and LBBAP significantly reduced QRS duration (QRSd) compared with LBBB (from 172 to 148 and 152 ms, respectively, both <i>P</i> < 0.001), the difference between them was not significant (<i>P</i> = 0.2). Left bundle branch area pacing led to shorter e-DYS (24 ms) than Biv (33 ms; <i>P</i> = 0.008) and shorter Vdmean (53 vs. 59 ms; <i>P</i> = 0.003). No differences in QRSd, e-DYS, or Vdmean were found between NSLBBP, LVSP, and LBBAP with paced V6RWPTs < 90 and ≥ 90 ms. Both Biv CRT and LBBAP significantly reduce ventricular dyssynchrony in CRT patients with LBBB. Left bundle branch area pacing is associated with more physiological ventricular activation.</p>","PeriodicalId":11956,"journal":{"name":"European Heart Journal Supplements","volume":"25 Suppl E","pages":"E17-E24"},"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/c0/a3/suad109.PMC10206755.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9897483","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}