European Heart Journal Open最新文献

{"title":"Changes of intracardiac flow dynamics measured by HyperDoppler in patients with aortic stenosis","authors":"J. Sabatino, I. Leo, A. Strangio, Sabrina La Bella, Rosalba De Sarro, Vincenzo Montemurro, G. Pedrizzetti, Fabio Troilo, Marco Maglione, Daniele Torella, Giovanni Di Salvo, Salvatore De Rosa","doi":"10.1093/ehjopen/oeae069","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae069","url":null,"abstract":"\u0000 \u0000 \u0000 Assessment of intracardiac flow dynamics has recently acquired significance due to the development of new measurement methods based on echocardiography. Recent studies have demonstrated that cardiac abnormalities are associated with changes in intracardiac vortical flows. Yet, no previous study assessed the impact of aortic stenosis (AS) on intracardiac vortices.\u0000 \u0000 \u0000 \u0000 to explore the clinical potential of additional information provided by quantifying intracardiac flow dynamics in patients with AS.\u0000 \u0000 \u0000 \u0000 One hundred twenty patients with severe AS, sixty patients with concentric remodelling (VR) and hundred controls (CTRL) were prospectively included and underwent non-invasive evaluation of intracardiac flow dynamics. In addition to standard echocardiography, fluid dynamics were assessed by means of HyperDoppler.\u0000 \u0000 \u0000 \u0000 Vortex depth (p<0.001), vortex length (p=0.003), vortex intensity (p<0.001) and vortex area (p=0.049) were significantly increased in AS compared to CTRL. In addition, mean energy dissipation was significantly higher in AS compared to CTRL (p<0.001) and VR (p=0.002). At ROC analysis, vortex depth showed the best discrimination capacity for AS (p<0.001).\u0000 \u0000 \u0000 \u0000 Changes in fluid dynamics-based HyperDoppler indices can be reliably assessed in patients with AS. Significant changes in vortex depth and intensity can selectively differentiate AS from both concentric remodelling and healthy controls, suggesting that the assessment of intracardiac flow dynamics may provide complementary information to standard echocardiography to better characterize patients’ subsets.\u0000","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141927019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Small Animal Model Replicating Core Characteristics of Takotsubo Syndrome in Humans","authors":"E. Zulfaj, Amirali Nejat, A. Espinosa, Shafaat Hussain, A. Haamid, Ahmed Elmahdy, Yalda Kakei, Abhishek Jha, Björn Redfors, E. Omerovic","doi":"10.1093/ehjopen/oeae048","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae048","url":null,"abstract":"\u0000 \u0000 \u0000 Adequate animal models are necessary to understand human conditions such as Takotsubo syndrome (TS), characterized by the heart's transient regional wall motion abnormalities. This study aims to develop a reproducible, low-mortality TS model that closely mimics the human condition and addresses the limitations of existing models.\u0000 \u0000 \u0000 \u0000 We conducted six experiments using 309 Sprague Dawley rats, each approximately 300 grams and aged 7-8 weeks. Initially, we replicated an established model using intraperitoneal isoprenaline injections. Subsequent experiments varied the doses and infusion durations of intravenous isoprenaline and assessed the effects of sex, strain, and breeder on the development of reversible akinetic segments. High-resolution echocardiography monitored regional wall motion over 30 days to correlate with histological changes.\u0000 \u0000 \u0000 \u0000 Increasing isoprenaline dose and infusion time significantly enhanced akinesia (p < 0.01), resulting in pronounced apical ballooning observed in 3D imaging. Akinesia peaked at 6 hours post-infusion, with recovery observed at 24 hours; most rats recovered from akinetic segments within 48-72 hours. Optimizing the mode of administration, dose, and duration achieved a TS-like phenotype in 90% of cases with a 16.7% mortality rate. Histological examinations confirmed myocardial injury occurred independently of apical ballooning.\u0000 \u0000 \u0000 \u0000 This study presents a refined TS model that reliably replicates the syndrome's key features, including morphological and electrocardiographic changes, demonstrating its transient nature with high fidelity and reduced mortality. The model’s reproducibility, evidenced by consistent results across trials, suggests its potential for broader application pending further validation.\u0000","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141347745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elastin turnover in Williams Beuren and 7q11.23 microduplication syndromes","authors":"Alexandre Guilhem, Séverine Ruet, Patrick Edery, Cecile Acquaviva, Massimiliano Rossi","doi":"10.1093/ehjopen/oeae045","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae045","url":null,"abstract":"","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141350187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myeloid cell derived Interleukin-6 induces vascular dysfunction and vascular and systemic inflammation","authors":"Tanja Knopp, Rebecca Jung, J. Wild, Magdalena L. Bochenek, P. Efentakis, Annika Lehmann, Tabea Bieler, V. Garlapati, Cindy Richter, M. Molitor, Katharina Perius, S. Finger, J. Lagrange, Iman Ghasemi, Konstantinos Zifkos, K. Kommoss, Joumana Masri, S. Reissig, V. Randriamboavonjy, T. Wunderlich, Nadine Hövelmeyer, Alexander N R Weber, I. Mufazalov, M. Bosmann, Ingo Bechmann, I. Fleming, M. Oelze, A. Daiber, T. Münzel, Katrin Schäfer, P. Wenzel, Ari Waisman, S. Karbach","doi":"10.1093/ehjopen/oeae046","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae046","url":null,"abstract":"\u0000 \u0000 \u0000 The cytokine interleukin-6 (IL-6) plays a central role in the inflammation cascade as well as in cardiovascular disease progression. Since myeloid cells are a primary source of IL-6 formation, we aimed to generate a mouse model to study the role of myeloid cell-derived IL-6 in vascular disease.\u0000 \u0000 \u0000 \u0000 IL-6 overexpressing (IL-6OE) mice were generated and crossed with LysM-Cre mice, to generate mice (LysM-IL-6OE mice) overexpressing the cytokine in myeloid cells. Eight to 12 week old LysM-IL-6OE mice spontaneously developed inflammatory colitis, significantly impaired endothelium dependent aortic relaxation, increased aortic reactive oxygen species (ROS) formation and vascular dysfunction in resistance vessels. The latter phenotype was associated with decreased survival. Vascular dysfunction was accompanied by a significant accumulation of neutrophils, monocytes and macrophages in the aorta, increased myeloid cell reactivity (elevated ROS production), and vascular fibrosis associated with phenotypic changes of vascular smooth muscle cells. In addition to elevated Mcp1 and Cxcl1 mRNA levels, aortae from LysM-IL-6OE mice expressed higher levels of iNOS and endothelin-1, thus partially accounting for vascular dysfunction whereas systemic blood pressure alterations were not observed. Bone marrow transplantation experiments revealed that vascular dysfunction and ROS formation were driven by bone marrow cell-derived IL-6 in a dose-dependent manner.\u0000 \u0000 \u0000 \u0000 Mice with conditional overexpression of IL-6 in myeloid cells show systemic and vascular inflammation as well as endothelial dysfunction. Decrease of circulating IL-6 levels by replacing IL-6 producing myeloid cells in the bone marrow improved vascular dysfunction in this model, underpinning the relevant role of IL-6 in vascular disease.\u0000","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141353830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myeloid-specific interleukin-6 response: from vascular effects to the potential for novel personalized medicines","authors":"Daniel FJ Ketelhuth, Magnus Bäck","doi":"10.1093/ehjopen/oeae047","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae047","url":null,"abstract":"","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141351241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left atrial dysfunction in bicuspid aortic valve patients with severe aortic stenosis is associated with postoperative atrial fibrillation following aortic valve replacement","authors":"Johan O. Wedin, Sergey Rodin, Frank A Flachskampf, Oscar E Simonson, Johan Pallin, Jonathan Hörsne Malmborg, Stefan K James, Elisabeth Ståhle, K. Grinnemo","doi":"10.1093/ehjopen/oeae020","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae020","url":null,"abstract":"\u0000 \u0000 \u0000 To investigate (i) the association between preoperative left atrial (LA) reservoir strain and postoperative atrial fibrillation (AF), and (ii) the incidence of postoperative ischemic stroke events separately in bicuspid (BAV) and tricuspid aortic valve (TAV) patients after surgical aortic valve replacement for isolated severe aortic stenosis (AS).\u0000 \u0000 \u0000 \u0000 We prospectively enrolled 227 patients (n = 133 BAV and n = 94 TAV) with isolated severe AS scheduled for aortic valve replacement. A comprehensive intra- and interobserver validated preoperative echocardiogram with analysis of LA reservoir strain was performed. Postoperative AF was defined as a sustained (>30 s) episode of atrial fibrillation or atrial flutter. Timing of neurological events were defined in accordance with the Valve Academic Research Consortium (VARC)-3 criteria for stroke. Postoperative AF occurred in 114 of 227 patients (50.2%), with no difference between BAV and TAV patients (48.1% vs. 53.1%, P = 0.452). Persisting postoperative AF at discharge was more frequent in BAV patients (29.7% vs. 8.0%, P = 0.005). Preoperative LA reservoir strain was independently associated with postoperative AF (odds ratio [OR] = 1.064, 95% CI 1.032–1.095, P < 0.001), with a significant interaction between LA reservoir strain and aortic valve morphology (Pinteraction = 0.002). The cumulative TIA/stroke incidence during follow-up was significantly higher in BAV patients (19.1% vs. 5.8% at five years).\u0000 \u0000 \u0000 \u0000 Preoperative LA function was associated with postoperative AF after aortic valve replacement in BAV AS patients, while postoperative AF in TAV AS patients likely depends on transient postoperative alterations and traditional cardiovascular risk factors. TIA/stroke during follow-up was more common in BAV AS patients.\u0000","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140373106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Frailty Knowledge, Awareness, and Practices Among Physicians following the 2022 European Consensus Document on Frailty in Cardiology","authors":"Jie Jun Wong, Laureen Yi-Ting Wang, K. Hasegawa, Kay Woon Ho, Zijuan Huang, L. Teo, Jack Wei Chieh Tan, Kazuyuki Kasahara, R. Tan, Junbo Ge, A. Koh","doi":"10.1093/ehjopen/oeae025","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae025","url":null,"abstract":"\u0000 \u0000 \u0000 Aging-related cardiovascular disease and frailty burdens are anticipated to rise with global aging. In response to directions from major cardiovascular societies, we investigated frailty knowledge, awareness, and practices among cardiologists as key stakeholders in this emerging paradigm a year after the European Frailty in Cardiology consensus document was published.\u0000 \u0000 \u0000 \u0000 We launched a prospective multinational web-based survey via social networks to broad cardiology communities representing multiple World Health Organization regions, including Western Pacific and Southeast Asia regions.\u0000 \u0000 \u0000 \u0000 Overall, 578 respondents [38.2% female; ages 35-49 years (55.2%), 50-64 years (34.4%)] across subspecialties, including interventionists (43.3%), general cardiologists (30.6%), and heart failure specialists (HFs) (10.9%), were surveyed. Nearly half had read the consensus document (38.9%). Non-interventionists had better perceived knowledge of frailty assessment instruments (fully or vaguely aware, 57.2% vs 45%, adj. p=0.0002), exercise programs (well aware, 12.9% vs 6.0%, adj. p=0.001), and engaged more in multidisciplinary team care (frequently or occasionally 52.6% vs 41%, adj. p=0.002) than interventionists. HFs more often addressed preprocedural frailty (frequently or occasionally, 43.5% vs 28.2%, p=0.004) and polypharmacy (frequently or occasionally, 85.5% vs 71%, adj. p=0.014), and had consistently better composite knowledge (39.3% vs 21.6%, adj. p=0.001) and practice responses (21% vs 11.1%, adj. p=0.018) than non-HFs. Respondents with better knowledge responses also had better frailty practices (40.3% vs 3.6%, adj. p<0.001).\u0000 \u0000 \u0000 \u0000 Distinct response differences suggest that future strategies strengthening frailty principles should address practices peculiar to subspecialties, such as preprocedural frailty strategies for interventionists and rehabilitation interventions for heart failure specialists.\u0000","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140376908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of symptoms development and aortic valve replacement in patients with low gradient severe aortic stenosis","authors":"Daisuke Miyahara, M. Izumo, Yukio Sato, Tatsuro Shoji, Risako Murata, Ryutaro Oda, T. Okuno, S. Kuwata, Yoshihiro J. Akashi","doi":"10.1093/ehjopen/oeae018","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae018","url":null,"abstract":"\u0000 \u0000 \u0000 Current evidence on the prognostic value of exercise stress echocardiography (ESE) in asymptomatic patients with low-gradient severe AS is limited. Therefore, this study aimed to elucidate its prognostic implications for patients with low-gradient severe AS and determine the added value of ESE in risk stratification for this population.\u0000 \u0000 \u0000 \u0000 This retrospective observational study included 122 consecutive asymptomatic patients with either moderate (mean pressure gradient [MPG] <40 mmHg and aortic valve area [AVA] 1.0–1.5 cm2) or low-gradient severe (MPG <40 mmHg and AVA <1.0 cm2) AS and preserved left ventricular ejection fraction (≥50%) who underwent ESE. All patients were followed up for AS-related events. Of 143 patients, 21 who met any exclusion criteria, including early interventions, were excluded, and 122 conservatively managed patients (76.5 [71.0–80.3] years; 48.3% male) were included in this study. During a median follow-up period of 989 (578–1571) days, 64 patients experienced AS-related events. Patients with low-gradient severe AS had significantly lower event-free survival rates than those with moderate AS (log-rank test, p<0.001). Multivariable Cox regression analysis showed that the mitral E/e’ ratio during exercise was independently associated with AS-related events (hazard ratio=1.075, p<0.001) in patients with low-gradient severe AS.\u0000 \u0000 \u0000 \u0000 This study suggests that asymptomatic patients with low-gradient severe AS have worse prognoses than those with moderate AS. Additionally, the mitral E/e’ ratio during exercise is a useful parameter for risk stratification in patients with low-gradient severe AS.\u0000","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140078245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental Pollution’s toll on the Heart: Rethinking Cardiovascular Risk Factors","authors":"Sameer Mehta, Yashendra Sethi","doi":"10.1093/ehjopen/oeae017","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae017","url":null,"abstract":"","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140081439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of left atrial enlargement with heart failure events in non-valvular atrial fibrillation patients with preserved left ventricular ejection fraction","authors":"Y. Hamatani, M. Iguchi, Keita Okamoto, Y. Nakanishi, K. Minami, K. Ishigami, S. Ikeda, K. Doi, T. Yoshizawa, Y. Ide, A. Fujino, M. Ishii, N. Masunaga, M. Esato, H. Tsuji, H. Wada, K. Hasegawa, M. Abe, M. Akao","doi":"10.1093/ehjopen/oeae015","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae015","url":null,"abstract":"\u0000 \u0000 \u0000 Atrial fibrillation (AF) increases the risk of heart failure (HF); however, little is known regarding the risk stratification for incident HF in AF patients, especially with preserved left ventricular ejection fraction (LVEF).\u0000 \u0000 \u0000 \u0000 The Fushimi AF Registry is a community-based prospective survey of AF patients. From the registry, 3,002 non-valvular AF patients with preserved LVEF and with the data of antero-posterior left atrial diameter (LAD) at enrollment were investigated. Patients were stratified by LAD (<40 mm, 40-44 mm, 45-49 mm, and ≥50 mm) with backgrounds and HF hospitalization incidences compared between groups. Of 3,002 patients (mean age: 73.5 ± 10.7 years, women: 1,226 [41%], paroxysmal AF: 1,579 [53%], and mean CHA2DS2-VASc score: 3.3 ± 1.7), the mean LAD was 43 ± 8 mm. Patients with larger LAD were older and less often paroxysmal AF, with a higher CHA2DS2-VASc score (all P < 0.001). HF hospitalization occurred in 412 patients during the median follow-up period of 6.0 years. Larger LAD was independently associated with a higher HF hospitalization risk (LAD ≥50 mm; hazard ratio [HR]: 2.36, 95% confidence interval [CI]: 1.75-3.18, LAD 45-49 mm; HR: 1.84, 95%CI: 1.37-2.46 and LAD 40-44 mm: HR: 1.34, 95%CI: 1.01-1.78, compared with LAD <40 mm) after adjustment by age, sex, AF type, and CHA2DS2-VASc score. These results were also consistent across major subgroups, showing no significant interaction.\u0000 \u0000 \u0000 \u0000 LAD is significantly associated with the risk of incident HF in AF patients with preserved LVEF, suggesting the utility of LAD regarding HF risk stratification for these patients.\u0000","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140089042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}