European Heart Journal Open最新文献

{"title":"2024: Year One - From Inception to Mass Disruption of Artificial Intelligence in Cardiology","authors":"Benjamin Marchandot, A. Trimaille, Olivier Morel","doi":"10.1093/ehjopen/oeae002","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae002","url":null,"abstract":"","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139617309","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":"Ceramides improve cardiovascular risk prediction beyond LDL-cholesterol","authors":"A. Leiherer, A. Muendlein, C. Saely, R. Laaksonen, P. Fraunberger, H. Drexel","doi":"10.1093/ehjopen/oeae001","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae001","url":null,"abstract":"\u0000 \u0000 \u0000 LDL-cholesterol (LDL-C) is the best documented cardiovascular risk predictor and at the same time serves as a target for lipid-lowering therapy. However, the power of LDL-C to predict risk is biased by advanced age, comorbidities, and medical treatment, all known to impact cholesterol levels. Consequently, such biased patient cohorts often feature a U-shaped or inverse association between LDL-C and cardiovascular or overall mortality. It is not clear whether these constraints for risk prediction may likewise apply to other lipid risk markers in particular to ceramides and phosphatidylcholines.\u0000 \u0000 \u0000 \u0000 In this observational cohort study, we recorded cardiovascular mortality in 1195 patients over a period of up to 16 years, comprising a total of 12.262 patient-years. The median age of patients at baseline was 67 years. All participants were either consecutively referred to elective coronary angiography or diagnosed with peripheral artery disease, indicating a high cardiovascular risk. At baseline, 51% of the patients were under statin therapy.\u0000 \u0000 \u0000 \u0000 We found a U-shaped association between LDL-C and cardiovascular mortality with a trough level around 150 mg/dL of LDL-C. Cox regression analyses revealed that LDL-C and other cholesterol species failed to predict cardiovascular risk. In contrast, no U-shaped but a linear association was found for ceramide- and phosphatidylcholine-containing markers and these markers were able to significantly predict the cardiovascular risk even after multivariate adjustment.\u0000 \u0000 \u0000 \u0000 We thus suggest that ceramides- and phosphatidylcholine-based predictors rather than LDL-C can be used for a more accurate cardiovascular risk prediction in high-risk patients.\u0000","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139446882","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":"Aortic arch shape after arch repair predicts exercise capacity: a multicenter analysis","authors":"J. Mandell, Jennifer Romanowicz, Y. Loke, Nobuyuki Ikeda, Pena Emily, Umar Siddiqi, Narutoshi Hibino, Mark E Alexander, Andrew J Powell, Laura J Olivieri","doi":"10.1093/ehjopen/oead138","DOIUrl":"https://doi.org/10.1093/ehjopen/oead138","url":null,"abstract":"Coarctation of the aorta is associated with long term morbidity including decreased exercise capacity, despite successful repair. In the absence of discrete recoarctation, the hemodynamic mechanism remains unknown. This multicenter study evaluated the relationship between aorta shape, flow, and exercise capacity in patients after arch repair, specifically through the lens of aortic size mismatch and descending aortic (DAo) flow and their association with exercise. Cardiac magnetic resonance (CMR), cardiopulmonary exercise test, and echocardiogram data within 1 year were analyzed from 58 patients (age 28 ± 10 years, 48% male) across 4 centers with history of isolated arch repair. Aortic arch measurements were correlated with % predicted VO2max with sub-group analyses of those with residual arch obstruction, bicuspid aortic valve, and hypertension. Ascending aorta (AAo) to DAo diameter ratio (DAAo/DDAo) was negatively correlated with % predicted VO2max. %DAo flow positively correlated with VO2max. Sub-analyses demonstrated the negative correlation of DAAo/DDAo with VO2max was maintained only in patients without arch obstruction and with a bicuspid aortic valve. Smaller aortic arch measurements were associated with both hypertension and exercise-induced hypertension. Aorta size mismatch, due to AAo dilation or small DAo, and associated decreased %DAo flow, correlated significantly with decreased exercise capacity after aortic arch repair. These correlations were stronger in patients without arch obstruction and with a bicuspid aortic valve. Aorta size mismatch and %DAo flow capture multiple mechanisms of altered hemodynamics beyond blood pressure gradient or discrete obstruction and can inform the definition of a successful repair.","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139155715","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":"Elevated arsenic level in fasting serum via ingestion of fish meat increased the risk of hypertension in humans and mice.","authors":"Takumi Kagawa,&nbsp;Nobutaka Ohgami,&nbsp;Tingchao He,&nbsp;Akira Tazaki,&nbsp;Shoko Ohnuma,&nbsp;Hisao Naito,&nbsp;Ichiro Yajima,&nbsp;Dijie Chen,&nbsp;Yuqi Deng,&nbsp;Takashi Tamura,&nbsp;Takaaki Kondo,&nbsp;Kenji Wakai,&nbsp;Masashi Kato","doi":"10.1093/ehjopen/oead074","DOIUrl":"10.1093/ehjopen/oead074","url":null,"abstract":"<p><strong>Aims: </strong>There has been a shortage of human studies to elucidate the association between serum arsenic levels and the prevalence of hypertension. This study multidirectionally investigated associations among arsenic exposure, dietary ingestion, and the risk of hypertension by combined human epidemiological and mouse experimental studies.</p><p><strong>Methods and results: </strong>This study focused on the total arsenic level in fasting serum, a biomarker of arsenic exposure. Associations among ingestion frequencies of 54 diet items of Japanese food separated into six categories, total arsenic level in fasting serum, and the prevalence of hypertension were investigated in 2709 general people in Japan. Logistic regression analysis demonstrated a dose-dependent association between serum arsenic level and hypertension and a positive association between the ingestion of fish meat and hypertension. Further analysis showed that the latter association was fully mediated by increased fasting serum arsenic levels in humans. Similarly, oral exposure to the putative human-equivalent dose of arsenic species mixture with the same ratios in a common fish meat in Japan increased systolic blood pressure and arsenic levels in fasting serum in mice.</p><p><strong>Conclusion: </strong>This interdisciplinary approach suggests that fish-meat ingestion is a potential risk factor for arsenic-mediated hypertension. Because the increased consumption of fish meat is a recent global trend, health risks of the increased ingestion of arsenic via fish meat should be further investigated.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e7/be/oead074.PMC10475452.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10170180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-year follow-up of patients treated with single antiplatelet therapy directly after percutaneous coronary intervention for non-ST-segment elevation acute coronary syndrome.","authors":"Niels M R van der Sangen,&nbsp;Bimmer E P M Claessen,&nbsp;I Tarik Küçük,&nbsp;Alexander W den Hartog,&nbsp;Wouter J Kikkert,&nbsp;Yolande Appelman,&nbsp;José P S Henriques","doi":"10.1093/ehjopen/oead075","DOIUrl":"https://doi.org/10.1093/ehjopen/oead075","url":null,"abstract":"<p><p>Graphical AbstractClinical outcomes and treatment adherence during 12 months follow-up. *Second bleeding event in same patient. PCI, percutaneous coronary intervention; TVR, target vessel revascularization.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/5d/oead075.PMC10482140.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10187846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: High prevalence of pre-eclampsia in women with coarctation of the aorta.","authors":"","doi":"10.1093/ehjopen/oead087","DOIUrl":"https://doi.org/10.1093/ehjopen/oead087","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ehjopen/oead072.].</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/80/be/oead087.PMC10504466.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10279487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of cangrelor and transition to oral P2Y₁₂ inhibitors in patients undergoing percutaneous coronary intervention: the ARCANGELO study.","authors":"Leonardo De Luca, Paolo Calabrò, Piera Capranzano, Carlo Di Mario, Fabio Chirillo, Cristina Rolfo, Alberto Menozzi, Maurizio Menichelli, Leonardo Bolognese, Giuseppe Musumeci","doi":"10.1093/ehjopen/oead076","DOIUrl":"10.1093/ehjopen/oead076","url":null,"abstract":"<p><strong>Aims: </strong>Cangrelor is the only intravenous P2Y₁₂ inhibitor available. Safety, efficacy, and transitioning from cangrelor to oral P2Y₁₂ inhibitors were recorded in patients with acute coronary syndrome (ACS). The ARCANGELO study aims to assess the safety of cangrelor on bleeding and the effects of the transition to oral P2Y₁₂ inhibitors in a real-world setting according to the European Medical Agency's requirement.</p><p><strong>Methods and results: </strong>Adult patients with ACS undergoing percutaneous coronary intervention (PCI) receiving cangrelor were included in the study. Patients were followed for 30 days. Incidence of bleeding events, major adverse cardiac events, and transition strategy to oral P2Y₁₂ were recorded. Among 1004 ACS patients undergoing PCI, 995 (99.1%) were eligible for the analysis; 597 (60.0%) of them had ST-segment elevation myocardial infarction. A total of 925 (93.1%) patients underwent PCI by radial catheter access, and 972 (97.2%) received drug-eluting stents. All eligible patients received bolus and cangrelor infusion between 2 and 4 h in 95% of the cases. A total of 730 patients (73.4%) received ticagrelor, 127 (12.8%) prasugrel, and 138 (13.9%) clopidogrel as transition therapy. Bleeding, according to Bleeding Academic Research Consortium (BARC) criteria, within 30 days post-PCI occurred in 5.2% of patients (95% confidence interval: 3.9-6.8%); 0.5% experienced a moderate (BARC 3), and all others mild (BARC 1-2) bleeding events. Major adverse cardiac events occurred in 14 (1.4%) patients, principally all-cause mortality (<i>n</i> = 6 patients) and myocardial infarction (<i>n</i> = 7 patients).</p><p><strong>Conclusion: </strong>The use of cangrelor in ACS patients undergoing PCI and the transition strategy to P2Y₁₂ inhibitors are confirmed as safe and effective in daily practice.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10462400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10176424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipoprotein(a): the enemy that we still don't know how to defeat.","authors":"Maciej Banach","doi":"10.1093/ehjopen/oead080","DOIUrl":"10.1093/ehjopen/oead080","url":null,"abstract":"","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/1e/oead080.PMC10460540.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10466750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic flow is associated with aging and exercise capacity.","authors":"Xiaodan Zhao, Pankaj Garg, Hosamadin Assadi, Ru-San Tan, Ping Chai, Tee Joo Yeo, Gareth Matthews, Zia Mehmood, Shuang Leng, Jennifer Ann Bryant, Lynette L S Teo, Ching Ching Ong, James W Yip, Ju Le Tan, Rob J van der Geest, Liang Zhong","doi":"10.1093/ehjopen/oead079","DOIUrl":"10.1093/ehjopen/oead079","url":null,"abstract":"<p><strong>Aims: </strong>Increased blood flow eccentricity in the aorta has been associated with aortic (AO) pathology, however, its association with exercise capacity has not been investigated. This study aimed to assess the relationships between flow eccentricity parameters derived from 2-dimensional (2D) phase-contrast (PC) cardiovascular magnetic resonance (CMR) imaging and aging and cardiopulmonary exercise test (CPET) in a cohort of healthy subjects.</p><p><strong>Methods and results: </strong>One hundred and sixty-nine healthy subjects (age 44 ± 13 years, M/F: 96/73) free of cardiovascular disease were recruited in a prospective study (NCT03217240) and underwent CMR, including 2D PC at an orthogonal plane just above the sinotubular junction, and CPET (cycle ergometer) within one week. The following AO flow parameters were derived: AO forward and backward flow indexed to body surface area (FFi, BFi), average flow displacement during systole (FDs_avg), late systole (FDls_avg), diastole (FDd_avg), systolic retrograde flow (SRF), systolic flow reversal ratio (sFRR), and pulse wave velocity (PWV). Exercise capacity was assessed by peak oxygen uptake (PVO₂) from CPET. The mean values of FDs_avg, FDls_avg, FDd_avg, SRF, sFRR, and PWV were 17 ± 6%, 19 ± 8%, 29 ± 7%, 4.4 ± 4.2 mL, 5.9 ± 5.1%, and 4.3 ± 1.6 m/s, respectively. They all increased with age (<i>r</i> = 0.623, 0.628, 0.353, 0.590, 0.649, 0.598, all <i>P</i> < 0.0001), and decreased with PVO₂ (r = -0.302, -0.270, -0.253, -0.149, -0.219, -0.161, all <i>P</i> < 0.05). A stepwise multivariable linear regression analysis using left ventricular ejection fraction (LVEF), FFi, and FDs_avg showed an area under the curve of 0.769 in differentiating healthy subjects with high-risk exercise capacity (PVO₂ ≤ 14 mL/kg/min).</p><p><strong>Conclusion: </strong>AO flow haemodynamics change with aging and predict exercise capacity.</p><p><strong>Registration: </strong>NCT03217240.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10460199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10163378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary microcirculatory dysfunction can be assessed by positive dicrotic wave and amplitude index on resting distal coronary pressure waveform, a newly developed index.","authors":"Yoshiharu Fujimori,&nbsp;Satoshi Hashimoto,&nbsp;Miki Takahashi,&nbsp;Hirotada Hoshino,&nbsp;Kenji Shimizu,&nbsp;Yuya Terasawa,&nbsp;Tadamasa Wakabayashi,&nbsp;Taku Imai","doi":"10.1093/ehjopen/oead070","DOIUrl":"10.1093/ehjopen/oead070","url":null,"abstract":"<p><strong>Aims: </strong>Some lesions have high resting distal coronary pressure/aortic pressure (Pd/Pa) despite low fractional flow reserve (FFR). This study aimed to assess microcirculatory dysfunction as a possible basal mechanism.</p><p><strong>Methods and results: </strong>Patients were grouped into two according to coffee intake (caffeine 222 mg) before coronary angiography. Through an adenosine-induced Pd/Pa decrease, amplitude index was calculated by dividing the difference between the highest pressure after the inflection point and the minimal diastolic pressure by the pulse pressure on the Pd waveform. In 130 coronary lesions (caffeine group, <i>n</i> = 69; non-caffeine group, <i>n</i> = 61) from 113 patients, the amplitude index through the adenosine-induced Pd/Pa decrease in all lesions was 0.54 ± 0.11 at resting Pd/Pa and 0.44 ± 0.12 at FFR (<i>P</i> < 0.0001). The positive dicrotic wave distribution on a maximal hyperaemia (FFRnicr)-resting Pd/Pa graph was analysed. In lesions with FFRnicr <0.80 on the FFRnicr-resting Pd/Pa graph, the resting Pd/Pa was divided into three zones based on Pd/Pa values: high-remaining, intermediate, and low. The high-remaining zone had a higher amplitude index than the intermediate zone (0.60 ± 0.09 vs. 0.48 ± 0.12; <i>P</i> < 0.005); the low zone lesions had no inflection point (no amplitude index). The high-remaining zone correlated with a larger positive dicrotic wave than the intermediate zone (94 vs. 30%; <i>P</i> < 0.005). Most lesions in the high-remaining zone corresponded to the caffeine group.</p><p><strong>Conclusion: </strong>In severe coronary stenosis, a high-remaining resting Pd/Pa with a high amplitude index or a positive dicrotic wave on the resting Pd waveform suggests microcirculatory dysfunction, such as insufficient arteriolar dilation reactive to myocardial ischaemia.</p><p><strong>Registration: </strong>UMIN000046883.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/91/82/oead070.PMC10334376.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10193268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}