European Heart Journal最新文献

{"title":"Early outcomes of children with univentricular circulation undergoing Fontan surgery: the EuroFontan registry.","authors":"Massimo A Padalino,Andrew Constantine,Emma Bergonzoni,Irene Cao,Jurgen Horer,Masamichi Ono,Helena Staehler,Eva Sames-Dolzer,Gregor Gierlinger,Mark Hazekamp,Friso M Rijnberg,Lorenzo Galletti,Gianfranco Butera,Mario Panebianco,Bart Meyns,Joeri Van Puyvelde,Illya Yemets,Elshad Bairamov,Andrzej Kansy,Matej Nosal,Marien Lenoir,Emanuela Angeli,Lucio Careddu,Thomas Martens,Thierry Bove,Carlo Pace Napoleone,Mauro Lo Rito,Alessandro Giamberti,Claudia Montanaro,Stefano Marianeschi,Salvatore Agati,George K Sarris,Eleftherios Protopapas,Alvaro Gonzalez Rocafort,Giuseppe Scrascia,Giovanni Meliota,Ugo Vairo,Guido Michielon,Anna Gozzi,Roberta Biffanti,Biagio Castaldi,Dario Gregori,Luca Vedovelli,Giovanni Di Salvo,Vladimiro Vida,Konstantinos Dimopoulos","doi":"10.1093/eurheartj/ehaf835","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf835","url":null,"abstract":"BACKGROUND AND AIMSThe Fontan operation and its modifications have transformed the management of children with functional single ventricle physiology. While outcomes have improved, peri-operative complications remain common. This study aimed to assess early outcomes and complications following Fontan completion in a large international European cohort.METHODSThe EuroFontan registry is a multicentre retrospective study involving 21 congenital heart disease and transplant centres across Europe. Data were collected on patients who underwent Fontan surgery from January 1990 to January 2023. Analyses focused on the most recent 15-year period. A composite early adverse outcome (death within 30 days or in-hospital, low cardiac output syndrome, stroke, or Fontan takedown) was used. Predictors were assessed using multivariable mixed-effects logistic regression, with centre included as a random effect. Missing data were handled using multiple imputation with Rubin's rules, and sensitivity analyses were performed to assess robustness.RESULTSOf 3510 patients, this analysis focused on 2075 individuals from the past 15 years, with a median age of 4.2 [interquartile range 3.2-6.2] years at Fontan completion. Early mortality was 1.0% (95% confidence interval .66%-1.54%). The composite adverse outcome occurred in 5.1% (95% confidence interval 4.2%-6.1%). On multivariable analysis, morphology other than tricuspid atresia was the only significant predictor of the composite outcome (odds ratio 2.2, 95% confidence interval 1.21-3.99, P = .01).CONCLUSIONSFontan surgery has evolved and, in contemporary practice, has low peri-operative morbidity and mortality. Morphology other than tricuspid atresia was associated with increased risk of early adverse outcomes, highlighting the importance of pre-operative risk stratification.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"52 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When bias correction becomes bias: lessons for cardiovascular age models.","authors":"Mendel Lebowitz,Gourav Modanwal,Anant Madabhushi","doi":"10.1093/eurheartj/ehaf800","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf800","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"102 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic deprivation: barriers to guideline implementation for cardiovascular disease.","authors":"Chris Wilkinson,Ramesh Nadarajah,Eva Irene Bossano Prescott,Blake Thomson,Rajesh Vedanthan,Antonio Luiz P Ribeiro,Chris P Gale","doi":"10.1093/eurheartj/ehaf735","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf735","url":null,"abstract":"The implementation of guideline-recommended care is associated with improved clinical outcomes for patients with cardiovascular disease. It is well documented that people living in low socioeconomic position have a high burden of cardiovascular disease and higher mortality rates. In this state-of-the-art review, the association of socioeconomic deprivation and guideline implementation is outlined, showing that across a range of settings, countries and clinical scenarios people with low socioeconomic position are further disadvantaged by sub-optimal provision of guideline recommended care. Reducing cardiovascular health inequality and improving population education should be priorities for governments. Greater attention to the provision of guideline-indicated care is recommended by tackling modifiable barriers to care. Broadly, the prioritization of use of advocacy, workforce, broader policy responses, data, randomized clinical trial re-design, quality indicators, and risk scores are recommended to reduce health inequalities for those who live in socioeconomic deprivation. A renewed focus on the provision of high-quality guideline-recommended cardiovascular care has the potential to reduce healthcare inequalities as well as improve clinical outcomes amongst our most socioeconomically deprived populations.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"10 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approaches to age bias correction.","authors":"Declan P O'Regan, Vladimir Losev","doi":"10.1093/eurheartj/ehaf801","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf801","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":35.6,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal timing for genetic verification of familial hypercholesterolaemia in children.","authors":"Sofie Taageby Nielsen,Ruth Frikke-Schmidt","doi":"10.1093/eurheartj/ehaf773","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf773","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"140 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implantable cardioverter-defibrillator for primary prevention in children and adolescents with long QT syndrome: rethinking the boundaries.","authors":"Qing Li,Ting-Ting Lv,Ping Zhang","doi":"10.1093/eurheartj/ehaf807","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf807","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"41 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LDL-cholesterol in newborns and children with genetically verified familial hypercholesterolaemia: implications for cholesterol-based screening.","authors":"Martin Prøven Bogsrud,Tonje Talsnes Stava,Knut Erik Berge,Thea Bismo Strøm,Kjetil Retterstøl,Kirsten B Holven","doi":"10.1093/eurheartj/ehaf815","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf815","url":null,"abstract":"BACKGROUND AND AIMSCholesterol screening in children, with subsequent genetic testing of top percentile, has been suggested as an efficient universal screening approach in familial hypercholesterolaemia (FH). The potential cholesterol-based screening efficacy was investigated in a national genetically based screening programme.METHODSData were from the Norwegian national family cascade screening programme in FH children from 1998 to 2023. Cholesterol levels [umbilical cord in newborns (n = 113) and venous blood in children 1-12 years old (n = 1346)] in variant positive and variant negative children were compared.RESULTSLDL cholesterol (LDL-C) was higher in FH newborns vs non-FH newborns [1.22 (.48) vs .68 (.32) mmol/L, P < .001], but overlapped widely. Cut-off levels corresponding to the 95th and 85th percentile would only identify 55.7% and 75.4% of newborns with FH, respectively. Screening efficacy in newborns did not differ in subgroups: boys and girls, null and non-null variants, variant gene, and neither for total cholesterol nor for non-HDL cholesterol. In all other age groups (from 1 to 12 years), LDL-C discriminated highly between mutation FH and non-FH children. Cut-off levels corresponding to 95th and 85th percentile of LDL-C would identify 88.4% and 94.1% of 1-12-year-old children with FH, respectively.CONCLUSIONSPrevious studies investigating lipid or genetic screening approaches for FH have limitations of only performing genetic testing in children with high LDL-C levels. The present study is the first to show the true LDL-C overlap in children with FH vs non-FH by utilizing unique data from a national family cascade screening programme. Cholesterol-based screening approaches for FH only seem feasible from 1 year of age onward.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"46 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The limitations of biomarkers in addressing bias in alcohol and cardiovascular disease research.","authors":"Elizabeth K Farkouh,Shantanu Srivatsa,Michael E Farkouh","doi":"10.1093/eurheartj/ehaf548","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf548","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"23 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endothelial to mesenchymal transition in cardiovascular diseases: molecular insights and clinical perspectives.","authors":"Ignacio Fernando Hall,Elena Aikawa,Judith Sluimer,Andrew H Baker,Jason C Kovacic","doi":"10.1093/eurheartj/ehaf670","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf670","url":null,"abstract":"Endothelial to mesenchymal transition (EndMT) is a process whereby endothelial cells transition to adopt a mesenchymal-like fate, e.g. to become smooth muscle cells, osteoblasts, fibroblasts, or chondrocytes. In embryonic heart development, the importance of EndMT was established several decades ago, with ECs undergoing EndMT to give rise to the endocardial cushions that ultimately develop into the cardiac valves. More recently, EndMT has been observed in various adult cardiovascular diseases. This has been established through the application of state-of-the-art research tools, including cell lineage tracing in mice and single cell RNA sequencing, which have allowed in depth profiling of endothelial cells that have undergone transition to a mesenchymal-like state. As with any emerging field, certain challenges have arisen, such as the lack of a standardized definition of what constitutes EndMT at a molecular level and obtaining proof in humans that EndMT is mechanistically involved in the pathophysiology of cardiovascular diseases. The greatest evidence for the presence of cells undergoing EndMT in the adult exists for transplant vasculopathy, pulmonary arterial hypertension, vein graft remodeling, atherosclerosis, and valvular heart disease. The transforming growth factor beta pathway is the major driver, but this is not the exclusive signalling mechanism governing this complex process. Translational large animal studies have already been undertaken to inhibit EndMT in both valvular heart disease and vein graft remodeling, with positive results. These studies pave the way towards first-in-human clinical inhibition of EndMT as a therapeutic strategy. Here we review this exciting field, with particular emphasis on the functional role of EndMT in adult cardiovascular diseases using atherosclerosis and valvular disease as exemplars.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"12 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospects for the treatment of paediatric LQT patients with a high-risk profile for major arrhythmic events.","authors":"Lea Lippert,Cordula M Wolf","doi":"10.1093/eurheartj/ehaf809","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf809","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"54 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}