European Heart Journal最新文献

{"title":"A 14.6 cm paediatric aortic monster: first LOX mutation shattering size records in childhood thoracic aortic aneurysm and dissection.","authors":"Nanjun Zhang,Jianfeng Pu,Chuan Wang","doi":"10.1093/eurheartj/ehaf333","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf333","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"138 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103778","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":"2024 Revision of the level of evidence grading system for ESC clinical practice guideline recommendations II: diagnostic tests and prediction models.","authors":"Emanuele Di Angelantonio, Lisa Pennells, Magdy Abdelhamid, Victor Aboyans, Riccardo Asteggiano, Jelena Čelutkienė, Diederick E Grobbee, Bernard Iung, Peter Jüni, John William McEvoy, Amina Rakisheva, Xavier Rossello, Frank L J Visseren, Colin Baigent, Eva B Prescott","doi":"10.1093/eurheartj/ehaf016","DOIUrl":"10.1093/eurheartj/ehaf016","url":null,"abstract":"<p><p>The level of evidence (LOE) grading system for European Society of Cardiology (ESC) Clinical Practice Guidelines (CPG) classifies the quality of the evidence supporting a recommendation. However, the current taxonomy does not fully consider the optimal study design necessary to establish evidence for different types of recommendations in ESC guidelines. Therefore, two separate task forces of clinical and methodological experts were appointed by the CPG Committee, with the first tasked with updating the LOE grading system for therapy and prevention and the second responsible for developing a LOE grading system for diagnosis and prediction. This report from the second of these Task Forces develops a new system for diagnostic tests and prediction models which maintains the three-level grading structure to classify the quality of the evidence but introduces new definitions specific for diagnosis and prediction. For diagnostic tests, LOE A represents conclusive evidence of adequate diagnostic ability from at least two high-quality studies. Level of evidence B represents suggestive evidence from one high-quality or at least two moderate-quality studies. Level of evidence C represents preliminary evidence not classified as A or B, including evidence from less than two moderate-quality studies, or from expert consensus. For prediction models, LOE A represents conclusive evidence of adequate predictive ability from at least one high-quality derivation and two or more external validation studies of at least moderate quality. Level of evidence B represents suggestive evidence in one or more derivation studies and one or more external validation studies of at least moderate quality. Level of evidence C represents preliminary evidence not classified as A or B, including evidence from a derivation study of at least moderate quality, but with low quality or no external validation, or a derivation study of low quality.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"1895-1906"},"PeriodicalIF":37.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Fontan Adult Brompton clinical score and mortality risk.","authors":"Claudia Montanaro, Alexandra Arvanitaki, William Kerrigan, Zehra Kadani, Rosaria Barracano, Giancarlo Scognamiglio, Aleksander Kempny, Wei Li, Margarita Brida, Ella McDonnell, Hajar Habibi, Konstantinos Dimopoulos, Isma Rafiq, Heng Ee Ling, Harith Alam, Berardo Sarubbi, Gerhard-Paul Diller, Michael A Gatzoulis","doi":"10.1093/eurheartj/ehaf137","DOIUrl":"10.1093/eurheartj/ehaf137","url":null,"abstract":"<p><strong>Background and aims: </strong>Adults with congenital heart disease who underwent a Fontan palliation are at increased risk of premature death. This study aimed to identify a risk score based on widely available clinical variables at the first adult visit and facilitate personalized care.</p><p><strong>Methods: </strong>A single tertiary centre retrospective study included adults with a Fontan circulation during their first adults with congenital heart disease outpatient visit. Anatomic and periprocedural data, clinical, laboratory, and echocardiographic parameters at the first visit, and mortality or heart transplantation data were examined. A stepwise backward conditional approach was used to build a multivariate prognostic model, validated in an external retrospective cohort.</p><p><strong>Results: </strong>Overall, 230 patients (49.6% female), the median age of 21.7 [interquartile range (IQR) 18.7-28.0] years, were included. Within 10.2 years of follow-up, 44 patients died and two received heart transplantation. A score including age at the first visit, history of atrial tachyarrhythmia, heart failure, New York Heart Association class, systolic blood pressure, and resting arterial oxygen saturation was derived, discriminating patients into low, intermediate, and high risk of death or transplantation [C-index: 0.71, 95% confidence interval (CI) 0.62-0.80]; discriminative ability was excellent (C-index 0.92, 95% CI 0.90-0.95) when externally validated in a cohort of 80 patients [41.2% female, median age 18.4 (IQR 17.3-24.8) years] with similar freedom from transplantation survival with the derivation cohort (log-rank P = .77).</p><p><strong>Conclusions: </strong>This novel, readily available, externally validated, clinical score identifies adult patients with a Fontan palliation at risk of mortality or transplantation and can be applied towards personalized care in this growing population with complex congenital heart disease.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"1933-1945"},"PeriodicalIF":37.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699842","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":"Possible perspectives for cardiovascular events following coronavirus disease 2019 vaccination.","authors":"Xue-Yan Gong, James Cheng-Chung Wei, Li-Yun Zhang","doi":"10.1093/eurheartj/ehaf112","DOIUrl":"10.1093/eurheartj/ehaf112","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"1950"},"PeriodicalIF":37.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575582","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":"Checkpoint kinase Wee1 activation drives inflammation and hypertrophy through the protein kinase B/phosphoinositide 3-kinases-nuclear factor κB pathway in cardiomyocytes.","authors":"Mengyang Wang,Xue Han,Qinyan Wang,Tianxiang Yu,Wu Luo,Shiju Ye,Xiaochen Guo,Zheng Xu,Zhuqi Huang,Julian Min,Ping Huang,Yi Wang,Guang Liang","doi":"10.1093/eurheartj/ehaf349","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf349","url":null,"abstract":"BACKGROUND AND AIMSHypertensive heart failure has an urgent need for new therapeutic targets. Protein kinases act as key regulators in cellular actions relevant to cardiac pathophysiology. This study identified a protein kinase, Wee1 G2 checkpoint kinase (Wee1), being activated and involved in this disease.METHODSRNA-seq-based kinase enrichment analysis was used to identify the involved kinase pathways. Cardiomyocyte-specific Wee1-deficiency mice with chronic angiotensin II (Ang II) infusion and transverse aortic constriction (TAC) were utilized to develop cardiac remodelling. RNA-seq and co-immunoprecipitation were used to explore the mechanism and substrate of Wee1.RESULTSKinase enrichment analysis and experimental evidence revealed that Wee1 phosphorylation at Ser642, but not increased expression, was observed in hypertrophic cardiac tissues from both mice and human patients. Knockdown, pharmacological inhibition, or mutational inactivation of Wee1 significantly alleviated Ang II-induced cardiomyocyte injuries. RNA-seq analysis showed that phosphoinositide 3-kinases/protein kinase B (AKT) pathway mediated the function of Wee1 in cardiomyocytes. Mechanistically, the phosphorylated Wee1 directly binds to the PHD domain of AKT to phosphorylate AKT inducing AKT/phosphoinositide 3-kinases-nuclear factor κB signalling pathway activation and subsequent inflammation and hypertrophy in cardiomyocytes. Cardiomyocyte-specific Wee1 deficiency was found to protect against cardiac inflammation, remodelling, and dysfunction in mice subjected to transverse aortic constriction or Ang II infusion. Pharmacological Wee1 inhibition also attenuated Ang II-induced cardiac remodelling in mice.CONCLUSIONSCardiomyocyte Wee1 activation drives inflammation and hypertrophy by directly phosphorylating AKT and activating AKT-nuclear factor κB pathway. This study identifies Wee1 as a new upstream kinase of AKT and a potential therapeutic target for hypertensive heart failure.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"6 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103727","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":"Key points for analysing cardiovascular disease after delivery of twin pregnancies.","authors":"Xin Li,Xue Xiao,Tianjiao Liu","doi":"10.1093/eurheartj/ehaf335","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf335","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"34 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103730","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":"Artificial intelligence applied to electrocardiogram to rule out acute myocardial infarction: the ROMIAE multicentre study.","authors":"Min Sung Lee, Tae Gun Shin, Youngjoo Lee, Dong Hoon Kim, Sung Hyuk Choi, Hanjin Cho, Mi Jin Lee, Ki Young Jeong, Won Young Kim, Young Gi Min, Chul Han, Jae Chol Yoon, Eujene Jung, Woo Jeong Kim, Chiwon Ahn, Jeong Yeol Seo, Tae Ho Lim, Jae Seong Kim, Jeff Choi, Joon-Myoung Kwon, Kyuseok Kim","doi":"10.1093/eurheartj/ehaf004","DOIUrl":"10.1093/eurheartj/ehaf004","url":null,"abstract":"<p><strong>Background and aims: </strong>Emerging evidence supports artificial intelligence-enhanced electrocardiogram (AI-ECG) for detecting acute myocardial infarction (AMI), but real-world validation is needed. The aim of this study was to evaluate the performance of AI-ECG in detecting AMI in the emergency department (ED).</p><p><strong>Methods: </strong>The Rule-Out acute Myocardial Infarction using Artificial intelligence Electrocardiogram analysis (ROMIAE) study is a prospective cohort study conducted in the Republic of Korea from March 2022 to October 2023, involving 18 university-level teaching hospitals. Adult patients presenting to the ED within 24 h of symptom onset concerning for AMI were assessed. Exposure included AI-ECG score, HEART score, GRACE 2.0 score, high-sensitivity troponin level, and Physician AMI score. The primary outcome was diagnosis of AMI during index admission, and the secondary outcome was 30 day major adverse cardiovascular event (MACE).</p><p><strong>Results: </strong>The study population comprised 8493 adults, of whom 1586 (18.6%) were diagnosed with AMI. The area under the receiver operating characteristic curve for AI-ECG was 0.878 (95% CI, 0.868-0.888), comparable with the HEART score (0.877; 95% CI, 0.869-0.886) and superior to the GRACE 2.0 score, high-sensitivity troponin level, and Physician AMI score. For predicting 30 day MACE, AI-ECG (area under the receiver operating characteristic, 0.866; 95% CI, 0.856-0.877) performed comparably with the HEART score (0.858; 95% CI, 0.848-0.868). The integration of the AI-ECG improved risk stratification and AMI discrimination, with a net reclassification improvement of 19.6% (95% CI, 17.38-21.89) and a C-index of 0.926 (95% CI, 0.919-0.933), compared with the HEART score alone.</p><p><strong>Conclusions: </strong>In this multicentre prospective study, the AI-ECG demonstrated diagnostic accuracy and predictive power for AMI and 30 day MACE, which was similar to or better than that of traditional risk stratification methods and ED physicians.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"1917-1929"},"PeriodicalIF":37.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weekly Journal Scan: Uncoupling thrombosis from hemostasis in atrial fibrillation? An AZALEA surfing over troubled water.","authors":"Mattia Galli, Carlo Patrono","doi":"10.1093/eurheartj/ehaf145","DOIUrl":"10.1093/eurheartj/ehaf145","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"1951-1952"},"PeriodicalIF":37.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699817","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":"European Society of Cardiology Clinical Practice Guidelines: fostering implementation in low-resource settings.","authors":"Eva Prescott","doi":"10.1093/eurheartj/ehaf075","DOIUrl":"10.1093/eurheartj/ehaf075","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"1879-1880"},"PeriodicalIF":37.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729500","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":"New level of evidence grading system for Guidelines, artificial intelligence, and adult congenital heart disease.","authors":"Filippo Crea","doi":"10.1093/eurheartj/ehaf298","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf298","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"13 1","pages":"1875-1878"},"PeriodicalIF":39.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103606","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}