European Heart Journal最新文献

{"title":"Monopolar biphasic pulsed field ablation and coronary endothelial function: the Vasc-PFA study.","authors":"Tasnim Mohaissen, Andreina Josefina Gil-Ramirez, Julie Norup Hertel, Charles Ye, Sevasti-Maria Chaldoupi, Benedikt Linz, Jim Hansen, Samuel N Baldwin, Jessica L Meades, Arnela Saljic, Sarah Dalgas Nissen, Thomas Jespersen, Thomas A Jepps, Dominik Linz","doi":"10.1093/eurheartj/ehag781","DOIUrl":"https://doi.org/10.1093/eurheartj/ehag781","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":45.3,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147883","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":"Palmitic acid promotes hypertrophic memory in cardiomyocytes via KDM5A/H3K4me3.","authors":"Kun Yang, Rifeng Gao, Jiaran Shi, Xiang Wei, Xujia Lu, Hanchuan Chen, Wei Wei, Jingjing Hu, Juntao Chen, Yang Lyu, Pingjin Gao, Chaofu Ke, Aijun Sun","doi":"10.1093/eurheartj/ehag761","DOIUrl":"https://doi.org/10.1093/eurheartj/ehag761","url":null,"abstract":"<p><strong>Background and aims: </strong>Palmitic acid (PA), the most abundant saturated fatty acid (SFA), is positively associated with heart failure (HF) risk. However, its role and mechanism underlying HF remain unclear. This study aimed to investigate the effects of a PA-enriched diet and potential therapeutic targets in HF.</p><p><strong>Methods: </strong>The association between plasma SFAs and HF was investigated in a cohort of 232 592 UK Biobank participants. Mice were randomly categorized into three groups, where they were fed a PA-enriched, olive oil-enriched, or control diet for 4 weeks, followed by a 4-week dietary adaptation period on the control diet. A pressure overload model was established by transverse aortic constriction in these mice and cardiac-specific lysine demethylase 5A (Kdm5A)-knockout mice.</p><p><strong>Results: </strong>The UK Biobank database revealed an association between high plasma SFA levels and increased HF risk. Our in vitro and in vivo results demonstrated that short-term PA treatment promoted cardiac hypertrophy and HF without further exposure to high levels of PA, indicating a pro-hypertrophic memory in cardiomyocytes. Mechanistically, PA promoted palmitoylation-driven KDM5A degradation via the ubiquitination pathway, thereby up-regulating histone 3 lysine 4 tri-methylation (H3K4me3). KDM5A/H3K4me3 promoted a pro-hypertrophic memory in cardiomyocytes, thus causing cardiac hypertrophy via a monocarboxylate transporter 4 (MCT4)-induced metabolic imbalance. Furthermore, KDM5A agonist D18 ameliorated this PA-mediated cardiac hypertrophy and HF.</p><p><strong>Conclusions: </strong>A PA-enriched diet promotes pro-hypertrophic memory in cardiomyocytes, cardiac hypertrophy, and HF via KDM5A/H3K4me3/MCT4. The application of D18 may represent a promising therapeutic approach for PA-mediated cardiac hypertrophy and HF.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":45.3,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147048","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":"Ethnicity does not equal region and patient-level evidence should always prevail over aggregate-data inference: the treatment effects of clopidogrel are consistent across Asian and non-Asian regions of enrolment.","authors":"Felice Gragnano, Daniele Giacoppo, Marco Valgimigli","doi":"10.1093/eurheartj/ehag802","DOIUrl":"https://doi.org/10.1093/eurheartj/ehag802","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":45.3,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147755","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":"Genetics of poor medication adherence: revealing risks and novel therapeutic targets.","authors":"Raphael S Schmieder, Heribert Schunkert","doi":"10.1093/eurheartj/ehag726","DOIUrl":"https://doi.org/10.1093/eurheartj/ehag726","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":45.3,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148043","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":"Correction to: 2023 ESC Guidelines for the management of cardiomyopathies: Developed by the task force on the management of cardiomyopathies of the European Society of Cardiology (ESC).","authors":"","doi":"10.1093/eurheartj/ehag645","DOIUrl":"10.1093/eurheartj/ehag645","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"5557"},"PeriodicalIF":45.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758092","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":"Blood aldosterone concentrations and effects of mineralocorticoid receptor antagonists in heart failure.","authors":"Veena S Rao, Juan B Ivey-Miranda, Zachary L Cox, Francis Perry Wilson, Mark C Petrie, Mark Sarnak, Christopher S Wilcox, Bertram Pitt, Wendy McCallum, Jeffrey M Testani","doi":"10.1093/eurheartj/ehag440","DOIUrl":"10.1093/eurheartj/ehag440","url":null,"abstract":"<p><strong>Background and aims: </strong>Low-dose mineralocorticoid receptor antagonists (MRAs) are guideline-recommended heart failure (HF) therapies. However, MRAs increase aldosterone production, and the sub-saturating doses utilized may allow continued mineralocorticoid receptor (MR) stimulation. The aim of the current analysis was to understand how baseline and change in aldosterone concentrations during MRA therapy impacts MR activity and clinical outcomes.</p><p><strong>Methods: </strong>HF cohorts with MRA exposure and plasma aldosterone concentrations available were included in patient-level, pooled cohort analyses [DOSE, CARRESS-HF, MDR, and TOPCAT (n = 1019)]. In the MDR cohort (n = 136), urine sodium to potassium ratio was utilized to quantitate MR activity. The relationship of pre-MRA aldosterone concentration, MRA use, and clinical outcomes were meta-analysed utilizing the above pooled cohorts in addition to the EARLIER (n = 300) and EPHESUS (n = 453) trials.</p><p><strong>Results: </strong>MRA use was associated with significantly higher median aldosterone concentrations [MRA = 310 (interquartile range, IQR 180, 533) pg/mL vs no MRA = 174 (IQR 106, 299) pg/mL, P < .001] in the pooled cohort. In the MDR cohort, higher aldosterone was correlated with higher MR activity, with a similar relationship on MRA (r = -.52, P < .001) vs off MRA (r = -.44, P < .001, P interaction = .65), differing only in that higher aldosterone concentrations were required on MRA to achieve the same level of MR activity. In patients with high pre-MRA aldosterone, new MRA initiation reduced MR activity, but MRA initiation increased MR activity in patients with low pre-MRA aldosterone [median change in urine Na/K with high aldosterone =1.4 (IQR 1.1, 2.9) vs low aldosterone = -.9 (IQR -2.1, -.1), P < .001]. In the pooled cohort, the association between MRA use and clinical outcomes was dependent on pre-MRA aldosterone concentration (P interaction = .005). In patients with high pre-MRA aldosterone, MRA was associated with substantially improved clinical outcomes [hazard ratio (HR) .63, 95% confidence interval (CI) .42-.92, P = .02]. However, in patients with low pre-MRA aldosterone, MRA use was associated with worse clinical outcomes (HR 1.66, 95% CI 1.12-2.45, P = .01).</p><p><strong>Conclusions: </strong>Low-dose MRAs significantly increase aldosterone but inadequately block MR activity (measured by urine Na/K) at these new higher aldosterone concentrations. In patients with high pre-MRA aldosterone, MRA use is associated with improved MR activity and clinical outcomes. However, in patients with lower pre-MRA aldosterone concentrations, MRA use is associated with worsened MR activity and clinical outcomes. MRAs remain guideline-directed HF medications with established population level benefit, but these hypothesis-generating findings indicate additional research is warranted to understand if outcomes can be further improved.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"5558-5568"},"PeriodicalIF":45.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257881","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 heart, sex hormones, and ageing: of women and men.","authors":"Viktor Čulić","doi":"10.1093/eurheartj/ehag676","DOIUrl":"10.1093/eurheartj/ehag676","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"5606-5607"},"PeriodicalIF":45.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886844","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":"ESC Guidelines, mechanisms of myocarditis, novel insights into treatment with mineralcorticoid receptor antagonists, cardiac glycosides, and GLP-1 receptor agonists.","authors":"Filippo Crea","doi":"10.1093/eurheartj/ehag792","DOIUrl":"https://doi.org/10.1093/eurheartj/ehag792","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"47 38","pages":"5327-5333"},"PeriodicalIF":45.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147819","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":"2026 ESC Guidelines for the management of heart failure.","authors":"Lars Køber, Marianna Adamo, Anne-Christine Ruwald, Daniela Tomasoni, Lisa J Anderson, Charlotte Andersson, Jasper J Brugts, Ovidiu Chioncel, Erwan Donal, Peter Ferdinandy, Pardeep S Jhund, Francisco Leyva, Roberto Lorusso, Michael Madigan, Wilfried Mullens, Stefania Paolillo, Nicola Ryan, Maggie Simpson, Holger Thiele, Jens Jakob Thune, Emeline M Van Craenenbroeck, Linda W Van Laake, Mariette Verbakel","doi":"10.1093/eurheartj/ehag100","DOIUrl":"10.1093/eurheartj/ehag100","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"5346-5457"},"PeriodicalIF":45.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839493","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":"Blinded withdrawal of randomized treatment with low-dose digoxin or placebo in heart failure: the DECISION trial.","authors":"Peter van der Meer, Dirk J van Veldhuisen, Geert H D Voordes, Jan Tijssen, Marco Alings, Marcel L Bouvy, Henk P Swart, H Jaco Houtgraaf, H G Reinhart Dorman, Michiel Rienstra, Kevin Damman, Arend Mosterd","doi":"10.1093/eurheartj/ehag385","DOIUrl":"10.1093/eurheartj/ehag385","url":null,"abstract":"<p><strong>Background and aims: </strong>Whether digoxin withdrawal is safe in patients with heart failure (HF) optimized on contemporary guideline-recommended medical therapy remains unknown. This pre-specified analysis of the DECISION trial evaluated outcomes following blinded withdrawal of digoxin or placebo.</p><p><strong>Methods: </strong>In DECISION, 1001 patients were randomized to low-dose digoxin or placebo and treated for a median of 36.5 months. At the end of the study, 587 patients on active treatment (digoxin 288 and placebo 299) underwent blinded withdrawal with an in-person follow-up visit at 6 weeks. All events were adjudicated.</p><p><strong>Results: </strong>During the pre-withdrawal phase (100 days), incidence rates of cardiovascular (CV) death or worsening HF events were 5.7 vs 6.5 events per 100 patient-years in the digoxin vs placebo group; rate ratio (RR) 0.88; 95% confidence interval (CI) [0.24-3.10]. Following withdrawal, the incidence rate increased markedly in patients withdrawn from digoxin but not placebo (42.8 vs 5.9 events per 100 patient-years; time period-by-treatment interaction, P = .036). Fourteen events (12 hospitalizations and 2 urgent HF visits) occurred in the digoxin withdrawal arm vs two (one HF hospitalization and one CV death) in the placebo withdrawal arm (RR 7.37, 95% CI 1.56-34.88; P = .012). Withdrawal of digoxin was accompanied by an increase in heart rate (P = .003), reduction in systolic blood pressure (P = .014), and rise in NT-proBNP (P = .002).</p><p><strong>Conclusions: </strong>Discontinuation of digoxin after long-term treatment is associated with clinical deterioration in patients with HF and a reduced or mildly reduced ejection fraction. These findings warrant caution when stopping digoxin.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"5545-5553"},"PeriodicalIF":45.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147867337","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}