Oliver B Vad, Nick van Vreeswijk, Ahmed S Yassin, Yuri Blaauw, Christian Paludan-Müller, Jørgen K Kanters, Claus Graff, Ulrich Schotten, Emelia J Benjamin, Jesper H Svendsen, Michiel Rienstra
{"title":"Atrial cardiomyopathy: markers and outcomes","authors":"Oliver B Vad, Nick van Vreeswijk, Ahmed S Yassin, Yuri Blaauw, Christian Paludan-Müller, Jørgen K Kanters, Claus Graff, Ulrich Schotten, Emelia J Benjamin, Jesper H Svendsen, Michiel Rienstra","doi":"10.1093/eurheartj/ehaf793","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf793","url":null,"abstract":"Background and Aims Atrial cardiomyopathy (AtCM) is increasingly recognized as an important substrate for atrial fibrillation (AF). This study aimed to examine potential markers and risk factors of AtCM, and associations with incident AF, heart failure (HF), and stroke. Methods Individuals from the UK Biobank with cardiac magnetic resonance imaging and electrocardiographic information were included. Atrial cardiomyopathy markers included left atrial dilation, left atrial mechanical dysfunction, P-wave prolongation, and abnormal P-wave terminal force. Risk factors for AtCM were assessed using logistic regressions. Incident AF, HF, and stroke according to AtCM markers were assessed in multivariable Cox-regression and cumulative incidence models. AF risk according to AtCM markers, clinical and genetic risk factors was evaluated by integrating the HARMS2-AF score and a polygenic risk score for AF. We used net reclassification improvement (NRI) to evaluate reclassification of risk when considering AtCM markers. Results Among 26 467 individuals, 4145 (15.7%) had ≥1 marker and 619 (2.3%) had ≥2 markers of AtCM. Age, coronary artery disease, and hypertension were consistently associated with AtCM. Having one AtCM marker conferred a hazard ratio (HR) for AF of 1.88 [95% confidence interval (CI): 1.54–2.31; P < .001], with higher rates observed in individuals with ≥2 markers (HR: 4.59; 95% CI: 3.52–5.99; P < .001). Addition of AtCM markers was associated with an NRI of 13.7% (95% CI: 9.2%–18.3%). Integration of clinical and genetic risk factors indicated an additive effect on AF rates. Having ≥2 markers associated with HF (HR: 3.08, 95% CI: 2.03–4.66, P < .001), and stroke (HR: 3.07, 95% CI: 1.78–5.28, P < .001). Conclusions One in seven individuals had at least one marker of AtCM. Atrial cardiomyopathy markers were associated with AF, HF, and stroke, supporting AtCM as a common substrate for all three outcomes.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"9 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145295657","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}
Jenish P Shroff,Deep Chandh Raja,Sreevilasam P Abhilash,Abhinav Mehta,Walter P Abhayaratna,Pugazhendhi Vijayaraman,Prashanthan Sanders,Rajeev K Pathak
{"title":"Left bundle branch area pacing vs right ventricular pacing in preserved or mildly reduced ejection fraction: the PACE-HF trial.","authors":"Jenish P Shroff,Deep Chandh Raja,Sreevilasam P Abhilash,Abhinav Mehta,Walter P Abhayaratna,Pugazhendhi Vijayaraman,Prashanthan Sanders,Rajeev K Pathak","doi":"10.1093/eurheartj/ehaf724","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf724","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"1 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145296191","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":"Beyond the immediate light: reappraising open surgery for long-term outcomes in infected native aortic aneurysms.","authors":"Feng-Cheng Chang,Shao-Wei Chen","doi":"10.1093/eurheartj/ehaf810","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf810","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"92 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145296190","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}
Rosa Maria Bruno, Smriti Badhwar, Leila Abid, Mohsen Agharazii, Fabio Anastasio, Jeremy Bellien, Otto Burghuber, Luca Faconti, Jan Filipovsky, Lorenzo Ghiadoni, Cristina Giannattasio, Bernhard Hametner, Alun D Hughes, Ana Jeroncic, Ignatios Ikonomidis, Mai Tone Lonnebakken, Alessandro Maloberti, Christopher C Mayer, Maria Lorenza Muiesan, Anna Paini, Andrie Panayiotou, Chloe Park, Chakravarthi Rajkumar, Carlos Ramos Becerra, Bart Spronck, Dimitrios Terentes-Printzios, Yesim Tuncok, Thomas Weber, Pierre Boutouyrie
{"title":"Accelerated vascular ageing after COVID-19 infection: the CARTESIAN study.","authors":"Rosa Maria Bruno, Smriti Badhwar, Leila Abid, Mohsen Agharazii, Fabio Anastasio, Jeremy Bellien, Otto Burghuber, Luca Faconti, Jan Filipovsky, Lorenzo Ghiadoni, Cristina Giannattasio, Bernhard Hametner, Alun D Hughes, Ana Jeroncic, Ignatios Ikonomidis, Mai Tone Lonnebakken, Alessandro Maloberti, Christopher C Mayer, Maria Lorenza Muiesan, Anna Paini, Andrie Panayiotou, Chloe Park, Chakravarthi Rajkumar, Carlos Ramos Becerra, Bart Spronck, Dimitrios Terentes-Printzios, Yesim Tuncok, Thomas Weber, Pierre Boutouyrie","doi":"10.1093/eurheartj/ehaf430","DOIUrl":"10.1093/eurheartj/ehaf430","url":null,"abstract":"<p><strong>Background and aims: </strong>Increasing evidence suggests that COVID-19 survivors experience long-term cardiovascular complications possibly through development of vascular damage. The study aimed to investigate whether accelerated vascular ageing occurs after COVID-19 infection, and if so, identify its determinants.</p><p><strong>Methods: </strong>This prospective, multicentric, cohort study, included 34 centres in 16 countries worldwide, in 4 groups of participants-COVID-19-negative controls (ⅰ) and three groups of individuals with recent (6 ± 3 months) exposure to SARS-CoV-2: not hospitalized (ⅱ), hospitalized in general wards (ⅲ), and hospitalized in intensive care units (ⅳ). The main outcome was carotid-femoral pulse wave velocity (PWV), an established biomarker of large artery stiffness.</p><p><strong>Results: </strong>2390 individuals (age 50 ± 15 years, 49.2% women) were recruited. After adjustment for confounders, all COVID-19-positive groups showed higher PWV (+0.41, +0.37, and +0.40 m/s for groups 2-4, P < .001, P = .001 and P = .003) vs. controls [PWV 7.53 (7.09; 7.97) m/s adjusted mean (95% CI)]. In sex-stratified analyses, PWV differences were significant in women [PWV (+0.55, +0.60, and +1.09 m/s for groups 2-4, P < .001 for all)], but not in men. Among COVID-19 positive women, persistent symptoms were associated with higher PWV, regardless of disease severity and cardiovascular confounders [adjusted PWV 7.52 (95% CI 7.09; 7.96) vs. 7.13 (95% CI 6.67; 7.59) m/s, P < .001]. A stable or improved PWV after 12 months was found in the COVID+ groups, whereas a progression was observed in the COVID- group.</p><p><strong>Conclusions: </strong>COVID-19 is associated with early vascular ageing in the long term, especially in women.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"3905-3918"},"PeriodicalIF":35.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872092","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}