European Heart Journal最新文献

{"title":"Transthyretin amyloid cardiomyopathy: natural history and treatment response assessed by cardiovascular magnetic resonance.","authors":"Rishi K Patel,Adam Ioannou,Awais Sheikh,Yousuf Razvi,Josephine Mansell,Ana Martinez-Naharro,Daniel Knight,Tushar Kotecha,Aldostefano Porcari,Liza Chacko,James Brown,Charlotte Manisty,James C Moon,Helen J Lachmann,Ashutosh Wechalekar,Carol Whelan,Lucia Venneri,Peter Kellman,Philip N Hawkins,Julian D Gillmore,Marianna Fontana","doi":"10.1093/eurheartj/ehaf412","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf412","url":null,"abstract":"BACKGROUND AND AIMSCardiovascular magnetic resonance (CMR) and extracellular volume (ECV) mapping can measure amyloid burden in vivo. This study sought to assess the natural history of transthyretin amyloid cardiomyopathy (ATTR-CM) in terms of amyloid deposition burden (ECV) over time, changes in cardiac amyloid load following treatment with patisiran, and the association between change in ECV and mortality.METHODSAll 189 patients (untreated = 119, patisiran = 70) underwent assessment with CMR at baseline, 160 patients (untreated = 94, patisiran = 66) had a 1-year follow-up CMR and 75 patients (untreated = 42, patisiran = 33) had a 2-year follow-up CMR, of whom 36 patients (untreated = 17, patisiran = 29) had follow-up CMR at both timepoints. CMR response was graded by change in ECV: progression (≥5% increase), stable (<5% change) and regression (≥5% decrease).RESULTSIn untreated patients, 36% progressed at 1 year which significantly increased to 62% at 2 years. Mean increase in ECV of 4.1% (after 1 year) and 6.8% (after 2 years) was observed and associated with significant worsening in biomarkers and structural parameters. No significant difference in mean ECV was observed following treatment with patisiran at both timepoints. Stable ECV was observed in 88% of patients (after 1 year) and 100% of patients (after 2 years). Structural parameters remained stable following treatment. ECV progression after 1 year was independently associated with mortality after adjusting for known predictors (hazard ratio 2.021; 95% confidence interval 1.081-3.781; P = .028).CONCLUSIONSCMR with ECV mapping can track changes in cardiac amyloid burden and treatment response in ATTR-CM, with changes in ECV being independently associated with outcomes.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"22 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603967","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":"Short-term benefit of early rhythm control for atrial fibrillation: the EAST-AFNET 4 trial.","authors":"Julius Obergassel,Anna Suling,Katrin Borof,Alan John Camm,Harry J G M Crijns,Lars Eckardt,Larissa Fabritz,Andreas Goette,Märit Jensen,Marc Daniel Lemoine,Christina Magnussen,Andreas Metzner,Andreas Rillig,Ulrich Schotten,Renate Schnabel,Götz Thomalla,Panos Vardas,Reza Wakili,Stephan Willems,Antonia Zapf,Paulus Kirchhof,Benedikt Schrage","doi":"10.1093/eurheartj/ehaf397","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf397","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"26 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593984","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":"Weekly Journal Scan: obicetrapib and the revival of cholesteryl ester transfer protein inhibition.","authors":"Rocco Vergallo,Massimo Volpe","doi":"10.1093/eurheartj/ehaf467","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf467","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"22 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593982","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":"Weekly Journal Scan: The promise of small interfering RNA in reducing lipoprotein(a).","authors":"Daniela Pedicino,Giovanna Liuzzo","doi":"10.1093/eurheartj/ehaf401","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf401","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"10 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593983","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":"Great debate: artificial intelligence will replace much of what cardiologists do.","authors":"Tauben Averbuch,Folkert W Asselbergs,Panos Vardas,Harriette G C Van Spall","doi":"10.1093/eurheartj/ehaf305","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf305","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"11 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593987","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: Beta-blocker interruption effects on blood pressure and heart rate after myocardial infarction: the AβYSS trial.","authors":"","doi":"10.1093/eurheartj/ehaf510","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf510","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"35 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603678","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":"Weekly Journal Scan: BedMed cannot overcome the uncertainties on the effects of night-time antihypertensive therapy on cardiovascular outcomes.","authors":"Giovanna Gallo,Massimo Volpe","doi":"10.1093/eurheartj/ehaf435","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf435","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"4 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593988","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":"Cardiac amyloidosis detection from a single echocardiographic video clip: a novel artificial intelligence-based screening tool.","authors":"Jeremy A Slivnick,Will Hawkes,Jorge Oliveira,Gary Woodward,Ashley Akerman,Alberto Gomez,Izhan Hamza,Viral K Desai,Zachary Barrett-O'Keefe,Martha Grogan,Angela Dispenzieri,Christopher G Scott,Halley N Davison,Juan Cotella,Mathew Maurer,Stephen Helmke,Marielle Scherrer-Crosbie,Marwa Soltani,Akash Goyal,Karolina M Zareba,Richard K Cheng,James N Kirkpatrick,Tetsuji Kitano,Masaaki Takeuchi,Viviane Tiemi Hotta,Marcelo Luiz Campos Vieira,Pablo Elissamburu,Ricardo E Ronderos,Aldo Prado,Efstratios Koutroumpakis,Anita Deswal,Amit Pursnani,Nitasha Sarswat,Amit R Patel,Karima Addetia,Frederick L Ruberg,Michael Randazzo,Federico M Asch,Jamie O'Driscoll,Nora Al-Roub,Jordan B Strom,Liam Kidd,Sarah Cuddy,Ross Upton,Roberto M Lang,Patricia A Pellikka","doi":"10.1093/eurheartj/ehaf387","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf387","url":null,"abstract":"BACKGROUND AND AIMSAccurate differentiation of cardiac amyloidosis (CA) from phenotypic mimics remains challenging using current clinical and echocardiographic techniques. The accuracy of a novel artificial intelligence (AI) screening algorithm for echocardiography-based CA detection was assessed.METHODSUtilizing a multisite, multiethnic dataset (n = 2612, 52% CA), a convolutional neural network was trained to differentiate CA from phenotypic controls using transthoracic apical four-chamber video clips. External validation was conducted globally across 18 sites including 597 CA cases and 2122 controls. Classification accuracy was assessed on the entire external validation dataset, and subgroup analyses were performed both on technetium pyrophosphate scintigraphy referrals, and individuals matched for age, sex, and wall thickness. Model accuracy was also compared with the transthyretin CA score and the increased wall thickness score within a subset of older heart failure with preserved ejection fraction patients with increased wall thickness.RESULTSCardiac amyloidosis patients and controls displayed similar age, sex, race, and comorbidities. After the removal of uncertain AI predictions (13%), model discrimination and classification were excellent for the entire external validation dataset [area under the receiver operating characteristic curve (AUROC) 0.93, sensitivity 85%, specificity 93%], irrespective of CA subtype (sensitivity: light-chain = 84%, wild-type transthyretin = 85%, and hereditary transthyretin = 86%). Performance was maintained in subgroup analysis in patients clinically referred for technetium pyrophosphate scintigraphy imaging (AUROC 0.86, sensitivity 77%, specificity 86%) and matched patients (AUROC 0.92, sensitivity 84%, specificity 91%). The AI model (AUROC 0.93) also outperformed transthyretin CA score (AUROC 0.73) and increased wall thickness (AUROC 0.80) scores.CONCLUSIONSThis AI screening model-using only an apical four-chamber view-effectively differentiated CA from other causes of increased left ventricular wall thickness.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"109 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586559","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":"Transcatheter edge-to-edge repair vs medical therapy in atrial functional mitral regurgitation: a propensity score-based comparison from the OCEAN-Mitral and REVEAL-AFMR registries.","authors":"Tomohiro Kaneko,Nobuyuki Kagiyama,Shinya Okazaki,Masashi Amano,Yukio Sato,Yohei Ohno,Masaru Obokata,Kimi Sato,Kojiro Morita,Shunsuke Kubo,Yuki Izumi,Masahiko Asami,Yusuke Enta,Shinichi Shirai,Masaki Izumo,Shingo Mizuno,Yusuke Watanabe,Makoto Amaki,Kazuhisa Kodama,Hisao Otsuki,Toru Naganuma,Hiroki Bota,Masahiro Yamawaki,Hiroshi Ueno,Gaku Nakazawa,Daisuke Hachinohe,Toshiaki Otsuka,Mike Saji,Masanori Yamamoto,Kentaro Hayashida","doi":"10.1093/eurheartj/ehaf511","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf511","url":null,"abstract":"BACKGROUND AND AIMSAtrial functional mitral regurgitation (AFMR) commonly affects elderly and frail individuals. The prognostic impact of transcatheter edge-to-edge repair (TEER) for AFMR has not been investigated.METHODSPatients with AFMR who underwent TEER were selected from the OCEANMitral registry, and medically managed controls were selected from the REVEALAFMR registry, using an identical AFMR definition. The primary endpoint was a composite of all-cause mortality and heart failure hospitalization. The secondary endpoint was all-cause mortality.RESULTSA total of 1,081 patients (mean age 80.1±8.2 years, 60.5% female) with moderate or severe AFMR were included, of whom 441 underwent TEER and 640 remained on medical treatment. Overlap weighting based on propensity score yielded well-balanced characteristics (n=441 vs. 640; all standardized mean differences <0.01), where TEER was associated with a lower incidence of the primary (hazard ratio [HR] 0.65 [0.43-0.99], p=0.044) and secondary endpoints (HR 0.58 [0.35-0.99], p=0.044). In an exploratory subgroup analysis, favorable outcomes might be pronounced in patients with ≤mild residual AFMR after TEER, while event rates in those with ≥moderate residual AFMR were comparable to the medication group. As sensitivity analyses, inverse probability of treatment weighting (n=158 vs. 173), propensity score matching (n=104 vs. 104), and multivariable Cox regression (n=441 vs. 640) all confirmed favorable associations of TEER with both endpoints.CONCLUSIONSIn real-world data, TEER for patients with moderate or severe AFMR was associated with a lower incidence of adverse events compared with medical treatment.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"21 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586585","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":"Are long QT syndrome patients managed differently in different countries?","authors":"Peter J Schwartz,Carla Spazzolini","doi":"10.1093/eurheartj/ehaf394","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf394","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"52 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586560","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}