European Heart Journal最新文献

{"title":"Fractional flow reserve-guided renal artery stenting in atherosclerotic renovascular hypertension: the FAIR randomized trial.","authors":"Yuxi Li,Jingang Zheng,Chengzhi Lu,Fangfang Fan,Zhihao Liu,Shengcong Liu,Tieci Yi,Long Zhang,Haoyu Weng,Beining Wang,Xu Liu,Hui Zhou,Dengfeng Ma,Zhi Jia,Li Xiang,Renqiang Yang,Dongmei Shi,Hui Chen,Li Xu,Cun Liu,Kazuomi Kario,Yan Zhang,Jianping Li","doi":"10.1093/eurheartj/ehaf746","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf746","url":null,"abstract":"BACKGROUND AND AIMSThe optimal therapy for patients with atherosclerotic renal artery stenosis (ARAS) remains unresolved. This study compared the efficacy of renal fractional flow reserve (FFR)-guided revascularization and traditional angiography-guided revascularization.METHODSIn total, 101 patients with ARAS and hypertension were randomly assigned to either the FFR-guided or angiography-guided group (ClinicalTrials.gov identifier: NCT05732077). Stenting was performed in the angiography-guided group regardless of FFR, whereas stenting was only performed in the FFR-guided group for patients with FFR < 0.80. The primary endpoints were the percentage changes in ambulatory daytime mean systolic blood pressure (DMSBP) and composite index of antihypertensive medicines (CIAHM) after 3 months.RESULTSThe percentage changes in DMSBP (4% [-2%, 11%] vs 4% [-3%, 10%]; P = .97) and CIAHM (0% [0%, 3%] vs 1% [0%, 4%]; P = .33) did not differ between groups. However, the rate of stenting was significantly lower in the FFR-guided group (46.0% vs 100.0%, P < .01). Moreover, compared with the findings in patients with FFR ≥ 0.80 who did not receive stenting, stenting was beneficial in patients with FFR < 0.80 (adjusted mean DMSBP reduction, 6.2 [95% confidence interval {CI}, 0.6-11.9] mmHg; mean CIAHM reduction, 3.1 [95% CI, 1.5-4.7]), but not in those with FFR ≥ 0.80 (1.4 [95% CI, -4.5-7.2] mmHg, and 0.7 [95% CI, -1.1-2.5], respectively).CONCLUSIONSFFR-guided revascularization significantly reduced unnecessary stenting compared with angiography-guided revascularization. Both blood pressure and antihypertensive medication usage decreased significantly after stenting in patients with FFR < 0.80.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"93 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240957","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":"Non-bacterial thrombotic endocarditis in cancer.","authors":"Francois Deharo, Alexander R Lyon, Franck Thuny","doi":"10.1093/eurheartj/ehaf786","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf786","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":35.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243980","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":"Non-amyloid specific treatment for transthyretin cardiac amyloidosis: a clinical consensus statement of the ESC Heart Failure Association.","authors":"Pablo Garcia-Pavia,Esther Gonzalez-Lopez,Lisa J Anderson,Francesco Cappelli,Thibaud Damy,Marianna Fontana,Jose Gonzalez-Costello,Ruxandra Jurcut,Olivier Lairez,Peter van der Meer,Marco Merlo,Stefano Perlini,Antoni Bayes-Genis","doi":"10.1093/eurheartj/ehaf710","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf710","url":null,"abstract":"This clinical consensus statement, developed by the Heart Failure Association of the European Society of Cardiology, offers a detailed review of the non-specific management of transthyretin amyloid cardiomyopathy (ATTR-CM). This progressive and often fatal condition is increasingly recognized as a major contributor to heart failure. This document provides advice on symptom management and enhancing quality of life, with a focus on volume management, neurohormonal modulation, and tailored use of diuretics and other supportive therapies that address the distinct pathophysiology of ATTR-CM. It also explores advanced treatment modalities such as heart transplantation and mechanical circulatory support, which play crucial roles in managing advanced stages of the disease. Furthermore, it addresses the management of aortic stenosis in the context of ATTR-CM, advising transcatheter aortic valve replacement as the preferred treatment for these patients. The advice provided in this document relies primarily on expert opinion and retrospective studies due to a notable lack of randomized clinical trials, which underscores a critical research gap and the pressing need for evidence-based treatment protocols.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"22 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235753","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":"A change of rhythm: EP Europace welcomes a new chief.","authors":"Judith Ozkan","doi":"10.1093/eurheartj/ehaf461","DOIUrl":"10.1093/eurheartj/ehaf461","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"3680-3681"},"PeriodicalIF":35.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947600","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":"Genetic variants of glucose-dependent insulinotropic polypeptide (GIP) signalling as proxy for body weight reduction and cardiovascular risk.","authors":"Frida Emanuelsson,Børge G Nordestgaard,Marianne Benn","doi":"10.1093/eurheartj/ehaf779","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf779","url":null,"abstract":"BACKGROUND AND AIMSAnti-obesity therapies co-targeting the glucose-dependent insulinotropic polypeptide (GIP) receptor achieve greater weight loss compared with glucagon-like peptide-1 receptor agonists. However, the implications for cardiovascular risk reduction and the mechanisms involved remain unclear. This study aimed to (i) investigate whether genetically proxied body weight reduction via the GIP receptor pathway lowers cardiovascular disease risk and (ii) compare the effect to polygenic weight reduction, excluding GIP-related genes, to assess if the observed benefits are attributable to weight loss per se or involve additional GIP-related effects.METHODSGenetic scores were constructed using four variants in GIP-related genes associated with lower body mass index (BMI) and 31 variants linked to lower BMI in general. Observational and one-sample Mendelian randomization (MR) analyses were performed in 408 056 individuals from the UK Biobank and two-sample MR analyses using summary statistics from 419 821 individuals in FinnGen.RESULTSIn one-sample MR analyses, 1 kg/m² lower BMI via the GIP/GIPR score was associated with 29% lower risk of major adverse cardiovascular events (MACE) (P = .0002) and 43% lower risk of heart failure (P = 5 × 10⁻⁵). Corresponding lower risks with the polygenic BMI score were 3% (P = .002) and 13% (P < 1 × 10-300). Two-sample MR analyses showed similar results. Of the reduced risk via the GIP/GIPR score, BMI and glycated haemoglobin (HbA1c) mediated 13% and 22% of the lower risk of MACE and 16% and 17% of the lower risk of heart failure (all P ≤ 7 × 10-5).CONCLUSIONSGenetic proxies for body weight reduction via GIP receptor targeting reduces the risk of MACE and heart failure, mediated partly through lower BMI and partly through lower HbA1c.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"80 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240958","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":"Redefining obesity: beyond body mass index.","authors":"Javed Butler, Francesco Fioretti, Melanie J Davies","doi":"10.1093/eurheartj/ehaf409","DOIUrl":"10.1093/eurheartj/ehaf409","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"3758-3761"},"PeriodicalIF":35.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505242","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":"Stable angina in young women.","authors":"Carolyn M Webb, Peter Collins","doi":"10.1093/eurheartj/ehaf728","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf728","url":null,"abstract":"<p><p>Ischaemic heart disease (IHD) is the primary cause of cardiovascular death worldwide. Worryingly, the prevalence of IHD is increasing in younger women, with a 3% increase between 1990 and 2019. Although global IHD death rates have decreased in younger women overall, IHD mortality in younger women is increasing in certain high-income countries. Angina is the primary presenting symptom of suspected IHD and coronary artery disease. The presence of angina in patients with stable coronary artery disease is associated with an increased risk of major cardiovascular events compared with those without angina. Angina in young women is linked to future premature IHD events. There are particular features to consider in younger women presenting with stable angina-anginal symptom characterization may align with older women, but angina may occur cyclically in younger women and a similar pattern may be evident on diagnostic testing. Pathophysiologic mechanisms for angina in some young women may involve effects of ovarian hormones on vascular beds of the cardiovascular system. Traditional IHD risk factors are common to women and men; however, there are certain sex differences in their relevance to IHD risk, as well as influences that female hormones and reproduction have over a life course that affect IHD risk. In this review, we will explore stable angina in young women, consider possible pathophysiological mechanisms involved in their symptom presentation, and present risk factors associated with IHD in women. In addition, potential treatment options will be discussed and attention will be drawn to gaps in the evidence, proposing areas where more research is necessary.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":35.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238320","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":"h-index, age-index, or fake-index?","authors":"Thomas F Lüscher, Giovanni G Camici","doi":"10.1093/eurheartj/ehaf688","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf688","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":35.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231829","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":"Urinary tartaric acid and cardiovascular disease risk.","authors":"Alberto Ortiz","doi":"10.1093/eurheartj/ehaf760","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf760","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"12 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215566","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":"Taurochenodeoxycholic acid alleviates obesity-induced endothelial dysfunction","authors":"Hanlin Lu, Zhinan Wu, Meng Wan, Sisi Xiong, Xin Huang, Teng Liu, Xiuxin Jiang, Lifan He, Chang Ma, Huiliang Cui, Xiaolin Yue, Jingyuan Li, Xiaoteng Qin, Yawei Wang, Cheng Zhang, Jianmin Yang, Shaozhuang Liu, Wencheng Zhang","doi":"10.1093/eurheartj/ehaf766","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf766","url":null,"abstract":"Background and Aims Obesity is a global health challenge significantly increasing cardiovascular disease (CVD) burden. Effective prevention and treatment necessitate targeting early pathological changes, particularly obesity-induced endothelial dysfunction (ED). This study aimed to characterize ED heterogeneity in non-hypertensive obese (NHO) individuals, investigate the association of serum metabolites with obesity-induced ED, and identify potentially predictive and therapeutic metabolites. Methods Utilizing wire myograph, this study assessed ED of ex vivo arterioles from omental adipose tissue of 213 NHO patients, categorized into metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). Targeted metabolomic profiling identified associations between serum metabolites and ED. Results Obesity-induced ED in NHO patients lacked correlations with many traditional cardiovascular risk factors. The MHO and MUO individuals exhibited similar ED and metabolomic profile characteristics. Serum metabolomics identified bile acids (BAs), particularly chenodeoxycholic acid (CDCA), as negatively correlated with ED in NHO patients. Taurochenodeoxycholic acid (TCDCA), a taurine-conjugated derivative of CDCA, protected against obesity-induced ED and hypertension. Mechanistically, endothelial Farnesoid X receptor (FXR) deletion aggravated obesity-induced ED and hypertension, negating the beneficial effects of bariatric surgery or TCDCA treatment. The TCDCA-FXR activation in endothelial cells upregulated ATF4 transcription, which was suppressed by PHB1, thereby enhancing serine and one-carbon metabolism. Conclusions This study suggests CDCA as a promising biomarker for identification of obesity-induced ED. Taurochenodeoxycholic acid demonstrates significant therapeutic potential for alleviating various forms of obesity-induced ED. This effect is mediated by the endothelial TCDCA-FXR-PHB1-ATF4 axis, which upregulates serine and one-carbon metabolism, thereby offering a novel strategy to delay the onset of hypertension and other CVDs.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"99 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215580","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}