European Heart Journal最新文献

{"title":"Refractory angina: mechanisms and stratified treatment in obstructive and non-obstructive chronic myocardial ischaemic syndromes","authors":"Ranil de Silva, Kevin Cheng, Timothy D Henry, Divaka Perera, Viviany R Taqueti, Ana Abreu, Fabienne Vervaat, Martha Gulati, Hiroaki Shimokawa, Felicita Andreotti, Juan-Carlos Kaski","doi":"10.1093/eurheartj/ehaf284","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf284","url":null,"abstract":"The diagnosis of refractory angina has conventionally been limited to patients with angina and ischaemia secondary to obstructive atherosclerotic epicardial coronary disease who experience persistent symptoms despite optimal pharmacological and revascularization therapies. It is now well-established that angina may also be caused by ischaemia resulting from coronary microcirculatory disorders, coronary vasospasm, and bridging in the absence of obstructive epicardial coronary disease or after “successful” revascularization. This increasingly prevalent and symptomatic group of patients, with both angina and demonstrable ischaemia, have been excluded from the conventional definition of refractory angina. In patients with obstructive epicardial coronary disease, disturbed microcirculatory and vasomotor function, amongst other ischaemic mechanisms, may account for continuing symptoms despite revascularization. Under-recognition of these mechanisms results in inadequate treatment and symptom persistence. In this review, a redefinition of refractory angina is proposed to include the full spectrum of patients experiencing persistent angina despite current maximal guideline-directed medical and revascularization therapies. Systematic approaches for comprehensive investigation are suggested to identify underlying mechanisms of ischaemia and stratify treatments accordingly. The complex needs of patients with refractory angina are likely best addressed by an inter-disciplinary Angina Heart Team with the aim of improving patient symptoms, quality of life, and clinical outcomes.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"19 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533062","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":"Post-capillary pulmonary hypertension in heart failure: addressing statistical and methodological issues in research.","authors":"Guang Xiong","doi":"10.1093/eurheartj/ehae812","DOIUrl":"10.1093/eurheartj/ehae812","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"2478"},"PeriodicalIF":37.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802852","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":"Heart failure: evolving management and new therapeutic targets.","authors":"Filippo Crea","doi":"10.1093/eurheartj/ehaf375","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf375","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"51 1","pages":"2359-2363"},"PeriodicalIF":39.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144521289","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":"Post-capillary Pulmonary Hypertension in Heart Failure is associated with higher mortality and morbidity risk: not just a matter of « hasard ».","authors":"Charles Fauvel, Nicolas Lamblin","doi":"10.1093/eurheartj/ehae814","DOIUrl":"10.1093/eurheartj/ehae814","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"2479-2480"},"PeriodicalIF":37.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802819","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 dysfunction related to cardiac mRNA and protein traffic impairment due to reduced unconventional motor protein myosin-5b expression.","authors":"Maren Heimerl, Sergej Erschow, Mirco Müller-Olling, Dietmar J Manstein, Niels Decher, Silke Kauferstein, Tina Jenewein, Andreas Pich, Melanie Ricke-Hoch, Denise Hilfiker-Kleiner","doi":"10.1093/eurheartj/ehaf047","DOIUrl":"10.1093/eurheartj/ehaf047","url":null,"abstract":"<p><strong>Background and aims: </strong>The present study analysed the expression patterns of class-5 myosin motor proteins (MYO5a, b, and c) in the heart with a specific focus on the role of MYO5b.</p><p><strong>Methods: </strong>RNA-sequencing, quantitative real-time polymerase chain reaction, immunohistochemistry, Western blot, immunoprecipitation, and proteomics were performed in mice and human tissues. Functional analyses were performed in mice with a cardiac-specific knockout (KO) of MYO5b (αMHC-Cretg/-; MYO5bflox/flox), wild-type (WT) (MYO5bflox/flox), and αMHC-Cretg/- mice and in isolated adult cardiomyocytes. Next-generation sequencing screened for MYO5B gene variants in a cohort of sudden cardiac death in the young/sudden infant death syndrome patients.</p><p><strong>Results: </strong>The expression of MYO5b, but not MYO5a or c, increased during postnatal cardiomyocyte maturation. Myosin-5b was reduced in end-stage failing human hearts and infarcted murine hearts. Heterozygous rare and likely pathogenic missense MYO5B gene variants (n = 6) were identified in three patients of a cohort of young patients (n = 95) who died of sudden cardiac death in the young/sudden infant death syndrome. MYO5b-KO mice revealed impaired electric conductance and metabolism, developed sarcomeric disarrangement, heart failure and death with altered mRNA levels for genes involved in sarcomere organization, fatty acid and glucose metabolism, ion channel sub-units, and Ca2+-homeostasis prior to heart failure. In cardiomyocytes, myosin-5b is associated with mitochondrial and ribosomal proteins. Myosin-5b-associated ribonucleoprotein particles (RNPs) contained mRNAs of sarcomeric, metabolic, cytoskeletal, and ion channel proteins.</p><p><strong>Conclusions: </strong>MYO5b is the major MYO5 gene expressed in postnatal cardiomyocytes where it transports vesicles, proteins, and multi-protein complexes. Among these are mRNA/RNP complexes affecting electric conductance, sarcomere homeostasis, cell metabolism, and cytoskeletal organization. Impairment in MYO5b expression and function promotes cardiac dysfunction, heart failure, and death.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"2437-2454"},"PeriodicalIF":37.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448710","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":"Criss-cross heart with double-outlet right ventricle and interrupted aortic arch in a rare adult survivor: computed tomography insights.","authors":"Wei-Feng Yan, Jin Wang, Zhi-Gang Yang","doi":"10.1093/eurheartj/ehaf158","DOIUrl":"10.1093/eurheartj/ehaf158","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"2482"},"PeriodicalIF":37.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709158","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":"Vaccination as a new form of cardiovascular prevention: a European Society of Cardiology clinical consensus statement","authors":"Bettina Heidecker, Peter Libby, Vassilios S Vassiliou, François Roubille, Orly Vardeny, Christian Hassager, Michael A Gatzoulis, Mamas A Mamas, Leslie T Cooper, Felix Schoenrath, Marco Metra, Offer Amir, Scott D Solomon, Ulf Landmesser, Thomas F Lüscher","doi":"10.1093/eurheartj/ehaf384","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf384","url":null,"abstract":"Vaccination is increasingly acknowledged as an effective preventive measure not only against specific infections, but also for the prevention of cardiovascular disease in high-risk patients. Specifically, a growing body of evidence suggests that vaccines against influenza, SARS-CoV-2, respiratory syncytial virus, herpes zoster, and other viruses significantly reduce infection and for influenza the incidence of major adverse cardiovascular events in vaccinated individuals. This clinical consensus statement examines the existing literature and accumulated evidence and offers practical clinical advice on vaccination timing and target demographics, specifically addressing complex clinical scenarios with a focus on cardiovascular conditions. It includes guidelines for vaccinating vulnerable populations such as immunosuppressed individuals, patients with congenital heart disease, and pregnant women as well as safety and potential complications of the procedure.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"19 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144516047","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":"Predictors of recurrent venous thromboembolism and bleeding in patients with cancer: a meta-analysis","authors":"Faizan Khan, Tobias Tritschler, Caterina E Marx, Vincent Lanting, Bram Rochwerg, Alexandre Tran, Shannon M Fernando, Diane L Lorenzetti, Hannah Wunsch, Jessalyn Holodinsky, Kirsten Fiest, Henry Thomas Stelfox, Aurélien Delluc, Dean A Fergusson, Grégoire Le Gal, Philip S Wells, Tzu-Fei Wang, Kristen Sanfilippo, Nick van Es, Deborah Schrag, Jean M Connors, Marc Carrier","doi":"10.1093/eurheartj/ehaf453","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf453","url":null,"abstract":"Background and Aims Patients with cancer and venous thromboembolism (VTE) have a high risk of recurrent VTE and anticoagulant-related bleeding. This study aimed to identify prognostic factors for these complications. Methods A systematic review was performed for randomized trials and cohort studies evaluating prognostic factors for recurrent VTE or anticoagulant-related bleeding in adult patients with cancer and VTE. Adjusted hazard ratios (aHRs) for factors were pooled using random-effects meta-analysis. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach. Results Thirty-three studies (n = 96 753) were included in the meta-analyses. Factors with high certainty of association with increased risk of recurrent VTE included a previous history of VTE [aHR 1.50 (95% CI 1.08–2.09)], Eastern Cooperative Oncology Group (ECOG) performance status &amp;gt;0 [1.81 (1.34–2.46)] or &amp;gt;1 [2.44 (1.55–3.84)], advanced cancer [1.38 (1.15–1.65)], and specific cancer sites including lung [1.78 (1.29–2.46)], hepatobiliary [2.37 (1.70–3.30)], pancreas [3.20 (2.06–4.96)], and genitourinary [1.38 (1.14–1.67)]. Conversely, recent surgery [aHR 0.56 (95% CI 0.40–0.76)] and breast cancer [0.43 (0.23–0.81)] had a high certainty of association with a decreased risk. Factors with a high certainty of association with an increased risk of anticoagulant-related bleeding included a history of bleeding [aHR 2.41 (95% CI 1.50–3.88)], ECOG performance status ≥2 [2.10 (1.48–2.99)], advanced cancer [1.60 (1.29–1.97)], and cancers of the brain [2.25 (1.64–3.09)], gastrointestinal system [1.74 (1.44–2.11)], genitourinary system [1.90 (1.48–2.45)], and prostate [1.72 (1.26–2.34)]. Conclusions The prognostic factors identified in this meta-analysis should be considered as part of risk stratification frameworks for anticoagulation management in patients with cancer and VTE.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"48 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144503526","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: A global observational study shows how modifying five cardiovascular risk factors at midlife may affect lifespan and healthspan.","authors":"Daniela Pedicino, Massimo Volpe","doi":"10.1093/eurheartj/ehaf398","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf398","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":37.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505245","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":"Medial arterial calcification in ageing and disease: current evidence and knowledge gaps.","authors":"Peter Lanzer, Leon Schurgers, Aleksandra Twarda-Clapa, Roberto Ferraresi, Huang Hui, Alexey Kamenskiy, Yabing Chen, Tomoyo Hamana, Pak-Wing Fok, Ángel Millán, Renu Virmani, Cynthia St Hilaire","doi":"10.1093/eurheartj/ehaf341","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf341","url":null,"abstract":"<p><p>Medial arterial calcification (MAC) characterizes human arterial ageing, potentially remaining clinically silent for decades. However, in susceptible individuals and patients with diabetes mellitus and chronic kidney disease, it becomes a critical risk factor for cardiovascular morbidity and mortality, and it is a significant risk factor for chronic limb-threatening ischaemia and limb amputation. A key biological feature of MAC pathogenesis is the phenotype switching of vascular smooth muscle cells, ultimately responsible for the deposition of hydroxyapatite crystals and the progressive medial layer destruction associated with intimal thickening. The signalling pathways targeting the vascular smooth muscle cells in ageing and disease are partly shared. Due to the MAC-related arterial wall stiffening and intimal thickening, MAC fundamentally alters central and peripheral haemodynamics. Yet, a comprehensive understanding of MAC's impact on haemodynamics is lacking. Ankle-brachial index, ultrasound, and X-ray radiography can detect only advanced MAC in the clinical setting. Due to the slow progression, MAC provides many early detection, prevention, and timely intervention targets. However, no effective pharmacological treatment is currently available to alter its course, and revascularizations remain the only treatment option in symptomatic patients. To prevent, reverse, or delay MAC, further research is needed to reveal the complete picture of molecular pathogenesis and haemodynamic impact of MAC vasculopathy.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":37.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505241","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}