Kristel Janssens, Stephen J Foulkes, Andre La Gerche
{"title":"Reply: Insights on Blood Pressure Response to Graded Exercise in Males and Females Across the Age and Fitness Spectrum.","authors":"Kristel Janssens, Stephen J Foulkes, Andre La Gerche","doi":"10.1093/eurjpc/zwae334","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae334","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Felicia H K Hakansson, Per Svensson, Hans J Pettersson, Ewa Ehrenborg, Jonas Spaak, Anna M Nordenskjold, Kai M Eggers, Per Tornvall
{"title":"Familial risk of myocardial infarction with non-obstructive and obstructive coronary arteries -A nation-wide cohort study.","authors":"Felicia H K Hakansson, Per Svensson, Hans J Pettersson, Ewa Ehrenborg, Jonas Spaak, Anna M Nordenskjold, Kai M Eggers, Per Tornvall","doi":"10.1093/eurjpc/zwae313","DOIUrl":"10.1093/eurjpc/zwae313","url":null,"abstract":"<p><strong>Background and aims: </strong>The familial risk among patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) is unknown. Previous studies of family history in myocardial infarction (MI), have not made a distinction between MINOCA and MI due to coronary artery disease (MI-CAD), based on angiographic findings. We therefore sought to investigate familial risk of MI without and with obstructive coronary arteries.</p><p><strong>Methods: </strong>Register-based cohort study with a total of 15,462 MINOCA cases, 204,424 MI-CAD cases, 38,220 control subjects without MI and with non-obstructive coronary arteries. First-degree relatives were identified 1995-2020. Cox proportional hazard regression models were used to compare familial risk in MINOCA and MI-CAD with control subjects.</p><p><strong>Results: </strong>During a mean follow-up of 8.1 ± 4.2 years, MINOCA occurred in 1.0% of first-degree relatives with MINOCA whereas MI-CAD occurred in 9.7% of first-degree relatives of MINOCA. The age- and sex-adjusted hazard ratio (HR) for a MINOCA-relative experiencing MINOCA and MI-CAD, compared to control subjects, was 0.99 (95% confidence interval [CI] 0.80-1.23) and 1.10 (95% CI 1.03-1.18), respectively. During a mean follow-up of 8.5 ±4.8 years, MI-CAD occurred in 12.2% of first- degree relatives with MI-CAD with age- and sex-adjusted HR 1.43 (95% CI 1.37-1.49).</p><p><strong>Conclusions: </strong>No increased familial risk of MINOCA was observed for MINOCA-patients whereas there was an increased familial risk for MI-CAD when compared to control subjects. These results may indicate that genetic factors and shared environmental factors within a family leading to CAD are important also for MINOCA, thus MI-CAD and MINOCA could share underlying mechanisms.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andreina Carbone, Francesco Ferrara, Eduardo Bossone
{"title":"Chronobiology and Cardiovascular Disease: The Time and Temperature Matter.","authors":"Andreina Carbone, Francesco Ferrara, Eduardo Bossone","doi":"10.1093/eurjpc/zwae326","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae326","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elias Edward Tannous, Shlomo Selitzky, Shlomo Vinker, David Stepensky, Eyal Schwarzberg
{"title":"Predictive modeling of medication adherence in post myocardial infarction patients: a bayesian approach using beta-regression.","authors":"Elias Edward Tannous, Shlomo Selitzky, Shlomo Vinker, David Stepensky, Eyal Schwarzberg","doi":"10.1093/eurjpc/zwae327","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae327","url":null,"abstract":"<p><strong>Aims: </strong>Predicting medication adherence in post myocardial infarction (MI) patients has the potential to improve patient outcomes. Most adherence prediction models dichotomize adherence metrics and status. This study aims to develop medication adherence prediction models that avoid dichotomizing adherence metrics and to test whether a simplified model including only 90-days adherence data would perform similarly to a full multivariable model.</p><p><strong>Methods: </strong>Post MI adult patients were followed for 1-year post the event. Data from pharmacy records were used to calculate proportion of days covered (PDC). We used Bayesian beta-regression to model PDC as a proportion, avoiding dichotomization. For each medication group, statins, P2Y12 inhibitors and aspirin, two prediction models were developed, a full and a simplified model.</p><p><strong>Results: </strong>3692 patients were included for model development. The median (Inter quartile range) PDC at 1-year for statins, P2Y12 inhibitors and aspirin was 0.8 (0.33, 1.00), 0.79 (0.23, 0.99) and 0.79 (0.23, 0.99), respectively. All models showed good fit to the data by visual predictive checks. Bayesian R2 for statins, P2Y12 inhibitors and aspirin models were 61.4%,71.2% and 55.2%, respectively. The simplified models showed similar performance compared with full complex models as evaluated by cross validation.</p><p><strong>Conclusions: </strong>We developed Bayesian multilevel models for statins, P2Y12 inhibitors and aspirin in post MI patients that handled 1-year PDC as a proportion using the beta-distribution. In addition, simplified models, with 90-days adherence as single predictor, had similar performance compared with full complex models.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Evolving Global Burden of Cardiovascular Diseases: What Lies Ahead.","authors":"Vasiliki Tsampasian, Gerald S Bloomfield","doi":"10.1093/eurjpc/zwae330","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae330","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kaitlyn Weinkauf, Emma Fyfe, Dean Hewitt, Jing Wang, Megan Kennedy, Edith Pituskin, Andre La Gerche, Stephen J Foulkes, Mark J Haykowsky
{"title":"Cardiorespiratory Fitness in Childhood Cancer Survivors: A Systematic Review and Meta-Analysis.","authors":"Kaitlyn Weinkauf, Emma Fyfe, Dean Hewitt, Jing Wang, Megan Kennedy, Edith Pituskin, Andre La Gerche, Stephen J Foulkes, Mark J Haykowsky","doi":"10.1093/eurjpc/zwae317","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae317","url":null,"abstract":"<p><strong>Aims: </strong>Cardiovascular disease (CVD) is a leading cause of mortality in childhood cancer survivors (CCS) that may be related to the cardiotoxic effects of radiation or chemotherapy and concomitant reductions in cardiorespiratory fitness. Therefore, we sought to compare cardiorespiratory fitness (peak oxygen uptake, V̇O2peak) between CCS and age-matched non-cancer controls (CON). Secondary outcomes included hemodynamics and resting cardiac function.</p><p><strong>Methods: </strong>Embase, Scopus, MEDLINE, CINAHL and SPORTDiscus databases were searched from inception to June 2023 for eligible studies. Cross-sectional studies with V̇O2peak measured in CCS and CON were included. Differences in outcomes and pooled estimates for each outcome were estimated from a fixed effects meta-analysis and between group differences were reported as a weighted mean difference (WMD).</p><p><strong>Results: </strong>Of 2026 studies identified, 18 reported V̇O2peak (CCS: n=786, 44% female, mean age: 16-years, time post-therapy: 5.8 years; CON: n=1379, 50% female, mean age: 16-years). V̇O2peak was lower in CCS (WMD: -7.08mL/kg/min, 95% CI: -7.75 to -6.42, I2: 79%, n=2,165) with no difference for peak exercise heart rate (WMD: -1.4bpm, 95% CI: -3.0 to 0.2, I2: 63%, n=741). Resting left-ventricular ejection fraction (WMD: -1.61%, 95% CI: -2.60 to -0.62, I2.: 49%, n=222) and systolic blood pressure were lower (WMD: -3.8mmHg, 95% CI: -5.7 to -1.9, I2: 25%, n=184) while resting heart rate was higher in CCS (WMD: 4.9bpm; 95% CI: 1.8 to 7.9, I2: 55%, n=262).</p><p><strong>Conclusions: </strong>CCS have a marked reduction in cardiorespiratory fitness (7.1ml/kg/min lower than CON) that may have important prognostic implications for their future risk of CVD and mortality.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fanchao Shi, Rajiv Chowdhury, Eleni Sofianopoulou, Albert Koulman, Luanluan Sun, Marinka Steur, Krasimira Aleksandrova, Christina C Dahm, Matthias B Schulze, Yvonne T van der Schouw, Claudia Agnoli, Pilar Amiano, Jolanda M A Boer, Christian S Bork, Natalia Cabrera-Castro, Fabian Eichelmann, Alexis Elbaz, Marta Farràs, Alicia K Heath, Rudolf Kaaks, Verena Katzke, Pekka Keski-Rahkonen, Giovanna Masala, Conchi Moreno-Iribas, Salvatore Panico, Keren Papier, Dafina Petrova, J Ramón Quirós, Fulvio Ricceri, Gianluca Severi, Anne Tjønneland, Tammy Y N Tong, Rosario Tumino, Nick Wareham, Elisabete Weiderpass, Emanuele Di Angelantonio, Nita Forouhi, John Danesh, Adam S Butterworth, Stephen Kaptoge
{"title":"Association of circulating fatty acids with cardiovascular disease risk: Analysis of individual-level data in three large prospective cohorts and updated meta-analysis.","authors":"Fanchao Shi, Rajiv Chowdhury, Eleni Sofianopoulou, Albert Koulman, Luanluan Sun, Marinka Steur, Krasimira Aleksandrova, Christina C Dahm, Matthias B Schulze, Yvonne T van der Schouw, Claudia Agnoli, Pilar Amiano, Jolanda M A Boer, Christian S Bork, Natalia Cabrera-Castro, Fabian Eichelmann, Alexis Elbaz, Marta Farràs, Alicia K Heath, Rudolf Kaaks, Verena Katzke, Pekka Keski-Rahkonen, Giovanna Masala, Conchi Moreno-Iribas, Salvatore Panico, Keren Papier, Dafina Petrova, J Ramón Quirós, Fulvio Ricceri, Gianluca Severi, Anne Tjønneland, Tammy Y N Tong, Rosario Tumino, Nick Wareham, Elisabete Weiderpass, Emanuele Di Angelantonio, Nita Forouhi, John Danesh, Adam S Butterworth, Stephen Kaptoge","doi":"10.1093/eurjpc/zwae315","DOIUrl":"10.1093/eurjpc/zwae315","url":null,"abstract":"<p><strong>Background: </strong>Associations of saturated and unsaturated fatty acids (FAs) with cardiovascular disease (CVD) remain controversial. We therefore aimed to investigate the prospective associations of objectively measured FAs with CVD, including incident coronary heart disease (CHD) and stroke, as well as CVD mortality.</p><p><strong>Methods: </strong>Circulating FA concentrations expressed as the percentage of total FAs were assayed in 172,891 participants without prior vascular disease at baseline from the European Prospective Investigation into Cancer and Nutrition-CVD (EPIC-CVD) (7,343 CHD; 6,499 stroke), UK Biobank (1,825; 1,474), and INTERVAL (285; 209) cohort studies. Hazard ratio (HR) per 1-standard deviation (SD) higher FA concentrations was estimated using Cox regression models and pooled by random-effects meta-analysis. Systematic reviews with meta-analysis published by 6 May 2023 on associations between FAs and CVDs were systematically searched and updated meta-analyses using random-effects model were conducted. Evidence from randomized controlled trials (RCTs) was also summarized.</p><p><strong>Results: </strong>Higher concentrations of total saturated FAs (SFAs) were associated with higher cardiovascular risks in the combined analysis, with differential findings noted for SFA subtypes in further analysis restricted to EPIC-CVD: positive associations for even-chain SFA [HR for CHD 1.24 (95% CI: 1.18-1.32); stroke 1.23 (1.10-1.38)] and negative associations for odd-chain [0.82 (0.76-0.87); 0.73 (0.67-0.78)] and longer-chain [0.95 (0.80-1.12); 0.84 (0.72-0.99)] SFA. In the combined analysis, total n-3 polyunsaturated FA (PUFA) [0.91 (0.85-0.97)], including docosahexaenoic acid (DHA) [0.91 (0.84-0.98)], was negatively associated with incident CHD risk. Similarly, total n-6 PUFA [0.94 (0.91-0.98)], including linoleic acid (LA) [0.89 (0.83-0.95)], was negatively associated with incident stroke risk. By contrast, more detailed analyses in EPIC-CVD revealed that several downstream n-6 PUFAs of LA were positively associated with CHD risk. Updated meta-analyses of 37 FAs including 49 non-overlapping studies, involving between 7,787 to 22,802 CHD and 6,499 to 14,221 stroke cases, showed broadly similar results as our combined empirical analysis and further suggested significant inverse associations of individual long-chain n-3 PUFAs and LA on both CHD and stroke. The findings of long-chain n-3 PUFAs were consistent with those from published RCTs on CHD despite insufficient evidence in monotherapy, while RCT evidence remained unclear for the rest of the explored FAs.</p><p><strong>Conclusions: </strong>Our study provides an overview of the most recent evidence on the associations between objectively measured FAs and CVD outcomes. Collectively, the data reveals notable differences in associations by SFA subtypes and calls for further studies, especially RCTs, to explore these links.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dominika Mihalikova, Paul Stamm, Miroslava Kvandova, Chinmayi Pednekar, Lea Strohm, Henning Ubbens, Matthias Oelze, Marin Kuntic, Claudius Witzler, Maria Teresa Bayo Jimenez, Sanela Rajlic, Katie Frenis, Qi Tang, Yue Ruan, Susanne Karbach, Hartmut Kleinert, Omar Hahad, Alex von Kriegsheim, Ning Xia, Tilman Grune, Huige Li, Swenja Kröller-Schön, Adrian Gericke, Wolfram Ruf, Philipp S Wild, Philipp Lurz, Thomas Münzel, Andreas Daiber, Thomas Jansen
{"title":"Exposure to aircraft noise exacerbates cardiovascular and oxidative damage in three mouse models of diabetes.","authors":"Dominika Mihalikova, Paul Stamm, Miroslava Kvandova, Chinmayi Pednekar, Lea Strohm, Henning Ubbens, Matthias Oelze, Marin Kuntic, Claudius Witzler, Maria Teresa Bayo Jimenez, Sanela Rajlic, Katie Frenis, Qi Tang, Yue Ruan, Susanne Karbach, Hartmut Kleinert, Omar Hahad, Alex von Kriegsheim, Ning Xia, Tilman Grune, Huige Li, Swenja Kröller-Schön, Adrian Gericke, Wolfram Ruf, Philipp S Wild, Philipp Lurz, Thomas Münzel, Andreas Daiber, Thomas Jansen","doi":"10.1093/eurjpc/zwae320","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae320","url":null,"abstract":"<p><strong>Background: </strong>Epidemiology links noise to increased risk of metabolic diseases like diabetes and obesity. Translational studies in humans and experimental animals showed that noise causes reactive oxygen species (ROS)-mediated cardiovascular damage. The interaction between noise and diabetes, specifically potential additive adverse effects, remains to be determined.</p><p><strong>Methods and results: </strong>C57BL/6 mice were treated with streptozotocin (i.p. injections, 50 mg/kg/d for 5d) to induce type-1 diabetes, with S961 (subcutaneous osmotic minipumps, 0.57 mg/kg/d for 7d) or fed a high-fat diet (HFD, 20 weeks) to induce type-2 diabetes. Control and diabetic mice were exposed to aircraft noise to an average sound pressure level of 72 dB(A) for 4d. While body weight was unaffected, noise reduced insulin production in all diabetes models. The oral glucose tolerance test showed only an additive aggravation by noise in the HFD model. Noise increased blood pressure and aggravated diabetes-induced aortic, mesenteric, and cerebral arterioles endothelial dysfunction. ROS formation in cerebral arterioles, the aorta, the heart, and isolated mitochondria was consistently increased by noise in all models of diabetes. Mitochondrial respiration was impaired by diabetes and noise, however without additive effects. Noise increased ROS and caused inflammation in adipose tissue in the HFD model. RNA sequencing data and alteration of gene pathway clusters also supported additive damage by noise in the setting of diabetes.</p><p><strong>Conclusion: </strong>In all three models of diabetes, aircraft noise exacerbates oxidative stress, inflammation, and endothelial dysfunction in mice with pre-existing diabetes. Thus, noise may potentiate the already increased cardiovascular risk in diabetic patients.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Derek N Opp, C Charles Jain, Alexander C Egbe, Barry A Borlaug, Yogesh V Reddy, Heidi M Connolly, Kyla M Lara-Breitinger, Rachael Cordina, William R Miranda
{"title":"Fontan hemodynamics in adults with obesity compared to overweight and normal body mass index: a retrospective invasive exercise study.","authors":"Derek N Opp, C Charles Jain, Alexander C Egbe, Barry A Borlaug, Yogesh V Reddy, Heidi M Connolly, Kyla M Lara-Breitinger, Rachael Cordina, William R Miranda","doi":"10.1093/eurjpc/zwae314","DOIUrl":"10.1093/eurjpc/zwae314","url":null,"abstract":"<p><strong>Aims: </strong>The effects of obesity on Fontan hemodynamics are poorly understood. Accordingly, we assessed its impact on exercise invasive hemodynamics and exercise capacity.</p><p><strong>Methods: </strong>Seventy-seven adults post-Fontan undergoing exercise cardiac catheterization (supine cycle protocol) were retrospectively identified using an institutional database and categorized according to the presence of obesity (body mass index [BMI] >30 kg/m2) and overweight/normal BMI (BMI≤30 kg/m2).</p><p><strong>Results: </strong>There were 18 individuals with obesity (BMI 36.4±3 kg/m2) and 59 (BMI 24.1±3.6 kg/m2) with overweight/normal BMI. Peak oxygen consumption (VO2) on noninvasive cardiopulmonary exercise testing was lower in patients with obesity (15.6±3.5 vs 19.6±5.8 ml/kg/min, p=0.04). At rest, systemic flow (Qs) (7.0 [4.8; 8.3] vs 4.8 [3.9; 5.8] l/min, p=0.001), pulmonary artery (PA) pressure (16.3±3.5 vs 13.1±3.5 mmHg, p=0.002), and PA wedge pressure (PAWP) (11.7±4.4 vs 8.9±3.1 mmHg, p=0.01) were higher, while arterial O2 saturation was lower (89.5% [86.5; 92.3] vs 93% [90; 95]) in obesity compared to overweight/normal BMI. Similarly, patients with obesity had higher exercise PA pressure (29.7±6.5 vs 24.7±6.8 mmHg, p=0.01) and PAWP (23.0±6.5 vs 19.8±7.3 mmHg, p=0.047), but lower arterial O2 saturation (82.4±7.0% vs 89% [85; 92], p=0.003).</p><p><strong>Conclusion: </strong>Adults post-Fontan with obesity have worse aerobic capacity, increased Qs, higher filling pressures, and decreased arterial O2 saturation compared to those with overweight/normal BMI, both at rest and during exercise, mirroring the findings observed in the obesity phenotype of heart failure with preserved ejection fraction. Whether treating obesity and its cardiometabolic sequelae in Fontan patients will improve hemodynamics and outcomes requires further study.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}