Heart最新文献

{"title":"Cardiac resident macrophages in cardiovascular disease: from physiology to pathology.","authors":"Jianshu Chen, Ziwei Zhu, Yi Wang, Jing Yu, Xiaowei Zhang, Yuansheng Xu","doi":"10.1136/heartjnl-2024-324333","DOIUrl":"10.1136/heartjnl-2024-324333","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) is the leading cause of death and disease burden worldwide. Macrophages are important components of the internal immune cells, which profoundly affects the internal environmental homeostasis and repair after injury. Cardiac resident macrophages have been shown to regulate a variety of myocardial physiology and pathological activities. Homeostatic resident macrophages in the heart promote angiogenesis, remove ageing and dying cells and participate in cardiac electrical conduction. However, the role of cardiac resident macrophages is still not fully understood despite the growing attention they have received. This review provides an overview of macrophage biology and highlights prominent and emerging interrelationships and functions between cardiac resident macrophages and CVD, aiming to prove a description of the functional diversity of cardiac resident macrophages in different CVD to explore potential options to regulate them. This may provide opportunities for successful therapeutic interventions to improve the prognosis of patients with CVD.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":"391-400"},"PeriodicalIF":5.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temperature and myocardial infarction among migrants in Kuwait.","authors":"Chenqing Wang, David Christiani, Ali Al-Hemoud, Barrak Alahmad","doi":"10.1136/heartjnl-2024-324629","DOIUrl":"10.1136/heartjnl-2024-324629","url":null,"abstract":"<p><strong>Background: </strong>Kuwait, one of the world's hottest countries, faces increasing temperatures due to climate change. With a large migrant population predominantly employed in physically demanding jobs, the exact effects and burdens of temperature exposure on cardiovascular risk among this population remain unknown. This study aimed to investigate the relationship between temperature and myocardial infarction (MI) risk among migrants in Kuwait.</p><p><strong>Methods: </strong>MI hospital admissions data from 17 public hospitals in Kuwait from 2000 to 2017 were collected. Meteorological data, including daily temperatures and humidity, were obtained from monitoring stations. A time series analysis was conducted to examine the association between temperature and MI hospitalisation. A distributed lag non-linear model was used to study the lagged association of temperature. Seasonality, relative humidity and day of the week were adjusted for in the model. Excess hospitalisations attributed to temperature variations were calculated.</p><p><strong>Results: </strong>A total of 26 839 MI cases were examined. The optimal temperature with the lowest MI cases was 39.2°C. Elevated MI risks were associated with both hot and cold temperatures above or below this threshold, particularly at shorter lag days. Hot temperatures showed a pronounced association at lag 0, while cold temperatures demonstrated a weak effect at lag 7. The cumulative risk of MI for cold temperatures was higher than the risk for hot temperatures. Annually, 300 (20.1%) MI cases can be attributed to all cool days (below 39.2°C). Very hot days (above 39.2°C) contributed to about 9 (0.6%) MI cases each year among migrants in Kuwait.</p><p><strong>Conclusion: </strong>The study revealed a substantial burden of both hot and cold ambient temperatures and the risk of MI at shorter lag days among the migrant population in Kuwait. This study provides valuable insights for government officials to mitigate exposure to extreme temperatures, especially in occupational settings.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":"430-435"},"PeriodicalIF":5.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028643","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":"Gaps in knowledge and management of iron deficiency in heart failure: a nationwide survey of cardiologists in China.","authors":"Lina Su, Peizhao Li, Zeng Li, Zhiping Chen, Dan Hu, Hui An, Lijie Sun, Chuanfen Liu, Manyan Wu, Ailifeire Maimaiti, Xiaoling Su, Zhan Lu, Sufang Li, Gusang Lamu, Xi Wang, Jingjing Gong, Jinsheng Lai, Xiang Hao, Pei Zhou, Hao Zhang, Yanqing Zhang, Guangsheng Su, Wenjie Liu, Bihe Xu, Ming Bai, Yujian Liu, Wanjun Liu, Sizhen Chen, Lina Feng, Jiang Liu, Ying Zhou, Xuecheng Zhao, Zhen Meng, Di Sun, Hong-Shuai Cao, Lulei Cao, Naidan Kang, Zhaoqi Zheng, Hu Zhang, Jingang Zheng, John G F Cleland, Jingyi Ren","doi":"10.1136/heartjnl-2024-324887","DOIUrl":"10.1136/heartjnl-2024-324887","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) guidelines recommend routine testing for iron deficiency (ID) and, for those with ID, intravenous iron if the left ventricular ejection fraction is <50%. Guideline adherence to these recommendations by cardiologists in China is unknown.</p><p><strong>Methods and results: </strong>An independent academic web-based survey was designed and distributed via social networks to cardiologists across China. Overall, 1342 cardiologists (median age 34 years, IQR 30-39, 51% women) from all provinces of China completed this survey. More than half were unaware of the need to screen for ID in HF and did not do so routinely in their clinical practice. Approximately 80% were not familiar with the diagnostic criteria for ID in HF guidelines, and only 0.8% recognised transferrin saturation <20% as an independent marker of ID. Regarding iron repletion, only 14% preferred intravenous to oral iron for correcting ID compared with 68% favouring oral iron. Three-quarters were unfamiliar with methods for calculating intravenous iron dose. Furthermore, over 80% were unaware that current guidelines only recommend ferric carboxymaltose or ferric derisomaltose for correcting ID. The main barriers to using intravenous iron were lack of knowledge and experience. Despite such poor awareness and practice, most cardiologists were interested in learning more about managing ID in HF.</p><p><strong>Conclusions: </strong>In this nationwide survey of cardiologists in China, we identified large gaps in both knowledge and management of ID. This survey will help guide the development of educational programmes to improve care for patients with HF and ID in China.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":"421-429"},"PeriodicalIF":5.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947780","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":"Hearing impairment, psychological distress, and incident heart failure: a prospective cohort study.","authors":"Yu Huang, Yanjun Zhang, Yuanyuan Zhang, Hao Xiang, Ziliang Ye, Sisi Yang, Xiaoqin Gan, Yiting Wu, Yiwei Zhang, Xianhui Qin","doi":"10.1136/heartjnl-2024-325394","DOIUrl":"https://doi.org/10.1136/heartjnl-2024-325394","url":null,"abstract":"<p><strong>Background: </strong>The relationship between objectively measured hearing ability and the risk of incident heart failure (HF) remains unclear. This study aimed to assess this association, explore potential modifying factors, and examine whether psychological factors mediate this relationship.</p><p><strong>Methods: </strong>We included 164 431 participants from the UK Biobank without HF at baseline. Speech-in-noise hearing ability was measured using the Digit Triplets Test and quantified by the speech-reception-threshold (SRT). Incident HF was identified through hospital admission and death records. Mediation analyses assessed the role of social isolation, psychological distress, and neuroticism.</p><p><strong>Results: </strong>Over a median follow-up of 11.7 years, 4449 (2.7%) participants developed incident HF. Higher SRT levels were associated with an increased risk of HF (adjusted HR per SD increment 1.05, 95% CI 1.02 to 1.08). Compared with those with normal hearing, participants with insufficient hearing, poor hearing, or hearing aid use had higher HF risks (adjusted HRs 1.15, 1.28, and 1.26, respectively). Psychological distress mediated 16.9% of the association between SRT levels and HF, while social isolation and neuroticism mediated 3.0% and 3.1%, respectively. The association was stronger in participants without coronary heart disease or stroke at baseline.</p><p><strong>Conclusions: </strong>Poor hearing ability is associated with an increased risk of incident HF, with psychological distress playing a notable mediating role. These findings suggest that hearing health and psychological well-being should be considered in cardiovascular risk assessment and prevention strategies.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810688","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":"Aspirin for primary prevention: new scores for old questions?","authors":"Bianca Rocca, Michael J Gaziano","doi":"10.1136/heartjnl-2025-325810","DOIUrl":"https://doi.org/10.1136/heartjnl-2025-325810","url":null,"abstract":"","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802889","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":"Genotype and arrhythmic risk in patients with apical hypertrophic cardiomyopathy.","authors":"Joo Hee Jeong, Hwajung Kim, Sung Ho Hwang, Chang-Ok Seo, Yeji Kim, Hyoung Seok Lee, Yun Gi Kim, Jaemin Shim, Young-Hoon Kim, So Ree Kim, Dong-Hyuk Cho, Mi-Na Kim, Seong-Mi Park, Young Choi, Jong-Il Choi","doi":"10.1136/heartjnl-2024-325218","DOIUrl":"https://doi.org/10.1136/heartjnl-2024-325218","url":null,"abstract":"<p><strong>Background: </strong>Apical hypertrophic cardiomyopathy (HCM) is a rare variant of HCM, often considered to have a benign prognosis. This study aimed to compare the clinical characteristics and genetic predisposition of apical HCM with non-apical HCM.</p><p><strong>Methods: </strong>We included 195 patients with HCM who underwent next-generation sequencing at two tertiary centres in South Korea (2017-2024). The primary outcome was a composite of lethal arrhythmic events (LAE), including death, ventricular arrhythmia, implantable cardioverter defibrillator (ICD) implantation and appropriate ICD shock. Secondary outcomes included major adverse cardiovascular events (MACE), such as new-onset atrial fibrillation, ischaemic stroke, heart failure hospitalisation, septal reduction therapy or heart transplant.</p><p><strong>Results: </strong>Of the 195 patients, 67 (34.4%) had apical HCM. Patients with apical HCM were older at diagnosis and had lower maximal left ventricular wall thickness compared with non-apical HCM. Disease-causing variants were less frequent in apical HCM (20.9% vs 46.9%, p<0.001). <i>MYBPC3</i> and <i>MYH7</i> variants were less common in apical HCM (50.0%) than in non-apical HCM (75.0%). MACE occurred less frequently in apical HCM (HR 0.38, 95% CI 0.19 to 0.75), but no difference was observed in LAE (HR 0.62, 95% CI 0.36 to 1.08). The presence of disease-causing variants was independently associated with LAE (adjusted HR 2.50, 95% CI 1.44 to 4.35).</p><p><strong>Conclusions: </strong>Although apical HCM is associated with less hypertrophy and lower genetic yield, it is not entirely benign. The presence of disease-causing variants is an important predictor of arrhythmic risk, underscoring the value of genetic testing in all HCM patients, regardless of phenotype.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803096","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":"Depression trajectories in HFpEF: what fluctuates hurts more.","authors":"Nan Zhang, Tong Liu","doi":"10.1136/heartjnl-2025-325989","DOIUrl":"https://doi.org/10.1136/heartjnl-2025-325989","url":null,"abstract":"","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788114","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":"Iron deficiency in patients with atrial fibrillation: moving towards a treatment target?","authors":"Paul R Kalra, Ian Ford","doi":"10.1136/heartjnl-2025-325755","DOIUrl":"https://doi.org/10.1136/heartjnl-2025-325755","url":null,"abstract":"","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788116","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":"Distinct early repolarisation patterns in male Brazilian soccer players: insights from a multicentre study.","authors":"Filipe Ferrari, Anderson D da Silveira, Arthur P Rossi, Luana G Pedrotti, Guilherme D Dilda, Haroldo C Aleixo, Flávia C O Magalhães, Luiz G M Emed, Luciano G Soares, Fernando B Cardoso, Fernando Bassan, Felipe E F Guerra, Aureliano I S Neto, Henrique C da Silva, Luiz F R M Mourão, José N Júnior, Frederico P L Coimbra, Ivan Z Arruda, Mateus F Teixeira, Gabriel F I de Lima, Valdir Torres, Carla T F Vieira, Diogo T Meira, Filipe C D Barbosa, Edílson F de Andrade Júnior, Rodrigo O B Alô, Marcelo R Facio, Luiz E F Ritt, Fabrício Braga, Artur H Herdy, Victor F Froelicher, Ricardo Stein","doi":"10.1136/heartjnl-2024-325484","DOIUrl":"https://doi.org/10.1136/heartjnl-2024-325484","url":null,"abstract":"<p><strong>Background: </strong>Early repolarisation (ER) is commonly observed during cardiovascular screenings of young athletes and can present with various morphologies. However, its prevalence and clinical significance in male Brazilian soccer players have not been characterised. This study aimed to compare the prevalence of different ER patterns and assess their potential clinical significance in this population.</p><p><strong>Methods: </strong>In this multicentre observational study, we analysed ECG data from male Brazilian soccer players who underwent preparticipation evaluations at 83 professional clubs across Brazil's five geographic regions between February 2002 and August 2024. Our analysis included white, mixed-race and black athletes, as well as seven distinct ER morphologies. Poisson regression with robust variance was used to derive age-adjusted prevalence ratios for the different ER morphologies.</p><p><strong>Results: </strong>We included 6353 athletes (median (IQR) age: 19 (16-23) years; 2556 white, 2071 mixed-race and 1726 black individuals). ER patterns appeared in 2552 (40.2%) players. The most common ER morphologies with ST-segment elevation (STE) were a classic J-wave with ascending ST-segment (1275; 20.1%) and a discrete J-point with ascending ST-segment (735; 11.6%) in leads V4-V6. Without STE, the most frequent patterns were a slur on the downslope of the R-wave with ascending ST- segment (760; 12%), a slur with horizontal ST-segment (335; 5.3%) and a J-wave (199; 3.1%) in leads II, III and aVF. ER was more prevalent in black (48.1%) than in white (34.4%) or mixed-race (40.6%) athletes. Over a mean follow-up period of 4.4±3.1 years, no cases of sudden cardiac death were identified.</p><p><strong>Conclusions: </strong>Our findings do not suggest that ER patterns observed in male Brazilian soccer players are associated with sudden cardiac death. Given the role of Brazil in exporting soccer talent, our results may help guide athlete assessments of ER worldwide.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779783","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":"Vascular endothelial growth factor inhibitor-induced cardiotoxicity: prospective multimodality assessment incorporating cardiovascular magnetic resonance imaging.","authors":"Stephen J H Dobbin, Kenneth Mangion, Colin Berry, Giles Roditi, Susmita Basak, John D McClure, Katriona Brooksbank, Piotr Sonecki, Steven Sourbron, Jeff Evans, Jeff White, Paul Welsh, Elaine Butler, Balaji Venugopal, Rhian M Touyz, Robert J Jones, Mark C Petrie, Ninian N Lang","doi":"10.1136/heartjnl-2024-325535","DOIUrl":"https://doi.org/10.1136/heartjnl-2024-325535","url":null,"abstract":"<p><strong>Background: </strong>Vascular endothelial growth factor inhibitors (VEGFIs) are effective anticancer agents, but are associated with cancer therapy-related cardiac dysfunction (CTRCD) and hypertension. The timing, frequency and magnitude of these toxicities are poorly defined. The objective of this study is therefore to investigate the incidence, time course and mechanisms of VEGFI-associated CTRCD and hypertension.</p><p><strong>Methods: </strong>Patients commencing VEGFI underwent blood pressure (BP) monitoring, echocardiography and cardiac biomarker measurement at baseline and prospectively over 24 weeks. Serial adenosine stress perfusion cardiovascular MRI (CMR) was performed in a substudy. CTRCD was defined as left ventricular ejection fraction (LVEF) decline by ≥10 percentage points from baseline to a value <50%.</p><p><strong>Results: </strong>78 patients participated (68% men; age 63±11 years). 15 patients (19%) developed CTRCD, and it was evident at 4 weeks in 93% of cases. Overall, LVEF was 4.2% (95% CI: -6.2% to -2.3%, p<0.001) lower than baseline at 4 weeks. At 4 weeks, N-terminal pro-brain natriuretic peptide, but not troponin, was higher in patients with CTRCD. 62 (77%) patients developed hypertension. Home systolic and diastolic BP increased by 7.2 mm Hg (4.7-9.8, p<0.001) and 4.8 mm Hg (3.1-6.5, p<0.001), respectively, at 1 week. There was no association between change in LVEF and BP.CMR-derived LVEF, T1 relaxation times and resting myocardial blood flow (n=46) were 5.2% (-7.3% to -3.1%, p<0.001), 27 ms (-40 to -14, p<0.001) and 14.7 mL/100mL/min (-24.2 to -5.1, p=0.004), respectively, lower at 4 weeks.</p><p><strong>Conclusion: </strong>VEGFI-associated CTRCD is frequent and occurs early. This finding has implications for prioritising early cardiac imaging follow-up after commencing treatment. Underlying mechanisms include myocardial and microvascular effects that are at least partly independent of hypertension.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779747","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}