Herz最新文献

{"title":"[2024 ESC guidelines: What is new? What is of particular importance?]","authors":"Rolf Dörr, Bernhard Maisch","doi":"10.1007/s00059-024-05290-x","DOIUrl":"https://doi.org/10.1007/s00059-024-05290-x","url":null,"abstract":"","PeriodicalId":12863,"journal":{"name":"Herz","volume":"50 1","pages":"1-2"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[What is new in the management of peripheral arterial occlusive disease and diseases of the aorta? : Highlights of the ESC guidelines 2024].","authors":"Heike Schulze-Bauer, Moritz Staudacher, Sabine Steiner, Oliver Schlager","doi":"10.1007/s00059-024-05286-7","DOIUrl":"10.1007/s00059-024-05286-7","url":null,"abstract":"<p><p>The European Society of Cardiology (ESC) guidelines on peripheral arterial disease (PAD) and diseases of the aorta published in September 2024 for the first time combine recommendations for both diseases in a joint guideline document. The consolidation of PAD and aorta guidelines follows a holistic approach, which underlines the entirety of the arterial vascular system. This aim is underlined by a specifically introduced recommendation to take the entirety of the circulatory system into account in patients with vascular diseases. The focus in the current ESC guideline document is on a multidisciplinary, patient-centered management of PAD and diseases of the aorta, whereby the prevention and follow-up of patients after therapeutic interventions are emphasized. In PAD the document highlights exercise training and the procedure for patients with chronic wounds as well as risk stratification and hereditary diseases of the aorta.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"25-33"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Management of acute coronary syndrome].","authors":"Maria Buske, Hans-Josef Feistritzer, Alexander Jobs, Holger Thiele","doi":"10.1007/s00059-024-05284-9","DOIUrl":"10.1007/s00059-024-05284-9","url":null,"abstract":"<p><p>Coronary artery disease (CAD) is the leading cause of death worldwide. Acute coronary syndrome (ACS) encompasses a spectrum of diagnoses ranging from unstable angina pectoris to myocardial infarction with and without ST-segment elevation and frequently presents as the first clinical manifestation. It is crucial in this scenario to perform a timely and comprehensive assessment of patients by evaluating the clinical presentation, electrocardiogram and laboratory diagnostics using highly sensitivity cardiac troponin in order to initiate a timely and risk-adapted continuing treatment with immediate or early invasive coronary angiography. In addition to revascularization, the subsequent antithrombotic and lipid-lowering treatment plays a major role in the further secondary prevention of CAD. The choice and duration of medication over time should be tailored to the individual risk profile of the patient. Furthermore, appropriate patient education regarding risk factor management is of paramount importance.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"66-76"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[European Society of Cardiology (ESC) guidelines on atrial fibrillation 2024 : What is new and what is important?]","authors":"Robert Hättasch, Verena Tscholl, Gerhard Hindricks, Nikolaos Dagres","doi":"10.1007/s00059-024-05287-6","DOIUrl":"10.1007/s00059-024-05287-6","url":null,"abstract":"<p><p>The 2024 guidelines of the European Society of Cardiology (ESC) on atrial fibrillation (AF) present current and comprehensive recommendations for the diagnosis, prevention and treatment of AF. They are based on the AF-CARE treatment pathway, which includes modification of cardiovascular risk factors, stroke prevention, symptom management and continuous re-evaluation. Accordingly, all patients with newly diagnosed AF should undergo transthoracic echocardiography. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are recommended for the treatment of heart failure across all clinical and echocardiographic levels of left ventricular ejection fraction (LVEF). The CHA2DS2-VASc score has been simplified to the CHA2DS2-VA score for the risk assessment of thromboembolism. For rate or rhythm control pharmacotherapy with beta-blockers, digitalis, amiodarone and flecainide are still the most important drugs. Pulmonary vein isolation is now also recommended as a first-line treatment for paroxysmal AF. Re-evaluation of risk factors and treatment of comorbidities is also emphasized. Overall the guidelines represent a further development and update based on recent studies. They remain practical and provide clear and detailed recommendations for action that are globally recognized in the clinical practice.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"3-7"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of risk factors for long-term atrial fibrillation development in patients undergoing typical atrial flutter ablation: a multicenter pilot study.","authors":"Ahmet Çağdaş Yumurtaş, Levent Pay, Ozan Tezen, Tuğba Çetin, Furkan Fatih Yücedağ, Ertan Arter, Hikmet Kadıoğlu, Hüseyin Akgün, Eyüp Özkan, Abdulkadir Uslu, Ayhan Küp, Faysal Şaylık, Tufan Çınar, Mert İlker Hayıroğlu","doi":"10.1007/s00059-024-05261-2","DOIUrl":"10.1007/s00059-024-05261-2","url":null,"abstract":"<p><strong>Background: </strong>Atrial flutter (AFL) and atrial fibrillation (AF) are the most commonly detected supraventricular arrhythmias and share similar pathophysiological mechanisms. After the successful ablation of AFL, AF frequently occurs in the long-term follow-up. As emphasized in some studies, certain mechanisms seem to predispose to the development of AF in AFL patients, and approximately 20% of these patients have accompanying AFL.</p><p><strong>Purpose: </strong>We aimed to analyze independent risk factors that predict the development of AF in patients who underwent typical AFL ablation.</p><p><strong>Methods: </strong>This was a multicenter, cross-sectional, and retrospective study. A total of 442 patients who underwent typical AFL ablation at three different centers between January 1, 2018 and January 1, 2022 were included retrospectively. After the ablation procedure the patients were divided into those who developed AF and those who did not. The patients were followed up for an average of 12 (4-20) months. In the post-procedural period, atrial arrhythmias were investigated with 24‑h Holter and ECG at 1 month, 6 months, and 12 months and then at 6‑month intervals thereafter.</p><p><strong>Results: </strong>Overall, AF developed in 206 (46.6%) patients in the long-term follow-up. Age, hypertension (HT), obstructive sleep apnea syndrome (OSAS), previous cerebrovascular accident (CVA), left atrium anteroposterior diameter, severe mitral regurgitation, hemoglobin, blood glucose, and HbA1c values were found to be significant in univariable analysis. According to multivariable analysis, HT (p = 0.014; HR: 1.483 [1.084-2.030]), OSAS (p = 0.008; HR: 1.520 [1.117-2.068]) and previous CVA (p = 0.038; HR: 1.749 [1.031-2.968]) were independently associated with the development of AF in AFL patients who underwent ablation procedure.</p><p><strong>Conclusion: </strong>In the present study, we found that HT, OSAS, and previous CVA were independently correlated with the development of AF in the long-term follow-up of patients who underwent typical AFL ablation. We consider that AFL patients with such risk factors should be followed up closely following cavotricuspid isthmus ablation for the development of AF.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"51-58"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Guidelines of the European Society of Cardiology on chronic coronary syndrome from 2024].","authors":"Stephan Achenbach","doi":"10.1007/s00059-024-05288-5","DOIUrl":"10.1007/s00059-024-05288-5","url":null,"abstract":"<p><p>The 2024 European Society of Cardiology (ESC) guidelines on chronic coronary syndrome comprehensively summarize the symptoms, diagnostics and treatment of coronary artery disease, excluding acute coronary syndromes. The processing always begins with an estimation of the clinical probability, which should include not only the symptom profile but also the number of cardiovascular risk factors and is further modified by any conspicuous findings in electrocardiography (ECG), exercise testing, or echocardiography. For further diagnostics, coronary angiography via computed tomography is the first-line approach if the probability lies between 5% and 50%. For probabilities of 50-85% procedures for imaging-based ischemia detection are indicated, while for even higher probabilities immediate invasive diagnostics are given priority. The treatment includes intensive risk modification, medicinal anti-anginal treatment and finally revascularization by coronary intervention or bypass surgery. In the absence of high-risk constellations a medication-based approach should be initially preferred, with revascularization indicated if symptoms persist. The new guidelines also extensively address angina and ischemia without obstructive coronary lesions. In this context, intensive risk modification and initial medication treatment are again recommended.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"8-16"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of single-catheter with two-catheter concept in older female patients undergoing transradial coronary angiography.","authors":"Murat Kerkütlüoğlu, Enes Çelik","doi":"10.1007/s00059-024-05289-4","DOIUrl":"10.1007/s00059-024-05289-4","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to compare the efficacy outcomes of the traditional Judkins left and right catheters with those of the recently introduced Tiger catheter in female participants aged 65 years and older who underwent transradial coronary angiography.</p><p><strong>Methods: </strong>A cohort of 160 female patients aged 65 and older who were scheduled for coronary angiography (CAG) were divided into two groups according to the use of Tiger (n = 80) or Judkins (n = 80) catheters for radial angiography at a ratio of 1:1, respectively. We analyzed the effectiveness of the Tiger and Judkins catheters, the incidence of catheter failure, contrast volume, CAG time, fluoroscopy time, dose-area product (in mGy/cm²), and the occurrence of radial spasm.</p><p><strong>Results: </strong>The Judkins catheter group had a significantly longer processing time than the Tiger catheter group, with an equivalent level of radiation exposure. The duration of fluoroscopy was longer, and the amount of contrast medium used was higher, but the frequency of radial spasm was not significantly different.</p><p><strong>Conclusion: </strong>The present investigation revealed that implementation of Tiger catheters for geriatric individuals with elevated frailty and female patients with more narrow radial artery diameters was associated with decreased overall procedure duration, contrast volume utilization, and fluoroscopy duration.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"59-65"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Elevated blood pressure and hypertension : Focus of the 2024 ESC guidelines on risk reduction].","authors":"Raphael S Schmieder, Heribert Schunkert","doi":"10.1007/s00059-024-05285-8","DOIUrl":"10.1007/s00059-024-05285-8","url":null,"abstract":"<p><p>The 2024 guidelines of the European Society of Cardiology (ESC) for the management of elevated blood pressure and hypertension introduce the new category \"elevated blood pressure\" (120-139/70-89 mm Hg). All patients with elevated blood pressure are advised to implement lifestyle modifications. The aim is to reduce the cardiovascular risk at an early stage. In addition, a structured assessment should be carried out based on the comorbidities, such as coronary artery disease, heart failure and stroke as well as on risk factors, which can result from an antihypertensive treatment in cases of moderate to high risk and a blood pressure of 130/80 mm Hg or more despite 3 months of lifestyle modifications. For patients with hypertension (≥ 140/90 mm Hg), the guidelines now recommend initiating lifestyle modifications and antihypertensive medication concurrently. The new target systolic blood pressure is 120-129 mm Hg, with establishment of individualized treatment goals in cases of frailty or age ≥85 years. Compared to the guidelines of the European Society of Hypertension (ESH) and the German national guidelines (NVL), the ESC extends the treatment recommendations to patients with elevated blood pressure even below the threshold of 140/90 mm Hg. For resistant hypertension spironolactone is recommended, with renal denervation being an alternative option to increasing the antihypertensive medication.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"17-24"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive strength of inflammatory scores for in-hospital mortality in infective endocarditis.","authors":"Vedat Cicek, Almina Erdem, Sahhan Kilic, Burak Tay, Mustafa Kamil Yemis, Solen Taslicukur, Mustafa Oguz, Ahmet Oz, Murat Selcuk, Tufan Cinar, Ulas Bagci","doi":"10.1007/s00059-024-05292-9","DOIUrl":"https://doi.org/10.1007/s00059-024-05292-9","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory markers have been proposed as prognostic tools for predicting in-hospital mortality in infective endocarditis (IE). Nonetheless, it is unclear whether these markers provide additional prognostic value over established indicators. This study compared nine different inflammation scores to assess their effectiveness in enhancing the prediction of in-hospital mortality.</p><p><strong>Methods: </strong>Patients with IE diagnosed between 2017 and 2023 at two cardiology centers in Istanbul were included in this study. Pre-treatment inflammatory markers were obtained from the hospital electronic database system. In-hospital mortality prognostication was assessed using Cox proportional hazards models.</p><p><strong>Results: </strong>A total of 122 patients who were diagnosed with IE were included in the analysis. Overall, 38 patients died during the hospital stay. The patients were categorized into two groups based on their mortality status. The prognostic nutritional index (PNI), platelet-to-lymphocyte ratio (PLR), and modified Glasgow prognostic score (mGPS) were identified as statistically significant predictors of in-hospital mortality. Based on the results of Cox regression analysis, the PNI (hazard ratio [HR]: 0.921, 95% confidence interval [CI]: 0.853-0.994, p = 0.035) emerged as the only independent predictor of in-hospital mortality of IE patients.</p><p><strong>Conclusion: </strong>Nine inflammatory scores were evaluated in this study. The PNI, PLR, and mGPS were statistically significant predictors of in-hospital mortality in patients with IE. The PNI was identified as the optimal score.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Vaccination and cardiovascular diseases].","authors":"Markus Therre, Mert Tokcan, Philipp Markwirth, Michael Böhm","doi":"10.1007/s00059-024-05291-w","DOIUrl":"https://doi.org/10.1007/s00059-024-05291-w","url":null,"abstract":"<p><p>Respiratory tract infections with influenza, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and respiratory syncytial (RS) viruses and pneumococci as well as endogenous reactivation of varicella zoster viruses presenting as herpes zoster, are associated with adverse cardiovascular outcomes, such as myocardial infarction or hospitalization for heart failure. Effective prevention of these events, particularly through influenza and pneumococcal vaccination, is well established and cost-effective. Despite guideline recommendations to vaccinate older patients and people at risk, vaccination rates in these population groups remain suboptimal and below average in international comparison. This article sheds light on the association of vaccine preventable diseases with cardiovascular complications and demonstrates the protective effect of the respective vaccinations. Additionally, recommendations on the practical approach to vaccinating high-risk patients are given.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}