Herz最新文献 - Book学术

[Diagnosis and treatment of heart failure with reduced ejection fraction]. [射血分数降低心衰的诊断与治疗]。

IF 1.1 4区医学

Herz Pub Date : 2025-07-02 DOI: 10.1007/s00059-025-05324-y

Samira Soltani, Johann Bauersachs

引用次数: 0

[Palliative care and change in treatment goals for heart failure in the outpatient sector : A survey among office-based physicians in Germany on the current state of healthcare provision]. [姑息治疗和门诊心力衰竭治疗目标的变化：一项针对德国诊所医生的医疗保健现状的调查]。

IF 1.1 4区医学

Herz Pub Date : 2025-06-26 DOI: 10.1007/s00059-025-05325-x

Moritz Blum, Mark Weber-Krüger, Hashim Abdul-Khaliq, Bernd Alt-Epping, Marc Dittrich, Tanja Henking, Gerald Neitzke, Harald Rittger, Henrikje Stanze, Dorit Knappe, Klaus K Witte, Jochen Dutzmann, Franz Goss

{"title":"[Palliative care and change in treatment goals for heart failure in the outpatient sector : A survey among office-based physicians in Germany on the current state of healthcare provision].","authors":"Moritz Blum, Mark Weber-Krüger, Hashim Abdul-Khaliq, Bernd Alt-Epping, Marc Dittrich, Tanja Henking, Gerald Neitzke, Harald Rittger, Henrikje Stanze, Dorit Knappe, Klaus K Witte, Jochen Dutzmann, Franz Goss","doi":"10.1007/s00059-025-05325-x","DOIUrl":"https://doi.org/10.1007/s00059-025-05325-x","url":null,"abstract":"Background: Palliative care is a crucial part of the holistic management of advanced heart failure; however, it remains unclear how palliative care is currently provided in the outpatient sector in Germany.Methods: We conducted a survey among office-based cardiologists and general practitioners (GPs) in Germany on the current provision of palliative care for people with advanced heart failure. The survey was developed by a multiprofessional project group of the German Cardiac Society (DGK e. V.) and administered online by the National Association of Office-Based Cardiologists (BNK e.V.).Results: A total of 235 individuals participated in the study. The majority of respondents reported frequently or always discussing goals of care with patients with advanced heart failure. The GPs reported significantly more often than cardiologists that they always or frequently address primary palliative care needs. None of the surveyed office-based cardiologists but 35.1% of GPs stated that they frequently or always prescribe specialized outpatient palliative care (SAPV) for patients with advanced heart failure. Over 90% of the cardiologists reported that they rarely or never continue to care for patients when they cannot come to the practice themselves.Conclusion: Only few office-based physicians in Germany regularly refer patients with advanced heart failure to specialized palliative care services. Primary palliative care and the involvement of SAPV are significantly more often managed by GPs than by office-based cardiologists.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505548","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}

引用次数: 0

Big data and cardiovascular risk-insights into obesity, diabetes, and coronary heart disease. 大数据和心血管风险——对肥胖、糖尿病和冠心病的洞察。

IF 1.1 4区医学

Herz Pub Date : 2025-06-24 DOI: 10.1007/s00059-025-05323-z

Marcus Dörr

{"title":"Big data and cardiovascular risk-insights into obesity, diabetes, and coronary heart disease.","authors":"Marcus Dörr","doi":"10.1007/s00059-025-05323-z","DOIUrl":"https://doi.org/10.1007/s00059-025-05323-z","url":null,"abstract":"Background: Cardiovascular diseases (CVD) remain a major global health burden. Obesity and type 2 diabetes mellitus (T2DM) are key modifiable risk factors for coronary heart disease (CHD). The emergence of big data has revolutionized cardiovascular research by enabling deeper risk stratification and detection of complex interactions among clinical, lifestyle, and molecular variables.Objective: This article reviews how big data has advanced our understanding of the links between obesity, T2DM, and CHD. It highlights key findings from large cohort studies and international consortia as well as methodological innovations transforming cardiovascular epidemiology.Results: The data reveal that obesity and diabetes show significant regional differences in prevalence and incidence and are associated with other risk factor such as hypertension. Large-scale cohorts and consortia have confirmed that diabetes substantially increases CVD and mortality risk two- to fourfold and is linked to an up to 75% higher mortality rate, with earlier onset and poor glycemic control worsening outcomes. Novel approaches, including polygenic risk scores, machine learning, and real-world data integration, have improved prediction and causal inference. The interplay between obesity and diabetes is a major driver of CHD burden.Conclusion: Big data has enhanced our understanding of cardiovascular risks associated with obesity and diabetes, improved risk prediction models, and provided a foundation for precision prevention strategies. Continued investment in large cohorts, data harmonization, and digital health tools is essential in order to translate these insights into effective public health strategies and reduce the global CVD burden.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475051","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}

引用次数: 0

Timing of RAS blocker administration and long-term cardiovascular outcomes in STEMI patients. STEMI患者RAS受体阻滞剂给药时机与长期心血管预后

IF 1.1 4区医学

Herz Pub Date : 2025-06-16 DOI: 10.1007/s00059-025-05317-x

Tuğba Çetin, Mehmet Baran Karataş, Semih Eren, Şeyda Dereli, Gündüz Durmuş

{"title":"Timing of RAS blocker administration and long-term cardiovascular outcomes in STEMI patients.","authors":"Tuğba Çetin, Mehmet Baran Karataş, Semih Eren, Şeyda Dereli, Gündüz Durmuş","doi":"10.1007/s00059-025-05317-x","DOIUrl":"https://doi.org/10.1007/s00059-025-05317-x","url":null,"abstract":"Background: Renin-angiotensin system (RAS) blockers constitute a cornerstone in the management of patients with cardiovascular disease. However, the relationship between the administration time of these drugs during the day and cardiovascular events is not yet fully elucidated. We aimed to examine the relationship between the administration time of RAS blockers during the day and long-term cardiovascular outcomes in patients with ST-segment elevation myocardial infarction (STEMI).Methods: A total of 701 patients who were admitted to our hospital between 2018 and 2020 with STEMI and underwent primary percutaneous coronary intervention (PCI) were included in this single-center, retrospective, observational study. Primary endpoints were acute heart failure (AHF), nonfatal myocardial infarction, major adverse cardiovascular events (MACE), and long-term mortality. Patients were divided into two group according to the administration of RAS blockers in the morning (06:00-10:00) or evening (20:00-00:00).Results: The mean age of the patients was 57.5 ± 11.9 years and 75.9% were male. After discharge, 485 patients were taking RAS blockers in the morning and 216 patients were taking them in the evening. There was a significantly higher rate of AHF, nonfatal myocardial infarction, MACE, and death in the group taking RAS blockers in the morning compared to the group taking them in the evening (p < 0.01, p = 0.02, p < 0.01, p < 0.01, respectively).Conclusion: Routine administration of RAS blockers in the evening rather than in the morning led to a remarkable decrease in the occurrence of AHF, nonfatal myocardial infarction, MACE, and mortality.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301972","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}

引用次数: 0

Understanding the pathophysiology of obesity-the relevance of weight loss strategies through behavior modification. 了解肥胖的病理生理-通过行为改变减肥策略的相关性。

IF 1.1 4区医学

Herz Pub Date : 2025-06-16 DOI: 10.1007/s00059-025-05321-1

Matthias Blüher

{"title":"Understanding the pathophysiology of obesity-the relevance of weight loss strategies through behavior modification.","authors":"Matthias Blüher","doi":"10.1007/s00059-025-05321-1","DOIUrl":"https://doi.org/10.1007/s00059-025-05321-1","url":null,"abstract":"Obesity is a chronic, progressive, and relapsing disease that can contribute to morbidity, reduced life expectancy, and adverse health outcomes. The prevalence of obesity increased worldwide in the past 60 years, mainly because of changes in our environment and society. With the technical revolution of the last century, new modes of transportation and working conditions, automatization, and computerization, human energy demands have decreased. In parallel, the availability of energy-dense food, refined carbohydrates, and fat has markedly increased. These developments in society clash with biological factors that predispose humans to the development of obesity. At the individual level, obesity is the result of a long-term imbalance between too much energy consumed and too little energy expended. Therefore, lifestyle and behavior interventions aimed at reducing calorie intake and increasing energy expenditure target the root causes of obesity. However, both at the individual and population level, obesity prevention and treatment strategies that are based only on behavior modification are frequently not successful in the long term. The limited effectiveness of behavior interventions on weight loss are explained by complex and persistent hormonal, metabolic, and neurochemical adaptations that prevent weight loss and promote weight regain. However, behavior interventions lead to important health benefits beyond weight loss and are therefore an integral part of obesity management. This review discusses how a better understanding of the pathophysiology of obesity can influence weight loss strategies through behavioral modification. The complex factors contributing to the development of obesity require a multimodal long-term approach that is based on behavior interventions but may also include pharmacological or surgical approaches. The treatment paradigm has recently shifted from simple weight loss strategies towards treating obesity as a multisystem disease.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301919","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}

引用次数: 0

Cardiovascular risk reduction in patients with diabetes mellitus and/or chronic kidney disease-an update. 糖尿病和/或慢性肾病患者心血管风险降低的最新研究进展

IF 1.1 4区医学

Herz Pub Date : 2025-06-16 DOI: 10.1007/s00059-025-05322-0

Katharina Marx-Schütt

引用次数: 0

[Bariatric surgery versus GLP-1 and dual GIP/GLP-1 receptor agonists : Effects on weight, risk factors and prognosis]. [减肥手术与GLP-1和双重GIP/GLP-1受体激动剂：对体重、危险因素和预后的影响]。

IF 1.1 4区医学

Herz Pub Date : 2025-06-13 DOI: 10.1007/s00059-025-05319-9

Jürgen Ordemann, Ulf Elbelt

引用次数: 0

Outcome of edge-to-edge vs. surgical repair in patients with functional mitral regurgitation and reduced left ventricular function. 对功能性二尖瓣反流和左心室功能降低的患者进行边缘修复与手术修复的结果。

IF 1.1 4区医学

Herz Pub Date : 2025-06-01 Epub Date: 2025-02-21 DOI: 10.1007/s00059-025-05294-1

Daniel Silva, Peter Wohlmuth, Friedrich-C Rieß, Joachim Schofer

{"title":"Outcome of edge-to-edge vs. surgical repair in patients with functional mitral regurgitation and reduced left ventricular function.","authors":"Daniel Silva, Peter Wohlmuth, Friedrich-C Rieß, Joachim Schofer","doi":"10.1007/s00059-025-05294-1","DOIUrl":"10.1007/s00059-025-05294-1","url":null,"abstract":"Background: This study aims to compare the midterm outcome of percutaneous edge-to-edge repair (TEER) using the first-generation MitraClip system (Abbott Vascular, Santa Clara, CA) with surgical repair, in patients with severe functional mitral regurgitation (fMR) and reduced left ventricular function (LVEF).Methods: The data of consecutive patients with severe fMR and LVEF ≤ 45%, who underwent either isolated surgical repair or MitraClip implantation between January 2007 and December 2015, were retrospectively analyzed. Clinical and echocardiographic follow-up data after 12 and 24 months were obtained in both groups. A propensity score matching analysis was performed to adjust for intergroup differences in baseline characteristics.Results: A total of 167 patients with significant fMR and LVEF ≤ 45% were identified, who underwent either isolated surgical mitral valve repair (n = 83, 49.7%) or MitraClip (n = 84, 50.3%) implantation. Because the two groups had very different risk profiles, propensity scores were calculated for age, sex, EuroSCORE, LVEF, and coronary artery disease, which reduced the number of patients to 74 (38 in the clip group and 36 in the surgical group). There was no significant difference between the two groups in terms of survival, number of reinterventions, heart failure symptoms according to New York Heart Association (NYHA) class, degree of mitral regurgitation, and LVEF.Conclusion: In this retrospective analysis of patients with severe fMR and LVEF ≤ 45%, the comparison between surgical repair, edge-to-edge repair and a first-generation MitraClip device showed similar midterm outcomes in terms of survival, number of reinterventions, NYHA class, degree of mitral regurgitation, and LVEF.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"207-216"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467819","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}

引用次数: 0

[Mortality in patients with ST-segment elevation myocardial infarction in Germany : Comparison of routine data vs. quality assurance vs. registry]. [德国st段抬高型心肌梗死患者的死亡率：常规数据、质量保证和登记的比较]。

IF 1.1 4区医学

Herz Pub Date : 2025-06-01 Epub Date: 2025-03-12 DOI: 10.1007/s00059-025-05307-z

Uwe Zeymer, Steffen Schneider, Susanne Stolpe, Ralf Zahn

引用次数: 0

[Quality assurance in cardiology with routine data : Requirement and reality]. 【心脏病学常规数据的质量保证：要求与现实】。

IF 1.1 4区医学

Herz Pub Date : 2025-06-01 Epub Date: 2025-03-13 DOI: 10.1007/s00059-025-05306-0

Volker Schächinger

{"title":"[Quality assurance in cardiology with routine data : Requirement and reality].","authors":"Volker Schächinger","doi":"10.1007/s00059-025-05306-0","DOIUrl":"10.1007/s00059-025-05306-0","url":null,"abstract":"Routine data are very helpful as an instrument for health services research. In German hospitals the input data of the statutory quality assurance (in cardiology: left heart catheterization, cardiac implantable electronic devices and transcatheter aortic valve implantation, TAVI), the data according to § 21 of the Hospital Remuneration Act and mandatory quality assurance reports of hospitals are available. In addition, the health insurance companies also have social data at their disposal. The very restrictive interpretation of data safety in Germany as well as a partition of the data according to the private or statutory health insurance status, outpatient and inpatient forms of treatment and two different remuneration sources exacerbate in the current reality an effective central use of routine data, as is possible in other countries, e.g., Sweden. Routine data are a powerful tool for quality assurance in terms of critical self-reflection and as a basis for peer review by colleagues; however, public reporting of routine data (publication of the results of individual hospitals) is questionable due to methodological limitations, such as data quality and risk adjustment, as it puts hospitals in the pillory without any chance to critically reflect on the validity of the data. Consequently, risk-avoiding behavior in medical services could compromise patient care. The current development of healthcare policies with a structural reform of the hospital landscape and the recommendations of the government committee will increase the demands on the quality assessment based on routine data. Simplified data acquisition, methodological improvements as well as new aspects, such as the quality of indications, assessment of nursing services and patient orientation will be added. In future, a quality-oriented remuneration based on routine data is intended to help control the healthcare system.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"171-178"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623890","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}

引用次数: 0