Herz最新文献_第10页

[Imaging diagnostics of cardiac sarcoidosis]. [心脏结节病的影像学诊断]。

IF 1.7 4区医学

Herz Pub Date : 2023-10-01 Epub Date: 2023-09-08 DOI: 10.1007/s00059-023-05208-z

Ron Blankstein, Stephan Achenbach

{"title":"[Imaging diagnostics of cardiac sarcoidosis].","authors":"Ron Blankstein, Stephan Achenbach","doi":"10.1007/s00059-023-05208-z","DOIUrl":"10.1007/s00059-023-05208-z","url":null,"abstract":"Cardiac involvement is clinically apparent in approximately 5% of all patients with systemic sarcoidosis, whereas evidence of cardiac involvement by imaging studies can be found in approximately 20% of cases. Occasionally, isolated cardiac sarcoidosis is encountered and is the only sign of the disease. The most frequent cardiac manifestations of the multifocal granulomatous inflammation include atrioventricular (AV) blocks and other conduction disorders, ventricular arrhythmias, sudden cardiac death and left and right ventricular wall disorders. Accordingly, symptoms that should raise suspicion include palpitations, lightheadedness and syncope. The diagnostic approach to cardiac sarcoidosis is not straightforward. Typical echocardiographic findings include regional thinning and contraction abnormalities particularly in basal, septal and lateral locations. Infrequently, myocardial hypertrophy may be present; however, the sensitivity of echocardiography is low and cardiac sarcoidosis can be present even when an echocardiogram is unrevealing. Cardiac magnetic resonance imaging (MRI) frequently shows late gadolinium enhancement (LGE) in a multifocal pattern often involving the basal septum and lateral walls. The sensitivity and specificity of MRI for detecting cardiac sarcoidosis are high. Fluorodeoxyglucose positron emission tomography (FDG-PET) plays an important role in the diagnostic algorithm due to its ability to visualize focal inflammatory activity both in the myocardium and in extracardiac locations. This may help target the optimal location for biopsy in order to obtain histologic proof of sarcoidosis and can also be used to follow the response to anti-inflammatory treatment. Notably, the sensitivity of endomyocardial biopsy is poor due to the patchy nature of myocardial involvement. In clinical practice, either histologic evidence of noncaseating granulomas from the myocardium or evidence from extracardiac tissue in combination with typical cardiac imaging findings are required to establish the diagnosis.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"366-371"},"PeriodicalIF":1.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10553898","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 treatment in chronic kidney disease]. [慢性肾脏疾病的心血管治疗]。

IF 1.7 4区医学

Herz Pub Date : 2023-10-01 Epub Date: 2023-09-11 DOI: 10.1007/s00059-023-05205-2

Vincent Brandenburg, Turgay Saritas, Stephan H Schirmer, Kyrill Rogacev, Gunnar Henrik Heine

引用次数: 0

[Coronary CT angiography and coronary atherosclerosis : Where do we stand today?] [冠状动脉CT血管造影术与冠状动脉粥样硬化：我们今天的处境如何？]

IF 1.7 4区医学

Herz Pub Date : 2023-10-01 Epub Date: 2023-08-25 DOI: 10.1007/s00059-023-05207-0

Stephan Achenbach

{"title":"[Coronary CT angiography and coronary atherosclerosis : Where do we stand today?]","authors":"Stephan Achenbach","doi":"10.1007/s00059-023-05207-0","DOIUrl":"10.1007/s00059-023-05207-0","url":null,"abstract":"Cardiac computed tomography (CT) has made substantial progress in recent years. The main field of application is CT coronary angiography for visualization of the coronary arteries and for the detection and exclusion of coronary artery stenosis. This has been included in international guidelines for the management of stable coronary artery disease or chronic coronary syndrome as well as for the diagnostic work-up of patients with acute chest pain; however, it must be taken into account that the diagnostic validity is only sufficiently high when the image quality is good and therefore alternative diagnostic procedures should be included in patients where an unrestricted good image quality is not to be expected. The fact that CT angiography enables the detection not only of coronary stenosis but also of nonobstructive atherosclerotic plaque is interesting for the estimation of the risk of atherosclerotic events. It is practically certain that in the absence of detectable atherosclerotic plaque in CT angiography, statin treatment does not lower the risk of atherosclerotic events. To what extent CT is suitable to provide indications for statin treatment and the threshold for which the presence of nonobstructive plaque should prompt initiation of statin treatment are currently the subject of intensive research.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"352-358"},"PeriodicalIF":1.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10444498","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

Overview of pharmacotherapy targeting COVID-19 disease based on ACE-2: current challenges and future directions. 基于ACE-2的新冠肺炎疾病药物治疗概述：当前挑战和未来方向。

IF 1.7 4区医学

Herz Pub Date : 2023-10-01 Epub Date: 2022-11-04 DOI: 10.1007/s00059-022-05142-6

Antonio Vitiello, Andrea Zovi, Ugo Trama, Francesco Ferrara

引用次数: 1

Computed tomography to guide transcatheter aortic valve implantation. 计算机断层扫描指导经导管主动脉瓣植入术。

IF 1.7 4区医学

Herz Pub Date : 2023-10-01 Epub Date: 2023-08-18 DOI: 10.1007/s00059-023-05203-4

Marwa Daghem, Florian Weidinger, Stephan Achenbach

引用次数: 0

Chronic thromboembolic pulmonary hypertension-medical, interventional, and surgical therapy. 慢性血栓栓塞性肺动脉高压的医学、介入和外科治疗。

IF 1.7 4区医学

Herz Pub Date : 2023-08-01 Epub Date: 2023-04-25 DOI: 10.1007/s00059-023-05172-8

Christoph B Wiedenroth, Diethard Pruefer, Miriam S D Adameit, Eckhard Mayer, Stefan Guth

引用次数: 0

Refined risk stratification, current treatment, and new therapeutic approaches in pulmonary arterial hypertension. 肺动脉高压的精细风险分层、目前的治疗方法和新的治疗方法。

IF 1.7 4区医学

Herz Pub Date : 2023-08-01 Epub Date: 2023-04-21 DOI: 10.1007/s00059-023-05179-1

Tobias J Lange

{"title":"Refined risk stratification, current treatment, and new therapeutic approaches in pulmonary arterial hypertension.","authors":"Tobias J Lange","doi":"10.1007/s00059-023-05179-1","DOIUrl":"10.1007/s00059-023-05179-1","url":null,"abstract":"The 2022 European Society of Cardiology/European Respiratory Society (ESC/ERS) guidelines for pulmonary hypertension have introduced a refined risk stratification to guide both initial and subsequent treatment of pulmonary arterial hypertension (PAH). The risk stratification at PAH diagnosis still comprises three risk categories (low, intermediate, high) and lists some new parameters. As the estimated 1‑year mortality is more than 20% in high-risk patients after diagnosis, an initial triple-combination therapy including parenteral prostacyclin analogues is recommended for this group. All other patients should receive a dual-combination therapy with an endothelin receptor antagonist and a phosphodiesterase‑5 inhibitor. However, this approach of initial combination therapy is only recommended for classic PAH, while monotherapy followed by regular follow-up and individualized therapy should be used for patients with cardiopulmonary comorbidities. For PAH patients without cardiopulmonary comorbidities, it is recommended to assess their risk at follow-up with a new 4‑strata classification, where the intermediate-risk group is split on the basis of three noninvasive parameters. Importantly, changes from intermediate-high to intermediate-low risk have been shown to be associated with a better prognosis. In addition, the recommendations on treatment escalation became more precise with the addition of a prostacyclin receptor agonist or switching a phosphodiesterase‑5 inhibitor to a soluble guanylate cyclase stimulator for intermediate-low risk and proceeding to triple-combination therapy with parenteral prostacyclin analogues already for intermediate-high risk. With sotatercept, the first non-vasodilator PAH treatment will become available in the near future to further enrich our treatment options for this chronic and still severe disease.","PeriodicalId":12863,"journal":{"name":"Herz","volume":"48 4","pages":"259-265"},"PeriodicalIF":1.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9897664","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: 1

[Cardiovascular pharmacotherapy in old age]. 【老年心血管药物治疗】。

IF 1.7 4区医学

Herz Pub Date : 2023-08-01 Epub Date: 2023-06-12 DOI: 10.1007/s00059-023-05191-5

Martin Schulz, Dietmar Trenk, Ulrich Laufs

引用次数: 0

Pulmonary hypertension associated with left heart disease. 肺动脉高压与左心疾病相关。

IF 1.7 4区医学

Herz Pub Date : 2023-08-01 DOI: 10.1007/s00059-023-05189-z

Max Wissmüller, Johannes Dohr, Joana Adler, Laurin Ochs, Tobias Tichelbäcker, Christopher Hohmann, Stephan Baldus, Stephan Rosenkranz

{"title":"Pulmonary hypertension associated with left heart disease.","authors":"Max Wissmüller, Johannes Dohr, Joana Adler, Laurin Ochs, Tobias Tichelbäcker, Christopher Hohmann, Stephan Baldus, Stephan Rosenkranz","doi":"10.1007/s00059-023-05189-z","DOIUrl":"https://doi.org/10.1007/s00059-023-05189-z","url":null,"abstract":"Pulmonary hypertension (PH) is a common condition in patients with left heart disease (LHD) that is highly relevant for morbidity and mortality. While post-capillary in nature, the pathophysiology of PH in patients with LHD (heart failure/cardiomyopathy, valvular heart disease; other: congenital/acquired) is complex, and decisions about management strategies are challenging. Recently, the updated European Society of Cardiology/European Respiratory Society guidelines on the diagnosis and treatment of PH revisited hemodynamic definitions and the sub-classification of post-capillary PH, and provided numerous new recommendations on the diagnosis and management of PH associated with various types of LHD. Here, we review several novel aspects that focus on: (a) updated hemodynamic definitions, including the distinction between isolated post-capillary PH (IpcPH) and combined post- and pre-capillary PH (CpcPH); (b) the pathogenesis of PH-LHD, considering various components contributing to PH, such as pulmonary congestion, vasoconstriction, and vascular remodeling; (c) the prognostic relevance of PH and hemodynamic markers; (d) the diagnostic approach to PH-LHD; (e) management strategies in PH-LHD, distinguishing between targeting the underlying left heart condition, the pulmonary circulation, and/or impaired right ventricular function. In conclusion, precise clinical and hemodynamic characterization and detailed phenotyping are essential for prognostication and the management of patients with PH-LHD.","PeriodicalId":12863,"journal":{"name":"Herz","volume":"48 4","pages":"266-273"},"PeriodicalIF":1.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9917336","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

Erratum to: Right ventricular failure in pulmonary hypertension: recent insights from experimental models. 勘误表：肺动脉高压右心室衰竭：实验模型的最新见解。

IF 1.7 4区医学

Herz Pub Date : 2023-08-01 DOI: 10.1007/s00059-023-05190-6

Athiththan Yogeswaran, Argen Mamazhakypov, Ralph T Schermuly, Astrid Weiß

引用次数: 0