Herz最新文献

{"title":"Life's Essential 8 and mortality among adults with early-onset cardiovascular diseases : A prospective community-based study.","authors":"Jing Yang, Xiao Chen, Yaqi Li, Shuohua Chen, Xiang Gao, Shouling Wu","doi":"10.1007/s00059-025-05293-2","DOIUrl":"10.1007/s00059-025-05293-2","url":null,"abstract":"<p><strong>Background: </strong>Information regarding the association between cardiovascular health (CVH) as assessed using Life's Essential 8 (LE8) approach and all-cause mortality in adults with early-onset cardiovascular diseases (CVDs) is limited.</p><p><strong>Objective: </strong>In this study, we aimed to assess the association between CVH constructed by the LE8 metrics and all-cause mortality in Chinese individuals with early-onset CVDs, including myocardial infarction, heart failure, atrial fibrillation, ischemic stroke, and hemorrhagic stroke as well as in those who had undergone coronary artery bypass surgery or coronary intervention.</p><p><strong>Methods: </strong>Data of 3454 participants who were first diagnosed with early-onset CVDs (men aged < 55 years and women aged < 65 years with CVDs) in the Kailuan study from 1 January 2006 to 31 December 2020 were analyzed. Assessment of CVH (score ranging from 0 to 100 points) was made using the LE8 metrics (including diet, physical activity, nicotine exposure, sleep duration, body mass index [BMI], lipid, blood glucose, and blood pressure). All-cause mortality information was collected from provincial vital statistics offices. Cox proportional hazard regression models and restricted cubic splines were utilized to examine associations between the CVH scores and all-cause mortality in adults with early-onset CVDs.</p><p><strong>Results: </strong>During a mean follow-up of 6.78 years (interquartile range [IQR]: 3.36-10.5 years), 460 deaths were documented. After controlling for demographic variables, lifestyles, and major clinical factors, higher CVH scores were associated with lower risks of all-cause mortality among participants with early-onset CVDs. The corresponding hazard ratios (HRs) with 95% confidence intervals (CIs) were 0.64 (0.49, 0.82) comparing two extreme quartiles of CVH scores and 0.85 (0.77, 0.82) for each 10-point increment in CVH score (p _trend = 0.001). Specifically, significant inverse associations were observed among participants with hemorrhagic stroke (HR _{Q4 vs. Q1} = 0.46, 0.23-0.93) and heart disease (HR _{Q4 vs. Q1} = 0.59, 0.41-0.87).</p><p><strong>Conclusion: </strong>Our findings supported the beneficial role of higher CVH scores in all-cause mortality among adults with early-onset CVD.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"199-206"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467738","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":"Left atrial appendage orifice morphology in sickness and in health.","authors":"Akbulut Muge, Tan Kürklü Seda, Gulyigit Halil, Ozerdem Emre, Kozluca Volkan, Esenboga Kerim, Baskovski Emir, Demirtola Ayse Irem, Tekin Cemre, Dincer Irem","doi":"10.1007/s00059-024-05277-8","DOIUrl":"10.1007/s00059-024-05277-8","url":null,"abstract":"<p><strong>Background: </strong>The left atrial appendage (LAA) is the primary site of embolism in individuals with atrial fibrillation (AF). We aimed to evaluate the morphological features of the LAA orifice in patients with sinus rhythm, paroxysmal AF, and persistent AF using three-dimensional (3D) transesophageal echocardiography (TOE). We also intended to identify morphometric parameters of the LAA orifice that may be potentially associated with an increased risk of ischemic stroke.</p><p><strong>Methods: </strong>We prospectively enrolled 106 patients undergoing TOE. Patients were divided into three groups: group 1 (sinus rhythm), group 2 (persistent AF), and group 3 (paroxysmal AF). All patients underwent a comprehensive evaluation through transthoracic echocardiography (TTE) and TOE. Off-line analyses were performed of the recorded images.</p><p><strong>Results: </strong>The LAA minor orifice area and minimal orifice diameter were greater in patients with persistent AF compared with individuals in sinus rhythm. Patients with persistent AF also had deeper LAAs compared with those in sinus rhythm. None of the LAA orifice morphometric measures were related to ischemic stroke risk. The only independent predictors of ischemic stroke were heart rhythm and the CHA₂DS₂VASc score.</p><p><strong>Conclusion: </strong>Persistent AF is associated with LAA dilation, increased depth, and larger orifice size. To our knowledge, this is the first study to demonstrate LAA orifice structural remodeling in patients with AF using 3D TOE.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"185-191"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463340","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":"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":"192-198"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","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":"[Health care research in cardiology].","authors":"Ralf Zahn, Karl Werdan","doi":"10.1007/s00059-025-05314-0","DOIUrl":"https://doi.org/10.1007/s00059-025-05314-0","url":null,"abstract":"","PeriodicalId":12863,"journal":{"name":"Herz","volume":"50 3","pages":"159"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225303","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":"[Quality assurance with routine data : Expectations and reality from a physician's perspective].","authors":"Susanne Macher-Heidrich","doi":"10.1007/s00059-025-05313-1","DOIUrl":"10.1007/s00059-025-05313-1","url":null,"abstract":"<p><p>An effective quality assurance concept with essential benefits for all patients concerned and without bureaucratic overload can only be achieved with all stakeholders working closely together with the inclusion of clinical medical expertise. The calculation of quality results based on routine data alone is not sufficient to reach this goal.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"169-170"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752390","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":"[Quality evaluation in cardiovascular medicine : Legal frameworks, practical implementation and challenges].","authors":"Sebastian von Podewils","doi":"10.1007/s00059-025-05308-y","DOIUrl":"10.1007/s00059-025-05308-y","url":null,"abstract":"<p><p>The quality assurance procedure for coronary surgery and heart valve interventions (QS KCHK) is designed to systematically evaluate and enhance the quality of complex cardiological interventional and cardiac surgical procedures. In this respect, the inclusion of indicators based on routine data facilitates the efficient and standardized analysis of the long-term quality of treatment; however, experiences from the first feedback procedures show that the use of social data is associated with challenges. For example, for the rehospitalization rates due to heart failure nonspecific exclusions and the lack of a differentiation between comorbidities and primary complications lead to distortions. The situation is similar for the 1‑year mortality. In this case, due to the long follow-up period of 365 days a sufficient association between the quality characteristic and the service provider carrying out the index procedure is often not possible to establish using social data. In addition, documentation problems, such as discrepancies between operative data and social data make a precise assessment more difficult. Nevertheless, the QS procedure KCHK makes a substantial contribution to quality assurance by creating transparency and comparability between service providers. In order to enhance the strength of the indicators methodological refinements, such as the harmonization of data standards and the improvement of the validity of the individual indicators, are essential for the documentation of a quality characteristic.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"160-168"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624252","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":"[Update on cardiovascular prevention 2025].","authors":"Harm Wienbergen, Ulrich Hanses, Hatim Kerniss, Rainer Hambrecht","doi":"10.1007/s00059-025-05305-1","DOIUrl":"10.1007/s00059-025-05305-1","url":null,"abstract":"<p><p>Despite an expensive healthcare system Germany performs poorly with respect to life-expectancy compared to other countries, for which cardiovascular diseases and deficits in cardiovascular prevention in particular are responsible. The basis of cardiovascular prevention is a healthy lifestyle with regular physical exercise, a predominantly plant-based diet, nonsmoking, good sleep and mental health. In many cases additional lipid-lowering, antidiabetic and antihypertensive medications are necessary. Recent studies have proven the prognostic effects of different groups of medications, such as proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, sodium-glucose transporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 (GLP-1) receptor agonists, in the appropriate indication areas. To improve the cardiovascular prevention in Germany, intensified public efforts are crucial. In addition, individual support of patients is effective for long-term preventive measures. To achieve this healthcare professionals must be trained (physicians, cardiovascular prevention assistants), who can sustainably support patients in lifestyle modifications and medicinal prevention.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"217-226"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735726","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":"Impact of functional mitral regurgitation on outcomes of high-power short-duration pulmonary vein isolation in patients with atrial fibrillation.","authors":"A Pinchuk, V Adam, P Biehler, P Hägele, S Hanger, S Löbig, F Ausbuettel, C Waechter, P Seizer, S Weyand","doi":"10.1007/s00059-025-05318-w","DOIUrl":"https://doi.org/10.1007/s00059-025-05318-w","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a common arrhythmia with significant health implications. Mitral regurgitation (MR) frequently coexists with AF and may affect treatment outcomes.</p><p><strong>Methods: </strong>This study aimed to analyze the impact of MR severity on the outcomes of high-power short-duration pulmonary vein isolation (PVI) in patients with AF. This observational cohort study involved 255 patients undergoing their first PVI. A total of 83 patients with moderate or severe MR were propensity score-matched with 83 controls based on age, sex, and body mass index (BMI). Procedural parameters, complication rates, AF recurrence within 1 year of PVI, and MR progression were analyzed.</p><p><strong>Results: </strong>Patients with moderate or severe MR demonstrated a higher percentage of atrial low-voltage areas (23.06% vs. 15.42%, p = 0.04) and more frequently required additional ablations (18.07% vs. 6.02%, p = 0.02). The 1‑year AF recurrence rates were identical between the groups (19.28% each, p = 1.00). The MR grade remained stable without significant differences between the groups after 1 year. However, among patients without AF recurrence, a statistically significant reduction in MR grade was observed after 1 year (1.54 ± 0.64 vs. 1.37 ± 0.53, p < 0.01). By contrast, patients with AF recurrence exhibited a trend toward worsening MR, although this change was not statistically significant (1.53 ± 0.57 vs. 1.75 ± 0.51, p = 0.09).</p><p><strong>Conclusion: </strong>High-power short-duration PVI is safe and effective in AF patients, even among those with moderate or severe MR. Patients with moderate or severe functional MR exhibit more LA low-voltage areas and require more extensive ablations, especially cavotricuspid isthmus CTI ablation, reflecting a more complex disease profile. Maintaining a stable sinus rhythm can contribute to a reduction in MR grade.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132297","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":"Outcomes of electronic health interventions for patients with heart failure: a network meta-analysis.","authors":"Jiamin Tang, Danni Ma, Meng Li, Yiqi Ding, Xuemei Zhou, Hong He","doi":"10.1007/s00059-025-05301-5","DOIUrl":"https://doi.org/10.1007/s00059-025-05301-5","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was to compare the effectiveness of different types of tele-interventions in improving exercise capacity and cardiac function in patients with heart failure.</p><p><strong>Methods: </strong>We searched five databases from inception to September 2024 for randomized controlled trials (RCTs) of telerehabilitation in people with heart failure. The primary outcomes were 6‑min walk distance (6MWD) and left ventricular ejection fraction (LVEF). The secondary outcome was patient adherence to rehabilitation. We used Review Manager (RevMan) 5.4 and Stata 16.0 for the analyses.</p><p><strong>Results: </strong>Overall, 17 studies with a total of four telerehabilitation interventions were included in the final analysis. Network meta-analysis showed that remote monitoring (mean difference [MD] = 29.03 [7.94, 50.13]) and combined interventions (MD = 28.86 [4.85, 53.86]) were more effective than usual rehabilitation in improving 6MWD. Remote monitoring (MD = 2.45 [0.14, 4.76]) was superior to usual rehabilitation in improving LVEF. The surface under the cumulative ranking curve (SUCRA) results showed that remote monitoring is the most effective way to improve the 6MWD (SUCRA = 71.7%) and LVEF (SUCRA = 76.3%) in patients with heart failure.</p><p><strong>Conclusion: </strong>The results of this study indicate that remote cardiac rehabilitation is effective in improving heart function and enhancing exercise capacity in patients with heart failure. Based on our data and the accessibility of remote rehabilitation equipment, telemedicine may be a useful and significant way to increase patient participation in cardiac rehabilitation.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965315","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":"Erratum to: Diabetes, obesity, and cardiovascular disease-what is the impact of lifestyle modification?","authors":"Celina Seth, Veronika Schmid, Stephan Mueller, Mark Haykowsky, Stephen J Foulkes, Martin Halle, Simon Wernhart","doi":"10.1007/s00059-025-05316-y","DOIUrl":"https://doi.org/10.1007/s00059-025-05316-y","url":null,"abstract":"","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996017","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}