Herz最新文献

{"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}

{"title":"Renal denervation plus cardiac ablation vs. cardiac ablation alone for patients with atrial fibrillation and uncontrolled arterial hypertension : A systematic review and updated meta-analysis of randomized controlled trials.","authors":"Ocílio Ribeiro Gonçalves, Altair Pereira de Melo Neto, Maria Antonia Oliveira Machado Pereira, Victor Arthur Ohannesian, Matheus Augusto Nepomuceno Fernandes, Clara Rocha Dantas, Maria Tereza Camarotti, João Victor Araújo de Oliveira, Gustavo José Silva Sanchez, Carlos Eduardo Batista de Lima, Avelar Alves da Silva","doi":"10.1007/s00059-025-05302-4","DOIUrl":"https://doi.org/10.1007/s00059-025-05302-4","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a complex arrhythmia often worsened by hypertension (HTN). Pharmacological treatments frequently underperform, and the best approach, particularly combining renal denervation (RDN) with cardiac ablation (CA), remains unclear.</p><p><strong>Objective: </strong>We conducted an updated meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of RDN combined with CA versus CA alone in patients with AF and uncontrolled HTN.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of RCTs retrieved from PubMed, Embase, and the Cochrane Library up to July 2024. Primary outcomes included AF recurrence, periprocedural complications, blood pressure changes, and estimated glomerular filtration rate (eGFR). Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were computed using a random-effects model.</p><p><strong>Results: </strong>Eight RCTs were included, involving 689 patients (37% female). Of these, 355 underwent RDN + CA, and 334 underwent CA alone, with a mean follow-up of at least 12 months. The RDN + CA group exhibited a significant reduction in AF recurrence (RR: 0.77; 95% CI: 0.61-0.97). There were no significant differences in periprocedural complications (RR: 1.06; 95% CI: 0.60-1.89), systolic blood pressure (MD: -6.79; 95% CI: -14.71-1.14), diastolic blood pressure (MD: -2.47; 95% CI: -8.13-3.20), or eGFR (MD: 1.14; 95% CI: -11.95-14.23).</p><p><strong>Conclusion: </strong>Our findings show that RDN combined with CA significantly reduces AF recurrence compared to CA alone, presenting a promising approach for patients with resistant HTN and AF.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017214","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":"Obesity and heart failure-the role of GLP-1 receptor agonists.","authors":"Gregor Simonis, Ulrike Schatz","doi":"10.1007/s00059-025-05312-2","DOIUrl":"https://doi.org/10.1007/s00059-025-05312-2","url":null,"abstract":"<p><p>Patients with obesity-driven heart failure with preserved ejection fraction (HFpEF) often suffer from symptoms despite guideline-recommended treatment with diuretics, sodium glucose cotransporter 2 (SGLT2) inhibition, and mineralocorticoid antagonists. Obesity by itself drives heart failure via multiple pathophysiological mechanisms. This review summarizes current data on glucagon-like peptide‑1 (GLP-1) receptor agonists and the dual GIP/GLP‑1 agonist tirzepatide, including symptoms and outcomes in patients with obesity-driven HFpEF with or without diabetes.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763893","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: Efficacy of sacubitril-valsartan vs. angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in preventing atrial fibrillation recurrence after catheter ablation: a systematic review and meta-analysis.","authors":"Fernando Baía Bezerra, Luis Eduardo Rodrigues Sobreira, Vitor Kendi Tsuchiya Sano, Artur de Oliveira Macena Lôbo, Jorge Henrique Cavalcanti Orestes Cardoso, Francinny Alves Kelly, Francisco Cezar Aquino de Moraes, Fernanda Marciano Consolim-Colombo","doi":"10.1007/s00059-024-05283-w","DOIUrl":"10.1007/s00059-024-05283-w","url":null,"abstract":"","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"148"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545123","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":"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":"149-158"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","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}

{"title":"Precision medicine in the management of cardiac arrhythmias.","authors":"Felix Wiedmann, Constanze Schmidt","doi":"10.1007/s00059-025-05298-x","DOIUrl":"10.1007/s00059-025-05298-x","url":null,"abstract":"<p><p>Precision medicine in cardiac electrophysiology tailors diagnosis, treatment, and prevention by integrating genetic, environmental, and lifestyle factors. Unlike traditional, generalized strategies, precision medicine focuses on individual patient characteristics to enhance care. Significant progress has been made, especially in managing channelopathies, where genetic insights now already drive personalized therapies. Identifying specific mutations has clarified molecular mechanisms and enabled targeted interventions, improving outcomes in conditions such as long QT syndrome. The integration of big data from clinical records, omics datasets, and biosignals from devices such as cardiac implantable electronic devices (CIEDs) or wearables may be on the verge of revolutionizing the diagnosis of cardiac arrhythmias once again. Progress is also expected in the field of human-induced pluripotent stem cells (hiPSCs) and in silico modeling, which may overcome the limitations of traditional expression systems for the functional evaluation of patient-specific mutations. Genome-wide association studies (GWAS) and polygenic risk scores (PRS) provide deeper insights into complex arrhythmogenic disorders, aiding in risk stratification and targeted treatment strategies. Finally, emerging technologies such as CRISPR/Cas9 promise gene editing for inherited and acquired arrhythmias. In summary, precision medicine offers the potential for individualized treatment of cardiac arrhythmias.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"88-95"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582281","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":"Acute atrial infarction: a relatively neglected and under-recognized entity in clinical practice.","authors":"Chengye Di, Haijiang Wang, Mingming Wang, Qun Wang, Yanxi Wu, Longyu Li, Yan Zhang, Wenhua Lin","doi":"10.1007/s00059-024-05272-z","DOIUrl":"10.1007/s00059-024-05272-z","url":null,"abstract":"<p><strong>Background: </strong>Electrocardiograms (ECGs) and angiographic features indicative of acute atrial infarction (AAI) often go unnoticed and are under-recognized in clinical practice.</p><p><strong>Methods: </strong>In this retrospective observational study, we analyzed the data of 3981 out of 9803 patients (40.61%) who were referred to our hospital for angiography and/or percutaneous coronary intervention due to acute coronary syndrome (ACS). These patients were diagnosed with acute ST segment elevation myocardial infarction (AMI) affecting the inferior, posterior, and/or right ventricular regions.</p><p><strong>Results: </strong>Of the 3981 patients, 270 (6.78%) had involvement of the main coronary atrial branch meeting the angiographic criteria for AAI. Among the 270 patients identified, the right coronary artery was diagnosed as the infarct-related artery (IRA) in 187 patients (group R), while the left circumflex artery was the IRA in 83 patients (group L). The incidence of PR-segment deviation was similar between the two groups (65.2% in group R vs. 66.3% in group L, p = 0.870), as was occurrence of atrial tachyarrhythmia (67.4% vs. 55.4%, p = 0.059). The prevalence of P wave morphology abnormalities (29.9% vs. 49.4%, p = 0.005) and sinus bradycardia or arrest (25.1% vs. 66.3%, p < 0.001) was significantly lower in Group R than in Group L.</p><p><strong>Conclusion: </strong>Acute atrial infarction represents a distinct yet frequently overlooked clinical entity. Clinicians should consider the potential for atrial arrhythmias, thromboembolism, hemodynamic instability, and atrial rupture when diagnosing AAI.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"122-134"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307541","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}