Herz最新文献

{"title":"Exploring Roemheld syndrome: a comprehensive review with proposed diagnostic criteria.","authors":"Muhammad Umair Javaid, Muhammad Ikrama, Shafqat Abbas, Muhammad Saad Javaid, Muhammad Danial Khalid, Nabeel Riaz, Malik Ahsan Safdar","doi":"10.1007/s00059-024-05249-y","DOIUrl":"10.1007/s00059-024-05249-y","url":null,"abstract":"<p><p>Roemheld syndrome (RS) is a condition that triggers cardiac symptoms due to gastrointestinal compression of the heart. It is often misdiagnosed as other types of cardiac or digestive disorders, leading to unnecessary treatments and reduced quality of life. Here, we provide a thorough review of RS, covering its pathogenesis, etiology, diagnosis, treatment, and outcome. We found that a number of conditions, including gallstones, hiatal hernia, excessive gas, and gastroesophageal reflux syndrome, can cause RS. The symptoms of RS can include chest pain, palpitations, shortness of breath, nausea, vomiting, bloating, and abdominal pain. Clinical history, physical examination, electrocardiograms, and improvement in symptoms following gastrointestinal therapy can all be used to identify RS. We also propose a set of criteria, the IKMAIR criteria, to improve the diagnostic approach for this condition. Dietary changes, lifestyle adjustments, pharmaceutical therapies, and surgical procedures can all be used to control RS. Depending on the underlying etiology and the outcome of treatment, RS has a varying prognosis. We conclude that RS is a complicated and understudied disorder that needs more attention from researchers and patients as well as from medical professionals. We recommend the inclusion of RS in the differential diagnosis for individuals with gastrointestinal problems and unexplained cardiac symptoms. Additionally, we advise treating RS holistically by attending to its cardiac and gastrointestinal components.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"448-455"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876300","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":"https://doi.org/10.1007/s00059-024-05283-w","url":null,"abstract":"","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-29","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":"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":"https://doi.org/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":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-16","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 role of peak VO₂ for short- and long-term major adverse cardiac events in patients with high cardiovascular risk.","authors":"Selin Cilli Hayıroğlu, Mehmet Uzun","doi":"10.1007/s00059-024-05276-9","DOIUrl":"https://doi.org/10.1007/s00059-024-05276-9","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to assess the accuracy of VO₂ measurements in predicting long-term major adverse cardiac events (MACEs) in patients with high cardiovascular risk.</p><p><strong>Methods: </strong>Based on a 10-year atherosclerotic cardiovascular disease risk score, 333 patients with high cardiovascular risk were included in this retrospective analysis. The study endpoint was MACEs, comprising all-cause mortality, cardiovascular mortality, non-fatal myocardial infarction or stroke, and coronary revascularization. The study cohort was divided into two groups according to the frequency of MACE occurrence. Measurements of VO₂ were assessed for the prediction of MACEs.</p><p><strong>Results: </strong>The best predictive accuracy for 1‑year MACEs was determined to be a VO₂ max value of ≥ 20.3 mL/kg/min, with 60% specificity and 60% sensitivity (area under the curve [AUC]: 0.61; 95% confidence interval [CI]: 0.51-0.71; p < 0.001), and for 5‑year MACEs it was ≥ 19.9 mL/kg/min, with 69% specificity and 64% sensitivity (AUC: 0.69; 95% CI: 0.62-0.76; p < 0.001). Multivariable Cox regression analysis, after adjusting for univariable factors, showed that VO₂ max was independently associated with both short- and long-term MACEs in patients at high cardiovascular risk (hazard ratio [HR]: 0.900, 95% CI: 0.858-0.943, p < 0.001).</p><p><strong>Conclusion: </strong>According to the results of this pilot study, VO₂ max can predict both short- and long-term MACEs in patients at high cardiovascular risk.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463341","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":"[eCardiology].","authors":"Peter W Radke","doi":"10.1007/s00059-024-05270-1","DOIUrl":"https://doi.org/10.1007/s00059-024-05270-1","url":null,"abstract":"","PeriodicalId":12863,"journal":{"name":"Herz","volume":"49 5","pages":"319-320"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345180","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":"[Diagnostics and treatment of syncope].","authors":"Nora Kähler, Gerhard Hindricks, Nikolaos Dagres, Verena Tscholl","doi":"10.1007/s00059-024-05260-3","DOIUrl":"10.1007/s00059-024-05260-3","url":null,"abstract":"<p><p>The 2018 guidelines of the European Society of Cardiology (ESC) provide improved algorithms for the diagnostics and treatment of syncope. New guidelines on ventricular tachycardia, on the prevention of sudden cardiac death and on cardiomyopathies and pacemakers have refined the recommendations. The detailed medical history and examination are crucial for differentiating between cardiac and noncardiac causes and determining the appropriate treatment. High-risk patients need urgent and comprehensive diagnostics. The basic diagnostics include medical history, physical examination and a 12-lead electrocardiography (ECG). Further tests, such as long-term ECG monitoring, implantable loop recorders and electrophysiological investigations are helpful in unclear cases. The treatment depends on the cause, with pacemaker implantation and implantable cardioverter defibrillators (ICD) being important for cardiac causes, while behavioral measures and medication management have priority for noncardiac syncope.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"394-403"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072610","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":"Guideline-endorsed follow-up after percutaneous valve therapies-non-attendance of TAVI and MitraClip patients.","authors":"Frank Patrick Schmidt, Martin Geyer, Efthymios Sotiriou, Yasemin Ardic, Pantea Sadegh, Eberhard Schulz, Thomas Münzel, Ralph Stephan von Bardeleben","doi":"10.1007/s00059-024-05245-2","DOIUrl":"10.1007/s00059-024-05245-2","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous valve therapies (PVT) are performed on a large number of patients. With increasing procedural volume, the need for follow-up has also increased. Follow-up in the heart valve clinic is endorsed by recent guidelines but utilization is unknown, making resource allocation in the clinic difficult. Central follow-up in valve centers may not be feasible for all patients in the future.</p><p><strong>Methods: </strong>In our center, follow-up for PVT patients is scheduled at 1 month and 12 months after the index procedure. Patients are reminded of their appointment by invitation letters or phone calls. We analyzed 150 consecutive patients who underwent transcutaneous aortic valve implantation (TAVI) and MitraClip implantation (n = 300) at our center.</p><p><strong>Results: </strong>At 1 month, 72.7% of patients attended their follow-up, while at 12 months the rate dropped to 58%. Patients who underwent TAVI were older than the MitraClip patients (82.7 vs. 76.1 years) but had lower mean logEuroSCORE (22.6% vs. 25.9%). There was no significant difference in 1‑year mortality between TAVI and MitraClip patients (20% vs. 17.3%). By contrast, the rate of missed follow-up visits was higher for TAVI compared to MitraClip patients (52% vs. 33.3%; p = 0.002). Female patients less frequently attended follow-up (p = 0.005), whereas age, EuroSCORE, NYHA class, ejection fraction, and health status (EQ-5DVAS) were not predictors of attendance in multivariable analysis. Although the result of the EQ-5D assessment was not associated with mortality or attendance, completing the questionnaire was associated with overall survival (p < 0.001).</p><p><strong>Conclusion: </strong>In our heart valve clinic, we observed a high percentage of missed follow-up appointments (42% at 12 months) despite a structured follow-up plan. Factors significantly associated with non-attendance in multivariable analysis were female gender and having a TAVI rather than MitraClip. Future follow-up concepts should take such findings into account, and decentralized approaches need to be explored.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"371-377"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922041","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":"[Healthcare 4.0-Medicine in transition].","authors":"Steffen Roßkopf, Benjamin Meder","doi":"10.1007/s00059-024-05267-w","DOIUrl":"10.1007/s00059-024-05267-w","url":null,"abstract":"<p><p>Healthcare 4.0 describes the future transformation of the healthcare sector driven by the combination of digital technologies, such as artificial intelligence (AI), big data and the Internet of Medical Things, enabling the advancement of precision medicine. This overview article addresses various areas such as large language models (LLM), diagnostics and robotics, shedding light on the positive aspects of Healthcare 4.0 and showcasing exciting methods and application examples in cardiology. It delves into the broad knowledge base and enormous potential of LLMs, highlighting their immediate benefits as digital assistants or for administrative tasks. In diagnostics, the increasing usefulness of wearables is emphasized and an AI for predicting heart filling pressures based on cardiac magnetic resonance imaging (MRI) is introduced. Additionally, it discusses the revolutionary methodology of a digital simulation of the physical heart (digital twin). Finally, it addresses both regulatory frameworks and a brief vision of data-driven healthcare delivery, explaining the need for investments in technical personnel and infrastructure to achieve a more effective medicine.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"350-354"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901460","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":"[Telemedical care concepts for heart failure: status and future].","authors":"F Koehler, M Hiddemann, M Koehler, K Koehler, S Spethmann, T Kaas, B Zippel-Schultz, T M Helms","doi":"10.1007/s00059-024-05266-x","DOIUrl":"10.1007/s00059-024-05266-x","url":null,"abstract":"<p><p>Telemedical care concepts provide opportunities to improve the care of patients with chronic heart failure (CHF). The current state of telemedical technologies enables the effective monitoring of the disease. Germany is one of the first European countries with an entitlement to telemedical supporting care for CHF patients. The decision of the German Federal Joint Committee in 2020 to introduce telemedical supporting care for CHF patients marks a milestone. For the first time, a digital care procedure was included in the benefits catalogue of the statutory health insurance funds due to its proven benefits in terms of morbidity and mortality. Privately insured CHF patients have been entitled to these benefits since January 2024. Future developments, particularly with respect to artificial intelligence procedures in telemedicine, are promising but require more evidence. Further research, technological innovation and supportive policy frameworks are needed to realize the full potential of these approaches. Continued collaboration between healthcare professionals, technology developers and policy makers will be crucial in sustainably improving the care of heart failure patients with telemedicine.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"342-349"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080026","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":"Artificial intelligence in cardiovascular imaging and intervention.","authors":"Sandy Engelhardt, Salman Ul Hussan Dar, Lalith Sharan, Florian André, Eike Nagel, Sarina Thomas","doi":"10.1007/s00059-024-05264-z","DOIUrl":"10.1007/s00059-024-05264-z","url":null,"abstract":"<p><p>Recent progress in artificial intelligence (AI) includes generative models, multimodal foundation models, and federated learning, which enable a wide spectrum of novel exciting applications and scenarios for cardiac image analysis and cardiovascular interventions. The disruptive nature of these novel technologies enables concurrent text and image analysis by so-called vision-language transformer models. They not only allow for automatic derivation of image reports, synthesis of novel images conditioned on certain textual properties, and visual questioning and answering in an oral or written dialogue style, but also for the retrieval of medical images from a large database based on a description of the pathology or specifics of the dataset of interest. Federated learning is an additional ingredient in these novel developments, facilitating multi-centric collaborative training of AI approaches and therefore access to large clinical cohorts. In this review paper, we provide an overview of the recent developments in the field of cardiovascular imaging and intervention and offer a future outlook.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"327-334"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906414","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}