Herz最新文献

{"title":"[Role of genetics in precision medicine of coronary artery disease].","authors":"V Sanin, R S Schmieder, W Koenig, L Li, H Schunkert, Z Chen","doi":"10.1007/s00059-025-05297-y","DOIUrl":"10.1007/s00059-025-05297-y","url":null,"abstract":"<p><p>Coronary artery disease (CAD) develops multifactorially through an interplay of lifestyle, environmental and genetic factors. Smoking, hypertension, hyperlipidemia, obesity and diabetes mellitus are modifiable risk factors for CAD. In addition, both rare mutations and multiple frequently occurring genetic variants can cause CAD, whereby the heritability of CAD is ca. 50%. Genetic diagnostics enable the early identification of affected children and adults and, based on a greatly increased cardiovascular risk, initiation of preventive treatment. In recent years, genome-wide association studies have identified hundreds of significant variants that together greatly increase the risk of CAD. In the general population the many frequently occurring risk alleles in combination with modifiable risk factors result in a widespread genetic predisposition to CAD. Their relevance arises in the context of an integrative risk assessment, whereby the additional genetic risk can be calculated by polygenic risk scores (PRS), which provide a hazard ratio that can be multiplied with the clinically determined risk. This overview article discusses the diagnostic principles of rare and frequent genetic causes of CAD as well as their implications in the precision treatment of the disease.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"79-87"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523257","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":"Evaluation of the acute effects of inhaled iloprost on aortic compliance in pulmonary arterial hypertension using invasive methods.","authors":"Alkım Ateşli Yazıcı, Kadriye Memiç Sancar, Serkan Kahraman, Ümit Bulut, Begüm Uygur, Batuhan Yazıcı, Şükrü Hakan Gündüz, Mustafa Yıldız","doi":"10.1007/s00059-025-05315-z","DOIUrl":"https://doi.org/10.1007/s00059-025-05315-z","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary arterial hypertension (PAH) is characterized by vascular remodeling and elevated pulmonary vascular resistance. Aortic compliance indicates vascular stiffness and may be increased in PAH. Inhaled iloprost, a prostacyclin analog, is commonly used for PAH treatment and vasoreactivity testing. Its acute effects on aortic compliance remain unclear. This study evaluated the immediate impact of inhaled iloprost on aortic compliance through aortic pulse wave velocity (aPWV) measurements and pressure parameters in patients with PAH undergoing right heart catheterization.</p><p><strong>Methods: </strong>This single-center, cross-sectional study enrolled patients with group 1 PAH who underwent right heart catheterization with pulmonary vasoreactivity testing between August 2022 and May 2023. Aortic compliance was measured via aPWV before and after inhaling 20 mcg/mL iloprost. On the basis of the post-iloprost changes, 32 patients were categorized into high-aPWV (n = 4) or low-aPWV (n = 28) groups. Multivariate regression analysis identified significant predictors of impaired aortic stiffness.</p><p><strong>Results: </strong>The median patient age was 54.5 years (42.2-60.5). No significant differences were found between groups regarding percentage reductions in proximal/distal aortic pressure and pulmonary artery pressure after iloprost administration. The QRS interval was a significant predictor of impaired aortic stiffness (odds ratio: 1.072, 95% confidence interval: 1.002-1.197, p = 0.045). The high-aPWV group demonstrated significantly lower QRS intervals compared to the low-aPWV group (79.0 ms [70.5-84.0] vs. 96.0 ms [85.5-102.0], p = 0.011).</p><p><strong>Conclusions: </strong>Inhaled iloprost effectively reduced both aortic pressure and pulmonary artery pressure regardless of aortic compliance in patients with group 1 PAH. The QRS interval emerged as an independent predictor of impaired aortic stiffness, offering potential for risk stratification in clinical practice.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752394","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 diagnostics and treatment of cardiomyopathies : State of the art].","authors":"Niklas Vetter, Benjamin Meder","doi":"10.1007/s00059-025-05296-z","DOIUrl":"10.1007/s00059-025-05296-z","url":null,"abstract":"<p><p>Cardiomyopathies (CMP) comprise a group of heterogeneous heart muscle diseases that have molecular genetic causes and cannot be adequately explained by other cardiovascular diseases. The diagnosis and treatment of CMPs have made significant progress in recent decades, which is reflected in novel specific cardiomyopathy guidelines of the European Society of Cardiology (ESC) published in 2023. A patient-centered approach combines multimodal diagnostics, such as echocardiography, magnetic resonance imaging, genetic testing and biopsy to enable precise etiological classification and thus personalized treatment. Existing treatment options have been expanded through innovative treatments. Mavacamten treats left ventricular outflow tract (LVOT) obstruction in hypertrophic CMP, while tafamidis and RNA-based treatment, such as patisiran and vutrisiran specifically affect transthyretin-mediated amyloidosis. Advances in gene therapy open up new perspectives. Artificial intelligence (AI) is pivotal in precision medicine where AI-assisted analyses enhance the diagnosis of subclinical diseases, optimize imaging modalities and accelerate the development of new treatment approaches. The ESC guidelines are an important milestone in the care of patients with CMP, while also emphasizing the need for further research and scientific ethical discussions, especially with respect to AI and innovative forms of treatment.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"96-102"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623708","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":"[Sex-specific diagnostics and treatment of cardiovascular diseases].","authors":"Verena Stangl, Anna Brand","doi":"10.1007/s00059-025-05303-3","DOIUrl":"10.1007/s00059-025-05303-3","url":null,"abstract":"<p><p>There are relevant sex-specific differences for coronary heart disease, heart failure, takotsubo syndrome and atrial fibrillation. The underrepresentation of women in clinical studies and the fact that sex-specific aspects and analyses are still insufficiently taken into consideration in preclinical and clinical research raises questions on the transferability of research results to women and strongly contrasts with the generally agreed requirements of evidence-based medicine. Sex-specific aspects are not always adequately addressed even in guidelines. Less than half of 24 ESC guidelines from 2018-2023 contain a corresponding section. In more recent recommendations, such as the guidelines on hypertension from 2024, sex-specific considerations are discussed, also with regards to the \"gaps of evidence\". In this context, in addition to the demands for more prospective sex-specific studies and data on epidemiology, risk factors, pathophysiology and outcomes, the importance of providing evidence with respect to sex-specific optimal dosages, effects and undesired side effects of drugs are also the subjects of discussion.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"113-121"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673452","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":"[Clinical application of cardiac computed tomography : Current recommendations].","authors":"Christian Tesche, Mohamed Marwan, Michaela Hell, Axel Schmermund, Dirk Loßnitzer, Stefan Möhlenkamp, Dieter Ropers, Stefan Achenbach, Grigorios Korosoglou","doi":"10.1007/s00059-025-05310-4","DOIUrl":"https://doi.org/10.1007/s00059-025-05310-4","url":null,"abstract":"<p><p>Cardiac computed tomography (CT) is suitable for use in patients with a low to intermediate pretest probability for risk stratification and for a clear exclusion of coronary heart disease. Furthermore, in addition to a purely anatomical depiction of coronary stenosis it enables the morphological assessment of the underlying plaques and a functional assessment of the hemodynamic relevance. The clinical value of cardiac CT is taken into account in the guidelines of the European Society of Cardiology (ESC) on chronic coronary syndrome with a class 1 recommendation. Cardiac CT therefore has an essential gatekeeper function with respect to the indications for coronary interventions. In the field of structural heart diseases cardiac CT is a core element in the preprocedural planning of heart valve interventions and is the first choice procedure in the postinterventional assessment of unclear findings. Therefore, for interventional heart valve replacement CT-based planning is nowadays the established standard in the clinical diagnostics.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709581","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":"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/s00059-025-05309-x","DOIUrl":"10.1007/s00059-025-05309-x","url":null,"abstract":"<p><p>Diabetes, obesity, and cardiovascular disease (CVD) represent an escalating global health challenge, contributing significantly to morbidity, mortality, and healthcare costs. Evidence from large cohort studies and clinical trials underscores the impact of diabetes and obesity as major risk factors for CVD, causing systemic inflammation, insulin resistance, and neurohormonal activation. Frequently, a sedentary lifestyle and unbalanced dietary habits are associated with these risk factors. Physical activity and exercise training interventions, a Mediterranean and plant-based diet, smoking cessation, and reduction of alcohol have shown promise in mitigating these risks. The implementation of lifestyle and pharmacotherapy have emerged as new pillars of preventive medicine. This review discusses the evidence of lifestyle interventions to reduce the burden of diabetes, obesity, and CVD. It is highlighted that only a multifaceted, sustained approach integrating lifestyle interventions and pharmacological strategies can reduce the burden of disease and improve long-term outcomes.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630322","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 value of PHR and FHR for in-hospital mortality risk in patients with acute myocardial infarction.","authors":"Yazhao Sun, Lingxiao Zhang, Yuanyuan Zuo, Xiaochen Liu","doi":"10.1007/s00059-025-05304-2","DOIUrl":"https://doi.org/10.1007/s00059-025-05304-2","url":null,"abstract":"<p><strong>Background: </strong>Inflammation is closely associated with various diseases. The platelet-to-high-density lipoprotein cholesterol (HDL-C) ratio (PHR) and the fibrinogen-to-HDL‑C ratio (FHR) are considered important biomarkers for assessing the level of inflammation. This study aimed to investigate the relationship between PHR, FHR, and in-hospital mortality risk in patients with acute myocardial infarction (AMI).</p><p><strong>Methods: </strong>This retrospective study included patients with first-time AMI at Cangzhou People's Hospital, China, from 2020 to 2021. Multivariable logistic regression analysis was performed to evaluate the association between PHR, FHR, and in-hospital mortality in patients with AMI. Restricted cubic spline (RCS) was used to visualize the dose-response relationship between PHR, FHR, and in-hospital mortality. Receiver operating characteristic (ROC) curve analysis was conducted to determine the predictive value of PHR and FHR for in-hospital mortality. Additionally, subgroup analyses were performed.</p><p><strong>Results: </strong>In the study, 170 out of 2398 patients with AMI (7.09%) died. In the multivariable logistic regression model, both PHR and FHR were identified as independent predictors of in-hospital mortality in patients with AMI. The adjusted RCS regression analysis indicated that there is no significant nonlinear association between PHR, FHR, and in-hospital mortality. The ROC curve analysis revealed that the area under the curve (AUC) for PHR and FHR was 0.718 (95% CI: 0.700-0.736, p < 0.001) and 0.717 (95% CI: 0.699-0.735, p < 0.001), respectively. In the subgroup analysis, we found that admission route, AMI type, congestive heart failure, and cardiac arrest significantly influenced the relationship between PHR, FHR, and in-hospital mortality (p < 0.05 for interaction).</p><p><strong>Conclusion: </strong>Both PHR and FHR are independent prognostic factors for in-hospital mortality in patients with AMI. The clinical utility of these inflammatory biomarkers needs to be further validated in studies with larger sample sizes and diverse populations.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604584","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":"Mechanism of action of aloperine in the treatment of pulmonary arterial hypertension based on network pharmacology and molecular docking methods.","authors":"Yanrong Wang, Baolan Yan, Pengsheng Ma, Ru Zhou, Fang Zhao","doi":"10.1007/s00059-025-05295-0","DOIUrl":"https://doi.org/10.1007/s00059-025-05295-0","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary arterial hypertension is a severe pulmonary vascular disease, marked by high mortality and substantial treatment costs, underscoring the urgent need for the exploration of traditional Chinese medicine as a potential therapeutic strategy for pulmonary hypertension. This study aimed to investigate the underlying mechanisms of aloperine in treating PAH through network pharmacology and molecular docking approaches.</p><p><strong>Methods: </strong>The Swiss Target Prediction database was employed to predict molecular targets of aloperine, while Cytoscape was used to construct the \"active component-target\" network. Disease-associated targets were identified through the GeneCards and OMIM databases and cross-referenced with drug targets to determine effective targets of aloperine for PAH treatment. Analysis of protein-protein interaction (PPI) was conducted using the STRING database. Furthermore, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were carried out via the Metascape platform.</p><p><strong>Results: </strong>Following screening, 42 molecular targets of aloperine, 1264 disease-related targets, and 23 effective targets of aloperine in treating PAH were identified. The PPI analysis revealed that aloperine targets SLC6A2, ADRA1B, CYP2D6, CCR5, and JAK2, all of which play a therapeutic role in PAH. The GO and KEGG pathway analyses identified relevant biological functions, such as membrane raft organization, G protein-coupled amine receptor activity, and regulation of tube diameter, as well as ten pathways including neuroactive ligand-receptor interaction, the cGMP-PKG signaling pathway, calcium signaling, and vascular smooth muscle contraction. Molecular docking results confirmed the interaction between aloperine and its key targets, with a high docking affinity observed between aloperine and the core target ADRA1A.</p><p><strong>Conclusion: </strong>Network pharmacology analysis demonstrated that aloperine exerts its therapeutic effects in PAH primarily through multi-target and multi-pathway mechanisms, providing a novel direction and foundation for PAH treatment.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585285","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":"[2024 ESC guidelines: What is new? What is of particular importance?]","authors":"Rolf Dörr, Bernhard Maisch","doi":"10.1007/s00059-024-05290-x","DOIUrl":"https://doi.org/10.1007/s00059-024-05290-x","url":null,"abstract":"","PeriodicalId":12863,"journal":{"name":"Herz","volume":"50 1","pages":"1-2"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052218","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":"[What is new in the management of peripheral arterial occlusive disease and diseases of the aorta? : Highlights of the ESC guidelines 2024].","authors":"Heike Schulze-Bauer, Moritz Staudacher, Sabine Steiner, Oliver Schlager","doi":"10.1007/s00059-024-05286-7","DOIUrl":"10.1007/s00059-024-05286-7","url":null,"abstract":"<p><p>The European Society of Cardiology (ESC) guidelines on peripheral arterial disease (PAD) and diseases of the aorta published in September 2024 for the first time combine recommendations for both diseases in a joint guideline document. The consolidation of PAD and aorta guidelines follows a holistic approach, which underlines the entirety of the arterial vascular system. This aim is underlined by a specifically introduced recommendation to take the entirety of the circulatory system into account in patients with vascular diseases. The focus in the current ESC guideline document is on a multidisciplinary, patient-centered management of PAD and diseases of the aorta, whereby the prevention and follow-up of patients after therapeutic interventions are emphasized. In PAD the document highlights exercise training and the procedure for patients with chronic wounds as well as risk stratification and hereditary diseases of the aorta.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"25-33"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}