Herz最新文献

{"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}

{"title":"[Management of acute coronary syndrome].","authors":"Maria Buske, Hans-Josef Feistritzer, Alexander Jobs, Holger Thiele","doi":"10.1007/s00059-024-05284-9","DOIUrl":"10.1007/s00059-024-05284-9","url":null,"abstract":"<p><p>Coronary artery disease (CAD) is the leading cause of death worldwide. Acute coronary syndrome (ACS) encompasses a spectrum of diagnoses ranging from unstable angina pectoris to myocardial infarction with and without ST-segment elevation and frequently presents as the first clinical manifestation. It is crucial in this scenario to perform a timely and comprehensive assessment of patients by evaluating the clinical presentation, electrocardiogram and laboratory diagnostics using highly sensitivity cardiac troponin in order to initiate a timely and risk-adapted continuing treatment with immediate or early invasive coronary angiography. In addition to revascularization, the subsequent antithrombotic and lipid-lowering treatment plays a major role in the further secondary prevention of CAD. The choice and duration of medication over time should be tailored to the individual risk profile of the patient. Furthermore, appropriate patient education regarding risk factor management is of paramount importance.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"66-76"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946915","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 risk factors for long-term atrial fibrillation development in patients undergoing typical atrial flutter ablation: a multicenter pilot study.","authors":"Ahmet Çağdaş Yumurtaş, Levent Pay, Ozan Tezen, Tuğba Çetin, Furkan Fatih Yücedağ, Ertan Arter, Hikmet Kadıoğlu, Hüseyin Akgün, Eyüp Özkan, Abdulkadir Uslu, Ayhan Küp, Faysal Şaylık, Tufan Çınar, Mert İlker Hayıroğlu","doi":"10.1007/s00059-024-05261-2","DOIUrl":"10.1007/s00059-024-05261-2","url":null,"abstract":"<p><strong>Background: </strong>Atrial flutter (AFL) and atrial fibrillation (AF) are the most commonly detected supraventricular arrhythmias and share similar pathophysiological mechanisms. After the successful ablation of AFL, AF frequently occurs in the long-term follow-up. As emphasized in some studies, certain mechanisms seem to predispose to the development of AF in AFL patients, and approximately 20% of these patients have accompanying AFL.</p><p><strong>Purpose: </strong>We aimed to analyze independent risk factors that predict the development of AF in patients who underwent typical AFL ablation.</p><p><strong>Methods: </strong>This was a multicenter, cross-sectional, and retrospective study. A total of 442 patients who underwent typical AFL ablation at three different centers between January 1, 2018 and January 1, 2022 were included retrospectively. After the ablation procedure the patients were divided into those who developed AF and those who did not. The patients were followed up for an average of 12 (4-20) months. In the post-procedural period, atrial arrhythmias were investigated with 24‑h Holter and ECG at 1 month, 6 months, and 12 months and then at 6‑month intervals thereafter.</p><p><strong>Results: </strong>Overall, AF developed in 206 (46.6%) patients in the long-term follow-up. Age, hypertension (HT), obstructive sleep apnea syndrome (OSAS), previous cerebrovascular accident (CVA), left atrium anteroposterior diameter, severe mitral regurgitation, hemoglobin, blood glucose, and HbA1c values were found to be significant in univariable analysis. According to multivariable analysis, HT (p = 0.014; HR: 1.483 [1.084-2.030]), OSAS (p = 0.008; HR: 1.520 [1.117-2.068]) and previous CVA (p = 0.038; HR: 1.749 [1.031-2.968]) were independently associated with the development of AF in AFL patients who underwent ablation procedure.</p><p><strong>Conclusion: </strong>In the present study, we found that HT, OSAS, and previous CVA were independently correlated with the development of AF in the long-term follow-up of patients who underwent typical AFL ablation. We consider that AFL patients with such risk factors should be followed up closely following cavotricuspid isthmus ablation for the development of AF.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"51-58"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975571","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":"[European Society of Cardiology (ESC) guidelines on atrial fibrillation 2024 : What is new and what is important?]","authors":"Robert Hättasch, Verena Tscholl, Gerhard Hindricks, Nikolaos Dagres","doi":"10.1007/s00059-024-05287-6","DOIUrl":"10.1007/s00059-024-05287-6","url":null,"abstract":"<p><p>The 2024 guidelines of the European Society of Cardiology (ESC) on atrial fibrillation (AF) present current and comprehensive recommendations for the diagnosis, prevention and treatment of AF. They are based on the AF-CARE treatment pathway, which includes modification of cardiovascular risk factors, stroke prevention, symptom management and continuous re-evaluation. Accordingly, all patients with newly diagnosed AF should undergo transthoracic echocardiography. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are recommended for the treatment of heart failure across all clinical and echocardiographic levels of left ventricular ejection fraction (LVEF). The CHA2DS2-VASc score has been simplified to the CHA2DS2-VA score for the risk assessment of thromboembolism. For rate or rhythm control pharmacotherapy with beta-blockers, digitalis, amiodarone and flecainide are still the most important drugs. Pulmonary vein isolation is now also recommended as a first-line treatment for paroxysmal AF. Re-evaluation of risk factors and treatment of comorbidities is also emphasized. Overall the guidelines represent a further development and update based on recent studies. They remain practical and provide clear and detailed recommendations for action that are globally recognized in the clinical practice.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"3-7"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739260","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}