IF 1.1 4区医学

Herz Pub Date : 2025-06-01 Epub Date: 2024-10-16 DOI: 10.1007/s00059-024-05277-8

Akbulut Muge, Tan Kürklü Seda, Gulyigit Halil, Ozerdem Emre, Kozluca Volkan, Esenboga Kerim, Baskovski Emir, Demirtola Ayse Irem, Tekin Cemre, Dincer Irem

{"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":"Background: 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.Methods: 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.Results: 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.Conclusion: 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.","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}

引用次数: 0

Predictive strength of inflammatory scores for in-hospital mortality in infective endocarditis. 炎症评分对感染性心内膜炎住院死亡率的预测强度。

IF 1.1 4区医学

Herz Pub Date : 2025-06-01 Epub Date: 2025-01-24 DOI: 10.1007/s00059-024-05292-9

Vedat Cicek, Almina Erdem, Sahhan Kilic, Burak Tay, Mustafa Kamil Yemis, Solen Taslicukur, Mustafa Oguz, Ahmet Oz, Murat Selcuk, Tufan Cinar, Ulas Bagci

{"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":"Background: 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.Methods: 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.Results: 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.Conclusion: 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.","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}

引用次数: 0

[Health care research in cardiology]. [心脏病学的保健研究]。

IF 1.1 4区医学

Herz Pub Date : 2025-06-01 Epub Date: 2025-06-05 DOI: 10.1007/s00059-025-05314-0

Ralf Zahn, Karl Werdan

引用次数: 0

[Update on cardiovascular prevention 2025]. 【2025年心血管预防最新进展】。

IF 1.1 4区医学

Herz Pub Date : 2025-06-01 Epub Date: 2025-03-28 DOI: 10.1007/s00059-025-05305-1

Harm Wienbergen, Ulrich Hanses, Hatim Kerniss, Rainer Hambrecht

引用次数: 0

[Quality assurance with routine data : Expectations and reality from a physician's perspective]. [常规数据的质量保证：从医生角度的期望和现实]。

IF 1.1 4区医学

Herz Pub Date : 2025-06-01 Epub Date: 2025-04-01 DOI: 10.1007/s00059-025-05313-1

Susanne Macher-Heidrich

引用次数: 0

[Quality evaluation in cardiovascular medicine : Legal frameworks, practical implementation and challenges]. [心血管医学质量评价：法律框架、实际实施和挑战]。

IF 1.1 4区医学

Herz Pub Date : 2025-06-01 Epub Date: 2025-03-13 DOI: 10.1007/s00059-025-05308-y

Sebastian von Podewils

{"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":"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.","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}

引用次数: 0

Impact of functional mitral regurgitation on outcomes of high-power short-duration pulmonary vein isolation in patients with atrial fibrillation. 功能性二尖瓣反流对房颤患者高功率短时间肺静脉隔离效果的影响。

IF 1.1 4区医学

Herz Pub Date : 2025-05-23 DOI: 10.1007/s00059-025-05318-w

A Pinchuk, V Adam, P Biehler, P Hägele, S Hanger, S Löbig, F Ausbuettel, C Waechter, P Seizer, S Weyand

{"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":"Background: Atrial fibrillation (AF) is a common arrhythmia with significant health implications. Mitral regurgitation (MR) frequently coexists with AF and may affect treatment outcomes.Methods: 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.Results: 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).Conclusion: 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.","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}

引用次数: 0

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. 勘误：Sacubitril-缬沙坦与血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂在预防导管消融术后心房颤动复发方面的功效：系统综述和荟萃分析。

IF 1.1 4区医学

Herz Pub Date : 2025-04-01 DOI: 10.1007/s00059-024-05283-w

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

引用次数: 0

Precision medicine in the management of cardiac arrhythmias. 精准医学在心律失常治疗中的应用。

IF 1.1 4区医学

Herz Pub Date : 2025-04-01 Epub Date: 2025-03-08 DOI: 10.1007/s00059-025-05298-x

Felix Wiedmann, Constanze Schmidt

{"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":"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.","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}

引用次数: 0

Acute atrial infarction: a relatively neglected and under-recognized entity in clinical practice. 急性心房梗塞：临床实践中一个相对被忽视和认识不足的实体。

IF 1.1 4区医学

Herz Pub Date : 2025-04-01 Epub Date: 2024-09-24 DOI: 10.1007/s00059-024-05272-z

Chengye Di, Haijiang Wang, Mingming Wang, Qun Wang, Yanxi Wu, Longyu Li, Yan Zhang, Wenhua Lin

{"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":"Background: Electrocardiograms (ECGs) and angiographic features indicative of acute atrial infarction (AAI) often go unnoticed and are under-recognized in clinical practice.Methods: 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.Results: 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.Conclusion: 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.","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}

引用次数: 0

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