Herz最新文献

{"title":"[eHealth: digital bridges in the healthcare system].","authors":"Simon Glück, Christian Perings","doi":"10.1007/s00059-024-05265-y","DOIUrl":"10.1007/s00059-024-05265-y","url":null,"abstract":"<p><p>Healthcare in Germany is divided into various service sectors, which differ in terms of outpatient and inpatient care as well as the legal and financial bases. The resulting breaks in consecutive patient care are to be overcome by integrating services into cross-sectoral processes (integrated care). Digitalization and the associated use of information and communication technology (ICT) play a decisive role in this. To derive implications and benefits it is necessary to classify the technical possibilities. For this purpose, eHealth is the basic generic term for all process support and direct patient applications that are based on the electronic exchange of data. A distinction can be made between technology for process support and technology for direct application on the patient. Applications in all categories are suitable for ensuring that interfaces in the flow of information between those involved in healthcare processes are adequately managed by eHealth. Furthermore, the allocation of specialized medicine through eHealth is independent of location and sector. New possibilities for generating and using structured data for evidence development and care research are realized through eHealth and the development of existing and new care models will be promoted.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"335-341"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106744","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":"[Lifelong learning in cardiology: success through innovation : Use of e-learning in further education and training].","authors":"A A Derda, A Hohneck","doi":"10.1007/s00059-024-05263-0","DOIUrl":"10.1007/s00059-024-05263-0","url":null,"abstract":"<p><p>Lifelong learning in cardiology is essential, as treatment standards, technologies and drug treatment are constantly evolving. In this respect e‑learning plays a central role, enabling doctors to flexibly and efficiently expand their knowledge. There are various offerings, from medical students and specialist training to highly specialised expert knowledge. The e‑learning platforms have become an indispensable tool in specialist training. Another concept is the combination of face-to-face teaching and e‑learning, known as blended learning. This is particularly effective in medical training. These models enable flexible preparation and follow-up and appeal to different types of learners. Overall, e‑learning offers a valuable resource for flexibly and efficiently acquiring knowledge and keeping up to date.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"321-326"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106745","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: 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/s00059-024-05271-0","DOIUrl":"10.1007/s00059-024-05271-0","url":null,"abstract":"","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"393"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106746","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":"Burden of disease in Germany attributed to ambient particulate matter pollution","authors":"Omar Hahad, Jos Lelieveld, Sadeer Al-Kindi, Volker H. Schmitt, Lukas Hobohm, Karsten Keller, Martin Röösli, Marin Kuntic, Andreas Daiber","doi":"10.1007/s00059-024-05269-8","DOIUrl":"https://doi.org/10.1007/s00059-024-05269-8","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Ambient fine particulate matter pollution with a diameter less than 2.5 micrometers (PM_2.5) is a significant risk factor for chronic noncommunicable diseases (NCDs), leading to a substantial disease burden, decreased quality of life, and deaths globally. This study aimed to investigate the disease and mortality burdens attributed to PM_2.5 in Germany in 2019.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Data from the Global Burden of Disease (GBD) Study 2019 were used to investigate disability-adjusted life–years (DALYs), years of life lost (YLLs), years lived with disability (YLDs), and deaths attributed to ambient PM_2.5 pollution in Germany.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>In 2019, ambient PM_2.5 pollution in Germany was associated with significant health impacts, contributing to 27,040 deaths (2.82% of total deaths), 568,784 DALYs (2.09% of total DALYs), 135,725 YLDs (1.09% of total YLDs), and 433,058 YLLs (2.92% of total YLLs). The analysis further revealed that cardiometabolic and respiratory conditions, such as ischemic heart disease, stroke, chronic obstructive pulmonary disease, lung cancer, and diabetes mellitus, were the leading causes of mortality and disease burden associated with ambient PM_2.5 pollution in Germany from 1990–2019. Comparative assessments between 1990 and 2019 underscored ambient PM_2.5 as a consistent prominent risk factor, ranking closely with traditional factors like smoking, arterial hypertension, and alcohol use contributing to deaths, DALYs, YLDs, and YLLs.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Ambient PM_2.5 pollution is one of the major health risk factors contributing significantly to the burden of disease and mortality in Germany, emphasizing the urgent need for targeted interventions to address its substantial contribution to chronic NCDs.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":"9 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142224665","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":"Assessing the efficacy of renal denervation in patients with resistant arterial hypertension","authors":"Ocílio Ribeiro Gonçalves, Francinny Alves Kelly, José Guilherme Maia, Artur de Oliveira Macena Lôbo, Vitor Kendi Tsuchiya Sano, Maria Eduarda Cavalcanti Souza, Francisco Cezar Aquino de Moraes, Nimra Farid, Arlindo Bispo da Silva Júnior, Avelar Alves da Silva","doi":"10.1007/s00059-024-05268-9","DOIUrl":"https://doi.org/10.1007/s00059-024-05268-9","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Renal denervation (RDN) is an innovative procedure designed to regulate the renal sympathetic nervous system for the control of arterial hypertension (HTN). RDN has emerged as an alternative for patients with resistant HTN. However, the clinical efficacy of RDN remains incompletely elucidated.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>PubMed, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs) comparing the use of RDN with sham procedure or pharmacological treatment in patients with resistant HTN. Statistical analyses were performed using R Studio 4.3.2 (R Foundation for Statistical Computing, Vienna, Austria). Heterogeneity was examined with the Cochran Q test I² statistics. Mean difference (MD) with 95% confidence interval (CI) were pooled across trials. <i>P</i> values of &lt;0.05 were considered statistically significant. The primary outcomes of interest were changes from baseline in systolic blood pressure (SBP), diastolic blood pressure (DBP), and serum creatinine.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Twenty-one RCTs comprising 3345 patients were included in this meta-analysis, whereby 2004 (59.91%) received renal denervation and 1341 (40.09%) received pharmacological treatment or sham procedure. Follow-up ranged from 2 to 48 months. Compared to control group, RDN significantly reduced SBP (MD −3.53 mm Hg; 95% CI −5.94 to −1.12; <i>p</i> = 0.004; I² = 74%) and DBP (MD −1.48 mm Hg; 95% CI −2.56 to −0.40; <i>p</i> = 0.007; I² = 51%). Regarding serum creatinine (MD −2.51; 95% CI −7.90 to 2.87; <i>p</i> = 0.36; I² = 40%), there was no significant difference between RDN and control groups.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>In this meta-analysis of RCTs of patients with resistant HTN, RDN was associated with a reduction in SBP and DBP compared to sham procedure or pharmacological treatment.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":"20 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142186980","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":"Rechtliche Aspekte in der digitalen Kardiologie","authors":"S. Manteufel, D. Duncker","doi":"10.1007/s00059-024-05262-1","DOIUrl":"https://doi.org/10.1007/s00059-024-05262-1","url":null,"abstract":"<p>Digitale Helfer sind inzwischen ein unverzichtbares Werkzeug in der modernen Kardiologie. Der damit einhergehende technologische Fortschritt bietet hierbei ein ausgesprochenes Potenzial, die Effizienz medizinischer Prozesse zu steigern, in kürzester Zeit präzisere Diagnosen zu ermöglichen und damit die Patientenversorgung zu verbessern. Doch mit der zunehmenden Integration digitaler Helfer im sonst arbeitsintensiven kardiologischen Berufsalltag ergeben sich auch neue Herausforderungen und Fragestellungen, insbesondere im Hinblick auf den Umgang mit dem Thema Recht. Der vorliegende Übersichtsartikel zielt darauf ab, ein Bewusstsein für einzelne juristische Themen zu schaffen, die aus der Verwendung digitaler Technologien in der Kardiologie resultieren. Dabei wird es im Kern um den wohlüberlegten Umgang mit den haftungsrechtlichen Themen der Therapiefreiheit, des kardiologischen Facharztstandards, der ärztlichen Schweigepflicht wie auch des Datenschutzes gehen. Die Integration digitaler Helfer in der Kardiologie führt insgesamt zu einer spürbaren Verbesserung der Effizienz und Qualität der Patientenversorgung, beinhaltet jedoch gleichzeitig eine Vielzahl rechtlicher Herausforderungen, die sorgfältig adressiert werden müssen.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":"40 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142224666","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":"Is an accurate self-perceived health risk beneficial for patients to minimize prehospital delay time at onset of a ST-segment elevated myocardial infarction (STEMI)?","authors":"Karl-Heinz Ladwig, Elisabeth Olliges, Loai Albarqouni, Sophia Hoschar, Wenlin Ma, Xiaoyan Fang","doi":"10.1007/s00059-024-05256-z","DOIUrl":"10.1007/s00059-024-05256-z","url":null,"abstract":"<p><p>High risk perception (HRP) is fundamental for adequate health behavior. However, its impact on rapid access to cardiac care after the onset of acute myocardial infarction (AMI) is not known. Conflicting evidence exists about sources that promote HRP. Data on sociodemographic and clinical characteristics of 588 AMI patients who participated in the Munich Examination of Delay in Patients Experiencing Acute Myocardial Infarction (MEDEA) study were collected at the bedside. Adjusted multivariate logistic regression models identified factors associated with HRP. Only 13.4% (n = 79) of patients had a favorable HRP level. The HRP patients did not differ from those with low risk perception (LRP) in terms of sex, age, other sociodemographic features, and somatic risk factors. Among the univariate contributors to HRP were prodromal chest pain (p = 0.0004), symptom mismatch during AMI (p < 0.0001), depression (p = 0.01), and anxiety (p = 0.005). However, family history of AMI, a previous AMI, and knowledge of AMI remained significant in the multivariate regression model. Median delay time to reach a hospital-based emergency facility after the onset of AMI was 127 min (interquartile range [IQR]: 83-43, p = 0.02) in HRP patients and 216 min (IQR: 106-721) in LRP patients. An increasing risk perception score was associated with a corresponding stepwise decline in median delay time (p > 0.004). Self-perceived AMI risk is associated in a dose-response relationship with the time needed to reach coronary care emergency facilities. Recurrent AMI, family history of AMI, and sufficient knowledge of MI contribute to risk perception, whereas somatic risk factors do not.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"270-276"},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534315","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":"Environmental and climate cardiology: some environmental issues highlighted at the annual meetings of the German Society for Cardiology (DGK) from 2007 to 2023.","authors":"Omar Hahad","doi":"10.1007/s00059-023-05223-0","DOIUrl":"10.1007/s00059-023-05223-0","url":null,"abstract":"","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"309-312"},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11286620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138176001","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":"Psychological burden in patients with angina and unobstructed coronary arteries-underestimated, underexplored, undertreated.","authors":"Peter Ong, Astrid Hubert, Zineb Moussaoui, Raffi Bekeredjian, Frank Vitinius, Karl-Heinz Ladwig","doi":"10.1007/s00059-024-05253-2","DOIUrl":"10.1007/s00059-024-05253-2","url":null,"abstract":"<p><p>Patients with angina and unobstructed coronary arteries (ANOCA) are frequently encountered in clinical practice. These cases represent a diagnostic and therapeutic challenge and are often characterized by a long patient journey until a diagnosis of coronary vasomotor disorders is established. Moreover, the unsatisfactory management of such patients leads to insecurity, ongoing symptoms, and psychological sequelae such as anxiety or depression. Currently, the psychological burden in patients with ANOCA is underestimated, underexplored, and undertreated. This review gives a new perspective on the pathophysiology of coronary vasomotor disorders including psychological risk factors and calls for comprehensive care by interdisciplinary ANOCA clinics.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"277-281"},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418586","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":"The predictive value of PRECISE-DAPT score for long-term mortality in patients with acute coronary syndrome complicated by cardiogenic shock.","authors":"Sukru Akyuz, Ali Nazmi Calik, Tolga Onuk, Baris Yaylak, Zeynep Kolak, Semih Eren, Feyza Mollaalioglu, Furkan Durak, Mustafa Cetin, Ibrahim Halil Tanboga","doi":"10.1007/s00059-023-05231-0","DOIUrl":"10.1007/s00059-023-05231-0","url":null,"abstract":"<p><strong>Background: </strong>Besides its primary clinical utility in predicting bleeding risk in patients with acute coronary syndrome (ACS), the PRECISE-DAPT (Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Anti-Platelet Therapy) score may also be useful for predicting long-term mortality in ACS patients presenting with cardiogenic shock (CS) since several studies have reported an association between the score and certain cardiovascular conditions or events. The aim of the present study was to evaluate the utility of the PRECISE-DAPT score for predicting the long-term all-cause mortality in patients (n = 293) with ACS presenting with CS.</p><p><strong>Methods: </strong>The PRECISE-DAPT score was calculated for each patient who survived in hospital, and the association with long-term mortality was studied. Median follow-up time was 2.7 years. The performance of the final model was determined with measurements of its discriminative power (Harrell's and Uno's C indices and time-dependent area under the receiver operating characteristic curve [AUC]) and predictive accuracy (coefficient of determination [R²] and likelihood ratio χ²). Hazard ratios (HRs) were used to assess the relationship between the variables of the model and long-term all-cause death.</p><p><strong>Results: </strong>All-cause death occurred in 197 patients (67%). There was a positive association between the PRECISE-DAPT score (change from 17 to 38 was associated with an HR of 2.42 [95% CI: 1.59-3.68], R² = 0.209, time-dependent AUC = 0.69) and the risk of death such that in the adjusted survival curve, the risk of mortality increased as the PRECISE-DAPT score increased.</p><p><strong>Conclusion: </strong>The PRECISE-DAPT score may be a useful easy-to-use tool for predicting long-term mortality in patients with ACS complicated by CS.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"302-308"},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139086579","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}