Herz最新文献

{"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":"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":"374-384"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","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":"[The heart team for coronary artery disease: perspectives from centers with heart surgery on site].","authors":"Philine Fleckenstein, Torsten Doenst, Marcus Franz","doi":"10.1007/s00059-025-05336-8","DOIUrl":"10.1007/s00059-025-05336-8","url":null,"abstract":"<p><p>The heart team is an important component for guideline-conform treatment of patients with complex coronary artery disease (CAD). Nevertheless, this integrative, multiprofessional approach is not always consistently implemented in clinical practice. This article highlights the role of the heart team, with a particular focus on cardiovascular centers with cardiac surgery on site, presents evidence-based benefits and draws attention to existing structural gaps in daily care, such as the probably widespread use of ad hoc percutaneous coronary intervention (PCI) in multivessel CAD or the lack of interdisciplinary coordination. Numerous studies have shown that consistently implemented heart team decisions and a culture of professional and evidence-based interaction improve patient outcomes. This article appeals to cardiological and cardiac surgery departments to actively shape the heart team process. The presence of both the heart team and cardiac surgery on site paired with modern possibilities of digital communication tools and the wish for individual treatment recommendations should enable faster heart team decisions (practically ad hoc) to improve patient care.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"349-355"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075091","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":"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":"385-394"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","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":"[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":"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":"362-373"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","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":"[The TAVI heart team].","authors":"Oliver Dumpies, Marik Urbschat, Thilo Noack, Mohamed Abdel-Wahab","doi":"10.1007/s00059-025-05331-z","DOIUrl":"10.1007/s00059-025-05331-z","url":null,"abstract":"<p><p>Since the earliest studies on transcatheter aortic valve implantation (TAVI), the heart team concept has been an integral component of treatment planning for patients with aortic valve stenosis (AS). The primary objective is to ensure patient-specific, guideline-based treatment through the structured involvement of all relevant medical disciplines. The TAVI heart team is strongly recommended with a class I indication in both European and US clinical guidelines. A TAVI heart team typically consists of interventional cardiologists, cardiac surgeons, anesthesiologists and cardiac imaging specialists and can be supplemented by additional experts depending on the clinical scenario. The team's responsibilities span the entire continuum of care, from diagnostic assessment and procedural planning to complication management and structured follow-up. The concept of lifetime management is gaining importance, aiming for a long-term strategic approach to valve care throughout the patient's lifespan. Given the evolving age boundaries for intervention, an extension of the heart team approach to all patients with AS is warranted. Clearly defined roles, standardized protocols and defined decision-making processes, supported by a dedicated TAVI coordinator, can substantially enhance both efficiency and quality of care. Looking ahead, digital technologies, artificial intelligence and structured upstream screening strategies for asymptomatic AS patients are expected to play an expanding role.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"309-318"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023187","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":"[Interdisciplinary endocarditis team : Structure, evidence and clinical benefit].","authors":"Carolyn Weber, Norma Jung, Stephan Baldus, Lenard Conradi, Maria Isabel Körber","doi":"10.1007/s00059-025-05333-x","DOIUrl":"10.1007/s00059-025-05333-x","url":null,"abstract":"<p><p>Infective endocarditis (IE) is a severe disease with high morbidity and mortality rates. Interdisciplinary endocarditis teams, consisting of specialists in cardiology, cardiac surgery, infectious diseases and microbiology, have been shown to improve patient care. Current guidelines of the European Society of Cardiology (ESC) and the American Heart Association (AHA) explicitly recommend the implementation. Observational studies showed significant reductions in hospital and 1‑year mortality, shorter hospital stays and fewer complications. Such multidisciplinary teams enable faster diagnosis through multimodal imaging, e.g. positron emission tomography (PET) computed tomography (CT), an early and targeted antibiotic therapy and optimized surgical care. A rapid referral to specialized centers with established teams clearly improves the prognosis. Registry data such as European Endocarditis (EURO-ENDO) and the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) also promote quality improvement and standardization. The widespread implementation of the endocarditis team concept is recommended.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"344-348"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951547","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":"Cardiovascular diseases and diabetes-new focus on obesity.","authors":"Rolf Dörr, Diethelm Tschöpe, Nikolaus Marx","doi":"10.1007/s00059-025-05320-2","DOIUrl":"10.1007/s00059-025-05320-2","url":null,"abstract":"","PeriodicalId":12863,"journal":{"name":"Herz","volume":"50 4","pages":"227-228"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794287","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":"Renal denervation plus cardiac ablation vs. cardiac ablation alone for patients with atrial fibrillation and uncontrolled arterial hypertension : A systematic review and updated meta-analysis of randomized controlled trials.","authors":"Ocílio Ribeiro Gonçalves, Altair Pereira de Melo Neto, Maria Antonia Oliveira Machado Pereira, Victor Arthur Ohannesian, Matheus Augusto Nepomuceno Fernandes, Clara Rocha Dantas, Maria Tereza Camarotti, João Victor Araújo de Oliveira, Gustavo José Silva Sanchez, Carlos Eduardo Batista de Lima, Avelar Alves da Silva","doi":"10.1007/s00059-025-05302-4","DOIUrl":"10.1007/s00059-025-05302-4","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a complex arrhythmia often worsened by hypertension (HTN). Pharmacological treatments frequently underperform, and the best approach, particularly combining renal denervation (RDN) with cardiac ablation (CA), remains unclear.</p><p><strong>Objective: </strong>We conducted an updated meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of RDN combined with CA versus CA alone in patients with AF and uncontrolled HTN.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of RCTs retrieved from PubMed, Embase, and the Cochrane Library up to July 2024. Primary outcomes included AF recurrence, periprocedural complications, blood pressure changes, and estimated glomerular filtration rate (eGFR). Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were computed using a random-effects model.</p><p><strong>Results: </strong>Eight RCTs were included, involving 689 patients (37% female). Of these, 355 underwent RDN + CA, and 334 underwent CA alone, with a mean follow-up of at least 12 months. The RDN + CA group exhibited a significant reduction in AF recurrence (RR: 0.77; 95% CI: 0.61-0.97). There were no significant differences in periprocedural complications (RR: 1.06; 95% CI: 0.60-1.89), systolic blood pressure (MD: -6.79; 95% CI: -14.71-1.14), diastolic blood pressure (MD: -2.47; 95% CI: -8.13-3.20), or eGFR (MD: 1.14; 95% CI: -11.95-14.23).</p><p><strong>Conclusion: </strong>Our findings show that RDN combined with CA significantly reduces AF recurrence compared to CA alone, presenting a promising approach for patients with resistant HTN and AF.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"277-286"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017214","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":"Big data and cardiovascular risk-insights into obesity, diabetes, and coronary heart disease.","authors":"Marcus Dörr","doi":"10.1007/s00059-025-05323-z","DOIUrl":"10.1007/s00059-025-05323-z","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases (CVD) remain a major global health burden. Obesity and type 2 diabetes mellitus (T2DM) are key modifiable risk factors for coronary heart disease (CHD). The emergence of big data has revolutionized cardiovascular research by enabling deeper risk stratification and detection of complex interactions among clinical, lifestyle, and molecular variables.</p><p><strong>Objective: </strong>This article reviews how big data has advanced our understanding of the links between obesity, T2DM, and CHD. It highlights key findings from large cohort studies and international consortia as well as methodological innovations transforming cardiovascular epidemiology.</p><p><strong>Results: </strong>The data reveal that obesity and diabetes show significant regional differences in prevalence and incidence and are associated with other risk factor such as hypertension. Large-scale cohorts and consortia have confirmed that diabetes substantially increases CVD and mortality risk two- to fourfold and is linked to an up to 75% higher mortality rate, with earlier onset and poor glycemic control worsening outcomes. Novel approaches, including polygenic risk scores, machine learning, and real-world data integration, have improved prediction and causal inference. The interplay between obesity and diabetes is a major driver of CHD burden.</p><p><strong>Conclusion: </strong>Big data has enhanced our understanding of cardiovascular risks associated with obesity and diabetes, improved risk prediction models, and provided a foundation for precision prevention strategies. Continued investment in large cohorts, data harmonization, and digital health tools is essential in order to translate these insights into effective public health strategies and reduce the global CVD burden.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"260-267"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475051","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":"[Bariatric surgery versus GLP-1 and dual GIP/GLP-1 receptor agonists : Effects on weight, risk factors and prognosis].","authors":"Jürgen Ordemann, Ulf Elbelt","doi":"10.1007/s00059-025-05319-9","DOIUrl":"10.1007/s00059-025-05319-9","url":null,"abstract":"<p><p>To overcome the increasing prevalence of obesity and associated secondary diseases, effective treatment strategies are required. While bariatric surgery (BS) is an established method for significant and sustainable weight reduction, drug treatment with glucagon-like peptide 1 (GLP-1), GLP‑1 receptor agonists (GLP‑1 RA) and dual glucose-dependent insulinotropic peptide (GIP)/GLP‑1 RA has gained increasing importance in recent years. This article highlights the effects of these both treatment approaches on body weight, cardiometabolic risk factors and long-term prognosis, particularly with respect to cardiovascular events and remission of type 2 diabetes. While BS shows more robust weight loss and greater improvement in metabolic parameters, GLP‑1 RA and dual GIP/GLP‑1 RA offer a conservative treatment alternative with a good safety profile. The choice of treatment should be individualized based on the patient risk profile and preferences.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"253-259"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293640","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}