IF 1.7 4区医学

Herz Pub Date : 2024-06-01 Epub Date: 2024-03-11 DOI: 10.1007/s00059-024-05241-6

Martin Möckel

{"title":"The new ESC acute coronary syndrome guideline and its impact in the CPU and emergency department setting.","authors":"Martin Möckel","doi":"10.1007/s00059-024-05241-6","DOIUrl":"10.1007/s00059-024-05241-6","url":null,"abstract":"The new guideline on acute coronary syndrome (ACS) of the European Society of Cardiology (ESC) replaces two separate guidelines on ST-elevation myocardial infarction (STEMI) and non-ST-elevation (NSTE) ACS. This change of paradigm reflects the experts view that the ACS is a continuum, starting with unstable angina and ending in cardiogenic shock or cardiac arrest due to severe myocardial ischemia. Secondary, partly non-atherosclerotic-caused myocardial infarctions (\"type 2\") are not integrated in this concept.With respect to acute care in the setting of emergency medicine and the chest pain unit structures, the following new aspects have to be taken into account:1. New procedural approach as \"think A.C.S.\" meaning \"abnormal ECG,\" \"clinical context,\" and \"stable patient\"2. New recommendation regarding a holistic approach for frail patients3. Revised recommendations regarding imaging and timing of invasive strategy in suspected NSTE-ACS4. Revised recommendations for antiplatelet and anticoagulant therapy in STEMI5. Revised recommendations for cardiac arrest and out-of-hospital cardiac arrest6. Revised recommendations for in-hospital management (starting in the CPU/ED) and ACS comorbid conditionsIn summary, the changes are mostly gradual and are not based on extensive new evidence, but more on focused and healthcare process-related considerations.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"185-189"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140101444","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

Epicardial adipose tissue as a prognostic marker in acute pulmonary embolism. 心外膜脂肪组织作为急性肺栓塞的预后标志物。

IF 1.7 4区医学

Herz Pub Date : 2024-06-01 Epub Date: 2023-10-17 DOI: 10.1007/s00059-023-05210-5

Anar Aghayev, Mattes Hinnerichs, Andreas Wienke, Hans-Jonas Meyer, Alexey Surov

{"title":"Epicardial adipose tissue as a prognostic marker in acute pulmonary embolism.","authors":"Anar Aghayev, Mattes Hinnerichs, Andreas Wienke, Hans-Jonas Meyer, Alexey Surov","doi":"10.1007/s00059-023-05210-5","DOIUrl":"10.1007/s00059-023-05210-5","url":null,"abstract":"Background: Epicardial adipose tissue (EAT) has been established as a quantitative imaging biomarker associated with disease severity in coronary heart disease. Our aim was to use this prognostic marker derived from computed tomography pulmonary angiography (CTPA) for the prediction of mortality and prognosis in patients with acute pulmonary embolism.Methods: The clinical database was retrospectively screened for patients with acute pulmonary embolism between 2015 and 2021. Overall, 513 patients (216 female, 42.1%) were included in the analysis. The study end-point was 30-day mortality. Epicardial adipose tissue was measured on the diagnostic CTPA in a semiquantitative manner. The volume and density of EAT were measured for every patient.Results: Overall, 60 patients (10.4%) died within the 30-day observation period. The mean EAT volume was 128.3 ± 65.0 cm3 in survivors and 154.6 ± 84.5 cm3 in nonsurvivors (p = 0.02). The density of EAT was -79.4 ± 8.3 HU in survivors and -76.0 ± 8.4 HU in nonsurvivors (p = 0.86), and EAT density was associated with 30-day mortality (odds ratio [OR] = 1.07; 95% confidence interval [CI]: 1.03; 1.1, p < 0.001) but did not remain statistically significant in multivariable analysis. No association was identified between EAT volume and 30-day mortality (OR = 1.0; 95% CI: 1.0; 1.0, p = 0.48).Conclusion: There might be an association between EAT density and mortality in patients with acute pulmonary embolism. Further studies are needed to elucidate the prognostic relevance of EAT parameters in patients with acute pulmonary embolism.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"219-223"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11136740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41234616","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}

引用次数: 0

[Utilization of video consultation in cardiovascular lipid treatment]. 【视频会诊在心血管脂质治疗中的应用】。

IF 1.7 4区医学

Herz Pub Date : 2024-06-01 Epub Date: 2023-10-19 DOI: 10.1007/s00059-023-05211-4

A Schuch, P Walther, L Timm, K Steinbach, L Haneklaus, T Münzel, J H Prochaska, P S Wild

{"title":"[Utilization of video consultation in cardiovascular lipid treatment].","authors":"A Schuch, P Walther, L Timm, K Steinbach, L Haneklaus, T Münzel, J H Prochaska, P S Wild","doi":"10.1007/s00059-023-05211-4","DOIUrl":"10.1007/s00059-023-05211-4","url":null,"abstract":"Background: Video consultation is a possibility for physician-patient communication independent of the location; however, only limited information is available for the possibility of sole use since 2018.Methods: After the implementation of video consultation (Viomedi) in lipid consultations at the Medical University Mainz, the patients in the first quarter of 2022 were assessed depending on the possibility, suitability and readiness to participate. Included were patients under lipid management and long COVID patients. After treatment an online survey was carried out on the utilization and appraisal.Results: Of the 134 patients 29.1% were inclusively treated (3 refusals). All subjects (16 replies) reported having managed (very) well. Advantages were seen in counselling and follow-up. Problems were feared with respect to technology and possible disorders. Data protection aspects played a subordinate role. In comparison to telephone calls, a significant improvement in the physician-patient relationship (p-value = 0.00027), the quality of treatment and information (p-value both = 0.00044), the access to care (p-value = 0.0053) and the communication (p-value = 0.021) was assumed. An improvement in access to care (p-value = 0.021) and the quality of information (p-value = 0.034) was seen in comparison to personal contact. The main problems were a lack of experience, technical requirements, technical problems and unpunctuality of the practitioner. The flexibility, low effort and the pleasant consultation were all praised. All subjects wanted to use the video consultation again.Conclusion: Video consultation can represent a supplement to treatment of patients under lipid management. The correct use requires exact planning and further research.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"224-232"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11136760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49676803","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}

引用次数: 0

Prognostic value of extended cardiac risk assessment before elective open abdominal aortic surgery. 选择性腹主动脉开放手术前扩展心脏风险评估的预后价值。

IF 1.7 4区医学

Herz Pub Date : 2024-06-01 Epub Date: 2023-10-03 DOI: 10.1007/s00059-023-05209-y

Martin Sigl, Stefan Baumann, Ann-Sophie Könemann, Michael Keese, Kay Schwenke, Andreas L H Gerken, Daniel Dürschmied, Stephanie Rosenkaimer

{"title":"Prognostic value of extended cardiac risk assessment before elective open abdominal aortic surgery.","authors":"Martin Sigl, Stefan Baumann, Ann-Sophie Könemann, Michael Keese, Kay Schwenke, Andreas L H Gerken, Daniel Dürschmied, Stephanie Rosenkaimer","doi":"10.1007/s00059-023-05209-y","DOIUrl":"10.1007/s00059-023-05209-y","url":null,"abstract":"Background: Major vascular surgery is associated with a high perioperative risk and significant mortality. Despite advances in risk stratification, monitoring, and management of perioperative complications, cardiac complications are still common. Stress echocardiography is well established in coronary artery disease diagnostics; however, its prognostic value before high-risk aortic surgery is unknown. This prospective, single-center study compared the outcome of patients undergoing extended cardiac risk assessment before open abdominal aortic surgery with the outcome of patients who had received standard preoperative assessment.Methods: The study included patients undergoing elective open abdominal aortic surgery. Patients who underwent standard preoperative assessment before the start of a dedicated protocol were compared with patients who had extended cardiac risk assessment, including dobutamine stress echocardiography, as part of a stepwise interdisciplinary cardiovascular team approach. The combined primary endpoint was cardiovascular death, myocardial infarction, emergency coronary revascularization, and life-threatening arrhythmia within 30 days. The secondary endpoint was acute renal failure and severe bleeding.Results: In total, 77 patients (mean age 68.1 ± 8.1 years, 70% male) were included: 39 underwent standard and 38 underwent cardiac risk assessment. The combined primary endpoint was reached significantly more often in patients before than after implementation of the extended cardiac stratification procedure (15% vs. 0%, p = 0.025). The combined secondary endpoint did not differ between the groups.Conclusions: Patients with extended cardiac risk assessment undergoing elective open abdominal aortic surgery had better 30-day outcomes than did those who had standard preoperative assessment.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"210-218"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41117858","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

Novel biomarkers identified by weighted gene co-expression network analysis for atherosclerosis. 通过加权基因共表达网络分析发现动脉粥样硬化的新生物标志物

IF 1.7 4区医学

Herz Pub Date : 2024-06-01 Epub Date: 2023-09-18 DOI: 10.1007/s00059-023-05204-3

Jiajun Ni, Kaijian Huang, Jialin Xu, Qi Lu, Chu Chen

{"title":"Novel biomarkers identified by weighted gene co-expression network analysis for atherosclerosis.","authors":"Jiajun Ni, Kaijian Huang, Jialin Xu, Qi Lu, Chu Chen","doi":"10.1007/s00059-023-05204-3","DOIUrl":"10.1007/s00059-023-05204-3","url":null,"abstract":"Background: This study aimed to screen out the potential diagnostic biomarkers for atherosclerosis (AS).Methods: We downloaded the gene expression profiles GSE66360, GSE28829, GSE41571, GSE71226, and GSE100927 from the Gene Expression Omnibus (GEO) database. The differentially expressed genes (DEGs) were identified using the \"limma\" package in R. Weighted gene co-expression network analysis (WGCNA) was applied to reveal the correlation between genes in different samples. Subsequently, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed. The interaction pairs of proteins were retained by the STRING database, and the protein-protein interaction (PPI) network was visualized with the hub genes. Finally, the R packages \"ggpubr\" and \"preprocessCore\" were used to analyze immune cell infiltration.Results: In total, 40 overlapping genes both in GSE66360 and GSE28829 were found to be related to the occurrence of AS. Further, the top 10 network hub genes including TYROBP, CSF1R, TLR2, CD14, CCL4, FCER1G, CD163, TREM1, PLEK, and C5AR1 were identified as significant key genes. Moreover, four genes (TYROBP, CSF1R, FCGR1B, and CD14) were verified that could efficiently diagnose AS. Finally, the gene TYROBP was found to have a strong correlation with immune-infiltrating cells.Conclusion: Our study identified four genes (TYROBP, CSF1R, FCGR1B, and CD14) that may be effective biomarkers for AS, with the potential to guide the clinical diagnosis of AS.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"198-209"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10287604","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

New categorization of chest pain: noncardiac is in, atypical is out! 胸痛的新分类：非心源性胸痛加入，非典型胸痛退出！

IF 1.7 4区医学

Herz Pub Date : 2024-06-01 Epub Date: 2024-03-01 DOI: 10.1007/s00059-024-05240-7

Stephan Settelmeier, Sebastian Steven, Felix Post, Ingo Ahrens, Evangelos Giannitsis, Frank Breuckmann

引用次数: 0

Cardiac, possible cardiac, and likely non-cardiac origin of chest pain : A hitherto underestimated parameter in German chest pain units. 胸痛的心脏病源、可能的心脏病源和可能的非心脏病源：德国胸痛科迄今为止低估的参数。

IF 1.7 4区医学

Herz Pub Date : 2024-06-01 Epub Date: 2023-12-28 DOI: 10.1007/s00059-023-05230-1

Sebastian Imhof, Matthias Hochadel, Stavros Konstantinides, Thomas Voigtländer, Claus Schmitt, Bernd Nowak, Tienush Rassaf, Jochen Senges, Thomas Münzel, Evangelos Giannitsis, Frank Breuckmann

{"title":"Cardiac, possible cardiac, and likely non-cardiac origin of chest pain : A hitherto underestimated parameter in German chest pain units.","authors":"Sebastian Imhof, Matthias Hochadel, Stavros Konstantinides, Thomas Voigtländer, Claus Schmitt, Bernd Nowak, Tienush Rassaf, Jochen Senges, Thomas Münzel, Evangelos Giannitsis, Frank Breuckmann","doi":"10.1007/s00059-023-05230-1","DOIUrl":"10.1007/s00059-023-05230-1","url":null,"abstract":"Background: Current guidelines emphasize the diagnostic value of non-cardiac or possibly cardiac chest pain. The goal of this analysis was to determine whether German chest pain units (CPUs) adequately address conditions with \"atypical\" chest pain in existing diagnostic structures.Method: A total of 11,734 patients from the German CPU registry were included. The analyses included mode of admission, critical time intervals, diagnostic steps, and differential diagnoses.Results: Patients with unspecified chest pain were younger, more often female, were less likely to have classic cardiovascular risk factors and tended to present more often as self-referrals. Patients with acute coronary syndrome (ACS) mostly had prehospital medical contact. Overall, there was no difference between these two groups regarding the time from the onset of first symptoms to arrival at the CPU. In the CPU, the usual basic diagnostic measures were performed irrespective of ACS as the primary working diagnosis. In the non-ACS group, further ischemia-specific diagnostics were rarely performed. Extra-cardiac differential diagnoses were not specified.Conclusion: The establishment of broader awareness programs and opening CPUs for low-threshold evaluation of self-referring patients should be discussed. Regarding the rigid focus on the clarification of cardiac causes of chest pain, a stronger interdisciplinary approach should be promoted.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"175-180"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058227","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

[Heart and blood: clonal hematopoiesis]. [心脏和血液：克隆造血]。

IF 1.7 4区医学

Herz Pub Date : 2024-03-01 Epub Date: 2024-02-29 DOI: 10.1007/s00059-024-05237-2

Stefanie Dimmeler, Andreas Zeiher

{"title":"[Heart and blood: clonal hematopoiesis].","authors":"Stefanie Dimmeler, Andreas Zeiher","doi":"10.1007/s00059-024-05237-2","DOIUrl":"10.1007/s00059-024-05237-2","url":null,"abstract":"Cardiovascular diseases are among the leading causes of death worldwide, with well-known modifiable risk factors, such as smoking, overweight, lipid metabolism disorders, lack of physical activity and high blood pressure playing a significant role. Recent studies have now identified \"clonal hematopoiesis\" as a novel blood-based risk factor. Clonal hematopoiesis arises from mutations in hematopoietic stem cells, which lead to the expansion of mutated blood cells. Mutated cell clones can be detected in over 40% of individuals over 50 years old, with more than 15% of those over 90 years old harboring large clones. Surprisingly, mutated cells predispose to the development of leukemia only to a minor extent, leading to the term clonal hematopoiesis of indeterminate potential (CHIP); however, it has been shown that CHIP is associated with an increased risk of cardiovascular diseases. Individuals with CHIP-associated gene mutations have an elevated risk of atherosclerotic vascular diseases, stroke and thrombosis. Patients with heart failure with reduced ejection fraction (HFrEF), whether of ischemic or non-ischemic origin and patients with heart failure with preserved ejection fraction (HFpEF) exhibit an increased number of mutated cells in the blood. The presence of CHIP mutations is linked to a poorer prognosis in patients with existing cardiovascular diseases. Future research should aim at a better understanding of the specific effects of different mutations, clone sizes and combinations to develop personalized therapeutic approaches. Various anti-inflammatory therapeutic drugs are available, which can be tested in controlled studies.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"105-110"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139996046","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

[Air pollution, noise and hypertension : Partners in crime]. [空气污染、噪音和高血压：犯罪伙伴]。

IF 1.7 4区医学

Herz Pub Date : 2024-03-01 Epub Date: 2024-02-06 DOI: 10.1007/s00059-024-05234-5

T Münzel, A Daiber, O Hahad

{"title":"[Air pollution, noise and hypertension : Partners in crime].","authors":"T Münzel, A Daiber, O Hahad","doi":"10.1007/s00059-024-05234-5","DOIUrl":"10.1007/s00059-024-05234-5","url":null,"abstract":"Air pollution and traffic noise are two important environmental risk factors that endanger health in urban societies and often act together as \"partners in crime\". Although air pollution and noise often co-occur in urban environments, they have typically been studied separately, with numerous studies documenting consistent effects of individual exposure on blood pressure. In the following review article, we examine the epidemiology of air pollution and noise, especially regarding the cardiovascular risk factor arterial hypertension and the underlying pathophysiology. Both environmental stressors have been shown to lead to endothelial dysfunction, oxidative stress, pronounced vascular inflammation, disruption of circadian rhythms and activation of the autonomic nervous system, all of which promote the development of hypertension and cardiovascular diseases. From a societal and political perspective, there is an urgent need to point out the potential dangers of air pollution and traffic noise in the American Heart Association (AHA)/American College of Cardiology (ACC) prevention guidelines and the European Society of Cardiology (ESC) guidelines on prevention. Therefore, an essential goal for the future is to raise awareness of environmental risk factors as important and, in particular, preventable risk factors for cardiovascular diseases.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"124-133"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697267","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

[Update on the treatment of aortic valve stenosis in symptomatic and asymptomatic patients]. [有症状和无症状患者主动脉瓣狭窄治疗的最新进展]。

IF 1.7 4区医学

Herz Pub Date : 2024-03-01 Epub Date: 2024-01-19 DOI: 10.1007/s00059-023-05229-8

Tobias Rheude, Costanza Pellegrini, Erion Xhepa, Michael Joner

引用次数: 0

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