IF 1.7 4区医学

Herz Pub Date : 2024-06-01 Epub Date: 2024-03-06 DOI: 10.1007/s00059-024-05239-0

Raymond D Bahr

{"title":"Acute prevention of a heart attack : Early identification of prodromal symptoms as the Rosetta Stone in decoding the heart attack problem.","authors":"Raymond D Bahr","doi":"10.1007/s00059-024-05239-0","DOIUrl":"10.1007/s00059-024-05239-0","url":null,"abstract":"Chest discomfort before severe chest pain represents a marker of clinical ischemia and indicates live myocardium in jeopardy and often precedes cardiac arrest or acute myocardial infarction (MI). The intermittent or \"stuttering\" symptoms that precede MI are referred to as \"prodromal symptoms.\" These symptoms have been shown to correlate with cyclic ST changes and repeated episodes of spontaneous reperfusion and occlusion, occurring during a period of hours or days before the acute ischemia proceeds to death or heart damage. These symptoms of premonitory angina have been associated with improved outcomes due to ischemic pre-conditioning or opening of collateral vascular channels around the area of ischemia. Acute prevention of an MI through recognition of prodromal symptoms represents an opportunity to significantly reduce heart attack deaths. The Early Heart Attack Care (EHAC) program puts emphasis on prodromal symptom recognition and allows for a shift in time backward to prevent the ischemic process from proceeding to MI. This strategy has been shown to detect the 15% of patients with ischemia in the low-probability group and to reduce inappropriate admissions to hospital as well as to reduce the number of patients with missed MI being sent home from the emergency department.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"167-174"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140039132","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

[Treatment with cardiac electronic implantable devices]. [使用心脏电子植入装置进行治疗]。

IF 1.7 4区医学

Herz Pub Date : 2024-06-01 Epub Date: 2024-05-06 DOI: 10.1007/s00059-024-05246-1

Jürgen Kuschyk, Katherine Sattler, Fabian Fastenrath, Boris Rudic, Ibrahim Akin

引用次数: 0

[Digitalization and clinical decision tools]. [数字化和临床决策工具］

IF 1.7 4区医学

Herz Pub Date : 2024-06-01 Epub Date: 2024-03-07 DOI: 10.1007/s00059-024-05242-5

C Reich, N Frey, E Giannitsis

{"title":"[Digitalization and clinical decision tools].","authors":"C Reich, N Frey, E Giannitsis","doi":"10.1007/s00059-024-05242-5","DOIUrl":"10.1007/s00059-024-05242-5","url":null,"abstract":"Digitalization in cardiovascular emergencies is rapidly evolving, analogous to the development in medicine, driven by the increasingly broader availability of digital structures and improved networks, electronic health records and the interconnectivity of systems. The potential use of digital health in patients with acute chest pain starts even in the prehospital phase with the transmission of a digital electrocardiogram (ECG) as well as telemedical support and digital emergency management, which facilitate optimization of the rescue pathways and reduce critical time intervals. The increasing dissemination and acceptance of guideline apps and clinical decision support tools as well as integrated calculators and electronic scores are anticipated to improve guideline adherence, translating into a better quality of treatment and improved outcomes. Implementation of artificial intelligence to support image analysis and also the prediction of coronary artery stenosis requiring interventional treatment or impending cardiovascular events, such as heart attacks or death, have an enormous potential especially as conventional instruments frequently yield suboptimal results; however, there are barriers to the rapid dissemination of corresponding decision aids, such as the regulatory rules related to approval as a medical product, data protection issues and other legal liability aspects, which must be considered.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"190-197"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140059169","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 chest pain in transition : New definitions, new standards and new developments]. [过渡时期的急性胸痛：新定义、新标准和新发展]。

IF 1.7 4区医学

Herz Pub Date : 2024-06-01 Epub Date: 2024-05-29 DOI: 10.1007/s00059-024-05243-4

Frank Breuckmann

引用次数: 0

The new ESC acute coronary syndrome guideline and its impact in the CPU and emergency department setting. ESC急性冠脉综合征新指南及其对中央急诊科的影响。

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

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