Herz最新文献

{"title":"Diabetes, obesity, and cardiovascular disease-what is the impact of lifestyle modification?","authors":"Celina Seth, Veronika Schmid, Stephan Mueller, Mark Haykowsky, Stephen J Foulkes, Martin Halle, Simon Wernhart","doi":"10.1007/s00059-025-05309-x","DOIUrl":"10.1007/s00059-025-05309-x","url":null,"abstract":"<p><p>Diabetes, obesity, and cardiovascular disease (CVD) represent an escalating global health challenge, contributing significantly to morbidity, mortality, and healthcare costs. Evidence from large cohort studies and clinical trials underscores the impact of diabetes and obesity as major risk factors for CVD, causing systemic inflammation, insulin resistance, and neurohormonal activation. Frequently, a sedentary lifestyle and unbalanced dietary habits are associated with these risk factors. Physical activity and exercise training interventions, a Mediterranean and plant-based diet, smoking cessation, and reduction of alcohol have shown promise in mitigating these risks. The implementation of lifestyle and pharmacotherapy have emerged as new pillars of preventive medicine. This review discusses the evidence of lifestyle interventions to reduce the burden of diabetes, obesity, and CVD. It is highlighted that only a multifaceted, sustained approach integrating lifestyle interventions and pharmacological strategies can reduce the burden of disease and improve long-term outcomes.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"240-245"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630322","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: Diabetes, obesity, and cardiovascular disease-what is the impact of lifestyle modification?","authors":"Celina Seth, Veronika Schmid, Stephan Mueller, Mark Haykowsky, Stephen J Foulkes, Martin Halle, Simon Wernhart","doi":"10.1007/s00059-025-05316-y","DOIUrl":"10.1007/s00059-025-05316-y","url":null,"abstract":"","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"295"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996017","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":"Understanding the pathophysiology of obesity-the relevance of weight loss strategies through behavior modification.","authors":"Matthias Blüher","doi":"10.1007/s00059-025-05321-1","DOIUrl":"10.1007/s00059-025-05321-1","url":null,"abstract":"<p><p>Obesity is a chronic, progressive, and relapsing disease that can contribute to morbidity, reduced life expectancy, and adverse health outcomes. The prevalence of obesity increased worldwide in the past 60 years, mainly because of changes in our environment and society. With the technical revolution of the last century, new modes of transportation and working conditions, automatization, and computerization, human energy demands have decreased. In parallel, the availability of energy-dense food, refined carbohydrates, and fat has markedly increased. These developments in society clash with biological factors that predispose humans to the development of obesity. At the individual level, obesity is the result of a long-term imbalance between too much energy consumed and too little energy expended. Therefore, lifestyle and behavior interventions aimed at reducing calorie intake and increasing energy expenditure target the root causes of obesity. However, both at the individual and population level, obesity prevention and treatment strategies that are based only on behavior modification are frequently not successful in the long term. The limited effectiveness of behavior interventions on weight loss are explained by complex and persistent hormonal, metabolic, and neurochemical adaptations that prevent weight loss and promote weight regain. However, behavior interventions lead to important health benefits beyond weight loss and are therefore an integral part of obesity management. This review discusses how a better understanding of the pathophysiology of obesity can influence weight loss strategies through behavioral modification. The complex factors contributing to the development of obesity require a multimodal long-term approach that is based on behavior interventions but may also include pharmacological or surgical approaches. The treatment paradigm has recently shifted from simple weight loss strategies towards treating obesity as a multisystem disease.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"233-239"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301919","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":"[Diagnosis and treatment of heart failure with reduced ejection fraction].","authors":"Samira Soltani, Johann Bauersachs","doi":"10.1007/s00059-025-05324-y","DOIUrl":"10.1007/s00059-025-05324-y","url":null,"abstract":"<p><p>The diagnosis of heart failure with reduced ejection fraction (HFrEF) is based on clinical symptoms, such as peripheral edema or dyspnea and a left ventricular ejection fraction (LVEF) of 40% or less. Treatment is based particularly on the \"fantastic four\" of renin-angiotensin-aldosterone system (RAAS) inhibitors, preferential angiotensin receptor neprilysin inhibitor (ARNI), beta-blockers, mineralocorticoid receptor antagonists (MRA) and sodium-glucose-linked transporter 2 (SGLT2) inhibitors. These agents have a class I recommendation and show significant benefits in terms of mortality and hospitalization rates. The rapid and complete implementation of the pharmacotherapy substantially improves the prognosis. Additional options, such as ivabradine, vericiguat or digoxin, can be considered if the standard treatment is insufficient. Iron deficiency frequently occurs in HFrEF patients and is associated with increased mortality. Intravenous iron supplementation improves the exercise capacity and reduces hospitalizations.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"297-304"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540034","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 zu: Warum brauchen wir Cardiac-Arrest-Zentren?","authors":"K H Scholz, B W Böttiger","doi":"10.1007/s00059-019-4804-9","DOIUrl":"10.1007/s00059-019-4804-9","url":null,"abstract":"","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"296"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37322852","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":"Mechanism of action of aloperine in the treatment of pulmonary arterial hypertension based on network pharmacology and molecular docking methods.","authors":"Yanrong Wang, Baolan Yan, Pengsheng Ma, Ru Zhou, Fang Zhao","doi":"10.1007/s00059-025-05295-0","DOIUrl":"10.1007/s00059-025-05295-0","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary arterial hypertension is a severe pulmonary vascular disease, marked by high mortality and substantial treatment costs, underscoring the urgent need for the exploration of traditional Chinese medicine as a potential therapeutic strategy for pulmonary hypertension. This study aimed to investigate the underlying mechanisms of aloperine in treating PAH through network pharmacology and molecular docking approaches.</p><p><strong>Methods: </strong>The Swiss Target Prediction database was employed to predict molecular targets of aloperine, while Cytoscape was used to construct the \"active component-target\" network. Disease-associated targets were identified through the GeneCards and OMIM databases and cross-referenced with drug targets to determine effective targets of aloperine for PAH treatment. Analysis of protein-protein interaction (PPI) was conducted using the STRING database. Furthermore, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were carried out via the Metascape platform.</p><p><strong>Results: </strong>Following screening, 42 molecular targets of aloperine, 1264 disease-related targets, and 23 effective targets of aloperine in treating PAH were identified. The PPI analysis revealed that aloperine targets SLC6A2, ADRA1B, CYP2D6, CCR5, and JAK2, all of which play a therapeutic role in PAH. The GO and KEGG pathway analyses identified relevant biological functions, such as membrane raft organization, G protein-coupled amine receptor activity, and regulation of tube diameter, as well as ten pathways including neuroactive ligand-receptor interaction, the cGMP-PKG signaling pathway, calcium signaling, and vascular smooth muscle contraction. Molecular docking results confirmed the interaction between aloperine and its key targets, with a high docking affinity observed between aloperine and the core target ADRA1A.</p><p><strong>Conclusion: </strong>Network pharmacology analysis demonstrated that aloperine exerts its therapeutic effects in PAH primarily through multi-target and multi-pathway mechanisms, providing a novel direction and foundation for PAH treatment.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"287-294"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585285","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":"Obesity and heart failure-the role of GLP-1 receptor agonists.","authors":"Gregor Simonis, Ulrike Schatz","doi":"10.1007/s00059-025-05312-2","DOIUrl":"10.1007/s00059-025-05312-2","url":null,"abstract":"<p><p>Patients with obesity-driven heart failure with preserved ejection fraction (HFpEF) often suffer from symptoms despite guideline-recommended treatment with diuretics, sodium glucose cotransporter 2 (SGLT2) inhibition, and mineralocorticoid antagonists. Obesity by itself drives heart failure via multiple pathophysiological mechanisms. This review summarizes current data on glucagon-like peptide‑1 (GLP-1) receptor agonists and the dual GIP/GLP‑1 agonist tirzepatide, including symptoms and outcomes in patients with obesity-driven HFpEF with or without diabetes.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"246-252"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763893","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 risk reduction in patients with diabetes mellitus and/or chronic kidney disease-an update.","authors":"Katharina Marx-Schütt","doi":"10.1007/s00059-025-05322-0","DOIUrl":"10.1007/s00059-025-05322-0","url":null,"abstract":"<p><p>People with diabetes mellitus have a significantly increased risk of developing cardiovascular disease as well as chronic kidney disease. The coexistence of these comorbidities has a significant impact on prognosis. In August 2023, the European Society of Cardiology published new guidelines that include specific recommendations for risk reduction in those affected. The key points of these guidelines, as well as recently published data and their respective practical relevance, are presented in this article.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"229-232"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301971","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":"Outcomes of electronic health interventions for patients with heart failure: a network meta-analysis.","authors":"Jiamin Tang, Danni Ma, Meng Li, Yiqi Ding, Xuemei Zhou, Hong He","doi":"10.1007/s00059-025-05301-5","DOIUrl":"10.1007/s00059-025-05301-5","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was to compare the effectiveness of different types of tele-interventions in improving exercise capacity and cardiac function in patients with heart failure.</p><p><strong>Methods: </strong>We searched five databases from inception to September 2024 for randomized controlled trials (RCTs) of telerehabilitation in people with heart failure. The primary outcomes were 6‑min walk distance (6MWD) and left ventricular ejection fraction (LVEF). The secondary outcome was patient adherence to rehabilitation. We used Review Manager (RevMan) 5.4 and Stata 16.0 for the analyses.</p><p><strong>Results: </strong>Overall, 17 studies with a total of four telerehabilitation interventions were included in the final analysis. Network meta-analysis showed that remote monitoring (mean difference [MD] = 29.03 [7.94, 50.13]) and combined interventions (MD = 28.86 [4.85, 53.86]) were more effective than usual rehabilitation in improving 6MWD. Remote monitoring (MD = 2.45 [0.14, 4.76]) was superior to usual rehabilitation in improving LVEF. The surface under the cumulative ranking curve (SUCRA) results showed that remote monitoring is the most effective way to improve the 6MWD (SUCRA = 71.7%) and LVEF (SUCRA = 76.3%) in patients with heart failure.</p><p><strong>Conclusion: </strong>The results of this study indicate that remote cardiac rehabilitation is effective in improving heart function and enhancing exercise capacity in patients with heart failure. Based on our data and the accessibility of remote rehabilitation equipment, telemedicine may be a useful and significant way to increase patient participation in cardiac rehabilitation.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"268-276"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965315","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":"Outcome of edge-to-edge vs. surgical repair in patients with functional mitral regurgitation and reduced left ventricular function.","authors":"Daniel Silva, Peter Wohlmuth, Friedrich-C Rieß, Joachim Schofer","doi":"10.1007/s00059-025-05294-1","DOIUrl":"10.1007/s00059-025-05294-1","url":null,"abstract":"<p><strong>Background: </strong>This study aims to compare the midterm outcome of percutaneous edge-to-edge repair (TEER) using the first-generation MitraClip system (Abbott Vascular, Santa Clara, CA) with surgical repair, in patients with severe functional mitral regurgitation (fMR) and reduced left ventricular function (LVEF).</p><p><strong>Methods: </strong>The data of consecutive patients with severe fMR and LVEF ≤ 45%, who underwent either isolated surgical repair or MitraClip implantation between January 2007 and December 2015, were retrospectively analyzed. Clinical and echocardiographic follow-up data after 12 and 24 months were obtained in both groups. A propensity score matching analysis was performed to adjust for intergroup differences in baseline characteristics.</p><p><strong>Results: </strong>A total of 167 patients with significant fMR and LVEF ≤ 45% were identified, who underwent either isolated surgical mitral valve repair (n = 83, 49.7%) or MitraClip (n = 84, 50.3%) implantation. Because the two groups had very different risk profiles, propensity scores were calculated for age, sex, EuroSCORE, LVEF, and coronary artery disease, which reduced the number of patients to 74 (38 in the clip group and 36 in the surgical group). There was no significant difference between the two groups in terms of survival, number of reinterventions, heart failure symptoms according to New York Heart Association (NYHA) class, degree of mitral regurgitation, and LVEF.</p><p><strong>Conclusion: </strong>In this retrospective analysis of patients with severe fMR and LVEF ≤ 45%, the comparison between surgical repair, edge-to-edge repair and a first-generation MitraClip device showed similar midterm outcomes in terms of survival, number of reinterventions, NYHA class, degree of mitral regurgitation, and LVEF.</p>","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"207-216"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467819","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}