Netherlands Heart Journal最新文献

{"title":"A comprehensive analysis of female participation in cardiovascular trials involving the WCN investigator network.","authors":"Marte F van der Bijl, Jeanine E Roeters van Lennep, Astrid Schut, Iris C D Westendorp, Yolande Appelman, Hester M den Ruijter, Eric Boersma","doi":"10.1007/s12471-025-01999-4","DOIUrl":"10.1007/s12471-025-01999-4","url":null,"abstract":"<p><strong>Background: </strong>Prior studies showed underrepresentation of females in cardiovascular disease (CVD) clinical trials, potentially hindering accurate treatment effect estimates. We assessed the female contribution to treatment effect estimates in selected CVD trials and explored sex differences in efficacy outcomes.</p><p><strong>Methods: </strong>We analyzed completed (1997-2024) randomized controlled CVD trials performed via the Dutch WCN Investigator Network. Female participation was quantified using the Participation to Prevalence (in the population) Ratio (PPR_F). In trials with a cardiovascular event as the primary efficacy endpoint, a meta-analysis was conducted to evaluate differences in treatment effect on the study-specific primary endpoint between females and males using a random-effects model.</p><p><strong>Results: </strong>In 115 trials investigating various treatments across different cardiovascular domains (801 k participants, 29.1% females), the median PPR_F was 0.75 (interquartile range: 0.64-0.83), while 58% of trials had a PPR_F below 0.8 (underrepresentation). Based on 46 trials, female contribution to primary endpoints was lower than their sample size contribution (mean 26.2% versus 28.5%). Similarly, based on 66 trials, female contribution to sex-stratified efficacy estimates was lower than their sample size contribution (27.4% versus 29.2%). Regarding the primary endpoint, the relative treatment effect was similar in females and males: pooled difference of the relative effect measure on the natural log scale of -0.02, 95% CI -0.05 to 0.01, p = 0.23, I² = 11%.</p><p><strong>Conclusion: </strong>Despite underrepresentation, female participation in the selected WCN-CVD trials was sufficient to exclude major sex differences in efficacy. Given the limited and heterogeneous trial sample, further disease-specific studies are needed, and greater female inclusion remains essential for equity and safety insights.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"404-411"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12638513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496162","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":"Sex-specific performance of clinical diagnostic algorithms for HFpEF across two independent cohorts.","authors":"Xinyu Li, Anouk Achten, Soufiane Nassiri, Sanne Mourmans, Arno A van de Bovenkamp, Christian Knackstedt, M Louis Handoko, Jerremy Weerts, Vanessa van Empel","doi":"10.1007/s12471-025-02000-y","DOIUrl":"10.1007/s12471-025-02000-y","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing heart failure with preserved ejection fraction (HFpEF) remains challenging. While diagnostic algorithms support clinical evaluation, their performance across sexes is understudied, despite HFpEF being more prevalent in females, which may result in sex-specific underdiagnosis.</p><p><strong>Purpose: </strong>To assess the diagnostic accuracy of three HFpEF algorithms-HFA-PEFF, H₂FPEF, and the ESC HF 2016 criteria-and to evaluate sex-related differences in performance.</p><p><strong>Methods: </strong>Two prospective cohorts with unexplained dyspnoea were analysed. The Amsterdam cohort (2014-2020; n = 135) had HFpEF confirmed or excluded via (exercise) right heart catheterization (RHC). The Maastricht cohort (2015-2021; n = 659) had HFpEF confirmed or excluded based on expert consensus with utilisation of HFpEF scores, and RHC when needed. Sex-specific diagnostic performance of three HFpEF algorithms was assessed using ROC curves, AUC, and a panel of metrics with cut-offs determined by the rule-in/rule-out strategies.</p><p><strong>Results: </strong>HFpEF prevalence was high in both cohorts (84.4% and 82.5%), with a female majority (69.6% and 66.5%). Across all algorithms, males consistently showed lower AUC values than females, although differences were not statistically significant. The highest diagnostic performance within the Amsterdam cohort was observed with H₂FPEF (AUC 0.86 and 0.82 for females and males), while HFA-PEFF performed best within Maastricht cohort (AUC 0.85 and 0.83, respectively). Performance for ruling-in and ruling-out HFpEF was numerically lower in males than females; Amsterdam cohort HFA-PEFF and ESC 2016 specificity were 83% versus 93% and 50% versus 73%, Maastricht cohort H₂FPEF specificity was 81% versus 89%.</p><p><strong>Conclusions: </strong>HFpEF diagnostic algorithms may perform better in females than males in referral outpatient settings. Inconsistent performance of diagnostic algorithms between different sexes warrants further optimisation to diagnose HFpEF.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"412-420"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12638578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145438647","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":"Bridging the Gap: Time to Integrate Sex- and Gender-Specific Insights into Research and Practice.","authors":"Lotte Paulis, Maryam Kavousi","doi":"10.1007/s12471-025-02002-w","DOIUrl":"10.1007/s12471-025-02002-w","url":null,"abstract":"","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"375-376"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12638611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145489214","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":"Gender disparities in coronary artery disease: a review of factors influencing clinical outcomes.","authors":"Arsalan Siddiqui, Randeep Gill, Marc Ringor, Jasmine K Dugal, Arpinder Malhi, Ala Abdallah, Dalia Hawwass, Nazanin Houshmand, Tahir Tak","doi":"10.1007/s12471-025-01996-7","DOIUrl":"10.1007/s12471-025-01996-7","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide, affecting both women and men. However, its evaluation and treatment have historically been influenced by gender, resulting in significant disparities for women.</p><p><strong>Objective: </strong>This review aims to comprehensively examine the literature on gender disparities in the care of patients with CAD.</p><p><strong>Results: </strong>Evidence highlights several key inequalities, including the relatively greater impact of shared risk factors in women, the presence of female-specific risk factors, differences in CAD symptom presentation, and reduced screening sensitivity and management quality in women compared with men.</p><p><strong>Conclusions: </strong>Addressing these disparities requires updated screening strategies that recognize the unique clinical manifestations of CAD in women, increasing awareness among both women and healthcare providers, greater inclusion of women in CAD research studies, revisiting the role of hormonal replacement therapy, and integrating emerging tools such as genetic research and artificial intelligence. These steps have the potential to improve the equity and effectiveness of CAD management across genders.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"377-384"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12638476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482512","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":"Spontaneous coronary artery dissection: dissecting an underdiagnosed problem.","authors":"Deborah N Kalkman, Arja S Vink, Marcel A M Beijk, Bert-Jan H van den Born, Jurriën M Ten Berg, Fatih Arslan, Yolande Appelman, Eric Wierda","doi":"10.1007/s12471-025-01992-x","DOIUrl":"10.1007/s12471-025-01992-x","url":null,"abstract":"<p><p>Spontaneous coronary artery dissection (SCAD) occurs in 1-4% of acute coronary syndromes (ACS). In SCAD, an intramural hematoma compresses the true lumen of the coronary artery, leading to ischemia and, even acute myocardial infarction.Approximately, 90% percent of SCAD patients are premenopausal women without classical risk factors for atherosclerosis. The gold standard for diagnosis is invasive coronary angiography and optical coherence tomography or intravascular ultrasound can be useful tools to confirm the diagnosis. Coronary intervention with stent placement is generally not recommended unless there is complete occlusion of the coronary artery with ongoing ischemia. In the acute phase, antiplatelet therapy and beta-blockers are advised, which are usually continued for life. Despite medical treatment, 10-20% of SCAD patients experience a recurrence within 4 years. Nearly two-thirds of SCAD patients have fibromuscular dysplasia (FMD) based on CT angiography. Current treatment recommendations are based on expert opinion. Therapy and follow-up are advised to include at least one antiplatelet agent, a beta-blocker, screening for FMD, cardiac rehabilitation and among patients with left ventricular systolic dysfunction ACE inhibitor or aldosterone receptor blocker. Randomized controlled trials have been initiated to evaluate the treatment effects of beta-blocker and antiplatelet therapy in SCAD patients.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"385-394"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12638533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145391514","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":"Radiofrequency ablation of supraventricular tachyarrhythmias in newborns and infants: why, when, and how?","authors":"Andreia Palma, Robin A Bertels, Marta de Riva, Katja Zeppenfeld, Nico A Blom","doi":"10.1007/s12471-025-01985-w","DOIUrl":"10.1007/s12471-025-01985-w","url":null,"abstract":"<p><p>Supraventricular tachyarrhythmias (SVTs) in newborns and infants (< 1 year) can usually be managed with antiarrhythmic drug therapy and often resolve spontaneously within the first year of life. However, some SVTs may be drug-refractory, leading to hemodynamic instability or tachycardia-induced cardiomyopathy, necessitating catheter ablation. Refinements in ablation techniques like electro-anatomical mapping and increased expertise have made catheter ablation an effective option for young children (< 5 years). Nonetheless, due to a lack of large-scale studies involving newborns and infants (< 1 year), concerns persist regarding the risk of major complications associated with ablation energy in small hearts. Potential risks include coronary artery lesions, valve damage, vessel injury, complications related to the transseptal puncture, and ablation lesion growth. In this review, we discuss the current literature on the indications, techniques, and outcomes of radiofrequency catheter ablation in newborns and infants, illustrated by recent cases.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"335-342"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075784","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":"Introducing nhj.nl-a website companion to the Netherlands Heart Journal.","authors":"Pim van der Harst","doi":"10.1007/s12471-025-01998-5","DOIUrl":"10.1007/s12471-025-01998-5","url":null,"abstract":"","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"331"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292929","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":"To shock or not to shock?","authors":"Mónica Dias, Bárbara Antunes Rocha, Sérgia Rocha, Rui Files Flores","doi":"10.1007/s12471-025-01982-z","DOIUrl":"10.1007/s12471-025-01982-z","url":null,"abstract":"","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"372-373"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144961948","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":"Cardiovascular disease and absenteeism in Dutch occupational health: a retrospective study in a regular working population.","authors":"Ivo M van Dongen, Jobst Winter, Bart Aben, Gilbert W M Wijntjens, Ronak Delewi, Jan Siebers, Robin N Kok, Frederieke G Schaafsma","doi":"10.1007/s12471-025-01989-6","DOIUrl":"10.1007/s12471-025-01989-6","url":null,"abstract":"<p><strong>Background: </strong>There is very limited data available on the impact of cardiovascular disease (CVD) on absenteeism occurrence, absenteeism duration, and the associated rough cost-estimate for employers.</p><p><strong>Methods: </strong>We extracted routinely collected absenteeism data for the years 2019-2022 from a database maintained by two large, nationally operating occupational health services (n = 443,740). All diagnoses and included sickness cases were recorded > 6 weeks of absenteeism. Descriptive statistics, including median values (IQR) and percentages, were calculated and compared using the Mann-Whitney U test and Pearson chi-square test. Subgroup comparisons were performed using the Kruskal-Wallis test. To analyse return-to-work over time, a Kaplan-Meier curve was constructed, and differences in return-to-work were assessed using the Log Rank (Mantel-Cox) test.</p><p><strong>Results: </strong>CVD is the primary cause of absenteeism in 3.2% of all absenteeism cases. The median duration of absenteeism following CVD was 119 working days (IQR 156; Q1-Q3 62.9-218.6) with a minimum rough cost-estimate to employers of € 37,000 per employee. The most frequently occurring CVD diagnoses were: acute myocardial infarction, cerebrovascular disease, cardiac arrhythmia, unspecified cardiovascular complaints and angina.</p><p><strong>Conclusions: </strong>CVD occurs frequently, results in prolonged absenteeism, and incurs high costs for employers. We strongly believe that CVD-related absenteeism should receive greater attention. Specifically, both in-hospital and outpatient treatments should place a stronger emphasis on work-related issues, including strategies for returning to work with or without tailored assignments in the workplace. This focus will help ensure that employees can sustainably return to work and continue to contribute to society.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"343-353"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065358","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":"To shock or not to shock?","authors":"Mónica Dias, Bárbara Antunes Rocha, Sérgia Rocha, Rui Files Flores","doi":"10.1007/s12471-025-01981-0","DOIUrl":"10.1007/s12471-025-01981-0","url":null,"abstract":"","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"370"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144961982","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}