Eva C I Woelders, Denise A M Peeters, Sanne Janssen, Jasper J P Luijkx, Patty J C Winkler, Peter Damman, Wouter S Remkes, Arnoud W J van 't Hof, Robert Jan M van Geuns
{"title":"Design and rationale of the South-East Netherlands Heart Registry (ZON-HR).","authors":"Eva C I Woelders, Denise A M Peeters, Sanne Janssen, Jasper J P Luijkx, Patty J C Winkler, Peter Damman, Wouter S Remkes, Arnoud W J van 't Hof, Robert Jan M van Geuns","doi":"10.1007/s12471-025-01934-7","DOIUrl":"10.1007/s12471-025-01934-7","url":null,"abstract":"<p><strong>Introduction: </strong>In patients undergoing percutaneous coronary intervention (PCI), personalised medicine is key to the secondary prevention of ischaemic and bleeding events. To provide an extensive overview of the quality of secondary prevention and of personalised medicine, a consortium in the southeastern region of the Netherlands has created a PCI registry: the South-East Netherlands Heart Registry (Zuid-Oost Nederland Hart Registratie, ZON-HR).</p><p><strong>Aim: </strong>To visualise and improve personalised secondary prevention post-PCI, focussing on key elements such as antiplatelet treatment, cholesterol management and comorbidities such as diabetes mellitus.</p><p><strong>Design and population: </strong>A prospective multicentre registry of all consecutive patients undergoing PCI at 4 participating PCI centres and 3 referral centres.</p><p><strong>Treatment: </strong>Interventional procedures and concomitant pharmaceutical treatment are performed in accordance with the guidelines. The ZON-HR promotes risk stratification after PCI using a simplified protocol for a personalised antiplatelet strategy.</p><p><strong>Data collection and quality: </strong>Demographics, laboratory values, baseline procedural characteristics and pharmaceutical treatment data are collected. Outcomes include thromboembolic and bleeding complications and medication changes. Data are pseudonymised, and a clinical event committee will review 20% of the adverse events (randomly selected).</p><p><strong>Strengths and weaknesses: </strong>This registry represents the entire PCI population and visualises gaps in secondary prevention. Weaknesses are the collection of outcomes and medication changes using mostly patient-reported outcomes.</p><p><strong>Conclusion: </strong>The ZON-HR is a comprehensive PCI registry that provides baseline and follow-up data of a large PCI cohort in the southeastern region of the Netherlands. The ZON-HR aims to improve secondary prevention after PCI and augment personalised treatment that focusses on key elements of secondary prevention.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"76-84"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365261","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}
Sander van der Brug, Tinka van Trier, Aaram Omar Khader, An-Ho Liem, Astrid Schut, Fabrice Martens, Marco Alings
{"title":"PENELOPE 1-year follow-up: legacy effect of a short protocol-led LDL-C-lowering strategy in patients after myocardial infarction.","authors":"Sander van der Brug, Tinka van Trier, Aaram Omar Khader, An-Ho Liem, Astrid Schut, Fabrice Martens, Marco Alings","doi":"10.1007/s12471-025-01939-2","DOIUrl":"https://doi.org/10.1007/s12471-025-01939-2","url":null,"abstract":"<p><strong>Objective: </strong>Lowering low-density lipoprotein cholesterol (LDL-C) reduces the risk of developing atherosclerotic cardiovascular disease (ASCVD). In the PENELOPE study, a guideline-based, protocol-led LDL-C-lowering strategy was applied in patients after myocardial infarction and resulted in 87% reaching target LDL‑C levels of ≤ 1.8 mmol/l within a median of 45 days. This study evaluated PENELOPE's legacy effect on LDL‑C levels after 1 year.</p><p><strong>Methods: </strong>In the PENELOPE study, 999 patients with a myocardial infarction and a history of ASCVD and/or diabetes mellitus were included. If LDL-C > 1.8 mmol/l, lipid-lowering therapy was intensified in three consecutive steps: (1) high-intensity statin (HIST) monotherapy, (2) HIST + ezetimibe, and (3) HIST + ezetimibe + proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i). LDL‑C levels were monitored 4-6 weeks after each step. The primary objective of this study was to assess the prevalence of the LDL‑C target level of ≤ 1.8 mmol/l being maintained after 1 year.</p><p><strong>Results: </strong>Data of 738 patients (74%) were available for 1‑year follow-up. The target LDL‑C level was met in 471 patients (64%). Median LDL‑C levels changed from 1.5 (1.2-1.7) mmol/l immediately after implementation of the protocol-led strategy to 1.6 (1.3-2.0) mmol/l after 1 year. Major treatment regimens were statin (58%), statin + ezetimibe (30%) and PCSK9i + ezetimibe (+ statin) (7%).</p><p><strong>Conclusion: </strong>After a myocardial infarction, implementation of a protocol-led LDL-C-lowering strategy resulted in 87% of patients attaining the LDL‑C target level of ≤ 1.8 mmol/l within a median of 45 (32-77) days. At 1‑year follow-up, 64% maintained this target level and the median LDL‑C increased by 0.1 mmol/l.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492781","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":"Noonan syndrome and parasternal pericardiocentesis.","authors":"Pitt O Lim, May H Ohn","doi":"10.1007/s12471-025-01931-w","DOIUrl":"https://doi.org/10.1007/s12471-025-01931-w","url":null,"abstract":"","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458690","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":"Tailoring evidence to clinical practice.","authors":"Pim van der Harst","doi":"10.1007/s12471-025-01928-5","DOIUrl":"10.1007/s12471-025-01928-5","url":null,"abstract":"","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"37"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008729","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}
Alexander H Maass, Anton Tuinenburg, Gideon Mairuhu, Miriam C Faes, Theo J Klinkenberg, Sanne Ruigrok, Marjolein Koster, Bernardine H Stegeman, Justin G L M Luermans
{"title":"2021 European Society of Cardiology guidelines on cardiac pacing and cardiac resynchronisation therapy : Statement of endorsement by the NVVC.","authors":"Alexander H Maass, Anton Tuinenburg, Gideon Mairuhu, Miriam C Faes, Theo J Klinkenberg, Sanne Ruigrok, Marjolein Koster, Bernardine H Stegeman, Justin G L M Luermans","doi":"10.1007/s12471-024-01927-y","DOIUrl":"10.1007/s12471-024-01927-y","url":null,"abstract":"<p><p>The European Society of Cardiology (ESC) has updated its guidelines on cardiac pacing and cardiac resynchronisation. As the majority are class II recommendations (61%) and based on expert opinion (59%), a critical appraisal for the Dutch situation was warranted. A working group has been established, consisting of specialists in cardiology, cardiothoracic surgery, geriatrics, allied professionals in cardiac pacing, and patient organisations with support from the Knowledge Institute of the Dutch Association of Medical Specialists. They assessed the evidence leading to the recommendations and the suitability for daily Dutch practice. Several recommendations have been amended or omitted altogether if a conflicting Dutch guideline has recently been published, such as a guideline on performing magnetic resonance imaging in patients with cardiac implantable electronic devices. The recent Dutch guideline on implantable cardioverter defibrillator implantation in patients with non-ischaemic cardiomyopathy has recommended implanting cardiac resynchronisation therapy devices without a defibrillator function. Shared decision making has received a more prominent role in the ESC guidelines and is discussed in more detail in this document. The recommendations given in this document are intended for health care professionals involved in the care of patients with an indication for cardiac pacing and are approved by the participating professional societies and the patient organisation Harteraad.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"38-45"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008724","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}
Isabelle P Thierry, Steven A Muller, Annette F Baas, Dennis Dooijes, R Laura E van Loon, Angela E Schoemaker, Pim van der Harst, Marish I F J Oerlemans, Hubert F Baars, Rutger J Hassink, Folkert W Asselbergs, J Peter van Tintelen, Anneline S J M Te Riele
{"title":"Yield of family screening for dilated cardiomyopathy: 10-year experience at a multidisciplinary cardiogenetic outpatient clinic.","authors":"Isabelle P Thierry, Steven A Muller, Annette F Baas, Dennis Dooijes, R Laura E van Loon, Angela E Schoemaker, Pim van der Harst, Marish I F J Oerlemans, Hubert F Baars, Rutger J Hassink, Folkert W Asselbergs, J Peter van Tintelen, Anneline S J M Te Riele","doi":"10.1007/s12471-024-01924-1","DOIUrl":"10.1007/s12471-024-01924-1","url":null,"abstract":"<p><strong>Introduction: </strong>Current family screening approaches in dilated cardiomyopathy (DCM) depend on the presence or absence of a familial genetic variant, in which variant pathogenicity (i.e. benign or pathogenic) classification drives screening recommendations. However, this approach has never been systematically evaluated.</p><p><strong>Methods: </strong>To describe the yield of DCM family screening stratified by variant classification in the Netherlands, we included 358 relatives (mean age ± standard deviation: 44.4 ± 15.9 years at baseline; 52% female; 41% (likely) pathogenic (LP/P) variant carriers from 210 families). Demographics, symptoms and genetic/cardiac test results were obtained. Endpoints were the development of DCM (left ventricular ejection fraction < 50% of non-ischaemic aetiology) or occurrence of major adverse cardiovascular events (MACE) (i.e. heart failure hospitalisation, ventricular arrhythmia or death). Probability of DCM or MACE was assessed with the Kaplan-Meier method.</p><p><strong>Results: </strong>DCM was present in 32 relatives (9%) (25/32 (78%) with LP/P variant) at baseline and in an additional 10/97 relatives (10%) (9/10 (90%) with LP/P variant) who were re-evaluated during a median follow-up time of 5.0 years (interquartile range: 3.2-7.4). Of the 128 relatives without the familial LP/P variant, none developed DCM. MACE was experienced by 5 relatives (1%) (4/5 (80%) with LP/P variant), all of whom had DCM at the time of the event.</p><p><strong>Conclusion: </strong>The yield of DCM family screening was ~10% at baseline and another ~10% during 5‑year follow-up. Relatives without the familial LP/P variant could be safely discharged. These results reinforce the use of a genetics-first screening approach in relatives from families with an LP/P variant. This will lower the burden on resources in Dutch hospitals and help allocate resources to those who are most likely to benefit.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"46-54"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008731","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}
Nikki van der Velde, Anne Poleij, Mattie J Lenzen, Ricardo P J Budde, Tessa Brabander, Jelle R Miedema, Arend F L Schinkel, Michelle Michels, Alexander Hirsch
{"title":"Screening for cardiac sarcoidosis: diagnostic approach and long-term follow-up in a tertiary centre.","authors":"Nikki van der Velde, Anne Poleij, Mattie J Lenzen, Ricardo P J Budde, Tessa Brabander, Jelle R Miedema, Arend F L Schinkel, Michelle Michels, Alexander Hirsch","doi":"10.1007/s12471-024-01925-0","DOIUrl":"10.1007/s12471-024-01925-0","url":null,"abstract":"<p><strong>Background: </strong>Cardiac sarcoidosis (CS) is associated with poor prognosis, making early diagnosis and treatment important. This study evaluated the results of a diagnostic approach in patients with known sarcoidosis and suspected cardiac involvement in a tertiary centre and their long-term outcomes.</p><p><strong>Methods: </strong>We included 180 patients with sarcoidosis and a clinical suspicion of CS. In addition to an electrocardiogram (ECG)/transthoracic echocardiogram (TTE), cardiovascular magnetic resonance imaging (CMR) and positron emission tomography (PET) were performed in 66% and 37% of the patients, respectively. The diagnosis of CS was based on the Heart Rhythm Society criteria. Follow-up was performed, and a composite endpoint of sustained ventricular tachycardia, ventricular fibrillation, aborted sudden cardiac death, heart failure hospitalisation, heart transplantation or cardiac death was used for the survival analysis.</p><p><strong>Results: </strong>Symptoms were present in 87% of the patients, and ECG/TTE abnormalities were found in 92/180 patients (51%). Using CMR and/or PET, 31/92 patients (34%) were diagnosed with CS. In 15 patients, an alternative diagnosis was found. CS was diagnosed in 11/88 patients (13%) without ECG/TTE abnormalities. During a median follow-up time of 4.4 years (interquartile range: 2.3-6.8), 11 composite endpoints occurred, more frequently in CS patients than in sarcoidosis patients without cardiac involvement (p < 0.001). Patients with ECG/TTE abnormalities at baseline had worse outcomes than those without abnormalities (p = 0.019).</p><p><strong>Conclusion: </strong>CS was diagnosed in 23% of the referred sarcoidosis patients. ECG/TTE were of limited diagnostic value for screening for CS but seemed to have important prognostic value as patients with normal ECG/TTE results who did meet the diagnostic CS criteria had a very good prognosis. CMR/PET provided a good diagnostic yield and identified other cardiac diseases.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"55-64"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142951733","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":"In sync or out of sync?","authors":"Benoît Delforge, Lukas Spruyt, Becker S N Alzand","doi":"10.1007/s12471-024-01918-z","DOIUrl":"10.1007/s12471-024-01918-z","url":null,"abstract":"","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"65-66"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882300","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}