Valérie C E Drost, Maaike Wösten, Luuk C Otterspoor, Kevin Damman, Laurens F Tops, Monica Gianoli, Michiel Kuijpers, Meindert Palmen, Jelena Sjatskig, Aria P Yazdanbakhsh, Kadir Caliskan, Linda W Van Laake
{"title":"Left ventricular assist device utilization across the different regions of the Netherlands.","authors":"Valérie C E Drost, Maaike Wösten, Luuk C Otterspoor, Kevin Damman, Laurens F Tops, Monica Gianoli, Michiel Kuijpers, Meindert Palmen, Jelena Sjatskig, Aria P Yazdanbakhsh, Kadir Caliskan, Linda W Van Laake","doi":"10.1007/s12471-026-02019-9","DOIUrl":"10.1007/s12471-026-02019-9","url":null,"abstract":"<p><strong>Introduction: </strong>The accessibility of left ventricular assist device (LVAD) therapy is a crucial factor in the survival and quality of life of patients suffering from advanced heart failure. However, there is a lack of clarity regarding the utilization of this therapy across regions in the Netherlands as well as whether any disparities exist based on socioeconomic status (SES). This study aimed to determine the utilization of LVAD therapy at a regional level using administrative data and to identify potential disparities based on SES by comparing postal code data to demographic governmental data.</p><p><strong>Methods: </strong>All patients aged 16 or older who underwent a primary LVAD implantation between 2015 and 2024 were included. The data was visualized with a heatmap using Python.</p><p><strong>Results: </strong>A total of 710 patients received an LVAD during the study period. LVAD utilization was lower in the southernmost regions compared to the northernmost regions and varied in the central regions. An ANOVA test between SES groups did not show significant differences in LVAD utilization (p = 0.20).</p><p><strong>Conclusion: </strong>The findings of this study indicate that there are notable variations in the utilization of LVAD therapy across different geographical regions in the Netherlands. Nevertheless, no differences in LVAD use were found between areas with different SES categories. Future research should focus on identifying the underlying factors associated with referral for advanced heart failure therapies to ensure equitable access to LVAD therapy.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"100-106"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157796","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}
Ricardo Carvalheiro, Miguel Marques Antunes, Vera Vaz Ferreira, Ana Leal, Fernanda Gameiro, Isabel Cardoso, José Viegas, Tânia Mano, Pedro Rio, Sílvia Aguiar Rosa, Ana Teresa Timóteo, Ana Isabel Galrinho, Rui Cruz Ferreira
{"title":"Left atrial reservoir strain by speckle-tracking echocardiography predicts prognosis in secondary mitral valve insufficiency.","authors":"Ricardo Carvalheiro, Miguel Marques Antunes, Vera Vaz Ferreira, Ana Leal, Fernanda Gameiro, Isabel Cardoso, José Viegas, Tânia Mano, Pedro Rio, Sílvia Aguiar Rosa, Ana Teresa Timóteo, Ana Isabel Galrinho, Rui Cruz Ferreira","doi":"10.1007/s12471-026-02022-0","DOIUrl":"10.1007/s12471-026-02022-0","url":null,"abstract":"<p><strong>Background: </strong>Functional mitral regurgitation (FMR) contributes significantly to morbidity and mortality and may result from left ventricular (VFMR) or atrial (AFMR) remodelling. Left atrial reservoir strain (LASR) is a sensitive marker of atrial dysfunction and may offer incremental prognostic value. This study evaluated whether LASR predicts all-cause mortality and heart failure (HF) hospitalizations in FMR, its performance in VFMR versus AFMR, and its utility over standard echocardiographic parameters.</p><p><strong>Methods: </strong>We retrospectively analyzed 102 patients (mean age 68 ± 14 years, 41.2% female) with at least moderate FMR who underwent transesophageal echocardiography between 2018 and 2023. Patients were categorized into VFMR (LV dysfunction or remodelling) and AFMR (LA enlargement with preserved LV function). LASR was assessed using speckle-tracking echocardiography. Primary and secondary endpoints were all-cause mortality and HF hospitalization, respectively. Cox models evaluated associations with outcomes, including subgroup analysis by LASR quartiles and additional risk stratification combining LASR with peak tricuspid regurgitation (TR) velocity.</p><p><strong>Results: </strong>LASR was independently associated with all-cause mortality in multivariate Cox regression (adjusted HR = 0.887, p = 0.039). Higher LASR quartiles were associated with improved survival (p = 0.013). When combined with peak TR velocity in a composite risk model, patients with LASR ≤ 9.0% or TR velocity > 3.0 m/s had significantly higher risks of mortality (HR = 2.853, p = 0.012) and HF hospitalization (HR = 3.922, p = 0.029).</p><p><strong>Conclusions: </strong>LASR, particularly when combined with TR velocity, provides strong prognostic value in FMR, supporting its potential role in refining risk assessment.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"117-123"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146106233","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}
Federico Tancredi Magni, Michelle Samuel, Bart A Mulder, Michelle van der Stoel, Rutger J Hassink, Serge A Trines, Michiel J B Kemme, Jippe C Balt, Pepijn H van der Voort, Justin G L M Luermans, Jonas S S G de Jong, Yuri Blaauw
{"title":"Repeat ablation strategies in atrial fibrillation patients with durably isolated pulmonary veins: insights from the Netherlands Heart Registration.","authors":"Federico Tancredi Magni, Michelle Samuel, Bart A Mulder, Michelle van der Stoel, Rutger J Hassink, Serge A Trines, Michiel J B Kemme, Jippe C Balt, Pepijn H van der Voort, Justin G L M Luermans, Jonas S S G de Jong, Yuri Blaauw","doi":"10.1007/s12471-026-02021-1","DOIUrl":"10.1007/s12471-026-02021-1","url":null,"abstract":"<p><strong>Background and aims: </strong>In 15-40% of patients undergoing repeat ablation for AF recurrence, all pulmonary veins (PVs) are durably isolated. Currently, there is limited evidence on the appropriate treatment strategy for these patients. We aimed to characterize and compare the effectiveness of different re-ablation strategies.</p><p><strong>Methods: </strong>All patients referred for repeat AF ablation with all PVs durably isolated at 8 hospitals in the Netherlands were included [Netherlands-Heart-Registration (NHR); 2016-2019]. NHR data were were used to determine the presence of PV-reconnection, the ablation strategy used, and the outcome of ablation (atrial arrhythmia recurrence > 30 sec.). The effectiveness of ablation strategies was assessed with multivariable Cox models.</p><p><strong>Results: </strong>Of 2311 repeat AF ablations performed, 274 (11.9%) patients had all PVs durably isolated. Median age was 66 (IQR:58-70) years, 44.2% women, 45.6% had persistent/long-standing-persistent AF. In 33 (12.0%) patients, no ablation was performed. A single ablation strategy was performed most often (41.2%). Posterior wall ablation (58.4%) was performed most often, followed by PV-antralization (26.3%). Over 2.0 (1.0-3.3) years, 147 (59.8%) patients had an atrial arrhythmia recurrence, and 30 (12.7%) patients had another repeat AF ablation within 1 year. After multivariable adjustment, no difference in atrial-arrhythmia recurrences was detected between individual ablation strategies, number of strategies performed, and type of atrial-arrhythmia (p > 0.05 for all). Left-atrial-volume-index was associated with a higher recurrence-risk [aHR 1.03(95%CI 1.01-1.05)].</p><p><strong>Conclusion: </strong>In patients with durably isolated PVs, a high proportion experienced recurrence of atrial arrhythmias, with no difference in recurrence rates between different re-ablation strategies.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"107-116"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157815","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}
Rita Almeida Carvalho, Débora Sá, Pedro Magro, Marisa Trabulo, Miguel Mendes, Regina Ribeiras
{"title":"Understanding an aorto-atrial fistula in a patient with heart failure.","authors":"Rita Almeida Carvalho, Débora Sá, Pedro Magro, Marisa Trabulo, Miguel Mendes, Regina Ribeiras","doi":"10.1007/s12471-026-02023-z","DOIUrl":"10.1007/s12471-026-02023-z","url":null,"abstract":"","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"125-126"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146106322","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":"Making variation visible.","authors":"Pim van der Harst","doi":"10.1007/s12471-026-02027-9","DOIUrl":"10.1007/s12471-026-02027-9","url":null,"abstract":"","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"89"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202235","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}
Sulayman El Mathari, Einar A Hart, Rosemarijn Jansen, Annemieke Wind, Jeroen Schaap, Maarten J Cramer, Michiel L Bots, Sebastian A F Streukens, Lodewijk Wagenaar, S Matthijs Boekholdt, Mohamed Bentala, Jolanda Kluin, Steven A J Chamuleau
{"title":"Early mitral valve repair surgery versus active surveillance in asymptomatic severe primary mitral regurgitation-insights from the Dutch AMR registry.","authors":"Sulayman El Mathari, Einar A Hart, Rosemarijn Jansen, Annemieke Wind, Jeroen Schaap, Maarten J Cramer, Michiel L Bots, Sebastian A F Streukens, Lodewijk Wagenaar, S Matthijs Boekholdt, Mohamed Bentala, Jolanda Kluin, Steven A J Chamuleau","doi":"10.1007/s12471-025-02015-5","DOIUrl":"10.1007/s12471-025-02015-5","url":null,"abstract":"<p><strong>Background: </strong>Management of asymptomatic severe mitral regurgitation (MR) is challenging. Both early mitral valve repair surgery and active surveillance with facilitated surgery are possible strategies. The DutchAMR registry compares clinical outcomes between these two strategies.</p><p><strong>Methods: </strong>Patients were included between 2013-2019. Primary endpoints were cerebrovascular accidents (CVA), reoperations, and mortality. Facilitated surgery was defined as mitral valve repair surgery performed after developing a surgical indication during active surveillance.</p><p><strong>Results: </strong>Ninety-nine patients were enrolled; 71 in active surveillance and 28 in early surgery. Over a median follow-up time of 5.1 years, 51% of active surveillance patients underwent facilitated surgery due to ESC guideline triggers. Both the early and facilitated surgery groups had one perioperative CVA. During follow-up, in the active surveillance group, 5 (7%) patients died (3 without surgery and 2 after facilitated surgery), and 3 (4%) underwent reoperations. In the early surgery group, 4 (14%) patients reached a primary endpoint, including 2 (7%) CVAs (without residual symptoms) and 2 (7%) deaths. No reoperations occurred in the early surgery group. Baseline additional testing parameters based on CPET, Holter monitoring, and CMR showed no differences between the groups.</p><p><strong>Conclusions: </strong>After 5.1 years, half of the active surveillance patients required facilitated surgery, with comparable postoperative outcomes to early surgery. Clinical endpoints were comparable between the early and facilitated surgery strategies. There were no differences in baseline additional testing parameters, suggesting no clear targets for upfront stratificatio. Thus, shared decision making weighing the different risks can be used to determine the strategy per patient.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"90-99"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143019","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}
Augustijn Mortelé, Jan Van der Heyden, Sander Trenson
{"title":"A curious coronary-pulmonary communication: What lies beneath?","authors":"Augustijn Mortelé, Jan Van der Heyden, Sander Trenson","doi":"10.1007/s12471-026-02029-7","DOIUrl":"https://doi.org/10.1007/s12471-026-02029-7","url":null,"abstract":"","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258916","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}
Augustijn Mortelé, Jan Van der Heyden, Sander Trenson
{"title":"A curious coronary pulmonary communication: What lies beneath?","authors":"Augustijn Mortelé, Jan Van der Heyden, Sander Trenson","doi":"10.1007/s12471-026-02030-0","DOIUrl":"https://doi.org/10.1007/s12471-026-02030-0","url":null,"abstract":"","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258975","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}
Lukas Peeters, Mick Hoen, Delian Hofman, Bjorn Hompes, Bart Langenveld, Danae Smeets, Timo Lenderink, Hans Peter Brunner-La Rocca, Sandra Sanders-van Wijk
{"title":"PRACTICE-HF: Implementation of an updated clinical protocol for acute heart failure.","authors":"Lukas Peeters, Mick Hoen, Delian Hofman, Bjorn Hompes, Bart Langenveld, Danae Smeets, Timo Lenderink, Hans Peter Brunner-La Rocca, Sandra Sanders-van Wijk","doi":"10.1007/s12471-025-02004-8","DOIUrl":"10.1007/s12471-025-02004-8","url":null,"abstract":"<p><strong>Background: </strong>Despite recent advances in the treatment of acute heart failure (AHF), implementation of new evidence into clinical practice remains challenging.</p><p><strong>Methods: </strong>We conducted a single-center descriptive exploratory study within an ongoing prospective AHF registry. Adult patients admitted with AHF, without requiring intensive care, were included consecutively. An updated local AHF protocol was developed and implemented by group-education sessions, pocket cards, and posters. Patients before (control group) and after (intervention group) implementation of the new protocol were compared in terms of compliance to the protocol and 90-day outcomes-blanking the implementation period. Subgroups entailed HF with (mildly) reduced and preserved ejection fraction.</p><p><strong>Results: </strong>Patients were elderly, with almost half being de novo HF patients. Groups were comparable except for higher NT-proBNP in the implementation group and a higher cancer prevalence in the control group. The intervention group showed an increase in in-hospital use of acetazolamide (59.8 vs 0%, p < 0.001), in iron deficiency testing and correct iv. iron administration (42.9% vs 78.6% p ≤ 0.001). Pre-discharge installation of SGLT2 inhibitors showed a positive trend (44.2 vs 20% in HF(m)rEF patients and 29.4 vs 4% in HFpEF, both p = 0.01) HF-event-free survival at 90 days numerically favored the intervention group (29.9 vs 44.3%, p = 0.054), whereas length of hospital stay increased by 1 day (p = 0.011).</p><p><strong>Conclusion: </strong>Implementing a local updated AHF protocol improved adoption of several evidence based AHF interventions. This may translate into improved patient outcomes, against a minor increase in hospital duration.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"46-53"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12852520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900526","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}