IJC Heart and Vasculature最新文献

{"title":"Incidence of cardiovascular risk factors and exercise phenotyping in cardiomyopathies: One size does not fit all","authors":"Simon Wernhart ,&nbsp;Florian Karcher ,&nbsp;Mark J Haykowsky ,&nbsp;Martin Halle","doi":"10.1016/j.ijcha.2025.101722","DOIUrl":"10.1016/j.ijcha.2025.101722","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease risk factors (CVDRF) are linked to increased morbidity in cardiomyopathies (CMP), but whether new onset CVDRF differ among CMPs is unknown. In addition, whether the acute exercise response during cardiopulmonary exercise testing (CPET) differs among CMPs remains unclear.</div></div><div><h3>Methods</h3><div>This single-center, retrospective study analyzed patients with arrhythmogenic, hypertrophic, and dilated (DCM) cardiomyopathy without CVDRF at baseline. Resting echocardiography and CPET were performed, and exercise response was assessed depending on sex and CMP. After a median follow-up of 19.5 months, CPET and echocardiography were analyzed in relation to the development of new CVDRF.</div></div><div><h3>Results</h3><div>A total of 104 CMPs were included (median age 53.0 years). New-onset CVDRF was rare (11.5 %) and driven by arterial hypertension (8.7 %) but did not differ among CMPs. DCM displayed significantly lower resting left ventricular ejection fraction (40.5 %, interquartile range, IQR, 11.5 %, p &lt; 0.001), diastolic function (E/e‘ 9.3, IQR 5.5, p &lt; 0.001), and had the lowest peak systolic blood pressure (170.0 mmHg, IQR 52.5 mmHg, p = 0.011), predicted peak oxygen consumption (82.0 %, IQR 39.8 %, p = 0.003), oxygen pulse (101.0 %, IQR 28.8 %, p = 0.030) as well as lower ventilatory (VP, 5.5 mmHg, IQR 1.4 mmHg, p = 0.033) and circulatory (CP, 4096.0 mL/kg/min x mmHg, IQR 2299.3 mL/kg/min x mmHg, p = 0.015) power compared to the other groups. Lower VP (5.0 mmHg, IQR 1.3 mmHg, p = 0.003) and CP (3660.0 mL/kg/min x mmHg, IQR 3298.0 mL/kg/min x mmHg, p = 0.004) were observed for females.</div></div><div><h3>Conclusions</h3><div>Arterial hypertension was the most common CVDRF among CMPs, underscoring the importance of monitoring this outcome. Exercise limitations differ between CMPs and should be interpreted depending on sex.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101722"},"PeriodicalIF":2.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144297937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of severe mitral annular calcification in aortic stenosis: implications for aortic valve replacement outcome","authors":"Valeria Pergola ,&nbsp;Dan-Alexandru Cozac ,&nbsp;Maria Teresa Savo ,&nbsp;Saima Mushtaq ,&nbsp;Raffaella Motta ,&nbsp;Roberto Pedrinelli ,&nbsp;Pasquale Perrone-Filardi ,&nbsp;Gianfranco Sinagra ,&nbsp;Morena De Amicis ,&nbsp;Maria Vittoria Chiaruttini ,&nbsp;Gabriele Cordoni ,&nbsp;Giulia Lorenzoni ,&nbsp;Giuseppe Tarantini ,&nbsp;Gino Gerosa ,&nbsp;Dario Gregori ,&nbsp;Giorgio De Conti ,&nbsp;Domenico Corrado ,&nbsp;Gianluca Pontone ,&nbsp;on behalf of the Italian Society of Cardiology SIC Working Group on Cardiac CT&Nuclear Cardiology","doi":"10.1016/j.ijcha.2025.101720","DOIUrl":"10.1016/j.ijcha.2025.101720","url":null,"abstract":"<div><h3>Background</h3><div>Mitral annulus calcification (MAC) is no longer seen as merely age-related. Recent evidence links MAC to calcific aortic stenosis (AS), but its prognostic value in AS patients undergoing aortic valve replacement (AVR) remains unclear. This study aims to assess the impact of cardiac CT-derived MAC on cardiovascular outcomes in this population.</div></div><div><h3>Methods</h3><div>Pre-procedural contrast-enhanced CCT was performed, and Guerrero CCT-derived MAC score was used to quantify the MAC severity. Major adverse cardiovascular events (MACE − cardiovascular mortality, significant arrhythmias [sustained ventricular tachycardia, asystole, complete atrioventricular block], stroke, hospitalizations due to heart failure) and all-cause and non-cardiovascular mortality were assessed during the 60 months of follow-up after AVR. Multivariate Cox models evaluated the predictive value of severe MAC alongside other significant variables.</div></div><div><h3>Results</h3><div>A total of 313 patients with severe AS and subsequent AVR were included in the study. Among these, 34.6 % of<!--> <!-->patients had no criteria for MAC, while 65.4 % exhibited MAC (54.1 % presented mild MAC, 33.6 % moderate MAC, and 12.1 % severe MAC). In multivariable Cox models, severe MAC, moderate-to-severe mitral regurgitation, and Society of Thoracic Surgeons (STS) score &gt; 2.5 % remained independent predictors of MACE (all p &lt; 0.05). Also, severe MAC and STS scores &gt; 2.5 % remained independent predictors of all-cause mortality (all p &lt; 0.05) in multivariable analysis.</div></div><div><h3>Conclusion</h3><div>The present study demonstrated that severe MAC independently predicted worse outcomes in patients undergoing AVR, suggesting that incorporating it into the clinical evaluation could ensure a critical change in patient care.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101720"},"PeriodicalIF":2.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144290682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The need for comprehensive assessment of sleep disorders in heart failure research: Recommendations for future research","authors":"Qiulu Wang ,&nbsp;Ying Hai","doi":"10.1016/j.ijcha.2025.101717","DOIUrl":"10.1016/j.ijcha.2025.101717","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101717"},"PeriodicalIF":2.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of transcatheter tricuspid valve replacement on hepatic and renal function in severe TR","authors":"Zhenzhen Li ,&nbsp;Dawei Lin ,&nbsp;Jiaxin Miao ,&nbsp;Jianing Fan ,&nbsp;Fanglin Lu ,&nbsp;Xiaochun Zhang ,&nbsp;Wenzhi Pan ,&nbsp;Daxin Zhou ,&nbsp;Junbo Ge","doi":"10.1016/j.ijcha.2025.101714","DOIUrl":"10.1016/j.ijcha.2025.101714","url":null,"abstract":"<div><h3>Objectives</h3><div>This study evaluated the impact of transcatheter tricuspid valve replacement (TTVR) on renal and hepatic function in patients with severe tricuspid regurgitation (TR).</div></div><div><h3>Background</h3><div>TR is associated with increased morbidity, mortality, and heart failure-related hospitalizations. Venous congestion and reduced forward stroke volume can compromise hepatic and renal function. TTVR has emerged as a promising option for high-risk patients, but its effects remain understudied.</div></div><div><h3>Methods</h3><div>In this prospective, multicenter study, 96 high-surgical-risk patients with severe TR (NYHA functional class III/IV) underwent LuX-Valve TTVR between September 2022 and March 2023. Follow-up at 7, 30, 180, and 360 days assessed cardiac, hepatic (total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP)), and renal (serum creatinine, urea, uric acid) function.</div></div><div><h3>Results</h3><div>Procedural success was 95.79 %, and 93 patients survived to 12 months. All survivors exhibited TR reduction to less than grade III. Significant hepatic improvement was noted at 12 months, especially among those with preoperative liver dysfunction (LD): total bilirubin decreased from 21.54 ± 11.14 to 18.33 ± 7.82 μmol/L (<em>P</em> = 0.044) and direct bilirubin from 7.95 ± 4.74 to 5.92 ± 2.98 μmol/L (<em>P</em> = 0.005). Renal function remained stable.</div></div><div><h3>Conclusions</h3><div>TTVR is an effective, minimally invasive approach for severe TR, facilitating significant hepatic recovery in patients with preoperative dysfunction while preserving renal function. These findings underscore the reversibility of TR-induced hepatic impairment and demonstrate TTVR’s potential to improve clinical outcomes.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101714"},"PeriodicalIF":2.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tricuspid regurgitation and chronic kidney disease in patients with cardiogenic shock: Review of the literature and real-world experience from a single center","authors":"Daniel Oren ,&nbsp;Sunil Ramchandani ,&nbsp;Adrian Lorenzana ,&nbsp;Ranjit Nair ,&nbsp;Julia Szinte ,&nbsp;Kian Maalizadeh ,&nbsp;Farage Ftiha ,&nbsp;Cathrine M. Moeller ,&nbsp;Andrea Fernandez-Valledor ,&nbsp;Roi Bar Cohen ,&nbsp;Ignacio Zepeda ,&nbsp;Shudhanshu Alishetti ,&nbsp;Nino Mihatov ,&nbsp;Kumudha Ramasubbu ,&nbsp;Ruth Minkin ,&nbsp;Anthony Saleh ,&nbsp;Manish A. Parikh ,&nbsp;Franklyn Fenton ,&nbsp;Stephen J. Peterson","doi":"10.1016/j.ijcha.2025.101716","DOIUrl":"10.1016/j.ijcha.2025.101716","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic kidney disease (CKD) frequently complicates Congestive Heart Failure (CHF) and can worsen outcomes in cardiogenic shock. Tricuspid Regurgitation (TR), by elevating central venous pressure, may exacerbate renal impairment. Limited data exist regarding CKD’s influence in TR interventions. This study assesses the impact of CKD on survival and explores RV dysfunction as a potential mediator in patients with TR in cardiogenic shock.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients admitted with HF-related or myocardial infarction-induced cardiogenic shock (2021–2025). Patients were stratified by TR severity (none/trivial, mild, moderate, severe) and CKD stage. Echocardiographic, laboratory, and hemodynamic data were collected. RV dysfunction was assessed using echocardiography and right heart catheterization. Survival outcomes, including HF readmissions and mortality, were evaluated using Kaplan-Meier analysis and Cox regression, considering predictors significant at p &lt; 0.10.</div></div><div><h3>Results</h3><div>Among 177 patients (median age 70 years, EF 35 %, 46 % Black), 55 % had CKD. TR severity distribution was: none/trivial 42 %, mild 16 %, moderate 22 %, and severe 20 %. Severe TR significantly increased in-hospital mortality (40 %) compared to non-severe TR (24 %) and correlated with worsening CKD stages. HF readmissions within 12 months occurred in 10 % of patients. Older age and RV dysfunction emerged as the strongest mortality predictors. Severe TR independently increased mortality and readmission risk.</div></div><div><h3>Conclusion</h3><div>Severe TR significantly worsens survival in cardiogenic shock patients, especially those with advanced CKD, mediated by RV dysfunction. CKD severity assessment may enhance patient stratification for valve interventions. Randomized studies are required to further validate these findings.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101716"},"PeriodicalIF":2.5,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144229767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simplified computed tomography pulmonary angiography score predicts clinical deterioration in patients with acute pulmonary embolism","authors":"Jian-Kuan Yeh ,&nbsp;Po-Wei Chen ,&nbsp;Wei-Ting Chang ,&nbsp;Pin-Hsuan Chiu ,&nbsp;Pei-Fang Su ,&nbsp;Chih-Hsin Hsu ,&nbsp;Chih-Chan Lin ,&nbsp;Hsien-Yuan Chang","doi":"10.1016/j.ijcha.2025.101712","DOIUrl":"10.1016/j.ijcha.2025.101712","url":null,"abstract":"<div><h3>Background</h3><div>Currently, simplified methods based on computed tomography pulmonary angiography (CTPA) to predict clinical deterioration in patients with acute pulmonary embolism (PE) are lacking. We developed a simplified imaging model with good clinical accessibility to predict this outcome.</div></div><div><h3>Study design and methods</h3><div>Patients with acute pulmonary embolism from 2008 to 2019 were retrospectively enrolled from two medical centers to form a study cohort and a validation cohort. Seven models of pulmonary artery obstruction index (PAOI) were developed based on the location and degree of obstruction. The outcome of interest was clinical deterioration during hospitalization. Logistic regression analysis was used to assess the association between different models and clinical deterioration. The category-free net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were used to quantify improvements in predictability.</div></div><div><h3>Results</h3><div>The study group included 210 patients (mean age: 65 ± 16 years; male: 40 %) and the external validation group included 109 patients (mean age: 64 ± 17 years; male: 43 %). Calculating the nearly total obstruction of 20 peripheral arteries demonstrated good predictive ability (AUC: 0.77). Total obstruction of six peripheral arteries did not increase the odds of clinical deterioration, while total obstruction of ten peripheral arteries nearly doubled the risk of deterioration. Combining PAOI with the simplified pulmonary embolism severity index (sPESI) improved the predictive ability for clinical deterioration compared to using sPESI alone (NRI: 0.09–0.12; IDI: 0.05–0.09).</div></div><div><h3>Conclusion</h3><div>Calculating totally obstructed pulmonary arteries simplifies the prediction of clinical deterioration. The combination of PAOI and sPESI enhances the ability to predict clinical deterioration in patients with acute PE.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101712"},"PeriodicalIF":2.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A missed opportunity: Incidental coronary artery calcification prior to acute coronary syndrome","authors":"Shubhang Hariharan ,&nbsp;William Meere ,&nbsp;Kevin Zhang ,&nbsp;Nicklas Howden ,&nbsp;Neil Goonetilleke ,&nbsp;Dhanesh Mohan ,&nbsp;Michael Parkinson ,&nbsp;Maged William ,&nbsp;Thomas J. Ford","doi":"10.1016/j.ijcha.2025.101713","DOIUrl":"10.1016/j.ijcha.2025.101713","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101713"},"PeriodicalIF":2.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic mitral regurgitation unmasked by handgrip exercise is linked with outcomes in (non-) dilated cardiomyopathy","authors":"Fabian Voß ,&nbsp;Niklas Guenther ,&nbsp;Lucas Christian ,&nbsp;Elric Zweck ,&nbsp;Jafer Haschemi ,&nbsp;Christian Schulze ,&nbsp;Ralf Westenfeld ,&nbsp;Patrick Horn ,&nbsp;Malte Kelm ,&nbsp;Amin Polzin ,&nbsp;Maximilian Spieker","doi":"10.1016/j.ijcha.2025.101715","DOIUrl":"10.1016/j.ijcha.2025.101715","url":null,"abstract":"<div><h3>Background</h3><div>Recent studies suggest that secondary mitral regurgitation (MR) is a dynamic condition influenced by global and regional left ventricular (LV) remodeling as well as by mitral valvular deformation. Exercise testing is crucial in assessing the hemodynamic relevance of MR and is recommended by current guidelines. However, data are still lacking on the prevalence and prognostic impact of dynamic MR in patients with non-ischemic cardiomyopathy.</div></div><div><h3>Aims</h3><div>We aimed to assess the prevalence, hemodynamic consequences, and prognostic impact of exercise-induced changes in patients with MR and hypokinetic non-dilated and dilated cardiomyopathy.</div></div><div><h3>Methods</h3><div>Patients with hypokinetic non-dilated and dilated cardiomyopathy and at least mild MR who underwent handgrip echocardiography at the University Hospital Duesseldorf between January 2018 and September 2021 were enrolled. Follow-up was performed at one year.</div></div><div><h3>Results</h3><div>Fifty-eight patients were included (median age 73 [65;81] years; 41 % female; mean LVEF 37 ± 10 %). At rest, 28 patients (48 %) presented with mild MR and 30 patients with moderate MR (52 %). Fifteen patients (26 %) with non-severe MR at rest, developed severe MR during handgrip exercise. Patients with dynamic MR had larger left ventricular volumes, increased mitral annular diameter, and more advanced mitral valve tenting during exercise than those without dynamic MR. Patients with dynamic MR were more likely to undergo MV surgery/interventions (Chi² 23.19; log-rank test p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The hemodynamic changes provoked by isometric exercise unmasked dynamic MR in a significant number of patients without severe MR at rest. These data may have implications for therapeutic decision-making in symptomatic patients with non-severe MR at rest.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101715"},"PeriodicalIF":2.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paradoxical clinical outcomes of severe versus very severe aortic valve stenosis after transcatheter aortic valve implantation? a propensity score matched analysis and review of literature","authors":"Matthias Hammerer ,&nbsp;Elke Boxhammer ,&nbsp;Erika Prinz ,&nbsp;Bernhard Scharinger ,&nbsp;Wilfried Wintersteller ,&nbsp;Uta C. Hoppe","doi":"10.1016/j.ijcha.2025.101710","DOIUrl":"10.1016/j.ijcha.2025.101710","url":null,"abstract":"<div><h3>Background</h3><div>Very severe aortic stenosis (VSAS) is a critical condition with unfavourable clinical outcomes if left untreated or treated by surgical valve replacement. In contrast, after transcatheter valve implantation (TAVI) outcomes seem to be similar or – paradoxically – even better compared to severe aortic stenosis (SAS), as indicated by previous studies.</div></div><div><h3>Methods</h3><div>Data of patients from a single centre who underwent TAVI were retrospectively analysed. Patients with concordant AS (n = 475) were divided into SAS (n = 379) and VSAS (n = 96) groups. These groups are compared in terms of procedural (safety) and long-term (efficacy) outcomes, using propensity score matching. In addition, a review of relevant literature is provided.</div></div><div><h3>Results</h3><div>After propensity score matching, 96 patients remained in each group. Procedural outcomes did not differ significantly between VSAS and SAS groups. Cox proportional hazards regression analysis showed a favourable trend toward lower overall mortality within a mean follow-up of 42 months after TAVI in the VSAS group (hazard ratio, HR, 0.668; 95 % confidence interval, CI, 0.430–1.038). This difference did not reach statistical significance (p = 0.073), however, it was significant in the subgroups of females (p = 0.045) and patients with NYHA class III (p = 0.043).</div></div><div><h3>Conclusion</h3><div>Our analysis confirms – in line with previous studies – that patients with VSAS represent a substantial subgroup and have at least as favourable or – paradoxically −even better clinical results after TAVI compared to patients with SAS. Therefore, TAVI should not be withheld from these patients.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101710"},"PeriodicalIF":2.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiarrhythmic drug use in atrial fibrillation among different European countries – as determined by a physician survey","authors":"Espen Fengsrud ,&nbsp;Carina Blomström-Lundqvist ,&nbsp;A. John Camm ,&nbsp;Andreas Goette ,&nbsp;Peter R. Kowey ,&nbsp;Jose L. Merino ,&nbsp;Jonathan P. Piccini ,&nbsp;Sanjeev Saksena ,&nbsp;James A. Reiffel ,&nbsp;Giuseppe Boriani","doi":"10.1016/j.ijcha.2025.101709","DOIUrl":"10.1016/j.ijcha.2025.101709","url":null,"abstract":"<div><h3>Background</h3><div>There is limited knowledge of physicians’ antiarrhythmic drug (AAD) treatment practices for patients with atrial fibrillation and adherence to guidelines in European countries.</div></div><div><h3>Methods</h3><div>An online survey (n = 321) of cardiologists, cardiac electrophysiologists and interventional electrophysiologists was conducted in Germany (DE; n = 83), Italy (IT; n = 95), Sweden (SE; n = 60) and the United Kingdom (UK; n = 83) including 96 questions on treatment practices.</div></div><div><h3>Results</h3><div>ESC guidelines were the most important non-patient factor influencing treatment practice (55–72 %). However, while amiodarone was frequently (88–93 %) used in heart failure with reduced left ventricular ejection fraction, it was also a typical treatment choice for minimal/no-structural heart disease (SHD) (28 %), particularly in UK. Other deviations from guidelines were the use of class 1C drugs in coronary artery disease (CAD) and other SHD, and use of sotalol in left ventricular hypertrophy and renal impairment. In-hospital initiation of sotalol was low, with the exception of SE. Sotalol (16–41 %) and dronedarone use (10–54 %) in CAD varied among countries. For frequent, symptomatic paroxysmal AF, ablation was generally favoured, but AADs were preferred by 53 % in SE. In asymptomatic or subclinical AF, AADs were used by 41 % (range: 22–60 %), ablation by 11 % (range 2–18 %). In contrast to guidelines that prioritize safety, anticipated efficacy was more important (51 %) than safety (31 %) when selecting AADs.</div></div><div><h3>Conclusions</h3><div>Despite recognizing the importance of guidelines, deviations in AAD use were common with the potential to compromise patient safety. These findings indicate the need for more educational support for optimal AAD selection in AF management.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101709"},"PeriodicalIF":2.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}