Eurointervention最新文献

{"title":"Percutaneous Valvular and Structural Heart Disease Interventions.2024 Core Curriculum of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC in collaboration with the European Association of Cardiovascular Imaging (EACVI) and the Cardiovascular Surgery Working Group (WG CVS) of the European Society of Cardiology.","authors":"Rui Campante Teles, Eric Van Belle, Radoslaw Parma, Giuseppe Tarantini, Nicolas van Mieghem, Darren Mylotte, Joana Delgado Silva, Stephen O'Connor, Lars Sondegaard, Andre Luz, Ignacio Jesus Amat-Santos, Dabit Arzamendi, Daniel Blackman, Ole De Backer, Vijay Kunadian, Gill Louise Buchanan, Phil MacCarthy, Philipp Lurz, Christopher Naber, Alaide Chieffo, Valeria Paradies, Martine Gilard, Flavien Vincent, Chiara Fraccaro, Julinda Mehilli, Cristina Giannini, Bruno Silva, Petra Poliacikova, Nicole Karam, Verena Veulemans, Holger Thiele, Thomas Pilgrim, Marleen van Wely, Stefan James, Michael Rahbek Schmidt, Anselm Uebing, Andreas Rück, Alexander Ghanem, Ziyad Ghazzal, Francis R Joshi, Luca Favero, Renicus Hermanides, Vlasis Ninios, Luca Nai Fovino, Rutger-Jan Nuis, Pierre Deharo, Petr Kala, Gabby Elbaz-Greener, Didier Tchétché, Eustachio Agricola, Matthias Thielmann, Erwan Donal, Nikolaos Bonaros, Steven Droogmans, Martin Czerny, Andreas Baumbach, Emanuele Barbato, Dariusz Dudek","doi":"10.4244/EIJ-D-23-00983","DOIUrl":"https://doi.org/10.4244/EIJ-D-23-00983","url":null,"abstract":"<p><p>The percutaneous treatment of structural, valvular, and non-valvular heart disease (SHD) is rapidly evolving. The Core Curriculum (CC) proposed by the EAPCI describes the knowledge, skills, and attitudes that define competency levels required by newly trained SHD interventional cardiologists (IC) and provides guidance for training centres. SHD ICs are cardiologists who have received complete interventional cardiology training. They are multidisciplinary team specialists who manage adult SHD patients from diagnosis to follow-up and perform percutaneous procedures in this area. They are competent in interpreting advanced imaging techniques and master planning software. The SHD ICs are expected to be proficient in the aortic, mitral, and tricuspid areas. They may have selective skills in either the aortic area or mitral/tricuspid areas. In this case, they must still have common transversal competencies in the aortic, mitral, and tricuspid areas. Additional SHD domain competencies are optional. Completing dedicated SHD training, aiming for full aortic, mitral, and tricuspid competencies, requires at least 18 months. For full training in the aortic area, with basic competencies in mitral/tricuspid areas, the training can be reduced to 1 year. The same is true for training in the mitral/tricuspid area, with competencies in the aortic area. The SHD IC CC promotes excellence and homogeneous training across Europe and is the cornerstone of future certifications and patient protection. It may be a reference for future CC for national associations and other SHD specialities, including imaging and cardiac surgery.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Valvular and Structural Heart Disease Interventions. 2024 Core Curriculum of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC.","authors":"Rui Campante Teles, Eric Van Belle, Radoslaw Parma, Giuseppe Tarantini, Nicolas van Mieghem, Darren Mylotte, Joana Delgado Silva, Stephen O'Connor, Lars Sondegaard, Andre Luz, Ignacio Jesus Amat-Santos, Dabit Arzamendi, Daniel Blackman, Ole De Backer, Vijay Kunadian, Gill Louise Buchanan, Phil MacCarthy, Philipp Lurz, Christopher Naber, Alaide Chieffo, Valeria Paradies, Martine Gilard, Flavien Vincent, Chiara Fraccaro, Julinda Mehilli, Cristina Giannini, Bruno Silva, Petra Poliacikova, Nicole Karam, Verena Veulemans, Holger Thiele, Thomas Pilgrim, Marleen van Wely, Stefan James, Michael Rahbek Schmidt, Anselm Uebing, Andreas Rück, Alexander Ghanem, Ziyad Ghazzal, Francis R Joshi, Luca Favero, Renicus Hermanides, Vlasis Ninios, Luca Nai Fovino, Rutger-Jan Nuis, Pierre Deharo, Petr Kala, Gabby Elbaz-Greener, Didier Tchétché, Eustachio Agricola, Matthias Thielmann, Erwan Donal, Nikolaos Bonaros, Steven Droogmans, Martin Czerny, Andreas Baumbach, Emanuele Barbato, Dariusz Dudek","doi":"10.4244/EIJ-D-23-00983","DOIUrl":"https://doi.org/10.4244/EIJ-D-23-00983","url":null,"abstract":"<p><p>The percutaneous treatment of structural, valvular, and non-valvular heart disease (SHD) is rapidly evolving. The Core Curriculum (CC) proposed by the EAPCI describes the knowledge, skills, and attitudes that define competency levels required by newly trained SHD interventional cardiologists (IC) and provides guidance for training centres. SHD ICs are cardiologists who have received complete interventional cardiology training. They are multidisciplinary team specialists who manage adult SHD patients from diagnosis to follow-up and perform percutaneous procedures in this area. They are competent in interpreting advanced imaging techniques and master planning software. The SHD ICs are expected to be proficient in the aortic, mitral, and tricuspid areas. They may have selective skills in either the aortic area or mitral/tricuspid areas. In this case, they must still have common transversal competencies in the aortic, mitral, and tricuspid areas. Additional SHD domain competencies are optional. Completing dedicated SHD training, aiming for full aortic, mitral, and tricuspid competencies, requires at least 18 months. For full training in the aortic area, with basic competencies in mitral/tricuspid areas, the training can be reduced to 1 year. The same is true for training in the mitral/tricuspid area, with competencies in the aortic area. The SHD IC CC promotes excellence and homogeneous training across Europe and is the cornerstone of future certifications and patient protection. It may be a reference for future CC for national associations and other SHD specialities, including imaging and cardiac surgery.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impella - a treatment for all STEMI patients with cardiogenic shock? The effect of off-hours admission.","authors":"Thomas Engstrøm, Jasmine Melissa Madsen","doi":"10.4244/EIJ-E-24-00038","DOIUrl":"10.4244/EIJ-E-24-00038","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 16","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of off-hours admissions in STEMI-related cardiogenic shock managed with microaxial flow pump - insights from J-PVAD.","authors":"Takahiro Suzuki, Taku Asano, Daisuke Yoneoka, Masafumi Ono, Kotaro Miyata, Takayoshi Kanie, Yoshimitsu Takaoka, Akira Saito, Yosuke Nishihata, Yasufumi Kijima, Atsushi Mizuno, J-Pvad Investigators","doi":"10.4244/EIJ-D-24-00331","DOIUrl":"10.4244/EIJ-D-24-00331","url":null,"abstract":"<p><strong>Background: </strong>ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (STEMI-CS) is associated with high mortality rates. Patients admitted during off-hours, specifically on weekends and at night, show higher mortality rates, which is called the \"off-hours effect\". The off-hours effect in patients with STEMI-CS treated with mechanical circulatory support, especially Impella, has not been fully evaluated.</p><p><strong>Aims: </strong>We aimed to investigate whether off-hours admissions were associated with higher mortality rates in this population.</p><p><strong>Methods: </strong>We used large-scale Japanese registry data for consecutive patients treated with Impella between February 2020 and December 2021 and compared on- and off-hours admissions. On- and off-hours were defined as the time between 8:00 and 19:59 on weekdays and the remaining time, respectively. The Cox proportional hazards model was used to calculate the adjusted hazard ratios (aHRs) for 30-day mortality.</p><p><strong>Results: </strong>Of the 1,207 STEMI patients, 566 (46.9%) patients (mean age: 69 years; 107 females) with STEMI-CS treated with Impella were included. Of these, 300 (53.0%) were admitted during on-hours. During the follow-up period (median 22 days [interquartile range 13-38 days]), 112 (42.1%) and 91 (30.3%) deaths were observed among patients admitted during off- and on-hours, respectively. Off-hours admissions were independently associated with a higher risk of 30-day mortality than on-hours admissions (aHR 1.60, 95% confidence interval: 1.07-2.39; p=0.02).</p><p><strong>Conclusions: </strong>Our findings indicated the persistence of the \"off-hours effect\" in STEMI-CS patients treated with Impella. Healthcare professionals should continue to address the disparities in cardiovascular care by improving the timely provision of evidence-based treatments and enhancing off-hours medical services.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 16","pages":"987-995"},"PeriodicalIF":7.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in absolute coronary flow and microvascular resistance during exercise in patients with ANOCA.","authors":"Michel Zeitouni, Ghilas Rahoual, Niki Procopi, Frederic Beaupré, Maxime Michon, Clélia Martinez, David Sulman, Paul Guedeney, Nadjib Hammoudi, Eric Vicaut, Stéphane Hatem, Mathieu Kerneis, Johanne Silvain, Gilles Montalescot, For The Action Group","doi":"10.4244/EIJ-D-24-00247","DOIUrl":"10.4244/EIJ-D-24-00247","url":null,"abstract":"<p><strong>Background: </strong>Whether saline-induced hyperaemia captures exercise-induced coronary flow regulation remains unknown.</p><p><strong>Aims: </strong>Through this study, we aimed to describe absolute coronary flow (Q) and microvascular resistance (Rμ) adaptation during exercise in participants with angina with non-obstructive coronary artery disease (ANOCA) and to explore the correlations between saline- and exercise-derived coronary flow reserve (CFR) and microvascular resistance reserve (MRR).</p><p><strong>Methods: </strong>Rμ, Q, CFR and MRR were assessed in the left anterior descending artery using continuous thermodilution with saline infusion at 10 mL/min (rest), 20 mL/min (hyperaemia) and finally at a 10 mL/min infusion rate during stress testing with a dedicated supine cycling ergometer. An incremental workload of 30 watts every two minutes was applied. A saline-derived CFR (CFR_saline) cutoff <2.5 was used to identify coronary microvascular dysfunction (CMD).</p><p><strong>Results: </strong>CFR_saline-defined CMD was observed in 53.3% of the participants (16/30). While cycling, these patients less of an ability to increase Q (7 [interquartile range [IQR] 30.5-103.0] vs 21 [IQR 5.8-45.0] mL/min/30 watts; p=0.01) due to a smaller decrease of Rμ (109 {IQR 32-286} vs 202 [IQR 102-379] Wood units [WU]/30 watts; p<0.01) as compared with the group with normal CFR_saline. In the overall population, CFR_saline and exercise-derived CFR (CFR_exercise) were 2.70±0.90 and 2.85±1.54, respectively, with an agreement classification of 83.3%. A good correlation between saline and exercise techniques for both CFR (r=0.73; p<0.0001) and MRR (r=0.76; p<0.0001) was observed. Among participants with normal CFR_saline, 28.7% (4/14) had an impaired CFR_exercise <2.5 at the peak of exercise due to a moderate and late decrease of Rμ.</p><p><strong>Conclusions: </strong>Saline-induced hyperaemia provided a valid surrogate for exercise physiology independently of the absolute level of CFR and MRR, although exercise provided more granularity to evaluate adaptation among participants with exercise-related CMD.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 16","pages":"1008-1017"},"PeriodicalIF":7.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of newly diagnosed atrial fibrillation in patients with acute coronary syndromes.","authors":"Willem Lambertus Wilbert Bor, Jaouad Azzahhafi, Nino di Maio, Niels M R van der Sangen, Ashley Verburg, Senna Rayhi, Joyce Peper, Dean R P P Chan Pin Yin, Jurrien M Ten Berg","doi":"10.4244/EIJ-D-23-01049","DOIUrl":"10.4244/EIJ-D-23-01049","url":null,"abstract":"<p><strong>Background: </strong>Acute coronary syndrome (ACS) is frequently accompanied by newly diagnosed atrial fibrillation (AF).</p><p><strong>Aims: </strong>We aimed to compare the risk of major adverse cardiovascular events (MACE) in ACS patients presenting with known, newly diagnosed, or no AF.</p><p><strong>Methods: </strong>In our multicentre, prospective registry study, we included patients with confirmed ACS. Patients are classified as having known, newly diagnosed or no AF. Newly diagnosed AF is subdivided according to the duration of the episode, time of onset, post-coronary artery bypass graft (CABG) or spontaneous occurrence, and treatment with oral anticoagulants (OAC). The primary endpoint is MACE at 1 year. Key secondary endpoints include ischaemic stroke and bleeding complications.</p><p><strong>Results: </strong>Amongst 4,433 patients with confirmed ACS, 3,598 (81.2%) had no AF, 438 (9.9%) had newly diagnosed AF, and 397 (9.0%) had known AF. The rates of OAC treatment at discharge were 53.4% in patients with newly diagnosed AF and 89.2% in patients with known AF. After adjusting for baseline imbalances, only new AF was independently associated with increased rates of MACE, whereas known AF was not (hazard ratio [HR] 1.52, 95% confidence interval [CI]: 1.19-1.90 and HR 0.93, 95% CI: 0.70-1.23). For ACS patients with newly diagnosed AF, episodes lasting >24 hours were associated with a higher risk of MACE compared to episodes <24 hours (HR 1.99, 95% CI: 1.36-2.93). Episodes of new AF occurring post-CABG had more favourable outcomes compared to spontaneously occurring new AF (HR for MACE 0.52, 95% CI: 0.31-0.86). OAC treatment rates were higher in the new AF subcategories with higher rates of MACE and ischaemic stroke.</p><p><strong>Conclusions: </strong>Newly diagnosed AF in ACS patients was associated with higher rates of MACE and ischaemic stroke compared to ACS patients without or with known AF. Among the ACS patients with new AF, an episode lasting >24 hours was associated with worse outcomes than shorter episodes, while post-CABG occurrence of AF showed relatively better outcomes compared to spontaneously occurring AF. Only 53% of new AF patients were discharged on OAC therapy versus 89% with known AF.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 16","pages":"996-1007"},"PeriodicalIF":7.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recyclable and contaminated waste from cardiac procedures: a call to action for a sustainable catheterisation laboratory and operating theatre.","authors":"Haitham Amin, Nooraldaem Yousif, Thomas F Lüscher","doi":"10.4244/EIJ-D-24-00335","DOIUrl":"10.4244/EIJ-D-24-00335","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 16","pages":"968-969"},"PeriodicalIF":7.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concomitant left atrial appendage occlusion in patients undergoing mitral transcatheter edge-to-edge repair: pros and cons.","authors":"Fabian Nietlispach, John G Webb, Ole De Backer","doi":"10.4244/EIJ-E-24-00034","DOIUrl":"10.4244/EIJ-E-24-00034","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 16","pages":"970-971"},"PeriodicalIF":7.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of quantitative flow ratio in patients with arrhythmias.","authors":"Andrea Milzi, Tobias Álvaro Thomsen, Antonio Landi, Rosalia Dettori, Nikolaus Marx, Florian Kahles, Javier Escaned, Hernán Mejía-Rentería, Mathias Burgmaier, Marco Valgimigli","doi":"10.4244/EIJ-D-24-00144","DOIUrl":"10.4244/EIJ-D-24-00144","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 16","pages":"1039-1041"},"PeriodicalIF":7.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Identifying vulnerable coronary atherosclerotic plaques: from theory to practice.","authors":"Kyriakos Dimitriadis, Nikolaos Pyrpyris, Konstantinos Tsioufis","doi":"10.4244/EIJ-D-24-00560","DOIUrl":"10.4244/EIJ-D-24-00560","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 16","pages":"1044-1045"},"PeriodicalIF":7.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}