European heart journal open最新文献

{"title":"A primary isolated heart model of Takotsubo syndrome for mechanistic investigation and preclinical therapeutic testing.","authors":"Amirali Nejat, Ermir Zulfaj, Yalda Kakaei, Mana Kalani, Tetiana Pylova, Maryna Krasnikova, Ahmed Elmahdi, Sandeep Jha, Björn Redfors, Elmir Omerovic","doi":"10.1093/ehjopen/oeag141","DOIUrl":"https://doi.org/10.1093/ehjopen/oeag141","url":null,"abstract":"<p><strong>Aims: </strong>Current experimental models of Takotsubo syndrome (TTS) do not readily distinguish intrinsic myocardial responses from systemic neurohumoral influences. We sought to establish and comprehensively characterize a primary isolated heart TTS model, in which the complete TTS-like phenotype is induced entirely within a Langendorff-perfused rat heart, enabling mechanistic investigation and preclinical therapeutic testing under controlled conditions.</p><p><strong>Methods and results: </strong>Male Sprague-Dawley rat hearts were perfused, and TTS was induced by controlled intra-aortic isoprenaline infusion, while control hearts received vehicle alone. Haemodynamic function and coronary flow were monitored continuously for 6 h. The primary endpoint was the group-by-time interaction for left ventricular developed pressure, analysed using generalized additive mixed models. Prespecified exploratory analyses included principal component analysis, Gaussian mixture modelling, and machine-learning-based feature analysis. Echocardiography, cardiac troponin release, and representative histology were used for multimodal phenotypic validation. Primary isolated TTS hearts developed progressive systolic and diastolic dysfunction characterized by reductions in left ventricular developed pressure, rate-pressure product, and coronary flow together with prolongation of surrogate isovolumic relaxation constant (TAU) (primary endpoint: <i>P</i> = 0.001; <i>q</i> = 0.002). Temporal modelling identified three reproducible physiological phases: hyperactivation, transition, and functional nadir. Echocardiography demonstrated characteristic apical ballooning, reduced ejection fraction, impaired global longitudinal strain, and increased left ventricular akinesia index. Progressive cardiac troponin release and representative histological alterations provided supportive biochemical and structural corroboration of the functional phenotype.</p><p><strong>Conclusion: </strong>We describe the first primary isolated heart model reproducing the core functional phenotype of TTS entirely within an isolated heart preparation. Thus, intrinsic myocardial responses to acute catecholaminergic stress are sufficient to generate regional dysfunction of TTS in the absence of systemic neurohumoral input.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 5","pages":"oeag141"},"PeriodicalIF":4.3,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Context-dependent interactions between variable-loop pulsed field ablation and cardiac implantable electronic devices: a controlled preclinical study.","authors":"Masateru Takigawa, Ryosuke Kato, Iwanari Kawamura, Megumi Toda, Masaki Honda, Miho Negishi, Ryo Tateishi, Junji Yamaguchi, Kentaro Goto, Takuro Nishimura, Susumu Tao, Shinsuke Miyazaki, Tetsuo Sasano","doi":"10.1093/ehjopen/oeag124","DOIUrl":"10.1093/ehjopen/oeag124","url":null,"abstract":"<p><strong>Aims: </strong>Pulsed field ablation (PFA) is increasingly used for atrial fibrillation and is being extended beyond pulmonary vein isolation to right atrial (RA) and superior vena cava (SVC) targets. As its use expands, interactions with cardiac implantable electronic devices (CIEDs) have become an important yet incompletely defined safety concern. We aimed to evaluate context-dependent interactions between PFA and diverse CIED systems in a controlled pre-clinical model.</p><p><strong>Methods and results: </strong>Thirteen swine underwent implantation of contemporary CIED systems. Seven animals received PFA across multiple device configurations, including dual-chamber pacemakers, transvenous ICD/CRT-D generator systems with single- or dual-coil ICD leads, a leadless ventricular pacemaker, and a subcutaneous ICD. Six control animals underwent catheter manipulation without energy delivery. PFA was performed in the left atrium (LA), RA, and SVC, including applications near transvenous leads and pre-specified delivery over exposed SVC defibrillator coils. Device parameters were assessed sequentially.</p><p><strong>Results: </strong>When performed at an anatomical distance from device components, LA-PFA was not associated with critical device dysfunction under the studied conditions, although minor parameter changes occurred in a minority of cases, particularly with septal atrial lead positioning. During RA/SVC procedures, parameter perturbations and atrial lead dislodgement were observed and were most consistent with catheter-lead mechanical interaction. PFA delivered overexposed ICD coils that produced localized electrical changes without evidence of acute global device failure. The leadless ventricular pacemaker and subcutaneous ICD maintained stable function.</p><p><strong>Conclusion: </strong>PFA did not cause catastrophic CIED dysfunction under the studied conditions; however, device-PFA interactions were strongly context-dependent, influenced by anatomical proximity, conductive exposure, and mechanical interaction.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 5","pages":"oeag124"},"PeriodicalIF":4.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right ventricular dysfunction in cardiogenic shock on temporary mechanical circulatory support.","authors":"Jan Estoppey, Iulia Maia Muresan, Matthias Bossard, Gregor Leibundgut, Gregor Fahrni, Stefan Blöchlinger, Roger Ludwig, Anna S Messmer, Valentin Köchli, Thomas Seiler, Armin Spahr, Alain M Bernheim, Anna Schmidt, Florim Cuculi, Lukas Hunziker, Monika Fürholz","doi":"10.1093/ehjopen/oeag139","DOIUrl":"10.1093/ehjopen/oeag139","url":null,"abstract":"<p><strong>Aims: </strong>Right ventricular dysfunction (RVD) is common in cardiogenic shock (CS) due to left ventricular failure and is associated with increased mortality, but its impact in patients requiring temporary mechanical circulatory support (tMCS) remains unclear. We explored RVD and its association with clinical outcomes in CS patients under tMCS.</p><p><strong>Methods and results: </strong>Individuals with CS from the SWISS Circulatory Support Registry (NCT04117230) were included. RVD was defined by ≥1 of the following parameters: tricuspid annular plane systolic excursion (TAPSE) < 14 mm, TAPSE/systolic pulmonary artery pressure (sPAP) < 0.34, right atrial pressure (RAP) > 15 mmHg, RAP/pulmonary capillary wedge pressure >0.63 or pulmonary artery pulsatility index (PAPi) < 1.85. The primary endpoint was 6-month mortality; secondary endpoints were hemodynamic stabilization markers. 745 patients were included: 580 supported with left-side-Impella-devices^© (with 39 requiring concomitant second device) and 165 with VA-ECMO. RVD was more prevalent in patients on VA-ECMO compared to Impella (60% vs. 33%, <i>P</i> < 0.001). In Impella patients, RVD was associated with higher 6-month mortality (43% vs. 30%, <i>P</i> = 0.015), higher lactate levels (1.6 mmol/L vs. 1.3 mmol/L; <i>P</i> = 0.01), lower central venous saturation (55% vs. 61%; <i>P</i> = 0.005) and reduced mean arterial pressure (55 mmHg vs. 58 mmHg; <i>P</i> = 0.002). In VA-ECMO patients with RVD, 6-month mortality was numerically higher, without statistical significance (61% vs. 45%, <i>P</i> = 0.13).</p><p><strong>Conclusion: </strong>RVD was linked to increased mortality and worse haemodynamic stabilization in patients supported with Impella, whereas this association was not demonstrated in those under VA-ECMO. RV function is a key prognostic marker in CS patients under tMCS and should be assessed to guide device selection, management, and weaning.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 5","pages":"oeag139"},"PeriodicalIF":4.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitral annulus calcification and the risk of infective endocarditis: insights from DANCAVAS screening trials.","authors":"Lytfi Krasniqi, Axel C P Diederichsen, Jes S Lindholt, Camilla Engelsgaard, Martin Busk, Lars Frost, Jess Lambrechtsen, Marek Karon, Jordi Sanchez Dahl","doi":"10.1093/ehjopen/oeag140","DOIUrl":"10.1093/ehjopen/oeag140","url":null,"abstract":"<p><strong>Aims: </strong>Risk stratification in infective endocarditis (IE) does not incorporate structural substrates involved in early disease initiation. The aim of this study was to examine the association between mitral annulus calcification (MAC) burden and the risk of IE.</p><p><strong>Methods and results: </strong>This substudy utilized the population-based DANCAVAS cohort undergoing non-contrast computed tomography (CT) with MAC quantification with follow-up until 19 August 2025. The primary outcome was incidence rates and 10-year risk of IE across three exploratory categorical groups: No MAC (0 arbitrary units (AU)), MAC 1-299 AU, and MAC ≥300 AU. A total of 14 793 participants were included with mean (SD) age, 66.9 (3.8) years, and 14 053 males (95.0%). Median MAC was 13 AU (IQR3.3-56.2) in the MAC 1-299 group and 680 AU (IQR447-1271) in the MAC ≥300 group. IE incidence rate per 10 000 person-years was 1.92 for no MAC, 2.48 for MAC 1-299, and 21.3 for MAC ≥300 (<i>P</i> < 0.001). The 10-year cumulative risk was, 0.20%(95%CI 0.12-0.33) for no MAC, 0.22% (95%CI 0.10-0.49) for MAC 1-299, and 1.85% (95%CI 0.93-3.69) for MAC ≥300 (<i>P</i> < 0.001). Each 100 AU increase in MAC was associated with a 3% increase in the risk of IE (HR 1.03, 95%CI 1.01-1.05, <i>P</i> = 0.011). MAC ≥300 AU remained associated with IE after adjustment for established risk factors (HR 7.05, 95%CI 2.85 to 17.4, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Greater MAC burden was associated with a higher risk of IE. In exploratory categorical analyses, MAC ≥300 AU was associated with the highest observed risk, although these findings should be interpreted with caution given the limited number of events.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 5","pages":"oeag140"},"PeriodicalIF":4.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting cognitive performance in patients with atrial fibrillation by 24-hour Holter electrocardiography: the potential role of an arrhythmic fingerprint.","authors":"Andrea Saglietto, Luca Congiu, Rachele Marcato, Martina Amanzio, Cristiano Manco, Eleonora Bertello, Carola Griffith Brookles, Elena Cavallone, Gaia Miceli, Luca Ridolfi, Carla Giustetto, Veronica Dusi, Federico Ferraris, Gaetano Maria De Ferrari, Stefania Scarsoglio, Matteo Anselmino","doi":"10.1093/ehjopen/oeag137","DOIUrl":"https://doi.org/10.1093/ehjopen/oeag137","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 5","pages":"oeag137"},"PeriodicalIF":4.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotypic clustering of atrial fibrillation patients using latent class analysis and its potential utility for ablation strategy: insights from the DIRECT-Extend and EARNEST-PVI studies.","authors":"Shun Sasaki, Yuki Matsuoka, Akihiro Sunaga, Daisuke Sakamoto, Hideaki Hasegawa, Tomoharu Dohi, Hirota Kida, Tetsuhisa Kitamura, Katsuki Okada, Daisaku Nakatani, Hidetaka Kioka, Nobuaki Tanaka, Masaharu Masuda, Tetsuya Watanabe, Yasuo Okumura, Yoshiharu Higuchi, Koichi Inoue, Shungo Hikoso, Yohei Sotomi, Yasushi Sakata","doi":"10.1093/ehjopen/oeag135","DOIUrl":"10.1093/ehjopen/oeag135","url":null,"abstract":"<p><strong>Aims: </strong>AF is a heterogeneous syndrome. We aimed to assess whether latent class analysis (LCA) can identify phenotypes that stratify prognosis and predict differential responses to catheter ablation strategies.</p><p><strong>Methods and results: </strong>We first developed an LCA-based phenotyping model using the DIRECT-Extend registry (<i>N</i> = 7512), a pooled AF cohort of patients receiving anticoagulation therapy. Patients with echocardiographic data (<i>N</i> = 2741) were classified into latent clusters based on 16 clinical, laboratory, and echocardiographic variables. This phenotypic classification was then applied to the randomized Effect of Extensive Ablation on Recurrence in Patients with Persistent AF Treated with Pulmonary Vein Isolation (EARNEST-PVI) trial to evaluate whether the effectiveness of ablation strategies-pulmonary vein isolation (PVI) alone vs. PVI plus extensive ablation (PVI-plus)-varied across phenotypes. In the DIRECT-Extend registry, three phenotypes were identified: Phenotype 1 (<i>N</i> = 1565; 'low comorbidity'), Phenotype 2 (<i>N</i> = 981; 'cardiomyopathy & chronic kidney disease'), and Phenotype 3 (<i>N</i> = 195; 'inflammatory-enriched AF'). Over a median of 600 days, the primary endpoint-a composite of all-cause death, acute myocardial infarction, any stroke, and major bleeding differed across phenotypes (log-rank <i>P</i> < 0.001). In EARNEST-PVI, patients were stratified into Phenotype 1 (<i>N</i> = 328), Phenotype 2 (<i>N</i> = 139), and Phenotype 3 (<i>N</i> = 30) according to the classification model. AF recurrence was significantly lower in the PVI-plus group compared to the PVI-alone group in Phenotype 1 (log-rank <i>P</i> = 0.013), whereas there was no significant difference in Phenotypes 2 and 3.</p><p><strong>Conclusion: </strong>LCA identified distinct AF phenotypes associated with prognoses. These phenotypes may also provide insights into heterogeneity in response to ablation strategies. This phenotyping approach may support risk stratification and individualized AF management.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 5","pages":"oeag135"},"PeriodicalIF":4.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac magnetic resonance T1 mapping predicts outcome in patients with a systemic right ventricle: <i>a sub-analysis of the SERVE study</i>.","authors":"Odile Burdet, Kerstin Wustmann, Barbara E U Burkhardt, Emanuela R Valsangiacomo Buechel, Jean-Paul Vallée, Judith Bouchardy, Matthias Greutmann, Markus Schwerzmann, Harald Gabriel, Dominik Stambach, Daniel Tobler, Juerg Schwitter, Tobias Rutz","doi":"10.1093/ehjopen/oeag138","DOIUrl":"10.1093/ehjopen/oeag138","url":null,"abstract":"<p><strong>Aims: </strong>In patients with a systemic right ventricle (sRV), the sRV is faced with an increased afterload compared to a right ventricle in sub-pulmonary position, leading to the development of fibrosis followed by ventricular dysfunction. Cardiac magnetic resonance (CMR) T1 mapping (T1) and its derived parameter, such as the extracellular volume (ECV), allow quantification of interstitial fibrosis. The SERVE study, a multicentric, placebo-controlled trial evaluated the effect of tadalafil in sRV patients. The aim of this sub-analysis of the SERVE trial was to evaluate (i) the relationship between T1 mapping parameters and the clinical composite endpoint of hospitalization for heart failure, clinically relevant arrhythmias, and all-cause mortality and (ii) their evolution over time, their correlation with CMR functional parameters, and the impact of study treatment.</p><p><strong>Methods and results: </strong>Patients included in the SERVE trial underwent a 1.5T CMR at baseline and at 1- and 3-year follow-up. For each CMR exam, native and post-contrast T1, as well as ECV, were calculated. In addition, late gadolinium enhancement (LGE) imaging was performed. Cardiac magnetic resonance was available for 60 patients. Native sRV T1 and ECV above the 75th percentile, but not LGE, were associated with the clinical composite endpoint. There was no significant change and no influence of tadalafil treatment on sRV T1 and ECV.</p><p><strong>Conclusion: </strong>T1 mapping as a non-invasive biomarker of the degree of myocardial fibrosis predicts outcome in patients with sRV and should be incorporated in risk stratification in these patients. The phosphodiesterase-5 inhibitor tadalafil appears to have no impact on the development of interstitial or macroscopic fibrosis.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 5","pages":"oeag138"},"PeriodicalIF":4.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants and prognostic value of atrial and ventricular ectopic burden in adults without structural heart disease.","authors":"Amit Moses, Rotem Givoli Vilensky, Noam Makmal, Kobi Faierstein, Elad Maor, Roy Beinart, Avi Sabbag","doi":"10.1093/ehjopen/oeag133","DOIUrl":"10.1093/ehjopen/oeag133","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;Atrial and ventricular ectopy are frequently encountered during ambulatory monitoring in asymptomatic adults; however, their independent long-term prognostic significance in low-risk populations without structural heart disease remains a subject of ongoing clinical debate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To identify the distinct clinical and physiological determinants of atrial ectopic burden (AEB) and ventricular ectopic burden (VEB) and to evaluate their independent long-term associations with major adverse cardiovascular events (MACE) in a primary prevention cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods and results: &lt;/strong&gt;We evaluated 931 asymptomatic individuals (mean age 52 ± 7 years; 13% female) without structural heart disease who completed a baseline 24-h Holter recording. High AEB and VEB were defined using cohort-specific medians and/or the presence of ambulatory arrhythmic complexity. Complete longitudinal tracking for MACE (composite of acute coronary syndrome, cerebrovascular accident, new-onset heart failure, or cardiovascular mortality) was available for 840 participants over a median follow-up of 8 years (IQR 5-11 years). To evaluate the robustness of the atrial findings, a prespecified sensitivity analysis was performed by excluding patients with baseline atrial fibrillation. Over the follow-up period, the primary MACE endpoint occurred in 149 (18%) participants. In multivariable logistic regression models, high AEB was independently driven by older age (OR 1.09, 95% CI 1.06-1.12; &lt;i&gt;P&lt;/i&gt; &lt; 0.001), male sex (OR 1.60, 95% CI 1.02-2.52; &lt;i&gt;P&lt;/i&gt; = 0.042), reduced estimated glomerular filtration rate (eGFR) (OR 0.98, 95% CI 0.97-0.99; &lt;i&gt;P&lt;/i&gt; = 0.049), and low cardiorespiratory fitness (OR 1.38, 95% CI 1.01-1.92; &lt;i&gt;P&lt;/i&gt; = 0.049). Conversely, high VEB was independently associated only with older age (OR 1.04, 95% CI 1.02-1.07; &lt;i&gt;P&lt;/i&gt; &lt; 0.001) and reduced eGFR (OR 0.98, 95% CI 0.977-0.99; &lt;i&gt;P&lt;/i&gt; = 0.034). In fully adjusted multivariable Cox proportional hazards models, high VEB remained a robust independent predictor of MACE, conferring a three-fold increase in risk (HR 3.06, 95% CI 2.06-4.56; &lt;i&gt;P&lt;/i&gt; &lt; 0.001). In tertile-based analyses of pure ectopic burden, increasing VEB demonstrated a robust graded association with MACE after adjustment for age, sex, beta-blocker use, and antiarrhythmic drug therapy (HR per tertile increase 2.02, 95% CI 1.60-2.53; &lt;i&gt;P&lt;/i&gt; &lt; 0.001), whereas AEB showed only a borderline association that did not reach statistical significance (HR per tertile increase 1.21, 95% CI 0.98-1.50; &lt;i&gt;P&lt;/i&gt; = 0.076).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In asymptomatic adults without structural heart disease, the clinical determinants and long-term prognostic trajectories of ectopy exhibit a profound chamber-specific divergence. Ventricular ectopic burden stands out as a powerful, independent marker of intrinsic electrical vulnerability and long-term cardiovascular risk. Meanwhile, atrial ectopy is high","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 5","pages":"oeag133"},"PeriodicalIF":4.3,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of low-flow oxygen therapy on 6 minute walk test in pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: a randomized non-inferiority crossover trial.","authors":"Carmen Wick, Mona Lichtblau, Anna Titz, Julian Müller, Alessandro Vella, Zoe Bousraou, Michael Furian, Stéphanie Saxer, Esther I Schwarz, Silvia Ulrich","doi":"10.1093/ehjopen/oeag125","DOIUrl":"10.1093/ehjopen/oeag125","url":null,"abstract":"<p><strong>Aims: </strong>Patients with pulmonary arterial and distal chronic thromboembolic pulmonary hypertension (PAH/CTEPH) frequently experience exertional dyspnoea with desaturation. Although ambulatory low-flow supplemental oxygen therapy (SOT) is commonly prescribed, its effect via portable concentrators in daily life has not been studied. We investigated the effect of ambulatory SOT on six-minute walk distance (6MWD).</p><p><strong>Methods and results: </strong>This was a randomized non-inferiority crossover study in patients with PAH or CTEPH desaturating by >3% during exercise. Patients performed two 6MWD tests in randomized order: one in ambient air and one with pulsed low-flow (1-2 L/min) nasal supplemental oxygen (SOT) by a portable back-packed concentrator. The primary outcome was 6MWD with a predefined non-inferiority margin of -35 m for ambient air vs. SOT. Forty patients (age 62 ± 15 years, 21 female, 20 PAH, 20 CTEPH) were included. The mean difference in 6MWD between ambient air and SOT was 0 m (95% CI: -15 to 14 m, <i>P</i> <0.001).Five patients exceeded the minimal clinically important difference of 35 m with SOT. At end-exercise, the cohort desaturated 2% less with SOT (95% CI -3 to -0.2%, <i>P</i> = 0.025) and reported 1 point less dyspnoea (95% CI 0.3 to 1, <i>P</i> < 0.002). These effects were also observed in PAH but not in CTEPH.</p><p><strong>Conclusion: </strong>Walking on ambient air was non-inferior to low-flow SOT during 6MWD in treated PAH/CTEPH patients with exercise-induced desaturation and relatively preserved exercise capacity. SOT reduced dyspnoea in PAH. Future research should identify SOT responders and develop lighter, more effective devices tailored to patient needs.</p><p><strong>Registration: </strong>ClinicalTrials.gov (NCT06384534).</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 5","pages":"oeag125"},"PeriodicalIF":4.3,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of cardiac rehabilitation completion after acute myocardial infarction in young women: the French WAMIF Registry.","authors":"Pierre-Guillaume Piriou, Théodora Angoulvant, Claire Bouleti, Geneviève Jarry, Yves Cottin, Pascal Motreff, Stéphanie Marliere, Sabrina Uhry, Guillaume Cayla, Guillaume Leurent, Matthieu Godin, Emmanuelle Filippi Codaccioni, Grégoire Rangé, Hélène Eltchaninoff, Jules Mesnier, Martine Gilard, Stéphane Manzo-Silberman","doi":"10.1093/ehjopen/oeag132","DOIUrl":"10.1093/ehjopen/oeag132","url":null,"abstract":"<p><strong>Aims: </strong>Cardiac rehabilitation (CR) is a cornerstone of secondary prevention after acute myocardial infarction (AMI), yet its implementation remains suboptimal, particularly among women. Young women represent an understudied subgroup with distinct presentations and psychosocial vulnerabilities that may influence access to CR. We aimed to identify factors associated with CR completion within 1 year after AMI in young women.</p><p><strong>Methods and results: </strong>This exploratory analysis was conducted within the prospective multicentre WAMIF cohort. Women aged <50 years with AMI and available data on CR participation were included. The primary endpoint was CR completion within 1 year. Baseline characteristics were compared according to CR status. Univariable and multivariable logistic regression were used to identify factors independently associated with CR completion. Among 305 young women, 182 (59.7%) completed CR within 1 year after AMI. Age, cardiovascular risk factors, socioeconomic deprivation (EPICES score >30), and prior cardiovascular disease were not significantly different between groups. In univariable analysis, coronary occlusion, ST-elevation myocardial infarction (STEMI), and cardiac arrest were positively associated with CR completion, whereas absence of revascularization and higher LVEF were negatively associated. In multivariable analysis, STEMI remained independently associated with higher odds of CR completion (adjusted odds ratio [aOR] 1.9, 95% confidence interval [CI] 1.1-3.1; <i>P</i> = 0.019), whereas absence of revascularization was independently associated with lower CR completion (aOR 0.4, 95% CI 0.2-0.8; <i>P</i> = 0.007).</p><p><strong>Conclusion: </strong>In young women with AMI, this exploratory analysis showed that CR completion remained suboptimal and was mainly associated with index-event severity and management rather than baseline risk factor burden or social deprivation.</p><p><strong>Registration: </strong>WAMIF NCT03073447.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 5","pages":"oeag132"},"PeriodicalIF":4.3,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}