European heart journal open最新文献

{"title":"Where your heart lies across the Atlantic may demand further assessment in cardiovascular management for non-cardiac surgery.","authors":"Benjamin Marchandot, Adrien Carmona, Olivier Morel","doi":"10.1093/ehjopen/oeae105","DOIUrl":"10.1093/ehjopen/oeae105","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 1","pages":"oeae105"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974034","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":"Causes of death in patients with atrial fibrillation in the UK: a nationwide electronic health record study.","authors":"Yongtong Lai, Hiroyuki Yoshimura, Nadine Zakkak, Eloi Marijon, Anwar Chahal, Gregory Y H Lip, Floriaan Schmidt, Rui Providencia","doi":"10.1093/ehjopen/oeae103","DOIUrl":"10.1093/ehjopen/oeae103","url":null,"abstract":"<p><strong>Aims: </strong>Causes of death remain largely unexplored in the atrial fibrillation (AF) population. We aimed to (i) thoroughly assess causes of death in patients with AF, especially those associated with sudden cardiac death (SCD) and (ii) evaluate the potential association between AF and SCD.</p><p><strong>Methods and results: </strong>Linked primary and secondary care United Kingdom Clinical Practice Research Datalink dataset comprising 6 529 382 individuals aged ≥18. We identified 214 222 patients with newly diagnosed AF, and an equivalent number of non-AF patients matched for age, sex and primary care practice. The underlying primary cause of death for each patient was assessed in the form of International Classification of Diseases Tenth Revision (ICD-10) codes and also as part of broader disease categories (i.e. ICD-10 chapters).</p><p><strong>Findings: </strong>Over a median follow-up of 2.7 (interquartile range: 0.7-6.0) years, 124 781 (58.25%) patients with AF died. Sudden cardiac death occurred in 13 923 patients with AF [6.50% patients with AF vs. 2.01% non-AF patients; odds ratio (OR) = 3.38, 95% confidence interval (CI): 3.27-3.50, <i>P</i> < 0.0001], contributing to 11.05% of all AF mortality. Diseases of the circulatory system, neoplasms and respiratory diseases explained 45% of AF mortality. Sudden cardiac death occurred more frequently in males (OR = 1.87, 95% CI: 1.80-1.93, <i>P</i> < 0.0001), and females with AF died more often of diseases of the circulatory, respiratory, digestive, and genitourinary system and less often of neoplastic disorders.</p><p><strong>Interpretation: </strong>Conditions of the circulatory system are the main driver of mortality in the AF population. Females with AF experience higher cardiovascular and respiratory mortality but die less frequently of neoplasms. The risk of SCD is higher in the AF population, occurring more frequently in males.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 1","pages":"oeae103"},"PeriodicalIF":0.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960521","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":"Impact of pulmonary vein isolation on atrial arrhythmias in patients with typical atrial flutter: systematic review and meta-analysis of randomized clinical trials.","authors":"Daniel A Gomes, Rita Reis Santos, Jorge Ferreira, Frédéric Anselme, Peter Calvert, Amand Floriaan Schmidt, Dhiraj Gupta, Serge Boveda, Pedro Adragão, Rui Providência","doi":"10.1093/ehjopen/oeae102","DOIUrl":"10.1093/ehjopen/oeae102","url":null,"abstract":"<p><strong>Aims: </strong>Cavotricuspid isthmus (CTI) ablation is the current ablation treatment for typical atrial flutter (AFL). However, post-ablation atrial tachyarrhythmias, mostly in the form of atrial fibrillation (AF), are frequently observed after CTI ablation. We aimed to evaluate the effectiveness and safety of concomitant or isolated pulmonary vein isolation (PVI) in patients with typical AFL scheduled for ablation.</p><p><strong>Methods and results: </strong>Electronic databases (PubMED, EMBASE, Clinicaltrials.gov) were searched through July, 2024. Randomized controlled trials (RCTs) were eligible if comparing PVI ± CTI ablation vs. CTI alone. The primary outcomes were any sustained atrial arrhythmia, typical AFL relapse, and AF. Secondary outcomes were need for redo-ablation or antiarrhythmic drugs. Random-effects and fixed-effects meta-analyses were undertaken for each individual outcome. Seven RCTs, with a total of 902 patients, were included. Comparing to CTI ablation alone, PVI ± CTI was more effective in preventing atrial tachyarrhythmias [risk ratio (RR) = 0.57, 95% CI: 0.41-0.79, <i>P</i> = 0.0007, <i>I</i> ² = 50%, number needed to treat (NNT) = 4.1]. The results were driven mainly by a reduction of new onset/recurrent AF (RR = 0.41, 95% CI: 0.27-0.61, <i>P</i> < 0.0001, <i>I</i> ² = 0%, NNT = 3.3), whereas there were no differences in typical AFL relapse (RR = 1.52, 95% CI: 0.63-3.66, <i>P</i> = 0.35, <i>I</i> ² = 9%). Major complication rate was low and comparable across groups, although uncomplicated pericardial effusion was higher in PVI ± CTI (1.8% vs. 0.0%, <i>P</i> = 0.04). Results were comparable for the sub-analysis of PVI alone vs. CTI ablation.</p><p><strong>Conclusion: </strong>In patients with typical AFL, PVI ± CTI ablation is more effective than CTI alone in reducing the atrial tachyarrhythmias and subsequent AF during follow-up, without affecting major complications rate. These results set the rationale for a well-designed, larger-scale RCT comparing both strategies.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 1","pages":"oeae102"},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901415","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":"Acute cardiovascular effects of electronic cigarettes: a systematic review and meta-analysis.","authors":"Mahdis Cheraghi, Mehrnaz Amiri, Fatemeh Omidi, Amir Hashem Shahidi Bonjar, Hooman Bakhshi, Atefeh Vaezi, Mohammad Javad Nasiri, Mehdi Mirsaeidi","doi":"10.1093/ehjopen/oeae098","DOIUrl":"10.1093/ehjopen/oeae098","url":null,"abstract":"<p><p>Electronic cigarette (EC) is widely advertised as a safe alternative to traditional cigarette (TC). We aimed to investigate the cardiovascular effect of EC with/without nicotine compared with TC. We systematically searched PubMed/MEDLINE, EMBASE, and Cochrane CENTRAL for randomized controlled trials that compared the effect of different smoking modalities on cardiovascular function up to 1 October 2024. Analysis used the weighted mean difference (WMD) with a 95% confidence interval (CI) via Comprehensive Meta-Analysis software, version 3.0. The study evaluated key cardiovascular parameters, including pulse wave velocity (PWV), augmentation index at 75 beats/min (AIx75), flow-mediated dilation (FMD), heart rate (HR), systolic blood pressure, and diastolic blood pressure. We analysed 9 trials involving 370 participants. Acute exposure to EC with nicotine (ECN) compared with nicotine-free EC (EC0) increased PWV (WMD = 0.26; 95% CI: 0.14-0.38, <i>P</i> < 0.001), AIx75 (WMD = 4.29; 95% CI: 2.07-6.51, <i>P</i> < 0.001), and HR (WMD = 5.06; 95% CI: 2.13-7.98, <i>P</i> = 0.001), significantly. In contrast, comparison between ECN and TC revealed no significant differences in FMD (WMD = 0.80; 95% CI: -0.09-1.70, <i>P</i> = 0.08). Our meta-analysis suggests that ECN acutely increases arterial stiffness more than EC0 does. Additionally, we found that the acute effect of ECN on endothelial dysfunction is not different from TC. Therefore, our study suggests that vaping cannot be considered as a safe substitute for TC. Further investigation is needed to explore the long-term cardiovascular effects of vaping and its modalities.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"4 6","pages":"oeae098"},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878860","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":"Antibodies against angiotensin II type 1 and endothelin-1 type A receptors are associated with microvascular obstruction after revascularized ST-elevation myocardial infarction.","authors":"Giovanni Civieri, Laura Iop, Emanuele Cozzi, Sabino Iliceto, Francesco Tona","doi":"10.1093/ehjopen/oeae099","DOIUrl":"10.1093/ehjopen/oeae099","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"4 6","pages":"oeae099"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879044","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":"The acute effect of high-dose supplemental oxygen on haemodynamics assessed by echocardiography in patients with pulmonary vascular disease living in Quito at 2850 m: a randomized, single-blind, placebo-controlled crossover trial.","authors":"Julian Müller, Mona Lichtblau, Stéphanie Saxer, Mirjam Schmucki, Michael Furian, Simon R Schneider, Joël J Herzig, Meret Bauer, Diego Saragoni, Esther I Schwarz, Elizabeth Cajamarca, Rodrigo Hoyos, Silvia Ulrich","doi":"10.1093/ehjopen/oeae097","DOIUrl":"10.1093/ehjopen/oeae097","url":null,"abstract":"<p><strong>Aims: </strong>More than 220 Mio people live at altitudes above 2000 m, many of whom have pre-existing chronic diseases, including pulmonary vascular diseases (PVDs) such as pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH). We investigated the acute effects of high-dose supplemental oxygen on pulmonary haemodynamics assessed by echocardiography in patients with PVD permanently living at 2850 m.</p><p><strong>Methods and results: </strong>In a randomized, single-blind, placebo-controlled crossover trial, patients with PVD diagnosed with PAH or CTEPH were allocated to receive 10 L/min supplemental oxygen (FiO₂ ≈ 95%) and placebo air administered via a facial mask with reservoir near their living altitude in Quito at 2850 m (FiO₂0.21, PiO₂ ≈ 60% of sea level) in random order with a washout period of >2 h. After >15 min of breathing the respective FiO₂, systolic pulmonary artery pressure (sPAP), cardiac output (CO), and other parameters were assessed by echocardiography. Furthermore, radial arterial blood gases were analysed. Twenty-eight patients with PVD (24 females, 26 PAH, age 45 ± 12 years) treated with phosphodiesterase-5 inhibitors (<i>n</i> = 28) and endothelin receptor antagonists (<i>n</i> = 9) were included. With oxygen vs. placebo air, sPAP was 57 ± 23 vs. 68 ± 24 mmHg, mean difference -11 mmHg (-15 to -6 mmHg, <i>P</i> < 0.001), CO was 3.2 ± 0.9 vs. 3.9 ± 1.1 L/min; -0.7 L/min (-0.9 to -0.4 L/min, <i>P</i> < 0.001), while sPAP/CO was unchanged, and the right ventriculo-arterial coupling was increased. PaO₂ was 22.5 ± 9.7 vs. 7.6 ± 1.5 kPa; 14.9 kPa (11.4-18.4 kPa, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>High-dose oxygen therapy in prevalent patients with PVD living near 2850 m significantly lowered sPAP but also CO by a reduced heart rate, resulting in an unchanged pulmonary resistance. Whether longer-term oxygen therapy would improve pulmonary vascular resistance requires further investigation.</p><p><strong>Registration: </strong>NCT06084559 URL: https://clinicaltrials.gov/study/NCT06084559.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"4 6","pages":"oeae097"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857380","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":"Percutaneous thrombectomy with the FlowTriever for pulmonary embolism with right heart thrombi: a retrospective two centres study.","authors":"Laurent Bonello, Clément Tardivel, Marc Laine, François Roubille","doi":"10.1093/ehjopen/oeae092","DOIUrl":"10.1093/ehjopen/oeae092","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"4 6","pages":"oeae092"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712231","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":"Single high-sensitivity troponin-I for ruling out acute coronary syndrome: a detection limit approach.","authors":"Siobhan Hickling, Chelsea J Francis, Derek P Chew, Biswadev Mitra, Graham S Hillis","doi":"10.1093/ehjopen/oeae094","DOIUrl":"10.1093/ehjopen/oeae094","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was determine the incidence of major adverse cardiac events within 30 and 365-days among patients discharged from emergency departments (EDs), following a single high-sensitivity cardiac troponin I test result below or close to the limits of detection (LoD).</p><p><strong>Methods and results: </strong>Patients ≥20 years old who presented to four EDs from mid-2014 to end-2015, underwent a single high-sensitivity troponin test and were discharged were included. Data from ED presentations, hospital admissions, mortality records, and pathology laboratories were linked and harmonized. High-sensitivity troponin levels were categorized as below (<2 ng/L) or close to (<5 ng/L) the LoD. The primary outcome was cardiovascular death and myocardial infarction (MI), identified using ICD-10-AM codes. In a cohort of 6633 patients, 49% had high-sensitivity troponin levels below the LoD (<2 ng/L), and 79% had levels <5 ng/L. There were no primary outcome events at 30-day follow-up among patients with high-sensitivity troponin results below 2 or 5 ng/L. At 365-days, there were 5 (0.15%) and 11 (0.21%) primary outcome events for patients with high-sensitivity troponin results below 2 and 5 ng/L, indicating negative predictive values of 99.85% and 99.79%.</p><p><strong>Conclusion: </strong>These findings confirm that patients with a single very low level of high-sensitivity troponin on presentation to EDs are at low risk of MI and cardiovascular death at 30 and 365 days, supporting the safety of a triage strategy incorporating a single high-sensitivity troponin result below the LoD to identify patients at low-risk, who may be suitable for expedited discharge.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"4 6","pages":"oeae094"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684015","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":"Beyond the heart: multisystem complications fuelling cardiac dysfunction in myotonic dystrophy type 1.","authors":"Sofia Khaja","doi":"10.1093/ehjopen/oeae096","DOIUrl":"10.1093/ehjopen/oeae096","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"4 6","pages":"oeae096"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808930","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":"Implementing and evaluating shared decision-making before transcatheter aortic valve implantation with a dedicated pathway and questionnaire.","authors":"Ermes Carulli, Suzy Browne, Sara Woolley, Alexander Tindale, Alison Pottle, Kate Nagle, Rebecca Lane, Navin Chandra, Niket Patel, Rodney De Palma, Gareth Barnes, Tito Kabir, Vasileios Panoulas, David Smith, Robert Smith, Sharon Clernon, Ee Ling Heng, Mohammed Akhtar, Mark Bowers, Ian McGovern, Thomas Lüscher, Miles Dalby","doi":"10.1093/ehjopen/oeae095","DOIUrl":"10.1093/ehjopen/oeae095","url":null,"abstract":"<p><strong>Aims: </strong>Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement for patients with aortic valve stenosis. The choice between TAVI, surgery, or a conservative approach should be based upon multiple factors including clinical considerations, technical feasibility, and informed patient preference. In this context, engaging patients in a shared decision-making (SDM) process becomes essential, but this practice is generally underused.</p><p><strong>Methods and results: </strong>To comply with the European and UK national guidelines, in January 2023 we established a structured SDM pathway in which patients are offered virtual/physical decision aids and after 1 week are invited to a meeting to reach a shared decision. From December 2022 to June 2023, a custom-developed questionnaire was prospectively administered to 23 patients prior to, and 38 patients after, the implementation of the SDM pathway. The answers to 12 core questions were recorded on a Likert scale (1-5). Global satisfaction, as measured by mean Likert score, was significantly higher for the post-SDM group than for the pre-SDM group (4.46 ± 0.14 vs. 3.78 ± 0.30, <i>P</i> < 0.001). The percentage of positive (Likert 4-5) responses was significantly higher in the post-SDM group (289/312, 92.6% vs. 155/234, 66.2%, <i>P</i> < 0.001). The percentage of negative (Likert 1-2) responses was significantly lower in the post-SDM group (5/312, 1.6% vs. 53/234, 22.6%, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The SDM pathway proved effective in delivering SDM in compliance with national and international guidance. A similar approach leveraging digital technology to minimize cost and enhance patient convenience could be implemented for other treatments and across other institutions.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"4 6","pages":"oeae095"},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11643346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831448","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}