European heart journal open最新文献

{"title":"Assessing heart rate fragmentation to predict atrial fibrillation in the general population aged 65: the PROOF-AF study.","authors":"Jean-Baptiste Guichard, David Hupin, Vincent Pichot, Mathieu Berger, Sébastien Celle, Roger Borràs, Ivo Roca-Luque, Lluís Mont, Antoine Da Costa, Jean-Claude Barthélémy, Frédéric Roche","doi":"10.1093/ehjopen/oeaf030","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf030","url":null,"abstract":"<p><strong>Aims: </strong>Screening the general population aged 65 for atrial fibrillation (AF) has been proposed as a preventive measure against potential complications. Metrics derived from heart rate variability (HRV) that depict heart rate fragmentation (HRF) have been suggested to reflect autonomic nervous system dysfunction. The aim of the study was to assess the predictive capacity of HRV markers, including HRF, for AF occurrence over an 18-year follow-up and to develop a predictive score for AF onset among the general population aged 65 at the study's inception.</p><p><strong>Methods and results: </strong>The PROOF prospective cohort consisted of 1011 subjects aged 65 with no history of AF nor history of cardiovascular disease. A 24 h Holter-electrocardiogram was performed at baseline and HRV, from which HRV indices using temporal, frequency, and non-linear methods, and the percentage of inflection points (PIPs) were calculated. The PROOF cohort demonstrated a cumulative incidence of AF of 13.0% during a median follow-up of 17.8 years. Male gender, hypertension, decreased heart rate and α1, and increased premature atrial complex burden, PNN50, and PIP were independent predictors of AF occurrence. Subsequently, the PROOF-AF risk score was developed, ranging from 0 to 7, providing interesting predictive capacity [area under the curve (AUC) = 70.1%, negative predictive value = 92.0%, and accuracy = 72.0%]. The high-risk group (PROOF-AF score from 5 to 7) and the intermediate-risk group (PROOF-AF score from 2 to 4) exhibited a 16.8- and 5.4-fold higher risk, respectively, of developing AF.</p><p><strong>Conclusion: </strong>Heart rate fragmentation parameters, included in the PROOF-AF score, may be used to identify healthy individuals aged 65 who are at high risk of developing AF and assist population screening.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 3","pages":"oeaf030"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059785","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":"Inhibiting atrial natriuretic peptide clearance reduces myocardial fibrosis and improves cardiac function in diabetic rats.","authors":"Jules Joel Bakhos, Youakim Saliba, Joelle Hajal, Guy Achkouty, Hrag Oskaridjian, Miguel Albuquerque, Chloé Azevedo, Albert Semaan, Nadine Suffee, Elise Balse, Stéphane N Hatem, Nassim Fares","doi":"10.1093/ehjopen/oeaf031","DOIUrl":"10.1093/ehjopen/oeaf031","url":null,"abstract":"<p><strong>Aims: </strong>Natriuretic peptides (NPs) exert pleiotropic effects through the recruitment of cyclic guanosine monophosphate (cGMP) signalling pathways depending on their bioavailability, which is regulated by clearance receptors and peptidases. Here, we tested the hypothesis that increasing myocardial bioavailability of NP has a beneficial effect on heart failure. We studied the effects of a mutated NP, M-atrial natriuretic peptide (MANP), resistant to neprilysin in a model of diabetic cardiomyopathy characterized by marked myocardial fibrosis.</p><p><strong>Methods and results: </strong>Natriuretic peptides as well as sacubitril were delivered via osmotic mini-pumps to high-fat/streptozotocin-induced Type 2 diabetic (T2D) rats. Cardiac function was evaluated by echocardiography. Myocardial remodelling was studied by histological approaches, collagen phenotype, and atrial natriuretic peptide (ANP)/cGMP concentrations. Live-cell cGMP biosensing was conducted on cultured rat cardiac fibroblasts to investigate the biological effects of NP. Cyclic guanosine monophosphate signalling pathway was studied using multiple antibody arrays and biochemical assays in cardiac tissue and cultured fibroblasts. M-atrial natriuretic peptide exhibits superior efficacy than ANP in reducing left ventricular dysfunction and myocardial fibrosis with less extracellular matrix deposition. <i>In vitro</i>, MANP and ANP similarly generated cGMP and activated the protein kinase G (PKG) signalling pathway in cardiac fibroblasts, attenuating Mothers against decapentaplegic homolog 2 (SMAD) activation, collagen secretion, and cell proliferation. Nevertheless, <i>in vivo</i>, MANP specifically enhanced cardiac cGMP accumulation and was more potent than ANP in activating myocardial cGMP/PKG signalling and inhibiting the profibrotic SMAD, extracellular signal-regulated kinases 1/2, and nuclear factor of activated T cells 3 pathways. Endopeptidase inhibition using sacubitril also led to cardiac ANP/cGMP accumulation and reduced myocardial fibrosis.</p><p><strong>Conclusion: </strong>Myocardial bioavailability of ANP is a major determinant of peptide efficacy in reducing cardiac fibrosis and improving pump function during diabetic cardiomyopathy.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf031"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813248","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":"Fluoroquinolones and the risk of aortic aneurysm or aortic dissection: evidence from a nationwide nested case-control study paralleled with matched experimental models.","authors":"Callan D Wesley, Jarl Emanuel Strange, Anders Holt, Gunnar H Gislason, Cédric H G Neutel, Dustin N Krüger, Celine Civati, Mart Theunis, Tania Naessens, Lynn Roth, Guido R Y De Meyer, Wim Martinet, Peter Vibe Rasmussen, Pieter-Jan Guns","doi":"10.1093/ehjopen/oeaf021","DOIUrl":"10.1093/ehjopen/oeaf021","url":null,"abstract":"<p><strong>Aims: </strong>Fluoroquinolones (FQ) have been associated with aortic aneurysm and aortic dissection (AA/AD) resulting in an official warning. Recently, large-scale epidemiological studies failed to confirm this.</p><p><strong>Methods and results: </strong>The current study aimed to scrutinize the FQ-AA/AD association through a retrospective nested case-cohort analysis supplemented with animal experimentation. FQ exposure was not associated with increased AA/AD hazard ratios in main and high-risk (elderly ≥65 years, hypertensive, and prevalent aortic disease) populations. Additionally, FQ did not cause increased mortality or aortic interventions in aortic disease patients. In addition, in animal experimentation, ciprofloxacin did not enlarge aortic diameters nor increase arterial stiffness.</p><p><strong>Conclusion: </strong>Conventional use of FQ should not be avoided when clinically indicated.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 3","pages":"oeaf021"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015452","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":"Exercise-based cardiac rehabilitation for patients with atrial fibrillation: a narrative review.","authors":"Benjamin J R Buckley, Liz van Hout, Charlotte Fitzhugh, Gregory Y H Lip, Rod S Taylor, Dick H J Thijssen","doi":"10.1093/ehjopen/oeaf025","DOIUrl":"10.1093/ehjopen/oeaf025","url":null,"abstract":"<p><p>The role of physical activity (i.e. any bodily movement that requires energy expenditure) and exercise (i.e. planned, structured, and repetitive physical activity to improve/maintain fitness) in the primary and secondary prevention of atrial fibrillation (AF) is increasingly recognized. Physical activity has been associated with lower risks to develop AF and associated complications (e.g. stroke, heart failure, and myocardial infarction). Exercise-based cardiac rehabilitation (ExCR) is increasingly examined in the treatment of AF and sometimes combined with rhythm control strategies (e.g. catheter ablation). Nonetheless, several important clinical, practical, and mechanistic questions remain not fully understood. This state-of-the-art review first provides a contemporary update on the evidence base for the clinical effects of ExCR in AF. Despite the ongoing need for high-quality studies, existing randomized controlled trials and cohort studies suggest ExCR reduces AF burden, lowers risks for major adverse cardiovascular events, and improves health-related quality of life. Second, to facilitate implementation of ExCR, we have observed comparable effects of distinct exercise protocols (e.g. type of training and centre-/home-based) and discussed similarity of effectiveness across patient characteristics (e.g. age, sex, and AF subtype). Critically, we have discussed potential barriers that may prohibit the uptake of ExCR for patients with AF, categorized at clinician- (e.g. referral and training), patient- (e.g. motivation, transportation, and psychosocial factors), and system-levels (e.g. insurance and resources). Third, we have summarized the potential mechanisms underlying these effects of ExCR, classified by their potential role in reducing AF burden (e.g. atrial/ventricular function, autonomic balance, and inflammation) and lowering risks for adverse events (e.g. modifiable risk factors, vascular function, and thrombogenesis). Based on the increasing evidence for clinical benefits, e.g. improved health-related quality of life and better clinical outcomes, we advocate stronger focus on regular physical activity and referral to multidisciplinary ExCR for sustainable lifestyle changes within the ESC AF-CARE pathway for the prevention and treatment of AF.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf025"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756806","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":"Efficacy and safety of renal denervation therapy in hypertension: a meta-analysis.","authors":"Husam M Salah, Jorge Antonio Gutierrez, Jennifer A Rymer, Hidenori Yaku, Rajesh V Swaminathan, Manesh R Patel, Marat Fudim","doi":"10.1093/ehjopen/oeaf026","DOIUrl":"10.1093/ehjopen/oeaf026","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf026"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775096","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":"Rationale and design of the acetazolamide as a chloride sparing diuretic in patients admitted with heart failure (ADA-HF) trial.","authors":"Joseph J Cuthbert, Elton Luo, Aia S M Ahmed, Meenakshy Ajith, Hafiz Butt, Henrietta Pinhol, Felix Baffour Korsah, Jeanne Bulemfu, Sarah Ford, Grant Constable, Leanne Cox, Alan S Rigby, Andrew L Clark","doi":"10.1093/ehjopen/oeaf019","DOIUrl":"10.1093/ehjopen/oeaf019","url":null,"abstract":"<p><strong>Aims: </strong>The Acetazolamide as a chloride-sparing Diuretic in patients Admitted with Heart Failure (ADA-HF) trial will assess the safety and diuretic effect of oral ACZ given alongside a high-dose IV loop diuretic in patients admitted to the hospital with heart failure (HF) and severe fluid retention. Hypochloraemia is common in patients with HF and is associated with worse outcomes, but there are few treatment options available: we will also assess whether ACZ reduces urine chloride loss.</p><p><strong>Methods and results: </strong>The ADA-HF trial is a single centre, open-label, randomized-controlled trial of ACZ 250 mg twice daily plus standard care vs. standard care alone. The trial duration is 4 days. We will recruit 50 patients with severe peripheral oedema due to HF requiring standard care (240 mg of IV furosemide per day given via continuous infusion at 10 mg per hour). The co-primary endpoints are (1) the difference in net fluid loss daily, and over 4 days; and (2) difference in serum chloride concentrations between baseline and day 4. The trial has 80% power to detect a difference in fluid balance of 500-1000 mL per day; and a difference in serum chloride concentration of 1 mmol/L per day. Secondary endpoints include but are not limited to: time to recruit per patient; rate of adverse events; rate of recruitment; and cause-specific rate of drop-out of the study.</p><p><strong>Conclusion: </strong>ACZ may be a useful adjunct to diuretic therapy, but the safety and diuretic efficacy of oral ACZ when used alongside high-dose loop diuretics is unknown. ADA-HF will complement the ADVOR trial and may clarify what role ACZ may have for patients with severe congestion.</p><p><strong>Trial registration: </strong>ISRCTN registry. ISRCTN13060336. Registered on 09/02/2023. URL: https://doi.org/10.1186/ISRCTN13060336.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf019"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712334","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 and clinical impact of initial misdiagnosis of acute type A aortic dissection.","authors":"Karl Teurneau-Hermansson, David von Rosen, Jacob Ede, Mårten Larsson, Johan Sjögren, Per Wierup, Shahab Nozohoor, Igor Zindovic","doi":"10.1093/ehjopen/oeaf027","DOIUrl":"10.1093/ehjopen/oeaf027","url":null,"abstract":"<p><strong>Aims: </strong>The high mortality in untreated acute type A aortic dissection (ATAAD) stresses the need for prompt diagnosis and immediate surgical treatment. Our aim was to evaluate the frequency and clinical impact of misdiagnosis and delayed diagnosis of ATAAD.</p><p><strong>Methods and results: </strong>This was a single-centre, retrospective, observational study including all ATAAD patients with available admission charts between 2001 and 2021 in an area of 1.9 million inhabitants in southern Sweden. The primary endpoints were initial misdiagnosis, delayed diagnosis, and 30-day mortality. Surgical treatment was a secondary endpoint. Independent predictors of misdiagnosis and 30-day mortality were identified by multivariable logistic regression and subgroup analyses by severity of clinical presentation were performed. There were 556 patients included in the study (418 surgically treated and 138 non-surgically treated), and 45.3% were initially misdiagnosed. Misdiagnosed patients were more often female (47.6 vs. 35.9%; <i>P</i> = 0.005) and demonstrated significantly lower rates of syncope, hypotensive shock, and malperfusion. Patients without signs of malperfusion subjected to diagnostic delay were less likely offered surgical treatment (74.0 vs. 91.5%; <i>P</i> < 0.001) and had higher 30-day mortality (21.3 vs. 10.8%; <i>P</i> = 0.040). Female sex was an independent predictor of misdiagnosis (OR: 1.748; 95% CI 1.145-2.668; <i>P</i> = 0.010), but neither misdiagnosis nor delayed diagnosis were independent predictors of 30-day mortality.</p><p><strong>Conclusion: </strong>Although misdiagnosis and delayed diagnosis did not influence overall 30-day mortality, delayed diagnosis led to significantly higher 30-day mortality in the large group of patients presenting without signs of malperfusion, likely caused by the observed higher risk of being denied surgical treatment.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf027"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11935741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712293","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":"Cognitive behavioural therapy targeting cardiac anxiety post-myocardial infarction: results from two sequential pilot studies.","authors":"Amanda Johnsson, Brjánn Ljótsson, Björn E Liliequist, Helga Skúladóttir, Linnea Maurex, Ida Boberg, Eva Ólafsdóttir, Sofia Klavebäck, Frieder Braunschweig, Linda G Mellbin, Josefin Särnholm","doi":"10.1093/ehjopen/oeaf020","DOIUrl":"10.1093/ehjopen/oeaf020","url":null,"abstract":"<p><strong>Aims: </strong>Cardiac anxiety, which is cardiac-related fear and avoidance behaviours, is common following myocardial infarction (MI) and has been associated with increased risk for cardiovascular events. However, there are currently no treatments specifically designed to target cardiac anxiety. The aim of the two pilot studies was to evaluate an exposure-based cognitive behavioural therapy protocol (MI-CBT) targeting cardiac anxiety following MI, assessing feasibility, acceptability, and the intervention's potential for reducing cardiac anxiety and improving health-related quality of life (QoL).</p><p><strong>Methods and results: </strong>A series of two sequential, uncontrolled pilot studies were conducted. In Pilot Study 1 (<i>n</i> = 15), MI-CBT was delivered via face-to-face videoconference, while Pilot Study 2 (<i>n</i> = 23) was delivered online. Patients with a history of MI (≥6 months before assessment, type 1 ST- or non-ST-segment elevation MI, and elevated cardiac anxiety as per clinical interview) were included. The interventions lasted 8 weeks and were therapist-led, with key components including exposure to cardiac-related symptoms and reduction of avoidance behaviours. Participants completed self-rated assessments, including the Cardiac Anxiety Questionnaire (CAQ) and the 12-Item Short Form Health Survey (SF-12), at baseline, post-treatment, and 6-month follow-up. Treatment adherence and satisfaction were high. Cognitive behavioural therapy led to a large reduction in cardiac anxiety, as measured by the CAQ (<i>P</i> < 0.001), and significant improvements in health-related QoL, as measured by the SF-12 (<i>P</i> < 0.001), in both pilot studies.</p><p><strong>Conclusion: </strong>These studies suggest that exposure-based CBT is a feasible, acceptable, and promising approach to reduce cardiac anxiety and improve QoL following MI. A randomized controlled trial should be conducted to evaluate the efficacy of the intervention.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf020"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775092","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":"Baseline characteristics and 1-year outcome by left ventricular function in the CABG PREFERS.","authors":"Ulrika Löfström, Cecilia Linde, Maria J Eriksson, Eva Maret, Matthias Corbascio, Mattias Ekström, Patrik Lyngå, Håkan Wallén, Bengt Persson, Hans Persson, Camilla Hage","doi":"10.1093/ehjopen/oeaf014","DOIUrl":"10.1093/ehjopen/oeaf014","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study is to describe patients undergoing elective coronary artery bypass grafting (CABG) surgery by left ventricular (LV) function at baseline and 1-year follow-up.</p><p><strong>Methods and results: </strong>In the single-centre CABG PREFERS cohort prospective study, we classified patients planned for elective CABG by LV function assessed by echocardiography and N-terminal pro-B-type natriuretic peptide (NT-proBNP) into three phenotype groups: preserved ejection fraction (EF; pEF), reduced EF (rEF), and normal, irrespective of signs or symptoms of heart failure (HF). At baseline and 1-year follow-up, electrocardiogram, echocardiography, cardiac magnetic resonance imaging, laboratory tests, and quality of life were assessed. Sixty-one of a total of 136 patients (45%) had systolic and/or diastolic LV dysfunction (25% pEF, 20% rEF, and the rest 55% none: the normal group). Median EF was 59% (pEF), 40% (rEF), and 59% (normal). Most patients had multivessel coronary artery disease without left main stem stenosis (60%). At 1-year follow-up, some improvements in echo parameters were seen in pEF and rEF. But in the normal group compared to baseline, there were deteriorations in the following: E/é: 7.8-8.9, <i>P</i> < 0.001; NT-proBNP 150-182 ng/L, <i>P</i> = 0.015; and estimated glomerular filtration rate (eGFR) 82.5-78.9 mL/min/1.73 m², <i>P</i> = 0.003. During a median follow-up time of 2.9 years, eight patients (5.8%) died and eight (5.8%) were hospitalized for HF.</p><p><strong>Conclusion: </strong>In patients undergoing elective CABG, signs of LV dysfunction were common and found in 45%. Patients with normal LV function showed signs of worsening systolic and diastolic LV function, eGFR, and NT-pro-BNP at 1-year follow-up.</p><p><strong>Registration: </strong>Clinicaltrials.gov identifier: NCT03671122.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf014"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775089","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":"Pulmonary haemodynamics by echocardiography over 3 days of acclimatization in lowlanders with chronic obstructive pulmonary disease travelling to 3100 m of high altitude.","authors":"Konstantinos Bitos, Julian Müller, Adilet Omuralieva, Simon R Schneider, Mona Lichtblau, Stéphanie Saxer, Felix C Tanner, Michael Furian, Maamed Mademilov, Talant Sooronbaev, Konrad E Bloch, Silvia Ulrich","doi":"10.1093/ehjopen/oeaf017","DOIUrl":"10.1093/ehjopen/oeaf017","url":null,"abstract":"<p><strong>Aims: </strong>Patients with chronic obstructive pulmonary disease experience an increase in systolic pulmonary artery pressure (sPAP) when exposed to high altitude with an unclear acclimatization. We investigated the effects of acute ascent to 3100 m on pulmonary haemodynamics of patients with chronic obstructive pulmonary disease and their acclimatization during a 3-day stay at high altitude.</p><p><strong>Methods and results: </strong>In this prospective, interventional study, stable, normocapnic patients with chronic obstructive pulmonary disease, with FEV₁ 40-80%predicted and SpO₂ ≥ 92%, residing at low altitude and staying for 3 days/nights at 3100 m without adverse events, were included. Echocardiography was performed at 760 m, directly after arrival at 3100 m (HA1) and the two following days (HA2/HA3). The primary outcome was the change in sPAP at different time points. Additionally, cardiac output (CO), tricuspid annular plane systolic excursion (TAPSE), and other echocardiographic parameters were measured. Thirty-eight patients with chronic obstructive pulmonary disease (37% females), aged (mean ± SD) 55 ± 10years, with FEV₁ 63 ± 12%predicted, were included. After acute ascent to 3100 m vs. 760 m, sPAP increased by 12 mmHg [95% confidence interval (CI): 9-15, <i>P</i> < 0.001], total pulmonary resistance (sPAP/CO) increased by 2 WU (1-3, <i>P</i> = 0.001), and TAPSE/sPAP decreased by -0.6 mm/mmHg (-0.9 to -0.2, <i>P</i> = 0.002). Right atrial pressure and CO were unchanged. At HA3 compared to HA1, sPAP decreased by -4 mmHg (-7 to -1, <i>P</i> = 0.008); no significant changes in further echocardiographic parameters were observed.</p><p><strong>Conclusion: </strong>In stable patients with chronic obstructive pulmonary disease travelling to and staying at 3100 m for 3 days/nights without adverse events, sPAP initially increased, along with an increased pulmonary resistance and a reduced right ventricular-arterial coupling reflected by a lower TAPSE/sPAP. Whereas sPAP steadily decreased during acclimatization, other echocardiographic parameters remained unchanged.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf017"},"PeriodicalIF":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11935530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712325","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}