European heart journal open最新文献

{"title":"Management of cardiac emergencies in women: a clinical consensus statement of the Association for Acute CardioVascular Care (ACVC), the European Association of Percutaneous Cardiovascular Interventions (EAPCI), the Heart Failure Association (HFA), and the European Heart Rhythm Association (EHRA) of the ESC, and the ESC Working Group on Cardiovascular Pharmacotherapy.","authors":"Antonia Sambola, Sigrun Halvorsen, David Adlam, Christian Hassager, Susanna Price, Giuseppe Rosano, Francois Schiele, Lene Holmvang, Marta de Riva, Amina Rakisheva, Patrick Sulzgruber, Eva Swahn","doi":"10.1093/ehjopen/oeae011","DOIUrl":"10.1093/ehjopen/oeae011","url":null,"abstract":"<p><p>Cardiac emergencies in women, such as acute coronary syndromes, acute heart failure, and cardiac arrest, are associated with a high risk of adverse outcomes and mortality. Although women historically have been significantly underrepresented in clinical studies of these diseases, the guideline-recommended treatment for these emergencies is generally the same for both sexes. Still, women are less likely to receive evidence-based treatment compared to men. Furthermore, specific diseases affecting predominantly or exclusively women, such as spontaneous coronary dissection, myocardial infarction with non-obstructive coronary arteries, takotsubo cardiomyopathy, and peripartum cardiomyopathy, require specialized attention in terms of both diagnosis and management. In this clinical consensus statement, we summarize current knowledge on therapeutic management of these emergencies in women. Key statements and specific quality indicators are suggested to achieve equal and specific care for both sexes. Finally, we discuss several gaps in evidence and encourage further studies designed and powered with adequate attention for sex-specific analysis.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"4 2","pages":"oeae011"},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11020263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873893","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":"Authors' response to: How to manage ventricular arrhythmia in patients with viral myocarditis.","authors":"Andrea Villatore, Giovanni Peretto","doi":"10.1093/ehjopen/oeae006","DOIUrl":"10.1093/ehjopen/oeae006","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"4 1","pages":"oeae006"},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139975091","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":"Editors' highlight picks from 2023 in <i>EHJ Open</i>.","authors":"Magnus Bäck, Maciej Banach, Frieder Braunschweig, Salvatore De Rosa, Frank A Flachskampf, Thomas Kahan, Daniel F J Ketelhuth, Patrizio Lancellotti, Susanna C Larsson, Linda Mellbin, Edit Nagy, Gianluigi Savarese, Karolina Szummer, Denis Wahl","doi":"10.1093/ehjopen/oeae008","DOIUrl":"10.1093/ehjopen/oeae008","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"4 1","pages":"oeae008"},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10882979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934717","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 use of mechanical circulatory support in elective high-risk percutaneous coronary interventions: A literature-based review","authors":"Alexander Geppert, K. Mashayekhi, K. Huber","doi":"10.1093/ehjopen/oeae007","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae007","url":null,"abstract":"\u0000 Contemporary medical practices allow complete percutaneous coronary intervention (PCI) in a considerable number of patients who previously would have been considered too “high-risk” for such procedures. Use of mechanical circulatory support (MCS) devices during these high-risk PCIs (HR-PCIs) is thought to reduce the potential risk for major adverse events during and after revascularization. The Intra-aortic balloon pump (IABP), veno-arterial extracorporal membrane oxygenation (V-A ECMO), and the Impella are the most common MCS devices in use. This review aims to summarize the clinical evidence for each of these devices and the potential mechanisms for the improvement in patient outcomes in HR-PCI. IABP use has rapidly declined in recent years due to no evidence of benefit in HR-PCI and cardiogenic shock. V-A ECMO results in low rates of major adverse cardiac and cerebrovascular events (MACCEs) but higher rates of acute kidney injury and increased need for transfusions. In initial studies, Impella resulted in a reduced need for repeat interventions and reduced rates of hypotension, but no benefit in mortality. However, MACCE rates with Impella have gradually declined over the last ten years, reflecting increased operator experience and technical improvements. Thus, a large, randomized trial is needed to assess the efficacy of Impella in HR-PCI with contemporary standards of care. There is currently no individual parameter that can identify patients who would benefit from MCS use in elective HR-PCI. To address this gap, we propose an algorithm that combines anatomical complexity, co-morbidities, and clinical presentation to accurately identify candidates for MCS-assisted HR-PCI.","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139848295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of mechanical circulatory support in elective high-risk percutaneous coronary interventions: A literature-based review","authors":"Alexander Geppert, K. Mashayekhi, K. Huber","doi":"10.1093/ehjopen/oeae007","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae007","url":null,"abstract":"\u0000 Contemporary medical practices allow complete percutaneous coronary intervention (PCI) in a considerable number of patients who previously would have been considered too “high-risk” for such procedures. Use of mechanical circulatory support (MCS) devices during these high-risk PCIs (HR-PCIs) is thought to reduce the potential risk for major adverse events during and after revascularization. The Intra-aortic balloon pump (IABP), veno-arterial extracorporal membrane oxygenation (V-A ECMO), and the Impella are the most common MCS devices in use. This review aims to summarize the clinical evidence for each of these devices and the potential mechanisms for the improvement in patient outcomes in HR-PCI. IABP use has rapidly declined in recent years due to no evidence of benefit in HR-PCI and cardiogenic shock. V-A ECMO results in low rates of major adverse cardiac and cerebrovascular events (MACCEs) but higher rates of acute kidney injury and increased need for transfusions. In initial studies, Impella resulted in a reduced need for repeat interventions and reduced rates of hypotension, but no benefit in mortality. However, MACCE rates with Impella have gradually declined over the last ten years, reflecting increased operator experience and technical improvements. Thus, a large, randomized trial is needed to assess the efficacy of Impella in HR-PCI with contemporary standards of care. There is currently no individual parameter that can identify patients who would benefit from MCS use in elective HR-PCI. To address this gap, we propose an algorithm that combines anatomical complexity, co-morbidities, and clinical presentation to accurately identify candidates for MCS-assisted HR-PCI.","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":" 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139788709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to manage ventricular arrhythmia in patients with viral myocarditis","authors":"Naoya Kataoka, T. Imamura","doi":"10.1093/ehjopen/oeae005","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae005","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"13 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139803547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to manage ventricular arrhythmia in patients with viral myocarditis","authors":"Naoya Kataoka, T. Imamura","doi":"10.1093/ehjopen/oeae005","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae005","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"12 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139863531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of extracorporeal membrane oxygenation on mortality in patients with cardiogenic shock post acute myocardial infarction: a systematic review and meta-analysis","authors":"S. Paddock, James Meng, Nicholas Johnson, Rahul Chattopadhyay, V. Tsampasian, V. Vassiliou","doi":"10.1093/ehjopen/oeae003","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae003","url":null,"abstract":"\u0000 \u0000 \u0000 Cardiogenic shock remains the leading cause of death in patients hospitalised with acute myocardial infarction. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used in the treatment of infarct-related cardiogenic shock. However, there is limited evidence regarding its beneficial impact on mortality.\u0000 \u0000 \u0000 \u0000 To systematically review studies reporting the impact of VA-ECMO on mortality in patients with acute myocardial infarction complicated by cardiogenic shock.\u0000 \u0000 \u0000 \u0000 Comprehensive search of medical databases (Cochrane Register, PubMed) was conducted. Studies that reported mortality outcomes in patients treated with VA-ECMO for infarct-related cardiogenic shock were included.\u0000 \u0000 \u0000 \u0000 The database search yielded 1194 results, of which 11 studies were included in the systematic review. Four of these studies, with a total of 586 patients, were randomised-controlled trials and were included in the meta-analysis. This demonstrated that there was no significant difference in 30-day all-cause mortality with the use of VA-ECMO compared to standard medical therapy (OR 0.91; 95% confidence interval (CI) 0.65-1.27). Meta-analysis of two studies showed that VA-ECMO was associated with a significant reduction in 12-month all-cause mortality (OR 0.31, CI 0.11-0.86). Qualitative synthesis of the observational studies showed that age, serum creatinine, serum lactate and successful revascularisation are independent predictors of mortality.\u0000 \u0000 \u0000 \u0000 VA-ECMO does not improve 30-day all-cause mortality in patients with cardiogenic shock following acute myocardial infarction, however there may be significant reduction in all-cause mortality at 12 months. Further studies are needed to delineate the potential benefit of VA-ECMO in long-term outcomes.\u0000 \u0000 \u0000 \u0000 The protocol was registered in the PROSPERO International Prospective Register of Systematic Reviews (ID: CRD42023461740).\u0000","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"76 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139526517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to articles in EHJ Open missing data availability statements.","authors":"","doi":"10.1093/ehjopen/oead137","DOIUrl":"https://doi.org/10.1093/ehjopen/oead137","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ehjopen/oeac008.][This corrects the article DOI: 10.1093/ehjopen/oeab044.][This corrects the article DOI: 10.1093/ehjopen/oeab014.][This corrects the article DOI: 10.1093/ehjopen/oeab022.][This corrects the article DOI: 10.1093/ehjopen/oeab023.][This corrects the article DOI: 10.1093/ehjopen/oeac054.][This corrects the article DOI: 10.1093/ehjopen/oeab002.][This corrects the article DOI: 10.1093/ehjopen/oeab006.][This corrects the article DOI: 10.1093/ehjopen/oeab013.][This corrects the article DOI: 10.1093/ehjopen/oeac001.][This corrects the article DOI: 10.1093/ehjopen/oeac005.].</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"4 1","pages":"oead137"},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10791141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479719","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":"Prognostic role of discordance between quantitative flow ratio and visual estimation in revascularization guidance.","authors":"Dimitrios Terentes-Printzios, Dimitrios Oikonomou, Konstantia-Paraskevi Gkini, Vasiliki Gardikioti, Konstantinos Aznaouridis, Ioanna Dima, Konstantinos Tsioufis, Charalambos Vlachopoulos","doi":"10.1093/ehjopen/oead125","DOIUrl":"10.1093/ehjopen/oead125","url":null,"abstract":"<p><strong>Aims: </strong>Revascularization guided by functional severity has presented improved outcomes compared with visual angiographic guidance. Quantitative flow ratio (QFR) is a reliable angiography-based method for functional assessment. We sought to investigate the prognostic value of discordance between QFR and visual estimation in coronary revascularization guidance.</p><p><strong>Methods and results: </strong>We performed offline QFR analysis on all-comers undergoing coronary angiography. Vessels with calculated QFR were divided into four groups based on the decision to perform or defer percutaneous coronary intervention (PCI) and on the QFR result, i.e.: Group A (PCI-, QFR > 0.8); Group B (PCI+, QFR ≤ 0.8); Group C (PCI+, QFR > 0.8); Group D (PCI-, QFR ≤ 0.8). Patients with at least one vessel falling within the disagreement groups formed the discordance group, whereas the remaining patients formed the concordance group. The primary endpoint was the composite endpoint of cardiovascular death, myocardial infarction, and ischaemia-driven revascularization. Overall, 546 patients were included in the study. Discordance between QFR and visual estimation was found in 26.2% of patients. After a median follow-up period of 2.5 years, the discordance group had a significantly higher rate of the composite outcome (hazard ratio: 3.34, 95% confidence interval 1.99-5.60, <i>P</i> < 0.001). Both disagreement vessel Groups C and D were associated with increased cardiovascular risk compared with agreement Groups A and B.</p><p><strong>Conclusion: </strong>Discordance between QFR and visual estimation in revascularization guidance was associated with a worse long-term prognosis. Our results highlight the importance of proper patient selection for intervention and the need to avoid improper stent implantations when not dictated by a comprehensive functional assessment.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"4 1","pages":"oead125"},"PeriodicalIF":0.0,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10763540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089731","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}