European Heart Journal

Journal Information
ISSN / EISSN: 0195668X / 15229645
Total articles ≅ 54,199

Latest articles in this journal

Published: 28 November 2022
Abstract:
This is an erratum to: Mihir A Kelshiker, Henry Seligman, James P Howard, Haseeb Rahman, Michael Foley, Alexandra N Nowbar, Christopher A Rajkumar, Matthew J Shun-Shin, Yousif Ahmad, Sayan Sen, Rasha Al-Lamee, Ricardo Petraco, the Coronary Flow Outcomes Reviewing Committee, Coronary flow reserve and cardiovascular outcomes: a systematic review and meta-analysis, European Heart Journal, Volume 43, Issue 16, 21 April 2022, Pages 1582–1593, https://doi.org/10.1093/eurheartj/ehab775.
Published: 24 November 2022
Abstract:
This editorial refers to ‘Association between basic life support and survival in sports-related sudden cardiac arrest: a meta-analysis’, by L. Michelland et al., https://doi.org/10.1093/eurheartj/ehab586.
Published: 24 November 2022
Abstract:
The long-term survival of patients with isolated congenital ventricular septal defect (VSD) is not well described. The aim of this study was to describe the survival of a national cohort of patients with VSD compared with the general population. Using Danish nationwide medical registries, all patients diagnosed with congenital VSD (n = 9,136) in the period 1977–2018 were included. Patients with chromosomal abnormalities and concomitant congenital cardiac malformations other than atrial septal defect were excluded. Each patient was matched by birthyear and sex with ten controls from the general Danish population. Kaplan−Meier survival function and Cox proportional hazard regression were used to compute survival and mortality risk. Median follow-up was 22 years (interquartile range: 11–37). VSD patients displayed lower survival (P<0.001) yielding a hazard ratio (HR) for mortality of 2.7 [95% confidence interval (CI): 2.4–3.0] compared with matched controls. The adjusted HR for mortality among patients with unrepaired VSD was 2.7 (95% CI: 2.4–3.0) and 2.8 (95% CI: 2.1–3.7) for patients with surgically closed VSD. Stratified by era of VSD diagnosis, the HR for mortality was 3.2 (95% CI: 2.8–3.7) for unrepaired patients diagnosed before 1990 and 2.4 (95% CI: 2.0–2.7) for patients diagnosed later. Cardiac-related death was the commonest cause of death among unrepaired (30%) and surgically closed (65%) patients. Patients with VSD had lower survival compared with the general population. The HR for mortality was increased over 2.5-fold in patients with unrepaired defect (Eisenmenger syndrome excluded) and over 1.5-fold in patients with surgically closed defect (excluding surgical mortality).
Published: 24 November 2022
Abstract:
The 2022 European Society of Cardiology (ESC) guidelines on cardio-oncology1 advise cardiologists, oncologists, and haematologists how to manage patients with cancer who may be at risk of cancer therapy-related cardiovascular toxicity (CTR-CVT).
Bo Wang, Randall J Lee,
Published: 24 November 2022
Abstract:
A 55-year-old male with dilated cardiomyopathy presented with decompensated heart failure (HF). Magnetic resonance imaging (MRI) revealed left ventricular (LV) enlargement (Panel A). The LV ejection fraction (LVEF), end-diastolic volume index (EDVI), and end-systolic volume index (ESVI) were 16%, 234 and 196.8 mL/m2, respectively. The heart team enrolled him in our clinical trial (NCT04781660), designed to evaluate the feasibility and safety of transcatheter endocardial alginate hydrogel implantation (TEAi) for treating HF. The concept of LV augmentation with the alginate hydrogel (AH) uses Laplace's law (Panel B), which increases the LV wall's thickness, reduces the wall stress, and improves cardiac function.1–5 Three-dimension printing techniques were used to evaluate the LV wall thickness (Panels C and D) and to simulate the procedure (Panel F). An 18-F guiding catheter was inserted via the femoral artery and guided crossing the aortic valve under fluoroscopy. Injections were performed with a steerable, dual-lumen needle catheter (Panel E). Transesophageal echocardiography was used to locate the injection sites. The tip of the catheter reached the endocardium (Panel G, arrow), and contrast was injected into the LV wall to identify no leakage or perforation (Panel H). The AH was injected into the myocardium at the mid-LV free wall for 10 sites and 3 ml (Panels I, arrow). Six-month following the procedure, the patient's clinical status was significantly improved (NYHA Class II). MRI confirmed that the LVEF was 22%, with a reduction in EDVI (188.25 mL/m2) and ESVI (146.36 mL/m2). This case demonstrated that TEAi could be effectively and safely performed.
, Hongpeng Zhang,
Published: 22 November 2022
Abstract:
A 73-year-old man presented with a history of thoracic endovascular aortic repair for aortic dissection 10 years earlier. Computed tomography angiography revealed post-dissection aneurysm (maximum diameter 5.6 cm) with incomplete thrombosis of a false lumen (Panel A) and multiple distal re-entry tears [two on the descending thoracic aorta (Panels B and C) and others on the left renal artery and both iliac arteries; see Supplementary material online , Video S1]. The ENDOPATCH™ has an implant and a matched delivery system.1 The implant, which has a double-disc structure connected by a short central waist, crossed the re-entry tears through the steerable delivery sheath (Panel D) and released each disc on both sides of the re-entry tear sequentially (Panels E and F). Finally, a mechanical interlock stabilized the two attached discs on the intimal flap (Panel G). Following intercostal artery embolization, the ENDOPATCH entered the false lumen through the re-entry tear on the right iliac artery (Panel H), and the implants were released successively to seal the two separate re-entry tears on the descending thoracic aorta (Panel I); Supplementary material online , Video S2 illustrates the first implant release in detail. Intraoperative angiography showed that both implants obtained an adequate sealing effect (see Supplementary material online , Video S3). Other re-entry tears were conventionally covered by stent graft. Computed tomography angiography 12 months later showed that both implants were well fixed without surrounding endoleak and complete thrombosis in the false lumen (Panels J–L; Supplementary material online , Video S4).
Leizhi Ku, Youping Chen, Xiaojing Ma
Published: 22 November 2022
Abstract:
A 48-year-old male visited our emergency department for sudden onset of chest pain for 5 h. He had undergone radiofrequency ablation for atrial fibrillation 20 days ago. Laboratory tests revealed a white blood cell count of 12.2 × 109/L, a neutrophil percentage of 91%, an ultrasensitive C-reactive protein of 20.73 mg/L, and an erythrocyte sedimentation rate of 54 mm/1 h end. Transthoracic echocardiography revealed left heart enlargement, moderate mitral regurgitation, and mildly decreased left ventricular systolic function. Computed tomography (CT) showed clustered air bubbles adjacent to the mid-oesophagus (Panel A), a large amount of pneumopericardium, and a small amount of intrapericardial fluid (Panels B and C). Given his history, we suspected a pericardial–esophageal fistula (PEF). Emergency PEF was explored, intraoperatively, and it was observed that there was an 8 mm fistula in the mid-oesophagus and pyopericardium. The patient underwent surgical repair of the PEF with the wrapping of the omentum and pericardiotomy for abscess evacuation. Cardiac computed tomography angiography reexamination showed that the fistula had completely healed after 3 days (Panel D). The patient had an uneventful recovery and was discharged without further incident.
, Aenne S von Falkenhausen
Published: 18 November 2022
Abstract:
Atrial cardiomyopathy continuously develops over the life span. A healthy (left) and a severely altered (right) atrium are symbolized by electro-anatomical mapping results and by the electrocardiogram rhythm strips in sinus rhythm and atrial fibrillation, respectively. In relation to the progressing atrial cardiomyopathy, bone morphogenetic protein 10 (BMP10) levels, the prevalence of atrial fibrillation, and the risk of stroke also increase. Yet, the exact magnitude and timing of their associations have not been fully determined, as indicated by the increasing degree of uncertainty visualized by the error bars. Electro-anatomical mapping images obtained from the authors' own repositories, with permissions.
, , , John H Alexander, Stuart J Connolly, , Christopher B Granger, Peter Kastner, , André Ziegler, et al.
Published: 16 November 2022
Abstract:
Biomarkers specifically related to atrial tissue may increase the understanding of the pathophysiology of atrial fibrillation (AF) and further improve risk prediction in this setting. Bone morphogenetic protein 10 (BMP10) is a protein expressed in the atrial myocardium. We evaluated the association between BMP10 and the risk of ischaemic stroke and other cardiovascular events in large cohorts of patients with AF, treated with and without oral anticoagulation (OAC). BMP10 was measured in plasma samples collected at randomisation in patients with AF without OAC in the ACTIVE A and AVERROES trials (n = 2974), and with OAC in the ARISTOTLE trial (n = 13 079). BMP10 was analysed with a prototype Elecsys immunoassay. Associations with outcomes were evaluated by Cox-regression models adjusted for clinical characteristics, kidney function, and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Median concentrations of BMP10 were 2.47 and 2.44 ng/mL, in the non-OAC and OAC cohort, respectively. Increasing BMP10 was associated with lower body mass index, older age, female sex, kidney dysfunction, and AF rhythm. BMP10 was consistently associated with ischaemic stroke. In the non-OAC cohort, BMP10 increased the concordance index of the multivariable model from 0.713 to 0.733 (P = 0.004) and in the OAC cohort from 0.673 to 0.694 (P < 0.001). Additionally, BMP10 maintained a significant prognostic value after additionally adjusting for NT-proBNP. BMP10 was not independently associated with bleeding or with death. The novel atrial biomarker BMP10 was independently associated with ischaemic stroke in patients with AF irrespective of OAC treatment. BMP10 seems to be more specifically related to the risk of ischaemic stroke in AF. In this study, BMP10 may be a novel specific biomarker of ischaemic stroke in patients with atrial fibrillation, irrespective of oral anticoagulation.
Back to Top Top