Pub Date : 2024-11-21DOI: 10.1093/eurheartj/ehae565
Giovanna Liuzzo, Paul M Ridker
{"title":"Universal screening for hsCRP in patients with atherosclerotic disease: a Major therapeutic opportunity.","authors":"Giovanna Liuzzo, Paul M Ridker","doi":"10.1093/eurheartj/ehae565","DOIUrl":"10.1093/eurheartj/ehae565","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"4731-4733"},"PeriodicalIF":37.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-21DOI: 10.1093/eurheartj/ehae563
Eva Havers-Borgersen, Dorthe Hartwell, Charlotte Ekelund, Jawad H Butt, Lauge Østergaard, Christine Holgersson, Morten Schou, Lars Køber, Emil L Fosbøl
Background and aims: Endometriosis, a systemic gynaecological disease affecting 10% of women in reproductive age, shares pathophysiological characteristics with cardiovascular disease. However, data on the relationship between endometriosis and cardiovascular outcomes are scarce, prompting this study to address the knowledge gap.
Methods: Using Danish nationwide registries, women diagnosed with endometriosis (1977-2021) were identified and matched with controls in a 1:4 ratio based on year of birth. The primary outcome was a composite of acute myocardial infarction and ischaemic stroke. The secondary outcomes were arrhythmias, heart failure, and mortality.
Results: In total, 60 508 women with endometriosis and 242 032 matched controls were included (median age 37.3 years). Women with endometriosis were more comorbid and used more medications than controls. The incidence rates of the composite outcomes were 3.2 [95% confidence interval (CI) 3.2-3.3] and 2.7 (95% CI 2.7-2.8) per 1000 person-years among women with and without endometriosis, respectively. Women with endometriosis had a significantly higher associated rate of the composite outcome compared with controls [unadjusted hazard ratio (HR) 1.18 (95% CI 1.14-1.23), adjusted HR 1.15 (95% CI 1.11-1.20)]. Likewise, women with endometriosis were also at significantly increased associated risk of arrhythmias [unadjusted HR 1.24 (95% CI 1.20-1.28) and adjusted HR 1.21 (95% CI 1.17-1.25)] and heart failure [unadjusted HR 1.16 (95% CI 1.09-1.22) and adjusted HR 1.11 (95% CI 1.05-1.18)] but at decreased risk of mortality [unadjusted HR 0.95 (95% CI 0.92-0.97) and adjusted HR 0.93 (95% CI 0.91-0.96)].
Conclusions: Women with endometriosis have a higher associated long-term risk of cardiovascular outcomes compared with controls. Despite subtle absolute risk differences, the high prevalence of endometriosis underscores the importance of these findings.
背景和目的：子宫内膜异位症是一种系统性妇科疾病，影响10%的育龄妇女，与心血管疾病具有相同的病理生理特征。然而，有关子宫内膜异位症与心血管疾病结果之间关系的数据却很少，因此本研究旨在填补这一知识空白：方法：利用丹麦全国范围的登记资料，对确诊患有子宫内膜异位症的女性（1977-2021 年）进行鉴定，并根据出生年份按 1:4 的比例与对照组进行配对。主要结果是急性心肌梗死和缺血性中风的综合结果。次要结果为心律失常、心力衰竭和死亡率：共纳入了 60,508 名患有子宫内膜异位症的妇女和 242,032 名匹配的对照组妇女（中位年龄为 37.3 岁）。与对照组相比，患有子宫内膜异位症的妇女合并症更多，使用的药物也更多。在患有和未患有子宫内膜异位症的妇女中，综合结果的发生率分别为每 1000 人年 3.2 例（95% 置信区间 [CI] 3.2-3.3）和 2.7 例（95% 置信区间 [CI] 2.7-2.8）。与对照组相比，患有子宫内膜异位症的妇女的综合结果相关率明显更高（未经调整的危险比 [HR] 为 1.18 [95% CI 1.14-1.23]，调整后的危险比为 1.15 [95% CI 1.11-1.20]）。同样，患有子宫内膜异位症的妇女发生心律失常（未调整 HR 1.24 [95% CI 1.20-1.28]，调整 HR 1.21 [95% CI 1.17-1.25]）和心力衰竭（未调整 HR 1.16 [95% CI 1.09-1.22]，调整后 HR 1.11 [95% CI 1.05-1.18]），但死亡风险降低（未调整 HR 0.95 [95% CI 0.92-0.97]，调整后 HR 0.93 [95% CI 0.91-0.96]）：结论：与对照组相比，患有子宫内膜异位症的妇女患心血管疾病的相关长期风险更高。结论：与对照组相比，患有子宫内膜异位症的妇女有更高的相关心血管疾病的长期风险。尽管绝对风险存在细微差别，但子宫内膜异位症的高发病率凸显了这些发现的重要性。
{"title":"Endometriosis and long-term cardiovascular risk: a nationwide Danish study.","authors":"Eva Havers-Borgersen, Dorthe Hartwell, Charlotte Ekelund, Jawad H Butt, Lauge Østergaard, Christine Holgersson, Morten Schou, Lars Køber, Emil L Fosbøl","doi":"10.1093/eurheartj/ehae563","DOIUrl":"10.1093/eurheartj/ehae563","url":null,"abstract":"<p><strong>Background and aims: </strong>Endometriosis, a systemic gynaecological disease affecting 10% of women in reproductive age, shares pathophysiological characteristics with cardiovascular disease. However, data on the relationship between endometriosis and cardiovascular outcomes are scarce, prompting this study to address the knowledge gap.</p><p><strong>Methods: </strong>Using Danish nationwide registries, women diagnosed with endometriosis (1977-2021) were identified and matched with controls in a 1:4 ratio based on year of birth. The primary outcome was a composite of acute myocardial infarction and ischaemic stroke. The secondary outcomes were arrhythmias, heart failure, and mortality.</p><p><strong>Results: </strong>In total, 60 508 women with endometriosis and 242 032 matched controls were included (median age 37.3 years). Women with endometriosis were more comorbid and used more medications than controls. The incidence rates of the composite outcomes were 3.2 [95% confidence interval (CI) 3.2-3.3] and 2.7 (95% CI 2.7-2.8) per 1000 person-years among women with and without endometriosis, respectively. Women with endometriosis had a significantly higher associated rate of the composite outcome compared with controls [unadjusted hazard ratio (HR) 1.18 (95% CI 1.14-1.23), adjusted HR 1.15 (95% CI 1.11-1.20)]. Likewise, women with endometriosis were also at significantly increased associated risk of arrhythmias [unadjusted HR 1.24 (95% CI 1.20-1.28) and adjusted HR 1.21 (95% CI 1.17-1.25)] and heart failure [unadjusted HR 1.16 (95% CI 1.09-1.22) and adjusted HR 1.11 (95% CI 1.05-1.18)] but at decreased risk of mortality [unadjusted HR 0.95 (95% CI 0.92-0.97) and adjusted HR 0.93 (95% CI 0.91-0.96)].</p><p><strong>Conclusions: </strong>Women with endometriosis have a higher associated long-term risk of cardiovascular outcomes compared with controls. Despite subtle absolute risk differences, the high prevalence of endometriosis underscores the importance of these findings.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"4734-4743"},"PeriodicalIF":37.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-21DOI: 10.1093/eurheartj/ehae734
{"title":"Correction to: Great debate: myocardial infarction after cardiac surgery must be redefined.","authors":"","doi":"10.1093/eurheartj/ehae734","DOIUrl":"10.1093/eurheartj/ehae734","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"4715"},"PeriodicalIF":37.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1093/eurheartj/ehae779
Matthew R Weir
{"title":"In memoriam: George L. Bakris, MD, 1952-2024.","authors":"Matthew R Weir","doi":"10.1093/eurheartj/ehae779","DOIUrl":"https://doi.org/10.1093/eurheartj/ehae779","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":37.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1093/eurheartj/ehae788
Omair Ahmed, Nicholas E King, Muhammad Ahmad Qureshi, Abira Afzal Choudhry, Muhammad Osama, Carl Zehner, Abdelrahman Ali, Ihab R Hamzeh, Nicolas L Palaskas, Kara A Thompson, Efstratios Koutroumpakis, Anita Deswal, Syed Wamique Yusuf
Non-bacterial thrombotic endocarditis (NBTE), formerly recognized as marantic endocarditis, represents a rare cardiovascular pathology intricately linked with hypercoagulable states, notably malignancy and autoimmune disorders. Characterized by the development of sterile vegetations comprised of fibrin and platelets on cardiac valves, NBTE poses a diagnostic challenge due to its resemblance to infective endocarditis. Therapeutic endeavours primarily revolve around addressing the underlying aetiology and instituting anticoagulant regimens to forestall embolic events, with surgical intervention seldom warranted. Non-bacterial thrombotic endocarditis frequently coexists with malignancies and autoimmune conditions, such as lupus and antiphospholipid antibody syndrome, and, more recently, has been associated with COVID-19. Its pathogenesis is underpinned by a complex interplay of endothelial dysfunction, hypercoagulability, hypoxia, and immune complex deposition. Clinical manifestations typically manifest as embolic phenomena, particularly cerebrovascular accidents, bearing substantial mortality rates. Diagnosis necessitates a high index of suspicion and meticulous exclusion of infective endocarditis, often facilitated by advanced cardiac imaging modalities. Anticoagulation, typically employing low molecular weight heparin or warfarin, constitutes the cornerstone of pharmacological intervention. Surgical recourse may be warranted in instances of refractory heart failure or recurrent embolic events. Given its multifaceted nature, the management of NBTE mandates a multidisciplinary approach, with prognosis contingent upon individual clinical intricacies. Future endeavours should prioritize further research to refine therapeutic strategies and enhance patient outcomes.
{"title":"Non-bacterial thrombotic endocarditis: a clinical and pathophysiological reappraisal","authors":"Omair Ahmed, Nicholas E King, Muhammad Ahmad Qureshi, Abira Afzal Choudhry, Muhammad Osama, Carl Zehner, Abdelrahman Ali, Ihab R Hamzeh, Nicolas L Palaskas, Kara A Thompson, Efstratios Koutroumpakis, Anita Deswal, Syed Wamique Yusuf","doi":"10.1093/eurheartj/ehae788","DOIUrl":"https://doi.org/10.1093/eurheartj/ehae788","url":null,"abstract":"Non-bacterial thrombotic endocarditis (NBTE), formerly recognized as marantic endocarditis, represents a rare cardiovascular pathology intricately linked with hypercoagulable states, notably malignancy and autoimmune disorders. Characterized by the development of sterile vegetations comprised of fibrin and platelets on cardiac valves, NBTE poses a diagnostic challenge due to its resemblance to infective endocarditis. Therapeutic endeavours primarily revolve around addressing the underlying aetiology and instituting anticoagulant regimens to forestall embolic events, with surgical intervention seldom warranted. Non-bacterial thrombotic endocarditis frequently coexists with malignancies and autoimmune conditions, such as lupus and antiphospholipid antibody syndrome, and, more recently, has been associated with COVID-19. Its pathogenesis is underpinned by a complex interplay of endothelial dysfunction, hypercoagulability, hypoxia, and immune complex deposition. Clinical manifestations typically manifest as embolic phenomena, particularly cerebrovascular accidents, bearing substantial mortality rates. Diagnosis necessitates a high index of suspicion and meticulous exclusion of infective endocarditis, often facilitated by advanced cardiac imaging modalities. Anticoagulation, typically employing low molecular weight heparin or warfarin, constitutes the cornerstone of pharmacological intervention. Surgical recourse may be warranted in instances of refractory heart failure or recurrent embolic events. Given its multifaceted nature, the management of NBTE mandates a multidisciplinary approach, with prognosis contingent upon individual clinical intricacies. Future endeavours should prioritize further research to refine therapeutic strategies and enhance patient outcomes.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"14 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142672948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1093/eurheartj/ehae729
Marco Witkowski, Stanley L Hazen
{"title":"Erythritol and xylitol and cardiovascular disease risk: a growing concern.","authors":"Marco Witkowski, Stanley L Hazen","doi":"10.1093/eurheartj/ehae729","DOIUrl":"https://doi.org/10.1093/eurheartj/ehae729","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":37.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1093/eurheartj/ehae725
Peter Libby, Marc A Pfeffer
{"title":"Happy birthday, Dr Braunwald!","authors":"Peter Libby, Marc A Pfeffer","doi":"10.1093/eurheartj/ehae725","DOIUrl":"https://doi.org/10.1093/eurheartj/ehae725","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":37.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1093/eurheartj/ehae801
Pankaj Garg, Anna Giulia Pavon, Martin Penicka, Seth Uretsky
This paper describes the role of cardiovascular magnetic resonance (CMR) imaging in assessing patients with mitral valve disease. Mitral regurgitation (MR) is one of the most prevalent valvular heart diseases. It often progresses without significant symptoms, leading to left ventricular overload, dysfunction, frequent decompensated heart failure episodes, and excess mortality. Cardiovascular magnetic resonance assessment is recommended for MR when routine ultrasound imaging information is insufficient or discordant. A well-planned CMR can provide an in-depth assessment of the mitral valve apparatus, leaflet morphology, and papillary muscles. In addition, it can precisely inform the impact of MR on left atrial and ventricular remodelling. The review aims to highlight established and emerging techniques for morphological assessment, flow assessment (including regurgitation and stenosis), myocardial assessment, and haemodynamic assessment of mitral valve disease by CMR. It also proposes a simplified clinical flow chart for CMR assessment of the mitral valve.
{"title":"Cardiovascular magnetic resonance imaging in mitral valve disease.","authors":"Pankaj Garg, Anna Giulia Pavon, Martin Penicka, Seth Uretsky","doi":"10.1093/eurheartj/ehae801","DOIUrl":"https://doi.org/10.1093/eurheartj/ehae801","url":null,"abstract":"<p><p>This paper describes the role of cardiovascular magnetic resonance (CMR) imaging in assessing patients with mitral valve disease. Mitral regurgitation (MR) is one of the most prevalent valvular heart diseases. It often progresses without significant symptoms, leading to left ventricular overload, dysfunction, frequent decompensated heart failure episodes, and excess mortality. Cardiovascular magnetic resonance assessment is recommended for MR when routine ultrasound imaging information is insufficient or discordant. A well-planned CMR can provide an in-depth assessment of the mitral valve apparatus, leaflet morphology, and papillary muscles. In addition, it can precisely inform the impact of MR on left atrial and ventricular remodelling. The review aims to highlight established and emerging techniques for morphological assessment, flow assessment (including regurgitation and stenosis), myocardial assessment, and haemodynamic assessment of mitral valve disease by CMR. It also proposes a simplified clinical flow chart for CMR assessment of the mitral valve.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":37.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1093/eurheartj/ehae673
Sandra Ortega-Martorell, Ivan Olier, Gregory Y H Lip
{"title":"A European network to develop virtual twin technology for personalized stroke management in atrial fibrillation: the TARGET consortium.","authors":"Sandra Ortega-Martorell, Ivan Olier, Gregory Y H Lip","doi":"10.1093/eurheartj/ehae673","DOIUrl":"https://doi.org/10.1093/eurheartj/ehae673","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":37.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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