Pub Date : 2024-10-05DOI: 10.1093/eurheartj/ehae345
Jocelyn M Friday, John G F Cleland, Pierpaolo Pellicori, Maria K Wolters, John J V McMurray, Pardeep S Jhund, Paul Forsyth, David A McAllister, Fraser J Graham, Yola Jones, Jim Lewsey
Background and aims: Many patients are prescribed loop diuretics without a diagnostic record of heart failure. Little is known about their characteristics and prognosis.
Methods: Glasgow regional health records (2009-16) were obtained for adults with cardiovascular disease or taking loop diuretics. Outcomes were investigated using Cox models with hazard ratios adjusted for age, sex, socioeconomic deprivation, and comorbid disease (adjHR).
Results: Of 198 898 patients (median age 65 years; 55% women), 161 935 (81%) neither took loop diuretics nor had a diagnostic record of heart failure (reference group), 23 963 (12%) were taking loop diuretics but had no heart failure recorded, 7844 (4%) had heart failure recorded and took loop diuretics, and 5156 (3%) had heart failure recorded but were not receiving loop diuretics. Compared to the reference group, five-year mortality was only slightly higher for heart failure in the absence of loop diuretics [22%; adjHR 1.2 (95% CI 1.1-1.3)], substantially higher for those taking loop diuretics with no record of heart failure [40%; adjHR 1.8 (95% CI 1.7-1.8)], and highest for heart failure treated with loop diuretics [52%; adjHR 2.2 (95% CI 2.0-2.2)].
Conclusions: For patients with cardiovascular disease, many are prescribed loop diuretics without a recorded diagnosis of heart failure. Mortality is more strongly associated with loop diuretic use than with a record of heart failure. The diagnosis of heart failure may be often missed, or loop diuretic use is associated with other conditions with a prognosis similar to heart failure, or inappropriate loop diuretic use increases mortality; all might be true.
背景与目的:许多患者在没有心力衰竭诊断记录的情况下被处方襻利尿剂。人们对这些患者的特征和预后知之甚少:收集了格拉斯哥地区心血管疾病或服用襻利尿剂成人的健康记录(2009-2016 年)。结果:在 198,898 名患者(198,898 人)中,有 1,440,000 人(198,898 人)患有心血管疾病或服用襻利尿剂:在198,898名患者(中位年龄65岁;55%为女性)中,161,935人(81%)既没有服用襻利尿剂,也没有心衰诊断记录(参照组);23,963人(12%)服用襻利尿剂但没有心衰记录;7,844人(4%)有心衰记录并服用襻利尿剂;5,156人(3%)有心衰记录但没有服用襻利尿剂。未服用襻利尿剂的心力衰竭患者的五年死亡率仅略高于襻利尿剂(22%;adjHR:1.2 [95% CI 1.1-1.3]),服用襻利尿剂但无心力衰竭记录的患者的五年死亡率大幅高于襻利尿剂(40%;adjHR:1.8 [95% CI 1.7-1.8]),而服用襻利尿剂的心力衰竭患者的五年死亡率最高(52%;adjHR:2.2 [95% CI 2.0-2.2]):结论:对于心血管疾病患者,许多人在没有心力衰竭诊断记录的情况下被处方襻利尿剂。死亡率与使用襻利尿剂的关系比与心衰记录的关系更为密切。心力衰竭的诊断可能经常被漏诊,或者襻利尿剂的使用与预后类似于心力衰竭的其他疾病有关,或者不适当地使用襻利尿剂会增加死亡率;所有这些可能都是事实。
{"title":"Loop diuretic therapy with or without heart failure: impact on prognosis.","authors":"Jocelyn M Friday, John G F Cleland, Pierpaolo Pellicori, Maria K Wolters, John J V McMurray, Pardeep S Jhund, Paul Forsyth, David A McAllister, Fraser J Graham, Yola Jones, Jim Lewsey","doi":"10.1093/eurheartj/ehae345","DOIUrl":"10.1093/eurheartj/ehae345","url":null,"abstract":"<p><strong>Background and aims: </strong>Many patients are prescribed loop diuretics without a diagnostic record of heart failure. Little is known about their characteristics and prognosis.</p><p><strong>Methods: </strong>Glasgow regional health records (2009-16) were obtained for adults with cardiovascular disease or taking loop diuretics. Outcomes were investigated using Cox models with hazard ratios adjusted for age, sex, socioeconomic deprivation, and comorbid disease (adjHR).</p><p><strong>Results: </strong>Of 198 898 patients (median age 65 years; 55% women), 161 935 (81%) neither took loop diuretics nor had a diagnostic record of heart failure (reference group), 23 963 (12%) were taking loop diuretics but had no heart failure recorded, 7844 (4%) had heart failure recorded and took loop diuretics, and 5156 (3%) had heart failure recorded but were not receiving loop diuretics. Compared to the reference group, five-year mortality was only slightly higher for heart failure in the absence of loop diuretics [22%; adjHR 1.2 (95% CI 1.1-1.3)], substantially higher for those taking loop diuretics with no record of heart failure [40%; adjHR 1.8 (95% CI 1.7-1.8)], and highest for heart failure treated with loop diuretics [52%; adjHR 2.2 (95% CI 2.0-2.2)].</p><p><strong>Conclusions: </strong>For patients with cardiovascular disease, many are prescribed loop diuretics without a recorded diagnosis of heart failure. Mortality is more strongly associated with loop diuretic use than with a record of heart failure. The diagnosis of heart failure may be often missed, or loop diuretic use is associated with other conditions with a prognosis similar to heart failure, or inappropriate loop diuretic use increases mortality; all might be true.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":null,"pages":null},"PeriodicalIF":37.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283308","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 : 2024-10-05DOI: 10.1093/eurheartj/ehae479
Stephan von Haehling, Wolfram Doehner, Ruben Evertz, Tania Garfias-Veitl, Carlotta Derad, Monika Diek, Mahir Karakas, Ralf Birkemeyer, Gerasimos Fillippatos, Mitja Lainscak, Javed Butler, Piotr Ponikowski, Michael Böhm, Tim Friede, Stefan D Anker
Background and aims: Evidence is lacking that correcting iron deficiency (ID) has clinically important benefits for patients with heart failure with preserved ejection fraction (HFpEF).
Methods: FAIR-HFpEF was a multicentre, randomized, double-blind trial designed to compare intravenous ferric carboxymaltose (FCM) with placebo (saline) in 200 patients with symptomatic HFpEF and ID (serum ferritin < 100 ng/mL or ferritin 100-299 ng/mL with transferrin saturation < 20%). The primary endpoint was change in 6-min walking test distance (6MWTD) from baseline to week 24. Secondary endpoints included changes in New York Heart Association class, patient global assessment, and health-related quality of life (QoL).
Results: The trial was stopped because of slow recruitment after 39 patients had been included (median age 80 years, 62% women). The change in 6MWTD from baseline to week 24 was greater for those assigned to FCM compared to placebo [least square mean difference 49 m, 95% confidence interval (CI) 5-93; P = .029]. Changes in secondary endpoints were not significantly different between groups. The total number of adverse events (76 vs. 114) and serious adverse events (5 vs. 19; rate ratio 0.27, 95% CI 0.07-0.96; P = .043) was lower with FCM than placebo.
Conclusions: In patients with HFpEF and markers of ID, intravenous FCM improved 6MWTD and was associated with fewer serious adverse events. However, the trial lacked sufficient power to identify or refute effects on symptoms or QoL. The potential benefits of intravenous iron in HFpEF with ID should be investigated further in a larger cohort.
背景与目的:目前尚无证据表明纠正缺铁(ID)对射血分数保留型心力衰竭(HFpEF)患者有重要临床益处:FAIR-HFpEF是一项多中心、随机、双盲试验,旨在比较静脉注射羧甲基铁蛋白(FCM)和安慰剂(生理盐水)对200名有症状的高射血分数心力衰竭和ID(血清铁蛋白<100纳克/毫升或铁蛋白100-299纳克/毫升,转铁蛋白饱和度<20%)患者的治疗效果。主要终点是6分钟步行测试距离(6MWTD)从基线到第24周的变化。次要终点包括纽约心脏协会分级、患者总体评估和健康相关生活质量(QoL)的变化:试验在纳入 39 名患者(中位年龄为 80 岁,62% 为女性)后因招募缓慢而停止。与安慰剂相比,接受 FCM 治疗的患者从基线到第 24 周的 6MWTD 变化更大[最小平方均差 49 米,95% 置信区间 (CI) 5-93; P = .029]。各组次要终点的变化无显著差异。FCM的不良事件总数(76对114)和严重不良事件总数(5对19;比率比0.27,95% CI 0.07-0.96;P = .043)均低于安慰剂:结论:静脉注射 FCM 可改善 HFpEF 患者的 6MWTD 并减少严重不良事件的发生。然而,该试验缺乏足够的力量来确定或反驳对症状或 QoL 的影响。静脉注射铁剂对 HFpEF 伴 ID 患者的潜在益处应在更大的群体中进一步研究。
{"title":"Ferric carboxymaltose and exercise capacity in heart failure with preserved ejection fraction and iron deficiency: the FAIR-HFpEF trial.","authors":"Stephan von Haehling, Wolfram Doehner, Ruben Evertz, Tania Garfias-Veitl, Carlotta Derad, Monika Diek, Mahir Karakas, Ralf Birkemeyer, Gerasimos Fillippatos, Mitja Lainscak, Javed Butler, Piotr Ponikowski, Michael Böhm, Tim Friede, Stefan D Anker","doi":"10.1093/eurheartj/ehae479","DOIUrl":"10.1093/eurheartj/ehae479","url":null,"abstract":"<p><strong>Background and aims: </strong>Evidence is lacking that correcting iron deficiency (ID) has clinically important benefits for patients with heart failure with preserved ejection fraction (HFpEF).</p><p><strong>Methods: </strong>FAIR-HFpEF was a multicentre, randomized, double-blind trial designed to compare intravenous ferric carboxymaltose (FCM) with placebo (saline) in 200 patients with symptomatic HFpEF and ID (serum ferritin < 100 ng/mL or ferritin 100-299 ng/mL with transferrin saturation < 20%). The primary endpoint was change in 6-min walking test distance (6MWTD) from baseline to week 24. Secondary endpoints included changes in New York Heart Association class, patient global assessment, and health-related quality of life (QoL).</p><p><strong>Results: </strong>The trial was stopped because of slow recruitment after 39 patients had been included (median age 80 years, 62% women). The change in 6MWTD from baseline to week 24 was greater for those assigned to FCM compared to placebo [least square mean difference 49 m, 95% confidence interval (CI) 5-93; P = .029]. Changes in secondary endpoints were not significantly different between groups. The total number of adverse events (76 vs. 114) and serious adverse events (5 vs. 19; rate ratio 0.27, 95% CI 0.07-0.96; P = .043) was lower with FCM than placebo.</p><p><strong>Conclusions: </strong>In patients with HFpEF and markers of ID, intravenous FCM improved 6MWTD and was associated with fewer serious adverse events. However, the trial lacked sufficient power to identify or refute effects on symptoms or QoL. The potential benefits of intravenous iron in HFpEF with ID should be investigated further in a larger cohort.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":null,"pages":null},"PeriodicalIF":37.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055270","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 : 2024-10-05DOI: 10.1093/eurheartj/ehae331
Troels Højsgaard Jørgensen, Hans Gustav Hørsted Thyregod, Mikko Savontaus, Yannick Willemen, Øyvind Bleie, Mariann Tang, Matti Niemela, Oskar Angerås, Ingibjörg J Gudmundsdóttir, Ulrik Sartipy, Hanna Dagnegaard, Mika Laine, Andreas Rück, Jarkko Piuhola, Petur Petursson, Evald H Christiansen, Markus Malmberg, Peter Skov Olsen, Rune Haaverstad, Lars Sondergaard, Ole De Backer
Background and aims: Transcatheter aortic valve implantation (TAVI) has become the first choice to treat older patients with severe symptomatic aortic stenosis (AS). This study aimed to compare TAVI with surgery in low-risk patients ≤75 years of age, including both tricuspid and bicuspid AS.
Methods: The Nordic Aortic Valve Intervention (NOTION)-2 trial enrolled and 1:1 randomized low-risk patients aged ≤75 years with severe symptomatic AS to TAVI or surgery. The primary endpoint was a composite of all-cause mortality, stroke, or rehospitalization (related to the procedure, valve, or heart failure) at 12 months.
Results: A total of 370 patients were enrolled with a mean age of 71.1 years and a median Society of Thoracic Surgeons risk score of 1.1%. A total of 100 patients had bicuspid AS. The 1-year incidence of the primary endpoint was 10.2% in the TAVI group and 7.1% in the surgery group [absolute risk difference 3.1%; 95% confidence interval (CI), -2.7% to 8.8%; hazard ratio (HR) 1.4; 95% CI, 0.7-2.9; P = .3]. Patients with TAVI, when compared to surgery, had lower risk of major bleeding and new-onset atrial fibrillation and higher risk of non-disabling stroke, permanent pacemaker implantation, and moderate or greater paravalvular regurgitation. The risk of the primary composite endpoint was 8.7% and 8.3% in patients with tricuspid AS (HR 1.0; 95% CI, 0.5-2.3) and 14.3% and 3.9% in patients with bicuspid AS (HR 3.8; 95% CI, 0.8-18.5) treated with TAVI or surgery, respectively (P for interaction = .1).
Conclusions: Among low-risk patients aged ≤75 years with severe symptomatic AS, the rate of the composite of death, stroke, or rehospitalization at 1 year was similar between TAVI and surgery. Transcatheter aortic valve implantation outcomes in young bicuspid AS patients warrant caution and should be further investigated. (NOTION-2, ClinicalTrials.gov, NCT02825134).
{"title":"Transcatheter aortic valve implantation in low-risk tricuspid or bicuspid aortic stenosis: the NOTION-2 trial.","authors":"Troels Højsgaard Jørgensen, Hans Gustav Hørsted Thyregod, Mikko Savontaus, Yannick Willemen, Øyvind Bleie, Mariann Tang, Matti Niemela, Oskar Angerås, Ingibjörg J Gudmundsdóttir, Ulrik Sartipy, Hanna Dagnegaard, Mika Laine, Andreas Rück, Jarkko Piuhola, Petur Petursson, Evald H Christiansen, Markus Malmberg, Peter Skov Olsen, Rune Haaverstad, Lars Sondergaard, Ole De Backer","doi":"10.1093/eurheartj/ehae331","DOIUrl":"10.1093/eurheartj/ehae331","url":null,"abstract":"<p><strong>Background and aims: </strong>Transcatheter aortic valve implantation (TAVI) has become the first choice to treat older patients with severe symptomatic aortic stenosis (AS). This study aimed to compare TAVI with surgery in low-risk patients ≤75 years of age, including both tricuspid and bicuspid AS.</p><p><strong>Methods: </strong>The Nordic Aortic Valve Intervention (NOTION)-2 trial enrolled and 1:1 randomized low-risk patients aged ≤75 years with severe symptomatic AS to TAVI or surgery. The primary endpoint was a composite of all-cause mortality, stroke, or rehospitalization (related to the procedure, valve, or heart failure) at 12 months.</p><p><strong>Results: </strong>A total of 370 patients were enrolled with a mean age of 71.1 years and a median Society of Thoracic Surgeons risk score of 1.1%. A total of 100 patients had bicuspid AS. The 1-year incidence of the primary endpoint was 10.2% in the TAVI group and 7.1% in the surgery group [absolute risk difference 3.1%; 95% confidence interval (CI), -2.7% to 8.8%; hazard ratio (HR) 1.4; 95% CI, 0.7-2.9; P = .3]. Patients with TAVI, when compared to surgery, had lower risk of major bleeding and new-onset atrial fibrillation and higher risk of non-disabling stroke, permanent pacemaker implantation, and moderate or greater paravalvular regurgitation. The risk of the primary composite endpoint was 8.7% and 8.3% in patients with tricuspid AS (HR 1.0; 95% CI, 0.5-2.3) and 14.3% and 3.9% in patients with bicuspid AS (HR 3.8; 95% CI, 0.8-18.5) treated with TAVI or surgery, respectively (P for interaction = .1).</p><p><strong>Conclusions: </strong>Among low-risk patients aged ≤75 years with severe symptomatic AS, the rate of the composite of death, stroke, or rehospitalization at 1 year was similar between TAVI and surgery. Transcatheter aortic valve implantation outcomes in young bicuspid AS patients warrant caution and should be further investigated. (NOTION-2, ClinicalTrials.gov, NCT02825134).</p><p><strong>Trial registration number: </strong>ClinicalTrials.gov NCT02825134.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":null,"pages":null},"PeriodicalIF":37.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921358","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 : 2024-10-05DOI: 10.1093/eurheartj/ehae427
Daniela Pedicino, Massimo Volpe
{"title":"Weekly Journal Scan: a 'thousand-mile' journey in obesity-related heart failure treatment begins with a few STEPs.","authors":"Daniela Pedicino, Massimo Volpe","doi":"10.1093/eurheartj/ehae427","DOIUrl":"10.1093/eurheartj/ehae427","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":null,"pages":null},"PeriodicalIF":37.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141563069","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}
Background and aims: Heart failure (HF) is a leading cause of mortality worldwide and characterized by significant co-morbidities and dismal prognosis. Neutrophil extracellular traps (NETs) aggravate inflammation in various cardiovascular diseases; however, their function and mechanism of action in HF pathogenesis remain underexplored. This study aimed to investigate the involvement of a novel VWF-SLC44A2-NET axis in HF progression.
Methods: NET levels were examined in patients with HF and mouse models of transverse aortic constriction (TAC) HF. PAD4 knockout mice and NET inhibitors (GSK-484, DNase I, NEi) were used to evaluate the role of NETs in HF. RNA sequencing was used to investigate the downstream mechanisms. Recombinant human ADAMTS13 (rhADAMTS13), ADAMTS13, and SLC44A2 knockouts were used to identify novel upstream factors of NETs.
Results: Elevated NET levels were observed in patients with HF and TAC mouse models of HF. PAD4 knockout and NET inhibitors improved the cardiac function. Mechanistically, NETs induced mitochondrial dysfunction in cardiomyocytes, inhibiting mitochondrial biogenesis via the NE-TLR4-mediated suppression of PGC-1α. Furthermore, VWF/ADAMTS13 regulated NET formation via SLC44A2. Additionally, sacubitril/valsartan amplifies the cardioprotective effects of the VWF-SLC44A2-NET axis blockade.
Conclusions: This study established the role of a novel VWF-SLC44A2-NET axis in regulating mitochondrial homeostasis and function, leading to cardiac apoptosis and contributing to HF pathogenesis. Targeting this axis may offer a potential therapeutic approach for HF treatment.
背景和目的:心力衰竭(HF)是导致全球死亡的主要原因,其特点是并发症多、预后差。中性粒细胞胞外捕获物(NET)会加重各种心血管疾病的炎症反应;然而,它们在心力衰竭发病机制中的功能和作用机制仍未得到充分探索。本研究旨在探讨新型 VWF-SLC44A2-NET 轴参与高血压进展的情况:方法:研究人员检测了高血脂患者和横纹主动脉缩窄(TAC)高血脂小鼠模型中的 NET 水平。采用 PAD4 基因敲除小鼠和 NET 抑制剂(GSK-484、DNase I、NEi)来评估 NET 在高房颤动中的作用。RNA 测序用于研究下游机制。利用重组人ADAMTS13(rhADAMTS13)、ADAMTS13和SLC44A2基因敲除来确定NET的上游新因素:结果:在高血压患者和高血压TAC小鼠模型中观察到NET水平升高。PAD4基因敲除和NET抑制剂改善了心脏功能。从机理上讲,NETs 可诱导心肌细胞线粒体功能障碍,通过 NE-TLR4 介导的 PGC-1α 抑制作用抑制线粒体的生物生成。此外,VWF/ADAMTS13 还通过 SLC44A2 调节 NET 的形成。此外,sacubitril/valsartan还能扩大VWF-SLC44A2-NET轴阻断的心脏保护作用:本研究证实了新型 VWF-SLC44A2-NET 轴在调节线粒体稳态和功能、导致心脏凋亡和引发高血压发病机制中的作用。以该轴为靶点可能为治疗高血压提供一种潜在的治疗方法。
{"title":"Von Willebrand factor exacerbates heart failure through formation of neutrophil extracellular traps.","authors":"Ge Mang, Jianfeng Chen, Ping Sun, Ruishuang Ma, Jingwen Du, Xiaoqi Wang, Jingxuan Cui, Mian Yang, Zhonghua Tong, Xiangyu Yan, Dongni Wang, Huiqi Xie, Yujia Chen, Qiannan Yang, Yingjin Kong, Jiaqi Jin, Jian Wu, Maomao Zhang, Bo Yu","doi":"10.1093/eurheartj/ehae517","DOIUrl":"10.1093/eurheartj/ehae517","url":null,"abstract":"<p><strong>Background and aims: </strong>Heart failure (HF) is a leading cause of mortality worldwide and characterized by significant co-morbidities and dismal prognosis. Neutrophil extracellular traps (NETs) aggravate inflammation in various cardiovascular diseases; however, their function and mechanism of action in HF pathogenesis remain underexplored. This study aimed to investigate the involvement of a novel VWF-SLC44A2-NET axis in HF progression.</p><p><strong>Methods: </strong>NET levels were examined in patients with HF and mouse models of transverse aortic constriction (TAC) HF. PAD4 knockout mice and NET inhibitors (GSK-484, DNase I, NEi) were used to evaluate the role of NETs in HF. RNA sequencing was used to investigate the downstream mechanisms. Recombinant human ADAMTS13 (rhADAMTS13), ADAMTS13, and SLC44A2 knockouts were used to identify novel upstream factors of NETs.</p><p><strong>Results: </strong>Elevated NET levels were observed in patients with HF and TAC mouse models of HF. PAD4 knockout and NET inhibitors improved the cardiac function. Mechanistically, NETs induced mitochondrial dysfunction in cardiomyocytes, inhibiting mitochondrial biogenesis via the NE-TLR4-mediated suppression of PGC-1α. Furthermore, VWF/ADAMTS13 regulated NET formation via SLC44A2. Additionally, sacubitril/valsartan amplifies the cardioprotective effects of the VWF-SLC44A2-NET axis blockade.</p><p><strong>Conclusions: </strong>This study established the role of a novel VWF-SLC44A2-NET axis in regulating mitochondrial homeostasis and function, leading to cardiac apoptosis and contributing to HF pathogenesis. Targeting this axis may offer a potential therapeutic approach for HF treatment.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":null,"pages":null},"PeriodicalIF":37.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142010234","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 : 2024-10-05DOI: 10.1093/eurheartj/ehae643
Filippo Crea
{"title":"New light shed on the treatment of heart failure and on novel therapeutic targets.","authors":"Filippo Crea","doi":"10.1093/eurheartj/ehae643","DOIUrl":"https://doi.org/10.1093/eurheartj/ehae643","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":null,"pages":null},"PeriodicalIF":37.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375315","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}