Heart rhythm最新文献_第10页

Three-year outcomes of glucagon-like peptide-1 agonists in atrial fibrillation with sarcoidosis and diabetes 胰高血糖素样肽-1激动剂治疗伴有结节病和糖尿病的心房颤动的3年疗效

IF 5.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm

Pub Date : 2026-03-01 Epub Date: 2025-05-08 DOI: 10.1016/j.hrthm.2025.04.067

Min Choon Tan MD , Aravinthan Vignarajah MD , Yong Shen Teo , Justin Z. Lee MD, FHRS , Andrea M. Russo MD, FHRS , Christopher V. DeSimone MD, FHRS , Abhishek J. Deshmukh MD, FHRS , Dan Sorajja MD, FHRS , Hicham Z. El Masry MD, FHRS

引用次数: 0

Commentary: Sudden death in competitive student-athletes with hypertrophic cardiomyopathy at a crossroads: Critical views on liberalizing return-to-play eligibility 评论：突然死亡的竞争性学生运动员与肥厚性心肌病在一个十字路口：对自由回归比赛资格的批评意见。

IF 5.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm

Pub Date : 2026-03-01 Epub Date: 2025-06-19 DOI: 10.1016/j.hrthm.2025.06.014

Barry J. Maron MD , Ethan J. Rowin MD , Jiri Bonaventura MD , Cristina Basso MD , Domenico Corrado MD , Gaetano Thiene MD , Andre L. Churchwell MD , Fred Basilico MD , Paul D. Thompson MD , Rick A. Nishimura MD , N.A. Mark Estes MD

引用次数: 0

Preprocedural computed tomography angiography-based conduction system simulation for optimized patient-specific transcatheter aortic valve implantation deployment 术前基于cta的传导系统仿真优化患者特异性TAVI部署。

IF 5.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm

Pub Date : 2026-03-01 Epub Date: 2025-11-17 DOI: 10.1016/j.hrthm.2025.11.024

Philipp Ruile MD , Philipp Breitbart MD , Tau Hartikainen MD , Shlomo A. Ben-Haim MD , Justin T. Tretter MD , Dirk Westermann MD, PhD

Background

Conduction disturbances requiring permanent pacemaker implantation (PPI) remain a major limitation to transcatheter aortic valve implantation (TAVI).

Objective

We applied post hoc classification using a novel preprocedural computed tomography angiography (CTA)-based conduction system simulation technology to understand optimized patient-specific TAVI implantation depth to reduce PPI risk.

Methods

CARA Metis conduction system simulation based on identifying key landmarks of the conduction axis was retrospectively applied to patients who received TAVI. Device depth was measured from postprocedural CTA. The primary outcome was postprocedural PPI. Post hoc classification of patients into 4 implantation strategies was applied: (1) patient-specific conduction system protocol vs (2) implantation 1–2 mm, (3) 2–3 mm, and (4) 3–4 mm below the aortic annulus, respectively.

Results

Among 228 patients (median age 82.0; 57% female), 51 (22.4%) required PPI. Mean (standard deviation) distances of the estimated course of His bundle (point B and midpoint BC) and left bundle branch origin (point C) to the aortic annulus were 5.3 mm (2.3), 3.9 mm (2.1), and 2.5 mm (2.2), respectively. Implantation below the conduction pathway (n = 203) resulted in significantly higher odds of PPI (for each 1 mm below points B, midpoint BC, and C, odds ratio [OR] 1.25 [95% confidence interval {CI} 1.14–1.39], OR 1.27 [95% CI 1.14–1.42], and OR 1.24 [95% CI 1.12–1.38], respectively). Implantation above (n = 25) resulted in significantly fewer PPI (0.0% vs 17.4%, 10.0%, and 25.0% implanting above the patient’s conduction system vs 1–2 mm, 2–3 mm, and 3–4 mm below the aortic annulus, respectively; P < .0001).

Conclusion

CTA-based conduction system simulation may offer a patient-specific, conduction-axis-guided TAVI deployment strategy, minimizing the need for PPI. The results of this study are hypothesis generating and require prospective trial validation.

背景：需要永久性起搏器植入（PPI）的传导障碍仍然是经导管主动脉瓣植入（TAVI）的主要限制。目的：我们采用一种新的术前计算机断层血管造影（CTA）为基础的传导系统模拟技术进行事后分类，以了解最佳的患者特异性TAVI植入深度，以降低PPI风险。方法：回顾性应用基于识别传导轴关键标志的CARA Metis传导系统模拟技术应用于TAVI患者。术后CTA测量装置深度。主要结局为术后PPI。将患者分为四种植入策略：(1)患者特异性传导系统方案，(2)分别植入主动脉环下1-2mm、(3)2-3mm和(4)3-4mm。结果：228例患者（中位年龄82.0岁，57%为女性）中，51例（22.4%）需要使用PPI。His束（B点和BC中点）和左束分支起点（C点）到主动脉环的估计路径的平均（SD）距离分别为5.3(2.3)mm, 3.9(2.1) mm和2.5(2.2)mm。植入传导通路以下（n=203）导致PPI的发生率显著升高(在B点、BC点和C点以下每1mm: OR=1.25(95% CI[1.14-1.39]， OR=1.27(95% CI[1.14-1.42])， OR=1.24（95% CI[1.12-1.38]）。植入于主动脉环下方1-2mm、2-3mm和3-4mm的上方（n=25）， PPI明显降低（分别为0.0%、17.4%、10.0%和25.0%,p < 0.0001）。结论：基于cta的传导系统模拟可以提供一种患者特异性的、传导轴引导的TAVI部署策略，最大限度地减少对PPI的需求。本研究的结果是假设产生的，需要前瞻性试验验证。

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引用次数: 0

Ablation of idiopathic ventricular arrhythmias from the right ventricular apex 特发性室性心律失常的右心室尖消融。

IF 5.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm

Pub Date : 2026-03-01 Epub Date: 2025-11-20 DOI: 10.1016/j.hrthm.2025.11.035

Jeremy Y. Feng MD , David S. Frankel MD , Gregory Supple MD , Fermin C. Garcia MD , Jeffrey S. Arkles MD , Saman Nazarian MD, PhD , Vincent Y. See MD , Roderick Tung MD , Erica S. Zado PA-C , Francis E. Marchlinski MD , Luis C. Saenz MD , Robert D. Schaller DO

Background

Idiopathic ventricular arrhythmias (VAs) from the right ventricle (RV) are well-described, but limited data exist regarding those from the RV apex.

Objective

The purpose of this study was to define the electrocardiographic (ECG) characteristics and ablation outcomes of RV apical VAs, including premature ventricular contractions (PVCs) and ventricular tachycardia.

Methods

Patients undergoing catheter ablation for RV apical VAs at 3 centers were retrospectively analyzed. VAs from the moderator band, papillary muscles, or associated with significant structural heart disease were excluded. Clinical characteristics, ECG features, procedural details, and follow-up data were assessed.

Results

12 patients were included (4 (33%) with PVCs, 7 (58%) with monomorphic ventricular tachycardia, and 1 (8%) with PVCs triggering ventricular fibrillation). All VAs exhibited a left bundle branch block pattern with a left superior axis and negative concordance. The mean QRS duration was 167 ± 14 ms. Nine patients (75%) underwent a single ablation procedure, 2 (17%) required 1 repeat procedure, and 1 (8%) required 2. Endocardial ablation was effective in 8 patients (67%), with 4 (33%) requiring endocardial and epicardial ablation. After a median follow-up of 57 months (interquartile range 12–74 months) in 11 patients, 10 (91%) remained free of recurrence (7 by rhythm monitoring and 3 by symptom resolution). 1 patient (9%) required antiarrhythmic therapy for recurrence; all others remained off therapy. One implantable cardioverter-defibrillator was extracted after successful ablation. Of the 2 patients with suspected PVC-induced cardiomyopathy, 1 fully recovered and 1 progressed to heart failure requiring transplantation, despite normal cardiac magnetic resonance imaging and PVC suppression.

Conclusion

RV apical VAs demonstrate a distinctive ECG morphology that aids localization. Catheter ablation is effective but may require an epicardial approach.

背景：特发性室性心律失常（VAs）来自右心室（RV）的描述很好，但关于右心室（RV）的数据有限。目的：探讨左室尖顶输精管的心电图特征及消融结果，包括室性早搏（PVCs）和室性心动过速（VT）。方法：回顾性分析三个中心行RV根尖输精管消融的患者。排除来自调节带、乳头状肌或有明显结构性心脏病的VAs。评估临床特征、心电图特征、手术细节和随访资料。结果：共纳入12例患者，其中室性早搏4例，单型室性早搏7例，室性早搏诱发室颤1例。所有VAs均表现为左束支阻滞模式，左上轴呈负一致性。QRS平均持续时间为167±14 ms。9例患者接受了一次消融，2例需要一次重复消融，1例需要两次消融。心内膜消融在8例患者中有效，其中4例需要心内膜和心外膜消融。11例患者中位随访57个月（IQR 12-74）后，10例无复发（7例节律监测，3例症状缓解）。一种需要抗心律失常治疗复发；其他所有人都没有接受治疗。消融成功后取出1台植入式心律转复除颤器。在2例疑似室性早搏诱发心肌病患者中，1例完全恢复，1例进展为心力衰竭需要移植，尽管心脏磁共振成像正常且室性早搏抑制。结论：右心室根尖VAs表现出独特的心电图形态，有助于定位。导管消融是有效的，但可能需要心外膜入路。

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引用次数: 0

Epicardial connection after radiofrequency mitral isthmus ablation 射频二尖瓣峡部消融后的心外膜连接。

IF 5.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm

Pub Date : 2026-03-01 Epub Date: 2025-12-03 DOI: 10.1016/j.hrthm.2025.11.047

Naohiko Kawaguchi MD , Yasuaki Tanaka MD , Kenji Okubo MD , Joonmo Chang MD , Hirotaka Yano MD , Emiko Nakashima MD , Hiroyuki Hikita MD , Tetsuo Sasano MD , Atsushi Takahashi MD

Background

Epicardial Marshall bundle (MB) conduction status after successful mitral isthmus (MI) ablation remains uncertain.

Objective

This study investigated the incidence of epicardial MB reconduction and its clinical importance as a critical isthmus for atrial tachycardia (AT).

Methods

We enrolled consecutive patients undergoing repeat ablation who had a previously confirmed MI conduction block after radiofrequency ablation. MI conduction status, particularly via the epicardial MB, was assessed using a catheter in the vein of Marshall (VOM). MB reconnection was evaluated during sinus rhythm analyzing activation sequences and differential pacing studies via the VOM catheter. During AT, reconnection was further assessed using 3-dimensional mapping and entrainment pacing studies.

Results

55 patients with successful VOM catheter insertion were evaluated. Recurrent MI conduction was observed in 33 patients (60%). 31 of these (94%) had epicardial MB involvement; 17 had reconnections through the endocardial MI and coronary sinus musculature, whereas 14 had reconnections exclusively through the MB. These exclusive epicardial reconnections served as an isthmus for reentrant AT in 7 of the 14 patients (50%). Among 22 patients with sustained MI block including the MB, 2 demonstrated AT using a blocked MB remnant. 33 MBs, including 9 that functioned as an AT isthmus, were ablated. VOM ethanol infusion alone or with radiofrequency ablation successfully eliminated all target MB conductions.

Conclusion

Epicardial MB conduction frequently reconnects, even after a previous MI block creation, and is strongly associated with AT involving this connection. VOM ethanol infusion may facilitate effective epicardial ablation, thereby contributing to durable transmural MI block.

背景：二尖瓣峡部（MI）消融成功后心外膜马歇尔束（MB）传导状态仍不确定。目的：探讨心外膜MB再传导的发生率及其作为房性心动过速（AT）关键峡部的临床意义。方法：我们招募了连续接受重复消融的患者，这些患者之前在射频消融后证实有心肌梗死传导阻滞。心肌传导状态，特别是通过心外膜MB，评估使用导管在静脉马歇尔（VOM）。通过VOM导管进行窦性心律分析激活序列和差异起搏研究，评估MB重连。在AT期间，通过三维测绘和夹带起搏研究进一步评估再连接。结果：对55例成功置入VOM导管的患者进行了评价。33例（60%）患者心肌传导复发。其中31例（94%）有心外膜MB受累；17例通过心内膜心肌梗死和冠状窦肌组织进行再连接，14例仅通过MB进行再连接。14例患者中有7例（50%）通过心外膜再连接作为再入性AT的峡部。在包括MB在内的22例持续心肌梗死阻断患者中，2例使用阻断的MB残余表现出AT。共切除33个mb，其中9个具有AT峡功能。VOM乙醇输注单独或射频消融成功消除所有靶MB传导。结论：心外膜MB传导频繁地重新连接，即使在先前的心肌梗塞形成后也是如此，并且与涉及该连接的AT密切相关。VOM乙醇输注可促进有效的心外膜消融，从而有助于持久的、跨壁心肌梗死阻滞。

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引用次数: 0

Acute kidney injury and haptoglobin depletion after pulsed field ablation: Impact of device type under routine hydration protocol 脉冲场消融后急性肾损伤和珠蛋白耗竭：常规水合方案下装置类型的影响。

IF 5.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm

Pub Date : 2026-03-01 Epub Date: 2025-12-08 DOI: 10.1016/j.hrthm.2025.12.009

Yosuke Hayashi MD , Shinsuke Miyazaki MD , So Asano MD , Yukio Sekiguchi MD , Junichi Nitta MD , Tetsuo Sasano MD

Background

Hemolysis can occur after pulsed field ablation (PFA) and cause acute kidney injury (AKI).

Objectives

This study aimed to identify the risk factors for severe hemolysis, defined as haptoglobin depletion, and AKI after PFA for atrial fibrillation (AF).

Methods

Consecutive patients who underwent postoperative blood testing to assess renal function and hemolysis after AF ablation using 2 different PFA systems were included. All patients received 1500 mL of perioperative intravenous saline. Haptoglobin depletion was defined as levels below the assay’s lower detection limit for the phenotype.

Results

A total of 211 patients (68 years; 69% male; 58% paroxysmal AF; Farapulse: n = 117; PulseSelect: n = 94) were included. The total PFA application number was 56 (44–62) and 43 (39–48) in the Farapulse and PulseSelect groups, respectively. Haptoglobin depletion and AKI occurred in 56 (27%) and 13 (6%) patients. One patient was rehospitalized, and 5 had prolonged stays owing to AKI. AKI was significantly more frequent in patients with higher body mass index (26.5 ± 4.7 vs 23.8 ± 3.7 kg/m², P = .014) and lower baseline estimated glomerular filtration rate (50.9 ± 14.8 vs 63.0 ± 12.6 mL/min per 1.73 m², P < .01). In multivariate analysis, Farapulse use (odds ratio, 3.33; 95% confidence interval, 1.56–7.10; P < .01) and absence of diabetes mellitus (odds ratio, 3.59; 95% confidence interval, 1.170–11.100; P = .026) were significantly associated with haptoglobin depletion. No significant association was observed among postoperative AKI and haptoglobin depletion, type of PFA system, or total application numbers.

Conclusions

Under routine perioperative fluid administration, lower renal function and higher body mass index were associated with postoperative AKI, whereas Farapulse use and absence of diabetes mellitus were associated with severe hemolysis.

背景：脉冲场消融（PFA）后可发生溶血并导致急性肾损伤（AKI）。目的：本研究旨在确定心房颤动（AF）患者PFA后严重溶血（定义为触珠蛋白耗竭）和AKI的危险因素。方法：采用两种不同的PFA系统进行房颤消融后连续患者的术后血液检测以评估肾功能和溶血情况。所有患者围手术期静脉滴注生理盐水1500 mL。触珠蛋白耗竭被定义为低于检测表型的最低检测限的水平。结果：共纳入211例患者（68岁，男性69%，阵发性房颤58%，Farapulse: n=117, PulseSelect: n=94）。Farapulse组和PulseSelect组PFA总申请量分别为56例[44-62]和43例[39-48]。56例（27%）和13例（6%）患者出现触珠蛋白缺失和AKI。1名患者再次住院，5名患者因AKI延长住院时间。体重指数（BMI）较高（26.5±4.7 vs. 23.8±3.7 kg/m2, p=0.014）和基线肾小球滤过率较低（50.9±14.8 vs. 63.0±12.6 mL/min/1.73m2）的患者AKI发生率更高。结论：围手术期常规给液，肾功能降低和BMI升高与术后AKI相关，而使用Farapulse和无糖尿病与严重溶血相关。

{"title":"Acute kidney injury and haptoglobin depletion after pulsed field ablation: Impact of device type under routine hydration protocol","authors":"Yosuke Hayashi MD , Shinsuke Miyazaki MD , So Asano MD , Yukio Sekiguchi MD , Junichi Nitta MD , Tetsuo Sasano MD","doi":"10.1016/j.hrthm.2025.12.009","DOIUrl":"10.1016/j.hrthm.2025.12.009","url":null,"abstract":"<div><h3>Background</h3><div>Hemolysis can occur after pulsed field ablation (PFA) and cause acute kidney injury (AKI).</div></div><div><h3>Objectives</h3><div>This study aimed to identify the risk factors for severe hemolysis, defined as haptoglobin depletion, and AKI after PFA for atrial fibrillation (AF).</div></div><div><h3>Methods</h3><div>Consecutive patients who underwent postoperative blood testing to assess renal function and hemolysis after AF ablation using 2 different PFA systems were included. All patients received 1500 mL of perioperative intravenous saline. Haptoglobin depletion was defined as levels below the assay’s lower detection limit for the phenotype.</div></div><div><h3>Results</h3><div>A total of 211 patients (68 years; 69% male; 58% paroxysmal AF; Farapulse: n = 117; PulseSelect: n = 94) were included. The total PFA application number was 56 (44–62) and 43 (39–48) in the Farapulse and PulseSelect groups, respectively. Haptoglobin depletion and AKI occurred in 56 (27%) and 13 (6%) patients. One patient was rehospitalized, and 5 had prolonged stays owing to AKI. AKI was significantly more frequent in patients with higher body mass index (26.5 ± 4.7 vs 23.8 ± 3.7 kg/m<sup>2</sup>, <em>P</em> = .014) and lower baseline estimated glomerular filtration rate (50.9 ± 14.8 vs 63.0 ± 12.6 mL/min per 1.73 m<sup>2</sup>, <em>P</em> < .01). In multivariate analysis, Farapulse use (odds ratio, 3.33; 95% confidence interval, 1.56–7.10; <em>P</em> < .01) and absence of diabetes mellitus (odds ratio, 3.59; 95% confidence interval, 1.170–11.100; <em>P</em> = .026) were significantly associated with haptoglobin depletion. No significant association was observed among postoperative AKI and haptoglobin depletion, type of PFA system, or total application numbers.</div></div><div><h3>Conclusions</h3><div>Under routine perioperative fluid administration, lower renal function and higher body mass index were associated with postoperative AKI, whereas Farapulse use and absence of diabetes mellitus were associated with severe hemolysis.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"23 3","pages":"Pages e368-e374"},"PeriodicalIF":5.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145722146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Novel use of KardiaMobile device to assess for vector suitability for subcutaneous implantable cardioverter-defibrillator implantation 新应用的可移动KardiaMobile装置评估皮下植入式心脏除颤器植入载体的适用性。

IF 5.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm

Pub Date : 2026-03-01 Epub Date: 2025-11-13 DOI: 10.1016/j.hrthm.2025.11.013

Rand Ibrahim MD , Ali Bahrami Rad PhD , Mikael Toye PhD , Michael Debakey MD , Mikhael El-Chami MD, FHRS , Shahriar Iravanian MD , Anand Shah MD , Michael Lloyd MD, FHRS , Stacy Westerman MD , Faisal M. Merchant MD, FHRS , Gari Clifford PhD , Neal K. Bhatia MD

引用次数: 0

Associations between biomarkers and P-wave indices in relation to atrial fibrillation development in heart failure patients 心力衰竭患者心房颤动发展的生物标志物和p波指数之间的关系

IF 5.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm

Pub Date : 2026-03-01 Epub Date: 2025-11-13 DOI: 10.1016/j.hrthm.2025.11.015

Zainu Nezami MD , Amra Jujic MSc, PhD , Marcus Ohlsson MD, PhD , Martin Magnusson MD, PhD , Hannes Holm Isholth MD, PhD , Pyotr G. Platonov MD, PhD, FHRS

Background

The predictive value of atrial conduction abnormalities, reflected by P-wave indices (PWIs), and their association with biomarkers signaling fibrosis for the development of atrial fibrillation (AF) in patients with heart failure (HF) remains underexplored.

Objective

We aimed to investigate the associations among PWIs, fibrosis biomarkers, and the risk of incident AF in patients with HF.

Methods

A total of 476 patients (mean age 74.6 years; 68% male) with new-onset or worsening HF were followed for 5 years. Fibrosis-associated biomarkers (tissue inhibitor of metalloproteinase 4, matrix metalloproteinase 2 [MMP-2], matrix metalloproteinase 3, matrix metalloproteinase 9, suppression of tumorigenicity 2, growth/differentiation factor 15 [GDF-15], galectin-3) were analyzed using the proximity extension assay. PWIs, including P-wave duration, P-wave amplitude in lead I, P-wave terminal force in lead V1, axis, and morphology, were derived from electrocardiograms processed with the Glasgow algorithm. Cox regression assessed associations among the biomarkers, PWIs, and incident AF.

Results

During follow-up, 41 developed AF over 5 years. Low P-wave amplitude correlated negatively with GDF-15 (P < .001) and MMP-2 (P = .037) in leads I and II. 6 biomarkers were significantly associated with incident AF in adjusted analysis: tissue inhibitor of metalloproteinase 4 (P = .007), MMP-2 (P = .046), matrix metalloproteinase 3 (P = .007), suppression of tumorigenicity 2 (P = .003), GDF-15 (P = .001), and galectin-3 (P = .048). Among PWIs, P-wave axis of <0° (P = .021) and low P-wave amplitude in lead I (P = .036) were significantly associated with incident AF.

Conclusion

In patients with advanced HF, fibrotic biomarkers were associated with incident AF. Low P-wave amplitude and abnormal P-wave axis (<0°) were associated with incident AF. This may reflect an abnormal LA-conduction pathway and a displaced intra-atrial conduction pattern in advanced HF.

背景：由p波指数（PWI）反映的心房传导异常及其与生物标志物信号纤维化对心力衰竭（HF）患者心房颤动（AF）发展的预测价值仍未得到充分探讨。目的：研究心衰患者PWI、纤维化生物标志物与房颤发生风险之间的关系。方法：对476例新发或恶化的心衰患者（平均年龄74,6岁，68%为男性）进行5年随访。采用接近延伸法分析纤维化相关生物标志物（TIMP-4、MMP-2、MMP-3、MMP-9、ST-2、GDF-15、Gal-3）。PWI包括p波持续时间、导联I的p波振幅、V1的p波末端力、轴和形态。Cox回归评估了生物标志物、PWI和AF事件之间的关系。结果：在随访期间，41例患者在5年内发生了AF。低p波振幅与ⅰ、ⅱ铅的GDF-15和MMP-2呈负相关（p < 0.001）。在校正分析中，6个生物标志物与AF事件显著相关：TIMP-4 （p=0.007）、MMP-2 （p=0.046）、MMP-3 （p=0.007）、ST-2 （p=0.003）、GDF-15 （p=0.001）和Gal-3 （p=0.048）。结论：在晚期HF患者中，纤维化生物标志物与房颤的发生相关。

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引用次数: 0

A female-specific rabbit model of heart failure with preserved ejection fraction 保留射血分数的心力衰竭雌性兔模型。

IF 5.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm

Pub Date : 2026-03-01 Epub Date: 2025-11-24 DOI: 10.1016/j.hrthm.2025.11.034

Liyang Zhang MD , Xiaochun Li PhD , Taiga Andersson MSHS , Anxhela Kote MS , Minjing Yang MD, PhD , Po-Tseng Lee MD , James E. Tisdale PharmD , Zhenhui Chen PhD , Thomas H. Everett IV PhD, FHRS , Michael C. Fishbein MD , Joshua I. Goldhaber MD , Peng-Sheng Chen MD, FHRS , Xiao Liu MD, PhD

Background

Women had a higher risk of heart failure with preserved ejection fraction (HFpEF) and diastolic dysfunction than men.

Objectives

We hypothesize that (1) the high cholesterol (HC) diet causes HFpEF in female but not male hearts, and (2) adding salt to the HC diet worsens HFpEF.

Methods

We fed rabbits an HC diet (4 males and 4 females) or a high salt (HS)-HC diet (4 males and 4 females) for 14 weeks. The hearts were Langendorff-perfused for optical mapping.

Results

The HC diet and female sex were associated with increased E/e' ratios at sacrifice (P < .001 for both). The E/e' ratios were higher in the HC than in the HS-HC group (P < .001). Females had a larger left atrial diameter (P = .002) and more atrial fibrosis than males (P < .001). There was more ventricular fibrosis in HC than in HS-HC (P < .001). Apamin, a specific blocker of apamin-sensitive small conductance calcium-activated potassium current (I_KAS), lengthened action potential duration more in females than males (by 8 ± 2 ms, P = .002) in the absence of isoproterenol. Apamin reduced intracellular calcium amplitudes (P < .001) and conduction velocity (P = .008), the phase singularities during ventricular fibrillation (VF) (P = .002), and dominant frequency during VF (P = .016) more in females. HC females (but not HC males or any HS-HC rabbits) showed significant increases in N-terminal pro-B-type natriuretic peptide levels at sacrifice (P < .001).

Conclusion

The HC rabbit is a female-specific model of HFpEF. Adding salt to the HC diet improved rather than worsened the HFpEF. Apamin modulates this HFpEF model’s electrophysiological parameters and VF patterns.

背景：与男性相比，女性有更高的风险发生心力衰竭并保留射血分数（HFpEF）和舒张功能障碍。目的：我们假设(1)高胆固醇（HC）饮食导致女性心脏HFpEF，而不是男性心脏HFpEF；(2)在高胆固醇饮食中添加盐会加重HFpEF。方法：饲喂HC饲粮（公母各4只）或高盐(HS)-HC饲粮（公母各4只）14周。心脏经兰根多夫灌注进行光学成像。结果：HC饮食和女性与牺牲时E/ E比值（pKAS）升高相关，在不添加异丙肾上腺素的情况下，女性比男性动作电位持续时间延长（8±2 ms, p=0.002）。结论：HC兔是HFpEF的雌性特异性模型。在HC饮食中加入盐可以改善而不是恶化HFpEF。维生素a调节HFpEF模型的电生理参数和VF模式。

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引用次数: 0

To the Editor— DNA methylation and the potential role of extracellular vesicles in epilepsy-associated atrial fibrillation DNA甲基化和细胞外囊泡在癫痫相关心房颤动中的潜在作用。

IF 5.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm

Pub Date : 2026-03-01 Epub Date: 2025-12-15 DOI: 10.1016/j.hrthm.2025.10.065

Lucio Barile PhD , Concetta Schiano PhD

引用次数: 0