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Quadruple therapy in HFpEF with type 2 diabetes: Time to implement? 四联疗法治疗HFpEF合并2型糖尿病:何时实施?
IF 3.8 3区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01 Epub Date: 2025-12-18 DOI: 10.33963/v.phj.110268
Gregg C Fonarow, Mohammad Keykhaei
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引用次数: 0
Practical approach to the management of diabetic cardiomyopathy: From molecular pathways to treatment strategies. 糖尿病性心肌病管理的实用方法:从分子途径到治疗策略。
IF 3.8 3区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01 Epub Date: 2026-01-07 DOI: 10.33963/v.phj.110057
Nuria Prieto-Laín, Alicia Trenas, Ricardo Gómez-Huelgas, Luis M Pérez-Belmonte

Diabetic cardiomyopathy (DCM) has emerged as a major health challenge, further intensified by the rising global prevalence of type 2 diabetes mellitus. It plays a key role in the morbidity and mortality linked to diabetes, mainly through myocardial dysfunction that develops independently of coronary artery disease or hypertensive heart disease, and it is a major contributor to heart failure. Despite the significance of DCM, there is no gold standard diagnostic test; rather, a multimodal approach is required that includes clinical evaluation (risk factors, and symptoms and signs), cardiac imaging techniques, and biomarkers. The integration of all evaluations may ultimately allow for earlier identification and improved outcomes through timely intervention. In addition, there is scarce evidence on treatment of DCM. The conventional treatment approach is primarily focused on achieving glycemic control, managing cardiac dysfunction, and reducing cardiovascular events using therapies extrapolated from diabetes and heart failure guidelines, rather than targeting the underlying pathophysiological mechanisms. On the other hand, beyond pharmacological approaches, lifestyle modifications, particularly exercise and dietary interventions, could play an important role in the management of DCM due to the associated cardiometabolic benefits in patients with diabetes. In this review, due to the urgent need of clarification for the specific management of DCM and the lack of consistent evidence, we provide a practical updated overview from the pathophysiology to current and future treatment strategies. By integrating this knowledge, we aim to summarize the diagnosis and therapeutic approach that could effectively mitigate or prevent the progression of DCM.

糖尿病性心肌病(DCM)已成为一项重大的健康挑战,全球2型糖尿病患病率的上升进一步加剧了这一挑战。它在与糖尿病相关的发病率和死亡率中起着关键作用,主要是通过独立于冠状动脉疾病或高血压心脏病发展的心肌功能障碍,并且是心力衰竭的主要原因。尽管DCM具有重要意义,但没有金标准诊断测试;相反,需要一种多模式的方法,包括临床评估(危险因素、症状和体征)、心脏成像技术和生物标志物。所有评估的整合最终可能允许早期识别和通过及时干预改善结果。此外,关于DCM的治疗也缺乏证据。传统的治疗方法主要侧重于实现血糖控制,管理心功能障碍,并使用从糖尿病和心力衰竭指南推断的治疗方法减少心血管事件,而不是针对潜在的病理生理机制。另一方面,除了药理学方法之外,生活方式的改变,特别是运动和饮食干预,由于相关的心血管代谢益处,可能在糖尿病患者的DCM管理中发挥重要作用。在这篇综述中,由于迫切需要澄清DCM的具体管理和缺乏一致的证据,我们从病理生理学到当前和未来的治疗策略提供了一个实用的最新概述。通过整合这些知识,我们的目的是总结诊断和治疗方法,可以有效地减轻或预防DCM的进展。
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引用次数: 0
State-of-the-Art: Central Europe's first hybrid unilateral left-sided thoracoscopic MAZE ablation of atrial fibrillation with left atrial appendage occlusion followed by robotic coronary artery bypass LIMA-LAD. 最先进的技术:中欧首次采用混合型单侧胸腔镜MAZE消融左心房附件闭塞的房颤,随后采用机器人冠状动脉搭桥LIMA-LAD。
IF 3.8 3区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01 Epub Date: 2025-09-03 DOI: 10.33963/v.phj.108301
Mariusz Kowalewski, Radosław Smoczyński, Natalia Ogorzelec, Sebastian Stec, Marta Kornaszewska, Bart Maesen, Piotr Suwalski
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引用次数: 0
Quadruple combination therapy with SGLT2i, GLP-1RA, ARNI and MRA in heart failure with preserved ejection fraction patients with type 2 diabetes mellitus: A prospective and observational cohort study. SGLT2i、GLP-1RA、ARNI和MRA四联治疗保留射血分数的心力衰竭合并2型糖尿病患者:一项前瞻性观察性队列研究
IF 3.8 3区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01 Epub Date: 2026-01-07 DOI: 10.33963/v.phj.109920
Jiahan Ke, Xiaohan Qiu, Min Wang, Huasu Zeng, Changqian Wang, Junfeng Zhang, Kan Chen, Jun Gu

Background: Treatments for heart failure with preserved ejection fraction (HFpEF) remain inconclusive.

Aims: We aim to explore in this prospective and observational cohort study how combined therapy with sodium-dependent glucose transporter 2 inhibitor (SGLT2i), glucagon-like peptide 1 receptor agonists (GLP-1RA), angiotensin receptor-neprilysin inhibitor (ARNI), or mineralocorticoid receptor antagonists (MRA) impact clinical outcomes in HFpEF patients with type 2 diabetes mellitus (T2DM).

Methods: We enrolled 1445 HFpEF patients with T2DM from a prospective cohort between October 2018 and October 2022. The patients were divided into five groups based on their medications at 3 months after discharge: defined as a combination of SGLT2i, GLP-1RA, ARNI, and MRA. The primary outcome is major adverse cardiovascular (CV) events (MACEs), corresponding to the CV mortality and/or HF rehospitalization. The secondary outcome is CV mortality as well as left ventricular ejection fraction (LVEF) change or HF category transition.

Results: During a median follow-up period of 54 (27-75) months, participants with quadruple combination showed the most benefits, corresponding to MACEs (79/174; P <0.001), CV mortality (46/174; P = 0.03), LVEF change, or HF transitions. Quadruple combination was a protective factor for MACEs, while higher N-terminal pro-B-type natriuretic peptide level was an independent risk factor. For participants with LVEF less than 60%, quadruple combination reduced the incidence of composite endpoint events compared to those with LVEF over 60%.

Conclusions: Quadruple combination therapy with SGLT2i, GLP-1RA, ARNI, and MRA in HFpEF patients with T2DM was associated with favorable clinical outcomes, especially in participants with LVEF less than 60%.

背景:保留射血分数(HFpEF)治疗心力衰竭尚无定论。目的:我们旨在通过这项前瞻性和观察性队列研究,探讨钠依赖性葡萄糖转运蛋白2抑制剂(SGLT2i)、胰高血糖素样肽-1受体激动剂(GLP-1RA)、血管紧张素受体-neprilysin抑制剂(ARNI)或矿化皮质激素受体拮抗剂(MRA)联合治疗对HFpEF合并2型糖尿病(T2DM)患者临床结局的影响。材料和方法:我们从2018年10月至2022年10月的前瞻性队列中招募了1445名HFpEF合并T2DM患者。根据出院后3个月的用药情况将患者分为5组:定义为SGLT2i、GLP-1RA、ARNI和MRA的联合用药。主要终点是主要心血管不良事件(mace),与心血管死亡率和/或心衰再住院率相对应。次要结局是CV死亡率以及左心室射血分数(LVEF)变化或HF类别转换。结果:在54(27-75)个月的中位随访期间,四联治疗组获益最多,与mace(79/174)相对应;结论:四联治疗联合SGLT2i、GLP-1RA、ARNI和MRA治疗HFpEF合并T2DM患者具有良好的临床结果,特别是在LVEF小于60%的患者中。
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引用次数: 0
Ascending aortic pseudoaneurysm as a rare complication following TAVR. 升主动脉假性动脉瘤是TAVR术后罕见的并发症。
IF 3.8 3区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01 Epub Date: 2025-07-04 DOI: 10.33963/v.phj.107058
Wiktoria Karos, Ewa Mazur, Paweł Żelechowski, Agnieszka Mickiewicz, Dariusz Jagielak
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引用次数: 0
Utilization of cardiac magnetic resonance in patients with heart failure associated with cardiomyopathy: Insights from the HEart failuRe ObsErvational Study (HEROES). 心脏磁共振在心衰合并心肌病患者中的应用:来自心衰观察性研究(HEROES)的见解
IF 3.8 3区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01 Epub Date: 2025-09-23 DOI: 10.33963/v.phj.108638
Maciej Nadel, Oliwia Matuszewska-Brycht, Paweł Maeser, Agnieszka Kapłon-Cieślicka, Agata Galas, Katarzyna Byczkowska, Piotr Hamala, Iwona Gorczyca-Głowacka, Anna Furman-Niedziejko, Dominika Klimczak-Tomaniak, Michał Bączek, Adrian Stefański, Mateusz Guzik, Małgorzata Zachura, Mateusz Staciwa, Ewa Pierzchała, Robert Morawiec
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引用次数: 0
Effect of deactivation of biventricular pacing on patients with left ventricular assist device and cardiac resynchronization therapy. 双室起搏失活对左室辅助装置及心脏再同步化治疗患者的影响。
IF 3.8 3区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01 Epub Date: 2025-10-06 DOI: 10.33963/v.phj.108921
Magdalena Sawicka, Agnieszka Biełka, Katarzyna Ratman, Mariusz Kalinowski, Tomasz Hrapkowicz, Piotr Przybyłowski
{"title":"Effect of deactivation of biventricular pacing on patients with left ventricular assist device and cardiac resynchronization therapy.","authors":"Magdalena Sawicka, Agnieszka Biełka, Katarzyna Ratman, Mariusz Kalinowski, Tomasz Hrapkowicz, Piotr Przybyłowski","doi":"10.33963/v.phj.108921","DOIUrl":"10.33963/v.phj.108921","url":null,"abstract":"","PeriodicalId":17784,"journal":{"name":"Kardiologia polska","volume":" ","pages":"96-98"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Ventricular and supraventricular ectopic beats burden is correlated with bone mineral density and osteoporotic fracture risk in postmenopausal women. 绝经后妇女室性和室上性异搏负荷与骨密度和骨质疏松性骨折风险相关。
IF 3.8 3区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01 Epub Date: 2025-09-29 DOI: 10.33963/v.phj.108822
Anna Kawińska, Ewa Sewerynek, Jan Krekora, Małgorzata Kurpesa, Jarosław D Kasprzak, Jerzy K Wranicz

Background: Patients with osteoporosis (OP) have an increased 10-year cardiovascular death risk. Low bone mineral density (BMD) observed in OP may be associated with arrhythmic presentation of cardiovascular diseases.

Aims: We assessed arrhythmia occurrence in females with osteoporosis.

Methods: One hundred three postmenopausal females, consulted by an endocrinologist, were divided into 2 groups according to BMD (assessed by dual-energy X-ray absorptiometry), expressed as T-score (T-sc; OP ≤-2.5, control >-2.5), taken from the femoral neck (T-sc Neck), the entire total hip (T-sc TH), and/or the spine (T-sc L2-L4, L1-L4). The occurrence of arrhythmia was evaluated using 24-hour Holter electrocardiography monitoring (HM). Major osteoporotic and total hip fracture risks (MOFR and THFR, respectively) were assessed by the FRAX scale.

Results: Arrhythmic burden correlated with BMD: correlations were observed between the number of ventricular ectopic beats (VEB) in HM and the T-sc Neck (r = -0.20; P = 0.04), T-sc TH (r = -0.22; P = 0.03) as well as between the number of supraventricular ectopic beats (SVEB) in HM and the T-sc Neck (r = -0.21; P = 0.03), and T-sc TH (r = -0.23; P = 0.02). Multivariable analysis (linear regression model) showed age and T-sc TH as independently related with ectopy: age (b = 0.07; 95% CI, 0.01-0.13; P = 0.03) and T-sc TH (b = -0.58; 95% CI, -1.07 to -0.08; P = 0.02) were predictors for VEB. Ectopic beats count was also positively correlated with osteoporotic fracture risk: VEB with THFR (r = 0.206; P = 0.04), and SVEB with MOFR (r = 0.21; P = 0.04).

Conclusions: Postmenopausal women diagnosed with osteoporosis are likely to have higher risk of ventricular and supraventricular arrhythmias than women without osteoporosis. Moreover, we documented that the presence of cardiac arrhythmia increases with the risk of osteoporotic fractures.

背景:骨质疏松症(OP)患者10年心血管死亡风险增加。OP患者的低骨密度(BMD)可能与心血管疾病的心律失常表现有关。目的:我们评估女性骨质疏松患者心律失常的发生率。方法:经内分泌科医师咨询,绝经后女性103例,根据骨密度(采用双能x线骨密度仪评估)分为2组,分别取股骨颈(T-sc neck)、全髋(T-sc TH)和/或脊柱(T-sc L2-L4、L1-L4),以t评分(T-sc; OP≤-2.5,对照>-2.5)表示。采用24小时动态心电图监测(HM)评估心律失常的发生情况。主要骨质疏松和全髋骨折风险(MOFR和THFR分别)通过FRAX量表进行评估。结果:心律失常负荷与BMD相关:HM室性异位搏(VEB)次数与T-sc颈(r = -0.20; P = 0.04)、T-sc TH (r = -0.22; P = 0.03)、HM室上异位搏(SVEB)次数与T-sc颈(r = -0.21; P = 0.03)、T-sc TH (r = -0.23; P = 0.02)之间存在相关性。多变量分析(线性回归模型)显示年龄和T-sc TH与异位相关:年龄(b = 0.07; 95% CI, 0.01-0.13; P = 0.03)和T-sc TH (b = -0.58; 95% CI, -1.07 ~ -0.08; P = 0.02)是VEB的预测因子。异位心跳计数与骨质疏松性骨折风险也呈正相关:VEB与THFR (r = 0.206; P = 0.04), SVEB与MOFR (r = 0.21; P = 0.04)。结论:诊断为骨质疏松的绝经后妇女发生室性和室上性心律失常的风险可能高于没有骨质疏松的妇女。此外,我们还记录了心律失常的存在与骨质疏松性骨折的风险增加有关。
{"title":"Ventricular and supraventricular ectopic beats burden is correlated with bone mineral density and osteoporotic fracture risk in postmenopausal women.","authors":"Anna Kawińska, Ewa Sewerynek, Jan Krekora, Małgorzata Kurpesa, Jarosław D Kasprzak, Jerzy K Wranicz","doi":"10.33963/v.phj.108822","DOIUrl":"10.33963/v.phj.108822","url":null,"abstract":"<p><strong>Background: </strong>Patients with osteoporosis (OP) have an increased 10-year cardiovascular death risk. Low bone mineral density (BMD) observed in OP may be associated with arrhythmic presentation of cardiovascular diseases.</p><p><strong>Aims: </strong>We assessed arrhythmia occurrence in females with osteoporosis.</p><p><strong>Methods: </strong>One hundred three postmenopausal females, consulted by an endocrinologist, were divided into 2 groups according to BMD (assessed by dual-energy X-ray absorptiometry), expressed as T-score (T-sc; OP ≤-2.5, control >-2.5), taken from the femoral neck (T-sc Neck), the entire total hip (T-sc TH), and/or the spine (T-sc L2-L4, L1-L4). The occurrence of arrhythmia was evaluated using 24-hour Holter electrocardiography monitoring (HM). Major osteoporotic and total hip fracture risks (MOFR and THFR, respectively) were assessed by the FRAX scale.</p><p><strong>Results: </strong>Arrhythmic burden correlated with BMD: correlations were observed between the number of ventricular ectopic beats (VEB) in HM and the T-sc Neck (r = -0.20; P = 0.04), T-sc TH (r = -0.22; P = 0.03) as well as between the number of supraventricular ectopic beats (SVEB) in HM and the T-sc Neck (r = -0.21; P = 0.03), and T-sc TH (r = -0.23; P = 0.02). Multivariable analysis (linear regression model) showed age and T-sc TH as independently related with ectopy: age (b = 0.07; 95% CI, 0.01-0.13; P = 0.03) and T-sc TH (b = -0.58; 95% CI, -1.07 to -0.08; P = 0.02) were predictors for VEB. Ectopic beats count was also positively correlated with osteoporotic fracture risk: VEB with THFR (r = 0.206; P = 0.04), and SVEB with MOFR (r = 0.21; P = 0.04).</p><p><strong>Conclusions: </strong>Postmenopausal women diagnosed with osteoporosis are likely to have higher risk of ventricular and supraventricular arrhythmias than women without osteoporosis. Moreover, we documented that the presence of cardiac arrhythmia increases with the risk of osteoporotic fractures.</p>","PeriodicalId":17784,"journal":{"name":"Kardiologia polska","volume":" ","pages":"47-54"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Exploratory use of [18F]NaF PET/CT in monitoring amyloid burden in patients with ATTR-CM on tafamidis: A case report. [18F]NaF PET/CT在他法底肌atr - cm患者淀粉样蛋白负荷监测中的探索性应用:1例报告。
IF 3.8 3区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-12-31 DOI: 10.33963/v.phj.110479
Daria M Keller, Paulina Cegla, Witold Cholewinski, Ewa Straburzyńska-Migaj
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引用次数: 0
Outcomes of patients with acute end-stage heart failure after mechanical circulatory support by biventricular Berlin Heart Excor system. 急性终末期心力衰竭患者在双心室柏林心脏Excor系统机械循环支持后的结果。
IF 3.8 3区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-12-31 DOI: 10.33963/v.phj.110472
Ioannis Nenekidis, George Samanidis, Meletios Kanakis, Sotirios Katsaridis, Nektarios Kogerakis, Sokrates Fragoulis, Evangelos Leontiadis, Aggeliki Gkouziouta, Michael Bonios, Apostolis Thanopoulos, Konstantinos Perreas, Themistocles Chamogeorgakis, Stamatis Adamopoulos
{"title":"Outcomes of patients with acute end-stage heart failure after mechanical circulatory support by biventricular Berlin Heart Excor system.","authors":"Ioannis Nenekidis, George Samanidis, Meletios Kanakis, Sotirios Katsaridis, Nektarios Kogerakis, Sokrates Fragoulis, Evangelos Leontiadis, Aggeliki Gkouziouta, Michael Bonios, Apostolis Thanopoulos, Konstantinos Perreas, Themistocles Chamogeorgakis, Stamatis Adamopoulos","doi":"10.33963/v.phj.110472","DOIUrl":"https://doi.org/10.33963/v.phj.110472","url":null,"abstract":"","PeriodicalId":17784,"journal":{"name":"Kardiologia polska","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145863352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
期刊
Kardiologia polska
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