Pub Date : 2024-05-14DOI: 10.3389/fcvm.2024.1385281
G. Ferrannini, M. E. Biber, S. Abdi, Marcus Ståhlberg, L. Lund, G. Savarese
To assess the barriers to guideline-directed medical therapy (GDMT) use in heart failure (HF), diagnostic workup and general knowledge about HF among physicians in Sweden.A survey about the management of HF was sent to 828 Swedish physicians including general practitioners (GPs) and specialists during 2021–2022. Answers were reported as percentages and comparisons were made by specialty (GPs vs. specialists).One hundred sixty-eight physicians participated in the survey (40% females, median age 43 years; 41% GPs and 59% specialists). Electrocardiography and New York Heart Association class evaluations are mostly performed once a year by GPs (46%) and at every outpatient visit by specialists (40%). Echocardiography is mostly requested if there is clinical deterioration (60%). One-third of participants screen for iron deficiency only if there is anemia. Major obstacles to implementation of different drug classes in HF with reduced ejection fraction are related to side effects, with no significant differences between specialties. Device implantation is deemed appropriate regardless of aetiology (69%) and patient age (86%). Specialists answered correctly to knowledge questions more often than GPs. Eighty-six percent of participants think that GDMT should be implemented as much as possible. Most participants (57%) believe that regular patient assessment in nurse-led HF clinics improve adherence to GDMT.Obstacles to GDMT implementation according to physicians in Sweden mainly relate to potential side effects, lack of specialist knowledge and organizational aspects. Further efforts should be placed in educational activities and structuring of nurse-led clinics.
{"title":"The management of heart failure in Sweden—the physician’s perspective: a survey","authors":"G. Ferrannini, M. E. Biber, S. Abdi, Marcus Ståhlberg, L. Lund, G. Savarese","doi":"10.3389/fcvm.2024.1385281","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1385281","url":null,"abstract":"To assess the barriers to guideline-directed medical therapy (GDMT) use in heart failure (HF), diagnostic workup and general knowledge about HF among physicians in Sweden.A survey about the management of HF was sent to 828 Swedish physicians including general practitioners (GPs) and specialists during 2021–2022. Answers were reported as percentages and comparisons were made by specialty (GPs vs. specialists).One hundred sixty-eight physicians participated in the survey (40% females, median age 43 years; 41% GPs and 59% specialists). Electrocardiography and New York Heart Association class evaluations are mostly performed once a year by GPs (46%) and at every outpatient visit by specialists (40%). Echocardiography is mostly requested if there is clinical deterioration (60%). One-third of participants screen for iron deficiency only if there is anemia. Major obstacles to implementation of different drug classes in HF with reduced ejection fraction are related to side effects, with no significant differences between specialties. Device implantation is deemed appropriate regardless of aetiology (69%) and patient age (86%). Specialists answered correctly to knowledge questions more often than GPs. Eighty-six percent of participants think that GDMT should be implemented as much as possible. Most participants (57%) believe that regular patient assessment in nurse-led HF clinics improve adherence to GDMT.Obstacles to GDMT implementation according to physicians in Sweden mainly relate to potential side effects, lack of specialist knowledge and organizational aspects. Further efforts should be placed in educational activities and structuring of nurse-led clinics.","PeriodicalId":510752,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"19 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140982331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-14DOI: 10.3389/fcvm.2024.1333749
B. Sasko, Marios Matiakis, F. Seibert, N. Pagonas, Hans-Jörg Hippe, N. Babel, Christian Ukena, Timm H. Westhoff
During the SARS-CoV-2 pandemic it was speculated that the virus might be associated with a persistent increase of cardiovascular risk. The present study compares pre- and post-pandemic hospital admission rates for hypertension and coronary artery disease.Systematic multicentric retrospective cohort analysis of 57.795 hospital admissions in an urban region in Germany during two different periods (pre-pandemic 01–06/2019 vs. post-pandemic era 01–06/2023). Information on hospital admissions for arterial hypertension, chronic coronary syndrome, unstable angina pectoris and acute myocardial infarction were extracted from the hospitals data systems. Additionally, six comorbidities and performed coronary interventions were monitored.Compared to the pre-pandemic era, there was no increase in hospitalizations for arterial hypertension (516 vs. 483, −6.8%, p = 0.07) or myocardial infarction (487 vs. 349, −23.8%, p < 0.001), but the total number of patient admissions with chest pain as the presenting symptom increased (chronic coronary syndrome: 759 vs. 943, +24.2%, p < 0.001; unstable angina pectoris: 270 vs. 451, +67.0%, p < 0.001). At the same time, the number of performed coronary angiographies increased, but less patients underwent percutaneous interventions. Patients admitted with chest pain in the post-pandemic era were in general healthier with less comorbidities.The present multicenter cohort study found no evidence for an increase in hospitalizations for arterial hypertension or coronary artery disease after the end of the pandemic. However, further studies with larger sample sizes are needed to confirm our results.
{"title":"Impact of the COVID-19 pandemic on hospital admission rates for arterial hypertension and coronary heart disease: a German database study","authors":"B. Sasko, Marios Matiakis, F. Seibert, N. Pagonas, Hans-Jörg Hippe, N. Babel, Christian Ukena, Timm H. Westhoff","doi":"10.3389/fcvm.2024.1333749","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1333749","url":null,"abstract":"During the SARS-CoV-2 pandemic it was speculated that the virus might be associated with a persistent increase of cardiovascular risk. The present study compares pre- and post-pandemic hospital admission rates for hypertension and coronary artery disease.Systematic multicentric retrospective cohort analysis of 57.795 hospital admissions in an urban region in Germany during two different periods (pre-pandemic 01–06/2019 vs. post-pandemic era 01–06/2023). Information on hospital admissions for arterial hypertension, chronic coronary syndrome, unstable angina pectoris and acute myocardial infarction were extracted from the hospitals data systems. Additionally, six comorbidities and performed coronary interventions were monitored.Compared to the pre-pandemic era, there was no increase in hospitalizations for arterial hypertension (516 vs. 483, −6.8%, p = 0.07) or myocardial infarction (487 vs. 349, −23.8%, p < 0.001), but the total number of patient admissions with chest pain as the presenting symptom increased (chronic coronary syndrome: 759 vs. 943, +24.2%, p < 0.001; unstable angina pectoris: 270 vs. 451, +67.0%, p < 0.001). At the same time, the number of performed coronary angiographies increased, but less patients underwent percutaneous interventions. Patients admitted with chest pain in the post-pandemic era were in general healthier with less comorbidities.The present multicenter cohort study found no evidence for an increase in hospitalizations for arterial hypertension or coronary artery disease after the end of the pandemic. However, further studies with larger sample sizes are needed to confirm our results.","PeriodicalId":510752,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"35 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140979205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-13DOI: 10.3389/fcvm.2024.1300074
C. Jøns, P. B. Bloch Thomsen, Sam Riahi, Tom Smilde, Ulrich Bach, Peter Karl K Jacobsen, Miloš Táborský, József Faluközy, Marcus Wiemer, Per Dahl Christensen, Attila Kónyi, Dan Schelfaut, Alan Bulava, Marcin Grabowski, Béla Merkely, Dieter Nuyens, R. Mahajan, Patrick Nagel, Roland Tilz, J. Malczynski, Clemens Steinwender, Johannes Brachmann, Harvey Serota, Jürgen Schrader, Steffen Behrens, Peter Søgaard
Cardiac arrhythmias predict poor outcome after myocardial infarction (MI). We studied if arrhythmia monitoring with an insertable cardiac monitor (ICM) can improve treatment and outcome.BIO|GUARD-MI was a randomized, international open-label study with blinded outcome assessment.Tertiary care facilities monitored the arrhythmias, while the follow-up remained with primary care physicians.Patients after ST-elevation (STEMI) or non-ST-elevation MI with an ejection fraction >35% and a CHA2DS2-VASc score ≥4 (men) or ≥5 (women).Patients were randomly assigned to receive or not receive an ICM in addition to standard post-MI treatment. Device-detected arrhythmias triggered immediate guideline recommended therapy changes via remote monitoring.MACE, defined as a composite of cardiovascular death or acute unscheduled hospitalization for cardiovascular causes.790 patients (mean age 71 years, 72% male, 51% non-STEMI) of planned 1,400 pts were enrolled and followed for a median of 31.6 months. At 2 years, 39.4% of the device group and 6.7% of the control group had their therapy adapted for an arrhythmia [hazard ratio (HR) = 5.9, P < 0.0001]. Most frequent arrhythmias were atrial fibrillation, pauses and bradycardia. The use of an ICM did not improve outcome in the entire cohort (HR = 0.84, 95%-CI: 0.65–1.10; P = 0.21). In secondary analysis, a statistically significant interaction of the type of infarction suggests a benefit in the pre-specified non-STEMI subgroup. Risk factor analysis indicates that this may be connected to the higher incidence of MACE in patients with non-STEMI.The burden of asymptomatic but actionable arrhythmias is large in post-infarction patients. However, arrhythmia monitoring with an ICM did not improve outcome in the entire cohort. Post-hoc analysis suggests that it may be beneficial in non-STEMI patients or other high-risk subgroups. [https://www.clinicaltrials.gov/ct2/show/NCT02341534], NCT02341534.
{"title":"Arrhythmia monitoring and outcome after myocardial infarction (BIO|GUARD-MI): a randomized trial","authors":"C. Jøns, P. B. Bloch Thomsen, Sam Riahi, Tom Smilde, Ulrich Bach, Peter Karl K Jacobsen, Miloš Táborský, József Faluközy, Marcus Wiemer, Per Dahl Christensen, Attila Kónyi, Dan Schelfaut, Alan Bulava, Marcin Grabowski, Béla Merkely, Dieter Nuyens, R. Mahajan, Patrick Nagel, Roland Tilz, J. Malczynski, Clemens Steinwender, Johannes Brachmann, Harvey Serota, Jürgen Schrader, Steffen Behrens, Peter Søgaard","doi":"10.3389/fcvm.2024.1300074","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1300074","url":null,"abstract":"Cardiac arrhythmias predict poor outcome after myocardial infarction (MI). We studied if arrhythmia monitoring with an insertable cardiac monitor (ICM) can improve treatment and outcome.BIO|GUARD-MI was a randomized, international open-label study with blinded outcome assessment.Tertiary care facilities monitored the arrhythmias, while the follow-up remained with primary care physicians.Patients after ST-elevation (STEMI) or non-ST-elevation MI with an ejection fraction >35% and a CHA2DS2-VASc score ≥4 (men) or ≥5 (women).Patients were randomly assigned to receive or not receive an ICM in addition to standard post-MI treatment. Device-detected arrhythmias triggered immediate guideline recommended therapy changes via remote monitoring.MACE, defined as a composite of cardiovascular death or acute unscheduled hospitalization for cardiovascular causes.790 patients (mean age 71 years, 72% male, 51% non-STEMI) of planned 1,400 pts were enrolled and followed for a median of 31.6 months. At 2 years, 39.4% of the device group and 6.7% of the control group had their therapy adapted for an arrhythmia [hazard ratio (HR) = 5.9, P < 0.0001]. Most frequent arrhythmias were atrial fibrillation, pauses and bradycardia. The use of an ICM did not improve outcome in the entire cohort (HR = 0.84, 95%-CI: 0.65–1.10; P = 0.21). In secondary analysis, a statistically significant interaction of the type of infarction suggests a benefit in the pre-specified non-STEMI subgroup. Risk factor analysis indicates that this may be connected to the higher incidence of MACE in patients with non-STEMI.The burden of asymptomatic but actionable arrhythmias is large in post-infarction patients. However, arrhythmia monitoring with an ICM did not improve outcome in the entire cohort. Post-hoc analysis suggests that it may be beneficial in non-STEMI patients or other high-risk subgroups.\u0000[https://www.clinicaltrials.gov/ct2/show/NCT02341534], NCT02341534.","PeriodicalId":510752,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"63 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140984842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-10DOI: 10.3389/fcvm.2024.1371750
Melissa Tracy, C. Mancusi, Andrea Salzano
{"title":"Editorial: Reviews in cardiac rehabilitation","authors":"Melissa Tracy, C. Mancusi, Andrea Salzano","doi":"10.3389/fcvm.2024.1371750","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1371750","url":null,"abstract":"","PeriodicalId":510752,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":" 73","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140993071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.3389/fcvm.2024.1408616
L. Roever
{"title":"Editorial—Spotlights on cardioneurology","authors":"L. Roever","doi":"10.3389/fcvm.2024.1408616","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1408616","url":null,"abstract":"","PeriodicalId":510752,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-06DOI: 10.3389/fcvm.2024.1413184
Abhijeet R. Sonawane, Michel Pucéat, Hanjoong Jo
{"title":"Editorial: Single-cell OMICs analyses in cardiovascular diseases","authors":"Abhijeet R. Sonawane, Michel Pucéat, Hanjoong Jo","doi":"10.3389/fcvm.2024.1413184","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1413184","url":null,"abstract":"","PeriodicalId":510752,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"46 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141007730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.3389/fcvm.2024.1379282
G. Kouvelos, K. Spanos, Wolf-Hans Eilenberg, T. Kölbel
{"title":"Editorial: Challenges and outcomes of complex endovascular aortic repair","authors":"G. Kouvelos, K. Spanos, Wolf-Hans Eilenberg, T. Kölbel","doi":"10.3389/fcvm.2024.1379282","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1379282","url":null,"abstract":"","PeriodicalId":510752,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"106 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140380663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-22DOI: 10.3389/fcvm.2024.1392073
Fabio Martelli, P. K. Mishra, Andrea Caporali
{"title":"Editorial: Nucleic acid-based therapies for cardiovascular diseases","authors":"Fabio Martelli, P. K. Mishra, Andrea Caporali","doi":"10.3389/fcvm.2024.1392073","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1392073","url":null,"abstract":"","PeriodicalId":510752,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140215960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-21DOI: 10.3389/fcvm.2024.1396852
J. Bi, Xiangchen Dai
{"title":"Editorial: Critical issues and hot topics in endovascular repair of aortic dissection","authors":"J. Bi, Xiangchen Dai","doi":"10.3389/fcvm.2024.1396852","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1396852","url":null,"abstract":"","PeriodicalId":510752,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"63 s237","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140223135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.3389/fcvm.2024.1377230
Ismail M Kabakus, Jordan H. Chamberlin, Emily J. Miller
{"title":"Cardiac MRI assessment of myocardial viability in chronic myocardial infarction: how should we do it?","authors":"Ismail M Kabakus, Jordan H. Chamberlin, Emily J. Miller","doi":"10.3389/fcvm.2024.1377230","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1377230","url":null,"abstract":"","PeriodicalId":510752,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140226324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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