Pub Date : 2025-11-01DOI: 10.1016/j.hjc.2024.05.019
Hong Meng , Lin-Yuan Wan , Ran Qu , Qian-Qian Liu , Mu-Zi Li , Ye-Dan Li , Shi-Wei Pan , Shou-Jun Li , Qiang Wang , Jun Yan , Ke-Ming Yang
Objective
We aimed to examine biventricular remodeling and function after Ebstein anomaly (EbA) surgical correction using echocardiographic techniques, particularly, the relations between the biventricular changes and the EbA types.
Methods
From April 2015 to August 2022, 110 patients with EbA were included in this retrospective study based on the Carpentier classification. Echocardiography assessments during the preoperative, early, and mid-term postoperative periods were performed.
Results
The 54 patients with types A and B EbA were included in group 1, whereas the 56 patients with types C and D were in group 2. Seventy-eight patients underwent surgical correction of EbA. The median age at operation was 8.8 years. During the mid-term follow-up, only 9.1% of the patients had moderate or severe tricuspid regurgitation. Right ventricular (RV) systolic function worsened in group 2 at discharge (fractional area change: 27.6 ± 11.2 vs. 35.4 ± 11.5 [baseline], P < 0.05; global longitudinal strain: −10.8 ± 4.4 vs. −17.9 ± 4.7 [baseline], P = 0.0001). RV function slowly recovered at a mean of 12 months of follow-up. Regarding left ventricular (LV) and RV systolic function, no statistical difference was found between before and after surgery in group 1.
Conclusion
A high success rate of surgical correction of EbA, with an encouraging durability of the valve, was noted. Biventricular systolic function was maintained fairly in most patients with types A and B postoperatively. A late increase in RV systolic function after an initial reduction and unchanged LV systolic function were observed in the patients with types C and D postoperatively.
背景：我们旨在利用超声心动图技术研究爱博斯坦畸形（EbA）手术矫正后的双心室重塑和功能，尤其是双心室变化与EbA类型之间的关系：从2015年4月至2022年8月，110名EbA患者被纳入这项基于Carpentier分类的回顾性研究。在术前、术后早期和中期进行超声心动图评估：结果：54 名 A 型和 B 型 EbA 患者被列入第一组，56 名 C 型和 D 型 EbA 患者被列入第二组。手术时的中位年龄为 8.8 岁。在中期随访期间，只有9.1%的患者存在中度或重度三尖瓣反流。第2组患者出院时右心室收缩功能有所恶化（分数面积变化：27.6±11.2对35.4±11.5[基线]，PC结论：手术矫正 EbA 的成功率很高，瓣膜的耐用性令人鼓舞。大多数 A 型和 B 型患者的双心室收缩功能在术后都得到了很好的维持。在 C 型和 D 型患者中，术后发现 RV 收缩功能在最初下降后出现了后期的上升，而 LV 收缩功能则保持不变。
{"title":"Biventricular function after Ebstein anomaly repair from a single-center echocardiography study","authors":"Hong Meng , Lin-Yuan Wan , Ran Qu , Qian-Qian Liu , Mu-Zi Li , Ye-Dan Li , Shi-Wei Pan , Shou-Jun Li , Qiang Wang , Jun Yan , Ke-Ming Yang","doi":"10.1016/j.hjc.2024.05.019","DOIUrl":"10.1016/j.hjc.2024.05.019","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to examine biventricular remodeling and function after Ebstein anomaly (EbA) surgical correction using echocardiographic techniques, particularly, the relations between the biventricular changes and the EbA types.</div></div><div><h3>Methods</h3><div>From April 2015 to August 2022, 110 patients with EbA were included in this retrospective study based on the Carpentier classification. Echocardiography assessments during the preoperative, early, and mid-term postoperative periods were performed.</div></div><div><h3>Results</h3><div>The 54 patients with types A and B EbA were included in group 1, whereas the 56 patients with types C and D were in group 2. Seventy-eight patients underwent surgical correction of EbA. The median age at operation was 8.8 years. During the mid-term follow-up, only 9.1% of the patients had moderate or severe tricuspid regurgitation. Right ventricular (RV) systolic function worsened in group 2 at discharge (fractional area change: 27.6 ± 11.2 vs. 35.4 ± 11.5 [baseline], <em>P</em> < 0.05; global longitudinal strain: −10.8 ± 4.4 vs. −17.9 ± 4.7 [baseline], <em>P</em> = 0.0001). RV function slowly recovered at a mean of 12 months of follow-up. Regarding left ventricular (LV) and RV systolic function, no statistical difference was found between before and after surgery in group 1.</div></div><div><h3>Conclusion</h3><div>A high success rate of surgical correction of EbA, with an encouraging durability of the valve, was noted. Biventricular systolic function was maintained fairly in most patients with types A and B postoperatively. A late increase in RV systolic function after an initial reduction and unchanged LV systolic function were observed in the patients with types C and D postoperatively.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"86 ","pages":"Pages 80-90"},"PeriodicalIF":3.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285393","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}
Implantable loop recorders (ILRs) are increasingly being used for long-term cardiac monitoring in different clinical settings. The aim of this study was to investigate the real-world performance of ILRs—including the time to diagnosis—in unselected patients with different ILR indications.
Methods and Results
In this multicenter, observational study, 871 patients with an indication of pre-syncope/syncope (61.9%), unexplained palpitations (10.4%), and atrial fibrillation (AF) detection with a history of cryptogenic stroke (CS) (27.7%) underwent ILR implantation. The median follow-up was 28.8 ± 12.9 months. In the presyncope/syncope group, 167 (31%) received a diagnosis established by the device. Kaplan-Meier estimates indicated that 16.9% of patients had a diagnosis at 6 months, and the proportion increased to 22.5% at 1 year. Of 91 patients with palpitations, 20 (22%) received a diagnosis based on the device. The diagnosis was established in 12.2% of patients at 6 months, and the proportion increased to 13.3% at 1 year. Among 241 patients with CS, 47 (19.5%) were diagnosed with AF. The diagnostic yield of the device was 10.4% at 6 months and 12.4% at 1 year. In all cases, oral anticoagulation was initiated. Overall, ILR diagnosis altered the therapeutic strategy in 26.1% of the presyncope/syncope group, 2.2% of the palpitations group, and 3.7% of the CS group in addition to oral anticoagulation initiation.
Conclusion
In this real-world patient population, ILR determines diagnosis and initiates new therapeutic management for nearly one-fourth of patients. ILR implantation is valuable in the evaluation of patients with unexplained presyncope/syncope, CS, and palpitations.
{"title":"Diagnostic yield of implantable loop recorders: results from the hellenic registry","authors":"Konstantinos P. Letsas , Athanasios Saplaouras , Panagiotis Mililis , Ourania Kariki , George Bazoukis , Stefanos Archontakis , Ioannis Anagnostopoulos , Sokratis Triantafyllou , Lina Palaiodimou , Anastasios Chatziantoniou , Anastasios Lykoudis , Athena Mpatsouli , Georgia Katsa , Olga Kadda , Stylianos Dragasis , Vasileios Cheilas , Eleftheria Garyfalia Tsetika , Dimitrios Asvestas , Panagiotis Korantzopoulos , George Poulos , Georgios Tsivgoulis","doi":"10.1016/j.hjc.2024.05.004","DOIUrl":"10.1016/j.hjc.2024.05.004","url":null,"abstract":"<div><h3>Objective</h3><div>Implantable loop recorders (ILRs) are increasingly being used for long-term cardiac monitoring in different clinical settings. The aim of this study was to investigate the real-world performance of ILRs—including the time to diagnosis—in unselected patients with different ILR indications.</div></div><div><h3>Methods and Results</h3><div>In this multicenter, observational study, 871 patients with an indication of pre-syncope/syncope (61.9%), unexplained palpitations (10.4%), and atrial fibrillation (AF) detection with a history of cryptogenic stroke (CS) (27.7%) underwent ILR implantation. The median follow-up was 28.8 ± 12.9 months. In the presyncope/syncope group, 167 (31%) received a diagnosis established by the device. Kaplan-Meier estimates indicated that 16.9% of patients had a diagnosis at 6 months, and the proportion increased to 22.5% at 1 year. Of 91 patients with palpitations, 20 (22%) received a diagnosis based on the device. The diagnosis was established in 12.2% of patients at 6 months, and the proportion increased to 13.3% at 1 year. Among 241 patients with CS, 47 (19.5%) were diagnosed with AF. The diagnostic yield of the device was 10.4% at 6 months and 12.4% at 1 year. In all cases, oral anticoagulation was initiated. Overall, ILR diagnosis altered the therapeutic strategy in 26.1% of the presyncope/syncope group, 2.2% of the palpitations group, and 3.7% of the CS group in addition to oral anticoagulation initiation.</div></div><div><h3>Conclusion</h3><div>In this real-world patient population, ILR determines diagnosis and initiates new therapeutic management for nearly one-fourth of patients. ILR implantation is valuable in the evaluation of patients with unexplained presyncope/syncope, CS, and palpitations.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"86 ","pages":"Pages 36-42"},"PeriodicalIF":3.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904677","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}
Pub Date : 2025-11-01DOI: 10.1016/j.hjc.2025.05.003
Eleni Giannopoulou , George Latsios , Damianos Tsilivarakis , Elias Sanidas , Konstantinos Toutouzas , Konstantinos Tsioufis , Stavroula Kosmopoulou
Cardiac arrest is a global health problem. Evidence from the literature highlights significant gaps in research related to cardiopulmonary resuscitation. The aim was to conduct a scoping review of the randomized controlled trials involving adults who experienced non-traumatic cardiac arrest, published between January 1, 2015 and December 31, 2024, focusing on therapeutic interventions during cardiac arrest or within 24 h of return of spontaneous circulation (ROSC). MEDLINE and DOAJ databases were used to identify primary articles. Data on demographic characteristics, cardiac arrest location, initial heart rhythm, type of intervention, and primary research objectives were extracted. A total of 78 studies with 80,600 participants (70.4% men, 29.6% women; mean age 64.6 years) were included. Fifty-six trials (71.8%) studied out-of-hospital cardiac arrest, 9 (11.5%) studied in-hospital cardiac arrest, and 10 (12.8%) studied both types. Few studies included patients with exclusively shockable (9 studies, 11.5%) or non-shockable (2 studies, 2.6%) initial cardiac arrest rhythm. Interventions before ROSC were investigated in 51.3% of studies (40 trials). The common primary research objectives were patient survival (24 articles, 30.8%), neurological function (20 articles, 25.6%), biomarker evaluation (16 articles, 20.5%), and ROSC rates (14 articles, 17.9%). Only 5 studies (6.4%) investigated long-term effects beyond 6 months. This scoping review showed that gaps exist in the research of cardiopulmonary resuscitation. They mainly concern age and gender representation and research on in-hospital cardiac arrest, initial arrest cardiac rhythms, and long-term prognosis. Future studies should be designed accordingly.
{"title":"Revealing key research gaps in contemporary randomized controlled trials on cardiopulmonary resuscitation: a scoping review","authors":"Eleni Giannopoulou , George Latsios , Damianos Tsilivarakis , Elias Sanidas , Konstantinos Toutouzas , Konstantinos Tsioufis , Stavroula Kosmopoulou","doi":"10.1016/j.hjc.2025.05.003","DOIUrl":"10.1016/j.hjc.2025.05.003","url":null,"abstract":"<div><div>Cardiac arrest is a global health problem. Evidence from the literature highlights significant gaps in research related to cardiopulmonary resuscitation. The aim was to conduct a scoping review of the randomized controlled trials involving adults who experienced non-traumatic cardiac arrest, published between January 1, 2015 and December 31, 2024, focusing on therapeutic interventions during cardiac arrest or within 24 h of return of spontaneous circulation (ROSC). MEDLINE and DOAJ databases were used to identify primary articles. Data on demographic characteristics, cardiac arrest location, initial heart rhythm, type of intervention, and primary research objectives were extracted. A total of 78 studies with 80,600 participants (70.4% men, 29.6% women; mean age 64.6 years) were included. Fifty-six trials (71.8%) studied out-of-hospital cardiac arrest, 9 (11.5%) studied in-hospital cardiac arrest, and 10 (12.8%) studied both types. Few studies included patients with exclusively shockable (9 studies, 11.5%) or non-shockable (2 studies, 2.6%) initial cardiac arrest rhythm. Interventions before ROSC were investigated in 51.3% of studies (40 trials). The common primary research objectives were patient survival (24 articles, 30.8%), neurological function (20 articles, 25.6%), biomarker evaluation (16 articles, 20.5%), and ROSC rates (14 articles, 17.9%). Only 5 studies (6.4%) investigated long-term effects beyond 6 months. This scoping review showed that gaps exist in the research of cardiopulmonary resuscitation. They mainly concern age and gender representation and research on in-hospital cardiac arrest, initial arrest cardiac rhythms, and long-term prognosis. Future studies should be designed accordingly.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"86 ","pages":"Pages 120-130"},"PeriodicalIF":3.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096762","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}
Pulmonary arterial hypertension (PAH) is a life-threatening condition characterised by the excessive proliferation of pulmonary artery vessels. Despite significant advancements in treatment strategies over recent years, mortality rates remain high. The current treatment strategy focuses on risk assessment both at the time of diagnosis and during follow-up. It involves the initial use of combination therapies targeting PAH. These therapies regulate vascular tone through 3 main pathways: the endothelin pathway, the nitric oxide/cyclic guanosine monophosphate pathway, and the prostacyclin pathway. Sotatercept, a fusion protein that binds to ligands of the transforming growth factor-β superfamily, rebalances the pro- and anti-proliferative signalling of activin receptor type II (A/B), thus targeting a unique pathogenic pathway and promoting anti-proliferative effects on the pulmonary vasculature. Recently, it received approval from the European Medicines Agency for patients with PAH classified as World Health Organisation functional class II or III. Proceedings from the latest World Symposium on Pulmonary Hypertension stress the importance of adding sotatercept to the treatment regimen for the majority of patients during follow-up, including those at high risk. In anticipation of upcoming scientific guidelines and with the hope of improved outcomes for patients with PAH, an expert opinion for the treatment of Greek patients has been developed, focusing on the integration of this novel agent into the therapeutic algorithm.
{"title":"Revisiting treatment of pulmonary arterial hypertension in the current era: a Greek scientific document","authors":"Eftychia Demerouti , Frantzeska Frantzeskaki , Tonia Adamidi , Anastasia Anthi , Effrosyni Filiou , Panagiotis Karyofyllis , Athanasios Manginas , Ioanna Mitrouska , Stylianos E. Orfanos , Georgia Pitsiou , Iraklis Tsangaris , George Giannakoulas","doi":"10.1016/j.hjc.2025.02.004","DOIUrl":"10.1016/j.hjc.2025.02.004","url":null,"abstract":"<div><div>Pulmonary arterial hypertension (PAH) is a life-threatening condition characterised by the excessive proliferation of pulmonary artery vessels. Despite significant advancements in treatment strategies over recent years, mortality rates remain high. The current treatment strategy focuses on risk assessment both at the time of diagnosis and during follow-up. It involves the initial use of combination therapies targeting PAH. These therapies regulate vascular tone through 3 main pathways: the endothelin pathway, the nitric oxide/cyclic guanosine monophosphate pathway, and the prostacyclin pathway. Sotatercept, a fusion protein that binds to ligands of the transforming growth factor-β superfamily, rebalances the pro- and anti-proliferative signalling of activin receptor type II (A/B), thus targeting a unique pathogenic pathway and promoting anti-proliferative effects on the pulmonary vasculature. Recently, it received approval from the European Medicines Agency for patients with PAH classified as World Health Organisation functional class II or III. Proceedings from the latest World Symposium on Pulmonary Hypertension stress the importance of adding sotatercept to the treatment regimen for the majority of patients during follow-up, including those at high risk. In anticipation of upcoming scientific guidelines and with the hope of improved outcomes for patients with PAH, an expert opinion for the treatment of Greek patients has been developed, focusing on the integration of this novel agent into the therapeutic algorithm.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"86 ","pages":"Pages 152-158"},"PeriodicalIF":3.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472592","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}
Pub Date : 2025-11-01DOI: 10.1016/j.hjc.2024.06.003
Qian Guo , Xiao Wang , Ruifeng Guo , Yingying Guo , Yan Yan , Wei Gong , Wen Zheng , Hui Wang , Lei Xu , Bin Que , Shaoping Nie
Background
A couple of cardiac magnetic resonance (CMR) attributes strongly predict adverse remodeling after ST-segment elevation myocardial infarction (STEMI); however, the value of incorporating high-risk CMR attributes, particularly, in patients with non-reduced ejection fraction, remains undetermined. This study sought to evaluate the independent and incremental predictive value of a multiparametric CMR approach for adverse remodeling after STEMI across left ventricular ejection fraction (LVEF) categories.
Methods
A total of 157 patients with STEMI undergoing primary percutaneous coronary intervention were prospectively enrolled. Adverse remodeling was defined as ≥20% enlargement in left ventricular end-diastolic volume from index admission to 3 months of follow-up.
Results
Adverse remodeling occurred in 23.6% of patients. After adjustment for clinical risk factors, a stroke volume index <29.6 mL/m2, a global longitudinal strain >−7.5%, an infarct size >39.2%, a microvascular obstruction >4.9%, and a myocardial salvage index <36.4 were independently associated with adverse remodeling. The incidence of adverse remodeling increased with the increasing number of high-risk CMR attributes, regardless of LVEF (LVEF ≤ 40%: P = 0.026; 40% < LVEF < 50%: P = 0.001; LVEF ≥ 50%: P < 0.001). The presence of ≥4 high-risk attributes was an independent predictor of LV adverse remodeling (70.0% vs. 16.8%, adjusted OR 9.68, 95 CI% 3.25–28.87, P < 0.001). Furthermore, the number of high-risk CMR attributes had an incremental predictive value over reduced LVEF and baseline clinical risk factors (AUC: 0.81 vs. 0.68; P = 0.002).
Conclusions
High-risk CMR attributes showed a significant association with adverse remodeling after STEMI across LVEF categories. This imaging-based model provided incremental value for adverse remodeling over traditional clinical factors and LVEF.
{"title":"Incremental value of high-risk CMR attributes to predict adverse remodeling after ST-segment elevation myocardial infarction across LVEF categories","authors":"Qian Guo , Xiao Wang , Ruifeng Guo , Yingying Guo , Yan Yan , Wei Gong , Wen Zheng , Hui Wang , Lei Xu , Bin Que , Shaoping Nie","doi":"10.1016/j.hjc.2024.06.003","DOIUrl":"10.1016/j.hjc.2024.06.003","url":null,"abstract":"<div><h3>Background</h3><div>A couple of cardiac magnetic resonance (CMR) attributes strongly predict adverse remodeling after ST-segment elevation myocardial infarction (STEMI); however, the value of incorporating high-risk CMR attributes, particularly, in patients with non-reduced ejection fraction, remains undetermined. This study sought to evaluate the independent and incremental predictive value of a multiparametric CMR approach for adverse remodeling after STEMI across left ventricular ejection fraction (LVEF) categories.</div></div><div><h3>Methods</h3><div>A total of 157 patients with STEMI undergoing primary percutaneous coronary intervention were prospectively enrolled. Adverse remodeling was defined as ≥20% enlargement in left ventricular end-diastolic volume from index admission to 3 months of follow-up.</div></div><div><h3>Results</h3><div>Adverse remodeling occurred in 23.6% of patients. After adjustment for clinical risk factors, a stroke volume index <29.6 mL/m<sup>2</sup>, a global longitudinal strain >−7.5%, an infarct size >39.2%, a microvascular obstruction >4.9%, and a myocardial salvage index <36.4 were independently associated with adverse remodeling. The incidence of adverse remodeling increased with the increasing number of high-risk CMR attributes, regardless of LVEF (LVEF ≤ 40%: <em>P</em> = 0.026; 40% < LVEF < 50%: <em>P</em> = 0.001; LVEF ≥ 50%: <em>P</em> < 0.001). The presence of ≥4 high-risk attributes was an independent predictor of LV adverse remodeling (70.0% vs. 16.8%, adjusted OR 9.68, 95 CI% 3.25–28.87, <em>P</em> < 0.001). Furthermore, the number of high-risk CMR attributes had an incremental predictive value over reduced LVEF and baseline clinical risk factors (AUC: 0.81 vs. 0.68; <em>P</em> = 0.002).</div></div><div><h3>Conclusions</h3><div>High-risk CMR attributes showed a significant association with adverse remodeling after STEMI across LVEF categories. This imaging-based model provided incremental value for adverse remodeling over traditional clinical factors and LVEF.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"86 ","pages":"Pages 100-110"},"PeriodicalIF":3.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318967","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}
Pub Date : 2025-11-01DOI: 10.1016/j.hjc.2024.05.013
Ruicong Xue , Jiancheng Zhang , Zhe Zhen , Weihao Liang , Yi Li , Lili Zhang , Yugang Dong , Bin Dong , Chen Liu
Objective
Estimated pulse wave velocity (ePWV), a newly established arterial stiffness (AS) parameter, predicts the development of cardiovascular disease (CVD) and death in the general population or in patients with CVD risk factors. However, whether ePWV is associated with adverse outcomes in heart failure with preserved ejection fraction (HFpEF) patients remains unknown. Our study aimed to evaluate the prognostic value of ePWV on clinical outcomes in HFpEF.
Methods and Results
We analyzed HFpEF participants from the Americas in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial with available baseline data (n = 1764). Cox proportional hazard model was used to explore the prognostic value of ePWV on long-term clinical outcomes (all-cause mortality, cardiovascular mortality, all-cause hospitalization, and heart failure hospitalization). Each ePWV increase by 1 m/s increased the risk for all-cause death by 16% (HR:1.16; 95% CI:1.10–1.23; P < 0.001) and CVD mortality by 13% (HR:1.13; 95% CI:1.04–1.21; P = 0.002) after adjusting for confounders. Patients were then grouped into 4 quartiles of ePWV. Our study indicated that the highest ePWV quartile (ePWV ≥ 12.806 m/s) was associated with increased risk of all-cause mortality (HR: 1.96; 95% CI: 1.43–2.69; P < 0.001) and CVD mortality (HR: 1.72; 95% CI: 1.16–2.56; P = 0.008) after adjusting for potential confounders.
Conclusion
These results suggested ePWV is independently associated with increased all-cause mortality and CVD mortality in HFpEF patients, indicating ePWV is an appropriate predictor of prognosis in patients with HFpEF.
目的估计脉搏波速度（ePWV）是一个新建立的动脉硬度（AS）参数，可预测普通人群或有心血管疾病危险因素的患者心血管疾病（CVD）的发展和死亡。然而，ePWV是否与保留射血分数（HFpEF）心力衰竭患者的不良结局相关仍不清楚。本研究旨在评估ePWV对HFpEF临床预后的预测价值。方法和结果我们分析了来自美洲的HFpEF参与者，在醛固酮拮抗剂（TOPCAT）治疗保留心功能心力衰竭的试验中，有可用的基线数据（n = 1764）。采用Cox比例风险模型探讨ePWV对长期临床结局（全因死亡率、心血管死亡率、全因住院率和心力衰竭住院率）的预后价值。调整混杂因素后，ePWV每增加1 m/s，全因死亡风险增加16% (HR:1.16; 95% CI: 1.10-1.23; P < 0.001)，心血管疾病死亡率增加13% （HR:1.13; 95% CI: 1.04-1.21; P = 0.002）。然后将患者分为4个ePWV四分位数。我们的研究表明，在调整潜在混杂因素后，最高ePWV四分位数（ePWV≥12.806 m/s）与全因死亡率（HR: 1.96; 95% CI: 1.43-2.69; P < 0.001）和心血管疾病死亡率（HR: 1.72; 95% CI: 1.16-2.56; P = 0.008）的风险增加相关。结论ePWV与HFpEF患者全因死亡率和CVD死亡率升高独立相关，提示ePWV可作为HFpEF患者预后的预测指标。
{"title":"Estimated pulse wave velocity predicts mortality in patients with heart failure with preserved ejection fraction","authors":"Ruicong Xue , Jiancheng Zhang , Zhe Zhen , Weihao Liang , Yi Li , Lili Zhang , Yugang Dong , Bin Dong , Chen Liu","doi":"10.1016/j.hjc.2024.05.013","DOIUrl":"10.1016/j.hjc.2024.05.013","url":null,"abstract":"<div><h3>Objective</h3><div>Estimated pulse wave velocity (ePWV), a newly established arterial stiffness (AS) parameter, predicts the development of cardiovascular disease (CVD) and death in the general population or in patients with CVD risk factors. However, whether ePWV is associated with adverse outcomes in heart failure with preserved ejection fraction (HFpEF) patients remains unknown. Our study aimed to evaluate the prognostic value of ePWV on clinical outcomes in HFpEF.</div></div><div><h3>Methods and Results</h3><div>We analyzed HFpEF participants from the Americas in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial with available baseline data (n = 1764). Cox proportional hazard model was used to explore the prognostic value of ePWV on long-term clinical outcomes (all-cause mortality, cardiovascular mortality, all-cause hospitalization, and heart failure hospitalization). Each ePWV increase by 1 m/s increased the risk for all-cause death by 16% (HR:1.16; 95% CI:1.10–1.23; P < 0.001) and CVD mortality by 13% (HR:1.13; 95% CI:1.04–1.21; P = 0.002) after adjusting for confounders. Patients were then grouped into 4 quartiles of ePWV. Our study indicated that the highest ePWV quartile (ePWV ≥ 12.806 m/s) was associated with increased risk of all-cause mortality (HR: 1.96; 95% CI: 1.43–2.69; P < 0.001) and CVD mortality (HR: 1.72; 95% CI: 1.16–2.56; P = 0.008) after adjusting for potential confounders.</div></div><div><h3>Conclusion</h3><div>These results suggested ePWV is independently associated with increased all-cause mortality and CVD mortality in HFpEF patients, indicating ePWV is an appropriate predictor of prognosis in patients with HFpEF.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"86 ","pages":"Pages 51-62"},"PeriodicalIF":3.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141143238","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}
Trimethylamine N-oxide (TMAO) has been associated with atherosclerosis and poor outcome. We evaluated the prognostic impact of intra-hospital TMAO variation on patient outcome.
Methods and Results
Blood samples from 149 patients with acute myocardial infarction (AMI) were taken on admission and discharge. Plasma TMAO was determined by HPLC-MS. The endpoint was a composite three-point MACE (major adverse cardiovascular events), including all-cause mortality, re-infarction, or heart failure (HF) development. Median TMAO concentration on admission was significantly higher than on discharge (respectively, 7.81 [3.47–19.98] vs 3.45 [2.3–4.78] μM, p < 0.001). After estimating the 3.45 μM TMAO cut-off with the analysis of the continuous hazard ratio, we divided our cohort into two groups. The first group included 75 (50.3%) patients whose TMAO levels remained below or decreased under cut-off (low-low/high-low; LL/HL), while the second group included 74 (49.7%) patients whose TMAO levels remained high or increased above the cut-off during hospitalisation (high-high/low-high; HH/LH). During the median 30-month follow-up, 21.5% of patients experienced the composite endpoint. At Kaplan-Meier analysis, a trend of increasing MACE risk was observed in patients in the HH/LH group (p = 0.05). At multivariable Cox analysis, patients from the HH/LH group had more than two times higher risk of MACE during the follow-up than the LL/HL group (HR = 2.15 [95% CI, 1.03–4.5], p = 0.04). Other independent predictors of MACE were older age and worse left ventricular systolic function.
Conclusion
In patients with AMI, permanently high or increasing TMAO levels during hospitalisation are associated with a higher risk of MACE during long-term follow-up.
{"title":"Intra-hospital variation of gut microbiota product, trimethylamine N-oxide (TMAO), predicts future major adverse cardiovascular events after myocardial infarction","authors":"Aneta Aleksova , Alessandra Lucia Fluca , Mariano Stornaiuolo , Giulia Barbati , Alessandro Pierri , Donna R. Zwas , Daniela Santon , Stefano D’Errico , Maria Marketou , Gianfranco Sinagra , Yosefa Avraham , Ettore Novellino , Milijana Janjusevic","doi":"10.1016/j.hjc.2024.05.007","DOIUrl":"10.1016/j.hjc.2024.05.007","url":null,"abstract":"<div><h3>Objective</h3><div>Trimethylamine N-oxide (TMAO) has been associated with atherosclerosis and poor outcome. We evaluated the prognostic impact of intra-hospital TMAO variation on patient outcome.</div></div><div><h3>Methods and Results</h3><div>Blood samples from 149 patients with acute myocardial infarction (AMI) were taken on admission and discharge. Plasma TMAO was determined by HPLC-MS. The endpoint was a composite three-point MACE (major adverse cardiovascular events), including all-cause mortality, re-infarction, or heart failure (HF) development. Median TMAO concentration on admission was significantly higher than on discharge (respectively, 7.81 [3.47–19.98] vs 3.45 [2.3–4.78] μM, p < 0.001). After estimating the 3.45 μM TMAO cut-off with the analysis of the continuous hazard ratio, we divided our cohort into two groups. The first group included 75 (50.3%) patients whose TMAO levels remained below or decreased under cut-off (low-low/high-low; LL/HL), while the second group included 74 (49.7%) patients whose TMAO levels remained high or increased above the cut-off during hospitalisation (high-high/low-high; HH/LH). During the median 30-month follow-up, 21.5% of patients experienced the composite endpoint. At Kaplan-Meier analysis, a trend of increasing MACE risk was observed in patients in the HH/LH group (p = 0.05). At multivariable Cox analysis, patients from the HH/LH group had more than two times higher risk of MACE during the follow-up than the LL/HL group (HR = 2.15 [95% CI, 1.03–4.5], p = 0.04). Other independent predictors of MACE were older age and worse left ventricular systolic function.</div></div><div><h3>Conclusion</h3><div>In patients with AMI, permanently high or increasing TMAO levels during hospitalisation are associated with a higher risk of MACE during long-term follow-up.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"86 ","pages":"Pages 4-16"},"PeriodicalIF":3.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904695","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}
The aim of the study was to explore the individual impact of BMI and height on LV size and geometry in a cohort of healthy athletes.
Methods
From a total cohort of 1857 healthy élite athletes (21 ± 5 years, males 70%) investigated with ECG and echocardiogram, we considered three groups: Group 1 n = 50: BMI ≥ 30 and height < 1.90 m; Group 2 n = 87: height ≥ 1.95 m and BMI < 30; control Group 3 n = 243: height < 1.90 m and BMI = 20–29.
Results
BSA was ≤2.3 m2 in 52% of athletes in group 1 and 47% of athletes in group 2. Athletes in group 1 and in group 2 showed an enlarged LV end-diastolic diameter (LVEDD) (57 ± 6 vs 57 ± 4 vs 53 ± 4 mm in Group 3); 50% of athletes in group 1 and 38% of athletes in group 2 exhibited a LVEDD > 57 mm (p = 0.23). LV wall thickness was higher in group 1 (11 ± 1 vs 10 ± 2 mm in Group 2, p = 0.001). Concentric hypertrophy or concentric remodelling was found in 20% of athletes in group 1 vs 7% of athletes in group 2 (p = 0.04). Athletes of group 1 with BSA ≤ 2.3 m2 showed lower LVEDD (53 ± 5 vs 60 ± 5 mm, p < 0.001), similar LV wall thickness (10 ± 1 vs 11 ± 1 mm, p = 0.128) and higher prevalence of concentric hypertrophy or concentric remodelling (31% vs 8%, p = 0.04) compared to those with BSA > 2.3 m2.
Conclusion
Athletes with high BMI have similar LV dimensions but greater wall thickness and higher prevalence of concentric remodelling compared to very tall athletes. Athletes with high BMI and large BSA have the widest LV dimensions.
{"title":"Left ventricular morphology and geometry in élite athletes characterised by extreme anthropometry","authors":"Eleonora Moccia , Harshil Dhutia , Aneil Malhotra , Efstathios Papatheodorou , Elijah Behr , Rajan Sharma , Michael Papadakis , Sanjay Sharma , Gherardo Finocchiaro","doi":"10.1016/j.hjc.2024.06.007","DOIUrl":"10.1016/j.hjc.2024.06.007","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of the study was to explore the individual impact of BMI and height on LV size and geometry in a cohort of healthy athletes.</div></div><div><h3>Methods</h3><div>From a total cohort of 1857 healthy élite athletes (21 ± 5 years, males 70%) investigated with ECG and echocardiogram, we considered three groups: Group 1 n = 50: BMI ≥ 30 and height < 1.90 m; Group 2 n = 87: height ≥ 1.95 m and BMI < 30; control Group 3 n = 243: height < 1.90 m and BMI = 20–29.</div></div><div><h3>Results</h3><div>BSA was ≤2.3 m<sup>2</sup> in 52% of athletes in group 1 and 47% of athletes in group 2. Athletes in group 1 and in group 2 showed an enlarged LV end-diastolic diameter (LVEDD) (57 ± 6 vs 57 ± 4 vs 53 ± 4 mm in Group 3); 50% of athletes in group 1 and 38% of athletes in group 2 exhibited a LVEDD > 57 mm (p = 0.23). LV wall thickness was higher in group 1 (11 ± 1 vs 10 ± 2 mm in Group 2, p = 0.001). Concentric hypertrophy or concentric remodelling was found in 20% of athletes in group 1 vs 7% of athletes in group 2 (p = 0.04). Athletes of group 1 with BSA ≤ 2.3 m<sup>2</sup> showed lower LVEDD (53 ± 5 vs 60 ± 5 mm, p < 0.001), similar LV wall thickness (10 ± 1 vs 11 ± 1 mm, p = 0.128) and higher prevalence of concentric hypertrophy or concentric remodelling (31% vs 8%, p = 0.04) compared to those with BSA > 2.3 m<sup>2</sup>.</div></div><div><h3>Conclusion</h3><div>Athletes with high BMI have similar LV dimensions but greater wall thickness and higher prevalence of concentric remodelling compared to very tall athletes. Athletes with high BMI and large BSA have the widest LV dimensions.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"86 ","pages":"Pages 111-119"},"PeriodicalIF":3.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556000","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}
Pub Date : 2025-11-01DOI: 10.1016/j.hjc.2024.10.003
Leizhi Ku , Youping Chen , Yuhang Wang , Zheng Liu , Xiaojing Ma
{"title":"Multimodality imaging for the diagnosis of giant cavernous hemangioma of the right ventricle","authors":"Leizhi Ku , Youping Chen , Yuhang Wang , Zheng Liu , Xiaojing Ma","doi":"10.1016/j.hjc.2024.10.003","DOIUrl":"10.1016/j.hjc.2024.10.003","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"86 ","pages":"Pages 159-160"},"PeriodicalIF":3.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481333","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号