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Effect of DASH vs. mediterranean diet accompanied by a salt restriction on metabolic syndrome and cardiometabolic risk factors in adults with high normal blood pressure or grade 1 hypertension: secondary analyses of a randomized controlled trial DASH 与地中海饮食(伴有盐限制)对血压正常或 1 级高血压成人代谢综合征和心脏代谢风险因素的影响:随机对照试验的二次分析。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-09-01 DOI: 10.1016/j.hjc.2024.05.006
Christina D. Filippou , Costas G. Thomopoulos , Dimitrios G. Konstantinidis , Kyriakos S. Dimitriadis , Christina A. Chrysochoou , Fotis A. Tatakis , Eirini P. Siafi , Dimitrios M. Tousoulis , Petros I. Nihoyannopoulos , Demosthenes B. Panagiotakos , Konstantinos P. Tsioufis

Objective

Lifestyle interventions are recommended as the first-line treatment to control metabolic syndrome components and improve cardiometabolic risk factors. However, studies directly comparing the cardiometabolic effects of the Dietary Approaches to Stop Hypertension (DASH) vs. the Mediterranean diet (MedDiet) accompanied by salt restriction are currently lacking. Thus, with the present secondary analyses of a randomized trial, we aimed to assess the cardiometabolic effects of a 3-month intensive dietary intervention implementing salt restriction alone or on top of the DASH and MedDiet compared to no/minimal intervention in never drug-treated adults with high normal blood pressure (BP) or grade 1 hypertension.

Methods

We randomly assigned individuals to the control group (CG, n = 60), salt restriction group (SRG, n = 60), DASH diet with salt restriction group (DDG, n = 60), or MedDiet with salt restriction group (MDG, n = 60).

Results

According to the intention-to-treat analysis, the DDG and the MDG had lower odds ratio (OR) (95% CI) of metabolic syndrome [0.29 (0.12, 0.72), and 0.15 (0.06, 0.41), respectively] compared to the CG. Moreover, the MDG had lower odds of metabolic syndrome compared to the SRG and lower odds of elevated BP levels than the DDG and the SRG. Moreover, total and LDL-cholesterol, fasting glucose, HbA1c, and systolic/diastolic BP were reduced in all three intervention groups compared to the CG.

Conclusion

On a background of salt restriction, the MedDiet was superior in BP reduction, but the DASH and MedDiet reduced the prevalence of metabolic syndrome to the same extent.
背景:生活方式干预被推荐为控制代谢综合征成分和改善心脏代谢风险因素的一线治疗方法。然而,目前还缺乏在限盐背景下直接比较 "高血压饮食疗法"(DASH)与 "地中海饮食疗法"(MedDiet)对心脏代谢影响的研究。因此,通过本随机试验的二次分析,我们旨在评估对从未接受过药物治疗的血压(BP)正常或 1 级高血压成人进行为期 3 个月的强化饮食干预(仅实施限盐或在 DASH 和 MedDiet 的基础上实施限盐)与不干预/最小干预相比对心脏代谢的影响:我们将患者随机分配到对照组(CG,n = 60)、限盐组(SRG,n = 60)、DASH饮食加限盐组(DDG,n = 60)或MedDiet加限盐组(MDG,n = 60):根据意向治疗分析,与 CG 相比,DDG 和 MDG 患代谢综合征的几率比(OR)(95% CI)较低[分别为 0.29(0.12,0.72)和 0.15(0.06,0.41)]。此外,与 SRG 相比,MDG 患代谢综合征的几率更低,与 DDG 和 SRG 相比,MDG 患血压升高的几率更低。此外,与 CG 相比,所有三个干预组的总胆固醇和低密度脂蛋白胆固醇、空腹血糖、HbA1c 和收缩压/舒张压都有所降低:结论:在限盐的背景下,MedDiet 在降低血压方面更胜一筹,但 DASH 和 MedDiet 在降低代谢综合征发病率方面的效果相同。
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引用次数: 0
To Care for the Rare. Setting the Economic Bar for Treating Rare Diseases 关爱稀有。为治疗罕见疾病设定经济标准。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-09-01 DOI: 10.1016/j.hjc.2025.09.002
Charalambos Vlachopoulos, Konstantinos Toutouzas
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引用次数: 0
First cases of transcatheter edge-to-edge repair after orthotopic heart transplantation in Greece 希腊首例正位心脏移植术后经导管边缘到边缘修补术。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-09-01 DOI: 10.1016/j.hjc.2024.08.002
Leontiadis Evangelos , Smyrli Anna , Perlepe Kalliopi , Ninios Vlasis , Kosmas Ilias , Ninios Ilias , Athanassopoulos George , Antoniou Theofani , Iakovou Ioannis
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引用次数: 0
Ventricular arrhythmias in patients with chronic total occlusion of coronary arteries: a review focused on interventional treatments 慢性冠状动脉全闭塞患者室性心律失常:介入治疗综述
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-09-01 DOI: 10.1016/j.hjc.2025.04.006
Nikitas Katsillis , Ourania Kariki , Gerasimos Gavrielatos , Antonios Dimopoulos , Nikolaos Papakonstantinou , Elena Bousoula , Sarantos Linardakis , Athanasios Saplaouras , John Malakos , Stylianos Dragasis , Konstantinos P. Letsas , Michael Efremidis , Nikolaos Patsourakos
A chronic total occlusion (CTO) of a coronary artery is present in almost one-fifth of patients undergoing a scheduled coronary angiography. A CTO may be classified as infarct related when there is evidence of myocardial dysfunction in the territory of the obstructed vessel or as non-infarct related when the myocardial substrate has preserved its systolic function. The presence of a CTO has been associated with an increased risk of malignant ventricular arrhythmias (VAs), appropriate ICD shocks, and cardiac mortality, with infarct-related CTOs exhibiting a worse prognosis. During the last decade, technological advancements have improved the success rates of transcatheter revascularization, a treatment that has been proven valuable for persistently symptomatic patients. However, the role of revascularization in reducing the arrhythmic burden is unclear. On the contrary, catheter ablation of VAs has been suggested to be effective, despite the presence of a CTO. As for device therapies, an increased prevalence of appropriate ICD shocks should be expected in this population, bringing into consideration the implementation of the presence of CTO as a risk modifier in sudden cardiac death prevention algorithms. The aim of this review is to present the existing literature on the role of all kinds of interventions in the management of patients with CTOs and VAs.
慢性冠状动脉全闭塞(CTO)存在于几乎五分之一的患者接受预定的冠状动脉造影。当存在心肌功能障碍的证据时,CTO可归类为梗死相关;当心肌底物保留其收缩功能时,CTO可归类为非梗死相关。CTO的存在与恶性室性心律失常(VAs)的风险增加、适当的ICD电击和梗死相关CTO预后较差的心脏死亡率相关。在过去十年中,技术进步提高了经导管血运重建术的成功率,这种治疗方法已被证明对持续有症状的患者很有价值。然而,血运重建在减轻心律失常负担中的作用尚不清楚。相反,尽管存在CTO,仍认为导管消融VAs是有效的。至于设备治疗,考虑到CTO作为心源性猝死预防算法中的风险调节剂的实施,应该预计该人群中适当的ICD电击的流行率会增加。本综述的目的是介绍各种干预措施在cto和VAs患者管理中的作用的现有文献。
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引用次数: 0
Key messages and critical approach of the 2024 guidelines of the European Society of Cardiology on chronic coronary syndromes 欧洲心脏病学会慢性冠状动脉综合征2024指南的关键信息和关键方法
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-09-01 DOI: 10.1016/j.hjc.2025.02.003
Athanasios J. Manolis , Peter Collins , Manolis S. Kallistratos , Giuseppe Rosano
The updated European Society of Cardiology (ESC) guidelines empower physicians to tailor treatment plans more effectively to individual patient characteristics, preferences, and responses. With a more flexible and individualized approach to angina management, it seems that the traditional stepwise approach may not be optimal for all patients. In addition, there is a significant shift in the diagnostic approach for chronic coronary syndromes (CCS). In this review, we mainly refer to key points and queries concerning the current ESC recommendations regarding the diagnostic approach and treatment of patients with stable angina, recommending practical directions to physicians managing patients with CCS.
更新后的指南使医生能够更有效地根据患者的个体特征、偏好和反应量身定制治疗计划。随着更灵活和个性化的方法来心绞痛管理,似乎传统的逐步方法可能不是所有患者的最佳选择。此外,慢性冠状动脉综合征(CCS)的诊断方法也发生了重大变化。在这篇综述中,我们将主要参考目前ESC关于稳定型心绞痛患者的诊断方法和治疗建议的关键点和疑问,为管理CCS患者的医生提供实用的指导。
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引用次数: 0
Vascular calcification in Takayasu arteritis: relationship with metabolic syndrome, left ventricular mass index, and intima-media thickness 高安动脉炎的血管钙化;与代谢综合征、左心室质量指数和内膜厚度的关系
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-09-01 DOI: 10.1016/j.hjc.2024.04.007
Hazan Karadeniz , Sevcihan Kesen , Mert Burak Akhan , Serkan Unlu , Rıza Can Kardas , Aslıhan Avanoglu Guler , Derya Yıldırım , Ibrahim Vasi , Burcugul Kaya , Rahime Duran , Nurten Gizem Tore , Abdulsamet Erden , Hamit Kucuk , Berna Goker , Mehmet Akif Ozturk , Abdurrahman Tufan

Objective

The present study aims to determine the frequency of vascular calcification in Takayasu arteritis (TA) and the risk factors for it and to evaluate its relation with atherosclerotic predictors such as metabolic syndrome (MS), left ventricular mass index (LVMI) and carotid intima-media thickness (CIMT).

Methods

A cross-sectional study was conducted in patients with TA; MS was defined according to the US National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) criteria. The study included 49 TA patients (22 with MS, 27 without MS) and 31 healthy controls (HCs). Non-contrast computed tomography measured calcification in coronary arteries, aorta, and branches.

Results

Forty-seven patients (95.9%) were female and mean age was 33.45 ± 8.53 years. Total calcification score (mean ± SD; 5223.9 ± 18041.1 AU vs. 35.87 ± 72.70 AU (p = 0.05)), CIMT, and LVMI were found to be significantly higher in TA patients than HCs (p < 0.05). While there was no significant difference between the total calcification score of MS (+) TA patients and MS (−) TA patients, in both patient groups, the total calcification score was found to be significantly higher than HCs. MS (+) and MS (−) groups were found to have significantly higher CIMT and LVMI values than the control group, in addition, MS (+) patients were found to have significantly higher LVMI and CIMT values than MS (−) group (p < 0.05).

Conclusion

Vascular calcification, CIMT, and LVMI are elevated in all TA patients, with greater impact in the presence of MS.
简介:本研究旨在确定高安动脉炎(TA)患者血管钙化的频率及其风险因素,并评估其与代谢综合征(MS)、左心室质量指数(LVMI)和颈动脉内膜中层厚度(CIMT)等动脉粥样硬化预测指标的关系:方法:对TA患者进行了一项横断面研究;MS是根据美国国家胆固醇教育计划/成人治疗小组III(NCEP/ATP III)标准定义的。研究对象包括 49 名 TA 患者(22 名 MS 患者,27 名非 MS 患者)和 31 名健康对照组(HCs)。非对比计算机断层扫描测量了冠状动脉、主动脉和分支的钙化情况:47名患者(95.9%)为女性,平均年龄(33.45±8.53)岁。TA患者的钙化总分(平均值±SD;5223.9±18041.1 AU vs 35.87±72.70 AU(P=0.05))、CIMT和LVMI均显著高于HC(P结论:所有TA患者的血管钙化、CIMT和LVMI均升高,MS患者的影响更大。
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引用次数: 0
Depression and anxiety in patients with hypertrophic cardiomyopathy: a call for action 肥厚性心肌病患者的抑郁和焦虑行动的号召。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-09-01 DOI: 10.1016/j.hjc.2024.12.001
George Michas , Ioannis Liatakis , Panagioula Niarchou , Dimitra Kentroti , Efstathia Prappa , Athanasios Trikas
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引用次数: 0
New guidelines of EACTS/STS on aortic disease: a useful tool for the management of “aortic organ” disease EACTS/STS 关于主动脉疾病的新指南:管理 "主动脉器官 "疾病的有用工具。
IF 2.7 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-07-01 DOI: 10.1016/j.hjc.2024.10.001
Nikolaos Schizas , Panagiotis Dedeilias
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引用次数: 0
Combining catheter ablation and left atrial appendage occlusion in high-risk patients with atrial fibrillation: a propensity score-matched analysis 对高危心房颤动患者联合使用导管消融术和左心房阑尾闭塞术:倾向评分匹配分析
IF 2.7 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-07-01 DOI: 10.1016/j.hjc.2024.03.002
Ziyong Hao , Bin Liu , Xiaoyi Xie , Yiting Fan , Jian Wang , Qin Shao , Lisheng Jiang , Ben He

Background

The safety and efficacy of a combined approach of catheter ablation (CA) and left atrial appendage occlusion (LAAO) compared to LAAO alone remain unknown.

Methods

Patients with atrial fibrillation (AF) at increased stroke risk who underwent LAAO were divided into either combined (CA and LAAO) procedures or LAAO alone group. Propensity score matching was utilized to balance baseline characteristics. The primary endpoint of the study was a composite of death, thromboembolic events, major bleeding, heart failure (HF) rehospitalization, and major periprocedural complications.

Results

A total of 707 AF patients who underwent LAAO were included. After 1:1 propensity score matching, 166 patients who underwent LAAO alone (n = 83) or the combined procedure (n = 83) were analyzed. Successful LAAO was achieved in all (100%) patients, with a low incidence of periprocedural complications in both groups (2.4% vs. 4.8%, LAAO vs. combined, p = 0.68). The incidence of peri-device leak post-LAAO was significantly higher in the combined group (25.3% vs. 43.4%, p = 0.01). After a median follow-up of 2 years, there were no significant differences in the rates of the primary composite endpoint between the two strategies (22.2% vs. 14.3%, HR: 1.24 [95% CI: 0.51–2.97], p = 0.63). However, the rate of HF rehospitalization was significantly lower in the combined group (19.6% vs. 3.6%, HR: 4.89 [95% CI: 1.50–15.97], p = 0.024).

Conclusions

Combining CA and LAAO in a “one-stop” approach is safe and brings additional benefits in relieving symptoms of heart failure, although peri-device leak was more common compared to LAAO alone.
背景:导管消融术(CA)和左心房阑尾封堵术(LAAO)联合治疗与单纯 LAAO 相比,其安全性和有效性仍是未知数:方法:将中风风险较高且接受 LAAO 的心房颤动(房颤)患者分为联合手术(CA 和 LAAO)组或单纯 LAAO 组。采用倾向评分匹配法平衡基线特征。研究的主要终点是死亡、血栓栓塞事件、大出血、心力衰竭(HF)再住院和主要围手术期并发症的综合结果:共纳入了707名接受LAAO手术的房颤患者。经过1:1倾向评分匹配后,对166名单独接受LAAO(83人)或联合手术(83人)的患者进行了分析。所有患者(100%)都成功进行了 LAAO,两组患者的围手术期并发症发生率都很低(2.4% 对 4.8%,LAAO 对联合手术,P=0.68)。LAAO术后器械周围渗漏的发生率在联合组中明显较高(25.3% 对 43.4%,P=0.01)。中位随访 2 年后,两种策略的主要复合终点发生率无显著差异(22.2% 对 14.3%,HR:1.24 [95% CI:0.51-2.97],P=0.63)。然而,联合组的心房颤动再住院率明显降低(19.6% vs. 3.6%,HR:4.89 [95% CI:1.50-15.97],P=0.024):结论:"一站式 "联合 CA 和 LAAO 是安全的,并能在缓解心衰症状方面带来额外的益处,尽管与单独 LAAO 相比,器械周围渗漏更为常见。
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引用次数: 0
Endomyocardial biopsy in clinical practice: the diagnostic yield and insights from a 5-year single-center experience 临床实践中的心内膜心肌活检:心内膜心肌活检在临床实践中的应用:五年单中心经验的诊断率和启示。
IF 2.7 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-07-01 DOI: 10.1016/j.hjc.2024.03.004
Mutaz Karameh , Karen Meir , Abed Qadan , Orit Pappo , Dotan Cohen , Ronen Durst , Offer Amir , Rabea Asleh

Objectives

Endomyocardial biopsy (EMB) is a diagnostic tool for evaluating various cardiac conditions, such as myocarditis and myocardial infiltrative diseases. It is also the gold standard screening technique for detecting allograft rejection after heart transplantation. Despite advances in noninvasive imaging modalities for myocardial tissue characterization, EMB is still necessary for making a definitive diagnosis and determining treatment for certain conditions. Herein, we report our recent experience using EMB and its diagnostic yield.

Methods and Results

We retrospectively reviewed EMBs performed at our institution from March 2018 through March 2023. Clinical data, including patient characteristics, indication and diagnostic yield of EMB, and procedure-related complications, were collected. Histopathological findings of the biopsies were recorded and classified based on the degree to which they matched the clinical diagnosis and cardiac magnetic resonance imaging (CMR) findings. A total of 212 EMBs obtained in 178 consecutive patients were retrospectively analyzed, with 42 biopsies performed for allograft rejection surveillance (10 patients) and the remaining performed for presumptive diagnosis of acute myocarditis or unexplained cardiomyopathy. Among the non-heart transplant cases, 54.7% of EMBs provided a clear diagnosis. The most common diagnosis was myocarditis (69%), followed by cardiac amyloidosis (CA) (26%). EMB was also helpful in detecting several rare cardiac conditions, such as eosinophilic granulomatosis with polyangiitis (EGPA), Fabry disease, and cardiac sarcoidosis. In a cohort of 101 patients who underwent both CMR and EMB, the results were concordant in 66% of cases. However, in 24.7% of patients, EMB was able to identify pathological conditions where CMR results were inconclusive, highlighting its complementary role in determining an accurate diagnosis. No complications were reported in any of the 212 EMBs performed.

Conclusions

With advances in cardiac imaging modalities, EMB is not routinely indicated for the diagnosis of cardiomyopathy. However, EMB is still an important tool for diagnosing specific cardiac diseases and could be crucial for confirming the diagnosis. EMB is generally safe if performed at experienced centers.
背景和目的:心内膜活检(EMB)是评估心肌炎和心肌浸润性疾病等各种心脏疾病的诊断工具。它也是检测心脏移植后异体移植排斥反应的金标准筛查技术。尽管用于心肌组织特征描述的无创成像模式不断进步,但 EMB 仍是明确诊断和确定某些疾病治疗方法的必要手段。在此,我们报告了最近使用 EMB 的经验及其诊断结果:我们回顾性审查了我院自 2018 年 3 月至 2023 年 3 月期间进行的 EMB。我们收集了临床数据,包括患者特征、EMB 的适应症和诊断率以及手术相关并发症。记录活检组织病理学结果,并根据其与临床诊断和心脏磁共振成像(CMR)结果的匹配程度进行分类。对178名连续患者的212例EMB进行了回顾性分析,其中42例活检用于监测异体移植排斥反应(10名患者),其余活检用于推测诊断急性心肌炎或原因不明的心肌病。在非心脏移植病例中,54.7%的心肌活检提供了明确诊断。最常见的诊断是心肌炎(69%),其次是心脏淀粉样变性(CA)(26%)。EMB 还有助于发现几种罕见的心脏疾病,如嗜酸性粒细胞肉芽肿伴多血管炎(EGPA)、法布里病和心脏肉样瘤病。在一组同时接受 CMR 和 EMB 检查的 101 名患者中,66% 的病例结果一致。然而,在 24.7% 的患者中,EMB 能够确定 CMR 结果不确定的病理情况,这突出了其在确定准确诊断方面的补充作用。在已进行的212例EMB中,无一例出现并发症:结论:随着心脏成像技术的发展,EMB 已不再是诊断心肌病的常规方法。然而,EMB 仍是诊断特定心脏疾病的重要工具,对确诊至关重要。如果在经验丰富的中心进行,EMB 一般是安全的。
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引用次数: 0
期刊
Hellenic Journal of Cardiology
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