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Speckle-tracking global longitudinal strain predicts death and cardiovascular events in patients with systemic sclerosis. 斑点追踪全局纵向应变可预测系统性硬化症患者的死亡和心血管事件。
Pub Date : 2024-04-03 eCollection Date: 2024-03-01 DOI: 10.1093/ehjopen/oeae023
Giulia Stronati, Federico Guerra, Devis Benfaremo, Cristina Dichiara, Federico Paolini, Gianmarco Bastianoni, Leonardo Brugiatelli, Michele Alfieri, Paolo Compagnucci, Antonio Dello Russo, Gianluca Moroncini

Aims: Albeit often asymptomatic, heart involvement in systemic sclerosis (SSc) represents a negative prognostic factor, accounting for nearly one-fourth of all deaths. Global longitudinal strain (GLS) is accurate in detecting heart involvement in patients with SSc and no overt cardiac disease and allows early detection and longitudinal monitoring, but its association with clinical endpoints has not been tested so far. The primary outcome was the association between left and right GLS and mortality for all causes. The secondary outcome was the association between left and right GLS and hospitalizations.

Methods and results: A prospective longitudinal study enrolling all consecutive patients with SSc without structural heart disease or previous cardiovascular event.A total of 164 patients were enrolled, of whom 19 (11.5%) died during follow-up and 48 (29.3%) were hospitalized. Both left (LV) and right ventricle (RV) GLS at enrolment were independently associated with an increased risk of death for all causes and hospitalizations. Patients with biventricular GLS impairment, respectively, had a 4.2-, 4.9-, and 13.9-fold increased risk of death when compared with patients with only LV, only RV, or no impairment (P < 0.001). The incidence of hospitalization in patients with biventricular GLS impairment was nearly four times higher when compared with patients with only LV or only RV impairment, and nine times higher when compared with normal biventricular GLS (P < 0.001).

Conclusion: Biventricular GLS is associated with an increased risk of death and hospitalization in patients with SSc during a median of 3-year follow-up, acting as a reliable and accurate prognostic tool in everyday practice.

目的:尽管系统性硬化症(SSc)患者通常无症状,但心脏受累是一个不利的预后因素,占所有死亡病例的近四分之一。整体纵向应变(GLS)能准确检测出没有明显心脏疾病的系统性硬化症患者的心脏受累情况,并能进行早期检测和纵向监测,但其与临床终点的相关性迄今尚未得到测试。主要结果是左侧和右侧GLS与各种原因死亡率之间的关系。次要结果是左右GLS与住院治疗之间的关系:这项前瞻性纵向研究招募了所有无结构性心脏病或既往无心血管事件的连续 SSc 患者,共招募了 164 名患者,其中 19 人(11.5%)在随访期间死亡,48 人(29.3%)住院治疗。入选时的左心室和右心室GLS均与各种原因死亡和住院风险的增加有关。与只有左心室、只有右心室或没有损伤的患者相比,双心室 GLS 损伤的患者死亡风险分别增加了 4.2 倍、4.9 倍和 13.9 倍(P < 0.001)。与仅有左心室或仅有左心室功能受损的患者相比,双心室GLS受损患者的住院发生率高出近四倍,与正常双心室GLS患者相比,住院发生率高出九倍(P < 0.001):在中位 3 年的随访中,双心室 GLS 与 SSc 患者死亡和住院风险的增加有关,在日常实践中是一种可靠而准确的预后工具。
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引用次数: 0
Impact of multimorbidity patterns on outcomes and treatment in patients with coronary artery disease. 多病模式对冠心病患者预后和治疗的影响。
Pub Date : 2024-03-27 eCollection Date: 2024-03-01 DOI: 10.1093/ehjopen/oeae009
Wen Zheng, Xin Huang, Xiao Wang, Min Suo, Yan Yan, Wei Gong, Hui Ai, Bin Que, Shaoping Nie

Aims: With an aging population and better survival rates, coronary artery disease (CAD) with multimorbidity has become more prevalent, complicating treatment and impacting life quality and longevity. This study identifies multimorbidity patterns in CAD patients and their effect on clinical outcomes, emphasizing treatment strategies.

Methods and results: The study analysed data from the DCEM registry (173 459 patients) and BleeMACS cohort (15 401 patients) to categorize CAD patients into three multimorbidity patterns. The focus was on how these patterns influence outcomes, especially concerning the efficacy and safety of dual antiplatelet therapy (DAPT). The study identified three distinct multimorbidity patterns: Class 1 encompassed cardiovascular-kidney-metabolic comorbidities indicating the highest risk; Class 2 included hypertension-dyslipidaemia comorbidities, reflecting intermediate risk; and Class 3 involved non-specific comorbidities, indicating the lowest risk. Class 1 patients demonstrated a six-fold increase in in-hospital mortality and a four-fold increase in severe in-hospital complications compared with Class 3. Over a 1-year period, Class 1 was associated with the highest risk, displaying a significant increase in all-cause mortality [adjusted hazard ratio (HR) 1.87, 95% confidence interval (CI) 1.52-2.31, P < 0.001] and a notable risk for major bleeding (adjusted HR 1.74, 95% CI 1.36-2.24, P < 0.001) compared with Class 3. The use of DAPT, particularly aspirin combined with clopidogrel, significantly reduced the 1-year all-cause mortality in Class 1 patients (adjusted HR 0.60, 95% CI 0.37-0.98, P = 0.04) without increasing in major bleeding.

Conclusion: Coronary artery disease patients with a cardiovascular-kidney-metabolic profile face the highest mortality risk. Targeted DAPT, especially aspirin and clopidogrel, effectively lowers mortality without significantly raising bleeding risks.

Registration: DCEM registry (NCT05797402) and BleeMACS registry (NCT02466854).

目的:随着人口老龄化和生存率的提高,冠状动脉疾病(CAD)的多病发率越来越高,使治疗复杂化,影响生活质量和寿命。本研究确定了 CAD 患者的多病模式及其对临床结果的影响,并强调了治疗策略:研究分析了 DCEM 登记(173 459 名患者)和 BleeMACS 队列(15 401 名患者)的数据,将 CAD 患者分为三种多病模式。研究重点是这些模式如何影响疗效,尤其是双联抗血小板疗法(DAPT)的疗效和安全性。研究确定了三种不同的多病模式:第一类包括心血管-肾脏-代谢合并症,表明风险最高;第二类包括高血压-血脂异常合并症,反映了中等风险;第三类涉及非特异性合并症,表明风险最低。与 3 级患者相比,1 级患者的院内死亡率增加了 6 倍,严重院内并发症增加了 4 倍。1 年内,1 级患者的风险最高,与 3 级患者相比,全因死亡率显著增加[调整后危险比 (HR) 1.87,95% 置信区间 (CI) 1.52-2.31,P <0.001],大出血风险显著增加(调整后危险比 1.74,95% 置信区间 (CI) 1.36-2.24,P <0.001)。使用DAPT,尤其是阿司匹林联合氯吡格雷,可显著降低1级患者的1年全因死亡率(调整后HR为0.60,95% CI为0.37-0.98,P = 0.04),且不会增加大出血风险:结论:具有心血管-肾脏-代谢特征的冠心病患者面临最高的死亡风险。有针对性的 DAPT,尤其是阿司匹林和氯吡格雷,可有效降低死亡率,而不会显著增加出血风险:注册:DCEM 注册(NCT05797402)和 BleeMACS 注册(NCT02466854)。
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引用次数: 0
Balancing bleeding and valve thrombosis risk after transcatheter tricuspid valve replacement. 平衡经导管三尖瓣置换术后的出血和瓣膜血栓风险。
Pub Date : 2024-03-23 eCollection Date: 2024-03-01 DOI: 10.1093/ehjopen/oeae022
Mathias Claeys, Geraldine Ong, Mark D Peterson, Sami M Alnasser, Neil P Fam
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引用次数: 0
Comment on: European Heart Journal global spotlight on European Medicines Agency evaluation of mavacamten. 发表评论:欧洲心脏杂志》全球聚焦欧洲药品管理局对 mavacamten 的评估。
Pub Date : 2024-03-06 eCollection Date: 2024-03-01 DOI: 10.1093/ehjopen/oeae013
John A Spertus
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引用次数: 0
Evaluating the effect of inequalities in oral anti-coagulant prescribing on outcomes in people with atrial fibrillation. 评估口服抗凝剂处方的不平等对心房颤动患者疗效的影响。
Pub Date : 2024-03-05 eCollection Date: 2024-03-01 DOI: 10.1093/ehjopen/oeae016
Ryan J Mulholland, Francesco Manca, Giorgio Ciminata, Terry J Quinn, Robert Trotter, Kevin G Pollock, Steven Lister, Claudia Geue

Aims: Whilst anti-coagulation is typically recommended for thromboprophylaxis in atrial fibrillation (AF), it is often never prescribed or prematurely discontinued. The aim of this study was to evaluate the effect of inequalities in anti-coagulant prescribing by assessing stroke/systemic embolism (SSE) and bleeding risk in people with AF who continue anti-coagulation compared with those who stop transiently, permanently, or never start.

Methods and results: This retrospective cohort study utilized linked Scottish healthcare data to identify adults diagnosed with AF between January 2010 and April 2016, with a CHA2DS2-VASC score of ≥2. They were sub-categorized based on anti-coagulant exposure: never started, continuous, discontinuous, and cessation. Inverse probability of treatment weighting-adjusted Cox regression and competing risk regression was utilized to compare SSE and bleeding risks between cohorts during 5-year follow-up. Of an overall cohort of 47 427 people, 26 277 (55.41%) were never anti-coagulated, 7934 (16.72%) received continuous anti-coagulation, 9107 (19.2%) temporarily discontinued, and 4109 (8.66%) permanently discontinued. Lower socio-economic status, elevated frailty score, and age ≥ 75 were associated with a reduced likelihood of initiation and continuation of anti-coagulation. Stroke/systemic embolism risk was significantly greater in those with discontinuous anti-coagulation, compared with continuous [subhazard ratio (SHR): 2.65; 2.39-2.94]. In the context of a major bleeding event, there was no significant difference in bleeding risk between the cessation and continuous cohorts (SHR 0.94; 0.42-2.14).

Conclusion: Our data suggest significant inequalities in anti-coagulation prescribing, with substantial opportunity to improve initiation and continuation. Decision-making should be patient-centred and must recognize that discontinuation or cessation is associated with considerable thromboembolic risk not offset by mitigated bleeding risk.

目的:虽然抗凝疗法通常被推荐用于心房颤动(房颤)患者的血栓预防,但却经常从未使用或过早停用。本研究旨在通过评估继续抗凝与暂时停止、永久停止或从未开始抗凝的房颤患者的中风/系统性栓塞(SSE)和出血风险,评估抗凝剂处方不平等的影响:这项回顾性队列研究利用关联的苏格兰医疗保健数据,对 2010 年 1 月至 2016 年 4 月期间确诊为房颤且 CHA2DS2-VASC 评分≥2 分的成年人进行识别。根据抗凝剂暴露情况对他们进行了细分:从未开始、持续、间断和停止。利用治疗加权调整的逆概率 Cox 回归和竞争风险回归来比较 5 年随访期间队列间的 SSE 和出血风险。在 47 427 人的总体队列中,26 277 人(55.41%)从未接受抗凝治疗,7934 人(16.72%)持续接受抗凝治疗,9107 人(19.2%)暂时停止治疗,4109 人(8.66%)永久停止治疗。较低的社会经济地位、虚弱评分升高以及年龄≥ 75 岁与开始和继续接受抗凝治疗的可能性降低有关。与持续抗凝相比,中断抗凝者的卒中/系统性栓塞风险明显更高[亚危险比(SHR):2.65;2.39-2.94]。在发生大出血的情况下,停药组和持续组的出血风险没有明显差异(SHR 0.94;0.42-2.14):我们的数据表明,抗凝处方中存在严重的不平等现象,因此有很大的机会改善抗凝处方的使用和持续性。决策应当以患者为中心,必须认识到停药或停药会带来相当大的血栓栓塞风险,而出血风险的降低并不能抵消这种风险。
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引用次数: 0
Correction to: Effectiveness of icosapent ethyl on first and total cardiovascular events in patients with metabolic syndrome, but without diabetes: REDUCE-IT MetSyn. 更正:对患有代谢综合征但未患糖尿病的患者首次和总体心血管事件的疗效:REDUCE-IT MetSyn.
Pub Date : 2024-03-01 DOI: 10.1093/ehjopen/oeae004

[This corrects the article DOI: 10.1093/ehjopen/oead114.].

[此处更正了文章 DOI:10.1093/ehjopen/eoad114]。
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引用次数: 0
Procedural performance and outcome after pulsed field ablation for pulmonary vein isolation: comparison with a reference radiofrequency database. 脉冲场消融肺静脉隔离术后的手术效果和结果:与射频参考数据库的比较。
Pub Date : 2024-02-28 eCollection Date: 2024-03-01 DOI: 10.1093/ehjopen/oeae014
Benjamin De Becker, Milad El Haddad, Maarten De Smet, Clara François, Rene Tavernier, Jean-Benoit le Polain de Waroux, Sébastien Knecht, Mattias Duytschaever

Aims: Pulsed field ablation (PFA) is a promising ablation technique for pulmonary vein isolation (PVI) with appealing advantages over radiofrequency (RF) including speed, tissue selectivity, and the promise of enhanced durability. In this study, we determine the procedural performance, efficacy, safety, and durability of PFA and compare its performance with a dataset of optimized RF ablation.

Methods and results: After propensity score matching, we compared 161 patients who received optimized RF-guided PVI in the PowerPlus study (CLOSE protocol) with 161 patients undergoing PFA-guided PVI for paroxysmal or persistent atrial fibrillation (AF; pentaspline basket catheter). The median age was 65 years with 78% paroxysmal AF in the PFA group (comparable characteristics in the RF group). Pulsed field ablation-guided PVI was obtained in all patients with a procedure time of 47 min (vs. 71 min in RF, P < 0.0001) and a fluoroscopy time of 15 min (vs. 11 min in RF, P < 0.0001). One serious adverse event [transient ischaemic attack] occurred in a patient with thrombocytosis (0.6 vs. 0% in RF). During the 6-month follow-up, 24 and 27 patients experienced a recurrence with 20 and 11 repeat procedures in the PFA and the RF groups, respectively (P = 0.6 and 0.09). High-density mapping revealed a status of 4 isolated veins in 7/20 patients in the PFA group and in 2/11 patients in the RF group (35 vs. 18%, P = 0.3).

Conclusion: Pulsed field ablation fulfils the promise of offering a short and safe PVI procedure, even when compared with optimized RF in experienced hands. Pulmonary vein reconnection is the dominant cause of recurrence and tempers the expectation of a high durability rate with PFA.

目的:脉冲场消融术(PFA)是一种很有前景的肺静脉隔离(PVI)消融技术,与射频(RF)相比,它具有速度快、组织选择性强等吸引人的优点,而且有望提高耐用性。在这项研究中,我们确定了 PFA 的程序性能、疗效、安全性和耐用性,并将其性能与优化射频消融的数据集进行了比较:经过倾向评分匹配后,我们将在 PowerPlus 研究(CLOSE 方案)中接受优化射频引导下 PVI 的 161 名患者与接受 PFA 引导下 PVI 治疗阵发性或持续性房颤(房颤;五线篮导管)的 161 名患者进行了比较。中位年龄为 65 岁,PFA 组中 78% 为阵发性房颤(射频组的特征与之相当)。所有患者均在脉冲场消融引导下进行了 PVI,手术时间为 47 分钟(射频为 71 分钟,P < 0.0001),透视时间为 15 分钟(射频为 11 分钟,P < 0.0001)。一名血小板增多症患者发生了一起严重不良事件[短暂性缺血发作](0.6%,而 RF 为 0%)。在 6 个月的随访期间,PFA 组和 RF 组分别有 24 名和 27 名患者复发,重复手术次数分别为 20 次和 11 次(P = 0.6 和 0.09)。高密度绘图显示,PFA 组有 7/20 名患者存在 4 条孤立静脉,RF 组有 2/11 名患者存在 4 条孤立静脉(35% 对 18%,P = 0.3):脉冲场消融术实现了提供简短、安全的 PVI 手术的承诺,即使与经验丰富的优化射频相比也是如此。肺静脉再连接是导致复发的主要原因,这也降低了对脉冲场消融术高持久率的期望。
{"title":"Procedural performance and outcome after pulsed field ablation for pulmonary vein isolation: comparison with a reference radiofrequency database.","authors":"Benjamin De Becker, Milad El Haddad, Maarten De Smet, Clara François, Rene Tavernier, Jean-Benoit le Polain de Waroux, Sébastien Knecht, Mattias Duytschaever","doi":"10.1093/ehjopen/oeae014","DOIUrl":"10.1093/ehjopen/oeae014","url":null,"abstract":"<p><strong>Aims: </strong>Pulsed field ablation (PFA) is a promising ablation technique for pulmonary vein isolation (PVI) with appealing advantages over radiofrequency (RF) including speed, tissue selectivity, and the promise of enhanced durability. In this study, we determine the procedural performance, efficacy, safety, and durability of PFA and compare its performance with a dataset of optimized RF ablation.</p><p><strong>Methods and results: </strong>After propensity score matching, we compared 161 patients who received optimized RF-guided PVI in the PowerPlus study (CLOSE protocol) with 161 patients undergoing PFA-guided PVI for paroxysmal or persistent atrial fibrillation (AF; pentaspline basket catheter). The median age was 65 years with 78% paroxysmal AF in the PFA group (comparable characteristics in the RF group). Pulsed field ablation-guided PVI was obtained in all patients with a procedure time of 47 min (vs. 71 min in RF, <i>P</i> < 0.0001) and a fluoroscopy time of 15 min (vs. 11 min in RF, <i>P</i> < 0.0001). One serious adverse event [transient ischaemic attack] occurred in a patient with thrombocytosis (0.6 vs. 0% in RF). During the 6-month follow-up, 24 and 27 patients experienced a recurrence with 20 and 11 repeat procedures in the PFA and the RF groups, respectively (<i>P</i> = 0.6 and 0.09). High-density mapping revealed a status of 4 isolated veins in 7/20 patients in the PFA group and in 2/11 patients in the RF group (35 vs. 18%, <i>P</i> = 0.3).</p><p><strong>Conclusion: </strong>Pulsed field ablation fulfils the promise of offering a short and safe PVI procedure, even when compared with optimized RF in experienced hands. Pulmonary vein reconnection is the dominant cause of recurrence and tempers the expectation of a high durability rate with PFA.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"4 2","pages":"oeae014"},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10939121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Women4Health cohort: a unique cohort to study women-specific mechanisms of cardio-metabolic regulation. Women4Health 队列:研究女性特有的心血管代谢调节机制的独特队列。
Pub Date : 2024-02-27 eCollection Date: 2024-03-01 DOI: 10.1093/ehjopen/oeae012
Fabio Busonero, Stefania Lenarduzzi, Francesca Crobu, Roberta Marie Gentile, Andrea Carta, Francesco Cracco, Andrea Maschio, Silvia Camarda, Michele Marongiu, Daniela Zanetti, Claudio Conversano, Giovanni Di Lorenzo, Daniela Mazzà, Francesco De Seta, Giorgia Girotto, Serena Sanna

Aims: Epidemiological research has shown relevant differences between sexes in clinical manifestations, severity, and progression of cardiovascular and metabolic disorders. To date, the mechanisms underlying these differences remain unknown. Given the rising incidence of such diseases, gender-specific research on established and emerging risk factors, such as dysfunction of glycaemic and/or lipid metabolism, of sex hormones and of gut microbiome, is of paramount importance. The relationships between sex hormones, gut microbiome, and host glycaemic and/or lipid metabolism are largely unknown even in the homoeostasis status. Yet this knowledge gap would be pivotal to pinpoint to key mechanisms that are likely to be disrupted in disease context.

Methods and results: Here we present the Women4Health (W4H) cohort, a unique cohort comprising up to 300 healthy women followed up during a natural menstrual cycle, set up with the primary goal to investigate the combined role of sex hormones and gut microbiota variations in regulating host lipid and glucose metabolism during homoeostasis, using a multi-omics strategy. Additionally, the W4H cohort will take into consideration another ecosystem that is unique to women, the vaginal microbiome, investigating its interaction with gut microbiome and exploring-for the first time-its role in cardiometabolic disorders.

Conclusion: The W4H cohort study lays a foundation for improving current knowledge of women-specific mechanisms in cardiometabolic regulation. It aspires to transform insights on host-microbiota interactions into prevention and therapeutic approaches for personalized health care.

目的:流行病学研究表明,不同性别在心血管和新陈代谢疾病的临床表现、严重程度和病情发展方面存在相关差异。迄今为止,这些差异背后的机制仍不为人知。鉴于此类疾病的发病率不断上升,针对不同性别的既有和新出现的风险因素(如血糖和/或血脂代谢障碍、性激素和肠道微生物组)进行研究至关重要。即使在平衡状态下,性激素、肠道微生物组和宿主血糖和/或脂质代谢之间的关系在很大程度上也是未知的。然而,这一知识空白对于确定在疾病情况下可能被破坏的关键机制至关重要:在此,我们将介绍 "Women4Health(W4H)"队列,这是一个独特的队列,由多达 300 名健康女性组成,她们在自然月经周期中接受随访,建立该队列的主要目的是利用多组学策略研究性激素和肠道微生物群变化在调节体内脂质和葡萄糖代谢过程中的综合作用。此外,W4H 队列还将考虑到女性特有的另一个生态系统--阴道微生物群,研究其与肠道微生物群的相互作用,并首次探索其在心脏代谢紊乱中的作用:W4H队列研究为提高目前对女性特有的心脏代谢调节机制的认识奠定了基础。结论:W4H 队列研究为提高当前对女性特有的心脏代谢调节机制的认识奠定了基础,有望将对宿主-微生物群相互作用的认识转化为预防和治疗方法,从而实现个性化保健。
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引用次数: 0
Management of cardiac emergencies in women: a clinical consensus statement of the Association for Acute CardioVascular Care (ACVC), the European Association of Percutaneous Cardiovascular Interventions (EAPCI), the Heart Failure Association (HFA), and the European Heart Rhythm Association (EHRA) of the ESC, and the ESC Working Group on Cardiovascular Pharmacotherapy. 女性心脏急症的处理:急性心血管护理协会 (ACVC)、欧洲经皮心血管介入协会 (EAPCI)、心力衰竭协会 (HFA) 和欧洲心律协会 (EHRA) 的临床共识声明,以及 ESC 心血管药物治疗工作组。
Pub Date : 2024-02-26 eCollection Date: 2024-03-01 DOI: 10.1093/ehjopen/oeae011
Antonia Sambola, Sigrun Halvorsen, David Adlam, Christian Hassager, Susanna Price, Giuseppe Rosano, Francois Schiele, Lene Holmvang, Marta de Riva, Amina Rakisheva, Patrick Sulzgruber, Eva Swahn

Cardiac emergencies in women, such as acute coronary syndromes, acute heart failure, and cardiac arrest, are associated with a high risk of adverse outcomes and mortality. Although women historically have been significantly underrepresented in clinical studies of these diseases, the guideline-recommended treatment for these emergencies is generally the same for both sexes. Still, women are less likely to receive evidence-based treatment compared to men. Furthermore, specific diseases affecting predominantly or exclusively women, such as spontaneous coronary dissection, myocardial infarction with non-obstructive coronary arteries, takotsubo cardiomyopathy, and peripartum cardiomyopathy, require specialized attention in terms of both diagnosis and management. In this clinical consensus statement, we summarize current knowledge on therapeutic management of these emergencies in women. Key statements and specific quality indicators are suggested to achieve equal and specific care for both sexes. Finally, we discuss several gaps in evidence and encourage further studies designed and powered with adequate attention for sex-specific analysis.

急性冠状动脉综合征、急性心力衰竭和心脏骤停等女性心脏急症与不良后果和死亡的高风险相关。虽然在有关这些疾病的临床研究中,女性的比例历来明显偏低,但指南推荐的这些急症治疗方法对男女一般都是相同的。然而,与男性相比,女性接受循证治疗的可能性较低。此外,主要或仅影响女性的特殊疾病,如自发性冠状动脉夹层、冠状动脉非阻塞性心肌梗死、拓扑型心肌病和围产期心肌病,在诊断和治疗方面都需要特别关注。在这份临床共识声明中,我们总结了目前对女性这些急症的治疗管理知识。我们提出了关键声明和具体的质量指标,以实现对两性的平等和特殊护理。最后,我们讨论了证据方面的一些不足,并鼓励在设计和开展进一步研究时充分关注性别特异性分析。
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引用次数: 0
Authors' response to: How to manage ventricular arrhythmia in patients with viral myocarditis. 作者回复如何处理病毒性心肌炎患者的室性心律失常。
Pub Date : 2024-02-23 eCollection Date: 2024-01-01 DOI: 10.1093/ehjopen/oeae006
Andrea Villatore, Giovanni Peretto
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引用次数: 0
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