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Hot topics in ischaemic heart disease: revascularization, hibernation, type 2 infarction, and proteomics
Filippo Crea
doi : 10.1093/eurheartj/ehab902
European Heart Journal, Volume 43, Issue 2, 7 January 2022, Pages 89–92
Recognition for heart failure breakthrough
Mark Nicholls
doi : 10.1093/eurheartj/ehab321
European Heart Journal, Volume 43, Issue 2, 7 January 2022, Pages 93–94
Small blebs, big potential — can extracellular vesicles cure cardiovascular disease?
Andreas Zietzer, Georg Nickenig, Felix Jansen
doi : 10.1093/eurheartj/ehab334
European Heart Journal, Volume 43, Issue 2, 7 January 2022, Pages 95–97
How cardiac magnetic resonance is changing cardiovascular medicine: Mark Nicholls speaks to EuroCMR2021 Programme chair Professor Robert Manka about the conference highlights and what the future holds for cardiac magnetic resonance (CMR) imaging.
Mark Nicholls
doi : 10.1093/eurheartj/ehab328
European Heart Journal, Volume 43, Issue 2, 7 January 2022, Pages 98–99
What’s your gut telling you? How researchers are investigating the link between myocarditis and intestinal microbiota
Judith Ozkan
doi : 10.1093/eurheartj/ehab396
European Heart Journal, Volume 43, Issue 2, 7 January 2022, Pages 100–102
Computed tomography coronary angiography in acute chest pain: an excellent diagnostic tool with poor added value on clinical outcomes
Giovanna Liuzzo, Massimo Volpe
doi : 10.1093/eurheartj/ehab766
European Heart Journal, Volume 43, Issue 2, 7 January 2022, Pages 103–104
Invasive and non-invasive assessment of ischaemia in chronic coronary syndromes: translating pathophysiology to clinical practice
Ozan M Demir, Haseeb Rahman, Tim P van de Hoef, Javier Escaned, Jan J Piek, Sven Plein, Divaka Perera
doi : 10.1093/eurheartj/ehab548
European Heart Journal, Volume 43, Issue 2, 7 January 2022, Pages 105–117
Intracoronary physiology testing has emerged as a valuable diagnostic approach in the management of patients with chronic coronary syndrome, circumventing limitations like inferring coronary function from anatomical assessment and low spatial resolution associated with angiography or non-invasive tests. The value of hyperaemic translesional pressure ratios to estimate the functional relevance of coronary stenoses is supported by a wealth of prognostic data. The continuing drive to further simplify this approach led to the development of non-hyperaemic pressure-based indices. Recent attention has focussed on estimating physiology without even measuring coronary pressure. However, the reduction in procedural time and ease of accessibility afforded by these simplifications needs to be counterbalanced against the increasing burden of physiological assumptions, which may impact on the ability to reliably identify an ischaemic substrate, the ultimate goal during catheter laboratory assessment. In that regard, measurement of both coronary pressure and flow enables comprehensive physiological evaluation of both epicardial and microcirculatory components of the vasculature, although widespread adoption has been hampered by perceived technical complexity and, in general, an underappreciation of the role of the microvasculature. In parallel, entirely non-invasive tools have matured, with the utilization of various techniques including computational fluid dynamic and quantitative perfusion analysis. This review article appraises the strengths and limitations for each test in investigating myocardial ischaemia and discusses a comprehensive algorithm that could be used to obtain a diagnosis in all patients with angina scheduled for coronary angiography, including those who are not found to have obstructive epicardial coronary disease.
Myocardial viability testing: all STICHed up, or about to be REVIVED?
Matthew Ryan, Holly Morgan, Amedeo Chiribiri, Eike Nagel, John Cleland, Divaka Perera
doi : 10.1093/eurheartj/ehab729
European Heart Journal, Volume 43, Issue 2, 7 January 2022, Pages 118–126
Patients with ischaemic left ventricular dysfunction frequently undergo myocardial viability testing. The historical model presumes that those who have extensive areas of dysfunctional-yet-viable myocardium derive particular benefit from revascularization, whilst those without extensive viability do not. These suppositions rely on the theory of hibernation and are based on data of low quality: taking a dogmatic approach may therefore lead to patients being refused appropriate, prognostically important treatment. Recent data from a sub-study of the randomized STICH trial challenges these historical concepts, as the volume of viable myocardium failed to predict the effectiveness of coronary artery bypass grafting. Should the Heart Team now abandon viability testing, or are new paradigms needed in the way we interpret viability? This state-of-the-art review critically examines the evidence base for viability testing, focusing in particular on the presumed interactions between viability, functional recovery, revascularization and prognosis which underly the traditional model. We consider whether viability should relate solely to dysfunctional myocardium or be considered more broadly and explore wider uses of viability testingoutside of revascularization decision-making. Finally, we look forward to ongoing and future randomized trials, which will shape evidence-based clinical practice in the future.
Risk factors for type 1 and type 2 myocardial infarction
Ryan Wereski, Dorien M Kimenai, Anda Bularga, Caelan Taggart, David J Lowe, Nicholas L Mills, Andrew R Chapman
doi : 10.1093/eurheartj/ehab581
European Heart Journal, Volume 43, Issue 2, 7 January 2022, Pages 127–135
Whilst the risk factors for type 1 myocardial infarction due to atherosclerotic plaque rupture and thrombosis are established, our understanding of the factors that predispose to type 2 myocardial infarction during acute illness is still emerging. Our aim was to evaluate and compare the risk factors for type 1 and type 2 myocardial infarction.
Risk factors for type 2 MI: the usual suspects or guilt by association?
Michelle L O’Donoghue, Nicholas A Marston
doi : 10.1093/eurheartj/ehab707
European Heart Journal, Volume 43, Issue 2, 7 January 2022, Pages 136–137
Effects of initial invasive vs. initial conservative treatment strategies on recurrent and total cardiovascular events in the ISCHEMIA trial
Jose L Lopez-Sendon, Derek D Cyr, Daniel B Mark, Sripal Bangalore, Zhen Huang, Harvey D White, Karen P Alexander, Jianghao Li, Rajesh Goplan Nair, Marcin Demkow, Jesus Peteiro, Gurpreet S Wander, Elena A Demchenko, Reto Gamma, Milind Gadkari, Kian Keong Poh, Thuraia Nageh, Peter H Stone, Matyas Keltai, Mandeep Sidhu, Jonathan D Newman, William E Boden, Harmony R Reynolds, Bernard R Chaitman, Judith S Hochman, David J Maron, Sean M O’Brien
doi : 10.1093/eurheartj/ehab509
European Heart Journal, Volume 43, Issue 2, 7 January 2022, Pages 148–149
The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial prespecified an analysis to determine whether accounting for recurrent cardiovascular events in addition to first events modified understanding of the treatment effects.
First and recurrent events in the ISCHEMIA trial: two sides of the same coin
Davide Cao, Carl J Pepine, Roxana Mehran
doi : 10.1093/eurheartj/ehab603
European Heart Journal, Volume 43, Issue 2, 7 January 2022, Pages 150–152
Glycosylated apolipoprotein J in cardiac ischaemia: molecular processing and circulating levels in patients with acute ischaemic events
Judit Cubedo, Teresa Padró, Gemma Vilahur, Filippo Crea, Robert F Storey, Jose Luis Lopez Sendon, Juan Carlos Kaski, Alessandro Sionis, Jordi Sans-Rosello, EstefanÃa Fernández-Peregrina, Alex Gallinat, Lina Badimon
doi : 10.1093/eurheartj/ehab691
European Heart Journal, Volume 43, Issue 2, 7 January 2022, Pages 153–163
Using proteomics, we previously found that serum levels of glycosylated (Glyc) forms of apolipoprotein J (ApoJ), a cytoprotective and anti-oxidant protein, decrease in the early phase of acute myocardial infarction (AMI). We aimed to investigate: (i) ApoJ-Glyc intracellular distribution and secretion during ischaemia; (ii) the early changes in circulating ApoJ-Glyc during AMI; and (iii) associations between ApoJ-Glyc and residual ischaemic risk post-AMI.
A new biomarker of acute coronary ischaemia: from bench to bedside?
L Kristin Newby
doi : 10.1093/eurheartj/ehab776
European Heart Journal, Volume 43, Issue 2, 7 January 2022, Pages 164–166
Fibroelastoma presenting with recurrent myocardial infarction and diagnosed with intracoronary imaging: a novel intracoronary image of fibroelastoma
Wan Cheol Kim, Wael Sumaya, Osama Essam Elkhateeb
doi : 10.1093/eurheartj/ehab137
European Heart Journal, Volume 43, Issue 2, 7 January 2022, Page 167
Emergency treatment of a giant coronary aneurysm: percutaneous intervention with coronary and peripheral tools
Giorgio Quadri, Francesco Tomassini, Enrico Cerrato, Ferdinando Varbella
doi : 10.1093/eurheartj/ehab690
European Heart Journal, Volume 43, Issue 2, 7 January 2022, Page 168
