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EHJ-ACVC Highlights

Scientific articles from the European Heart Journal - Acute CardioVascular Care (EHJ-ACVC) authored and co-authored by the ACVC.

By Milica Aleksic, EHJ-ACVC editorial board member and Maria Bergami, Young ACVC Member.

March 2024 Highlights

 

The light in the end of the tunel – unrevealing mechanisms of ventricular fibrillation during the first ST elevation myocardial infarction by the use of proteonomics. 

Stampe et al. conducted a study using proteonomics that unrevealed that 26 proteins are associated with ventricular fibrillation. Pending further analysis two of the proteins were strongly associated with VF (ACTBL2, F13A1). The findings of this study represent a groundbreaking moment that points the light towards further investigation of early VF in  ST elevation myocardial infarction.

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Embrace the challenge – the role of ventricular assist device in management of fulminant myocarditis

The study by Takahito Nasu et al. represent a pioneering large-scale registry study using data from Japanese Registry for Percutaneous Ventricular Assist Devices. Use of Impella device showed better success rate in comparison with ECPELLA. Having in mind the high percentage of adverse events further investigation is needed to optimize patient selection and treatment in this matter.

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Deep dive into pulmonary embolism – identifying early predictors affects the outcome?

Zuin et al. deal with “ Early predictors of clinical deterioration in intermediate-high risk pulmonary embolism” Their educational paper is complemented by a clinical consensus statement from the Association for Acute Cardiovascular Care that outlines the diagnostic and treatment pathways for acute right ventricular failure secondary to acutely increased right ventricular afterload.

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Triglyceride deposit cardiomyovasculopathy (TGCV) – rare or just undiagnosed condition?

Nakano et al. introduce us to TGCV by conducting a study on 400 patients with ACS and 148 patients with diabetes and ACS. The study reports 4.3-5.4% prevalence emphasizing the need for further investigation and risk stratification of these patients, having in mind that they may present with diffuse coronary artery stenosis.

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Figure from Maria Bergami

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February 2024 Highlights

Cardiogenic shock patients on VA-ECMO – individual approach as the solution in prediction and reduction of complications?

VA-ECMO is a well-established method of treating patients with cardiogenic shock. But the risk of complications is still very high. Benedict N. Beer et al. conducted a retrospective multicenter cohort study with the aim to accurately describe the risk of complications and mortality events and to evaluate possible predictors of such events in those patients.

The study showed that the majority of 30-day survival patients treated with VA-ECMO had favorable neurological outcome (CPC 1/2). The presence of AEs, which are more common in women, are strongly associated with worsened neurological outcome and 30-day survival.

Further studies are needed to identify patients that could benefit from this strategy, having in mind the high risk of complications, whose prediction is still challeging and in need for RCTs. One possible solution might be the use of ECMELLA strategy that may reduce typical VA-ECMO complications but the strong evidence is still lacking. Patient selection might be improved by forming the multidisciplinary cardiogenic shock teams worldwide.

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Figure from Maria Bergami

January 2024 Highlights

Sex-specific 99th percentile high-sensitivity cardiac troponin assays – are we there yet? 

Dr. Maria Rubini Gimenez discusses the diagnostic and prognostic value of sex-specific 99th percentiles in high sensitivity cardiac troponin assays for AMI.

The study by Lehmacher et al. reveals comparable diagnostic accuracy between uniform and sex-specific cutoffs, suggesting no clear advantage for the latter.

The results extend this message to uniform cutoffs for hs-cTnI, but the diagnostic accuracy’s reliance on hs-cTnT concentrations is acknowledged as a limitation which requires futher studies before recommending sex-specific cutoffs in clinical practice.

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Figure from Maria Bergami

Climate change as a global health problem – are we too late to prevent the consequences?

The EHJ-ACVC joins over 200 heart journals and urges the United Nations, political leaders, and health professionals to address climate change and biodiversity loss together as an indivisible global health emergency. 

Recognising the interconnectedness of climate and nature crisis, they emphasise the severe impact on health, from infectious diseases to mental health issues. The call urges the WHO to declare this crisis a global health emergency to be able to restore biodiversity and combat climate change.


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Figures from Maria Bergami 

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