The presence of hypertension (HTN) in patients with diabetes mellitus (DM) further worsens cardiovascular disease (CVD) prognosis. In addition, masked HTN and abnormal circadian blood pressure (BP) variability are common among patients with DM. Clinical trial data show that sodium-glucose cotransporter 2 inhibitors (SGLT2i) improve CVD prognosis and prevent progression of renal dysfunction in high-risk

Elevated circulating concentrations of lipoprotein(a) [Lp(a)] is strongly associated with increased risk of atherosclerotic cardiovascular disease (CVD) and degenerative aortic stenosis. This relationship was first observed in prospective observational studies, and the causal relationship was confirmed in genetic studies. Everybody should have their Lp(a) concentration measured once in their lifetime

Recent trials have shown impressive results in low-risk patients undergoing Transcatheter Aortic Valve Replacement (TAVR) with low procedural complication rates, short hospital length of stay, zero mortality, and zero disabling stroke at 30 days and have led to a Food and Drug Administration indication for TAVR in these patients. The long-term data on subclinical leaflet thrombosis, valve durability

MitraClip therapy for the treatment of functional mitral regurgitation (FMR) is an increasingly used intervention for high‐risk surgical patients. The aim of this observational study was to assess the impact of residual mitral regurgitation (rMR) at discharge on long‐term outcome after MitraClip therapy in patients with FMR.

This editorial refers to ‘Comparison of newer generation self-expandable vs. balloon-expandable valves in transcatheter aortic valve implantation: the randomized SOLVE-TAVI trial’, by H. Thiele et al., doi:10.1093/eurheartj/ehaa036.

AimsTo determine whether the combination of standard electrocardiographic (ECG) markers reflecting domains of arrhythmic risk improves sudden and/or arrhythmic death (SAD) risk stratification in patients with coronary heart disease (CHD). Methods and resultsThe association between ECG markers and SAD was examined in a derivation cohort (PREDETERMINE; N = 5462) with adjustment for clinical risk factors

From the emerging literature, cardiovascular disease appears to play a prominent role in the COVID-19 pandemic on multiple levels: (i) patients with cardiovascular risk factors and pre-existent cardiovascular disease seem to have an increased risk of a poor outcome;1,2,3 (ii) patients with COVID-19 have been, also in the absence of underlying cardiovascular disease, reported to develop cardiovascular

A 43-year-old woman presented to the emergency room for a 3-day history of oppressive chest pain and dyspnoea. Her past medical history was unremarkable. On admission, she had a temperature of 37.7°C, blood pressure 120/80 mmHg, and heart rate 79 b.p.m. Physical exam revealed decreased breath sounds at lung bases with ronchi. Because of oxygen desaturation (SpO2 89%), continuous positive airway pressure

Background:Prior studies of cardiac contractility modulation (CCM) employed a 3-lead Optimizer system. A new 2-lead system eliminated the need for an atrial lead. This study tested the safety and effectiveness of this 2-lead system compared with the 3-lead system.Methods:Patients with New York Heart Association III/IVa symptoms despite medical therapy, left ventricular ejection fraction 25% to 45%

Background:The NuPulseCV intravascular ventricular assist system (iVAS) provides extended duration ambulatory counterpulsation via a durable pump placed through the distal subclavian artery.Methods:We performed a prospective, single-arm, multicenter, US Food and Drug Administration-approved feasibility trial of iVAS therapy as a bridge to transplant or decision following the FIH (First-In-Human) trial

Background:Ischemic tolerance of donor hearts has a major impact on the efficiency in utilization and clinical outcomes. Molecular events during storage may influence the severity of ischemic injury.Methods:RNA sequencing was used to study the transcriptional profile of the human left ventricle (LV, n=4) and right ventricle (RV, n=4) after 0, 4, and 8 hours of cold storage in histidine-tryptophan-ketoglutarate

SARS-CoV-2Coronavirus Pandemic Angiotensin-converting enzyme 2Cardiovascular system

Angiotensin-converting enzyme (ACE2) has a multiplicity of physiological roles that revolve around its trivalent function: a negative regulator of the renin-angiotensin system (RAS), facilitator of amino acid transport, and the SARS-CoV and SARS-CoV-2 receptor. ACE2 is widely expressed, including, in the lungs, cardiovascular system, gut, kidneys, central nervous system, and adipose tissue. ACE2 has

Background: Since the approval of the oral factor Xa (FXa) inhibitors, there have been concerns regarding the ability to neutralize their anticoagulant effects after intracranial hemorrhage (ICH). Multiple guidelines suggest using prothrombin complex concentrates (PCC) in these patients based upon research that includes a limited number of patients with ICH. Given this, we aimed to evaluate the safety

Background: The cAMP-hydrolyzing phosphodiesterase 4B (PDE4B) is a key negative regulator of cardiac β-adrenergic receptor (β-AR) stimulation. PDE4B deficiency leads to abnormal Ca2+ handling and PDE4B is decreased in pressure overload hypertrophy, suggesting that increasing PDE4B in the heart is beneficial in heart failure (HF).Methods: We measured PDE4B expression in human cardiac tissues, developed

Background A novel coronavirus disease (COVID-19) in Wuhan has caused an outbreak and become a major public health issue in China and great concern from international community. Myocarditis and myocardial injury were suspected and may even be considered as one of the leading causes for death of COVID-19 patients. Therefore, we focused on the condition of the heart, and sought to provide firsthand evidence

Background Risk stratification with specific biomarkers is proposed for tailored P2Y12 inhibitor therapy in patients with STEMI. Methods This nationwide registry and quality improvement study is from November 1, 2014, to June 30, 2017. In total, 11,512 STEMI patients received aspirin and P2Y12 receptor inhibitor (clopidogrel or ticagrelor) and underwent PCIs in hospitals. Of the patients, 2992 were

Hieronymus Fabricius ab Acquapendente, famous anatomist of the medical school of Padua, Italy, marked a further step not only in the morphological studies, but also in anatomical illustration and physiology. His researches were inspired by the work of Aristotle which was focused on the understanding of biological “functions” in an anatomo-comparative way. The anatomo-comparative approach of Fabrici

Background Cardiorenal syndrome (CRS) is a major health burden worldwide in need of novel therapies, as current treatments remain suboptimal. The present study assessed the therapeutic potential of apoptosis signal-regulating kinase 1 (ASK1) inhibition in a rat model of CRS. Methods Adult male Sprague-Dawley rats underwent surgery for myocardial infarction (MI) (week 0) followed by 5/6 subtotal nephrectomy

Background Dexmedetomidine induces cooperative and arousable sedation. Our aim was to analyze dexmedetomidine use in medical cardiac intensive care units (CICU). Methods Multicenter prospective registry of patients treated with dexmedetomidine in CICU. Consecutive inclusion during a 12-month period. Results A total of 410 patients were included, mean age was 67.4 ± 13.9 years, and 94 (22.9%) were women

AimsTo evaluate the safety and efficacy of left atrial appendage occlusion (LAAO) with the Amplatzer™ Amulet™ occluder. Methods and resultsPatients with atrial fibrillation eligible for LAAO were recruited to a prospective global study. Implant procedures were undertaken with echocardiographic guidance. Transoesophageal echocardiography (TOE) was undertaken 1–3 months post-LAAO. Implant and follow-up

Since COVID-19 has spread around the globe, most countries have applied quarantines and travel bans as a strategy to reduce or halt the spread of the virus and to avoid deaths reaching critical numbers.1 However, one country, South Korea, appears to have greatly slowed its epidemic without resorting to drastic lockdown; it reported about 75 new cases today (18 March 2020), down from 909 at its peak

Aims Intravascular ultrasound (IVUS) imaging can visualize vulnerable plaque features including attenuation (AP) and echolucency (ELP). While IVUS-derived vulnerable plaque features associate with microvascular obstruction during percutaneous coronary intervention, the relationship between these plaque features and clinical outcomes has not been established. This analysis aimed to evaluate the association

The novel coronavirus disease 2019 (COVID-19) continues to spread internationally. Worldwide, almost 700 000 cases of coronavirus disease 2019 (COVID-19) (697 2744 ‘confirmed cases’ from Situation Dashboard WHO 30 March 2020), more than 33 000 deaths, and more than 100 000 recovered patients have been reported. The death rate estimated globally at 3.4% by the World Health Organization (WHO) varies

Bergamo is the town most affected by the COVID-19 epidemic, not only in the Lombardy Region but also throughout Italy, with >9000 COVID-positive cases, and 2300 ascertained deaths. Unfortunately, the infection is not even sparing young people.

This editorial refers to ‘A systematic review and meta-analysis of the prevalence of left ventricular non-compaction in adults’††, by S.B. Ross et al., on page 1428.

AimsTo assess the reported prevalence of left ventricular non-compaction (LVNC) in different adult cohorts, taking in to consideration the role of diagnostic criteria and imaging modalities used. Methods and resultsA systematic review and meta-analysis of studies reporting LVNC prevalence in adults. Studies were sourced from Pre-Medline, Medline, and Embase and assessed for eligibility according to

Ventricular septal defects (VSDs) are the most common congenital cardiac malformations accounting for ∼30% of congenital heart disease. Although open heart surgery is considered a standard treatment, catheter-based intervention is a promising alternative, associated with a lower incidence of myocardial injury, less blood transfusion, faster recovery, and shorter hospitalization. The most relevant complications

AIMS We aimed to assess structural progression in arrhythmogenic cardiomyopathy (AC) patients and mutation-positive family members and its impact on arrhythmic outcome in a longitudinal cohort study. METHODS AND RESULTS Structural progression was defined as the development of new Task Force imaging criteria from inclusion to follow-up and progression rates as annual changes in imaging parameters. We

A 79-year-old woman with hypertrophic obstructive cardiomyopathy (HOCM) underwent percutaneous transluminal septal myocardial ablation (PTSMA) for drug-refractory symptoms of New York Heart Association (NYHA) functional Class IIm. Four-dimensional flow magnetic resonance imaging (MRI) was performed before, 3 months after and 1 year after PTSMA to evaluate the blood flow pattern and turbulent kinetic

This commentary refers to ‘Cardiovascular magnetic resonance imaging volume criteria for arrhythmogenic right ventricular cardiomyopathy: need for update?’, by M.Y. Khanji et al., doi:10.1093/eurheartj/ehz965.

AIMS Transthyretin amyloidosis cardiomyopathy (ATTR-CM) is an increasingly recognized cause of heart failure. We sought to characterize the structural and functional echocardiographic phenotype across the spectrum of wild-type (wtATTR-CM) and hereditary (hATTR-CM) transthyretin cardiomyopathy and the echocardiographic features predicting prognosis. METHODS AND RESULTS We studied 1240 patients with

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart muscle disease characterized by progressive fibrofatty replacement of the right ventricular (RV) myocardium which may act as a substrate for ventricular arrhythmias and sudden cardiac death (SCD).1,2 The classic form of ARVC is a genetically determined cardiomyopathy caused by heterozygous or compound mutations in genes encoding

This editorial refers to ‘Echocardiographic phenotype and prognosis in transthyretin cardiac amyloidosis’††, by L. Chacko et al., on page 1439.

This commentary refers to ‘Arrhythmogenic right ventricular cardiomyopathy: evaluation of the current diagnostic criteria and differential diagnosis’, by D. Corrado et al., doi:10.1093/eurheartj/ehz669.

We wish to thank the following reviewers for their contributions during 2019 (**Elite Reviewer of the Year 2019; *Elite Reviewers 2019).

Arrhythmogenic cardiomyopathy (ACM) is a heritable cardiomyopathy characterized by frequent ventricular arrhythmias and progressive ventricular dysfunction. Risk of sudden cardiac death is elevated in ACM patients and can be the presenting symptom particularly in younger individuals and athletes. This review describes current understanding of the genetic architecture of ACM and molecular mechanisms

Executive summary of meeting, 16 November 2019, European Heart House, SophiaAntipolis, France

Background:The REDUAL PCI trial (Evaluation of Dual Therapy With Dabigatran vs Triple Therapy With Warfarin in Patients With AF That Undergo a PCI With Stenting) demonstrated that, in patients with atrial fibrillation following percutaneous coronary intervention, bleeding risk was lower with dabigatran plus clopidogrel or ticagrelor (dual therapy) than warfarin plus clopidogrel or ticagrelor and aspirin

The combination of oral anticoagulation and the antiplatelet drug clopidogrel increases the risk of bleeding after transcatheter aortic valve implantation (TAVI) compared with oral anticoagulation alone, according to the results of the POPular TAVI trial cohort B.

Renal denervation compared with a sham procedure can significantly reduce 24-h and office systolic blood pressure levels in patients with uncontrolled hypertension who are not receiving antihypertensive drugs.

Aims Hypertensive left ventricular hypertrophy (LVH) is associated with increased cardiovascular events. We previously developed the remodelling index (RI) that incorporated left ventricular (LV) volume and wall-thickness in a single measure of advanced hypertrophy in hypertensive patients. This study examined the prognostic potential of the RI in reference to contemporary LVH classifications. Methods

AimsCalcific aortic valve disease is the most common heart valve disease in the Western world. It has been reported that zinc is accumulated in calcified human aortic valves. However, whether zinc directly regulates calcific aortic valve disease is yet to be elucidated. The present study sought to determine the potential role of zinc in the pathogenesis of calcific aortic valve disease. Methods and

Aortic intramural hematoma is a life-threatening condition reported with increasing frequency. It can be classified into Stanford type A or B depending on whether the ascending or descending aorta are involved, respectively. However, the onset of acute type A aortic dissection following recovery of type B intramural haematoma is rarely reported. We present an uncommon case of acute Stanford type A

The COngenital HeARt Disease in adult and Pulmonary Hypertension (COHARD-PH) registry is the first registry for congenital heart disease (CHD) and CHD-related pulmonary hypertension (PH) in adults in Indonesia. The study aims to describe the demographics, clinical presentation, and hemodynamics data of adult CHD and CHD-related PH in Indonesia. The COHARD-PH registry is a hospital-based, single-center

Several models have been developed to predict asymptomatic carotid stenosis (ACS), however these models did not pay much attention to people with lower level of stenosis (<50% or carotid plaques, especially instable carotid plaques) who might benefit from early interventions. Here, we developed a new model to predict unstable carotid plaques through systematic screening in population with high risk

Infection with the novel coronavirus, SARS-CoV-2, produces a clinical syndrome known as COVID-19. When severe, COVID-19 is a systemic illness characterized by hyperinflammation, cytokine storm and elevations of cardiac injury biomarkers. Here we review what is known about the pathophysiology of COVID-19, its cardiovascular manifestations, and emerging therapeutic prospects. In this rapidly moving field

Background Filamin C is a cytoskeletal protein expressed in cardiac cells. Nonsense variations in the filamin C gene (FLNC) were associated with dilated and arrhythmogenic cardiomyopathies. Methods and results We identified an intronic variation in FLNC gene (c.3791-1G > C) in three unrelated Ashkenazi Jewish families with variable expression of arrhythmia and cardiomyopathy. cDNA was prepared from

Background Despite recent technical advances, interventional cardiac catheterization is still challenging in neonatal age and no specific data concerning early outcome are so far published in literature. Methods Neonatal trans-catheter cardiac interventions performed in high-volume Italian referral centers were retrospectively analyzed. Primary outcomes were procedural major adverse events, in-hospital

Aims During embryogenesis, the onset of circulatory blood flow generates a variety of hemodynamic forces which reciprocally induce changes in cardiovascular development and performance. It has been known for some time that these forces can be detected by as yet unknown mechanosensory systems which in turn promote cardiogenic events such as outflow tract and aortic valve development. PIEZO1 is a mechanosensitive

Danon disease (OMIM 300257) is an X-linked lysosomal storage disorder, characterized by hypertrophic cardiomyopathy (HCM), skeletal myopathy, variable intellectual disability, and other minor clinical features. This condition accounts for ~ 4% of HCM patients, with a more severe and early onset phenotype in males, causing sudden cardiac death (SCD) in the first three decades of life. Genetic alterations

We studied the course of plasma concentrations of 4 cardiovascular biomarkers: natriuretic peptides (BNP, NT-proBNP; mid-regional (MR) pro-atrial NP); and soluble endothelial CD146 (sCD146), in patients with severe mitral valve stenosis undergoing percutaneous mitral commissurotomy (PMC) to identify potential markers of procedural success. Biomarkers were tested in 40 patients the day before and the

Aim of the study was to find predictors of allocating patients after transcatheter aortic valve implantation (TAVI) to geriatric (GR) or cardiac rehabilitation (CR) and describe this new patient group based on a differentiated characterization. From 10/2013 to 07/2015, 344 patients with an elective TAVI were consecutively enrolled in this prospective multicentric cohort study. Before intervention,