Objectives To investigate the long-term outcomes and risk factors for morbidity and mortality in patients with Ebstein’s anomaly, including the effects of type and timing of valve surgery. Methods For this retrospective, record-based study, all patients with Ebstein’s anomaly enrolled in the German National Register for Congenital Heart Defects up to June 2021 were eligible for...
Background and aims Tissue remodelling and extracellular matrix (ECM) changes are primary consequences of ST-elevated myocardial infarction (STEMI), leading to an increased risk of developing heart failure and mortality. Collagen type I is the top constituent of the cardiac ECM and is rapidly degraded at sites of tissue injury occurring in STEMI. We aimed to investigate the...
Aims Left ventricular heart failure (LVHF) remains a major contributor to morbidity and mortality, with sex-specific differences. This study investigates the influence of sex and New York Heart Association (NYHA) classification on clinical outcomes and healthcare costs. Methods and results We analyzed data from 2,616,462 LVHF hospitalization cases in Germany (2014–2022), sourced...
Background Mavacamten is the first approved myosin inhibitor for symptomatic obstructive hypertrophic cardiomyopathy (oHCM), addressing hypercontractility and left ventricular outflow tract (LVOT) obstruction. Objectives This study evaluates left ventricular performance by non-invasive measurements of pressure–strain loops in patients treated with Mavacamten. Methods In 36...
Background Current guidelines recommend frailty assessment for risk stratification of candidates for transcatheter mitral and tricuspid valve repair (TMTVR), but it remains unclear which frailty score is most appropriate. Methods In a retrospective monocentric analysis of patients who received TMTVR, a modified version of the essential frailty toolset (EFT) was calculated from...
Background The role of cardiovascular magnetic resonance (CMR)-imaging-based pulse wave velocity (PWV) and aortic distensibility (AD) in population-based cohorts as a risk stratification tool remains unclear. The purpose of this study was the CMR-based quantification of PWV and AD in the context of cardiovascular risk factors (CVRF) and/or diseases (CVD) in the Hamburg City...
Background Administering antithrombotic therapy (ATT) in patients with infective endocarditis (IE) involves a complex balance of bleeding and thromboembolic risks. Data on outcomes beyond the acute phase remain limited. This retrospective single-center cohort study had two aims: first, to describe the use of anticoagulation during the acute phase of left-sided IE; and second, to...
Background Severe symptomatic aortic stenosis is associated with increased morbidity and mortality. Surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) are established treatment options. Neurological complications such as subclinical cerebral ischemia, delirium, and postoperative cognitive decline can occur during either treatment; however...
Purpose Our hypothesis was that computed tomography angiography (CTA)-derived Hounsfield units (HU) can differentiate between thrombosis and leaflet fibrosis (defined by a lack of response to oral anticoagulation) in patients with bioprosthetic heart valve dysfunction. Materials and methods Valvular leaflet HU were retrospectively assessed in 95 patients (derivation cohort...
Background Heart failure (HF), including heart failure with reduced ejection fraction (HFrEF), remains a major public health issue with increasing disease burden. Recent advances, particularly data on sodium-glucose cotransporter-2 inhibitors (SGLT2i), have shifted HFrEF treatment paradigms based on strong evidence from randomised-controlled trials (RCTs). There is a lack of data...
Background Intravascular lithotripsy (IVL) emerged for the treatment of coronary artery calcification with encouraging safety and effectiveness rates in previous trials. Knowledge about the in-hospital safety of IVL in comparison to frequently used plaque modification techniques remains limited. Objectives The aim of this study was to assess the in-hospital outcomes of IVL in...
Background Beyond global left ventricular function, identification of regional wall motion abnormalities (RWMA) is an essential component of emergency echocardiography in patients with non-ST-elevation myocardial infarction (NSTEMI). This study investigated the prognostic significance and diagnostic value of RWMA. Methods Echocardiographies of 1110 consecutive NSTEMI patients...
Background Electrical storm (ES) is associated with high mortality and may lead to worsening of heart failure or repeat ICD therapy deliveries. Catheter ablation of ventricular tachycardia (VT) in ischemic heart disease has proven to be successful in reducing ventricular arrhythmia recurrences. The prognostic impact of ablation on patients with ES needs to be further elucidated...
Background The efficacy of transthyretin stabilisation in cardiac transthyretin amyloidosis (ATTR-CM) has been demonstrated in a clinical trial setting, but little is known about treatment decision-making in the real world. Particularly, initiating or discontinuing specific therapy is challenging in early and advanced disease. We evaluated current decision pathways for tafamidis...
Background The prognostic benefit of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) in stable coronary artery disease (CAD) remains uncertain. Objectives To evaluate long-term survival following CTO PCI compared with medical therapy (MT) using target trial emulation and a nationwide real-world registry. Methods We included 7813 patients with stable CAD...
Background and Objective Related to ongoing demographic, the number of patients with cardiac and non-cardiac comorbidities increases. Heart failure with mildly reduced ejection fraction (HFmrEF) represents a heterogeneous population with diverse clinical profiles. The study investigates the prevalence and prognostic impact of multimorbidity in patients hospitalized with HFmrEF...
Background High-sensitivity cardiac troponin (hs-cTn) assays are the gold standard for the early diagnosis and risk stratification of acute myocardial infarction (AMI). PERFORM-TSIX (clinicaltrials.gov identifier: NCT06734117) is a prospective, international, observational, longitudinal cohort study to evaluate the clinical performance of the next-generation Elecsys® Troponin T...
Background Full post-mortem examinations (conventional autopsies) are a valuable tool for understanding disease mechanisms but are commonly rare, especially in epidemiological research. This study aimed to (1) assess conventional autopsy implementation in the Hamburg City Health Study (HCHS), (2) identify factors associated with conventional autopsy performance, and (3) compare...
Background Malignant ventricular arrhythmias (MVA)—sustained ventricular tachycardia or fibrillation—remain a major early complication after ST-segment elevation myocardial infarction (STEMI) despite timely reperfusion. The no-reflow phenomenon is a key substrate for arrhythmogenesis. The no-reflow prediction in acute coronary syndrome (NORPACS) score, originally developed to...
Background 20 years ago, drug coated balloon (DCB) angioplasty was introduced into the interventionalist’s toolbox initially to treat in-stent restenosis. Since then, considerable clinical evidence was generated in patients with de novo lesions. Whether drug-eluting stents (DES) or DCB angioplasty are associated with better clinical outcomes for de novo lesion treatment is still...
Dyslipidaemia, especially elevated low-density lipoprotein cholesterol (LDL-C), is a major modifiable risk factor for atherosclerotic cardiovascular disease (ASCVD). Dyslipidaemia remains underdiagnosed and undertreated. Dyslipidemia is highly prevalent in Germany. Even among patients with high- and very-high cardiovascular risk, LDL-C targets are often not achieved. This paper...
Background Cardiovascular disease (CVD) is a leading cause of death globally, especially in the aging population. As a novel biomarker integrating inflammation and metabolic dysregulation, the C-reactive protein-triglyceride glucose index (CTI) may offer superior risk stratification, but its prognostic value for mortality in the elderly remains unclear. Methods This multi-cohort...
Aim This study evaluated the efficacy and safety of the subcutaneous implantable cardioverter defibrillator (S-ICD) in patients with obesity. Methods In this bicentric, retrospective study, S-ICD recipients were divided into two groups based on body mass index (BMI: < 30 kg/m2 and ≥ 30 kg/m2). Defibrillation testing (DFT) failure, shock impedance, rates of appropriate and...