European Heart Journal

In this secondary analysis of the EMPEROR-Reduced trial, we sought to evaluate whether the benefits of empagliflozin varied by baseline health status and how empagliflozin impacted patient-reported outcomes in patients with heart failure with reduced ejection fraction.

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Quality of life in EMPEROR-Reduced: emphasizing what is important to patients while identifying strategies to support more patient-centred care

John A Spertus

doi : 10.1093/eurheartj/ehab057

European Heart Journal, Volume 42, Issue 13, 1 April 2021, Pages 1213–1215

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Effects of dapagliflozin on mortality in patients with chronic kidney disease: a pre-specified analysis from the DAPA-CKD randomized controlled trial

Hiddo J L Heerspink, C David Sj?str?m, Niels Jongs, Glenn M Chertow, Mikhail Kosiborod

doi : 10.1093/eurheartj/ehab094

European Heart Journal, Volume 42, Issue 13, 1 April 2021, Pages 1216–1227

Mortality rates from chronic kidney disease (CKD) have increased in the last decade. In this pre-specified analysis of the DAPA-CKD trial, we determined the effects of dapagliflozin on cardiovascular and non-cardiovascular causes of death.

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Dapagliflozin, advanced chronic kidney disease, and mortality: new insights from the DAPA-CKD trial

Nikolaus Marx, Jürgen Floege

doi : 10.1093/eurheartj/ehab092

European Heart Journal, Volume 42, Issue 13, 1 April 2021, Pages 1228–1230

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Arrhythmogenic right ventricular cardiomyopathy and sports activity: from molecular pathways in diseased hearts to new insights into the athletic heart mimicry

Alessio Gasperetti, Cynthia A James, Marina Cerrone, Mario Delmar, Hugh Calkins

doi : 10.1093/eurheartj/ehaa821

European Heart Journal, Volume 42, Issue 13, 1 April 2021, Pages 1231–1243

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited disease associated with a high risk of sudden cardiac death. Among other factors, physical exercise has been clearly identified as a strong determinant of phenotypic expression of the disease, arrhythmia risk, and disease progression. Because of this, current guidelines advise that individuals with ARVC should not participate in competitive or frequent high-intensity endurance exercise. Exercise-induced electrical and morphological para-physiological remodelling (the so-called ‘athlete’s heart’) may mimic several of the classic features of ARVC. Therefore, the current International Task Force Criteria for disease diagnosis may not perform as well in athletes. Clear adjudication between the two conditions is often a real challenge, with false positives, that may lead to unnecessary treatments, and false negatives, which may leave patients unprotected, both of which are equally inacceptable. This review aims to summarize the molecular interactions caused by physical activity in inducing cardiac structural alterations, and the impact of sports on arrhythmia occurrence and other clinical consequences in patients with ARVC, and help the physicians in setting the two conditions apart.

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The cardiovascular–dialysis nexus: the transition to dialysis is a treacherous time for the heart

Kevin Chan, Sharon M Moe, Rajiv Saran, Peter Libby

doi : 10.1093/eurheartj/ehaa1049

European Heart Journal, Volume 42, Issue 13, 1 April 2021, Pages 1244–1253

Chronic kidney disease (CKD) patients require dialysis to manage the progressive complications of uraemia. Yet, many physicians and patients do not recognize that dialysis initiation, although often necessary, subjects patients to substantial risk for cardiovascular (CV) death. While most recognize CV mortality risk approximately doubles with CKD the new data presented here show that this risk spikes to >20 times higher than the US population average at the initiation of chronic renal replacement therapy, and this elevated CV risk continues through the first 4 months of dialysis. Moreover, this peak reflects how dialysis itself changes the pathophysiology of CV disease and transforms its presentation, progression, and prognosis. This article reviews how dialysis initiation modifies the interpretation of circulating biomarkers, alters the accuracy of CV imaging, and worsens prognosis. We advocate a multidisciplinary approach and outline the issues practitioners should consider to optimize CV care for this unique and vulnerable population during a perilous passage.

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The management of secondary mitral regurgitation in patients with heart failure: a joint position statement from the Heart Failure Association (HFA), European Association of Cardiovascular Imaging (EACVI), European Heart Rhythm Association (EHRA), and European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC

Andrew J S Coats, Stefan D Anker, Andreas Baumbach, Ottavio Alfieri, Ralph Stephan von Bardeleben

doi : 10.1093/eurheartj/ehab086

European Heart Journal, Volume 42, Issue 13, 1 April 2021, Pages 1254–1269

Secondary (or functional) mitral regurgitation (SMR) occurs frequently in chronic heart failure (HF) with reduced left ventricular (LV) ejection fraction, resulting from LV remodelling that prevents coaptation of the valve leaflets. Secondary mitral regurgitation contributes to progression of the symptoms and signs of HF and confers worse prognosis. The management of HF patients with SMR is complex and requires timely referral to a multidisciplinary Heart Team. Optimization of pharmacological and device therapy according to guideline recommendations is crucial. Further management requires careful clinical and imaging assessment, addressing the anatomical and functional features of the mitral valve and left ventricle, overall HF status, and relevant comorbidities. Evidence concerning surgical correction of SMR is sparse and it is doubtful whether this approach improves prognosis. Transcatheter repair has emerged as a promising alternative, but the conflicting results of current randomized trials require careful interpretation. This collaborative position statement, developed by four key associations of the European Society of Cardiology—the Heart Failure Association (HFA), European Association of Percutaneous Cardiovascular Interventions (EAPCI), European Association of Cardiovascular Imaging (EACVI), and European Heart Rhythm Association (EHRA)—presents an updated practical approach to the evaluation and management of patients with HF and SMR based upon a Heart Team approach.

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Different genotypes of Brugada syndrome may present different clinical phenotypes: electrophysiology from bench to bedside

Ibrahim El-Battrawy, Siegfried Lang, Xiaobo Zhou, Ibrahim Akin

doi : 10.1093/eurheartj/ehab070

European Heart Journal, Volume 42, Issue 13, 1 April 2021, Pages 1270–1272

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Common modulators of Brugada syndrome phenotype do not affect SCN5A prognostic value

Carlo Pappone, Giuseppe Ciconte, Emanuele Micaglio, Michelle M Monasky

doi : 10.1093/eurheartj/ehab071

European Heart Journal, Volume 42, Issue 13, 1 April 2021, Pages 1273–1274

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Thrombus in giant right atrial appendage aneurysm

Hao Niu, Jiayu Shen, Weitao Liang, Zhenghua Xiao

doi : 10.1093/eurheartj/ehaa910

European Heart Journal, Volume 42, Issue 13, 1 April 2021, Page 1275

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Cardiac angiosarcoma detected using 68Ga-fibroblast activation protein inhibitor positron emission tomography/magnetic resonance

Liang Zhao, Yizhen Pang, Qin Lin, Haojun Chen

doi : 10.1093/eurheartj/ehaa931

European Heart Journal, Volume 42, Issue 13, 1 April 2021, Page 1276

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Corrigendum to: Gone with wind: a novel biodegradable occluder for percutaneous closure of patent foramen ovale

doi : 10.1093/eurheartj/ehaa998

European Heart Journal, Volume 42, Issue 13, 1 April 2021, Page 1269

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Erratum to: Arrhythmogenic Right Ventricular Cardiomyopathy and Sports Activity: From Molecular Pathways in Diseased Hearts to New Insights into the Athletic Heart Mimicry

doi : 10.1093/eurheartj/ehaa985

European Heart Journal, Volume 42, Issue 13, 1 April 2021, Page 1272

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Corrigendum to: How to Diagnose Heart Failure with Preserved Ejection Fraction - The HFA-PEFF-SCORE An updated Consensus Statement of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

doi : 10.1093/eurheartj/ehaa1016

European Heart Journal, Volume 42, Issue 13, 1 April 2021, Page 1274

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