European Heart Journal

Patent foramen ovale (PFO) is implicated in the pathogenesis of a number of medical conditions but to date only one official position paper related to left circulation thromboembolism has been published. This interdisciplinary paper, prepared with the involvement of eight European scientific societies, reviews the available evidence and proposes a rationale for decision making for other PFO-related clinical conditions. In order to guarantee a strict evidence-based process, we used a modified grading of recommendations, assessment, development, and evaluation (GRADE) methodology. A critical qualitative and quantitative evaluation of diagnostic and therapeutic procedures was performed, including assessment of the risk/benefit ratio. The level of evidence and the strength of the position statements were weighed and graded according to predefined scales. Despite being based on limited and observational or low-certainty randomised data, a number of position statements were made to frame PFO management in different clinical settings, along with suggestions for new research avenues. This interdisciplinary position paper, recognising the low or very low certainty of existing evidence, provides the first approach to several PFO-related clinical scenarios beyond left circulation thromboembolism and strongly stresses the need for fresh high-quality evidence on these topics.

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Diagnosis and treatment of cardiac amyloidosis: a position statement of the ESC Working Group on Myocardial and Pericardial Diseases

Pablo Garcia-Pavia, Claudio Rapezzi, Yehuda Adler, Michael Arad, Cristina Basso

doi : 10.1093/eurheartj/ehab072

European Heart Journal, Volume 42, Issue 16, 21 April 2021, Pages 1554–1568

Cardiac amyloidosis is a serious and progressive infiltrative disease that is caused by the deposition of amyloid fibrils at the cardiac level. It can be due to rare genetic variants in the hereditary forms or as a consequence of acquired conditions. Thanks to advances in imaging techniques and the possibility of achieving a non-invasive diagnosis, we now know that cardiac amyloidosis is a more frequent disease than traditionally considered. In this position paper the Working Group on Myocardial and Pericardial Disease proposes an invasive and non-invasive definition of cardiac amyloidosis, addresses clinical scenarios and situations to suspect the condition and proposes a diagnostic algorithm to aid diagnosis. Furthermore, we also review how to monitor and treat cardiac amyloidosis, in an attempt to bridge the gap between the latest advances in the field and clinical practice.

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Temporal changes in total and hippocampal brain volume and cognitive function in patients with chronic heart failure—the COGNITION.MATTERS-HF cohort study

Anna Frey, Gy?rgy A Homola, Carsten Henneges, Larissa Mühlbauer, Roxane Sell

doi : 10.1093/eurheartj/ehab003

European Heart Journal, Volume 42, Issue 16, 21 April 2021, Pages 1569–1578

We quantified the concurring dynamics affecting total and hippocampal brain volume and cognitive function in patients with chronic heart failure (HF) over a period of three years.

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Heart failure, cognition, and brain damage

Arno Villringer, Ulrich Laufs

doi : 10.1093/eurheartj/ehab061

European Heart Journal, Volume 42, Issue 16, 21 April 2021, Pages 1579–1581

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Joint exposure to various ambient air pollutants and incident heart failure: a prospective analysis in UK Biobank

Mengying Wang, Tao Zhou, Yongze Song, Xiang Li, Hao Ma

doi : 10.1093/eurheartj/ehaa1031

European Heart Journal, Volume 42, Issue 16, 21 April 2021, Pages 1582–1591

Little is known about the relation between the long-term joint exposure to various ambient air pollutants and the incidence of heart failure (HF). We aimed to assess the joint association of various air pollutants with HF risk and examine the modification effect of the genetic susceptibility.

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Air pollution and flooding in the lungs: modern insights into ancient problems

Sanjay Rajagopalan, Robert D Brook, Sadeer Al-Kindi

doi : 10.1093/eurheartj/ehaa1105

European Heart Journal, Volume 42, Issue 16, 21 April 2021, Pages 1592–1594

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Pathophysiologic importance of visceral adipose tissue in women with heart failure and preserved ejection fraction

Hidemi Sorimachi, Masaru Obokata, Naoki Takahashi, Yogesh N V Reddy, Christopher C Jain

doi : 10.1093/eurheartj/ehaa823

European Heart Journal, Volume 42, Issue 16, 21 April 2021, Pages 1595–1605

Central obesity is a major risk factor for heart failure with preserved ejection fraction (HFpEF), particularly in women, but the mechanisms remain unclear. We hypothesized that sex-specific differences in visceral adipose tissue (VAT) content would differentially relate to haemodynamic severity of HFpEF in women and men.

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Fighting HFpEF in women: taking aim at belly fat

Coenraad Withaar, Laura M G Meems, Rudolf A de Boer

doi : 10.1093/eurheartj/ehaa952

European Heart Journal, Volume 42, Issue 16, 21 April 2021, Pages 1606–1608

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Myocarditis-associated necrotizing coronary vasculitis: incidence, cause, and outcome

Andrea Frustaci, Maria Alfarano, Romina Verardo, Chiara Agrati, Rita Casetti

doi : 10.1093/eurheartj/ehaa973

European Heart Journal, Volume 42, Issue 16, 21 April 2021, Pages 1609–1617

Necrotizing coronary vasculitis (NCV) is a rare entity usually associated to myocarditis which incidence, cause, and response to therapy is unreported.

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Myocarditis: endomyocardial biopsy and circulating anti-heart autoantibodies are key to diagnosis and personalized etiology-directed treatment

Alida L P Caforio

doi : 10.1093/eurheartj/ehab024

European Heart Journal, Volume 42, Issue 16, 21 April 2021, Pages 1618–1620

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The risk of cardiac events in patients receiving immune checkpoint inhibitors: a nationwide Danish study

Maria D’Souza, Dorte Nielsen, Inge Marie Svane, Kasper Iversen, Peter Vibe Rasmussen

doi : 10.1093/eurheartj/ehaa884

European Heart Journal, Volume 42, Issue 16, 21 April 2021, Pages 1621–1631

The study aimed to estimate the risk of cardiac events in immune checkpoint inhibitor (ICI)-treated patients with lung cancer or malignant melanoma.

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Are we underestimating the potential for cardiotoxicity related to immune checkpoint inhibitors?

Matthias Totzeck, Esther Lutgens, Tomas G Neilan

doi : 10.1093/eurheartj/ehaa959

European Heart Journal, Volume 42, Issue 16, 21 April 2021, Pages 1632–1635

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Immune check point inhibitors are associated with a spectrum of cardiac events in patients with cancer

Maria D’Souza, Inge Marie Svane, Gunnar Gislason, Morten Schou

doi : 10.1093/eurheartj/ehab066

European Heart Journal, Volume 42, Issue 16, 21 April 2021, Page 1636

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Cardiac events associated with immune checkpoint inhibitor therapy: the devil is in the detail

Markus S Anker, Andrew J S Coats, Stefan D Anker

doi : 10.1093/eurheartj/ehab063

European Heart Journal, Volume 42, Issue 16, 21 April 2021, Page 1637

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A novel deletion of the dystrophin gene in a patient without muscle-related symptoms

Tomoya Sato, Masahiro Wakita, Masaaki Matsushima, Takuma Sato

doi : 10.1093/eurheartj/ehaa928

European Heart Journal, Volume 42, Issue 16, 21 April 2021, Page 1638

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Delayed diffuse inflammatory myocardial damage in a child with a history of systemic inflammatory syndrome related to COVID-19

Mohammad Mahdavi, Golnaz Houshmand, Hamidreza Pouraliakbar, Golnar Mortaz Hejri

doi : 10.1093/eurheartj/ehaa1028

European Heart Journal, Volume 42, Issue 16, 21 April 2021, Page 1639

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