Cardiomyopathies
Cohort Study: Lower Risk of Cardiovascular Complications in Post–COVID-19 Vaccine Myocarditis Compared to Conventional Etiologies
7 Sep, 2024 | 20:36h | UTCStudy Design and Population: This French nationwide cohort study included 4,635 individuals aged 12-49 hospitalized for myocarditis between December 2020 and June 2022. The cohort was divided into three groups: 558 patients with post–COVID-19 mRNA vaccine myocarditis, 298 with post–COVID-19 infection myocarditis, and 3,779 with conventional myocarditis.
Main Findings: At 18 months of follow-up, the frequency of cardiovascular events was significantly lower in the postvaccine myocarditis group (5.7%) compared to conventional myocarditis (13.2%) with a weighted hazard ratio (wHR) of 0.55 (95% CI, 0.36-0.86). Hospital readmission for myopericarditis occurred in 3.2% of postvaccine cases, 4.0% of post–COVID-19 cases, and 5.8% of conventional cases. The all-cause mortality rate was 0.2% for postvaccine myocarditis, 1.3% for post–COVID-19 myocarditis, and 1.3% for conventional myocarditis.
Implications for Practice: Postvaccine myocarditis patients, primarily young males, experience fewer complications compared to conventional myocarditis, but long-term follow-up is still needed. These findings should guide future mRNA vaccine recommendations and clinical management for myocarditis patients.
Reference: Semenzato L. et al. (2024). Long-term Prognosis of Myocarditis Attributed to COVID-19 mRNA Vaccination, SARS-CoV-2, or Conventional Etiologies. JAMA, Online. DOI: http://doi.org/10.1001/jama.2024.16380
Link: https://jamanetwork.com/journals/jama/fullarticle/2822933
RCT: Vutrisiran Reduces Mortality and Cardiovascular Events in Patients with Transthyretin Amyloidosis Cardiomyopathy
6 Sep, 2024 | 21:57h | UTCStudy Design and Population: This double-blind, randomized clinical trial evaluated the efficacy of vutrisiran in 655 patients with transthyretin amyloidosis with cardiomyopathy (ATTR-CM). Participants were randomly assigned to receive either vutrisiran (25 mg) or placebo every 12 weeks for up to 36 months. The study population included patients both with and without baseline tafamidis treatment.
Main Findings: Vutrisiran treatment significantly reduced the risk of death from any cause and recurrent cardiovascular events compared to placebo (HR: 0.72, 95% CI: 0.56–0.93, p=0.01). In monotherapy patients (no tafamidis), the hazard ratio was 0.67 (95% CI: 0.49–0.93, p=0.02). Vutrisiran also preserved physical function, showing less decline in the 6-minute walk test distance (mean difference: 26.5 meters, p<0.001) and quality of life (mean KCCQ-OS difference: 5.8 points, p<0.001). Adverse events were comparable between groups.
Implications for Practice: Vutrisiran offers a promising treatment option for reducing mortality, cardiovascular events, and functional decline in ATTR-CM patients. Its favorable safety profile supports its potential use in long-term management.
Randomized Clinical Trial: Aficamten improves peak oxygen uptake in symptomatic obstructive hypertrophic cardiomyopathy – N Engl J Med
27 May, 2024 | 20:24h | UTCStudy Design and Population: This phase 3, double-blind trial randomized 282 adults with symptomatic obstructive hypertrophic cardiomyopathy (HCM) to receive aficamten or placebo for 24 weeks. The primary outcome was the change in peak oxygen uptake, with secondary outcomes including changes in the Kansas City Cardiomyopathy Questionnaire score and New York Heart Association functional class.
Main Findings: Aficamten significantly increased peak oxygen uptake by 1.7 ml/kg/min (95% CI, 1.0 to 2.4; P<0.001) compared to placebo. Improvements were also seen in all secondary outcomes. The incidence of adverse events was similar between the groups.
Implications for Practice: Aficamten shows promise in improving exercise capacity and symptoms in patients with obstructive HCM, potentially offering a new therapeutic option. Further research may confirm its long-term benefits and safety.
Reference (link to abstract – $ for full-text):
2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy – J Am Coll Cardiol
11 May, 2024 | 14:20h | UTCIn a significant advancement for the treatment of hypertrophic cardiomyopathy (HCM), the American Heart Association and the American College of Cardiology, along with other leading societies, have released updated guidelines to optimize patient care. Here are the essential updates and recommendations for practicing physicians:
1 – Updated Diagnostic Strategies: The guideline emphasizes the use of advanced imaging techniques and genetic testing to enhance diagnostic accuracy, enabling personalized treatment approaches.
2 – Risk Assessment Tools: Revised tools for sudden cardiac death (SCD) risk assessment are detailed, aiding clinicians in making informed decisions regarding the use of implantable cardioverter-defibrillators (ICDs).
3 – Management of Obstructive HCM: New recommendations for the pharmacological treatment of symptomatic obstructive HCM include the use of disopyramide and advanced therapies such as septal reduction when initial medication does not suffice.
4 – Guidelines on Exercise and Lifestyle: The guidelines provide a nuanced approach to physical activity, recognizing the benefits while outlining the risks for patients with HCM. Detailed advice is offered on managing competitive sports involvement and other lifestyle considerations.
5 – Multidisciplinary Approach: The guidelines advocate for a team-based approach involving specialized HCM centers, ensuring patients benefit from comprehensive expertise and the latest treatment modalities.
6 – Innovations in Treatment: Highlighting new therapeutic options like myosin inhibitors, the guidelines underscore their role in managing obstructive symptoms when traditional medications are inadequate.
7 – Special Populations: Detailed sections on the management of HCM in children and pregnant women, addressing the unique challenges these groups face.
These guidelines represent a cornerstone in the evolving landscape of HCM management, embodying a commitment to enhancing outcomes and quality of life for patients through evidence-based practices and collaborative care.
Reference (link to free full-text):
Cohort Study | Younger age at hypertrophic cardiomyopathy diagnosis, male sex among predictors of developing LV systolic dysfunction
11 Aug, 2023 | 15:16h | UTC
Commentary on Twitter
@sarahaboualaiwi and colleagues provide new #clinicalresearch; Left Ventricular Systolic Dysfunction in #HCM diagnosed in childhood, Important insights into prevalence and prognosis from the SHaRe Registry #Circulation @sday_hcm @CSHeartResearch @tikuowens https://t.co/2TJ0XMe3B7 pic.twitter.com/o2mhcNjUfw
— Circulation (@CircAHA) June 2, 2023
Phase 1 Trial | NI006 shows potential for cardiac amyloid depletion in transthyretin amyloid cardiomyopathy
1 Aug, 2023 | 14:17h | UTCPhase 1 Trial of Antibody NI006 for Depletion of Cardiac Transthyretin Amyloid – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
Amyloid Removal Looks Possible in ATTR Cardiomyopathy Imaging Trial – TCTMD
Antibody NI006 for Depletion of Cardiac Transthyretin Amyloid – American College of cardiology
AHA Scientific Statement | Treatment strategies for cardiomyopathy in children
12 Jun, 2023 | 13:49h | UTCNews Releases:
Top Things to Know: Treatment Strategies for Cardiomyopathy in Children – American Heart Association
Review | Takotsubo syndrome: more frequent in women, more dangerous in men
12 May, 2023 | 13:21h | UTCSee all articles in the series here
Guideline | Diagnosis and treatment of myocarditis
23 Mar, 2023 | 12:55h | UTCJCS 2023 Guideline on the Diagnosis and Treatment of Myocarditis – Circulation Journal (see PDF)
Review | Cardiac sarcoidosis: phenotypes, diagnosis, treatment, and prognosis
20 Mar, 2023 | 13:21h | UTCCardiac sarcoidosis: phenotypes, diagnosis, treatment, and prognosis – European Heart Journal
Review | Pathophysiological gaps, diagnostic challenges, and uncertainties in cardiac sarcoidosis
17 Mar, 2023 | 12:47h | UTC
Phase 2 RCT | Aficamten in patients with obstructive hypertrophic cardiomyopathy
14 Feb, 2023 | 10:37h | UTC
Review | Valvular heart disease: shifting the focus to the myocardium
7 Feb, 2023 | 13:37h | UTCValvular heart disease: shifting the focus to the myocardium – European Heart Journal
Commentary on Twitter
Valvular heart disease: shifting the focus to the myocardium https://t.co/u1Nu7nnQvq @escardio #EHJ #ESCYoung #cardiotwitter @ehj_ed @rladeiraslopes pic.twitter.com/QFM8BJItRl
— European Society of Cardiology Journals (@ESC_Journals) October 10, 2022
2023 ACC expert consensus decision pathway on comprehensive multidisciplinary care for the patient with cardiac amyloidosis
24 Jan, 2023 | 14:29h | UTCKey Points: 2023 ACC Expert Consensus on Cardiac Amyloidosis – American College of Cardiology
Commentary on Twitter
.@ACCinTouch's 🆕 Expert Consensus Decision Pathway provides practical and timely guidance on the diagnosis and management of cardiac #amyloidosis, with an emphasis on comprehensive multidisciplinary care.
Learn more: https://t.co/1SunbtuQpO#JACC #CardioOnc #CardioTwitter pic.twitter.com/DLvFUpajHC
— JACC Journals (@JACCJournals) January 23, 2023
The year in cardiovascular medicine 2022: the top 10 papers in heart failure and cardiomyopathies
9 Jan, 2023 | 14:10h | UTC
Commentary on Twitter
The Year in Cardiovascular Medicine 2022 series: the Top 10 papers in Heart Failure and Cardiomyopathies https://t.co/w6opcMPcBa@escardio #EHJ #ESCYoung #cardiotwitter @ehj_ed @rladeiraslopes #HeartFailure #Cardiomyopathies pic.twitter.com/UrrX2LUQdI
— European Society of Cardiology Journals (@ESC_Journals) January 2, 2023
Cohort Study | Prognostic prediction of genotype vs. phenotype in genetic cardiomyopathies.
23 Nov, 2022 | 13:57h | UTC
Commentary on Twitter
We are out with our last big work on the importance of genotype for the prognostic stratification of Cardiomyopathies! @CardiologyASUGI @Trieste_Denver @JACCJournals @PaldinoAlessia https://t.co/82byVNnUhK pic.twitter.com/KYoxDXkzr6
— matteo dal ferro (@matteodalferro) November 17, 2022
Under a Creative Commons license
Review | Differing strategies for sudden death prevention in hypertrophic cardiomyopathy.
4 Nov, 2022 | 13:28h | UTCDiffering strategies for sudden death prevention in hypertrophic cardiomyopathy – Heart
Consensus Paper | Diagnosis and management of syncope in hypertrophic cardiomyopathy.
31 Oct, 2022 | 13:49h | UTC
Cohort Study | Highly malignant disease in childhood-onset arrhythmogenic right ventricular cardiomyopathy.
24 Oct, 2022 | 14:08h | UTCEditorial: Arrhythmogenic cardiomyopathies in children: seek and you shall find – European Heart Journal
Commentary on Twitter
Highly malignant disease in childhood-onset arrhythmogenic right ventricular cardiomyopathy: discover more in EHJ!https://t.co/kA60A1zjRt#ARVC #children #screening #heart #transplantation #cardiotwitter @escardio @ESC_Journals pic.twitter.com/fq4X8doBMI
— EHJ Editor-in-Chief (@ehj_ed) September 6, 2022
Under a https://creativecommons.org/licenses/by-nc/4.0/ License
Review | Restrictive cardiomyopathy: definition and diagnosis.
24 Oct, 2022 | 13:58h | UTCRestrictive cardiomyopathy: definition and diagnosis – European Heart Journal
Commentary on Twitter
⚠️Great review 👉 Restrictive cardiomyopathy
📍definition
📍diagnosis
📍therapies available only for cardiac amyloidosis and, for iron overload cardiomyopath🆓📁 https://t.co/OtO7L45SBw pic.twitter.com/L55mPnmNtt
— Alfonso Valle (@ValleAlfonso) October 22, 2022
Under a https://creativecommons.org/licenses/by-nc/4.0/ License
Review | Cardiac care of children with Duchenne muscular dystrophy (DMD) and females carrying DMD-gene variations.
20 Oct, 2022 | 12:21h | UTCCardiac care of children with dystrophinopathy and females carrying DMD-gene variations – openheart
Incidence of myocarditis/pericarditis following mRNA COVID-19 vaccination among children and younger adults in the US.
13 Oct, 2022 | 13:51h | UTC
Commentary on Twitter (thread – click for more)
Let me me perfectly clear about the evidence for myocarditis after mRNA vaccines
1. There is a notable increased incidence, age 12-39, males, with each dose (Table)https://t.co/XXQbyeLiSP pic.twitter.com/wLTZT3fppy— Eric Topol (@EricTopol) October 12, 2022
Commentary on Twitter
Let me me perfectly clear about the evidence for myocarditis after mRNA vaccines
1. There is a notable increased incidence, age 12-39, males, with each dose (Table)https://t.co/XXQbyeLiSP pic.twitter.com/wLTZT3fppy— Eric Topol (@EricTopol) October 12, 2022
Guideline | Evaluation and management of myocarditis.
12 Oct, 2022 | 13:56h | UTC
Cohort Study | Cardiovascular MRI phenotypes and long-term outcomes in patients with suspected cardiac sarcoidosis.
30 Sep, 2022 | 12:39h | UTCCardiovascular Magnetic Resonance Imaging Phenotypes and Long-term Outcomes in Patients With Suspected Cardiac Sarcoidosis – JAMA Cardiology (link to abstract – $ for full-text)
Commentary on Twitter
Cardiovascular magnetic resonance phenotypes could be used to optimize clinical decision-making for treatment options, such as implantable cardioverter-defibrillators, and thus improve outcomes in patients with suspected cardiac #sarcoidosis. https://t.co/6hlpPFd7cd #Research
— JAMA Cardiology (@JAMACardio) September 14, 2022
Clinical risk score to predict pathogenic genotypes in patients with dilated cardiomyopathy.
26 Sep, 2022 | 11:57h | UTC
Commentary on Twitter
Is it possible to predict which pts w/ dilated cardiomyopathy/left ventricular dysfunction will have an assoc. predisposition on genetic testing?
Via the Madrid Score, Drs. @LuisEscobarL, @dr_pavia, & colleagues work to answer this question in #JACC: https://t.co/WDn8jA29aY pic.twitter.com/u0T9FffOwi
— JACC Journals (@JACCJournals) September 13, 2022