Cardiomyopathies are important causes of arrhythmias, sudden cardiac death, and heart failure. With accumulating knowledge in clinical, genetic, and molecular phenotyping, the number of distinct disease entities is growing. There is a need for broad, inclusive, high-quality prospective multi-center registries to better analyze these phenotypes, provide accurate risk stratification, and tailor therapies. The Dutch Cardiomyopathy Registry (DCR) will serve as a longitudinal registry for all cardiomyopathy patients, exploiting previously built local databases, allowing adequately powered research studies. The DCR is a multi-center observational registry that unites all Dutch University Medical centers. The registry will have local and central shared databases, which will be hosted and coordinated by the Netherlands Heart Institute. Patients with an established cardiomyopathy diagnosis and carriers of pathogenic or likely-pathogenic cardiomyopathy gene variants will be included. Furthermore, selected family members and individuals who are referred for screening for potential cardiomyopathy are eligible for inclusion. The subjects will receive, per best clinical practice, guideline-recommended diagnostics and treatment. Clinical data will be collected from clinical care at baseline and follow-up, including clinical visits, imaging studies, laboratory assessments, ECG, and additional functional tests. Outcome data consists of clinical performance status, cardiovascular complications and major adverse events, recorded through regular electronic health record files. The DCR will function as a national database, providing relevant information on epidemiology, demographics, natural history, diagnosis, and treatment. This will aid risk prediction and monitoring of new therapies. The DCR can identify patients who are eligible for future studies, including registry-based research.
The Orbital Atherectomy System (OAS) has demonstrated high procedural success, with excellent stent deliverability and low complication rates. The effects of orbital atherectomy (OA) and its impact on calcified coronary plaques are not yet fully understood, highlighting the need for a larger and more comprehensive study. Calcium Reduction by Orbital Atherectomy in Western Europe (CROWN) is an ongoing study that aims to evaluate the effects of OA in treating de novo, severely calcified coronary lesions before stent placement using optical coherence tomography (OCT), and to assess stent expansion by measuring the OCT-derived minimum stent area (MSA). The CROWN study is a prospective, multicenter, international, single-arm observational study. We will enroll 100 patients with severely calcified coronary lesions undergoing OCT-guided orbital atherectomy and stent placement. All patients will undergo peri-procedural OCT imaging, with assessments conducted before and after OA, as well as following stent placement. Patients will be enrolled at a maximum of 6 sites in the Netherlands, Germany, and Italy. The primary endpoint is to assess the proportion of patients achieving stent expansion, defined as an OCT-derived MSA ≥ 5.5 mm2. The CROWN study will evaluate the impact of OA on calcified plaques, potentially refine operator practices, and provide additional insights on device selection for treating severely calcified lesions (clinicaltrials.gov NCT06035783).
Postoperative pericardial effusion (PPE) is a common finding after cardiac surgery, with reported incidences ranging widely from 2
Reducing the environmental impact of healthcare is paramount to achieving zero-emission healthcare services. Considering the increasing amount of waste that is produced by cardiac procedures, we aimed to investigate whether plastic waste from these procedures could be recycled and repurposed into new medical instruments. To facilitate this process, the HartPlastic Foundation was established for research and awareness purposes. Primarily, the non-contaminated materials found in medical packaging were separated, identified, and rated based on suitability for recycling. Glycolized polyethylene terephthalate (PET-G) was found to be the most promising material, which comprised roughly 10
To evaluate the clinical impact of a dedicated multidisciplinary spontaneous coronary artery dissection (SCAD) care pathway compared with standard acute coronary syndrome management, focusing on safety, treatment patterns, clinical outcomes, and recurrence rates in patients with SCAD. In this retrospective observational cohort study, 117 SCAD patients were included: 63 managed within a SCAD-specific care pathway and 54 receiving standard care prior to or independent of its implementation. The SCAD pathway included protocolized angiographic diagnosis, conservative management when feasible, individualized medical therapy, screening for fibromuscular dysplasia (FMD) and systemic disorders, and SCAD-specific rehabilitation with structured follow-up. The primary endpoint was major adverse cardiovascular events (MACE) at 1‑year follow-up. Patients in the SCAD pathway group were more often managed conservatively in the acute setting (76
The use of extracorporeal cardiopulmonary resuscitation (ECPR) is emerging. In cardiac arrest patients with return of spontaneous circulation (ROSC), the electrocardiogram (ECG) guides the need for immediate coronary angiography (CAG). In ECPR patients, the diagnostic value of the ECG and the role of CAG remain unclear. This single-centre, retrospective study included all adult ECPR patients admitted to Amsterdam UMC (2018–2024). ECPR was defined as cannulation on venoarterial extracorporeal membrane oxygenation during ongoing continuous or intermittent resuscitation, before sustained ROSC (≥ 20 min). The primary outcome included the presence and extent of coronary artery disease (CAD). Logistic regression was used to identify predictors of undergoing CAG and having a culprit. The impact of CAG on survival was assessed using Cox proportional hazard models and Kaplan-Meier curves. Ninety-two patients (mean age of 53 years, 65
The HEART (history, ECG, age, risk factors, and troponin) score is used to stratify patients with chest pain into low- or higher-risk for major adverse cardiac events (MACE). We assessed the diagnostic performance and interobserver agreement of the pre-hospital HEART score for ruling out myocardial infarction (MI) and MACE. This prospective, multicentre study included 383 patients with suspected non-ST-elevation acute coronary syndrome. Patients with both a pre-hospital and in-hospital HEART scores were analysed (n = 331). Prehospital HEART scores (based on point-of-care troponin) were assessed by ambulance personnel, and in-hospital HEART scores (based on the European Society of Cardiology 0/1-hour high-sensitivity troponin algorithm) were assessed by emergency physicians blinded to the pre-hospital scores. Endpoints were interobserver agreement (intraclass correlation coefficient, ICC) and diagnostic performance for ruling out MI and MACE at 30 days. Among the 331 patients (mean age: 65 years, 48
