{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:00:15Z","timestamp":1788350415430,"version":"build-2803163510"},"reference-count":58,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"STOPSTORM"},{"name":"European Union\u2019s Horizon","award":["945119"],"award-info":[{"award-number":["945119"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Stereotactic arrhythmia radiotherapy (STAR) is an emerging non-invasive option for refractory ventricular tachycardia (VT); yet, the underlying myocardial effects in humans remain poorly understood. Within the STOPSTORM consortium, we developed the Bio-STAR framework for standardized ex vivo assessment of STAR-treated myocardium and here report its feasibility and initial findings in human samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Bio-STAR standardizes myocardial sampling into non-irradiated control (NFNI), minimally fibrotic irradiated, and fibrotic irradiated zones, guided by visual inspection, electroanatomical maps, and radiotherapy dose overlays. Recommended analyses span ex vivo MRI, histology, immunohistochemistry\/-fluorescence, molecular panels, and live-cell assays. Application to two explanted non-ischaemic cardiomyopathy hearts (transplantation 3\u20135 months post-STAR) confirmed the protocol\u2019s applicability to end-stage remodelling. In exploratory analyses of irradiated regions, patient-specific patterns emerged, including stress marker upregulation, and altered NaV1.5, SERCA2a, and CaV1.2 when normalized to cardiomyocyte content. Functional analyses in a limited number of viable cardiomyocytes from the respective regions demonstrated heterogeneous excitability, supporting the feasibility of isolating live cells from STAR-treated regions in which Ca2+ signalling can be quantitatively assessed in future studies involving larger patient cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Bio-STAR provides a reproducible framework for multimodal analysis of STAR-treated myocardium, enabling harmonized cross-centre research. Early human data demonstrate that cardiomyocyte viability and isolatability are preserved across all assessed regions and that STAR-exposed areas may exhibit region-specific structural features, while functional data on Ca2+ handling remain exploratory and require validation in larger datasets. Broad adoption will be the key to delineating dose\u2013time\u2013substrate relationships and disentangling radiation effects from underlying cardiomyopathy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjopen\/oeag086","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T11:43:03Z","timestamp":1779363783000},"source":"Crossref","is-referenced-by-count":1,"title":["Standardized processing of explanted hearts after stereotactic arrhythmia radiotherapy (Bio-STAR): a STOPSTORM framework and first human findings"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4222-6633","authenticated-orcid":false,"given":"Sotirios","family":"Nedios","sequence":"first","affiliation":[{"name":"Department of Electrophysiology, Heart Center Leipzig, University of Leipzig , Str\u00fcmpellstra\u00dfe 39, 04289 Leipzig ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8263-616X","authenticated-orcid":false,"given":"Judith","family":"H\u00fcttemeister","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum der Charit\u00e9 , Department of Cardiology, Angiology and Intensive Care Medicine, Charit\u00e9platz 1, 10117 Berlin ,","place":["Germany"]},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Charit\u00e9platz 1, 10117 Berlin ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), partner Site Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9782-8311","authenticated-orcid":false,"given":"Emanuel","family":"Heil","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum der Charit\u00e9 , Department of Cardiology, Angiology and Intensive Care Medicine, Charit\u00e9platz 1, 10117 Berlin ,","place":["Germany"]},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Charit\u00e9platz 1, 10117 Berlin ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), partner Site Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0799-4725","authenticated-orcid":false,"given":"Petra","family":"B\u00fcttner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center Leipzig at University of Leipzig , Str\u00fcmpellstra\u00dfe 39, 04289 Leipzig ,","place":["Germany"]},{"name":"Department of Radiation Oncology, University Hospital Leipzig , Stephanstra\u00dfe 9a, 04103 Leipzig ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1657-7897","authenticated-orcid":false,"given":"Kerstin","family":"Bode","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Center Leipzig, University of Leipzig , Str\u00fcmpellstra\u00dfe 39, 04289 Leipzig ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2550-1410","authenticated-orcid":false,"given":"Nils Henrik","family":"Nicolay","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital Leipzig , Stephanstra\u00dfe 9a, 04103 Leipzig ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"N\u00e4gler","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital Leipzig , Stephanstra\u00dfe 9a, 04103 Leipzig 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Zio\u0142owa 45-47, 40-635 Katowice ,","place":["Poland"]},{"name":"Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St.Anne\u2019s University Hospital Brno , Peka\u0159sk\u00e1 53, 602 00 Brno ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8296-920X","authenticated-orcid":false,"given":"Bert","family":"Vandenberk","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leuven , Herestraat 49, 3000 Leuven ,","place":["Belgium"]},{"name":"Cardiology, University Hospitals Leuven , Herestraat 49, 3000 Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1691-7599","authenticated-orcid":false,"given":"Tevfik","family":"Ismail","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering and Imaging Sciences, King\u2019s College London , St Thomas\u2019 Campus, St Thomas\u2019 Hospital, Westminster Bridge Road, London SE1 7EH ,","place":["UK"]},{"name":"Department of Cardiology, Guy\u2019s and St Thomas\u2019 Hospitals , Westminster Bridge Road, London SE1 7EH ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5278-6362","authenticated-orcid":false,"given":"Ursula","family":"Rohrer","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering and Imaging Sciences, King\u2019s College London , St Thomas\u2019 Campus, St Thomas\u2019 Hospital, Westminster Bridge Road, London SE1 7EH ,","place":["UK"]},{"name":"Division of Cardiology, Medical University Graz , Auenbruggerplatz 15, 8036 Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6881-3073","authenticated-orcid":false,"given":"Claudia Herrera","family":"Sikl\u00f3dy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, CHUV, Lausanne University Hospital , Rue du Bugnon 46, 1011 Lausanne ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Sinner","sequence":"additional","affiliation":[{"name":"Department of Medicine I, University Hospital Munich, Ludwig Maximilians University , Marchioninistr. 15, 81377 Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niccol\u00f2","family":"Giaj Levra","sequence":"additional","affiliation":[{"name":"Department of Advanced Radiation Oncology, IRCCS Sacro Cuore Don Calabria Hospital , Via Don A. 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