Circulation最新文献

{"title":"Optimizing Sedation Strategies for Catheter Ablation Procedures: Balancing Safety, Efficacy, and Practice Variations.","authors":"Louise Y Sun","doi":"10.1161/circulationaha.125.075339","DOIUrl":"https://doi.org/10.1161/circulationaha.125.075339","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"25 1","pages":"160-162"},"PeriodicalIF":37.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pause, A Block, A Path Restored: The Heart's Hidden Choreography.","authors":"Angkawipa Trongtorsak,Kenneth Ellenbogen,Ajay Pillai","doi":"10.1161/circulationaha.125.074781","DOIUrl":"https://doi.org/10.1161/circulationaha.125.074781","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"52 1","pages":"205-207"},"PeriodicalIF":37.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter by Pasupathy et al Regarding Article, \"Zibotentan in Microvascular Angina: A Randomized, Placebo-Controlled, Crossover Trial\".","authors":"Sivabaskari Pasupathy,Rosanna Tavella,John F Beltrame","doi":"10.1161/circulationaha.124.073687","DOIUrl":"https://doi.org/10.1161/circulationaha.124.073687","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"17 1","pages":"e28-e29"},"PeriodicalIF":37.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Smoking Cannabis With Cardiovascular Events Among Veterans With Coronary Artery Disease.","authors":"Salomeh Keyhani,Beth E Cohen,Marzieh Vali,Katherine J Hoggatt,Dawn M Bravata,Peter C Austin,Emily Lum,Deborah Hasin,Carl Grunfeld,Michael G Shlipak","doi":"10.1161/circulationaha.124.073193","DOIUrl":"https://doi.org/10.1161/circulationaha.124.073193","url":null,"abstract":"BACKGROUNDWhether cannabis is a risk factor for cardiovascular events is unknown. We examined the association between smoking cannabis and cardiovascular events in a cohort of older veterans (66 to 68 years of age) with coronary artery disease.METHODSThe THC Cohort (Heart and Cannabis) comprised 4285 veterans (mean [SD] age, 67.5 [1.01] years; 2% female) with coronary artery disease who were born in 1950 to 1952. Participants were recruited between April 5, 2018, and March 12, 2020, interviewed about health behaviors, and then classified according to their self-reported cannabis smoking status in the previous 30 days. In a separate analysis, we classified participants according to any form of cannabis use (smoking, vaping, or edible use) versus nonuse in the past 30 days. Data on demographic, behavioral, and clinical characteristics were collected by telephone interview and from national Department of Veterans Affairs and Medicare data sources. The primary outcome included a composite of fatal and nonfatal stroke, fatal and nonfatal acute myocardial infarction, and cardiovascular death. The follow-up period for each patient extended from the date of their initial interview until the end of study (June 14, 2022). All participants were followed until they experienced an outcome or until the end of the follow-up period. Survey nonresponse weights and propensity score-based weights were used to reduce bias and confounding. Hazard ratios were estimated using cause-specific hazard models.RESULTSThe cohort included 1015 veterans with coronary artery disease who reported smoking cannabis in the previous 30 days and 3122 veterans who did not smoke cannabis in the previous 30 days. Mean follow-up was 3.3 years, and 563 events occurred. Compared with veterans who did not smoke cannabis, smoking cannabis (past 30 days) was not associated with the composite outcome of acute myocardial infarction, stroke, and cardiovascular death (adjusted hazard ratio, 0.87 [95% CI, 0.61-1.24]). Similarly, use of any form of cannabis (smoking, vaping, dabbing, edibles) in the past 30 days was not associated with the composite outcome.CONCLUSIONSIn this cohort of older veterans with coronary artery disease, self-reported cannabis use was not independently associated with increased cardiovascular events over a mean of 3.3 years of follow-up.","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"1 1","pages":""},"PeriodicalIF":37.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter by Zhao Regarding Article, \"Zibotentan in Microvascular Angina: A Randomized, Placebo-Controlled, Crossover Trial\".","authors":"Jian Zhao","doi":"10.1161/circulationaha.124.073267","DOIUrl":"https://doi.org/10.1161/circulationaha.124.073267","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"5 1","pages":"e27"},"PeriodicalIF":37.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Elusiveness of \"Rest\": The Challenges of Assessing Resting Coronary Physiology.","authors":"Thabo Mahendiran,Adriaan Wilgenhof,Bernard De Bruyne","doi":"10.1161/circulationaha.125.074343","DOIUrl":"https://doi.org/10.1161/circulationaha.125.074343","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"30 1","pages":"147-149"},"PeriodicalIF":37.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computational Modeling Predicts Benefits of Proefferocytic Therapy in Human Atherosclerosis.","authors":"Kai-Uwe Jarr,Kaylin C A Palm,Gerard Pasterkamp,Michal Mokry,Nicholas J Leeper","doi":"10.1161/circulationaha.124.072676","DOIUrl":"https://doi.org/10.1161/circulationaha.124.072676","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"25 1","pages":"208-211"},"PeriodicalIF":37.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized Approach May Improve Hypertrophic Cardiomyopathy Diagnosis.","authors":"Bridget M Kuehn","doi":"10.1161/circulationaha.125.074663","DOIUrl":"https://doi.org/10.1161/circulationaha.125.074663","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"89 1","pages":"202-204"},"PeriodicalIF":37.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurodevelopmental Outcomes in Early Adolescence: The Pediatric Heart Network Single Ventricle Reconstruction Trial.","authors":"Thomas A Miller,Binu Sharma,Russell Gongwer,Felicia L Trachtenberg,Jane W Newburger,Caren S Goldberg,Kathryn E Gustafson,J William Gaynor,Jodie K Votava-Smith,Linda M Lambert,Renee Sananes,Mary C Kral,Rocky Tsang,Kimberley P Heinrich,James Cnota,Amee Shah,Dawn Ilardi, ","doi":"10.1161/circulationaha.125.074523","DOIUrl":"https://doi.org/10.1161/circulationaha.125.074523","url":null,"abstract":"BACKGROUNDNeurodevelopmental and functional impairments are among the most consequential morbidities for survivors of hypoplastic left heart syndrome after staged single ventricle surgical palliation. The SVRIII trial (Long-Term Outcomes of Children With Hypoplastic Left Heart Syndrome and the Impact of Norwood Shunt Type) enrolled adolescents, who were randomized to different surgical shunt types at the time of Norwood procedure as neonates, for multifaceted in-person evaluation. This study reports their neurodevelopmental outcomes.METHODSTransplant-free survivors from SVRIII were invited to complete an in-person comprehensive neurodevelopmental evaluation in early adolescence. Outcomes across domains of cognition, academics, learning, memory, and attention, as well as social, emotional, behavioral, adaptive, and executive function, were compared with those of normative populations. Associations with demographic and medical covariates, including Norwood shunt type, were also assessed.RESULTSAmong 549 participants enrolled in the SVR trial (Single Ventricle Reconstruction), 200 of the 237 SVRIII participants (84%) completed a neurodevelopmental evaluation at a mean age of 11 years (range, 10 to 14 years). SVRIII participants who did versus did not undergo evaluation were more likely to be male (63% versus 51%), to be White (87% versus 76%), and to have a higher Childhood Opportunity Index score (61±26 versus 46±39). Full-scale intelligence quotient (88±18) was significantly lower than in the normative population, with 39% >1 and 15% >2 SD below the normative mean. Similar patterns were seen for reading (38% >1 SD and 16% >2 SD below the normative mean) and math (38% >1 SD and 19% >2 SD below the normative mean) scores. Attention, executive functioning, social development, visual memory, and adaptive functioning were all more impaired than in the normative population. Measures of socioeconomic status, number of medical complications, and requirement for a gastrostomy tube were each independent predictors of neurodevelopment, with socioeconomic status the most consistently significant factor across models. Group differences by shunt type were inconsistent across neurodevelopmental domains without a clear benefit of one surgical strategy.CONCLUSIONSIn early adolescence, transplant-free survivors of surgical palliation for hypoplastic left heart syndrome show concerning impairments across all domains of neurodevelopment. The distribution of affected outcomes is broad and associated with demographic, medical, and, most frequently, socioeconomic factors. Our findings support recommendations for neurodevelopmental evaluation during adolescence to guide individualized interventions to promote educational success and psychosocial well-being.REGISTRATIONURL: https://www.clinicaltrials.gov; Unique identifier: NCT02455531.","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"201 1","pages":""},"PeriodicalIF":37.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Vascular Aging Determined by 3-Dimensional Aortic Geometry: Genetic Determinants and Clinical Consequences.","authors":"Cameron Beeche,Bingxin Zhao,Hamed Tavolinejad,Bianca Pourmussa,Joonghyun Kim,Jeffrey Duda,James Gee,Walter R Witschey,Julio A Chirinos, ","doi":"10.1161/circulationaha.125.074554","DOIUrl":"https://doi.org/10.1161/circulationaha.125.074554","url":null,"abstract":"BACKGROUNDVascular aging is an important phenotype characterized by structural and geometric remodeling. Some individuals exhibit supernormal vascular aging, associated with improved cardiovascular outcomes; others experience early vascular aging, linked to adverse cardiovascular outcomes. The aorta is the artery that exhibits the most prominent age-related changes; however, the biological mechanisms underlying aortic aging, its genetic architecture, and its relationship with cardiovascular structure, function, and disease states remain poorly understood.METHODSWe developed sex-specific models to quantify aortic age on the basis of aortic geometric phenotypes derived from 3-dimensional tomographic imaging data in 2 large biobanks: the UK Biobank and the Penn Medicine BioBank. Convolutional neural ne2rk-assisted 3-dimensional segmentation of the aorta was performed in 56 104 magnetic resonance imaging scans in the UK Biobank and 6757 computed tomography scans in the Penn Medicine BioBank. Aortic vascular age index (AVAI) was calculated as the difference between the vascular age predicted from geometric phenotypes and the chronological age, expressed as a percent of chronological age. We assessed associations with cardiovascular structure and function using multivariate linear regression and examined the genetic architecture of AVAI through genome-wide association studies, followed by Mendelian randomization to assess causal associations. We also constructed a polygenic risk score for AVAI.RESULTSAVAI displayed numerous associations with cardiac structure and function, including increased left ventricular mass (standardized β=0.144 [95% CI, 0.138, 0.149]; P<0.0001), wall thickness (standardized β=0.061 [95% CI, 0.054, 0.068]; P<0.0001), and left atrial volume maximum (standardized β=0.060 [95% CI, 0.050, 0.069]; P<0.0001). AVAI exhibited high genetic heritability (h2=40.24%). We identified 54 independent genetic loci (P<5×10-8) associated with AVAI, which further exhibited gene-level associations with the fibrillin-1 (FBN1) and elastin (ELN1) genes. Mendelian randomization supported causal associations between AVAI and atrial fibrillation, vascular dementia, aortic aneurysm, and aortic dissection. A polygenic risk score for AVAI was associated with an increased prevalence of atrial fibrillation, hypertension, aortic aneurysm, and aortic dissection.CONCLUSIONSEarly aortic aging is significantly associated with adverse cardiac remodeling and important cardiovascular disease states. AVAI exhibits a polygenic, highly heritable genetic architecture. Mendelian randomization analyses support a causal association between AVAI and cardiovascular diseases, including atrial fibrillation, vascular dementia, aortic aneurysms, and aortic dissection.","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"24 1","pages":""},"PeriodicalIF":37.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}