Circulation最新文献

{"title":"Navigating Uncertainty in PAH Classification: Wedge Pressure Versus Disease Phenotypes.","authors":"Marius M Hoeper","doi":"10.1161/circulationaha.125.073885","DOIUrl":"https://doi.org/10.1161/circulationaha.125.073885","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"9 1","pages":"4-6"},"PeriodicalIF":37.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578679","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":"Mitochondrial Tumor Suppressor 1A Attenuates Myocardial Infarction Injury by Maintaining the Coupling Between Mitochondria and Endoplasmic Reticulum.","authors":"Yingchao Gong,Xue Lu,Xingchen Wang,Yinfang Wang,Zhida Shen,Yun Gao,Lenan Zhuang,Luyang Yu,Jiawen Chen,Qinfeng Li,Fuyu Qiu,Jun Lin,Yuhang Tao,Chenyang Jiang,Guosheng Fu,Peng Zhang,Dongwu Lai","doi":"10.1161/circulationaha.124.069737","DOIUrl":"https://doi.org/10.1161/circulationaha.124.069737","url":null,"abstract":"BACKGROUNDPathological cardiac remodeling after myocardial infarction (MI) is a leading cause of heart failure and sudden death. The detailed mechanisms underlying the transition to heart failure after MI are not fully understood. Disruptions in the endoplasmic reticulum (ER)-mitochondria connectivity, along with mitochondrial dysfunction, are substantial contributors to this remodeling process. In this study, we aimed to explore the impact of mitochondrial tumor suppressor 1A (Mtus1A) on cardiac remodeling subsequent to MI and elucidate its regulatory role in ER-mitochondria interactions.METHODSSingle-nucleus RNA sequencing analysis was performed to delineate the expression patterns of Mtus1 in human cardiomyocytes under ischemic stress. MI models were induced in mice by left coronary artery ligation and replicated in vitro using primary neonatal rat ventricular myocytes exposed to oxygen glucose deprivation. Cardiac-specific deletion of Mtus1 was achieved by crossing floxed Mtus1 mice with the Myh6-MerCreMer mice. The impact of Mtus1A, a mitochondrial isoform of Mtus1, on cardiac function and the molecular mechanisms were investigated in both in vivo and in vitro settings. Mitochondria-associated ER membranes coupling levels were evaluated by transmission electron microscopy and live-cell imaging. Protein interactions involving Mtus1A were explored through immunoprecipitation-mass spectrometry, coimmunoprecipitation, and proximity ligation assay. The roles of Mtus1A and Fbxo7 (F-box protein 7) were validated in a murine MI model using adeno-associated virus serotype 9 (AAV9).RESULTSBioinformatics analysis revealed a significant downregulation of Mtus1 expression in human cardiomyocytes under ischemic conditions, indicating its potential role in stress response. The predominant isoform in murine cardiomyocytes, Mtus1A, showed reduced expression in the left ventricle of mice after MI, which is consistent with the decreased levels of its orthologs in heart tissues from patients with MI. Cardiac-specific knockout of Mtus1 in mice exacerbated cardiac dysfunction after MI. Both in vitro and in vivo studies demonstrated the vital role of Mtus1A in modulating mitochondria-associated ER membranes coupling and preserving mitochondrial function. Mechanistically, Mtus1A functions as a scaffold protein that maintains the formation of inositol 1,4,5-trisphosphate receptor 1 (IP3R1)-glucose-regulated protein 75 (Grp75)-voltage-dependent anion channel 1 (VDAC1) complex through its amino acid sequence 189-219. In addition, Mtus1A protein is stabilized by K6-linked ubiquitination through the E3 ubiquitin ligase Fbxo7. Mtus1A overexpression in mice mitigated MI-induced cardiac dysfunction and remodeling by maintaining ER-mitochondria connectivity.CONCLUSIONSOur study demonstrates that Mtus1A is crucial for modulating MI-induced cardiac remodeling by preserving ER-mitochondria communication and ameliorating mitochondrial function in cardiomyocytes. Mtus1A may serv","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"19 1","pages":""},"PeriodicalIF":37.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520883","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":"Exercise Intolerance and Response to Training in Patients With Postacute Sequelae of SARS-CoV2 (Long COVID): A Scientific Statement From the American Heart Association.","authors":"William K Cornwell,Benjamin D Levine,Diane Baptiste,Nicole Bhave,Sarika Desai,Elizabeth Dineen,Matthew Durstenfeld,Justin Edward,Mu Huang,Roni Jacobsen,Jonathan H Kim,Erica Spatz,","doi":"10.1161/cir.0000000000001348","DOIUrl":"https://doi.org/10.1161/cir.0000000000001348","url":null,"abstract":"The postacute sequelae of SARS-CoV-2, also known as Long COVID, may affect 10% to 25% of individuals diagnosed with SARS-CoV-2. More than 100 symptoms have been reported among patients with Long COVID, but almost all patients report severe fatigue, orthostatic intolerance, shortness of breath, and reductions in exercise tolerance. Emerging data suggest that cardiovascular deconditioning plays a major role in the development of this syndrome and that reductions in functional capacity among patients with Long COVID are comparable to reductions seen among individuals with cardiovascular deconditioning resulting from bed rest. Concern has been raised about the use of exercise training as part of the management strategy for patients with Long COVID. However, exercise training appropriately tailored to the patient with cardiovascular deconditioning may be an effective strategy to facilitate improvement in symptoms. This American Heart Association scientific statement provides a concise yet comprehensive overview of mechanisms contributing to development of Long COVID and methods by which exercise training may be applied to this unique patient population to alleviate symptoms and improve quality of life. In addition, methods of reintroducing exercise and return to play among athletes affected by COVID-19 are discussed.","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"19 1","pages":""},"PeriodicalIF":37.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520947","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":"Partnership Model of Regionalized Care for Congenital Heart Disease in Resource-Limited Settings: Results From the ASSIST Project.","authors":"Guocheng Shi,Shuyu Chen,Jin Shentu,Nian Liu,Hongbo Luo,Chunxiang Li,Lin Chen,Kai Luo,Qiang Chen,Qiliang Zhang,Jianfeng Zhang,Zhaohui Lu,Qi Sun,Hao Zhang,Xike Wang,Huiwen Chen","doi":"10.1161/circulationaha.125.074298","DOIUrl":"https://doi.org/10.1161/circulationaha.125.074298","url":null,"abstract":"BACKGROUNDEqual access to care for patients with congenital heart disease (CHD) remains unrealized globally. The ASSIST project (Academic Medical Hospitals-Local Institutions collaboration) is an ongoing national quality initiative implemented in low-resource settings in China attempting to reduce gaps in access to CHD care. This study sought to evaluate its feasibility and effectiveness.METHODSShanghai Children's Medical Center, an academic medical center, has partnered with 4 local hospitals in low-resource regions to enhance local CHD programs since 2021. Comparison was made between patients receiving treatments in these 4 local hospitals before (2013-2020) versus after the ASSIST project (2021-2024). In addition, contemporaneous patients receiving treatments in Shanghai Children's Medical Center (2021-2024) were compared with the post-ASSIST cohort of patients. The primary outcome was a composite of postoperative mortality and multiorgan dysfunction. A key secondary outcome was delayed treatment, defined as an interval of more than 6 months between the time of surgery and the time when the clinicians recommended surgery at the initial presentation.RESULTSThe analysis cohort included 11 895 pediatric patients (median age, 2.0 years [25th-75th percentile 0.7-5.0]; 5933 female [49.9%]), with 3333 cases in the pre-ASSIST group, 1566 in the post-ASSIST group, and 6996 in the Shanghai Children's Medical Center group. Lower family educational attainment (odds ratio, 1.50 [95% CI 1.21-1.85]; P<0.001) and lower annual household income (odds ratio, 1.65 [95% CI, 1.14-2.38]; P=0.008) were associated with increased incidence of the primary outcome in the low-resource regions but could be mitigated by the ASSIST project in a multivariable model. There was a change in case mix of the CHDs after the ASSIST project, with a significant increase in more complex cases (35.5% versus 7.3%; P<0.001) and neonatal surgery (9.1% versus 1.5%; P<0.001). A higher portion of patients in the pre-ASSIST group had delayed treatment compared with those in the post-ASSIST group (43.2% versus 23.3%; P<0.001). Primary outcome analyses showed that patients in the post-ASSIST group and the Shanghai Children's Medical Center group had equivalent outcomes (4.4% versus 3.6%; P=0.13).CONCLUSIONSInterhospital partnership appears to be a useful and feasible method to deliver regionalized quality care for pediatric patients with CHD in resource-limited regions.","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"13 1","pages":""},"PeriodicalIF":37.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520879","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":"New Algorithm for Estimating Left Ventricular Filling Pressure by Echocardiography.","authors":"Hossam Lababidi, Wissam Rahi, Otto A Smiseth, Kristen Billick, Katsuji Inoue, Faraz H Khan, Øyvind S Andersen, Eusebio García-Izquierdo, Jong-Won Ha, Nobuyuki Ohte, Einar Gude, Rajeev C Mohan, J Thomas Heywood, Allan Klein, Sherif F Nagueh","doi":"10.1161/CIRCULATIONAHA.125.074974","DOIUrl":"https://doi.org/10.1161/CIRCULATIONAHA.125.074974","url":null,"abstract":"<p><strong>Background: </strong>Evaluation of whether dyspnea has a cardiac cause is essential. Guidelines from 2016 were reported to result in a high incidence of indeterminate left ventricular (LV) filling pressure. We sought to validate a new algorithm for the estimation of LV filling pressure (LVFP) in a multicenter study, with the objective of decreasing the yield of indeterminate filling pressure and increasing accuracy.</p><p><strong>Methods: </strong>In an observational study, echocardiography was performed in 951 patients referred for cardiac catheterization. Echocardiographic measurements included mitral inflow, pulmonary vein and tissue Doppler mitral annulus velocities, tricuspid regurgitation velocity, assessment of mean right atrial pressure, biplane LV and left atrial volumes, and LV and left atrial strain. A stepwise approach was applied in a new algorithm for estimation of LVFP, whereby pressure >15 mm Hg was considered abnormally elevated. The first step included mitral annulus early diastolic velocity (e'), the ratio of mitral early flow velocity to e', and pulmonary artery systolic pressure. With concordant findings in all 3 variables, conclusions about LVFP could be reached. In case of discordant or incomplete variables, left atrial reservoir strain, left atrial maximum volume index, isovolumic relaxation time, and pulmonary vein flow were analyzed in a second step. In the presence of ≥1 abnormal measurement in the second step, the conclusion of elevated LVFP could be reached.</p><p><strong>Results: </strong>Only 2 patients had indeterminate LVFP as per the new algorithm versus 38 applying 2016 guidelines (<i>P</i><0.0001). In 949 patients, sensitivity was 86% and specificity was 86%, with accuracy of 86%. Accuracy was higher than the 2016 algorithm in all patients (<i>P</i><0.0001), and in patients with ejection fraction ≥50% (<i>P</i><0.0001), whereas accuracy was similar in patients with ejection fraction <50%. In 663 patients with natriuretic peptides data, net reclassification improvement for echocardiography over natriuretic peptides was 1.1 (<i>P</i><0.0001), and integrated discrimination improvement was 0.3 (<i>P</i><0.0001).</p><p><strong>Conclusions: </strong>The new algorithm increases the feasibility of estimating LVFP and has good accuracy with incremental value when natriuretic peptides are considered.</p>","PeriodicalId":10331,"journal":{"name":"Circulation","volume":" ","pages":""},"PeriodicalIF":35.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511632","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":"Correction to: Toward Heart-Healthy and Sustainable Cities: A Policy Statement From the American Heart Association.","authors":"Sanjay Rajagopalan, Anu Ramaswami, Aruni Bhatnagar, Robert D Brook, Mark Fenton, Christopher Gardner, Roni Neff, Armistead G Russell, Karen C Seto, Laurie P Whitsel","doi":"10.1161/CIR.0000000000001347","DOIUrl":"https://doi.org/10.1161/CIR.0000000000001347","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"151 25","pages":"e1097"},"PeriodicalIF":35.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474136","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":"Mitochondrial 1-Carbon Metabolism Drives CD34-Lineage Cells to Differentiate Into T Follicular Helper Cells to Form Tertiary Lymphoid Organs in Transplant Arteriosclerosis.","authors":"Xuejing Sun,Junru Wu,Tian He,Meng Yao,Li Qin,Chunyan Weng,Liping Peng,Qingzhong Xiao,Yao Lu,Hong Yuan,Qingbo Xu,Jingjing Cai","doi":"10.1161/circulationaha.125.073691","DOIUrl":"https://doi.org/10.1161/circulationaha.125.073691","url":null,"abstract":"BACKGROUNDAllograft arteriosclerosis, a significant cause of graft failure, is linked to the formation of tertiary lymphoid organs. T follicular helper (Tfh) cells are a vital subset of helper T cells that control the formation of the germinal center in tertiary lymphoid organs. Thus, understanding the origins and regulatory mechanisms of Tfh cells in allograft arteriosclerosis is essential for developing targeted therapies.METHODSWe used a lineage-tracing strategy to track Tfh cell fate in mouse models. Single-cell RNA sequencing, flow cytometry, and immunofluorescence staining were employed to analyze cell populations in remodeled arteries 2 and 4 weeks after transplantation. Additionally, we used VEGFR-3 inhibitors and lymph node dissection to suppress lymphatic vessel formation. Metabolic signatures and flux in different cell types were investigated using ultrahigh-performance liquid chromatography and high-resolution mass spectrometry-based metabolomics. CD4+ T cell-specific MTHFD2 knockout mice were used to corroborate our hypothesis about the role of mitochondrial 1-carbon metabolism in Tfh cell differentiation. Mechanisms discovered in vivo were also tested ex vivo.RESULTSCD34-lineage cells were found to be the major source of cells differentiating into T cell populations in allograft arteries. CD34-lineage cells mainly originated from the thymus, with drainage through lymphatic vessels, and differentiated into effective T cells around grafting arteries. Using CD34 lineage-tracing mice and single-cell RNA sequencing, we identified a Tfh cell population derived from CD34-lineage CD4+ T cells. Untargeted and targeted metabolomics revealed distinct upregulation of 1-carbon metabolism during CD4+ T-to-Tfh cell differentiation. Supplementation of amino acids essential for 1-carbon metabolism, such as serine, methionine or glycine, facilitated differentiation from CD4+ T to Tfh cells. Using deuterium-labeled serine, we found that the mitochondrial 1-carbon pathway is predominant. Inhibition of the mitochondrial 1-carbon metabolic enzyme MTHFD2 by administration of DS18561882 or generating CD4+ T cell-specific MTHFD2 knockout mice, significantly inhibited the numbers of Tfh cells and tertiary lymphoid organ formation as well as vascular remodeling.CONCLUSIONSThis study provides insights into the critical role of mitochondrial 1-carbon metabolism and MTHFD2 in governing the differentiation of CD34-lineage cells into Tfh cells, which contributes to tertiary lymphoid organ formation in transplant vasculopathy, offering potential therapeutic targets to enhance transplant outcomes.","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"640 1","pages":""},"PeriodicalIF":37.8,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370205","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":"Correction to: 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.","authors":"Seth S Martin, Aaron W Aday, Zaid I Almarzooq, Cheryl A M Anderson, Pankaj Arora, Christy L Avery, Carissa M Baker-Smith, Bethany Barone Gibbs, Andrea Z Beaton, Amelia K Boehme, Yvonne Commodore-Mensah, Maria E Currie, Mitchell S V Elkind, Kelly R Evenson, Giuliano Generoso, Debra G Heard, Swapnil Hiremath, Michelle C Johansen, Rizwan Kalani, Dhruv S Kazi, Darae Ko, Junxiu Liu, Jared W Magnani, Erin D Michos, Michael E Mussolino, Sankar D Navaneethan, Nisha I Parikh, Sarah M Perman, Remy Poudel, Mary Rezk-Hanna, Gregory A Roth, Nilay S Shah, Marie-Pierre St-Onge, Evan L Thacker, Connie W Tsao, Sarah M Urbut, Harriette G C Van Spall, Jenifer H Voeks, Nae-Yuh Wang, Nathan D Wong, Sally S Wong, Kristine Yaffe, Latha P Palaniappan","doi":"10.1161/CIR.0000000000001344","DOIUrl":"https://doi.org/10.1161/CIR.0000000000001344","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"151 25","pages":"e1095"},"PeriodicalIF":35.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474134","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":"Correction to: 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.","authors":"Sunil V Rao, Michelle L O'Donoghue, Marc Ruel, Tanveer Rab, Jaqueline E Tamis-Holland, John H Alexander, Usman Baber, Heather Baker, Mauricio G Cohen, Mercedes Cruz-Ruiz, Leslie L Davis, James A de Lemos, Tracy A DeWald, Islam Y Elgendy, Dmitriy N Feldman, Abhinav Goyal, Ijeoma Isiadinso, Venu Menon, David A Morrow, Debabrata Mukherjee, Elke Platz, Susan B Promes, Sigrid Sandner, Yader Sandoval, Rachel Schunder, Binita Shah, Jason P Stopyra, Amy W Talbot, Pam R Taub, Marlene S Williams","doi":"10.1161/CIR.0000000000001346","DOIUrl":"https://doi.org/10.1161/CIR.0000000000001346","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"151 25","pages":"e1098"},"PeriodicalIF":35.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474135","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 Wang et al Regarding Article, \"Bone Morphogenetic Protein 9 Protects Against Myocardial Infarction by Improving Lymphatic Drainage Function and Triggering DECR1-Mediated Mitochondrial Bioenergetics\".","authors":"Heng Wang,Taoran Zhao,Guoping Zheng","doi":"10.1161/circulationaha.124.072438","DOIUrl":"https://doi.org/10.1161/circulationaha.124.072438","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"242 1","pages":"e1091-e1092"},"PeriodicalIF":37.8,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370263","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}