Clinical Research in Cardiology最新文献

{"title":"Mid- to long-term outcomes of covered balloon-expandable stent implantation for the management of vascular injuries in patients undergoing transfemoral transcatheter aortic valve implantation: the BE-SAFE Registry : for the RECOVER (REsults after percutaneous interventions with COVERed stents) Investigators.","authors":"Hector A Alvarez-Covarrubias, Martin Jurisic, Finn Syryca, Charlotte Duesmann, Costanza Pellegrini, Tobias Rheude, N Patrick Mayr, Niklas Altaner, Moritz Kühlein, Tobias Lenz, Edna Blum, Yousuke Taniguchi, Gjin Ndrepepa, Christian Thilo, Heribert Schunkert, Adnan Kastrati, Sebastian Kufner, Salvatore Cassese, Michael Joner, Erion Xhepa","doi":"10.1007/s00392-025-02651-2","DOIUrl":"https://doi.org/10.1007/s00392-025-02651-2","url":null,"abstract":"<p><strong>Background and aims: </strong>Vascular complications occur in a non-negligible proportion of transfemoral transcatheter aortic valve implantation (Tf-TAVI) procedures. There is only limited evidence regarding the efficacy and safety of covered balloon-expandable (CBE) stents in the management of Tf-TAVI related vascular complications. We aimed to investigate the efficacy and safety of CBE stent implantation to treat access-related vascular complications in patients undergoing Tf-TAVI.</p><p><strong>Methods: </strong>The present retrospective analysis included patients undergoing CBE stent implantation following Tf-TAVI from April 2012 to January 2023 at our centre. The primary endpoint was technical success defined as successful device delivery and implantation at the intended location with angiographic confirmation of vessel patency and absence of residual bleeding. Clinical outcomes and color Doppler ultrasonography findings were evaluated at discharge, 30 days and longest available follow-up.</p><p><strong>Results: </strong>Among 3331 Tf-TAVI procedures, 93 patients (2.8%) required covered stent implantation for the treatment of access related vascular complications. Technical success was achieved in 92 patients (98.9%). BeGraft and Atrium Advanta V12 CBE stents were implanted in 76 (81.7%) and 17 (18.3%) patients, respectively. Median clinical follow-up was 455 [304; 798] days, with both in-hospital and 30-days mortality equaling 4.3% and 1-year mortality 15.1%. Pre-discharge Doppler ultrasonography was performed in 98.9% patients, with normal findings in 79.8% and minor findings (such as pseudoaneurysm, non-flow-limiting dissection, arterio-venous fistula) in the remaining patients. Clinical follow-up was available in 96.2% patients; no cases of new-onset claudication, need for repeat surgical or transcatheter vascular interventions were recorded. Follow-up Doppler ultrasonography (54.4% patients) showed persistent patency and no signs of stent failure in all patients.</p><p><strong>Conclusions: </strong>CBE stent implantation for the treatment of access site related vascular complications after Tf-TAVI is associated with excellent technical success rates, optimal short- to mid-term patency rates as well as satisfactory long-term clinical outcomes.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of stylet-driven leads compared to lumenless leads for left bundle branch are pacing: systematic review and meta-analysis.","authors":"Amr Abdin, Haran Burri, Guram Imnadze, Khaled Turkmani, Hussam Al Ghorani, Alhasan Almasri, Christian Werner, Saarraaken Kulenthiran","doi":"10.1007/s00392-025-02673-w","DOIUrl":"https://doi.org/10.1007/s00392-025-02673-w","url":null,"abstract":"<p><strong>Background: </strong>Most initial experience with Left bundle branch are pacing (LBBAP) has involved lumenless leads (LLLs). Recently, stylet-driven leads (SDLs) have also been introduced for LBBAP. This study examined the clinical success rates, outcomes, and complication rates between SDLs and LLLs.</p><p><strong>Methods and results: </strong>A systematic review of randomized clinical trials and observational studies comparing LLL and SDL up to November 30, 2024, was conducted. Random- and fixed-effects meta-analyses assessed the impact of implant technology on outcomes, including pacing metrics, lead complications, and procedural parameters. In total, 11 studies with 12,916 patients (SDLs: 3920; LLLs: 8996) were included. Implant success rates were comparable between SDL and LLL (RR 1.00, 95% CI 0.96-1.04, P = 0.96). SDL was associated with shorter procedure time (MD - 11.94 min, 95% CI - 19.48 to - 4.40, P = 0.002) and shorter fluoroscopy times, though this differences was not statistically significant (MD - 1.27 min, 95% CI - 2.92 to 0.39, P = 0.13). Pacing metrics, including impedance, pacing threshold, and R-wave amplitude, also showed no significant differences during follow-up (up to 28 months). However, SDLs were associated with a significantly higher risk of lead-related complications compared to LLLs (RR 1.89, 95% CI 1.47-2.41, P < 0001).</p><p><strong>Conclusion: </strong>LBBAP using SDL is feasible and demonstrates comparable success rates with a shorter procedure duration. A higher incidence of lead-related complications was observed in the SDL group; however, due to potential confounding factors and the absence of randomized head-to-head comparisons, no definitive conclusions can be drawn regarding causality. Further prospective studies are warranted to clarify this association.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of glp-1 receptor agonists on hospitalization for heart failure and all-cause death in patients with diabetes with and without heart failure: a real-world study.","authors":"Luisa Ojeda-Fernández, Ginevra Torrigiani, Mauro Molteni, Ida Fortino, Claudio Cimminiello, Marta Baviera","doi":"10.1007/s00392-025-02674-9","DOIUrl":"https://doi.org/10.1007/s00392-025-02674-9","url":null,"abstract":"<p><strong>Objective: </strong>Evidence on the impact of GLP-1 RAs on HF hospitalization (HHF) and mortality has been inconsistent across clinical trials in patients with diabetes. We investigated the association between GLP-1 RAs and these outcomes in a real-world setting.</p><p><strong>Methods: </strong>We selected individuals aged 45 years and older already treated with metformin living in Lombardy, Italy, and then split them into two groups if they initiated GLP-1 RAs or other antidiabetic drugs, between 2019 and 2021. A multivariable Cox proportional hazard regression model was performed to assess the association of GLP-1 RAs on HHF and all-cause death as hazard ratios (HRs) with 95% CI compared to the Other ADs group, stratifying by history of HF. The role of GLP-1 RAs was also investigated using the Inverse Probability Treatment Weighting (IPTW) and in the subgroup analyses.</p><p><strong>Results: </strong>In total, 9795 patients in the GLP-1 RAs group (302 with HF; 9493 without) and 6018 in the Other ADs group (405 with HF; 5613 without) were included in the analysis. GLP-1 RAs use was significantly associated with a lower risk of HHF in patients with a history of HF (HR 0.65; CI 95% 0.426-0.987) and in those without (HR 0.52; CI 95% 0.371-0.733). A lower risk for all-cause death was also observed in GLP-1 RAs users (with HF: HR 0.45; CI 95% 0.320-0.638; without HF: HR 0.44; CI 95% 0.383-0.514). The results of the IPTW and subgroup analyses confirmed those of the main analysis.</p><p><strong>Conclusion: </strong>Our findings showed a benefit of GLP-1 RAs on HHF and all-cause death in patients with diabetes regardless of HF history. Although, our study presents several limitations, if confirmed through dedicated randomized trial, this could further expand the role of GLP-1RAs in cardiovascular prevention\".</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive performance of the TRI-SCORE in patients with severe aortic stenosis and concomitant tricuspid regurgitation undergoing TAVR.","authors":"Mustafa Mousa Basha, Baravan Al-Kassou, Christopher Gestrich, Marcel Weber, Thomas Beiert, Sebastian Zimmer, Farhad Bakhtiary, Georg Nickenig, Jasmin Shamekhi","doi":"10.1007/s00392-025-02671-y","DOIUrl":"https://doi.org/10.1007/s00392-025-02671-y","url":null,"abstract":"<p><strong>Background: </strong>Tricuspid regurgitation (TR) is a common comorbidity in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) and represents a significant predictor of adverse outcomes. Precise risk stratification through clinical scoring systems is vital for tailoring treatment decisions in this patient population.</p><p><strong>Objectives: </strong>To assess the applicability of the TRI-SCORE for predicting adverse outcomes in patients with AS and concomitant moderate-to-severe TR undergoing TAVR and to compare its performance with established surgical risk scores like the EuroSCORE II and Society of Thoracic Surgeons score (STS-Score).</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 301 patients with severe AS and concomitant TR who underwent TAVR between 2013 and 2022 at the Heart Center Bonn. According to the TRI-SCORE, patients were stratified into a low or intermediate-risk group (TRI-SCORE 0-5) and a high-risk group (TRI-SCORE 6-12). The primary endpoint was 2-year all-cause mortality. Predictive values of the TRI-SCORE were compared to the EuroSCORE II and the STS-Score for both 30-day and 2-year mortality outcomes.</p><p><strong>Results: </strong>The 2-year mortality rate was significantly higher in the high-risk group compared to the low or intermediate-risk group (TRI-SCORE 6-12: 40.0% vs. TRI-SCORE 0-5: 17.9%; p < 0.001). For predicting 30-day mortality, the EuroSCORE II and the STS-Score demonstrated superior predictive values, with AUCs of 78.4% and 83.0%, respectively, in comparison to the TRI-SCORE, which showed an AUC of 70.0%. Conversely, the TRI-SCORE allowed a better risk prediction with regard to 2-year all-cause mortality, achieving an AUC of 69.7%, superior to the EuroSCORE II (60.6%) and the STS-Score (62.1%).</p><p><strong>Conclusion: </strong>The TRI-SCORE is effective in predicting mid-term mortality in patients with AS and moderate-to-severe TR undergoing TAVR, demonstrating greater robustness than the EuroSCORE II and the STS-Score for this timeframe.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Native QRS duration and outcomes in heart failure with mildly reduced ejection fraction: results from a large-scaled registry.","authors":"Finn Ole Kronberg, Michael Behnes, Marielen Reinhardt, Noah Abel, Alexander Schmitt, Felix Lau, Thomas Bertsch, Henning Johann Steffen, Kathrin Weidner, Mohammad Abumayyaleh, Jürgen Kuschyk, Ibrahim Akin, Tobias Schupp","doi":"10.1007/s00392-025-02667-8","DOIUrl":"https://doi.org/10.1007/s00392-025-02667-8","url":null,"abstract":"<p><strong>Objective: </strong>The study investigates the prognostic impact of the native QRS duration in patients with heart failure and mildly reduced ejection fraction (HFmrEF).</p><p><strong>Background: </strong>The prognostic impact of QRS duration in HFmrEF has rarely been investigated.</p><p><strong>Methods: </strong>Consecutive patients with HFmrEF and available 12-lead electrocardiogram were retrospectively included at one institution from 2016 to 2022. Patients with QRS duration ≥ 120 ms were compared to patients with QRS duration < 120 ms, further risk stratification was performed comparing patients with left and right bundle branch block (LBBB vs. RBBB). The primary endpoint was all-cause mortality at 30 months, secondary endpoints comprised the risk of HF-related rehospitalization.</p><p><strong>Results: </strong>In total, 1627 patients with HFmrEF were included with a median QRS duration of 90 ms (i.e., QRS duration ≥ 120 ms: 15%). Although the risk of long-term all-cause mortality was not affected by a prolonged QRS duration (35.1% vs. 28.7%; p = 0.057; HR = 1.254; 95% CI 0.993-1.583), patients with QRS duration ≥ 120 ms had a higher risk of HF-related rehospitalization (18.2% vs. 11.9%; p = 0.008; HR = 1.574; 95% CI 1.124-2.204). A QRS duration ≥ 120 ms was associated with long-term HF-related rehospitalization even after multivariable adjustment (HR 1.420, 95% CI 1.008-2.002, p = 0.045). Finally, the risks of long-term all-cause mortality and HF-related rehospitalization did not differ among patients with LBBB and RBBB.</p><p><strong>Conclusion: </strong>A prolonged native QRS duration is independently associated with a higher risk of HF-related rehospitalization in HFmrEF, but not long-term all-cause mortality.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ischemic outcomes after left atrial appendage closure following intracerebral hemorrhage: a retrospective inverse probability weighting analysis from the HANSE-LAAC registry.","authors":"Dominik Jurczyk, Matthias Mezger, Felicitas Lemmer, Caroline Fatum, Ramon Gradaus, Nele-Kristin Drochner-Brocks, Roza Saraei, Christian Frerker, Thomas Stiermaier, Christina Paitazoglou, Ingo Eitel","doi":"10.1007/s00392-025-02668-7","DOIUrl":"https://doi.org/10.1007/s00392-025-02668-7","url":null,"abstract":"<p><strong>Background: </strong>Intracerebral hemorrhage (ICH) is associated with worse outcomes and subsequent high risk for acute arterial ischemic events. Percutaneous left atrial appendage closure (LAAC) is an established procedure in case of atrial fibrillation and adverse events, such as severe bleeding. Clinical benefits of LAAC in patients with ICH are currently unclear.</p><p><strong>Methods: </strong>The single-center registry HANSE-LAAC included consecutively treated patients from 2014 to 2022. Index-procedure and standardized follow-ups at 3 and 12 months were analyzed regarding safety and efficacy retrospectively. Mortality, major adverse cardiovascular, and bleeding events were compared between patients with or without ICH. We used Cox proportional hazard models and inverse probability weights to adjust confounders.</p><p><strong>Results: </strong>401 patients received percutaneous LAAC (ICH 15.2%, n = 61 and non-ICH 84.8%, n = 340). The composite endpoint of death, MACE, and bleeding was significantly lower in the ICH group (HR 0.35, confidence interval [CI] 0.05-4.62, p = 0.0044). This clinical benefit was mainly driven by a significant reduction in bleeding events (HR 0.27; CI 0.06-1.15, p = 0.04). Re-hospitalization was significantly lower as well (HR 0.36; CI 0.20-0.64, p < 0.0001). Adjustment for confounders and inverse probability weighting for the probability of ICH showed no statistically significant difference in mortality (HR 0.53, CI 0.15-1.92, p = 0.33), stroke (HR 0.32 CI 0.03-3.13, p = 0.33), bleeding (HR 0.26; CI 0.05-1.29, p = 0.02), and MACE (HR 0.29; CI 0.04-2.36, p = 0.002).</p><p><strong>Conclusion: </strong>LAAC in ICH was safe and associated with less MACE, bleeding, and re-hospitalization. Randomized-controlled trials are needed to confirm these first positive signs.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence of bioprosthetic valve dysfunction during three-year follow-up following TAVR.","authors":"Verena Veulemans, Jacqueline Heermann, Rik Adrichem, Salome Hecht, Philipp C Seppelt, Thijmen W Hokken, Rutger-Jan Nuis, Mohamed Abdel-Wahab, Nicolas M van Mieghem, David Leistner, Marc M Vorpahl, Tobias Zeus","doi":"10.1007/s00392-025-02630-7","DOIUrl":"https://doi.org/10.1007/s00392-025-02630-7","url":null,"abstract":"<p><strong>Objective: </strong>Transcatheter aortic valve replacement (TAVR) has increased significantly in younger patients and patients at lower surgical risk. In this retrospective multicenter study, we aimed to assess for bioprosthetic valve dysfunction (BVD) during three-year follow-up (FU) and potential differences between self-expandable (SEV) and balloon-expandable valves (BEV) under real-world conditions.</p><p><strong>Methods: </strong>Endpoints were defined according to VARC-3 criteria, including VARC composite endpoints during three-year FU.</p><p><strong>Results: </strong>A total of 1233 patients with tricuspid aortic valve stenosis, who underwent TAVR with contemporary transcatheter heart valve (THV) devices from three different tertiary care centers were included. One-fifth of the study population showed BVD at three-year FU (BVD[-]: n = 957;77.6%; BVD[+]: n = 276;22.4%). Non-structural valve deterioration (NSVD) was the most represented category (8.5%) followed by structural valve deterioration (SVD, 5.3%). BVD was more common in association with BEV as compared with SEV (60.9% vs 39.1%; p < 0.001) owing to higher rates of SVD (13.5% vs 9.5%; p = 0.028) and NSVD (17.9% vs. 13.8%; p = 0.048). Subclinical leaflet thrombosis was only documented in BEV (1.7%, p < 0.001). At three years, all-cause mortality was higher in BVD+ patients (BVD[-] vs. BVD[+]: 13.2% vs. 22.5%; HR: 1.99; 95%-CI: 1.39-2.85; p < 0.001*) but did not differ between THV platform.</p><p><strong>Conclusion: </strong>BVD after TAVR is common and associated with higher all-cause mortality. Despite a preponderance of BVD in association with balloon-expandable valves, mortality rates remain similar between THV platforms.</p><p><strong>Clinical trial registration: </strong>NCT01805739.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head-to-head comparison of cardiac magnetic resonance imaging and transthoracic echocardiography in the general population (MATCH).","authors":"Jan-Per Wenzel, Jan-Niklas Albrecht, Betül Toprak, Elina Petersen, Julius Nikorowitsch, Ersin Cavus, Charlotte Jahnke, Katharina Alina Riedl, Gerhard Adam, Raphael Twerenbold, Stefan Blankenberg, Paulus Kirchhof, Gunnar Lund, Enver Tahir, Kai Müllerleile, Ulf K Radunski","doi":"10.1007/s00392-025-02660-1","DOIUrl":"https://doi.org/10.1007/s00392-025-02660-1","url":null,"abstract":"<p><strong>Background: </strong>Comparing transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMR) is crucial for cardiac assessment. This study aims to clarify their comparability in a large population sample.</p><p><strong>Methods: </strong>CMR and two- (2D) and three-dimensional (3D) TTE were used to quantify left and right heart dimensions in participants of the Hamburg City Health Study. Intertechnique agreement was evaluated using Bland-Altman analyses, Pearson correlation coefficients, and Cohen's Kappa.</p><p><strong>Results: </strong>Data from 2126 participants (median age 67 [IQR: 59-72] years, 897 (42.2%) female) were analyzed. Left ventricular (LV) diastolic volumes were similar (CMR: 117.0 [96.2, 138.0] ml, 2D-TTE: 111.8 [93.6, 134.3] ml, r = 0.7, p < 0.001), while systolic volumes were lower with CMR (CMR: 36.0 [26.9, 46.0] ml, 2D-TTE: 46.7 [37.9, 57.5] ml, r = 0.67, p < 0.001). CMR LV ejection fraction (LVEF) was 10% higher than 2D-TTE (CMR = 69.0 [64.0, 74.0]%, 2D-TTE = 58.3 [55.5, 61.7]%, p < 0.001; r = 0.40, p < 0.001). Left atrial volumes correlated moderately with low bias (CMR: 53.0 [40.0, 68.0] ml, 2D-TTE: 51.6 [41.5, 64.0] ml, r = 0.63, p < 0.001). LV mass showed good correlation but was higher using 2D-TTE (r = 0.74, p < 0.001). Right ventricular (RV) volumes showed the largest differences, with CMR demonstrating lower interobserver variability (ICC = 0.97 vs. 0.61 for 2D-TTE) and markedly larger volumes (RVEDV mean bias = 74.8 ml, r = 0.50, p < 0.001).</p><p><strong>Conclusion: </strong>In a large general population, CMR quantifies cardiac function and dimensions more reliably than TTE. Both modalities provide significantly different absolute values, limiting intertechnique transferability.</p><p><strong>Trial registration: </strong>Retrospectively registered at ClinicalTrial.gov, registration number: NCT03934957, registration date: 04/01/2019, https://clinicaltrials.gov/study/NCT03934957 .</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to 'Prospective comparison of temporal changes in myocardial function in women with Takotsubo versus anterior STEMI'.","authors":"Anna James, Mahmood Ahmad","doi":"10.1007/s00392-025-02657-w","DOIUrl":"https://doi.org/10.1007/s00392-025-02657-w","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observer variabilities for the diagnosis of coronary artery disease using anatomical and functional testing: the impact of certification.","authors":"Grigorios Korosoglou, Nadine Abanador-Kamper, Christian Tesche, Matthias Renker, Florian André, Loris Weichsel, Michaela Hell, Florian Bönner, Mareike Cramer, Sebastian Kelle, Jeanette Schulz-Menger, Wolfgang Fehske, Andreas Rolf, Norbert Frey, Holger Thiele, Stephan Baldus","doi":"10.1007/s00392-025-02661-0","DOIUrl":"https://doi.org/10.1007/s00392-025-02661-0","url":null,"abstract":"<p><strong>Aim: </strong>To compare the reproducibility in reporting of coronary computed tomography angiography (CCTA) or cardiovascular magnetic resonance imaging (CMR) by certified readers for CCTA and CMR by the German Society of Cardiology (DGK) versus that by non-certified readers.</p><p><strong>Methods: </strong>The study included 40 randomly selected CCTA and vasodilator stress CMR patient datasets. For CCTA, the degree of lumen narrowing, plaque composition, and high-risk plaque features were assessed. For CMR, wall motion and perfusion abnormalities and late gadolinium enhancement (LGE) were rated. All measures were conducted by segments and for individual patients. Intraclass correlation coefficients (ICC) were calculated to assess agreement between non-certified (n = 4) vs. DGK-certified readers (n = 4).</p><p><strong>Results: </strong>ICC for assessment of luminal narrowing, plaque composition, and high-risk features were, respectively, 0.65 (95% confidence intervals [CI] 0.59-0.69), 0.64 (95%CI 0.45-0.80), and 0.45 (95%CI 0.22-0.66) for non-certified versus 0.78 (95%CI 0.74-0.81), 0.88 (95%CI 0.79-0.93), and 0.89 (95%CI 0.81-0.95) for DGK-certified readers (p < 0.001 for all). ICC for the assessment of wall motion, perfusion, and LGE were, respectively, 0.41 (95%CI 0.35-0.48), 0.27 (95%CI 0.18-0.38), and 0.48 (95%CI 0.41-0.54) for non-certified versus 0.71 (95%CI 0.67-0.75), 0.71 (95%CI 0.67-0.75) and 0.67 (95%CI 0.62-0.71) for DGK-certified readers (p < 0.001 for all). The agreement was excellent among DGK-certified readers for obstructive CAD (≥ 70% lumen narrowing) assessed by CCTA and high for abnormal perfusion and for LGE by CMR in a per-patient analysis (0.88; 95%CI 0.79-0.94 and 0.84; 95%CI 0.71-0.92), respectively.</p><p><strong>Conclusion: </strong>Substantially better CCTA and CMR reporting was observed for DGK-certified cardiologists, who achieved high agreement for diagnosing the presence or absence of obstructive CAD by CCTA and abnormal perfusion by CMR. Since important clinical decisions may be based on these readings, our data support quality-controlled education programs for advanced cardiac imaging.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}