Clinical Research in Cardiology最新文献

{"title":"Inflammatory risk and clinical outcomes according to polyvascular atherosclerotic disease status in patients undergoing PCI.","authors":"Benjamin Bay, Birgit Vogel, Raman Sharma, Samantha Sartori, Pier Pasquale Leone, Mashal Nathani, Angelo Oliva, Kenneth F Smith, Amit Hooda, Joseph Sweeny, George Dangas, Annapoorna Kini, Prakash Krishnan, Samin K Sharma, Roxana Mehran","doi":"10.1007/s00392-024-02471-w","DOIUrl":"10.1007/s00392-024-02471-w","url":null,"abstract":"<p><strong>Background: </strong>Individuals suffering from polyvascular atherosclerotic disease (PolyVD) face a higher likelihood of adverse cardiovascular events. Additionally, inflammation, assessed by high-sensitivity C-reactive protein (hsCRP), affects residual risk following percutaneous coronary intervention (PCI). We aimed to explore the interplay between PolyVD and hsCRP in terms of clinical outcomes after PCI.</p><p><strong>Methods: </strong>Patients undergoing PCI for chronic coronary disease at a tertiary center between January 2012 and February 2020 were included for the current analysis. PolyVD was defined by additional history of cerebrovascular and/or peripheral artery disease. HsCRP levels were defined as elevated when the measured baseline concentration was > 3 mg/L. The primary outcome of interest was major adverse cardiovascular events (MACE), a composite of all-cause mortality, spontaneous MI, or target vessel revascularization.</p><p><strong>Results: </strong>Overall, 10,359 participants were included in the current study, with 17.4% affected by PolyVD and 82.6% included in the non-PolyVD subgroup. Patients with PolyVD had higher hsCRP levels than those without. Among the PolyVD group, a larger proportion (33.6%) exhibited elevated hsCRP compared to the non-PolyVD group (24.7%). Patients with both PolyVD and elevated hsCRP levels had significantly higher adverse event rates than all other subgroups at 1-year follow-up. Furthermore, an independent association between elevated hsCRP and MACE was observed within the PolyVD population, while this was not the case for individuals without PolyVD.</p><p><strong>Conclusion: </strong>A residual risk of adverse outcomes after PCI linked to inflammation appears to be present among individuals with PolyVD. This could help define further target populations for anti-inflammatory treatment options.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"969-977"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426504","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":"Validation of complex PCI criteria in drug-coated balloon angioplasty.","authors":"Francesco Tartaglia, Mauro Gitto, Pier Pasquale Leone, Mauro Chiarito, Gianmaria Calamita, Gianluca Mincione, Gabriele Gasparini, Bernhard Reimers, Ottavia F Cozzi, Marco L Rossi, Giulio G Stefanini, Damiano Regazzoli, Antonio Mangieri, Antonio Colombo","doi":"10.1007/s00392-025-02664-x","DOIUrl":"10.1007/s00392-025-02664-x","url":null,"abstract":"<p><strong>Background: </strong>Procedural complexity during percutaneous coronary interventions (PCI) with drug-eluting stent (DES) has been associated with adverse events, especially in case of long and multiple stents implantation.</p><p><strong>Objective: </strong>This study aims to validate contemporary complex PCI criteria for drug coated balloon (DCB)-based PCI.</p><p><strong>Methods: </strong>Consecutive patients undergoing DCB angioplasty at 2 Italian centers from 2018 to 2023 were retrospectively enrolled. Complex DCB-PCI was defined as the presence of at least 1 of the 6 following features: 3 vessels treated; ≥ 3 lesions treated; ≥ 3 devices (DES or DCB) used; bifurcation treated with 2 devices; total device length (DES + DCB) > 60 mm; CTO as target lesion. The primary endpoint was the 2 year incidence of target lesion failure (TLF), a composite of target lesion revascularization (TLR), target vessel-myocardial infarction and cardiac death, at time-to-first event analysis.</p><p><strong>Results: </strong>A total of 1279 patients were included, of whom 642 (50.2%) met complex PCI criteria. The most frequently met criteria was \"total device length > 60 mm\" (71.6% in the complex PCI group). The proportion of in-stent restenosis (ISR) was 30.8% in the complex DCB-PCI group and 43.8% in the non-complex PCI group (p < 0.001). After adjusting for relevant clinical covariates and for the presence of ISR, patients undergoing complex PCI had a higher incidence of TLF at 2 years as compared to those undergoing non-complex PCI (16.7 vs. 11.4%; adj. hazard ratio 1.73, 95% confidence interval 1.16-2.59, p = 0.007). However, such difference was significant only in the ISR subgroup, while outcomes of complex and non-complex PCI for de novo lesions were similar.</p><p><strong>Conclusions: </strong>In a real-world cohort of patients undergoing DCB angioplasty, complex PCI criteria were frequently met and associated with higher risk of TLF. However, their prognostic impact was limited in patients with de novo coronary lesions treated with DCB.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1059-1070"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092994","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":"New avenues for the assessment of stable ischemic heart disease.","authors":"Peter Ong, Johanna McChord, Valeria Martínez Pereyra, Udo Sechtem, Raffi Bekeredjian, Andreas Seitz","doi":"10.1007/s00392-024-02483-6","DOIUrl":"10.1007/s00392-024-02483-6","url":null,"abstract":"<p><p>Myocardial ischemia is a complex condition which may result from epicardial and/or microvascular causes involving functional and structural mechanisms. These mechanisms may overlap in a given patient illustrating the difficulties for appropriate management. Assessment of myocardial ischemia can be performed using noninvasive and invasive tools. However, despite living in the era of individualized precision medicine, these tools are not yet used in a broader fashion. Emerging noninvasive techniques such as quantitative perfusion cardiac magnetic resonance imaging (CMR) and stress perfusion computed tomography (CT) or photon-counting CT techniques may contribute to new standards in the assessment of stable angina patients. Invasive evaluation of myocardial ischemia should not only focus on hemodynamically relevant epicardial disease but also involve coronary vasomotor function testing (coronary spasm, coronary flow reserve, and microvascular resistance) where appropriate. Optimal patient management will depend on accurate and comprehensive diagnostic evaluation of myocardial ischemia and development of new treatment options in the future.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"945-951"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442249","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":"Absorb® bioresorbable scaffold in \"established\" versus \"off-label\" coronary lesions: 5-year data from the GABI-R® registry.","authors":"Aydin Huseynov, Michael Behnes, Holger Nef, Thomas Riemer, Steffen Schneider, Thomas Pfannebecker, Stephan Achenbach, Julinda Mehilli, Thomas Münzel, Tommaso Gori, Jochen Wöhrle, Ralf Zahn, Johannes Kastner, Axel Schmermund, Gert Richardt, Christian W Hamm, Ibrahim Akin","doi":"10.1007/s00392-025-02707-3","DOIUrl":"10.1007/s00392-025-02707-3","url":null,"abstract":"<p><strong>Background: </strong>The potential benefits of bioabsorbable stents can be better assessed over the long term. The implantation of bioresorbable scaffold (BRS) in situations with off-label indications provides real-world insights into how clinical events differ in contrast to standard proved indications.</p><p><strong>Objectives: </strong>The study provides long-term follow-up data about the use of bioresorbable scaffold (BRS) for off-label compared with approved indications.</p><p><strong>Methods: </strong>Five-year outcome data of an everolimus-eluting, poly-L-lactic acid-based bioresorbable scaffold system (ABSORB, Abbott Vascular, Santa Clara, CA, USA) were evaluated in the prospective, non-interventional, multicenter real-world German-Austrian ABSORB-RegIstRy (GABI-R). The patients were enrolled from a total of 93 centers. Data processing and prospective follow-up were conducted centrally and independently of industry.</p><p><strong>Results: </strong>A total of 3082 patients were enrolled between 2013 and 2016. Most patients were included into the off-label group (2317, 75.2%). ST-elevation myocardial infarction (STEMI) was significantly more common in the off-label group (35.9% vs. 27.8%, p = 0.003), and the extent of coronary heart disease was higher in the off-label group (coronary 3 vessel disease 28.4% vs. 22.4%, p < 0.001). Patients with off-label indications had statistically significant higher rates of stent thrombosis after 30 days (1.08% vs. 0.26%, p = 0.04) and target vessel failure (TVF) after 6 months (4.62% vs. 2.61%, p = 0.02).</p><p><strong>Conclusions: </strong>The off-label use of BRS is associated with a higher rate of stent thrombosis in the short term and in the long term with higher MACE events considering more complex lesions and a higher morbidity. In the long term, there are no differences regarding stent thrombosis.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1084-1094"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subtle echocardiographic markers of CAD: looking beyond the LV ejection fraction in stable angina patients.","authors":"Harshit Khare, Satyendra Tewari, Ankit Sahu, Prabhaker Mishra, Roopali Khanna, Sudeep Kumar, Naveen Garg, Aditya Kapoor","doi":"10.1007/s00392-024-02561-9","DOIUrl":"10.1007/s00392-024-02561-9","url":null,"abstract":"<p><strong>Background: </strong>A routine echocardiogram aims at identifying only regional wall motion abnormality (RWMA) or left ventricle diastolic dysfunction (LVDD) for coronary artery disease (CAD). When absent, a study is often labeled \"normal.\" This creates an unmet need to identify and add subtle markers of CAD to the routine echocardiogram to increase the diagnostic yield.</p><p><strong>Methods: </strong>Left ventricle (LV) systolic and diastolic parameters, along with left atrium (LA) strain parameters, were assessed using echocardiography in one hundred three patients of stable angina undergoing coronary angiography and compared with their SYNTAX score-II (SS-II).</p><p><strong>Results: </strong>The left ventricle global longitudinal strain (LV-GLS) and LA Volume indexed (LAVi) did not correlate significantly with the SS-II. The LA filling pressures reflected by the ratio of early mitral inflow velocity with early mitral annular velocity (E/e`), however, increased significantly with SS-II, with a cut-off value >10.39 for significant CAD (pvalue <0.001). The LA reservoir function parameters, peak atrial longitudinal strain (PALS), and peak global systolic strain rate (LAsSR) decreased significantly with increasing SS-II (p values of 0.011 and 0.001, respectively). The values < 23.56 for PALS and less than 1.15 for LAsSR, showed a significant association with CAD. The LA conduit function parameter, peak global early diastolic strain rate (LAeSR), also increased significantly with increasing SS-II (p-value <0.001), with values > 1.09 having a good correlation with CAD.</p><p><strong>Conclusion: </strong>Besides RWMA and LV-GLS, the LV diastolic and LA strain parameters can be potential echocardiographic markers for CAD in stable angina patients.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1019-1029"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459738","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":"Clinical outcomes after complex and high-risk percutaneous coronary intervention according to baseline chronic kidney disease.","authors":"Francesca Maria Di Muro, Samantha Sartori, Birgit Vogel, Yihan Feng, Mauro Gitto, Angelo Oliva, Prakash Krishnan, Benjamin Bay, Joseph Sweeny, Pedro Moreno, Parasuram Krishnamoorthy, George Dangas, Annapoorna Kini, Samin Sharma, Roxana Mehran","doi":"10.1007/s00392-025-02618-3","DOIUrl":"10.1007/s00392-025-02618-3","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is associated with unfavorable outcomes in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). However, its prognostic role in patients undergoing complex high-risk PCI (CHIP) remains unexplored, prompting our investigation.</p><p><strong>Methods: </strong>Consecutive CHIP patients treated at a tertiary care center from 2012 to 2022 were included in the current analysis. CHIP was identified by the presence of at least one patient and one procedural criterion from a validated score. Patients were stratified by CKD status, with CKD defined as eGFR < 60 ml/min/1.73m². The primary endpoint was one-year incidence of major adverse cardiovascular events (MACE), including all-cause mortality, spontaneous myocardial infarction (MI), and stroke. A multivariable Cox regression model was computed adjusted for relevant baseline risk factors and comorbidities.</p><p><strong>Results: </strong>Among 4855 CHIP patients, 39.6% (n = 1925) had CKD at baseline. CKD patients were older, with more comorbidities, and complex CAD. After multivariable adjustment, CKD was associated with increased 1-year risks of MACE (primarily driven by all-cause mortality and MI rates), and bleeding. In-hospital adjusted hazards for ischemic and bleeding events were similar between the two cohorts, while CA-AKI occurred twice as often in CKD patients compared to non-CKD ones.</p><p><strong>Conclusions: </strong>In CHIP patients, CKD is a strong predictor of ischemic and bleeding events at one-year follow-up and doubles the risk of post-procedural CA-AKI, underscoring the need for tailored risk assessment and management of this vulnerable population.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1049-1058"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490463","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":"Novel prognostic impact and cell specific role of endocan in patients with coronary artery disease.","authors":"Liang-Yu Lin, Ting-Ting Chang, Hsin-Bang Leu, Chin-Chou Huang, Tao-Cheng Wu, Ruey-Hsin Chou, Po-Hsun Huang, Wei-Hsian Yin, Wei-Kung Tseng, Yen-Wen Wu, Tsung-Hsien Lin, Hung-I Yeh, Kuan-Cheng Chang, Ji-Hung Wang, Chau-Chung Wu, Jaw-Wen Chen","doi":"10.1007/s00392-024-02458-7","DOIUrl":"10.1007/s00392-024-02458-7","url":null,"abstract":"<p><strong>Background: </strong>Both the clinical and mechanistic impacts of endocan were not well elucidated especially in coronary artery disease (CAD).</p><p><strong>Objective: </strong>This study aimed to investigate the prognostic and potential pathological role of endocan for cardiovascular (CV) events in stable CAD patients.</p><p><strong>Methods: </strong>A total of 1,071 stable CAD patients with previous percutaneous coronary intervention (PCI) were enrolled prospectively in a nationwide Biosignature study. Another cohort of 76 CAD patients with or without PCI were enrolled for validation. Baseline biomarkers including endocan level was measured and total CV events especially hard CV events (including CV mortality, non-fatal myocardial infection and stroke) during follow-up were identified. Circulating endothelial progenitor cells (EPCs) as an in vivo biological contributor to vascular repairment from CAD patients were used for the in vitro functional study.</p><p><strong>Results: </strong>After 24 months, there were 42 patients (3.92%) with hard CV events and 207 (19.3%) with total CV events in the study group. The incidence of both events was increased with the tertiles of baseline endocan level (hard events: 1.7%,3.4%, and 6.7% in 1st,2nd, and 3rd tertile respectively, p = 0.002; total events: 13.8%vs.16.2%vs.28.0%, p < 0.0001). Multivariate regression analysis revealed the independent association of endocan level with total and hard CV events. These findings were validated in another cohort with a 5-year follow-up. Furthermore, in vitro inhibition of endocan improved cell migration and tube formation capacities, and reduced cell adhesiveness of EPCs from CAD patients.</p><p><strong>Conclusions: </strong>Endocan might be a novel prognostic indicator, mechanistic mediator, and potential therapeutic target for clinical CAD.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"952-968"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140915917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative flow ratio of the donor coronary artery supplying a chronic total occlusion territory.","authors":"Karim Elbasha, Sultan Alotaibi, Mohamed Samy, Nader Mankerious, Ralph Toelg, Volker Geist, Gert Richardt, Abdelhakim Allali","doi":"10.1007/s00392-024-02589-x","DOIUrl":"10.1007/s00392-024-02589-x","url":null,"abstract":"<p><strong>Background: </strong>Coronary physiology to guide multi-vessel coronary intervention is associated with better outcome. In the presence of a coronary chronic total occlusion (CTO), hemodynamic evaluation of intermediate lesions in the donor coronary artery supplying a CTO territory still has limitations. We aim to evaluate implementing quantitative flow ratio (QFR) in assessing angiographically intermediate lesions of the main donor coronary artery supplying a CTO territory.</p><p><strong>Methods: </strong>We recruited 219 patients with a single main donor vessel to a CTO territory from a single-center CTO registry between 2017 and 2020. Angiographically intermediate coronary lesions of the donor vessels were evaluated using offline QFR before and at a median of 6 months after successful percutaneous coronary intervention (PCI) of CTO.</p><p><strong>Results: </strong>The mean age of the study population was 66.9 ± 11.3 years, and 77.6% were males. Three-vessel disease was documented in 49.8%. The mean QFR value increased significantly in the donor vessels after successful CTO revascularization (0.93 ± 0.062 vs. 0.95 ± 0.046, p < 0.001) and was more prominent in donor vessels with angiographically intermediate stenosis (0.88 ± 0.063 vs. 0.92 ± 0.053, p < 0.001). While the change in QFR was not significant in angiographically normal donor vessel (0.97 ± 0.025 vs. 0.97 ± 0.026, p = 0.814). Fifteen patients had hemodynamically significant stenosis in the donor coronary artery (QFR ≤ 0.80) before CTO-PCI. Among those patients, 40% (n = 6) were turned to be non-significant with QFR > 0.80 after CTO recanalization, and 30% (n = 5) patients remained significant and were treated with PCI.</p><p><strong>Conclusion: </strong>QFR overestimates the severity of intermediate coronary lesions of a donor vessel supplying a CTO territory like other invasive modalities for physiology assessment.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"1041-1048"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876392","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":"Prognostic impact of E- and A-wave adjacency after atrial fibrillation ablation.","authors":"Jumpei Saito, Kato Daiki, Sato Hirotoshi, Toshihiko Matsuda, Yui Koyanagi, Katsuya Yoshihiro, Yuma Gibo, Ishigaki Shigehiro, Soichiro Usumoto, Taro Kimura, Suguru Shimazu, Wataru Igawa, Seitaro Ebara, Toshitaka Okabe, Naoei Isomura, Masahiko Ochiai","doi":"10.1007/s00392-025-02714-4","DOIUrl":"https://doi.org/10.1007/s00392-025-02714-4","url":null,"abstract":"<p><strong>Background: </strong>In adult patients with systolic heart failure, the presence of adjacent, nonoverlapping E and A waves on Doppler echocardiography is associated with optimal cardiac output and favorable clinical outcomes. However, the clinical significance of echocardiographic adjacency in patients with atrial fibrillation (AF) remains uncertain. We aimed to explore the relationship between E- and A-wave adjacency assessed the day after catheter ablation and the recurrence of atrial arrhythmias (AR) following AF ablation.</p><p><strong>Methods: </strong>This study included patients with AF who underwent first-time arrhythmia ablation. Transthoracic echocardiography was performed on the day following catheter ablation to evaluate the presence of E- and A-wave adjacency. The relationship between overlap length and recurrence of AR after AF ablation was analyzed.</p><p><strong>Results: </strong>The study included 175 patients (124 males; mean age: 68 [range 52-79] years; mean CHA2DS2-Vasc score: 2 [range 0-4]; and 93 with paroxysmal AF) who underwent AF ablation. There were no significant differences between the two groups in terms of heart failure history or echocardiographic parameters prior to catheter ablation. However, the absolute overlap length was significantly prolonged in the AR group (59 [range 9-160] msec vs. 120 [range 28.6-226] msec; P < .001). Furthermore, the AR rate was significantly lower in the group without prolonged overlap length (hazard ratio, 0.15 [95% confidence interval, 0.07-0.30]; P < .001). These findings were consistent across all AF types.</p><p><strong>Conclusions: </strong>The length of E- and A-wave adjacency appears to be a significant predictor of AR following AF ablation.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741412","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":"Targeted proteomic profiling of transcatheter edge-to-edge repair failure in patients with mitral regurgitation and heart failure.","authors":"Mattia Di Pasquale, Susana Ravassa, Matteo Pagnesi, Edoardo Pancaldi, Begoña López, Gorka San José, Cristina Gussago, Letizia Fiorentino, Alice Ravera, Lisa Serafini, Giuliano Chizzola, Carlo Mario Lombardi, Marco Metra, Arantxa González, Marianna Adamo","doi":"10.1007/s00392-025-02712-6","DOIUrl":"https://doi.org/10.1007/s00392-025-02712-6","url":null,"abstract":"<p><strong>Aims: </strong>To assess the changes in circulating biomarkers concentrations after mitral valve transcatheter edge-to-edge repair (M-TEER) and their relationship with procedural success vs. failure in patients with severe mitral regurgitation (MR) and heart failure (HF).</p><p><strong>Methods and results: </strong>Pre-procedural, post-intervention, and 30 days post-intervention plasma samples were analyzed for 266 different proteins using the Olink Proseek® Multiplex cardiovascular (CVD) II, CVD III, and inflammation panels, in patients with MR undergoing M-TEER. Multiple biomarkers showed a differential expression 30 days after M-TEER in patients with procedural failure vs. those with a successful evolution. The proteins upregulated in patients with procedural failure were functionally enriched in pathways related to immune regulation, inflammation, extracellular matrix organization, and cellular structures. After adjustment for confounding variables, increases in IL2RA, RAGE, IGFBP2, and COL1A1 values at 30 days post-intervention were associated with procedural failure. Changes in IGFBP2 and IL2RA values were also independently associated with pulmonary artery systolic pressure (PASP) increases after M-TEER.</p><p><strong>Conclusion: </strong>In a cohort of patients with severe MR undergoing M-TEER, differences in circulating biomarkers concentrations related to inflammation and fibrosis were observed between patients with procedural success as compared to those with procedural failure. Biomarkers known to be associated with HF severity were over-expressed in patients with procedural failure, compared with those with procedural success, after M-TEER.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728449","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}