Expert Review of Cardiovascular Therapy最新文献

Pre-hospital delay and mortality in different age groups with acute coronary syndrome: do we have enough evidence? 不同年龄组急性冠状动脉综合征的院前延误和死亡率：我们有足够的证据吗？

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-05-16 DOI: 10.1080/14779072.2025.2505434

Dávid Bauer, Viktor Kočka

{"title":"Pre-hospital delay and mortality in different age groups with acute coronary syndrome: do we have enough evidence?","authors":"Dávid Bauer, Viktor Kočka","doi":"10.1080/14779072.2025.2505434","DOIUrl":"10.1080/14779072.2025.2505434","url":null,"abstract":"Introduction: Pre-hospital delay (p-HD) in acute coronary syndrome (ACS) influences the ability to perform percutaneous coronary intervention in a timely manner. Many factors, including age, have been identified to affect p-HD. An association between different age groups and p-HD in various ACS types is unclear. Moreover, data regarding the relationship between p-HD, age, and mortality are inconsistent.Areas covered: In this review, we present current evidence of how p-HD influences mortality in various age groups and subtypes of ACS. Specific subgroups with knowledge gaps and future perspectives are identified.Expert opinion: We identify specific subgroups of ACS where p-HD affects mortality in different age groups. First, p-HD may significantly affect the long-term prognosis of younger STEMI patients. Second, NSTEMI with known or presumed complex coronary lesions, often related to older age groups, might significantly benefit from p-HD reduction. Third, NSTEMI with ongoing myocardial infarction suffer from considerable p-HD, irrespective of age. These patients might benefit from reduced p-HD by improved education, public awareness, and increased medical service vigilance. Finally, incorporating artificial intelligence (AI) in pre-hospital care may provide further p-HD reduction.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Why low-dose aspirin remains an important antiplatelet in the management of chronic coronary syndromes. 为什么低剂量阿司匹林在慢性冠状动脉综合征治疗中仍然是一种重要的抗血小板药物。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-05-13 DOI: 10.1080/14779072.2025.2505439

Dirk Sibbing, Augusto María Lavalle Cobo, Zhongwei Shi, Gerhard Albrecht, Li Li

{"title":"Why low-dose aspirin remains an important antiplatelet in the management of chronic coronary syndromes.","authors":"Dirk Sibbing, Augusto María Lavalle Cobo, Zhongwei Shi, Gerhard Albrecht, Li Li","doi":"10.1080/14779072.2025.2505439","DOIUrl":"https://doi.org/10.1080/14779072.2025.2505439","url":null,"abstract":"Introduction: Low-dose aspirin has been the cornerstone of single and dual antiplatelet treatment across the cardiovascular risk continuum. It has a well-established efficacy and safety profile, supported by large-scale, placebo-controlled trials as well as long-standing clinical experience. Low-dose aspirin has the highest recommendations in international guidelines for patients with chronic coronary syndromes (CCS), including a lifelong recommendation in patients post vascular interventions and those without prior myocardial infarction or revascularization but with evidence of significant obstructive coronary artery disease.P2Y12 inhibitors - including clopidogrel, ticagrelor, and prasugrel - have recently been explored as an alternatives to low-dose aspirin in patients with CCS, with various trials comparing their efficacy and safety to aspirin.Areas covered: We reviewed the pharmacodynamic and pharmacokinetic properties of low-dose aspirin and P2Y12 inhibitors, data from trials and meta-analyses, and factors that may influence adherence to therapy.Expert opinion: The usefulness and generalizability of the current data on P2Y12 inhibitor monotherapy are limited by a lack of large-scale, multicenter, multiethnic trials. Furthermore, P2Y12 inhibitors lack the evidence for long-term safety and efficacy that are associated with low-dose aspirin. We feel that low-dose aspirin remains a cornerstone therapy in the management of patients with CCS.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Secundum atrial septal defects in adults: all you need to know with an emphasis on outcome. 成人二次房间隔缺损：所有你需要知道的重点是结果。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-04-01 Epub Date: 2025-05-02 DOI: 10.1080/14779072.2025.2495235

Qusi Shaban, Ziyad M Hijazi

{"title":"Secundum atrial septal defects in adults: all you need to know with an emphasis on outcome.","authors":"Qusi Shaban, Ziyad M Hijazi","doi":"10.1080/14779072.2025.2495235","DOIUrl":"10.1080/14779072.2025.2495235","url":null,"abstract":"Introduction: Atrial septal defect is the most common congenital heart disease in adults. The secundum defect is the most common anatomical variant. Atrial septal defect usually causes subtle or no symptoms in pediatrics. However, as patients age, the left-to-right shunt increases and more symptoms appear. Atrial septal defect closure is indicated when there is a clinically significant left-to-right shunt, either by echocardiographic data in terms of right-sided dilation, hemodynamic parameters with Qp:Qs ratio over 1.5:1, or the appearance of clinical symptoms.Areas covered: This article reviews secundum atrial septal defects (ASD) with emphasis on device closure outcome in comparison to surgical approaches. The article covers ASD anatomy, pathophysiology, clinical presentation, natural history, imaging evaluation, indications for closure, suitability for transcatheter closure, and outcome of both device closure and surgical closure in the adult patients.Expert opinion: Atrial septal defect closure can be performed either via a transcatheter approach or a surgical approach. The transcatheter approach is preferred worldwide to close secundum ASDs, provided they meet certain anatomical criteria (size and rim sufficiency). The transcatheter approach is more cost-effective, requires a shorter hospital stay, and has similar outcomes with a lower incidence of complications.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"165-178"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cardiac myosin inhibition in hypertrophic cardiomyopathy: review of the evolving evidence base. 肥厚性心肌病的心肌肌球蛋白抑制：不断发展的证据基础的回顾。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-04-01 Epub Date: 2025-05-06 DOI: 10.1080/14779072.2025.2497847

Milind Y Desai, Robert O Bonow

{"title":"Cardiac myosin inhibition in hypertrophic cardiomyopathy: review of the evolving evidence base.","authors":"Milind Y Desai, Robert O Bonow","doi":"10.1080/14779072.2025.2497847","DOIUrl":"10.1080/14779072.2025.2497847","url":null,"abstract":"Introduction: There is an unmet need for effective medical therapies in the treatment of obstructive hypertrophic cardiomyopathy (HCM). This is changing with emergence of cardiac myosin inhibitors (CMI), which reduce cardiac myocyte hypercontractility, normalize left ventricular function, and reduce left ventricular outflow tract obstruction. Mavacamten and aficamten are the first 2 drugs in this class with high-quality phase III randomized clinical trial data (Based on PUBMED search, last query April 2025).Areas covered: In the current review, we perform a detailed analysis of the background characteristics, primary endpoints, efficacy, and safety data available from 4 phase III randomized trials in which mavacamten and aficamten were tested against placebo. This includes understanding clinically meaningful class-based effects vs. specific drug differences.Expert opinion: CMI therapy represents an exciting evolution in management of HCM patients, targeting for the first time the underlying pathophysiologic mechanisms of the disease. There is a growing body of evidence based on high-quality scientific investigation that are broadening the therapeutic options for patients with this condition. However, as different drugs emerge in the same class, it is crucial to appreciate clinically meaningful class-based effects vs. specific drug differences.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"153-163"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Antithrombotic therapy after left atrial appendage occlusion. 左心耳闭塞后的抗血栓治疗。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-04-01 Epub Date: 2025-04-03 DOI: 10.1080/14779072.2025.2486154

Carmelo Raffo, Antonio Greco, Davide Capodanno

{"title":"Antithrombotic therapy after left atrial appendage occlusion.","authors":"Carmelo Raffo, Antonio Greco, Davide Capodanno","doi":"10.1080/14779072.2025.2486154","DOIUrl":"10.1080/14779072.2025.2486154","url":null,"abstract":"Introduction: Left atrial appendage occlusion (LAAO) represents a strategy to minimize thromboembolic risk in atrial fibrillation (AF) patients. However, LAAO carries some risks of periprocedural bleeding, device embolization, peri-device leaks or device-related thrombosis; the latter is due to direct blood contact with the device, justifying and represents the rationale behind antithrombotic therapy following LAAO.Areas covered: A comprehensive literature search (PubMed, Web of Science, Cochrane) has been performed up to November 2024. Antithrombotic drugs after LAAO include vitamin K antagonists (VKA), direct oral anticoagulants (DOAC), antiplatelet drugs, and their combinations. Initially, high-intensity regimens were implemented, while current strategies prioritize simplified approaches to promote device healing without increasing the bleeding risk. The aims of our review were to define the rationale and implications for post-LAAO antithrombotic therapy and provide an overview of current evidence on various antithrombotic regimens.Expert opinion: The optimal post-LAAO antithrombotic regimen remains controversial, highlighting the need for randomized trials on this topic. Current data suggest that DOACs have the lowest probability of thromboembolic events and major bleeding, while DAPT may be preferred in patients who do not tolerate OAC; finally, single antiplatelet therapy or no antithrombotic therapy are alternative options for patients at high bleeding risk.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"141-152"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Optimizing the management of tricuspid regurgitation: an update on current treatment strategies and perspectives. 优化三尖瓣反流的管理：当前治疗策略和观点的更新。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-04-01 Epub Date: 2025-04-06 DOI: 10.1080/14779072.2025.2488869

Domenico Angellotti, Anna Franzone, Nicolas Brugger, David Reineke, Giovanni Esposito, Fabien Praz

{"title":"Optimizing the management of tricuspid regurgitation: an update on current treatment strategies and perspectives.","authors":"Domenico Angellotti, Anna Franzone, Nicolas Brugger, David Reineke, Giovanni Esposito, Fabien Praz","doi":"10.1080/14779072.2025.2488869","DOIUrl":"10.1080/14779072.2025.2488869","url":null,"abstract":"Introduction: Tricuspid regurgitation (TR) is a prevalent condition and is independently associated with high morbidity and mortality rates. Despite its prognostic impact, TR remains undertreated, with patients often referred at late stages when medical therapy is ineffective and surgical intervention high risk. Emerging transcatheter therapies offer a promising alternative for safer and effective management of this elderly patient population with numerous comorbidities.Areas covered: This review highlights recent advances in treatment strategies and future directions for addressing significant TR. The literature search was conducted across the PubMed, Embase, Scopus, and Google Scholar databases. A structured search strategy was developed using 'tricuspid regurgitation' and 'management' or 'treatment' or 'therapy' and 'surgery' or 'tricuspid valve repair' or 'tricuspid valve replacement' or 'transcatheter tricuspid intervention' as MeSH terms and keywords. Selected articles from 2017 to present were critically analyzed for strengths, limitations, and gaps in evidence.Expert opinion: Enhancing disease awareness, the involvement of multidisciplinary Heart Team and intervening earlier are critical priorities for TR therapies to prevent treatment futility. Improved device designs, more performant imaging techniques, and dedicated research endpoints will help optimizing the management of TR.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"131-139"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What is the impact of dynamic score reassessment for stroke and bleeding risk outcome prediction in atrial fibrillation patients? 动态评分重估对房颤患者卒中和出血风险结局预测有何影响？

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-04-01 Epub Date: 2025-04-10 DOI: 10.1080/14779072.2025.2489725

Eva Soler-Espejo, Francisco Marín, Vanessa Roldán, José Miguel Rivera-Caravaca

{"title":"What is the impact of dynamic score reassessment for stroke and bleeding risk outcome prediction in atrial fibrillation patients?","authors":"Eva Soler-Espejo, Francisco Marín, Vanessa Roldán, José Miguel Rivera-Caravaca","doi":"10.1080/14779072.2025.2489725","DOIUrl":"10.1080/14779072.2025.2489725","url":null,"abstract":"Introduction: Dynamic reassessment of stroke and bleeding risks is a cornerstone of patient-centered care in atrial fibrillation (AF) management. Unlike traditional approaches that evaluate these risks only at diagnosis or at initiation of oral anticoagulation, current evidence emphasizes periodic reassessment due to the evolving nature of risks.Areas covered: Stroke and bleeding risks in AF patients are influenced by aging, new comorbidities, and worsening health conditions, requiring updates to management plans to optimize outcomes. Dynamic increases in CHA2DS2-VASc (or the sex-less CHA2DS2-VA) and HAS-BLED scores are associated with heightened risks of stroke and bleeding, underscoring the need for regular reassessment. Addressing modifiable risk factors such as hypertension, renal dysfunction, and concurrent medications is key to improving outcomes. Although several guidelines now recommend risk reassessment at least annually, optimal timing remains unclear. Evidence supports more frequent reassessments for low-risk stroke patients (every 4 months) and high-risk bleeding patients (within 4-6 weeks) to promptly identify changes requiring intervention.Expert opinion: Despite its benefits, challenges remain regarding risk reassessment, including the lack of universally applicable intervals and the complexity of multidisciplinary evaluations. Future advancements in artificial intelligence tools are expected to enhance risk reassessment by enabling more precise, personalized, and dynamic patient management.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"107-112"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patient-centric no-option refractory angina management: establishing comprehensive angina relief (CARE) clinics. 以患者为中心的无选择难治性心绞痛管理：建立综合心绞痛缓解（CARE）诊所。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-04-01 Epub Date: 2025-04-10 DOI: 10.1080/14779072.2025.2488859

Balaj Rai, Mehmet Yildiz, Jarrod Frizzell, Odayme Quesada, Timothy D Henry

{"title":"Patient-centric no-option refractory angina management: establishing comprehensive angina relief (CARE) clinics.","authors":"Balaj Rai, Mehmet Yildiz, Jarrod Frizzell, Odayme Quesada, Timothy D Henry","doi":"10.1080/14779072.2025.2488859","DOIUrl":"10.1080/14779072.2025.2488859","url":null,"abstract":"Introduction: Refractory angina (RA) is a debilitating condition characterized by persistent angina despite optimized medical therapy and limited options for further revascularization, leading to diminished quality of life and increased healthcare utilization. The RA patient population is rapidly expanding with significant unmet needs. Specialty clinics should be developed to focus on the long-term efficacy and safety of clinically available and novel treatment strategies, emphasizing quality of life.Areas covered: Patient-focused Comprehensive Angina Relief (CARE) clinics can enhance care and outcomes by providing individualized management for complex RA. This review summarizes peer-reviewed articles from PubMed and trial data from ClinicalTrials.gov. We discuss the epidemiology and pathophysiology of RA, introduce standardized tools for evaluating angina and psychosocial factors, and address symptom management. We also review treatment options such as risk factor modification, medication, and complex revascularization. Additionally, we explore emerging therapies, including coronary sinus occlusion, regenerative therapy, and neuromodulation for 'no-option' RA.Expert opinion: In the next five years, patients with refractory chest pain with or without coronary artery disease will increasingly be referred to specialty clinics for follow-up. Conducting more randomized control clinical trials with larger population subsets will bring novel therapies to the forefront.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"113-129"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Coronary atherosclerotic plaque modification: the present and the future. 冠状动脉粥样硬化斑块修饰：现在和未来。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-01-01 Epub Date: 2025-03-05 DOI: 10.1080/14779072.2025.2476132

Panagiotis Theofilis, Aggelos Papanikolaou, Paschalis Karakasis, Kyriakos Dimitriadis, Panayotis K Vlachakis, Evangelos Oikonomou, Konstantinos Tsioufis, Dimitris Tousoulis

{"title":"Coronary atherosclerotic plaque modification: the present and the future.","authors":"Panagiotis Theofilis, Aggelos Papanikolaou, Paschalis Karakasis, Kyriakos Dimitriadis, Panayotis K Vlachakis, Evangelos Oikonomou, Konstantinos Tsioufis, Dimitris Tousoulis","doi":"10.1080/14779072.2025.2476132","DOIUrl":"10.1080/14779072.2025.2476132","url":null,"abstract":"Introduction: Coronary atherosclerosis, marked by lipid deposition and inflammation, drives cardiovascular morbidity. Traditional treatments focus on lipid reduction, yet newer therapies target plaque composition, aiming to enhance stability and prevent coronary events.Areas covered: A comprehensive literature search was conducted across PubMed, Embase, and Scopus till January 2025 to identify studies on coronary plaque modification. This review highlights current and emerging therapies for coronary plaque modification. Key pharmacologic agents include Proprotein convertase subtilisin/kexin type 9 inhibitors for lipid management, colchicine for inflammation control, and Glucagon-like peptide-1 receptor agonists, and Sodium-glucose cotransporter-2 inhibitors for metabolic benefits. Clinical trials indicate these agents' roles in reducing plaque volume and vulnerability. Advances in imaging and biomarkers, such as lipoprotein(a) and inflammatory markers, enable refined monitoring of plaque changes over time.Expert opinion: Future management of atherosclerosis may involve personalized strategies, integrating AI-driven predictive tools and biomarkers to assess individual plaque characteristics and optimize therapy. Continued exploration of targeted anti-inflammatory therapies and novel biomarkers like Lp(a) could enhance outcomes, offering a more precise approach to reducing cardiovascular risk and stabilizing high-risk plaques.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"65-71"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impella effects on reverse myocardial remodeling in anterior ST-elevation myocardial infarction: insights from a comprehensive analysis of acute and chronic MRI findings. 前段st段抬高型心肌梗死中Impella对逆转心肌重构的影响：来自急性和慢性MRI结果综合分析的见解。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-01-01 Epub Date: 2025-03-11 DOI: 10.1080/14779072.2025.2476129

Daisuke Fukamachi, Akimasa Yamada, Kurara Takahashi, Ran Sumida, Yudai Tanaka, Shohei Migita, Saki Mizobuchi, Masatsugu Miyagawa, Hidesato Fujito, Yutaka Koyama, Akihito Oogaku, Katsunori Fukumoto, Riku Arai, Yasunari Ebuchi, Masaki Monden, Tomoyuki Morikawa, Takashi Mineki, Keisuke Kojima, Nobuhiro Murata, Mitsumasa Sudo, Daisuke Kitano, Naoya Matsumoto, Yasuo Okumura

{"title":"Impella effects on reverse myocardial remodeling in anterior ST-elevation myocardial infarction: insights from a comprehensive analysis of acute and chronic MRI findings.","authors":"Daisuke Fukamachi, Akimasa Yamada, Kurara Takahashi, Ran Sumida, Yudai Tanaka, Shohei Migita, Saki Mizobuchi, Masatsugu Miyagawa, Hidesato Fujito, Yutaka Koyama, Akihito Oogaku, Katsunori Fukumoto, Riku Arai, Yasunari Ebuchi, Masaki Monden, Tomoyuki Morikawa, Takashi Mineki, Keisuke Kojima, Nobuhiro Murata, Mitsumasa Sudo, Daisuke Kitano, Naoya Matsumoto, Yasuo Okumura","doi":"10.1080/14779072.2025.2476129","DOIUrl":"10.1080/14779072.2025.2476129","url":null,"abstract":"Background: Late adverse myocardial remodeling after ST elevation myocardial infarction (STEMI) is strongly associated with cardiac death. Global Longitudinal strain (GLS) and circumferential diastolic strain rate (CDSR) derived cardiovascular magnetic resonance imaging (CMRI) is a powerful predictor of late myocardial remodeling. However, the Impella's effects on CMRI after STEMI are not fully understood.Research design and methods: We retrospectively compared the CMRI in the acute (18 [14-22] vs. 14 [6-22] days, p = 0.43) and chronic phases (118 [102-242] vs. 117 [101-202] days, p = 1.0) after anterior STEMI.Results: Five patients received Impella before percutaneous coronary intervention (PCI), and seven underwent intra-aortic balloon pumping (IABP). There were no significant differences in the peak creatine kinase levels (2595 [2069 -12,932] vs. 4372 [2941-5601] IU/L, p = 0.76) and LVEF upon admission (51 ± 11 vs. 50 ± 9%, p = 1.0). The Impella group had significantly better acute CMRI-derived LVEF (49 ± 10 vs. 35 ± 7%, p = 0.02) and CDSR (0.9 ± 0.2 vs. 0.5 ± 0.3 s- 1, p = 0.018). In the chronic phase, the CMRI-derived LVEF and GLS were significantly higher in the Impella group (54 ± 9 vs. 39 ± 5%, p = 0.01; -9.9 ± 1.3 vs. -6.5 ± 2.2%, p = 0.01).Conclusions: The Impella implantation led to better LVEF and CDSR in the acute phase than IABP and better maintenance of both the LVEF and GLS through the chronic phase.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"97-105"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0