Heart and Vessels最新文献

Effectiveness of the repeated 3-time-balloon-inflation method in reducing coronary stent edge dissection. 反复3次球囊充气法减少冠状动脉支架边缘剥离的效果。

IF 1.4 4区医学

Heart and Vessels Pub Date : 2025-08-01 Epub Date: 2024-12-24 DOI: 10.1007/s00380-024-02510-6

Ryosuke Amisaki, Tomomi Watanabe, Satoshi Kobara, Kazuhiro Yamamoto

{"title":"Effectiveness of the repeated 3-time-balloon-inflation method in reducing coronary stent edge dissection.","authors":"Ryosuke Amisaki, Tomomi Watanabe, Satoshi Kobara, Kazuhiro Yamamoto","doi":"10.1007/s00380-024-02510-6","DOIUrl":"10.1007/s00380-024-02510-6","url":null,"abstract":"The optimal procedural protocol for coronary stent deployment remains undetermined. Post-dilation with a high-pressure balloon is often performed to optimize the stent expansion. However, high-pressure dilation also carries the potential risk of coronary artery injury. A previous in vitro study reported that multiple-times balloon inflation at the same pressure resulted in better stent expansion compared to one-time balloon inflation. In our facility, we frequently perform the repeated 3-time-balloon-inflation method, wherein the stent delivery balloon was inflated 3 times at nominal pressure to deploy the stent, to improve stent expansion without high-pressure balloon inflation. Although this method seems effective in avoiding excessive high-pressure dilation, its clinical data are insufficient. In this study, we investigated the clinical outcomes of the repeated 3-time-balloon-inflation method. This retrospective study included 370 patients with 467 stented coronary lesions. These subjects were divided into two groups: one with standard balloon inflation and the other with repeated 3-time balloon inflation, and treatment outcomes were compared. The repeated 3-time-balloon-inflation group had 254 lesions, and the standard-balloon-inflation group had 213 lesions. Stent edge dissection occurred in 6 lesions (2.8%) in the standard-balloon-inflation group, whereas did not occur in the repeated 3-time-balloon-inflation group. A statistically significant difference remained even after propensity score matching (p = 0.040). The final minimum stent area and long-term clinical outcomes were not significantly different between the two groups. The repeated 3-time-balloon-inflation method may reduce stent edge dissection while demonstrating comparable minimal stent area and long-term outcomes to the standard-balloon-inflation method.","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"688-695"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Late gadolinium enhancement in areas with electrically fractionated potentials during sinus rhythm in patients with atrial fibrillation. 心房颤动患者窦性心律期间电分异电位区的晚期钆增强。

IF 1.4 4区医学

Heart and Vessels Pub Date : 2025-08-01 Epub Date: 2025-02-08 DOI: 10.1007/s00380-025-02515-9

Yuya Suzuki, Kunihiko Kiuchi, Mitsuru Takami, Kimitake Imamura, Jun Sakai, Toshihiro Nakamura, Atsusuke Yatomi, Yusuke Sonoda, Hiroyuki Takahara, Kazutaka Nakasone, Kyoko Yamamoto, Kenichi Tani, Hidehiro Iwai, Yusuke Nakanishi, Mitsuhiko Shoda, Shogo Yonehara, Atushi Murakami, Ken-Ichi Hirata, Koji Fukuzawa

{"title":"Late gadolinium enhancement in areas with electrically fractionated potentials during sinus rhythm in patients with atrial fibrillation.","authors":"Yuya Suzuki, Kunihiko Kiuchi, Mitsuru Takami, Kimitake Imamura, Jun Sakai, Toshihiro Nakamura, Atsusuke Yatomi, Yusuke Sonoda, Hiroyuki Takahara, Kazutaka Nakasone, Kyoko Yamamoto, Kenichi Tani, Hidehiro Iwai, Yusuke Nakanishi, Mitsuhiko Shoda, Shogo Yonehara, Atushi Murakami, Ken-Ichi Hirata, Koji Fukuzawa","doi":"10.1007/s00380-025-02515-9","DOIUrl":"10.1007/s00380-025-02515-9","url":null,"abstract":"The areas with electrically fractionated potentials (AEFP) during sinus rhythm are related to non-pulmonary vein triggers and may serve as substrates of atrial fibrillation (AF) maintenance. However, the histological properties of these compounds remain unclear. Therefore, we aimed to evaluate the late gadolinium enhancement (LGE) properties of AEFP in patients with AF. We enrolled 15 patients with AF who had undergone LGE magnetic resonance imaging before catheter ablation. AEFP in the left atrium was detected using the HD-Grid and NavX systems after pulmonary vein isolation. We compared LGE properties between AEFP and the surrounding non-fractionated areas (non-AEFP). LGE heterogeneity and density were evaluated through entropy (LGE entropy) and the volume ratio of the enhancement voxel (LGE volume ratio), respectively. Thirty-three AEFP were detected in the left atrium. LGE entropy and LGE volume ratio were significantly higher in AEFP than in non-AEFP [LGE entropy: 6.2 (6.1-6.4) vs. 5.9 (5.8-6.0), p ≤ 0.0001; LGE volume ratio: 23.0% (17.2-29.0%) vs. 10.4% (3.4-20.2%), p ≤ 0.0001]. The atrial voltages did not differ [2.4 (1.3-3.7) vs. 2.5 (1.9-3.1) mV, p = 0.96]. AF recurrence was more significantly found in patients with more than three AEFP than in those without it (log-rank test: p = 0.009). AEFP is likely to be distributed in heterogeneous and moderate LGE areas, regardless of the atrial voltage.","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"718-725"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Non-invasive pressure-volume loop derived temporal elastance, contractility, and efficiency indices for assessing Duchenne muscular dystrophy patients. 非侵入性压力-容量环路衍生的时间弹性、收缩性和效率指标用于评估杜氏肌营养不良患者。

IF 1.4 4区医学

Heart and Vessels Pub Date : 2025-08-01 Epub Date: 2024-12-28 DOI: 10.1007/s00380-024-02511-5

Israel O Ajiboye, Sean M Lang, Michael D Taylor, Rupak K Banerjee

{"title":"Non-invasive pressure-volume loop derived temporal elastance, contractility, and efficiency indices for assessing Duchenne muscular dystrophy patients.","authors":"Israel O Ajiboye, Sean M Lang, Michael D Taylor, Rupak K Banerjee","doi":"10.1007/s00380-024-02511-5","DOIUrl":"10.1007/s00380-024-02511-5","url":null,"abstract":"Ejection fraction is commonly used to assess Duchenne muscular dystrophy-associated cardiomyopathy (DMDAC), but it may remain normal (wrongly) despite significant myocardial dysfunction in patients. Therefore, better indicators of myocardial dysfunction are needed for longitudinal (with time) assessment and treatment of DMDAC patients. This study evaluates non-invasive LV PV loop-derived elastance, contractility and efficiency in relation to EF for patients developing DMDAC. The current retrospective study includes thirty DMDAC patients who underwent two serial CMR imaging from 2014 to 2023. The patients were divided into EF < 55% and EF ≥ 55%. Brachial pressures from cuff sphygmomanometer and CMR short axis steady-state free-precession images for the LV were acquired, and a non-invasive PV loop algorithm based on temporal elastance was used to derive mean elastance, contractility, and efficiency. While mean elastance and contractility showed moderate correlations (r = 0.56, p < 0.01, and r = 0.65, p < 0.001 respectively), efficiency exhibited a strong correlation with EF (r = 0.97, p < 0.01). Importantly, mean elastance, efficiency, and contractility were significantly lower in the EF < 55% group compared to EF ≥ 55% (p < 0.001). Therefore, these indices could serve as viable diagnostic endpoints for longitudinal evaluation of DMDAC.","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"696-706"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy and safety of atrial fibrillation ablation in patients with aged 80 years or older. Letter to the editor (response to Kataoka N, et al.). 80岁及以上患者心房颤动消融的疗效和安全性。致编辑的信（回复Kataoka N， et al.）。

IF 1.4 4区医学

Heart and Vessels Pub Date : 2025-08-01 Epub Date: 2025-01-28 DOI: 10.1007/s00380-025-02519-5

Kenji Yodogawa, Yu-Ki Iwasaki, Nobuaki Ito, Toshiki Arai, Masato Hachisuka, Yuhi Fujimoto, Kanako Hagiwara, Hiroshige Murata, Yoshiyasu Aizawa, Wataru Shimizu, Kuniya Asai

引用次数: 0

Impact of polyvascular disease severity on acute heart failure prognosis. 多血管疾病严重程度对急性心力衰竭预后的影响。

IF 1.4 4区医学

Heart and Vessels Pub Date : 2025-08-01 Epub Date: 2024-12-01 DOI: 10.1007/s00380-024-02496-1

Marlon V Gatuz, Rami Abu-Fanne, Dmitry Abramov, Mamas A Mamas, Ariel Roguin, Ofer Kobo

{"title":"Impact of polyvascular disease severity on acute heart failure prognosis.","authors":"Marlon V Gatuz, Rami Abu-Fanne, Dmitry Abramov, Mamas A Mamas, Ariel Roguin, Ofer Kobo","doi":"10.1007/s00380-024-02496-1","DOIUrl":"10.1007/s00380-024-02496-1","url":null,"abstract":"Polyvascular disease, is a prevalent comorbidity among patients with acute heart failure (AHF). Previous research has shown that polyvascular disease is a poor prognostic factor in patients with heart failure. However, data on the relationship between the extent of vascular disease involvement and outcomes in AHF patients are limited. Using the National Inpatient Sample from 2016 to 2019, adult patients with AHF were stratified by number of diseased vascular beds and into heart failure with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). The study assessed in-hospital major adverse cardiovascular and cerebrovascular events (MACCE), mortality, cerebrovascular accident (CVA), and major bleeding. Multivariable regression models examined the association between outcomes and number of diseased vascular beds. This analysis included 652,710 patients hospitalized with AHF, of which 42.2% had disease of 1 vascular site and 57.8% had polyvascular disease. As the number of involved vascular beds increased, AHF patients tended to be older and with higher comorbidity burden. The mean length of stay and total hospital charge increased with a greater number of diseased vascular beds (p < 0.001). Moreover, the adjusted odds of MACCE, all-cause mortality, CVA, and major bleeding showed a significant increase with a greater number of diseased vascular beds (p trend < 0.001) with similar trends for patients with HFrEF and HFpEF. The extent of polyvascular disease involvement is associated with higher in-hospital adverse event rates in AHF patients. These findings highlight the importance of comprehensive vascular assessment and targeted interventions to improve outcomes in this high-risk population.","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"744-754"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perioperative management of postinfarction ventricular septal rupture: a comparison of Impella with intra-aortic balloon pump. 梗死后室间隔破裂的围手术期处理：Impella与主动脉内球囊泵的比较。

IF 1.4 4区医学

Heart and Vessels Pub Date : 2025-08-01 Epub Date: 2025-01-26 DOI: 10.1007/s00380-025-02513-x

Akihiro Tani, Kazuhiko Aramaki, Shota Uno, Natsumi Morisako, Takashi Hagiwara, Tsukasa Iwasaki, Shigeki Nishiyama, Junji Kaneyama, Ryoji Yanagisawa, Taro Shibasaki, Yutaka Koji, Takashi Iida, Tadanobu Irie, Yasuyuki Kato, Masahisa Yamane

{"title":"Perioperative management of postinfarction ventricular septal rupture: a comparison of Impella with intra-aortic balloon pump.","authors":"Akihiro Tani, Kazuhiko Aramaki, Shota Uno, Natsumi Morisako, Takashi Hagiwara, Tsukasa Iwasaki, Shigeki Nishiyama, Junji Kaneyama, Ryoji Yanagisawa, Taro Shibasaki, Yutaka Koji, Takashi Iida, Tadanobu Irie, Yasuyuki Kato, Masahisa Yamane","doi":"10.1007/s00380-025-02513-x","DOIUrl":"10.1007/s00380-025-02513-x","url":null,"abstract":"Postinfarction ventricular septal rupture (PIVSR) is a rare but serious complication of acute myocardial infarction. Determining how to conduct surgical repair safely is critical. We compared the outcomes of Impella and intra-aortic balloon pump (IABP) implantation during perioperative mechanical circulatory support management in patients with PIVSR (n = 22). The primary endpoint was the 12-month survival rate. Secondary endpoints included major adverse cardiovascular events (MACEs) and the number of waiting days for surgery. Using the log-rank test, we compared Kaplan-Meier curves between the groups. The 12-month survival rate was 87.5% and 53.6% in the Impella and IABP groups, respectively, with no significant difference (p = 0.17). The median number of days from circulatory support implantation to surgery was longer in the Impella group than in the IABP group (2.5 days vs. 1.0 days, interquartile range: 1.8-5.2 vs. 0-1.0; p = 0.003). In the subgroup analysis considering only the Society for Cardiovascular Angiography and Interventions (SCAI) shock stages B-D, the 12-month survival rate was higher (85.7% vs. 18.8%; p = 0.03) and the MACE rate was lower (14.3% vs. 53.3%; p = 0.010) in the Impella group than in the IABP group. In summary, when focusing on the SCAI shock stages B-D, the Impella group had significantly better outcomes than did the IABP group. In the perioperative management of PIVSR, the use of Impella may be more beneficial than the use of IABPs, particularly in patients with SCAI shock stages B-D.","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"726-735"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143038259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy of a 16 Fr sheath strategy during Impella support to reduce access site bleeding in patients with cardiogenic shock. 16 Fr护套策略在Impella支持期间减少心源性休克患者通路部位出血的疗效。

IF 1.4 4区医学

Heart and Vessels Pub Date : 2025-08-01 Epub Date: 2025-02-05 DOI: 10.1007/s00380-025-02514-w

Yuka Tanizaki, Motoki Fukutomi, Takayuki Onishi, Tomo Ando, Shuichiro Takanashi, Tetsuya Tobaru

{"title":"Efficacy of a 16 Fr sheath strategy during Impella support to reduce access site bleeding in patients with cardiogenic shock.","authors":"Yuka Tanizaki, Motoki Fukutomi, Takayuki Onishi, Tomo Ando, Shuichiro Takanashi, Tetsuya Tobaru","doi":"10.1007/s00380-025-02514-w","DOIUrl":"10.1007/s00380-025-02514-w","url":null,"abstract":"Access site bleeding is a complication which may occur during Impella support (Abiomed, Danvers, MA, USA), possibly due to unstable fixation of the device in the groin. Using a large-bore sheath for Impella insertion may reduce this complication. However, the efficacy and safety of this strategy are still unknown. The main aim of this study was to assess whether employing a large-bore sheath during Impella insertion mitigates access site bleeding without increasing limb ischemia. All consecutive patients who received either the Impella 2.5 or CP for cardiogenic shock from September 2019 to February 2023 were included in this study. We compared patients who underwent Impella insertion using the conventional peel-away introducer and the attached sheath (repositioning sheath) and patients in whom the Impella was inserted using a 16 Fr sheath. All patients received antegrade perfusion with a 4Fr sheath to prevent limb ischemia at the Impella site. The primary outcome was access site major bleeding: 36 patients were treated with a 16 Fr sheath and 39 were treated with a conventional sheath. The use of a 16 Fr sheath was associated with a significant reduction in major bleeding (33.0% vs. 64.0%, p = 0.01) in comparison to the conventional sheath. After adjusting for covariates, the risk of major bleeding at the access site in the 16 Fr sheath group was significantly lower than that in the conventional sheath group (adjusted odds ratio, 0.294; 95% confidence interval 0.087-0.991; p = 0.048). The insertion of Impella through a 16 Fr sheath significantly reduced the risk of major bleeding at the access site in comparison to the conventional sheath.","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"736-743"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How to demonstrate feasibility and efficacy of catheter ablation for atrial fibrillation in elderly patients. 如何论证导管消融治疗老年房颤的可行性和有效性。

IF 1.4 4区医学

Heart and Vessels Pub Date : 2025-08-01 Epub Date: 2025-01-23 DOI: 10.1007/s00380-025-02517-7

Naoya Kataoka, Teruhiko Imamura

引用次数: 0

A long-term clinical comparative study of left bundle branch pacing versus biventricular pacing in patients with heart failure and complete left bundle branch block. 左束支起搏与双心室起搏对心力衰竭和完全性左束支阻滞患者的长期临床比较研究。

IF 1.4 4区医学

Heart and Vessels Pub Date : 2025-08-01 Epub Date: 2025-01-03 DOI: 10.1007/s00380-024-02512-4

Jinhui Zhuo, Canghao Chen, Junhua Lin, Jing Wang, Fayuan Fu

{"title":"A long-term clinical comparative study of left bundle branch pacing versus biventricular pacing in patients with heart failure and complete left bundle branch block.","authors":"Jinhui Zhuo, Canghao Chen, Junhua Lin, Jing Wang, Fayuan Fu","doi":"10.1007/s00380-024-02512-4","DOIUrl":"10.1007/s00380-024-02512-4","url":null,"abstract":"Left bundle branch pacing (LBBP) is an emerging physiological pacing technique characterized by stable pacing parameters and a narrower QRS duration. This study aims to compare the long-term efficacy and safety of biventricular pacing (BIVP) and LBBP in patients with heart failure with reduced ejection fraction (HFrEF) and complete left bundle branch block (CLBBB). A retrospective analysis was conducted on 35 patients with chronic HFrEF accompanied by CLBBB treated at our center from April 2018 to October 2022. The patients were divided into two groups based on the surgical technique: the LBBP group and the BIVP group. Postoperative follow-up data were collected, including pacing parameters, QRS duration, echocardiographic indices (left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF), mitral and tricuspid regurgitation), NT-proBNP levels, and New York Heart Association (NYHA) classification. n addition, postoperative complications, heart failure readmission rates, and mortality rates were observed. 35 patients were recruited, 18 for LBBP and 17 for BIVP. The LBBP group demonstrated significantly lower pacing thresholds and impedance at 12 months post-surgery compared to the BIVP group (p < 0.05). The QRS duration in the LBBP group was significantly narrower than that in the BIVP group at 6, 12, and 24 months (p < 0.05). At 24 months post-surgery, LVEDD and LVESD were significantly lower in the LBBP group than those in the BIVP group (p < 0.05). No significant differences were observed between groups in response rates, tricuspid and mitral regurgitation, NYHA class, NT-proBNP levels, all-cause mortality, or heart failure rehospitalization rates (p > 0.05). LBBP may be a relatively safe and effective resynchronization therapy, serving as a complementary approach to BIVP for patients with HFrEF and CLBBB.","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"707-717"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prognostic value of stress phase entropy for predicting major cardiac events in patients with known or suspected stable coronary artery disease. 应激相熵预测已知或疑似稳定型冠状动脉疾病患者主要心脏事件的预后价值

IF 1.4 4区医学

Heart and Vessels Pub Date : 2025-08-01 Epub Date: 2025-02-28 DOI: 10.1007/s00380-024-02504-4

Katsunori Fukumoto, Shunichi Yoda, Yudai Tanaka, Takumi Hatta, Yasuyuki Suzuki, Naoya Matsumoto, Yasuo Okumura

{"title":"Prognostic value of stress phase entropy for predicting major cardiac events in patients with known or suspected stable coronary artery disease.","authors":"Katsunori Fukumoto, Shunichi Yoda, Yudai Tanaka, Takumi Hatta, Yasuyuki Suzuki, Naoya Matsumoto, Yasuo Okumura","doi":"10.1007/s00380-024-02504-4","DOIUrl":"10.1007/s00380-024-02504-4","url":null,"abstract":"There are no large-scale reports on the prediction of major cardiac events (MCEs) and risk stratification using phase entropy, a measure of left ventricular (LV) dyssynchrony, in Japanese patients with known or suspected coronary artery disease (CAD). We retrospectively investigated 5541 patients with known or suspected CAD who underwent rest 201Tl and stress 99mTc-tetrofosmin electrocardiogram (ECG)-gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) and followed them for three years to confirm their prognosis. We excluded patients undergoing revascularization within 3 months before and after the SPECT and those with non-sinus rhythm. The composite endpoint was the onset of MCEs, consisting of cardiac death, non-fatal myocardial infarction (MI), and severe heart failure requiring hospitalization. Poststress phase standard deviation (SD), bandwidth, and entropy were calculated by phase analysis using Heart Risk View-F software. During follow-up, 401 patients experienced MCEs: cardiac death (n = 98), non-fatal MI (n = 76), and severe heart failure (n = 227). Multivariate analysis showed that age, diabetes, estimated glomerular filtration rate (eGFR), stress LV ejection fraction (EF), and stress phase entropy were independent predictors of MCEs. Kaplan-Meier analysis showed significant risk stratification between each group in the stress phase entropy quartile. The global chi-squared value predicting MCE onset was significantly improved in the model with summed stress score and LVEF plus entropy but was comparable in the model with added bandwidth or phase SD. Stress phase entropy was a strong predictor of MCEs in Japanese patients with CAD (known or suspected) and was considered the most useful left ventricular dyssynchrony index to improve risk stratification over prediction by perfusion and LVEF assessment alone.","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"677-687"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0