Heart and Vessels最新文献

{"title":"Clinical outcomes of percutaneous coronary intervention for severely calcified lesions: comparison between the morphologies of severely calcified coronary lesions.","authors":"Yoriyasu Suzuki, Masahiro Uehara, Hirohiko Ando, Akihiro Suzuki, Akira Murata, Hiroaki Matsuda, Takahiro Tokuda, Tetsuya Amano","doi":"10.1007/s00380-024-02466-7","DOIUrl":"10.1007/s00380-024-02466-7","url":null,"abstract":"<p><p>Existing studies evaluating the comparison of clinical outcome of percutaneous coronary intervention (PCI) for severe calcified coronary lesions are limited, and the clinical outcomes of PCI for different morphologies of calcified lesions are controversial. Overall, consecutive 576 lesions with severe calcification that were treated with PCI from 2010 to 2021 at Nagoya Heart Center were investigated. All lesions were assessed using invasive coronary angiogram (CAG) or computed tomography-CAG at 12 months after DES implantation. We divided the patients into three groups based on the results of intravascular ultrasound (IVUS) imaging (concentric calcified lesion [CC] n = 273, eccentric calcified lesion [EC] n = 217, calcified nodule [CN] n = 86). The clinical and angiographic outcomes of each group were investigated retrospectively to compare the prognosis between the three groups and identify predictive factors for the device-oriented composite end points (DoCE). There were no differences in patient characteristics among the three groups, except that there were significantly more patients on dialysis in the CN group. The incidence of DoCE was significantly higher in the CN group than in the other groups (CC; 18.3% vs. EC; 23.5% vs. CN; 36.0%; Log-Rank test; p = 0.001). Cox regression analysis showed that the independent predictors of DoCE were CN, insulin use, hemodialysis, right coronary artery lesions, and calcium cracks. The incidence of DoCE was significantly higher in the CN group. Calcium cracks are crucial for improving outcomes in severely calcified lesions, being key predictors of DoCE.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"275-284"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345502","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}

{"title":"Differences in vascular tissue response after stent implantation between biolimus-eluting and everolimus-eluting stents: a sub-study of the NEXT study.","authors":"Hajime Imai, Masanori Kawasaki, Akihiro Yoshida, Hiromitsu Kanamori, Hiroyuki Okura","doi":"10.1007/s00380-024-02467-6","DOIUrl":"10.1007/s00380-024-02467-6","url":null,"abstract":"<p><p>NEXT [NOBORI biolimus-eluting stent (BES) versus XIENCE/PROMUS everolimus-eluting stent (EES) trial] was a multicenter, randomized, prospective trial that included 3235 patients with 8-12 months of follow-up imaging at 18 centers. IB-IVUS images were analyzed at an interval of 0.5 mm using a motorized pull-back system in each plaque that required stent implantation. We analyzed seven cross-sections at the site of minimal lumen area and ten cross-sections in proximal and distal peripheral sites prior to the procedure, after stent implantation and after 8 months. We averaged the relative blue volume, relative green volume, relative yellow volume, and relative red volume across seven cross-sections using the manufacturer's default setting. Fifty-four lesions in 50 patients were analyzed. There were 28 lesions in 25 patients in the EES group and 26 lesions in 25 patients in the BES group. The patient characteristics did not differ significantly between the two groups except high-density lipoprotein cholesterol. There were no significant differences before and after stent implantation after 8 months in relative red volume, relative yellow volume, relative green volume or relative blue volume. Although the present study was likely underpowered for statistical analyses and larger populations are needed to confirm the conclusions, the vascular response regarding tissue characterization was similar between EES and BES, even though the thickness and releasing materials differed between the stents.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"285-294"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390050","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}

{"title":"Imaging characteristics and clinical outcomes of hemodialysis vs. non-hemodialysis patients undergoing transcatheter aortic valve replacement: a Japanese single-center experience.","authors":"Toshiya Yoshida, Taishi Okuno, Shingo Kuwata, Yoshikuni Kobayashi, Takahiko Kai, Yukio Sato, Masashi Koga, Keisuke Kida, Yuki Ishibashi, Yasuhiro Tanabe, Masaki Izumo, Yoshihiro J Akashi","doi":"10.1007/s00380-024-02476-5","DOIUrl":"10.1007/s00380-024-02476-5","url":null,"abstract":"<p><p>In 2021, Japan approved transcatheter aortic valve replacement (TAVR) for end-stage renal disease patients on hemodialysis (ESRD-HD). Yet, clinical/anatomical differences and outcomes between patients with and without ESRD-HD remain underexplored. This single-center study enrolled consecutive patients who underwent TAVR with the SAPIEN 3 between 2021 and 2023. Baseline characteristics and outcomes up to 1 year were compared. Inverse probability treatment weighting (IPTW) approach and Cox regression were used. Among 287 eligible patients, 59 had ESRD-HD. Patients with ESRD-HD were predominantly male (59.2% vs. 40.7%; p = 0.01), younger (78.0 [73.5-83.5] vs. 84.0 [79.8-88.0]; < 0.001), with lower body mass index (21.4 [19.6-23.3] vs. 22.9 [20.3-25.3]; p = 0.02], higher surgical risk (Society of Thoracic Surgeons Predicted Risk of Mortality ≧8%: 28 [47.5%] vs. 34 [14.9%]; p < 0.001), and more peripheral artery disease (25.4% vs. 4.8%; p < 0.001). Patients with ESRD-HD had a significantly higher prevalence of severely calcified femoral arteries (12.5% vs. 2.6%; p < 0.001). However, there were no differences in the computed-tomographic (CT) anatomical characteristics of the aortic valve complex (AVC), including the aortic valve calcium score (1995 [1372-3374] vs. 2195 [1380-3172]; p = 0.65) or the presence of moderate or severe left ventricular outflow tract calcification (4.3% vs. 5.2%; p > 0.99). Major vascular complications were rare, and technical (98.3% vs. 98.7%; p > 0.99) and device success (75.9% vs. 82.4%; p = 0.26) rates were high in both. At 1 year, there were no significant differences in a composite endpoint of death, stroke, major bleeding, or myocardial infarction (32.4% vs. 33.2%; HR 1.12; 95% CI 0.45-2.80; p = 0.81), nor its components after baseline adjustment.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"361-368"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499264","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}

{"title":"Influence and molecular mechanism of cinnamaldehyde against ventricular arrhythmia via the TAK1-p38MAPK-NLRP3 pathway.","authors":"Guoping Ma, Mian Li, Wanyue Yang, Hai Wang, Xue Tian, Yajuan Yin, Yida Tang, Wenjie Liang","doi":"10.1007/s00380-025-02529-3","DOIUrl":"https://doi.org/10.1007/s00380-025-02529-3","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Based on the transforming growth factor β-activated kinase 1 (TAK1)-p38 mitogen-activated protein kinase (p38MAPK)-nucleotide-binding oligo-like receptor protein 3 (NLRP3) signalling pathway, the protective effect and mechanism of isoproterennaline (ISO)-induced cinnamaldehyde on inflammatory injury in ventricular rats were investigated. Fifty male SPF SD rats were randomly assigned to the normal group, model group, propranolol group, cinnamaldehyde low-dose group or cinnamaldehyde high-dose group. The ventricular arrhythmia model was constructed using the \"6 + 1\" ISO injection method. The rats in the propranolol group were given propranolol 15 mg·(kg d)&lt;sup&gt;-1&lt;/sup&gt;, those in the low and high-dose groups were given cinnamaldehyde 20 mg·(kg d)&lt;sup&gt;-1&lt;/sup&gt; and 50 mg·(kg d)&lt;sup&gt;-1&lt;/sup&gt;, respectively, and those in the control and model groups received an equal volume of 0.9% NaCl solution. Changes in the serum troponin (cTnI), creatine kinase isoenzyme (CK-MB), and interleukin-1β (IL-1β) levels in SD rats were determined by ELISA. HE staining was used to observe the tissue morphology of heart disease. The mRNA expression of IL-1β and NLRP3 was determined by RT‒PCR. Mitochondrial damage was observed by transmission electron microscopy. The expression of reactive oxygen species (ROS) was detected by immunofluorescence. Western blot or immunohistochemical detection of the protein expression of IL-1β, NLRP3, TAK1, phospho-TAK1 (p-TAK1), p38MAPK, phospho-p38MAPK (p-p38MAPK), nuclear factor-κB (NF-κB),and phospho-NF-κB (p-NF-κB) was also performed. Data analysis was performed using SPSS 25.0 software. In the control SD rats, there were no obvious ventricular arrhythmias on ECG, the cardiac tissue and mitochondria were basically normal, the serum IL-1β level was low, and the expression of myocardial IL-1β, NLRP3, ROS, p-TAK1, p-p38MAPK and p-NF-κB was weak. Compared with the control group, the model group of SD rats had significant increases in ventricular arrhythmia and arrhythmia scores according to ECG (P &lt; 0.01). Myocardial histopathological injury, cardiac weight index (HWI) and increases in serum cTnI and CK-MB levels were detected (P &lt; 0.01). Additionally, mitochondrial damage in myocardial tissue, increased ROS fluorescence intensity, and elevated expression of myocardial p-TAK1, p-p38MAPK and p-NF-κB were detected(P &lt; 0.01). The protein and mRNA expression of inflammation-related factors NLRP3 and IL-1β were increased (P &lt; 0.01 or P &lt; 0.05). Compared with those in the model group, the arrhythmia scores were decreased in the three treatment groups (P &lt; 0.01 or P &lt; 0.05). Cardiac histopathological morphology was significantly improved, and HWI and myocardial injury-related indicators were decreased(P &lt; 0.01 or P &lt; 0.05). Damaged mitochondria were significantly improved, and the expression of ROS, p-TAK1, p-p38MAPK, and p-NF-κB were decreased. The expression of inflammation-related factors in serum and myocardial tissue was decreased (P &lt; 0.0","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718797","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}

{"title":"Correction: Association between pre-treatment with statin and its inhibitory effect on the onset of coronary artery disease at the time of coronary computed tomography angiography: a new look at an old medication.","authors":"Erika Miura-Takahashi, Kohei Tashiro, Yuhei Shiga, Yuto Kawahira, Yuta Kato, Takashi Kuwano, Makoto Sugihara, Yuki Otsu, Hidetoshi Kamimura, Shin-Ichiro Miura","doi":"10.1007/s00380-025-02536-4","DOIUrl":"https://doi.org/10.1007/s00380-025-02536-4","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663346","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}

{"title":"A new technique of anterograde puncture for chronic limb-threatening ischemia with superficial femoral artery flush occlusion: vascular sheath fenestration.","authors":"Zhaopeng He, Boyu Wang, Haoyong Meng, Lei Zhang, Qingfu Zhang","doi":"10.1007/s00380-025-02534-6","DOIUrl":"https://doi.org/10.1007/s00380-025-02534-6","url":null,"abstract":"<p><p>We introduce a technique for treating chronic limb-threatening ischemia with superficial femoral artery flush occlusion, facilitating intravascular treatment when conventional anterograde puncture is challenging. This retrospective study reviewed 37 patients who underwent vascular sheath fenestration assisted anterograde puncture to complete endovascular treatment for chronic limb-threatening ischemia from December 2022 to December 2023. All patients had superficial femoral artery flush occlusion, meeting chronic limb-threatening ischemia diagnostic criteria. Evaluations included intraoperative radiation dose, technical success rate, patency rate, limb retention rate, and postoperative complications from surgery to a 12-month follow-up. The mean age of the patients was 70 ± 10 years, with an age range of 46 to 90 years. A significant proportion of the cases presented with severe chronic limb-threatening ischemia, with 78.4% classified as Rutherford ≥ 5, 51.3% as WiFi ≥ 3, and 97.3% as Global Limb Anatomic Staging System III. In all surgical procedures, a plain old balloon angioplasty was utilized for anterograde dilation. Subsequently, based on angiographic findings, treatment involved either drug-coated balloon dilation combined with stent implantation or drug-coated balloon dilation alone. Successful revascularization was achieved in all cases, resulting in marked clinical and hemodynamic improvements, as evidenced by the mean ankle-brachial index increasing from 0.49 preoperatively to 0.86 postoperatively. The 12-month follow-up outcomes were as follows: limb salvage rate of 94.6%, primary patency rate of 83.8%, assisted primary patency rate of 91.9%, and secondary patency rate of 94.6%. The incidence of postoperative complications was 8.1%. The average duration of hospital stay was 8.43 ± 2.72 days. The vascular sheath fenestration assisted anterograde puncture technique demonstrates favorable surgical outcomes and merits consideration as a viable treatment option for chronic limb-threatening ischemia patients with superficial femoral artery occlusion.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630333","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}

{"title":"Overnight stiffness index from finger photoplethysmography in relation to markers of cardiovascular risk and vascular ageing.","authors":"Henrik Hellqvist, Hermine Rietz, Ludger Grote, Jan Hedner, Dirk Sommermeyer, Thomas Kahan, Jonas Spaak","doi":"10.1007/s00380-025-02537-3","DOIUrl":"https://doi.org/10.1007/s00380-025-02537-3","url":null,"abstract":"<p><p>Wearable technology, such as photoplethysmography (PPG), enables easily accessible individual health data with the potential for improved risk assessment. We hypothesized that the overnight stiffness index (OSI), derived from nocturnal finger PPG, could be used to assess cardiovascular risk and vascular ageing. Subjects with confirmed or suspected hypertension (n = 79, 56 males) underwent simultaneous ambulatory blood pressure monitoring (ABPM) and overnight sleep polygraphy with a continuous PPG registration. Overnight PPG-based pulse propagation time was used to calculate OSI. Associations between OSI and markers of cardiovascular risk, blood pressure, and indices of arterial stiffness, as indicators of vascular ageing, were assessed. Subjects were stratified into low and high OSI (according to median, 10.9 m/s). SCORE2/SCORE2-OP and Framingham risk scores were calculated. The high OSI group had higher SCORE2/SCORE2-OP (9.5 [5.5;12.5] vs 5.0 [4.0;6.5]), and OSI correlated with SCORE2/SCORE2-OP and Framingham risk score (r_s = 0.40 and r_s = 0.41; both P < 0.01). Indices of arterial stiffness were increased in the high OSI group including ABPM awake and asleep pulse pressures (59 ± 14 vs 50 ± 9 mmHg, P < 0.01, and 54 ± 14 vs 45 ± 7 mmHg, P < 0.001), and ambulatory arterial stiffness index (0.47 ± 0.12 vs 0.37 ± 0.11, P < 0.001), respectively. OSI correlated with 24-h and asleep pulse pressure also after adjusting for confounders. OSI was related to systolic ABPM (awake r = 0.42, asleep r = 0.55; both P < 0.001) and diastolic ABPM (asleep r = 0.36, P < 0.01). OSI, a novel PPG-based measure of nocturnal arterial stiffness, correlates with established cardiovascular risk scores and with blood pressure-derived indices of vascular ageing. This simple method may facilitate cardiovascular risk assessment using readily available medical and wearable consumer devices.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630345","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}

{"title":"Sex disparities in mental distress, selfcare ability, and quality of life in patients with chronic heart failure.","authors":"Hiroyuki Sawatari, Mayumi Niitani","doi":"10.1007/s00380-025-02527-5","DOIUrl":"https://doi.org/10.1007/s00380-025-02527-5","url":null,"abstract":"<p><p>Previous studies have reported that the clinical features of chronic heart failure (CHF), such as symptoms, prognosis, mental distress, and quality of life (QOL), differ between men and women. However, no studies have shown sex disparities in distress, which has been assessed by multiple indicators in patients with CHF. This study evaluated sex disparities in physical and mental distress among patients with CHF. This prospective multicenter cross-sectional study included outpatients with CHF. Clinical characteristics such as age, sex, and echocardiography findings were extracted from the medical records. Anxiety/depression, selfcare ability, and QOL were assessed using the Hospital Anxiety and Depression Scale (HADS), the European Heart Failure Selfcare Behavior Scale (EHFScBS), and Short Form-12 (SF-12), respectively. The mean age of the participants was 69.7 ± 11.9 years, and 28.3% of the 251 patients were female. The mean left ventricular ejection fraction (LVEF) was 52.0 ± 13.9%, and LVEF was higher in women. The most common underlying disease was ischemic heart disease (38.3%). Multivariate analysis showed that women had significantly higher levels of anxiety/depression, lower mental component summary scores, and reduced physical functioning in terms of QOL, whereas selfcare ability did not differ between women and men. The findings of this study suggest that women have significantly more anxiety/depression and worse physical and mental QOL than men. Thus, more attention should be paid to psychological disorders, including QOL, during CHF management, especially in women.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565969","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}

{"title":"Impact of quantitative flow ratio on outcomes after percutaneous coronary intervention for chronic total occlusion.","authors":"Takuya Tsujimura, Takayuki Ishihara, Taku Toyoshima, Naoko Higashino, Sho Nakao, Yosuke Hata, Masaya Kusuda, Masaharu Masuda, Yasuhiro Matsuda, Toshiaki Mano","doi":"10.1007/s00380-025-02532-8","DOIUrl":"https://doi.org/10.1007/s00380-025-02532-8","url":null,"abstract":"<p><p>The clinical implication of a post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in coronary artery disease (CAD) patients with chronic total occlusion (CTO) remains insufficiently explored. This single-center retrospective observational study analyzed 195 CTO lesions from 195 CAD patients who underwent successful PCI with drug-eluting stent implantation and were assessed for post-PCI QFR. The primary end point was target lesion revascularization (TLR) at 3 years. The receiver-operating characteristic curve was used to calculate the optimal cutoff value of post-PCI QFR for predicting 3-year TLR. Patients were stratified on the basis of the optimal cutoff value, and the predictors for 3-year TLR were assessed by multivariate Cox proportional hazard models. The ROC curve demonstrated that the cutoff value of post-PCI QFR for predicting 3-year TLR was 0.84, with a sensitivity of 61% and specificity of 66%. The cumulative incidence of TLR at 3 years was significantly higher in the low post-PCI QFR group (≤ 0.84) compared to the high post-PCI QFR group (> 0.84) (22.0% versus 8.4%, P = 0.017). In multivariate analysis, age (hazard ratio [HR], 0.94 [0.91 to 0.98]), renal failure on dialysis (HR, 3.89 [1.58 to 9.55]), ostial lesion (HR, 5.01 [1.90 to 13.23]), and post-PCI QFR ≤ 0.84 (HR, 2.49 [1.04 to 5.97]) were independent predictors for 3-year TLR. Lower post-PCI QFR was associated with increased 3-year TLR in CAD patients with CTO.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565964","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}

{"title":"Heart-rate reduction during microaxial flow pump support and short-term outcomes in patients with cardiogenic shock.","authors":"Kenji Maemura, Yuki Ikeda, Saeko Iikura, Yu Takigami, Yuko Eda, Takumi Oki, Mayu Yazaki, Teppei Fujita, Yuichiro Iida, Takeru Nabeta, Shunsuke Ishii, Nobuhiro Sato, Junya Ako","doi":"10.1007/s00380-025-02533-7","DOIUrl":"https://doi.org/10.1007/s00380-025-02533-7","url":null,"abstract":"<p><p>Heart rate (HR) is a surrogate of systemic conditions, cardiac performances, and effect of chronotropic agents in patients with critical illness. The current study aimed to elucidate the association between HR during mechanical circulatory support with the Impella microaxial flow pump and clinical outcomes in patients with cardiogenic shock (CS). This study evaluated 92 patients (mean age: 67 ± 13 years; male: 77%) with CS who received temporary circulatory support with Impella. The absolute HR immediately before Impella implantation, at 24 h after implantation, immediately before explantation, and at 24 h after explantation, and its association with short-term outcomes were assessed. In total, 47 (51%) patients concomitantly used venoarterial extracorporeal membrane oxygenation. Patients who died or those who were bridged to left ventricular assist device (LVAD) implantation during Impella support (n = 20) were excluded from the outcome analysis. Four patients died within 24 h after Impella initiation. During Impella support, 14 patients died, and two had LVAD implantation. A high HR and a higher lactate level at Impella explantation were independently associated with 30 day mortality in 18 (25%) patients. An HR of < 82 bpm at Impella explantation was the optimal cutoff value for indicating a lower incidence of 30 day mortality. Up-titrated beta-blockers and decreases in the vasoactive-inotropic score were correlated with HR reduction during Impella support. In patients with CS receiving Impella support, a lower HR at weaning was associated with a decreased incidence of short-term mortality. HR reduction was a simple prognostic indicator, and chronotropic interventions including beta-blockers may be therapeutic options for patients with CS receiving Impella support.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566927","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}