Heart and Vessels最新文献

{"title":"Preoperative hyperamylasemia relates to renal dysfunction and hyperamylasemia in cardiac surgery: an observational study.","authors":"Hiroki Iwata, Shingo Kawashima, Yoshiki Nakajima, Hiroyuki Kinoshita","doi":"10.1007/s00380-024-02463-w","DOIUrl":"10.1007/s00380-024-02463-w","url":null,"abstract":"<p><p>The role of preoperative hyperamylasemia in the perioperative enzyme levels in patients undergoing cardiac surgery is unclear. The primary outcome of this observational clinical study was to determine whether patients with preoperative hyperamylasemia undergoing on-pump cardiac surgery document an increase in serum amylase levels perioperatively compared with patients with normal serum amylase levels preoperatively. This prospective study evaluated serum total, pancreatic, and salivary amylase levels, estimated glomerular filtration rate (eGFR), and serum creatinine before the operation at postoperative days (POD) 1, 2, 3, and 7. We also followed up on any perioperative symptoms, including abdominal pain and lower ear or jaw swelling. We preoperatively had 157 patients with normal amylase levels (Normal group) and 45 with hyperamylasemia (Hyperamylasemia group). The Hyperamylasemia group demonstrated continuously lower eGFR and higher creatinine values at the preoperative time, postoperative days 1, 2, 3, and 7, compared with the Normal group. The Hyperamylasemia group showed higher serum total, pancreatic, and salivary amylase levels at preoperative (total 70 [55-90] [Normal] vs. 142 [107 to 162] [Hyperamylasemia] IU/L, median [25-75th percentile], P < 0.001) and postoperative periods compared with the Normal group. The relationship between renal dysfunction and serum amylase levels in all patients was significant in the preoperative, but not postoperative, periods. We noted no patients demonstrating clinical symptoms. Preoperative hyperamylasemia in patients undergoing on-pump cardiac surgery was associated with renal dysfunction without needing hemodialysis. However, whether the relation affects postoperative serum amylase levels is inconclusive.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"267-273"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463915","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":"Prognostic significance of dobutamine stress echocardiography in patients with chronic kidney disease and known or suspected coronary artery disease: a 5-year follow-up study.","authors":"Ratthanan Leevongsakorn, Yodying Kaolawanich, Khemajira Karaketklang, Nithima Ratanasit","doi":"10.1007/s00380-024-02464-9","DOIUrl":"10.1007/s00380-024-02464-9","url":null,"abstract":"<p><p>Dobutamine stress echocardiography (DSE) is an effective noninvasive modality for evaluating coronary artery disease (CAD), with high accuracy. However, data on the prognostic value of DSE in patients with chronic kidney disease (CKD) are limited. This study aims to assess the prognostic significance of DSE in patients with CKD and known or suspected CAD. We included consecutive patients with CKD stage 3 or higher and known or suspected CAD who underwent clinically indicated DSE between 2007 and 2017. The primary endpoint was all-cause mortality at 5 years. Univariable and multivariable analyses were conducted to identify predictors of all-cause mortality, with a p value < 0.05 considered statistically significant. A total of 274 patients were included in the study. The mean age was 64.0 ± 13.1 years, with 54% being male and 13.1% having known CAD. Among the patients, 64.6% had advanced CKD (≥ stage 4). Abnormal DSE was observed in 62 patients (22.6%). During a follow-up period of 7.0 ± 3.5 years, 78 patients (28.5%) died. The mortality rate was significantly higher in patients with abnormal DSE compared to those with normal DSE (48.4% vs. 22.6%, p < 0.001). Multivariable analysis identified age (hazard ratio [HR] 1.03, 95% confidence interval [CI] 1.008-1.05, p = 0.005), New York Heart Association (NYHA) functional class (HR 1.60, 95% CI 1.05-2.43, p = 0.03), and chronotropic index < 0.73 (HR 2.61, 95% CI 1.60-4.25, p < 0.001) as independent predictors of mortality. Conversely, a normal DSE result was found to be a protective factor (HR 0.49, 95% CI 0.30-0.81, p = 0.005). In conclusion, DSE demonstrated significant prognostic value in patients with CKD and known or suspected CAD. Age, NYHA functional class, and a chronotropic index < 0.73 were identified as independent predictors of all-cause mortality.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"210-218"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285875","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":"Clinical advantages of reduced expiratory positive airway pressure setting in adaptive servo-ventilation therapy.","authors":"Teruhiko Imamura, Yoshihiro Fukumoto, Hitoshi Adachi, Shin-Ichi Momomura, Yoshio Yasumura, Takayuki Hidaka, Takatoshi Kasai, Koichiro Kinugawa, Yasuki Kihara","doi":"10.1007/s00380-024-02457-8","DOIUrl":"10.1007/s00380-024-02457-8","url":null,"abstract":"<p><p>The clinical ramifications of adaptive servo-ventilation (ASV) therapy have stirred debate within the medical community. Given the potential detrimental effect of elevated expiratory positive airway pressure (EPAP) on cardiac output, we hypothesized that relatively lower EPAP may be recommended for successful ASV therapy. In-hospital patients with congestive heart failure refractory to medical therapy were included in the prospective cohort study of ASV therapy on prognosis in repeatedly hospitalized patients with chronic heart failure: longitudinal observational study of effects on readmission and mortality (SAVIOR-L) study. Assignment to either the ASV treatment group or the medical management group was at the discretion of the attending physicians. For the purposes of this retrospective study, our focus remained solely on the ASV cohort. We conducted an extensive analysis to elucidate the influence of lower EPAP settings on midterm mortality. A total of 108 patients were included. The median age was 74 years, and 83 (77%) patients were male. The median EPAP setting employed was 4 cmH₂O, with 60 patients subjected to EPAP levels below 5 cmH₂O. There were no significant differences in the baseline characteristics between the lower and higher EPAP groups, which were divided at the EPAP cutoff of 4.5 cmH₂O (p > 0.05 for all). A trend toward reduced mortality emerged among patients with EPAP settings below 5 cmH₂O, exhibiting a hazard ratio of 0.48 (95% confidence interval 0.22-1.07, p = 0.072) after adjusting for potential confounding factors: 2-year mortality 26% vs. 38%; p = 0.095. Heart failure readmission rates were not significantly different between the two groups (p = 0.61). The adoption of relatively lower EPAP settings during ASV therapy may be advisable. Such an approach has the potential to ameliorate mortality rates while concurrently maintaining heart failure recurrence rates at levels commensurate with those with default EPAP settings.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"235-244"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285873","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":"High plasma levels of fortilin are associated with cardiovascular events in patients undergoing coronary angiography.","authors":"Masayuki Aoyama, Yoshimi Kishimoto, Emi Saita, Reiko Ohmori, Masato Nakamura, Kazuo Kondo, Yukihiko Momiyama","doi":"10.1007/s00380-024-02465-8","DOIUrl":"10.1007/s00380-024-02465-8","url":null,"abstract":"<p><p>Excessive apoptosis and its insufficient clearance is characteristic of atherosclerotic plaques. Fortilin has potent antiapoptotic property and is abundantly expressed in atherosclerotic plaques. Fortilin-deficient mice had less atherosclerosis with more macrophage apoptosis. Recently, we reported that plasma fortilin levels were high in patients with coronary artery disease (CAD). However, its prognostic value has not been elucidated. We investigated plasma fortilin levels and major adverse cardiovascular events (MACE) in 404 patients (mean age 68 ± 12 years; 276 males) undergoing coronary angiography for suspected CAD. MACE was defined as cardiovascular death, myocardial infarction, unstable angina, heart failure, stroke, or coronary revascularization. Of the 404 patients, 218 (54%) had CAD. Plasma fortilin levels were higher in patients with CAD than without CAD (median 74.9 vs. 70.9 pg/mL, p < 0.05). During a mean follow-up of 5.7 ± 4.2 years, MACE was observed in 59 (15%) patients. Notably, patients with MACE had higher fortilin levels (median 83.0 vs. 71.4 pg/mL) and more often had fortilin level > 80.0 pg/mL (54% vs. 36%) than those without MACE (p < 0.025). A Kaplan-Meier analysis showed lower event-free survival in patients with fortilin > 80.0 pg/mL than in those with ≤ 80.0 pg/mL (p < 0.001). In multivariate Cox proportional hazards analysis, fortilin level (> 80.0 pg/mL) was an independent predictor of MACE (hazard ratio: 2.29, 95%CI: 1.36-3.85, p < 0.002). Among the 218 patients with CAD, fortilin level was also a significant predictor of MACE (hazard ratio: 2.48; 95%CI: 1.34-4.61, p < 0.005). Thus, high plasma fortilin levels were found to be associated with cardiovascular events in patients with CAD as well as those undergoing coronary angiography.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"219-226"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345503","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 comprehensive assessment tool of acute-phase rehabilitation is associated with clinical outcomes in patients after cardiovascular surgery.","authors":"Ken Ogura, Nobuaki Hamazaki, Kentaro Kamiya, Tadashi Kitamura, Masashi Yamashita, Kohei Nozaki, Takafumi Ichikawa, Shuken Kobayashi, Yuta Suzuki, Emi Maekawa, Tomotaka Koike, Minako Yamaoka-Tojo, Masayasu Arai, Atsuhiko Matsunaga, Junya Ako, Kagami Miyaji","doi":"10.1007/s00380-024-02460-z","DOIUrl":"10.1007/s00380-024-02460-z","url":null,"abstract":"<p><p>Perme intensive care unit (ICU) mobility score is a comprehensive mobility assessment tool; however, its usefulness and validity for patients after cardiovascular surgery remain unclear. We investigated the association between the Perme Score and clinical outcomes after cardiovascular surgery. We retrospectively enrolled 249 consecutive patients admitted to the ICU after cardiac and/or major vascular surgery. The Perme Score contains categories on mental status, potential mobility barriers, muscle strength and mobility level and was assessed within 2 days after surgery. The outcomes of physical recovery were the number of days until 100-m ambulation achievement and 6-min walk distance (6MWD) at hospital discharge. The endpoint was a composite outcome of all-cause mortality and/or all-cause unplanned readmission. We analyzed the associations of the Perme Score with physical recovery and the incidence of clinical events. After adjusting for clinical confounding factors, a higher Perme Score was an independent factor of earlier achievement of 100-m ambulation (hazard ratio: 1.039, 95% confidence interval [CI]: 1.012-1.066) and higher 6MWD (β: 0.293, P = .001). During the median follow-up period of 1.1 years, we observed an incidence rate of 19.4/100 person-years. In the multivariate Poisson regression analysis, a higher Perme Score was significantly and independently associated with lower rates of all-cause death/readmission (incident rate ratio: 0.961, 95% CI: 0.930-0.992). The Perme Score within 2 days after cardiovascular surgery was associated with physical recovery during hospitalization and clinical events after discharge. Thus, it may be useful for predicting clinical outcomes.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"258-266"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345500","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":"Global use of angiotensin receptor neprilysin inhibitor in heart failure and reduced, below normal and supranormal ejection fraction.","authors":"Yu Horiuchi, Masahiko Asami, Kazuyuki Yahagi, Asahi Oshima, Yuki Gonda, Daiki Yoshiura, Kota Komiyama, Hitomi Yuzawa, Jun Tanaka, Jiro Aoki, Kengo Tanabe","doi":"10.1007/s00380-024-02459-6","DOIUrl":"10.1007/s00380-024-02459-6","url":null,"abstract":"<p><strong>Background: </strong>The global use of angiotensin receptor neprilysin inhibitor (ARNI) in clinical practice, especially in patients with heart failure and below-normal ejection fraction (HFbnEF), has not been thoroughly evaluated. We aimed to investigate the characteristics, outcomes, and adverse events in patients treated with ARNI for HF with reduced (HFrEF), below-normal (HFbnEF), and supranormal left ventricular EF (HFsnEF).</p><p><strong>Methods: </strong>This observational study analyzed data from the electronic healthcare records (EHR) of patients with HF treated with ARNI between 2015 and 2022 in North and South America, Europe, the Middle East, Africa, and Asia-Pacific. Based on the left ventricular EF, patients were categorized as HFrEF (< 40%), HFbnEF (40-60%), and HFsnEF (> 60%). Mortality and the incidence of adverse events were investigated.</p><p><strong>Results: </strong>Of the 11,141 patients analyzed, HFrEF, HFbnEF and HFsnEF accounted for 74%, 22%, and 4%, respectively. Patients with a higher EF were more likely to be older, female, and obese. Hypertension and atrial fibrillation were the most common in HFsnEF. Systolic blood pressure was lower and natriuretic peptide levels were higher in the lower EF groups. Mortality was lowest in HFbnEF (7.7 per 100 patient-years follow-up in HFrEF, 5.8 in HFmrEF, and 6.0 in HFsnEF). Similarly, hypotension and acute kidney injury were the least frequent in HFbnEF. Incidence of elevated serum potassium levels was similar between the groups.</p><p><strong>Conclusions: </strong>In this analysis of large-scale EHR, ARNI was mainly used in HFrEF and HFbnEF, consistent with previous randomized trials and pooled analyses. Adverse events were less common in HFbnEF.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"227-234"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377811","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":"Efficacy of a novel method: VaSodilator injection via the Over-the-wire lumen during drug-coated balloon dilatation to Prevent the slow-flow phenomenon in treatment of femoropopliteal lesions.","authors":"Yuki Kozai, Shinsuke Mori, Masafumi Mizusawa, Shigemitsu Shirai, Yohsuke Honda, Masakazu Tsutsumi, Norihiro Kobayashi, Masahiro Yamawaki, Yoshiaki Ito","doi":"10.1007/s00380-024-02462-x","DOIUrl":"10.1007/s00380-024-02462-x","url":null,"abstract":"<p><p>In drug-coated balloon (DCB) angioplasty for femoropopliteal lesions, there are adverse effects of drug embolization on downstream non-target organs following the slow-flow phenomenon. We devised a novel method, known as VaSodilator injection via the Over-the-wire lumen during DCB dilatation to Prevent the slow-flow phenomenon in treatment of femoropopliteal lesions (V.S.O.P.), and evaluated its efficacy and safety. This single-center, retrospective, observational study analyzed 196 femoropopliteal lesions treated with IN.PACT Admiral between April 2018 and July 2023. The IN.PACT Admiral is a DCB consisting of a 0.035-inch over-the-wire (OTW) lumen balloon coated with high-dose paclitaxel. Regarding the V.S.O.P. method, we injected vasodilators through the OTW lumen during DCB dilation of the lesions. The cohort was classified into two groups according to the use of the V.S.O.P. method (V.S.O.P. group: n = 53; non-V.S.O.P. group: n = 143). The V.S.O.P. group had lower rates of hemodialysis (21% vs. 43%, p = 0.01) and higher rates of critical limb-threatening ischemia (56% vs. 23%, p < 0.01) and severe calcification lesions (Peripheral Arterial Calcium Scoring Systems score 3/4) (53% vs. 34%, p = 0.01) than the non-V.S.O.P. group. The occurrence of the slow-flow phenomenon was significantly lower in the V.S.O.P. group than in the non-V.S.O.P. group. The V.S.O.P. method could be an effective method for preventing the slow-flow phenomenon after DCB angioplasty for femoropopliteal lesions.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"251-257"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307648","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":"Assessment of acute radial artery injury after distal transradial access for coronary intervention: an optical coherence tomography study.","authors":"Dan Niu, Yuntao Wang, Yongxia Wu, Zixuan Li, Hao Liu, Jincheng Guo","doi":"10.1007/s00380-024-02461-y","DOIUrl":"10.1007/s00380-024-02461-y","url":null,"abstract":"<p><p>There is a paucity of data on acute radial artery (RA) injuries using optical coherence tomography (OCT) in patients undergoing coronary intervention via distal transradial coronary access (dTRA). To evaluate the incidence of acute RA injury following dTRA for coronary intervention using OCT. We retrospectively analyzed 200 consecutive patients with acute coronary syndrome (ACS) who underwent coronary intervention guided by OCT and RA-OCT after dTRA at our center between June 2021 and November 2022. Total length of RA was divided into three segments based on the sheath location during dTRA: no sheath protection portion (proximal RA segment) and sheath protection portion (divided into mid- and distal segments). Acute RA injuries, including tears, dissections, perforations, thrombi, and spasms, were analyzed. Radial artery occlusion (RAO) was assessed using ultrasonography 24 h after dTRA. Acute RA injury was observed in 45.5% of patients after dTRA. The incidence of tear, dissection, perforation, thrombi, and spasm in all the patients was 11.5%, 16.5%, 1.5%, 17.5%, and 17.5%, respectively. In segment-level analysis, dissection and spasm were significantly more frequent in the proximal segment, followed by the mid and distal segments (11.0% vs. 5.5% vs. 4.5%, P = 0.015; 13.0% vs. 4.0% vs. 4.5%, P = 0.002). The rate of RAO at 24-h follow-up was 3.0%. Acute RA injuries were observed in nearly half of the patients using OCT via dTRA; dissection and spasm occurred more frequently in the proximal segment. Hydrophilic-coated sheaths have the potential advantage of preventing radial artery spasm and dissection.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"203-209"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345501","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":"Long-term outcomes of PCI in CTO patients with multi-vessel disease.","authors":"Saad Khan, Faraz Arshad, Rizwan Ahmad, Fatima Naveed, Ayesha Khan","doi":"10.1007/s00380-025-02518-6","DOIUrl":"10.1007/s00380-025-02518-6","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531365","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":"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":"https://doi.org/10.1007/s00380-024-02504-4","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-28","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}