Heart and Vessels最新文献

{"title":"Clinical outcomes of conservative management for acute Stanford type A intramural hematoma: a multicenter retrospective study.","authors":"Hiroshi Okada, Tadashi Kitamura, Fumiaki Shikata, Takuya Narita, Yusuke Motoji, Tomoki Tamura, Yujiro Miura, Hiroshi Matsushita, Hisato Takagi, Kagami Miyaji","doi":"10.1007/s00380-026-02771-3","DOIUrl":"https://doi.org/10.1007/s00380-026-02771-3","url":null,"abstract":"<p><p>The optimal management strategy for acute Stanford type A intramural hematoma (ATAIMH) remains controversial. This study compared outcomes between conservative and surgical management and to evaluate the validity of current treatment strategies. We retrospectively analyzed 274 consecutive patients with ATAIMH and treated at six centers between April 2011 and April 2024. Conservative management was initially considered for patients with stable hemodynamics, controlled pain, AoD < 50 mm, and HT < 11 mm. Outcomes included all-cause mortality, aortic-related mortality, and major adverse cardiovascular or cerebrovascular events (MACCE). Survival outcomes were compared between patients managed conservatively and those who underwent surgery using Cox proportional hazards models, with surgical intervention as a time-dependent covariate. Of the 274 patients, 88 (32.1%) underwent emergency surgery, whereas 186 (67.9%) were initially managed conservatively; among these, 58 (31.1%) required subsequent surgical conversion. Surgical intervention was not an independent predictor of all-cause mortality (HR 0.986; 95% CI 0.487-1.99; P = 0.970), aortic-related mortality (HR 0.836; 95% CI 0.319-2.18; P = 0.715), and MACCE (HR 1.29; 95% CI 0.633-2.64; P = 0.478). Five-year survival rates were 83.9% in the conservatively treated group and 86.8% in the surgically treated group. The only independent predictor of aortic-related mortality was aortic diameter indexed to body surface area, with a cutoff value of 32.3 mm/m². Initial conservative management with timely surgical conversion may be a feasible treatment strategy for selected patients with ATAIMH.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074489","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":"Re: Clinical characteristics and outcomes of isolated severe functional tricuspid regurgitation in a real-world setting.","authors":"Muhammad Adil Choudhry","doi":"10.1007/s00380-026-02764-2","DOIUrl":"https://doi.org/10.1007/s00380-026-02764-2","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074474","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: Combined assessment of left ventricular and atrial function for transthyretin amyloid cardiomyopathy.","authors":"Arisa Senda, Hidekazu Tanaka, Momo Fujiwara, Koya Uemura, Yasushi Ichikawa, Shun Nagai, Yu Nishihara, Chihiro Fujii, Hiroshi Tsunamoto, Masayuki Kintsu, Terunobu Fukuda, Eriko Hisamatsu, Hiromasa Otake","doi":"10.1007/s00380-026-02759-z","DOIUrl":"https://doi.org/10.1007/s00380-026-02759-z","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008445","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":"In response to \"Letter to the editor regarding \"Aortic calcification and contrast-associated acute kidney injury in patients undergoing urgent coronary angiography\"\".","authors":"Masatsugu Miyagawa, Riku Arai, Yasuo Okumura","doi":"10.1007/s00380-026-02757-1","DOIUrl":"https://doi.org/10.1007/s00380-026-02757-1","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976228","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":"Admission eosinophil count is associated with favorable cardiac remodeling after ST-segment elevation myocardial infarction.","authors":"Shingo Watanabe, Junichi Onuma, Ryota Ishida, Ryo Masuda, Michio Usui","doi":"10.1007/s00380-026-02761-5","DOIUrl":"https://doi.org/10.1007/s00380-026-02761-5","url":null,"abstract":"<p><p>Experimental studies suggest that eosinophils promote myocardial repair after myocardial infarction; however, their clinical significance in post-infarction cardiac remodeling remains unclear. We investigated the association between admission peripheral eosinophil counts and left ventricular (LV) and left atrial (LA) remodeling after ST-segment elevation myocardial infarction (STEMI). This retrospective single-center study included 452 consecutive patients with first-time STEMI who underwent successful primary percutaneous coronary intervention between 2016 and 2024. Patients were divided into high and low eosinophil groups according to the median admission eosinophil count (70 cells/µL). Echocardiography was performed during the acute phase and at 6-12 months. Changes in LV end-diastolic diameter (ΔLVDd) and left atrial volume index (ΔLAVI) were evaluated. Multivariable linear regression analysis was performed to identify independent predictors of remodeling. Patients with higher eosinophil counts showed significantly smaller increases in LVDd (ΔLVDd: - 0.4 ± 6.3 vs. + 1.0 ± 4.8 mm, p = 0.03) and greater reductions in LAVI (ΔLAVI: - 2.2 ± 9.6 vs. + 1.1 ± 11.4 mL/m², p = 0.01) than those with lower eosinophil counts. Admission eosinophil count was independently associated with ΔLVDd (standardized β = - 0.154, p = 0.046), whereas no independent association was observed with ΔLAVI. In subgroup analysis, the favorable association between eosinophils and LA remodeling was observed primarily in patients with LAD infarction. No significant differences were observed in one-year mortality or heart failure readmission. Higher admission eosinophil counts were associated with favorable LV and LA remodeling after STEMI. Admission eosinophil count was independently associated with attenuation of LV remodeling, suggesting that it may serve as a practical biomarker for identifying patients at lower risk of adverse cardiac remodeling after STEMI.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975883","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":"Calcified nodule as a distinct morphological risk factor after intravascular ultrasound-guided percutaneous coronary intervention.","authors":"Daisuke Kanda, Akihiro Tokushige, Kenta Ohmure, Hirokazu Shimono, Tatsuo Yokomine, Nobuhiro Ito, Hiroyuki Emura, Takuro Kubozono, Mitsuru Ohishi","doi":"10.1007/s00380-026-02763-3","DOIUrl":"https://doi.org/10.1007/s00380-026-02763-3","url":null,"abstract":"<p><p>Calcified nodules (CN) are recognized as high-risk morphological features; however, their prognostic impact on stable angina pectoris (SAP) in the contemporary era of intensive lipid-lowering therapy and advanced lesion preparation remains unclear. A total of 322 patients with SAP (450 procedures) who underwent elective intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) were analyzed. CN was identified in 40 patients (12%) at the patient level and in 61 lesions (14%) at the lesion level. The primary endpoint was clinically driven target lesion revascularization (TLR) at the lesion level. All patients received statin therapy following the index PCI. The CN group had higher prevalences of hypertension and hemodialysis and lower estimated glomerular filtration rate than the non-CN group, whereas age, diabetes mellitus, chronic kidney disease, left ventricular ejection fraction, low-density lipoprotein cholesterol (LDL-C), estimated small dense LDL-C (Esd LDL-C), and statin use did not differ significantly between groups. Kaplan-Meier analysis demonstrated a significantly higher cumulative incidence of major adverse cardiocerebrovascular events (MACCE) (p = 0.007) and clinically driven TLR at both patient (p = 0.005) and lesion levels (p < 0.001) in the CN group than in the non-CN group. In multivariable Cox regression adjusting for baseline clinical and procedural variables, CN remained independently associated with TLR (hazard ratio [HR]: 3.63, 95% confidence interval [CI] 1.62-8.14, p = 0.002) and MACCE (HR: 2.59, 95% CI 1.14-5.87, p = 0.023), whereas neither LDL-C nor other lipid parameters independently predicted outcomes. The drug-eluting stent (DES) strategy was independently associated with a lower risk of TLR (HR: 0.25, p = 0.002). In patients with SAP undergoing elective IVUS-guided PCI, all of whom received statin therapy following the index PCI, CN was independently associated with adverse clinical outcomes irrespective of baseline LDL-C or other lipid parameters. These findings suggest that CN represents a distinct high-risk morphological phenotype associated with adverse outcomes after PCI. In the overall cohort, DES use was independently associated with lower TLR than DCB use, although the optimal device strategy for CN lesions warrants further investigation. IVUS-based plaque characterization is essential and may facilitate morphology-oriented risk stratification in contemporary PCI practice.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975866","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":"Simple risk stratification of patients with ST-segment elevation myocardial infarction: based on the modified DanGer shock trial-derived criteria assessed at initial emergency room presentation.","authors":"Narumi Irie, Yuichi Sawayama, Mikitaka Fujita, Satoki Oka, Shunsuke Matsushita, Kohei Osakada, Shunsuke Kubo, Yasushi Fuku, Hiroyuki Tanaka, Mitsuru Abe, Kazushige Kadota","doi":"10.1007/s00380-026-02754-4","DOIUrl":"https://doi.org/10.1007/s00380-026-02754-4","url":null,"abstract":"<p><p>We aimed to investigate association of three DanGer Shock trial criteria [systolic blood pressure [SBP] < 100 mmHg, lactate ≥ 2.5 mmol/L, and left ventricular ejection fraction (LVEF) < 45%] on clinical outcomes among patients with ST-elevation myocardial infarction (STEMI) in Japan and evaluate whether these criteria could serve as a simple prognostic model for risk stratification. This single-center, retrospective, observational study included 1,211 patients with STEMI who underwent percutaneous coronary intervention (PCI) between 2014 and October 2023. The primary outcome was all-cause mortality at 180 days after the index PCI. To estimate the predictor of all cause death, a multivariable logistic regression analysis was conducted, and a scoring system was developed based on the results of the analysis. Patients were stratified according to the derived scoring system, and the prognostic utility of this stratification was evaluated. Among them, 4.1% met all the 3 key inclusion criteria of the DanGer Shock trial. The overall 180-day mortality rate was 6.5%. In multivariable analysis, each of the 2 criteria (SBP < 100 mmHg and LVEF < 45%) was significantly associated with 180-day all-cause death. Based on a multivariable logistic regression model, a simple shock score was developed (SBP < 100 mmHg, 1 point; lactate ≥ 2.5 mmol/L, 1 point; and LVEF < 45%, 2 points). With higher total shock scores, 180-day mortality increased exponentially (score 0: 1.9%, score 1: 2.8%, score 2: 6.1%, score 3: 16.4%, score 4 points, 42.7%, log-rank P< 0.001). In real-world clinical practice, few patients with STEMI fulfilled the 3 key inclusion criteria of the DanGer Shock trial. The simple score based on modified DanGer Shock trial-derived criteria assessed at initial emergency room presentation effectively stratified 180-day mortality risk in patients with STEMI.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911829","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":"From early LDL-C achievement to personalized management: considerations for future PCSK9 inhibitor research.","authors":"Yuxiang Wang, Youqin Jiang, Xiaohua Dai","doi":"10.1007/s00380-025-02624-5","DOIUrl":"10.1007/s00380-025-02624-5","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"637-638"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495324","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":"Non-invasive identification of high-risk plaques in non-culprit lesions of acute coronary syndrome.","authors":"Kazuyoshi Kakehi, Masafumi Ueno, Masaru Kayama, Kei Hamanaka, Haruka Minami, Nobuhiro Yamada, Kyohei Onishi, Keishiro Sugimoto, Yohei Funauchi, Takayuki Kawamura, Kosuke Fujita, Koichiro Matsumura, Gaku Nakazawa","doi":"10.1007/s00380-026-02663-6","DOIUrl":"10.1007/s00380-026-02663-6","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"590-601"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13486015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207034","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":"Balancing safety and efficiency in same-day discharge following transcatheter aortic valve replacement (TAVR).","authors":"Brijesh Sathian, Javed Iqbal, Hanadi Al Hamad, Syed Muhammad Ali","doi":"10.1007/s00380-025-02627-2","DOIUrl":"10.1007/s00380-025-02627-2","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"634-635"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145540446","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}