Heart and Vessels最新文献

{"title":"Retrograde percutaneous coronary intervention for chronic total occlusions in patients with reduced left ventricular ejection fraction: a single-center retrospective cohort study.","authors":"Song Wen, Chang Dai, Zehan Huang, Jing Wang, Feng Wang, Kaize Wu, Dunliang Ma, Feihuang Han, Jiquan Xiao, Yuqing Huang, Shulin Wu, Bin Zhang","doi":"10.1007/s00380-025-02526-6","DOIUrl":"10.1007/s00380-025-02526-6","url":null,"abstract":"<p><strong>Background: </strong>Data on the safety and prognostic implications of retrograde percutaneous coronary intervention (PCI) in patients with low left ventricular ejection fraction (LVEF) and chronic total occlusion (CTO) are unclear. This study aimed to assess the procedural results and long-term outcomes of retrograde CTO PCI in individuals with reduced LVEF (≤ 40%).</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 836 consecutive patients who underwent elective retrograde CTO PCI at a single center between January 2011 and April 2023. Patients and lesion characteristics, procedural details and results, and long-term outcomes were compared between patients with reduced (LVEF ≤ 40%) and preserved left ventricular systolic function (LVEF > 40%) based on echocardiographic assessment.</p><p><strong>Results: </strong>Baseline LVEF ≤ 40% was presented in 156 (18.7%) patients. The collateral channel (CC) tracking success was high (overall 93.5%) and similar among the groups (94.2% vs. 93.4%, p = 0.835), as well as retrograde technical success (87.8% vs. 89.9%, p = 0.548) and recanalization success (87.8% vs. 91.5%, p = 0.281). Procedure complications were low and similar between the groups (all p > 0.05). Clinical follow-up was available in 767 (91.2%) patients with a medium follow-up of 1041 (531-1511) days. In patients with lower LVEF, the incidence of MACE was higher (23.2% vs. 14.9%, p = 0.021), mainly the all-cause mortality (15.4% vs. 4.1%, p < 0.001) and cardiac death (12.2% vs. 2.5%, p < 0.001). Multivariable analysis revealed that age (hazard ratio [HR]: 1.03, 95% confidence interval [CI]: 1.01-1.04, p = 0.008), LVEF ≤ 40% (HR: 1.21, 95%CI: 1.01-1.45, p = 0.039), and revascularization success (HR: 0.38, 95% CI: 0.22-0.66, p < 0.001) were independently associated with MACE.</p><p><strong>Conclusions: </strong>Retrograde PCI may represent a safe and efficient management strategy for patients with reduced LVEF and CTO. Furthermore, our study demonstrated that successful CTO recanalization was associated with a significant survival benefit, regardless of left ventricular systolic function.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"814-825"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476481","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":"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":"778-788"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","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":"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":"826-836"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","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}

{"title":"Long-term outcome of tailored antithrombotic therapy based on platelet function testing in patients undergoing percutaneous coronary intervention: a 5-year retrospective cohort study.","authors":"Emanuele Cecchi, Andrea Grasso Granchietti, Claudia Assenza, Angela Ilaria Fanizzi, Manuel Garofalo, Francesca Maria Di Muro, Veronica Speranza Vitiello, Francesco Losanno, Sabina Caciolli, Chiara Piazzai, Marco Chiostri, Rossella Marcucci","doi":"10.1007/s00380-025-02584-w","DOIUrl":"https://doi.org/10.1007/s00380-025-02584-w","url":null,"abstract":"<p><p>Dual antiplatelet therapy is the standard therapy for the secondary prevention of acute and chronic coronary syndromes in patients undergoing percutaneous coronary intervention (PCI). The introduction of more potent antiplatelet agents and understanding of prognostic implications associated with bleeding have led to a substantial evolution in antiplatelet treatment regimens over the past decades. Several investigations have been conducted to better stratify patients undergoing PCI according to their ischemic and bleeding risks and to optimize antithrombotic regimens accordingly. One of the available strategies involves using platelet aggregation tests to determine the most suitable antiplatelet agent to combine with aspirin. Our aim was to evaluate the role of platelet function tests (PFT) in clinical practice in choosing dual antiplatelet therapy for patients undergoing PCI: in this study, we compared the impact on ischemic and hemorrhagic cardiovascular events in a 5 year follow-up between patients treated according to standard guidelines and those treated with a platelet function test guided approach. This study included 490 patients with acute or chronic coronary syndrome who underwent percutaneous angioplasty between 2013 and 2016 and were subsequently treated with dual antiplatelet therapy. Patients whose treatment strategy was based on PFT were 68.4% (n = 335), while others received standard therapy. The primary endpoint of the study was to assess the incidence of net adverse clinical events (NACE), defined as a composite of all-cause mortality, myocardial infarction, stroke, or major bleeding, according to the BARC scale. Follow-up was conducted 5 years after angioplasty by telephone contact or by consulting patients' medical records. Heart failure and stable angina were considered as secondary endpoints. From the univariate analysis, the incidence of NACE was significantly lower in patients who received tailored therapy (33.7% vs. 43.9% in the non-tailored group, p = 0.02). In addition, results showed that total length of implanted stents and left main coronary disease were independent risk factors for net adverse clinical events (NACE). Similarly, an initial diagnosis of N-STEMI or unstable angina was associated with an increased risk of adverse events during follow-up. In patients undergoing PCI, a tailored antithrombotic approach guided by PFT appears safe and effective, may represent a feasible strategy in contemporary practice and should be considered in case of high bleeding risk.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951554","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":"Exercise-induced brachial-ankle pulse wave velocity changes before and after transcatheter aortic valve replacement.","authors":"Ayano Osawa, Hiroki Ikenaga, Atsushi Kuraishi, Kiyotaka Togi, Mikio Shigehara, Ayano Hamada, Makoto Takeuchi, Yohei Hyodo, Atsuo Mogami, Akane Tsuchiya, Atsushi Takeda, Takayuki Nakano, Yusuke Ueda, Kosuke Takahari, Yuichi Morita, Tasuku Higashihara, Noriaki Watanabe, Yoshiharu Sada, Hiroto Utsunomiya, Taiichi Takasaki, Shinya Takahashi, Yukiko Nakano","doi":"10.1007/s00380-025-02593-9","DOIUrl":"https://doi.org/10.1007/s00380-025-02593-9","url":null,"abstract":"<p><p>Elevated arterial stiffness is associated with cardiovascular risk. Brachial-ankle pulse wave velocity (baPWV), a measure of arterial stiffness, is decreased by exercise stress, which is associated with good vascular endothelial function. Moreover, baPWV may predict outcomes following transcatheter aortic valve replacement (TAVR) and has been reported to change before and after TAVR. However, studies on baPWV changes in patients with TAVR undergoing exercise stress have not been conducted. This study aimed to assess the changes in baPWV before and after TAVR using a simple exercise stress method. We enrolled 40 patients (mean age, 84.6 ± 4.4 years; 45% males) with severe symptomatic aortic stenosis undergoing TAVR. baPWV was assessed at rest and immediately following the exercise protocol. Exercise stress was performed using a simple method wherein patients actively plantar flexed and dorsiflexed their legs in a resting supine position. Measurements were conducted at baseline and after TAVR. Resting baPWV significantly increased from 1673 ± 322 to 2073 ± 426 cm/s (p < 0.001), and exercise stress baPWV also significantly increased from 1662 ± 339 to 1972 ± 335 cm/s (p < 0.001) after TAVR. Compared with resting baPWV, post-exercise baPWV did not change before TAVR (from 1673 ± 322 to 1662 ± 339 cm/s, p = 0.68), but significantly decreased after TAVR (from 2073 ± 426 to 1972 ± 335 cm/s, p = 0.012). The arterial system demonstrated increased baPWV in response to the acute relief of the obstruction following TAVR. Exercise stress decreased baPWV following TAVR, suggesting that endothelial function was maintained, which was masked before TAVR.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872899","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 and safety of intravascular ultrasound-guided percutaneous coronary intervention with intravascular lithotripsy for severe calcified lesions.","authors":"Tetsuya Kobayashi, Masahiko Noguchi, Makio Muraishi, Tatsuya Nakama, Kotaro Obunai","doi":"10.1007/s00380-025-02596-6","DOIUrl":"https://doi.org/10.1007/s00380-025-02596-6","url":null,"abstract":"<p><p>Previous studies have demonstrated favorable outcomes with percutaneous coronary intervention (PCI) using initial intravascular lithotripsy (IVL) for calcified lesions. However, IVL outcomes under intravascular ultrasound (IVUS) guidance remain unclear. The aim of this study was to evaluate the initial clinical outcomes of PCI for severe calcified lesions using IVUS. In this study, we evaluated initial clinical outcomes of IVUS-guided PCI with IVL for severe calcified lesions. Consecutive IVL cases performed at our hospital between April and October 2023 were retrospectively analyzed. Primary outcomes included cross-sectional area (CSA, mm²) and percent area stenosis (%AS) at the pre-IVL minimum lumen area (MLA) site as measured by IVUS. Pre-IVL, post-IVL, and post-stent results were compared. Secondary outcomes included angiographic success, procedural complications, and major adverse cardiovascular events (MACE) within 1 year. Thirty-one patients with 32 lesions were included. CSA values at the pre-IVL MLA site were 2.2 ± 0.9, 4.2 ± 1.5, and 7.5 ± 2.3 mm², and %AS values were 80.1 ± 7.2%, 62.9 ± 12.3%, and 35.5 ± 16.3% (p < 0.001). Angiographic success was achieved in all cases without complications. At 1 year, the cumulative MACE rate was 9.6%, comprising cardiac death (3.2%), myocardial infarction (3.2%), and target vessel revascularization (3.2%). IVUS-guided PCI with IVL for severe calcified lesions demonstrated high procedural success, no complications, and low 1-year MACE rates, highlighting the safety, effectiveness, and clinical relevance of IVUS guidance in real-world practice.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859126","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":"Modified nutrition risk in critically ill (mNUTRIC) score on admission and mortality in acute heart failure patients admitted to the cardiac intensive care unit.","authors":"Shintaro Haruki, Yuichiro Minami, Hidetoshi Hattori, Motoko Kametani, Jihaeng Im, Kenjiro Oyabu, Makoto Kishihara, Junichi Yamaguchi","doi":"10.1007/s00380-025-02595-7","DOIUrl":"https://doi.org/10.1007/s00380-025-02595-7","url":null,"abstract":"<p><p>The modified nutrition risk in critically ill (mNUTRIC) score was developed to quantify the risk of adverse events related to malnutrition in the intensive care unit setting. However, its prognostic value has not been examined in patients with acute heart failure (AHF). This study aimed to investigate the relationship between mNUTRIC score and all-cause mortality in AHF patients in the cardiac intensive care unit (CCU). We retrospectively examined 307 patients with AHF who were admitted to our CCU from April 2014 to March 2017. mNUTRIC score was calculated within 24 h of CCU admission. Patients were classified as either high nutritional risk (score ≥ 5) or low nutritional risk (score < 5). The primary endpoint was death from any cause. Median follow-up was 272 days (interquartile range 59-588). Kaplan-Meier survival analysis showed that overall survival was significantly worse in the high nutritional risk group (p < 0.001). In the multivariate analysis adjusted for chronic kidney disease, systolic blood pressure, hypoalbuminemia, anemia, and C-reactive protein concentration, mNUTRIC score ≥ 5 was an independent predictor of higher all-cause mortality (adjusted hazard ratio, 2.23; 95% confidence interval, 1.33-3.72; p = 0.003). mNUTRIC score ≥ 5 at admission to the CCU is associated with increased risk of mortality in AHF patients in the CCU.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834943","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":"Improvements of cardiac function and metabolic parameters by sodium-glucose cotransporter 2 inhibitors with no significant effects on sympathetic or parasympathetic activity in chronic heart failure.","authors":"Jinya Takahashi, Yoshihiro Fukumoto","doi":"10.1007/s00380-025-02592-w","DOIUrl":"https://doi.org/10.1007/s00380-025-02592-w","url":null,"abstract":"<p><p>Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated significant cardiovascular benefits, including reductions in hospitalizations and mortality among patients with heart failure (HF). However, the mechanisms underlying these benefits, particularly their effects on autonomic nervous system activity, remain incompletely understood. This single-center, prospective observational study included 11 patients with chronic HF who were newly initiated on SGLT2 inhibitors. Sympathetic nerve activity was assessed using 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy, while parasympathetic activity was evaluated via heart rate recovery during cardiopulmonary exercise testing (CPET) conducted at baseline and three months post-treatment initiation. Echocardiographic and laboratory parameters were also analyzed. After three months of treatment, no significant changes were observed in MIBG-derived heart-to-mediastinum (H/M) ratios, washout rates, or heart rate recovery following exercise. Echocardiographic assessment revealed significant improvements in cardiac function. Laboratory findings demonstrated reductions in uric acid and HbA1c levels, improved liver function, and increased erythropoietin levels, while NT-proBNP exhibited a non-significant downward trend. Notably, free carnitine levels decreased significantly, possibly indicating enhanced energy metabolism within the failing myocardium. In patients with chronic HF, SGLT2 inhibitors had no significant effect on autonomic nervous system activity within the first three months of treatment. However, significant improvements in cardiac function and metabolic parameters were observed, supporting their cardioprotective role.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794225","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":"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":"<p><p>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.</p>","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}

{"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":"<p><p>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.</p>","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}