Heart and Vessels最新文献

{"title":"Prognostic significance of angiography-derived index of microcirculatory resistance assessment after rotational atherectomy in patients with severely calcified lesions.","authors":"Yuki Sakamoto, Hiroyuki Kawamori, Takayoshi Toba, Satoru Sasaki, Hiroyuki Fujii, Tomoyo Hamana, Yuto Osumi, Seigo Iwane, Tetsuya Yamamoto, Shota Naniwa, Koshi Matsuhama, Yuta Fukuishi, Hiroshi Tsunamoto, Hiroya Okamoto, Kotaro Higuchi, Ken-Ichi Hirata, Hiromasa Otake","doi":"10.1007/s00380-025-02575-x","DOIUrl":"https://doi.org/10.1007/s00380-025-02575-x","url":null,"abstract":"<p><p>Coronary microcirculatory dysfunction (CMD) is a known predictor of adverse outcomes after percutaneous coronary intervention (PCI). However, the prognostic significance of CMD in patients with severely calcified lesions treated with rotational atherectomy (RA) remains unclear. We retrospectively studied consecutive chronic coronary syndrome patients who underwent PCI with RA followed by second-generation drug-eluting stent (DES) implantation. CMD was evaluated by angiography-derived index of microcirculatory resistance (IMR_angio), calculated from the quantitative flow ratio (QFR) obtained immediately after PCI without hyperemia. The primary outcome was the occurrence of major adverse cardiovascular events (MACE) within 2 years, including cardiovascular death, spontaneous myocardial infarction, and target vessel revascularization. Among the 128 enrolled patients, 22 (17.2%) experienced MACE. Post-IMR_angio was significantly higher in patients who experienced MACE than in those who did not (39.3 ± 12.5 vs. 30.4 ± 9.8, p < 0.001). Increased post-IMR_angio was independently associated with MACE (hazard ratio, 1.05; 95% confidence interval [CI]: 1.02-1.09, p = 0.004). Receiver operating characteristic curve analysis identified optimal cutoff values of 40.6 for post-IMR_angio to predict MACE (area under the curve 0.72, 95% CI: 0.58-0.86). Including high post-IMR_angio (> 40U), along with clinical risk factors and QFR findings, significantly improved the discriminatory and reclassification ability to identify the risk of MACE after RA. IMR_angio measured immediately after the PCI with RA followed by second-generation DES implantation is a valuable tool for risk stratification in patients with severely calcified lesions.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626066","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":"\"Critical reflections on mid-range ejection fraction and outcomes in STEMI patients\".","authors":"Aleena Mumtaz, Naveed Ahmad","doi":"10.1007/s00380-025-02581-z","DOIUrl":"https://doi.org/10.1007/s00380-025-02581-z","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617174","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":"Response to letter by Dr. Mumtaz: critical reflections on mid-range ejection fraction and outcomes in STEMI patsients.","authors":"Kiriha Nanri, Kenichi Sakakura, Hideo Fujita","doi":"10.1007/s00380-025-02583-x","DOIUrl":"https://doi.org/10.1007/s00380-025-02583-x","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617176","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":"Comment on \"Overnight stiffness index from finger photoplethysmography in relation to markers of cardiovascular risk and vascular aging\".","authors":"Triwiyanto Triwiyanto","doi":"10.1007/s00380-025-02577-9","DOIUrl":"10.1007/s00380-025-02577-9","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617175","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":"Scoring of cardiac damage evaluated by echocardiography predicts prognosis of patients with severe aortic stenosis undergoing transcatheter aortic valve implantation: analysis of the LAPLACE-TAVI registry.","authors":"Shunsuke Edamura, Harutoshi Tamura, Tetsu Watanabe, Takayuki Sugai, Masahiro Wanezaki, Satoshi Nishiyama, Ryosuke Higuchi, Kenichi Hagiya, Itaru Takamisawa, Mamoru Nanasato, Nobuo Iguchi, Morimasa Takayama, Jun Shimizu, Shinichiro Doi, Shinya Okazaki, Masaki Ishiyama, Hiroaki Yokoyama, Shuichiro Takanashi, Motoki Fukutomi, Mike Saji, Masafumi Watanabe","doi":"10.1007/s00380-025-02569-9","DOIUrl":"https://doi.org/10.1007/s00380-025-02569-9","url":null,"abstract":"<p><p>Transcatheter aortic valve implantation (TAVI) has become available for elderly patients with aortic stenosis (AS). However, no markers have been established to predict prognosis after TAVI. Cardiac damage caused by AS progresses sequentially in most cases through the left ventricle, left atrium, and right ventricle. However, cardiac damage does not always progress sequentially. This study examined whether the burden of cardiac damage assessed by echocardiography predicts prognosis in patients with severe AS who underwent TAVI. We assessed patient data from a multicenter TAVI registry involving seven hospitals in Japan. Among 1,850 patients with severe AS, patients with preserved LV ejection fraction were included. We performed echocardiography before TAVI in 1,285 patients. The primary endpoint was cardiovascular (CV) events including CV deaths and rehospitalizations for heart failure. During a median follow-up of 741 days, 76 CV events occurred. A multivariate Cox-proportional hazards analysis revealed that four echocardiographic parameters, including tricuspid regurgitation pressure gradient, E/e', left atrial volume index, and left ventricular mass index were associated with CV events. We created a scoring system using these four echocardiographic parameters. The echocardiography-directed aortic stenosis score (EDA score) was computed by assigning one point each for the presence of abnormal parameters. The receiver operating characteristic curve of EDA score for CV events showed an area under the curve value of 0.74, a cutoff value of 3 points, a sensitivity value of 75%, and a specificity value of 63%. Kaplan-Meier analysis showed that CV event rates were significantly higher in patients with high EDA scores compared with those having low scores. Hazard ratio was 14.3-fold for the 3-point group and 26.6-fold for the 4-point group when compared with the 0-point group of patients. EDA score may be a feasible indicator for risk stratification in patients with severe AS who underwent TAVI.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608177","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":"Factors correlated with non-early achievement of target low-density lipoprotein cholesterol level using PCSK9 inhibitors.","authors":"Masami Nishino, Yasuyuki Egami, Ayako Sugino, Noriyuki Kobayashi, Masaru Abe, Mizuki Ohsuga, Hiroaki Nohara, Shodai Kawanami, Kohei Ukita, Akito Kawamura, Koji Yasumoto, Naotaka Okamoto, Yasuharu Matsunaga-Lee, Masamichi Yano","doi":"10.1007/s00380-025-02571-1","DOIUrl":"https://doi.org/10.1007/s00380-025-02571-1","url":null,"abstract":"<p><p>The international guidelines recommend a target low-density lipoprotein cholesterol (LDL-c) level of < 55 mg/dL in very-high-risk patients with dyslipidemia, which were defined as those with history of acute coronary syndrome (ACS), chronic coronary syndrome with multivessel disease, diabetes mellitus, chronic kidney disease, familiar hypercholesterolemia, recurrent coronary artery disease, or polyvascular disease. In addition, an early reduction in LDL-c levels is recommended especially for ACS. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been reported to be very effective for an early reduction in the LDL-c level, but some patients showed non-early reduction. We investigated the factors correlating with non-early lowering LDL-c levels using PSCK9 inhibitors in very-high-risk patients. We enrolled consecutive patients with dyslipidemia who received evolocumab due to very-high-risk. We divided them into the early achievement of the target LDL-c level (EAC) group whose LDL-c level decreased to < 55 mg/dL 1 month later and the non-EAC group. We investigated the various factors possibly correlated with non-EAC. The non-EAC group comprised 25 patients (35.2%). A univariable analysis revealed that a body mass index (BMI) > 23.9 kg/m², history of ACS, LDL-c > 144 mg/dL, and high-intensity statins were related to the non-EAC group. A multivariable analysis showed that a history of ACS was negatively and LDL cholesterol level > 144 mg/dL positively correlated with non-EAC. In conclusion, we induced PSCK9 inhibitors more aggressively in ACS, and we should pay attention to the patients with higher baseline LDL-c levels during the follow-up.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608176","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":"Comparison between contrast-guided and pressure-guided ablation using the novel pressure visualization tool for cryoballoon pulmonary vein isolation.","authors":"Philipp Bengel, Helge Haarmann, Eva Rasenack, Nibras Soubh, Simon Schlögl, Gerd Hasenfuß, Markus Zabel, Leonard Bergau","doi":"10.1007/s00380-025-02574-y","DOIUrl":"https://doi.org/10.1007/s00380-025-02574-y","url":null,"abstract":"<p><p>During cryoballon pulmonary vein isolation (PVI) complete occlusion of the pulmonary vein ostia during the freeze cycles is mandatory. Typically, PV occlusion is assessed by contrast injection under fluoroscopy. Using an update for the Cryo Console it is possible to directly visualize occlusion pressure as an indicator of complete PV occlusion during cryoballoon procedures. In this study, we compared PV pressure monitoring during cryoballoon PVI to a conventional approach regarding procedural outcomes. We retrospectively analysed the procedural data of 50 patients (25 patients with pressure-guided PVI and 25 patients with contrast-guided PVI) treated with cryoballoon PVI in our centre. Complete PV occlusion in the pressure-guided group was defined as an abrupt change in the pressure waveform with a loss of the a-wave after advancing the cryoballoon to the PV ostium. We observed comparable results regarding procedural time, left atrial dwell time or fluoroscopy time when comparing the pressure guided to our conventional approach. Moreover, there were no differences regarding acute procedural effectivity or freeze cycle characteristics. As expected, a significant reduction of contrast use was achieved in the pressure measurement group (10.4 vs. 25.5 ml, p < 0.0001). Monitoring complete PV occlusion by visualizing the occlusion pressure is feasible. Acute procedural outcome was comparable to our standard approach using contrast injection to verify complete PV occlusion. Most importantly, a significant reduction in contrast use could be achieved which has to be confirmed in larger patient cohorts.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583766","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":"Reply to: Comment on \"Safety and efficacy of high- and very high-power short-duration ablation in overweight and obese patients with atrial fibrillation\".","authors":"Viola Adam, Paloma Biehler, Patricia Hägele, Simon Hanger, Stephanie Löbig, Andrei Pinchuk, Felix Ausbuettel, Christian Waechter, Peter Seizer, Sebastian Weyand","doi":"10.1007/s00380-025-02573-z","DOIUrl":"https://doi.org/10.1007/s00380-025-02573-z","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567378","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":"HELT-E₂S₂ score is a promising marker for predicting left atrial appendage dysfunction in patients with ischemic stroke.","authors":"Naoto Hashimoto, Tetsu Watanabe, Atsushi Iizuka, Tomoki Kobayashi, Shunsuke Edamura, Takayuki Sugai, Masahiro Wanezaki, Harutoshi Tamura, Satoshi Nishiyama, Masafumi Watanabe","doi":"10.1007/s00380-025-02570-2","DOIUrl":"10.1007/s00380-025-02570-2","url":null,"abstract":"<p><p>The HELT-E₂S₂ score, replacing diabetes mellitus and heart failure and adding extreme elderly (≥ 85 years), type of atrial fibrillation (AF), and low body mass index (BMI), has been proposed as a new measure for stratifying the risk of stroke in Japanese patients with AF. However, the association of the HELT-E₂S₂ score with left atrial appendage (LAA) dysfunction in patients with ischemic stroke remains unclear. We performed transthoracic and transesophageal echocardiography and evaluated the HELT-E₂S₂ scores in 593 patients with acute ischemic stroke and 296 patients without acute ischemic stroke as the control group. LAA dysfunction, defined as the presence of an LAA thrombus and/or severe spontaneous echo contrast, was identified in 182 patients. In a receiver operating characteristic curve analysis, the area under the curve of the HELT-E₂S₂ score for predicting LAA dysfunction was significantly higher than those of the CHADS₂ score (0.74 vs. 0.67, P < 0.001) and the CHA₂DS₂-VA score (0.74 vs. 0.67, P < 0.001). Multivariate logistic regression analysis showed that the HELT-E₂S₂ score was an independent predictor of LAA dysfunction after adjusting for conventional risk factors. The HELT-E₂S₂ score is a promising marker for predicting LAA dysfunction in patients with ischemic stroke.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539970","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":"Excessive supraventricular ectopic activity is a simple cutoff for predicting late recurrence of atrial fibrillation after ablation.","authors":"Tomoki Fujisawa, Hiroshi Kawakami, Shunsuke Tamaki, Shigehiro Miyazaki, Yusuke Akazawa, Toru Miyoshi, Akinori Higaki, Fumiyasu Seike, Haruhiko Higashi, Kazuhisa Nishimura, Katsuji Inoue, Shuntaro Ikeda, Osamu Yamaguchi","doi":"10.1007/s00380-024-02498-z","DOIUrl":"10.1007/s00380-024-02498-z","url":null,"abstract":"<p><p>The relationship between post-ablation excessive supraventricular ectopic activity (ESVEA), a new marker for new-onset atrial fibrillation (AF), and late AF recurrence is uncertain. We enrolled 469 patients with AF who underwent initial radiofrequency catheter ablation and 24-h Holter monitoring the day after. Early AF recurrence (n = 57; 12%) and ESVEA (n = 242; 52%) were noted. During a median follow-up of 25 months, 152 (32%) patients experienced late AF recurrence. Patients with early AF recurrence or ESVEA were significantly more likely to experience late recurrence (p = 0.02). Even without AF, ESVEA was associated with late recurrence following AF ablation.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"629-635"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828294","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}