Heart and Vessels最新文献

{"title":"Comment on \"Safety and efficacy of high- and very high-power short-duration ablation in overweight and obese patients with atrial fibrillation\".","authors":"Munawara Zeb, Bilal Ahmad, Abdur Rehman, Sadeeq Khan","doi":"10.1007/s00380-025-02572-0","DOIUrl":"10.1007/s00380-025-02572-0","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527686","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":"Association of HDL-C levels with all-cause mortality in ACS patients after PCI: a multicenter prospective cohort study.","authors":"Hai-Tao Yang, Jing-Kun Liu, Zhi-Hui Jiang, Yi Yang, Jing Zhang","doi":"10.1007/s00380-025-02568-w","DOIUrl":"https://doi.org/10.1007/s00380-025-02568-w","url":null,"abstract":"<p><p>The association between high-density lipoprotein cholesterol (HDL-C) levels and prognosis in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) remains unclear. This study aimed to investigate the relationship between HDL-C levels and all-cause mortality in this population. This multicenter prospective cohort study included 17,180 ACS patients who underwent PCI from the Multicenter Prospective Cohort Study on Acute Coronary Syndrome (MPCS-ACS). HDL-C levels were categorized into four groups: < 30, 30-60, 60-90 (reference), and ≥ 90 mg/dL. The primary endpoint was all-cause mortality. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), with multivariable adjustments. During a median follow-up of 49 months, 1200 all-cause mortality events occurred. U-shaped associations were observed between HDL-C levels and risks of all-cause mortality. After multivariable adjustment, compared to patients with HDL-C levels of 60-90 mg/dL, ACS patients with HDL-C < 30 mg/dL or ≥ 90 mg/dL had a significantly increased risk of all-cause mortality, with HRs [95% CI] of 3.52 (2.66-4.64) and 2.71 (2.10-3.50), respectively. Both extremely low and high HDL-C levels were associated with increased risk of all-cause mortality in ACS patients undergoing PCI. Maintaining HDL-C levels within the 60-90 mg/dL range may be associated with better long-term outcomes.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474972","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":"Radiation safety in catheter ablation: clinical value of real-time operator dosimetry.","authors":"Machiko Miyoshi, Kanae Hasegawa, Rikiya Maruyama, Toshiki Tateishi, Ryohei Nomura, Toshihiko Tsuji, Moe Mukai, Tetsuya Tsujikawa, Hiroyasu Uzui, Hiroshi Tada","doi":"10.1007/s00380-025-02567-x","DOIUrl":"https://doi.org/10.1007/s00380-025-02567-x","url":null,"abstract":"<p><p>Advances in interventional cardiology have increased procedural complexity, raising concerns about radiation exposure-especially for women operators of reproductive age, who are subject to stricter dose limits. Standard dosimeters provide only delayed cumulative data, limiting timely risk assessment. Real-time personal dosimetry offers immediate feedback, but its clinical utility during catheter ablation (CA) remains underexplored. We retrospectively analyzed 82 CA procedures performed between January and May 2024. First operators wore real-time dosimeters positioned at the waist under lead aprons. Radiation exposure and procedural characteristics were recorded and analyzed. The median operator radiation dose per procedure was 2 [1, 3] µSv, while the median patient dose was 0.163 [0.082, 0.324] Gy. A procedure-related cardiac tamponade requiring pericardiocentesis resulted in the highest operator dose (50 µSv). Higher patient BMI (≥ 25 kg/m²) and longer fluoroscopy time were independently associated with increased operator exposure (OR: 1.238, P = 0.008; OR: 1.056, P = 0.022), though no linear correlation was observed between BMI and operator dose (r = 0.029, P = 0.797). Radiation exposure to operators during CA is generally low but may increase significantly in the event of complications or with higher-risk patient characteristics. Real-time dosimetry provides valuable immediate feedback and may be especially important for radiation-sensitive operators, supporting safer practice in the evolving field of interventional electrophysiology.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474974","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 diabetes and ejection fraction on non-ST-Segment elevation myocardial infarction outcomes.","authors":"Yong Hoon Kim, Ae-Young Her, Seung-Woon Rha, Cheol Ung Choi, Byoung Geol Choi, Soohyung Park, Jung Rae Cho, Min-Woong Kim, Ji Young Park, Myung Ho Jeong","doi":"10.1007/s00380-025-02564-0","DOIUrl":"https://doi.org/10.1007/s00380-025-02564-0","url":null,"abstract":"<p><p>Given the limited published data, we examined three-year outcomes in patients with and without diabetes mellitus (DM) in non-ST-segment elevation myocardial infarction (NSTEMI), according to left ventricular ejection fraction (LVEF). A total of 4594 patients were classified into DM (n = 1608) and non-DM (n = 2986) groups. They were further classified into heart failure with reduced EF (HFrEF, LVEF ≤ 40%), HF with mildly reduced EF (HFmrEF, LVEF 41-49%), and HF with preserved EF (HFpEF, LVEF ≥ 50%) subgroups. The primary outcome was all-cause mortality, and secondary outcomes included cardiac death (CD), non-CD (NCD), recurrent MI, any revascularization, and hospitalization for HF (HHF). In both DM and non-DM groups, in-hospital all-cause mortality rates were higher in the HFrEF subgroup than in the HFmrEF and HFpEF subgroups, but were similar between the HFmrEF and HFpEF subgroups. In the DM group, the three-year all-cause mortality (P < 0.001 for both), CD, NCD, recurrent MI, and HHF rates were higher in the HFrEF subgroup than in the HFmrEF and HFpEF subgroups. In the non-DM group, the three-year all-cause mortality (P = 0.001 and P < 0.001, respectively), CD, and HHF rates were higher in the HFrEF subgroup than in the HFmrEF and HFpEF subgroups. In both DM and non-DM groups, the three-year all-cause mortality and NCD rates were higher in the HFmrEF group than in the HFpEF group. Regardless of the presence of DM, the three-year outcomes were best in HFpEF, worst in HFrEF, and intermediate in HFmrEF patients.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474973","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 the letter to the editor: characteristics of cardiac rehabilitation progress during hospitalization and in‑hospital outcomes after mitral transcatheter edge‑to‑edge repair.","authors":"Kentaro Hori, Atsuko Nakayama, Shinya Tajima, Ruka Kanazawa, Kotaro Hirakawa, Yuichi Adachi, Yuki Izumi, Ryosuke Higuchi, Itaru Takamisawa, Mamoru Nanasato, Mitsuaki Isobe","doi":"10.1007/s00380-025-02566-y","DOIUrl":"https://doi.org/10.1007/s00380-025-02566-y","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274744","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":"Critique of cardiac rehabilitation progress and in-hospital outcomes following mitral transcatheter edge-to-edge repair: a call for comprehensive assessment and long-term follow-up.","authors":"Muhammad Khubaib Iftikhar","doi":"10.1007/s00380-025-02565-z","DOIUrl":"10.1007/s00380-025-02565-z","url":null,"abstract":"<p><p>Hori et al. (2025) present a valuable contribution to the growing body of literature on cardiac rehabilitation (CR) following mitral transcatheter edge-to-edge repair (M-TEER). Their study highlights the importance of early rehabilitation progress during hospitalization, but raises several concerns regarding its comprehensiveness and generalizability. The study's focus on ambulation as a primary marker of progress overlooks other crucial CR components such as exercise intensity, resistance training, and psychological factors. This critique emphasizes the need for a more comprehensive assessment of rehabilitation interventions, including psychological screenings and longitudinal follow-up data on functional status and quality of life. The absence of a multi-center, prospective design limits the study's external validity, and there is a notable lack of exploration of predictors for unplanned hospitalizations, which may significantly impact CR outcomes. Incorporating a broader range of assessments, such as hemodynamic profiling and psychological evaluations, would provide a more holistic understanding of CR's role in post-procedural recovery and guide future research in this field.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247560","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 NT-proBNP reduction on recurrence after cryoballoon pulmonary vein isolation and left atrial roof ablation in persistent atrial fibrillation.","authors":"Ryohei Nomura, Kanae Hasegawa, Toshihiko Tsuji, Moe Mukai, Machiko Miyoshi, Naoto Tama, Hiroyuki Ikeda, Kentaro Ishida, Hiroyasu Uzui, Hiroshi Tada","doi":"10.1007/s00380-025-02559-x","DOIUrl":"https://doi.org/10.1007/s00380-025-02559-x","url":null,"abstract":"<p><p>Pulmonary vein (PV) isolation by catheter ablation is a widely used curative therapy for atrial fibrillation (AF). However, in patients with persistent AF (PeAF), long-term outcomes are poor when PV isolation is performed alone. Although left atrial (LA) roof ablation is sometimes added to PV isolation, its effectiveness and predictors of success remain unclear. To identify predictors of arrhythmia recurrence in patients with PeAF undergoing LA roof ablation and PV isolation using a cryoballoon catheter. A retrospective assessment of LA roof ablation and PV isolation using a cryoballoon was performed in 65 consecutive patients with PeAF. The median age of the patients was 69 years [Q1:61, Q3:75]; 55% were female, and 49% had longstanding PeAF. The complete LA roof block success rate using a cryoballoon was 92.3%, with no esophagus-related complications. The 1-year post-ablation arrhythmia-free rate was 83.3%. Atrial arrhythmia recurrence was more common within the 3-month blanking period. The N-terminal prohormone of brain natriuretic peptide (NT-proBNP) reduction rate ≥60.7% and sinus rhythm at 1-month post-ablation, and no arrhythmia during the 3-month blanking period strongly predicted arrhythmia-free status at 1 year post-ablation. In patients with PeAF who underwent LA roof ablation and PV isolation using a cryoballoon, the arrhythmia-free rate was high. The NT-proBNP reduction rate at 1-month post-ablation may serve as a simple and potentially useful predictor of procedural success.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233969","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 the letter to the editor \"Is TEVAR the best method for thoracic aortic pathologies?\"","authors":"Akitoshi Takazawa, Kazuto Maruta, Toshihisa Asakura, Akihiro Yoshitake","doi":"10.1007/s00380-025-02548-0","DOIUrl":"https://doi.org/10.1007/s00380-025-02548-0","url":null,"abstract":"","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215673","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 changes in tissue properties of neointimal tissue of in-stent lesion during excimer laser coronary angioplasty (ELCA) evaluated by integrated-backscatter intravascular ultrasound (IB-IVUS).","authors":"Makoto Iwama, Shinichiro Tanaka, Hiroto Yagasaki, Takahiro Ueno, Takashi Yoshizane, Takashi Kato, Kentaro Morishita, Masazumi Arai, Toshiyuki Noda","doi":"10.1007/s00380-025-02563-1","DOIUrl":"https://doi.org/10.1007/s00380-025-02563-1","url":null,"abstract":"<p><p>Excimer laser coronary angioplasty (ELCA) plays an important role in modifying plaque composition, yet its impact on neointimal tissue (NIT) in in-stent restenosis lesions has remained unclear. While integrated backscatter intravascular ultrasound (IB-IVUS) can characterize plaque composition in de novo lesions, its ability to reflect tissue characteristics in NIT is limited due to the distinct structural and acoustic properties of neointimal tissue. This study aimed to investigate the effects of ELCA on NIT using IB-IVUS. We examined 49 in-stent lesions in 49 patients. IB-IVUS analysis focused on a 10 mm segment centered on the minimum lumen area (MLA), with data collected every 1 mm. Color maps were generated based on IB-IVUS backscatter values and included the following classifications: Red (typically calcification in de novo lesions), Yellow (dense fibrosis), Green (fibrosis), Blue (lipid pool), and Purple (lipid pool with attenuation). These classifications are based on tissue characteristics as defined in de novo settings and may differ in in-stent neointimal tissue. We compared Color-Ave (average color-coded area across 11 cross-sections, mm²) and %Color-Ave (relative to neointimal tissue area), before and after ELCA. IB-related values, including mean (Ave-IB) and variance (Variance-IB), were automatically obtained. Following ELCA, Purple-Ave and %Purple-Ave significantly decreased (from 0.95±1.28 mm² to 0.77±1.13 mm², and from 13.5±12.8% to 11.2±11.1%, both p=0.002). %Green-Ave increased significantly (from 53.6±14.1% to 55.5±12.7%, p=0.016), although Green-Ave remained unchanged. No significant changes were observed in Red-, Yellow-, and Blue-code areas. Similar trends were observed in MLA- and volume-based analyses. Ave-IB increased (p=0.028), while Variance-IB decreased (p=0.005). Changes in IB-related values were associated with their pre-ELCA levels. ELCA appears to ablate tissue with high IB-related values, leading to reduced tissue heterogeneity, even in NIT where tissue characterization by IB-IVUS is inherently limited.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208337","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":"Association of aerobic exercise habits with higher albumin-globulin ratio and lower cellular immune-inflammatory markers: implication of the preventive effect of aerobic exercise on atherosclerotic cardiovascular disease.","authors":"Shigemasa Tani, Kazuhiro Imatake, Yasuyuki Suzuki, Tsukasa Yagi, Atsuhiko Takahashi","doi":"10.1007/s00380-024-02490-7","DOIUrl":"10.1007/s00380-024-02490-7","url":null,"abstract":"<p><p>Aerobic exercise habits have shown promising potential in reducing inflammation. Several studies have suggested that a higher albumin-globulin ratio (AGR), a key indicator of the immune-inflammatory response, could potentially suppress the progression of atherosclerosis. In this study, we investigated the relationship between aerobic exercise and atherosclerotic cardiovascular disease (ASCVD) predictors, specifically, AGR and cellular immune-inflammatory markers. We conducted a cross-sectional study involving 8381 participants (average age, 46.7 ± 13.0 years; 59% men) with no history of ASCVD registered at the Health Planning Center, Nihon University Hospital between 2019 and 2020. We defined aerobic exercise habits as 30 min of sweating at least twice a week for over a year, per the guideline for conducting specific health examinations according to Japan's Ministry of Health, Labour and Welfare. Participants who engaged in habitual aerobic exercise (n = 2159) had a significantly higher AGR than those who did not (n = 6220) [1.70 (1.55/1.86) vs. 1.67 (1.53/1.84), P < 0.0001]. Cellular immune-inflammatory markers, including neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and systemic immune-inflammation index (neutrophil/lymphocyte × platelet count), were significantly lower in participants who engaged in habitual aerobic exercise than in those who did not (all P < 0.0001). Furthermore, lower cellular immune-inflammatory markers were associated with a higher AGR. Causal mediation analysis revealed that cellular immune-inflammatory markers partially mediated the association between aerobic exercise and AGR. In conclusion, aerobic exercise habits may be associated with a higher AGR and lower cellular immune-inflammatory markers. Moreover, the lower immune-inflammatory response related to aerobic exercise may partially mediate the higher AGR. These associations may explain the attenuating effects of aerobic exercise on the risk of ASCVD.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"509-522"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768425","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}