International journal of cardiology最新文献

{"title":"Novel high-burden thrombus criterion: Thrombectomy plus thrombolysis improves microvascular resistance in myocardial infarction.","authors":"Huaizhi Lu, Yanbin Zhang, Pengwei Yang, Hui Zhao, Yanwei Zhu, Xuesheng Xu","doi":"10.1016/j.ijcard.2025.133970","DOIUrl":"https://doi.org/10.1016/j.ijcard.2025.133970","url":null,"abstract":"<p><strong>Background: </strong>The thrombolysis in myocardial infarction (TIMI) thrombus grade has long been used to assess thrombus burden and guide treatment strategies. However, this grading system may not fully capture the complexities of thrombus management during PCI, which has caused potential biases in the selection and application of thrombectomy and coronary thrombolysis in large-scale randomized trials. To address this limitation, a novel high-burden thrombus criterion is proposed, defined as TIMI thrombus grade 4-5 after balloon angioplasty with a 2.0 mm balloon. A retrospective observational study was conducted to evaluate the clinical outcomes of combined thrombectomy/thrombolysis in high-burden thrombus patients, focusing on microcirculatory improvement and reperfusion.</p><p><strong>Methods: </strong>This retrospective observational study included 175 STEMI patients who underwent emergency PCI and met the novel high-burden thrombus criterion. Patients were classified into three groups according to intraoperative thrombus management strategies: thrombectomy alone, coronary thrombolysis alone, and combined thrombectomy/thrombolysis. Myocardial microcirculatory function was assessed using the index of microvascular resistance (IMR) and TIMI frame count (TFC), and their correlations with left ventricular ejection fraction (EF) were analyzed. IMR reflects microvascular resistance, with higher values indicating poorer myocardial perfusion.</p><p><strong>Results: </strong>No significant differences were observed in baseline clinical characteristics, infarct-related artery, stent implantation, or other factors among the three groups. The IMR in the combined thrombectomy/thrombolysis group was significantly lower than in the thrombectomy group and the thrombolysis group (26.07 ± 12.45 vs. 34.67 ± 11.79 vs. 32.97 ± 13.70, P < 0.01). TFC was also lower in the combined group compared with the other two groups (22.04 ± 9.94 vs. 28.70 ± 12.82 vs. 31.00 ± 12.69, P < 0.01). Compared with the thrombectomy and thrombolysis groups, the combined group demonstrated a higher EF and a lower LVEDd (56.91 ± 7.96 vs. 52.02 ± 10.85 vs. 53.22 ± 7.39, P < 0.01; 49.89 ± 3.78 vs. 50.51 ± 4.33 vs. 54.11 ± 5.39, P < 0.01). Correlation analysis revealed a significant negative association between IMR and EF (ρ = -0.256, P < 0.01). Additionally, symptom onset-to-balloon time (SOBT) correlated significantly with both IMR and TFC (ρ > 0.2, P < 0.01).</p><p><strong>Conclusion: </strong>The novel high-burden thrombus criterion provides a precise framework for guiding thrombus management strategies in clinical practice. In STEMI patients with high-burden thrombi after balloon angioplasty, combined thrombectomy/thrombolysis significantly reduces postoperative IMR, improves myocardial perfusion, facilitates left ventricular recovery, and enhances overall prognosis.</p>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":" ","pages":"133970"},"PeriodicalIF":3.2,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Murray law-based angiography-derived assessment of coronary microcirculatory resistance in myocardial ischemia and non-obstructive coronary arteries.","authors":"Alexander Marschall, Fernando Rivero, Carlos Cortés, David Del Val, Javier Cuesta, Blanca Santos Martín, Julio Ruiz-Ruiz, Teresa Bastante, Ignacio J Amat-Santos, Fernando Alfonso","doi":"10.1016/j.ijcard.2025.133968","DOIUrl":"https://doi.org/10.1016/j.ijcard.2025.133968","url":null,"abstract":"<p><strong>Background: </strong>The current European Society of Cardiology guidelines suggest invasive coronary function testing (CFT) for patients with suspected ischemia and non-obstructive coronary arteries (INOCA). We aimed to investigate the diagnostic yield of a novel Murray law-based coronary angiography derived assessment of coronary microcirculatory resistance in patients with INOCA.</p><p><strong>Methods: </strong>This is a prospective, investigator-driven, registry including consecutive patients with INOCA undergoing CFT. The index of microvascular resistance (IMR) and coronary flow reserve (CFR) were determined via bolus thermodilution. Absolute flow (Q) and resistance (R) were assessed by continuous thermodilution. Measurements of angiography-derived resistance (μR) were performed in a centralized, independent, corelab, blinded to clinical data and invasive functional tests results.</p><p><strong>Results: </strong>Out of 141 patients with suspected INOCA undergoing CFT, 118 patients were included in the final analysis. A positive linear correlation was found between μR and R (R = 0.36, p < 0.001). The discriminatory potential of μR was acceptable, using R ≥ 500 and IMR ≥25 as reference (AUC 0.675, p = 0.001 and AUC 0.639, p = 0.010, respectively). Notably, a μR of ≤145 had a negative predictive value of >99 %, and a μR ≥ 500 a positive predictive value of 88 %.</p><p><strong>Conclusions: </strong>Murray law-based angiography-derived assessment of coronary microcirculatory resistance in patients with INOCA is a feasible method and is especially helpful for the screening of coronary microvascular dysfunction. Although refinements of this technique are warranted, it may contribute to a wider application of guideline recommendations for the diagnosis and management of patients with microvascular angina in clinical practice.</p>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":" ","pages":"133968"},"PeriodicalIF":3.2,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response letter to \"Letter to the Editor: Clinical standards in angina and non-obstructive coronary arteries: A clinician and patient consensus statement\".","authors":"Colin Berry","doi":"10.1016/j.ijcard.2025.133954","DOIUrl":"https://doi.org/10.1016/j.ijcard.2025.133954","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":" ","pages":"133954"},"PeriodicalIF":3.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripartum cardiomyopathy: Life-giving, life-threatening.","authors":"Michele Golino, Aldo Bonaventura","doi":"10.1016/j.ijcard.2025.133956","DOIUrl":"https://doi.org/10.1016/j.ijcard.2025.133956","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":" ","pages":"133956"},"PeriodicalIF":3.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to \"Bleeding events of cangrelor usage for the treatment of patients with acute coronary syndrome: Gender differences or study design Bias?\"","authors":"Waiel Abusnina, Matteo Cellamare, Ron Waksman","doi":"10.1016/j.ijcard.2025.133964","DOIUrl":"https://doi.org/10.1016/j.ijcard.2025.133964","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":" ","pages":"133964"},"PeriodicalIF":3.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Person-centred care in congenital heart disease: Intercountry variation in patient-reported experiences across 32 countries.","authors":"Birgitte Lykkeberg, Anne Vinggaard Christensen, Selina Kikkenborg Berg, Signe Holm Larsen, Liesbet Van Bulck, Eva Goossens, Adrienne H Kovacs, Koen Luyckx, Laila Akbar Ladak, Mohamed Leye, Alexander Van De Bruaene, Ming Chern Leong, Anna Kaneva, Ernando Amaral, John Jairo Araujo, Navaneetha Sasikumar, Harald Gabriel, Dejuma Yadeta Goshu, Jou-Kou Wang, Junko Enomoto, Maria Emília Areias, Diamantis Kosmidis, Louise Coats, Anne Marie Valente, Ju Ryoung Moon, Magalie Ladouceur, Corina Thomet, Jamie L Jackson, Camilla Sandberg, Edward Callus, Yuli Y Kim, Luis Alday, Charlene Bredy, Arwa Saidi, Fernando Baraona Reyes, Samuel Menahem, Michèle de Hosson, Joanna Hlebowicz, Christina Christersson, Ali Zaidi, Bengt Johansson, Brith Andresen, Jean-Claude Ambassa, Zacharias Mandalenakis, Andrew Constantine, Pascal Amedro, Joost P Van Melle, Ari Cedars, Lucia Ortiz, Fatma Demir, Paul Khairy, Jonathan Windram, Judith Bouchardy, Maryanne Caruana, Susan M Jameson, Vaikom S Mahadevan, Lidija B McGrath, Julius Chacha Mwita, Philip Moons","doi":"10.1016/j.ijcard.2025.133958","DOIUrl":"https://doi.org/10.1016/j.ijcard.2025.133958","url":null,"abstract":"<p><strong>Introduction: </strong>Person-centred care (PCC) is widely recommended by the World Health Organisation and other leading healthcare organisations. Although individuals with congenital heart disease (CHD) require lifelong follow-up, it remains unclear whether healthcare systems worldwide provide PCC to this population. This study investigated one key component of PCC, autonomy support, using patient-reported experiences in a global sample of adults with CHD.</p><p><strong>Methods: </strong>The study was part of the international cross-sectional APPROACH-IS-II. Data were obtained from 8367 adults with congenital heart disease across 53 centres in 32 countries. Perceived autonomy support was measured using a modified version of the Health Care Climate Questionnaire. A general linear mixed model was used to analyse the data.</p><p><strong>Results: </strong>Autonomy support scores ranged from 27.9 (SD ± 9.4) to 37.7 (SD ± 6.3) on a six - 42 point scale. A significant clinical difference in perceived autonomy was observed, with calculated effect sizes using Cohen's D exceeding eight in several countries. Higher autonomy scores were associated with having a high school diploma and older age. Patient characteristics accounted for 1.4 % of the variance, while geographical location explained 7.5 %. A large proportion of the variance remained unexplained.</p><p><strong>Conclusion: </strong>This study highlights significant global differences in perceived autonomy support from healthcare providers among adults with CHD. Education and age were associated with higher levels of perceived autonomy support. The experience of PCC is challenged by diverse expectations of individuals and families, healthcare providers' beliefs and values, institutional policies, and broader sociocultural contexts.</p>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":" ","pages":"133958"},"PeriodicalIF":3.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes and predictors of mortality in patients with chronic ischemic left ventricular dysfunction undergoing PCI: A multicenter study.","authors":"Andrea Pezzato, Enrico Fabris, Gloria Lorenzon, Caterina Gregorio, Stefano Poli, Luca Franchin, Marco Mojoli, Andrea Pascotto, Marco Merlo, Matteo Dal Ferro, Giancarlo Vitrella, Serena Rakar, Leonardo Spedicato, Andrea Perkan, Daniela Pavan, Massimo Imazio, Gianfranco Sinagra","doi":"10.1016/j.ijcard.2025.133962","DOIUrl":"https://doi.org/10.1016/j.ijcard.2025.133962","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic ischemic left ventricular (LV) dysfunction represent a high-risk population. While percutaneous coronary intervention (PCI) is commonly performed in this setting, long-term outcome data and predictors of adverse events are limited.</p><p><strong>Objective: </strong>To analyse patients with chronic ischemic LV dysfunction who underwent PCI and evaluate predictors of all-cause mortality and myocardial infarction (MI).</p><p><strong>Methods: </strong>We performed a retrospective, multicenter, observational study including consecutive patients (2016-2022) from three Italian hub hospitals who underwent PCI with LV ejection fraction (LVEF) < 50 % due to chronic ischemic disease.</p><p><strong>Results: </strong>279 patients were included; median age 71 (IQR 64-78) years, 76.7 % male, 46.2 % diabetic, 26.2 % with chronic kidney disease (CKD) and 33.0 % with prior MI. Median LVEF was 35 % (28-40). Over a median follow-up of 53 (36-73) months, death and MI occurred in 33.7 % of the patients. Multiple Cox regression identified baseline NYHA class (HR 1.54, 95 % CI 1.15-2.06, p = 0.004) and CKD (HR 1.91, 95 % CI 1.24-2.95, p = 0.003) as independent predictors of death or MI. IPTW Adjusted Cox proportional hazard models showed that complete revascularization (HR 0.57, 95 %CI 0.32-0.99, p = 0.047), and PCI of LAD (HR 0.52, 95 %CI 0.33-0.81, p = 0.004), were independent predictors of death and MI.</p><p><strong>Conclusions: </strong>In this multicenter real-world cohort, heart failure severity and comorbidities adversely affected prognosis, while complete revascularization and PCI of the LAD were associated with reduced risk of death and MI. These findings underscore the importance of careful patient profiling as well as the importance of the revascularization to optimize prognosis in this high-risk population.</p>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":" ","pages":"133962"},"PeriodicalIF":3.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to \"efficacy of sodium-glucose cotransporter 2 inhibitors for super-aged heart failure population\".","authors":"Kaiqi Wang, Weiqin Gao","doi":"10.1016/j.ijcard.2025.133712","DOIUrl":"10.1016/j.ijcard.2025.133712","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":" ","pages":"133712"},"PeriodicalIF":3.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rate-adaptive pacing in right-sided heart failure with tricuspid regurgitation: A prospective pilot study.","authors":"Lifan Yang, Xueying Chen, Yanxing Fang, Dandan Chen, Yuliang Long, Yixiu Liang, Yangang Su, Daxin Zhou, Wenzhi Pan, Junbo Ge","doi":"10.1016/j.ijcard.2025.133957","DOIUrl":"https://doi.org/10.1016/j.ijcard.2025.133957","url":null,"abstract":"<p><strong>Background: </strong>Heart rate (HR) needs to be controlled at a lower level for patients with left ventricular systolic heart failure, but the appropriate HR for patients with right-sided heart failure (RHF) is still unclear. This study aims to test whether increasing HR in patients with RHF and severe tricuspid regurgitation (TR) could improve hemodynamics and quality of life.</p><p><strong>Methods: </strong>Patients with severe TR, RHF symptoms, and dependency on permanent pacemakers were enrolled. The pacing rate was adjusted to 90 bpm from <70 bpm. The right-sided heart hemodynamics before and after the HR acceleration, the Kansas City Cardiomyopathy Questionnaire (KCCQ) scores, the New York Heart Association (NYHA) class, edema degree, 6-min walk distance (6MWD), and echocardiography data were recorded at baseline, 1-month, and 3-month follow-ups.</p><p><strong>Results: </strong>Ten patients were enrolled with an average age of 75.6 ± 10.0 years. After HR acceleration, the vena cava and right atrial pressure were decreased by 2-4 mmHg (all P<0.05). Cardiac output increased from 3.2 ± 0.9 L/min to 4.1 ± 1.6 L/ min (mean difference: -0.96, 95 % CI: [0.30, 1.62], P = 0.009). At the 3-month follow-up, the edema degree (0.4 ± 0.7 vs 1.4 ± 0.9, P < 0.01), KCCQ scores (75.1 ± 10.3 vs 50.9 ± 14.8), NYHA class (2.2 ± 0.9 vs 2.9 ± 1.0), and 6MWD (315.6 ± 59.1 m vs 205.1 ± 65.9 m) were significantly improved (all P < 0.01).</p><p><strong>Conclusions: </strong>Increasing HR can improve right-sided heart hemodynamics and quality of life in patients with RHF and severe TR, which may be a novel, simple, and effective method to treat patients with RHF and severe TR who are dependent on permanent pacemakers.</p>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":" ","pages":"133957"},"PeriodicalIF":3.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Worsening tricuspid regurgitation after mitral valve surgery: a meta-analysis and meta-regression.","authors":"Gal Aviel, Bruria Hirsh-Raccah, Islam Idais, Rafat Abu Ghannam, Maxim Komodei, Alexander Lipey-Dyamant, Ori Wald, Amit Korach","doi":"10.1016/j.ijcard.2025.133931","DOIUrl":"https://doi.org/10.1016/j.ijcard.2025.133931","url":null,"abstract":"<p><strong>Objectives: </strong>Reports of tricuspid valve regurgitation (TR) following mitral valve (MV) surgery are unclear. This study aims to estimate the prevalence of worsening TR (WTR) following MV surgery for non-rheumatic mitral regurgitation and the benefit of concomitant tricuspid annuloplasty.</p><p><strong>Methods: </strong>Electronic databases including Embase, PubMed, GoogleScholar, and Cochrane Library were searched between 2013 and 2024. A systematic review of the literature was conducted to include cohort studies, case-control studies and randomized-controlled trials. WTR was defined as ≥ moderate TR or an increase in TR severity of ≥2 grades on follow-up echocardiography. A random effects meta-analysis was performed. Subgroup analysis was conducted to estimate the benefit of a concomitant TV annuloplasty. A meta-regression was conducted to identify potential variables accounting for between-study heterogeneity. Sensitivity analyses were used to confirm the robustness of the reported results.</p><p><strong>Results: </strong>Of 8923 studies identified, 8 studies were included in the final analysis involving 2978 patients and 14,592 patient years (MV surgery-only group = 1991 patients, TV annuloplasty group = 987). WTR occurred in 9 % (95 %CI:4-22) of patients after MV surgery over a pooled follow-up of 4.9 [3.1-6.7] years. A concomitant TV annuloplasty resulted in a significant reduction in the prevalence of WTR (OR = 0.27, 95 %CI: 0.13-0.57, p = 0.0079). A trend for lower overall mortality was detected in the TV annuloplasty group (OR = 0.73, 95 %CI: 0.5-1.08). The pooled estimates were not significantly affected using a leave-one-out analysis meta-analysis.</p><p><strong>Conclusions: </strong>Despite surgical treatment of non-rheumatic mitral regurgitation, TR progresses in a considerable number of patients. Concomitant tricuspid annuloplasty significantly decreases the prevalence of WTR without affecting mortality.</p>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":" ","pages":"133931"},"PeriodicalIF":3.2,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}