International journal of cardiology最新文献

{"title":"Rate-adaptive pacing in right-sided heart failure with tricuspid regurgitation: A prospective pilot study","authors":"Lifan Yang ,&nbsp;Xueying Chen ,&nbsp;Yanxing Fang ,&nbsp;Dandan Chen ,&nbsp;Yuliang Long ,&nbsp;Yixiu Liang ,&nbsp;Yangang Su ,&nbsp;Daxin Zhou ,&nbsp;Wenzhi Pan ,&nbsp;Junbo Ge","doi":"10.1016/j.ijcard.2025.133957","DOIUrl":"10.1016/j.ijcard.2025.133957","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>Patients with severe TR, RHF symptoms, and dependency on permanent pacemakers were enrolled. The pacing rate was adjusted to 90 bpm from &lt;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.</div></div><div><h3>Results</h3><div>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&lt;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], <em>P</em> = 0.009). At the 3-month follow-up, the edema degree (0.4 ± 0.7 vs 1.4 ± 0.9, <em>P</em> &lt; 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 <em>P</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 133957"},"PeriodicalIF":3.2,"publicationDate":"2025-10-07","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":"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 ,&nbsp;Enrico Fabris ,&nbsp;Gloria Lorenzon ,&nbsp;Caterina Gregorio ,&nbsp;Stefano Poli ,&nbsp;Luca Franchin ,&nbsp;Marco Mojoli ,&nbsp;Andrea Pascotto ,&nbsp;Marco Merlo ,&nbsp;Matteo Dal Ferro ,&nbsp;Giancarlo Vitrella ,&nbsp;Serena Rakar ,&nbsp;Leonardo Spedicato ,&nbsp;Andrea Perkan ,&nbsp;Daniela Pavan ,&nbsp;Massimo Imazio ,&nbsp;Gianfranco Sinagra","doi":"10.1016/j.ijcard.2025.133962","DOIUrl":"10.1016/j.ijcard.2025.133962","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>To analyse patients with chronic ischemic LV dysfunction who underwent PCI and evaluate predictors of all-cause mortality and myocardial infarction (MI).</div></div><div><h3>Methods</h3><div>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) &lt; 50 % due to chronic ischemic disease.</div></div><div><h3>Results</h3><div>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, <em>p</em> = 0.004) and CKD (HR 1.91, 95 % CI 1.24–2.95, <em>p</em> = 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, <em>p</em> = 0.047), and PCI of LAD (HR 0.52, 95 %CI 0.33–0.81, <em>p</em> = 0.004), were independent predictors of death and MI.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 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":"Worsening tricuspid regurgitation after mitral valve surgery: a meta-analysis and meta-regression","authors":"Gal Aviel ,&nbsp;Bruria Hirsh-Raccah ,&nbsp;Islam Idais ,&nbsp;Rafat Abu Ghannam ,&nbsp;Maxim Komodei ,&nbsp;Alexander Lipey-Dyamant ,&nbsp;Ori Wald ,&nbsp;Amit Korach","doi":"10.1016/j.ijcard.2025.133931","DOIUrl":"10.1016/j.ijcard.2025.133931","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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, <em>p</em> = 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 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}

{"title":"Subcutaneous ICD sports safety registry (SISS registry)","authors":"Martina Nesti ,&nbsp;Pasquale Notarstefano ,&nbsp;Luca Segreti ,&nbsp;Marzia Giaccardi ,&nbsp;Vincenzo Russo ,&nbsp;Gianluca Solarino ,&nbsp;Francesca Menichetti ,&nbsp;Zefferino Palamà ,&nbsp;Alessandro Paoletti Perini ,&nbsp;Chiara Bartoli ,&nbsp;Andrea Rossi ,&nbsp;Federico Landra ,&nbsp;Antonio Scarà ,&nbsp;Luigi Sciarra","doi":"10.1016/j.ijcard.2025.133945","DOIUrl":"10.1016/j.ijcard.2025.133945","url":null,"abstract":"<div><h3>Background</h3><div>Exercise has a positive impact on physical function and quality of life. However, individuals with an implantable cardioverter-defibrillator (ICD) may experience adverse events during sports activities. To date, scientific data on the safety of sports participation in patients with subcutaneous ICDs (S-ICDs) are lacking. This study aims to analyze the occurrence of appropriate and inappropriate arrhythmic events related to sports activity in a population of S-ICD patients.</div></div><div><h3>Methods</h3><div>Consecutive patients who underwent S-ICD implantation were enrolled. Baseline clinical data, as well as information on sports activity and arrhythmic events, were collected.</div></div><div><h3>Results</h3><div>Among 280 patients (median age 46 [32–55] years; 72 % male) included in the registry, 205 (73 %) engaged in sports activities. During a follow-up period of 38 ± 13 months, 27 patients (13 %) experienced appropriate shocks. Of these, 20 (74.1 %) occurred at rest and 7 (25.9 %) during peak performance in sports. All patients who received appropriate shocks were implanted for secondary prevention.</div><div>Additionally, 27 patients (13.1 %) experienced inappropriate shocks, with 15 (55.6 %) occurring at rest and 12 (44.4 %) during peak physical activity, primarily due to T-wave oversensing. No significant differences were observed in type or intensity of sports activity between patients who experienced shocks and those who did not.</div></div><div><h3>Conclusion</h3><div>In S-ICD patients, both appropriate and inappropriate shocks occur more frequently during peak physical performance but are not associated with the type or intensity of sports activity. Appropriate shocks were most common in patients with arrhythmogenic or ischemic cardiomyopathy, while inappropriate shocks were mainly due to T-wave oversensing.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 133945"},"PeriodicalIF":3.2,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238547","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":"CD163-positive macrophage enrichment in cardiogenic thrombi from atrial fibrillation than in atherosclerotic thrombi from sinus rhythm","authors":"Tomomi Koizumi ,&nbsp;Noriyuki Kato ,&nbsp;Yukinori Inadome ,&nbsp;Fumimasa Tabata ,&nbsp;Tomosato Yamazaki ,&nbsp;Masao Ono ,&nbsp;MITO Study Investigators","doi":"10.1016/j.ijcard.2025.133941","DOIUrl":"10.1016/j.ijcard.2025.133941","url":null,"abstract":"<div><h3>Background</h3><div>Differentiating between atherosclerotic and cardiogenic thrombi remains a clinical challenge and complicates the optimal selection of antithrombotic therapy for secondary prevention.</div></div><div><h3>Objectives</h3><div>This study aimed to investigate histopathological differences between thrombi presumed to be of atherosclerotic (sinus rhythm, SR) and cardiogenic (atrial fibrillation, AF) origin.</div></div><div><h3>Methods</h3><div>The Macrophage in Thrombus (MITO) study is a prospective observational study of patients with ST-elevation myocardial infarction (STEMI) or embolic stroke (ES), in whom solid thrombi were retrieved from infarct-related arteries. Patients were categorized into two groups: Group SR (presumed atherosclerotic thrombi) and Group AF (presumed cardiogenic thrombi). Thrombi were immunohistochemically stained for CD163-positive macrophages, scored on a three-point scale, score 1: no CD163-positive cell detectable at ×400; score 2: the cell detectable at ×400 but not ×100; score 3: easy to detect the cell in ×100 in the thrombus. Also, soluble CD163 was measured in plasma samples.</div></div><div><h3>Results</h3><div>The scores of Group SR were significantly lower than those of Group AF (<em>p</em> &lt; 0.01). Plasma level of soluble CD163 (ng/mL) in Group SR was significantly lower than in Group AF [487 (275, 636) vs. 630 (472,780), <em>p</em> = 0.04].</div></div><div><h3>Conclusion</h3><div>The distribution of CD163-positive cells differed between thrombi from Group SR and Group AF patients. These findings suggest a role for CD163-positive macrophages in the pathogenesis of cardiogenic thrombi and raise the possibility of CD163 as a biomarker for thrombus etiology.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 133941"},"PeriodicalIF":3.2,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238567","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":"Association of myocardial bridging and LAD length with Takotsubo syndrome: A MINOCA cross-sectional study","authors":"Oscar Winnberg ,&nbsp;Jens Jensen ,&nbsp;Shams Y-Hassan ,&nbsp;Loghman Henareh ,&nbsp;Peder Sörensson ,&nbsp;Olov Collste ,&nbsp;Christina Ekenbäck ,&nbsp;Magnus Lundin ,&nbsp;Kenneth Caidahl ,&nbsp;Stefan Agewall ,&nbsp;Kerstin Cederlund ,&nbsp;Jannike Nickander ,&nbsp;Martin G. Sundqvist ,&nbsp;Claes Hofman-Bang ,&nbsp;Patrik Lyngå ,&nbsp;Eva Maret ,&nbsp;Nondita Sarkar ,&nbsp;Jonas Spaak ,&nbsp;Martin Ugander ,&nbsp;Irene Santos-Pardo ,&nbsp;Elin Brolin","doi":"10.1016/j.ijcard.2025.133950","DOIUrl":"10.1016/j.ijcard.2025.133950","url":null,"abstract":"<div><h3>Background</h3><div>Takotsubo syndrome (TTS) is an acute cardiac condition triggered by emotional or physical stress, characterized by a catecholamine surge and transient left ventricular dysfunction.</div><div>Although myocardial bridging (MB) and left anterior descending artery (LAD) length have been proposed as contributing factors, their roles in TTS remain uncertain. This study aimed to assess whether TTS is associated with MB or LAD length in a well-characterized myocardial infarction with non-obstructive coronary arteries (MINOCA) cohort.</div></div><div><h3>Methods</h3><div>We analyzed 183 participants from the prospective Stockholm Myocardial Infarction with Normal Coronaries (SMINC) 1 and 2 studies, which focused on MINOCA. All participants underwent coronary computed tomography angiography (CCTA) and invasive coronary angiography (ICA). MB was assessed with CCTA, and LAD length was measured using ICA. TTS patients (<em>n</em> = 60) were compared with MINOCA controls without TTS (<em>n</em> = 123).</div></div><div><h3>Results</h3><div>MB was present in 37 % of TTS patients and 42 % of controls, with no significant association observed (<em>p</em> = 0.523), including when stratified by partial or full encasement. LAD length did not differ significantly between groups (<em>p</em> = 0.088).</div></div><div><h3>Conclusion</h3><div>This study found no significant association between MB or LAD length and the occurrence of TTS. These results suggest that structural variations in the LAD are unlikely to play a major role in the development of TTS, underscoring the importance of exploring alternative pathophysiological mechanisms beyond coronary anatomy.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 133950"},"PeriodicalIF":3.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232503","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":"Use of direct anticoagulants in chronic thromboembolic pulmonary hypertension: An anatomopathological study of endarterectomy material","authors":"William Salibe-Filho ,&nbsp;Yally Priscila Pessôa Nascimento ,&nbsp;Luiza Sarmento Tatagiba ,&nbsp;Vera Demarchi Aiello ,&nbsp;Jose Leonidas Alves-Junior ,&nbsp;Caio Julio Cesar Fernandes ,&nbsp;Carlos Viana Poyares Jardim ,&nbsp;Orival Freitas-Filho ,&nbsp;Fabio Biscegli Jatene ,&nbsp;Mario Terra-Filho ,&nbsp;Rogério Souza","doi":"10.1016/j.ijcard.2025.133951","DOIUrl":"10.1016/j.ijcard.2025.133951","url":null,"abstract":"<div><h3>Objetive</h3><div>Chronic thromboembolic pulmonary hypertension (CTEPH) is a potentially curable cause of pulmonary hypertension, characterized by persistent organized thrombi and micro vasculopathy leading to increased pulmonary vascular resistance and right heart failure. Pulmonary endarterectomy (PEA) remains the treatment of choice for operable patients. Although vitamin K antagonists (VKAs) are traditionally used for lifelong anticoagulation, direct oral anticoagulants (DOACs) have gained popularity despite limited evidence supporting their use in CTEPH. Histopathological assessment may provide new insights into anticoagulation effectiveness. This study aimed to evaluate the presence of recent thrombi in PEA specimens from patients using DOACs versus VKAs and to correlate these findings with surgical and hemodynamic outcomes.</div></div><div><h3>Methods</h3><div>Retrospective cohort study included 115 patients with CTEPH who underwent PEA at a national referral center for the treatment of CTEPH between 2018 and 2023. Patients were categorized based on anticoagulant type (DOAC or VKA). All surgical specimens underwent histopathological evaluation. Pre- and postoperative hemodynamic and clinical data were analyzed. Statistical comparisons were performed using appropriate parametric and non-parametric tests.</div></div><div><h3>Results</h3><div>Recent thrombi were identified in 26.2 % of patients on DOACs and 9.2 % of those on VKAs (<em>p</em> &lt; 0.05). Despite the higher prevalence of thrombi in the DOAC group, no significant differences were observed in extracorporeal circulation time, cardiac arrest duration, or postoperative hemodynamic parameters between groups. Microscopic evaluation proved to be more sensitive than macroscopic analysis for detecting thrombi.</div></div><div><h3>Conclusion</h3><div>Our findings demonstrate the presence of recent thrombi in patients with CTEPH undergoing PEA. This observation raises questions regarding the use of DOACs in patients with CTEPH.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 133951"},"PeriodicalIF":3.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228436","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":"Comparative efficacy of particulate embolic agents versus alcohol in percutaneous transluminal septal myocardial ablation","authors":"Yunshu Li ,&nbsp;Yuanjing Li ,&nbsp;Zhu Li,&nbsp;Bi Huang,&nbsp;Qian Dong,&nbsp;Suxin Luo,&nbsp;Yintao Chen","doi":"10.1016/j.ijcard.2025.133952","DOIUrl":"10.1016/j.ijcard.2025.133952","url":null,"abstract":"<div><h3>Background</h3><div>Percutaneous transluminal septal myocardial ablation (PTSMA) is a widely used therapy for drug-refractory obstructive hypertrophic cardiomyopathy (oHCM), but alcohol ablation's non-target retrograde flow (due to high fluidity/permeability) raises complication risks, driving research into particulate embolic alternatives</div></div><div><h3>Methods</h3><div>This study retrospectively analyzed 132 patients with oHCM admitted to the first affiliated Hospital of Chongqing Medical University between January 2018 and July 2024. Of these, 45 patients who underwent PTSMA at our hospital were further divided into the particulate group (<em>n</em> = 13) and the alcohol group (<em>n</em> = 32) based on the type of interventional material. The analysis focused on comparing short-term clinical outcomes and post-discharge transthoracic echocardiography (TTE) results among oHCM patients undergoing PTSMA with different ablation agents</div></div><div><h3>Results</h3><div>The particulate group demonstrated a significantly lower incidence of intraoperative complications compared with the alcohol group (<em>p</em> &lt; 0.05).The particulate group also demonstrated lower postoperative absolute cardiac troponin I(cTnI) levels (<em>p</em> &lt; 0.001). The post-discharge TTE revealed a significantly higher proportion of patients with left ventricular outflow tract gradient (LVOTG) &lt;50 mmHg in the alcohol group compared to the control group(p &lt; 0.05)</div></div><div><h3>Conclusion</h3><div>Particulate embolic agents can reduce the incidence of periprocedural complications in PTSMA and may hold potential clinical utility in high-risk patients. However, the higher reintervention risk of particulate embolic agents indicates that alcohol remains the preferred embolic agent for PTSMA. Future large-scale prospective studies are needed to validate the long-term safety and efficacy of particulate embolic agents</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 133952"},"PeriodicalIF":3.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228366","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}