International journal of cardiology最新文献

{"title":"The challenge of interpreting t-wave inversion in athletes","authors":"Alessandro Zorzi, Francesca Graziano, Domenico Corrado","doi":"10.1016/j.ijcard.2025.133169","DOIUrl":"10.1016/j.ijcard.2025.133169","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"430 ","pages":"Article 133169"},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673785","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":"Cumulative plaque burden analysis for phenotyping epicardial coronary artery disease","authors":"Tsung-Ying Tsai ,&nbsp;Pruthvi C. Revaiah ,&nbsp;Ali Aldujeli ,&nbsp;Kotaro Miyashita ,&nbsp;Akihiro Tobe ,&nbsp;Takashi Muramatsu ,&nbsp;Ken Kozuma ,&nbsp;Hideyuki Kawashima ,&nbsp;Yuki Ishibashi ,&nbsp;Gaku Nakazawa ,&nbsp;Kuniaki Takahashi ,&nbsp;Takayuki Okamura ,&nbsp;Yosuke Miyazaki ,&nbsp;Masato Nakamura ,&nbsp;Norihiro Kogame ,&nbsp;Taku Asano ,&nbsp;Yuki Katagiri ,&nbsp;Scot Garg ,&nbsp;Christos Bourantas ,&nbsp;Patrick W. Serruys ,&nbsp;Yoshinobu Onuma","doi":"10.1016/j.ijcard.2025.133173","DOIUrl":"10.1016/j.ijcard.2025.133173","url":null,"abstract":"<div><h3>Background</h3><div>Intravascular ultrasound (IVUS) reveals the location and burden of coronary artery disease (CAD) but is traditionally limited to segment-level analysis. We introduced the cumulative plaque burden index (CPBi), derived from AI-powered quantitative IVUS analysis, to characterize CAD morphological patterns across the entire vessel.</div></div><div><h3>Methods</h3><div>In this ASET JAPAN sub-study, pre- and post-percutaneous coronary intervention (PCI) IVUS and angiography were analyzed. Plaque burden was quantified per millimeter on the pre-PCI IVUS. After filtering out plaque burden &lt;40 %, CPB curves were generated to visualize morphological patterns. CPBi, a continuous metric derived from the CPB curves, was calculated to represent morphological patterns, with lower values indicating diffuse disease. Physiological CAD patterns were characterized by Murray law-based quantitative flow ratio (μFR)-derived pullback pressure gradient (PPG). Percentage reclassification was analyzed by comparing CPBi-derived CAD patterns with those derived from visual assessment and μFR-derived PPG.</div></div><div><h3>Results</h3><div>CPB analysis was feasible in 130 out of 138 vessels, quantifying 8101 mm of plaque burden. The Median CPB index (CPBi) was 0.45[0.32–0.58], significantly correlating with μFR-derived PPG (<em>r</em> = 0.35, <em>p</em> &lt; 0.001). Diffuse morphological pattern (low CPBi tertile) was associated with higher percent atheroma volume, longer segments with ≥40 % plaque burden, and longer stents. CPBi reclassified 55.4 % of visually assessed and 46.2 % of μFR-derived CAD patterns.</div></div><div><h3>Conclusions</h3><div>AI enables quantitative plaque burden analysis of the entire IVUS pullback, allowing visualization of morphological patterns via CPB curves and quantification with CPBi, which is associated with atherosclerosis severity and hemodynamics. Future studies need to validate the clinical implications of CPB analysis.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"430 ","pages":"Article 133173"},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673781","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":"Mortality after left main coronary artery bifurcation intervention; is it treatment or disease related?","authors":"Mohamed Salah Abdelbasit","doi":"10.1016/j.ijcard.2025.133178","DOIUrl":"10.1016/j.ijcard.2025.133178","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"429 ","pages":"Article 133178"},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673783","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":"DNA hypermethylation of MED1 and MED23 as early diagnostic biomarkers for unsolved issues in atrial fibrillation","authors":"Concetta Schiano ,&nbsp;Teresa Infante ,&nbsp;Giuditta Benincasa ,&nbsp;Jacopo Burrello ,&nbsp;Antonio Ruocco ,&nbsp;Ciro Mauro ,&nbsp;Mark E. Pepin ,&nbsp;Francesco Donatelli ,&nbsp;Ciro Maiello ,&nbsp;Enrico Coscioni ,&nbsp;Claudio Napoli","doi":"10.1016/j.ijcard.2025.133179","DOIUrl":"10.1016/j.ijcard.2025.133179","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide. Much effort was spent to identify biomarkers useful to stratify AF patients. Mediator complex (MED) is an ancestral regulator of transcriptional mechanisms. Here, we investigated the role of methyl DNA-MED regulatory networks in AF patients.</div></div><div><h3>Methods</h3><div>We analyzed the methylome of circulating CD4⁺T lymphocytes isolated from patients at the time of first AF diagnosis vs. healthy subjects for identifying epigenetic dysregulation of MED-related genes.</div></div><div><h3>Results</h3><div>We identified 10 differentially methylated regions (DMRs) which were hypermethylated and annotated to 10 genes encoding for MED complex subunits in CD4⁺T lymphocytes of AF patients vs. healthy subjects (HS). Network-oriented analysis prioritized 6 subunits including MED1, MED13, MED15, MED17, MED23 and MED30, which enriched significantly lipid metabolism pathways and cardiopathy onset. ROC curve analysis showed that elevated methylation levels of MED1 and MED23 discriminated AF patients with an area under the curve (AUC) of 92.7 % (<em>p</em> &lt; 0.001) and an AUC = 100 % (p &lt; 0.001), respectively. Methylation levels of MED23 correlated with the presence of mitral valve disease (<em>p</em> &lt; 0.05) and NT-proBNP (p &lt; 0.05); moreover, MED23 had a not inferior diagnostic value than circulating levels of NT-proBNP (AUC = 0.923, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>For the first time, we showed that DNA methylation changes are associated with regulation of MED complex subunits in early diagnosis of AF patients. Clinically, MED1 and MED23 hypermethylation showed a diagnostic value not inferior to circulating levels of NT-proBNP suggesting early diagnostic biomarker pathogenic molecular routes underlying disease onset.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"429 ","pages":"Article 133179"},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of radiofrequency versus cryoballoon ablation on left atrial calcification after atrial fibrillation ablation: A propensity score-matched comparison","authors":"Yusuke Hayashi,&nbsp;Miyako Igarashi,&nbsp;Hiro Yamasaki,&nbsp;Yuto Iioka,&nbsp;Tabito Kino,&nbsp;Yuichi Hanaki,&nbsp;Akira Kimata,&nbsp;Kojiro Ogawa,&nbsp;Yuki Komatsu,&nbsp;Tomoko Ishizu","doi":"10.1016/j.ijcard.2025.133177","DOIUrl":"10.1016/j.ijcard.2025.133177","url":null,"abstract":"<div><h3>Introduction</h3><div>Left atrial calcification (LAC) following atrial fibrillation (AF) ablation is associated with major adverse cardiovascular events, with prior reports focusing on radiofrequency catheter ablation (RFCA) rather than cryoballoon ablation (CBA). The aim of this study was to investigate the frequency of LAC and stiff LA physiology (SLAP) in patients undergoing CBA as the initial therapy for AF, compared with those undergoing RFCA, using a propensity score-matched (PSM) population.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study involving 2680 consecutive patients who underwent AF ablation with RFCA or CBA. Patients with rheumatic valve disease or mitral valve replacement, those undergoing dialysis, and those without postoperative computed tomography (CT) imaging were excluded. CT images acquired ≥1 year after the initial procedure were used to evaluate the LAC.</div></div><div><h3>Results</h3><div>In total, 473 eligible patients were identified. PSM created 125 pairs. After a median follow-up of 4.7 years, 9 (4 %) of 250 patients presented with LAC. Those who underwent CBA had a significantly lower incidence of LAC and SLAP compared to those who underwent RFCA (LAC: 1 % vs. 6 %, <em>P</em> = 0.03; SLAP: 1 % vs. 9 %, <em>P</em> = 0.005). Right ventricular systolic pressure significantly increased in the RFCA group (pre-ablation: 23 ± 8 vs. post-ablation: 26 ± 8, <em>P</em> = 0.01), but remained unchanged in the CBA group (pre-ablation: 23 ± 7 vs. post-ablation: 23 ± 8, <em>P</em> = 0.88).</div></div><div><h3>Conclusions</h3><div>The use of CBA as the initial ablation seems to have clinical benefits in preventing LAC and SLAP compared to RFCA.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"429 ","pages":"Article 133177"},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669825","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":"Outcomes of mitral valve reoperation and first-time surgery for mitral regurgitation: A nationwide study","authors":"Sofie Truong ,&nbsp;Jeppe Petersen ,&nbsp;Eva Havers-Borgersen ,&nbsp;Liv Borum Schöps ,&nbsp;Morten Smerup ,&nbsp;Lars Køber ,&nbsp;Emil Fosbøl ,&nbsp;Lauge Østergaard","doi":"10.1016/j.ijcard.2025.133175","DOIUrl":"10.1016/j.ijcard.2025.133175","url":null,"abstract":"<div><h3>Background</h3><div>While mitral reoperation has been assumed to carry higher surgical risk than first-time mitral surgery, outcomes of this procedure remain uncertain.</div></div><div><h3>Aims</h3><div>To examine characteristics and outcomes associated with mitral valve reoperation and first-time surgery for mitral regurgitation.</div></div><div><h3>Methods</h3><div>Patients undergoing surgery for mitral regurgitation were identified using Danish nationwide registries. The population was categorized into 1) patients undergoing first-time mitral surgery, 2) patients undergoing mitral reoperation. Mortality rates were examined during 180-day follow-up using Reverse Kaplan-Meier and Multivariable Cox-analysis.</div></div><div><h3>Results</h3><div>In total, 7734 patients underwent surgery for mitral regurgitation. Of these, 428 patients also underwent mitral reoperation. Compared to first-time surgery, reoperated patients were younger (median 64.9 and 66.7 years) and had more cardiovascular comorbidities including atrial fibrillation (61.6 % and 38.8 %) and heart failure (48.7 % and 29.9 %). Median time to reoperation was 2.3 years. Prosthetic replacement was performed in 34.0 % of first-time surgeries and 78.7 % of reoperations. Mortality was 7.1 % following first-time surgery and 10.1 % following reoperation. Following first-time surgery, factors associated with increased mortality rate was prior myocardial infarction (HR = 1.98, 95 %CI 1.62–2.41), heart failure (HR = 1.59, 95 %CI 1.33–1.90), concomitant aortic valve surgery (HR = 1.61–1.27, 95 % CI 1.27–2.02) and bypass grafting (HR = 1.58, 95 %CI 1.31–1.91). Following reoperation, heart failure was associated with increased mortality rate (HR = 2.23, 95 %CI 1.17–4.60).</div></div><div><h3>Conclusions</h3><div>Patients undergoing mitral reoperation are young but have developed high burden of comorbidities at the time of reoperation. In spite of this, outcomes of mitral reoperation were acceptable, reflecting that this procedure can be performed safely in selected patients.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"430 ","pages":"Article 133175"},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between workload-indexed blood pressure response to exercise (SBP/MET slope) and clinical and echocardiographic parameters among normotensive Olympic athletes","authors":"Giuseppe Di Gioia ,&nbsp;Armando Ferrera ,&nbsp;Viviana Maestrini ,&nbsp;Sara Monosilio ,&nbsp;Andrea Serdoz ,&nbsp;Antonio Nenna ,&nbsp;Federica Mango ,&nbsp;Maria Rosaria Squeo ,&nbsp;Antonio Pelliccia","doi":"10.1016/j.ijcard.2025.133171","DOIUrl":"10.1016/j.ijcard.2025.133171","url":null,"abstract":"<div><h3>Introduction</h3><div>The workload-indexed systolic blood pressure response to exercise (SBP/MET slope) has been proposed as a novel parameter for evaluating abnormal blood pressure response to exercise (ABPR) and its potential risks.</div><div>Aim of our study was to assess the association between SBP/MET slope and clinical and cardiac dimensional parameters in normotensive athletes.</div></div><div><h3>Methods</h3><div>A cohort of 292 normotensive Olympic athletes (155 male, 53.1 %) underwent a pre-participation evaluation that included clinical, echocardiographic, and exercise-stress test parameters. The SBP/MET slope was calculated as the increase in systolic blood pressure indexed to metabolic equivalents achieved during maximal exercise. Athletes were stratified into quartiles based on their SBP/MET slope, and comparisons across quartiles were made.</div></div><div><h3>Results</h3><div>Athletes in the highest SBP/MET slope quartile exhibited increased left ventricular wall thickness, i.e., interventricular septum (IVS) compared to those in lower quartiles (10.3 ± 0.9 vs. 9.5 ± 1.1, <em>p</em> = 0.014). Male athletes predominated in higher quartiles (<em>p</em> = 0.047), and endurance athletes were absent in the higher groups (<em>p</em> = 0.006). No differences were observed for systolic or diastolic function across quartiles. At multivariate analysis, SBP/MET slope was indipendently correlated to IVS (<em>p</em> = 0.040; R² = 0.566, standardized beta coefficient = 0.368) and inversely correlated to W/Kg (<em>p</em> = 0.014; R² = 0.566, standardized beta coefficient = −0.507). After a follow-up of 10.3 ± 2.6 years, 13.6 % of athletes in the highest quartile developed hypertension.</div></div><div><h3>Conclusion</h3><div>Athletes with higher SBP/MET slope exhibited increased wall thickness and lower exercise capacity and showed higher risk for late-onset hypertension.</div><div>Long-term follow-up studies are warranted to further elucidate its prognostic implications.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"429 ","pages":"Article 133171"},"PeriodicalIF":3.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643919","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":"The prognostic role of Fibrosis-4 score in heart failure with reduced ejection fraction","authors":"Abdullahi A. Mohamed ,&nbsp;Daniel M. Christensen ,&nbsp;Milan Mohammad ,&nbsp;Lise L. Gluud ,&nbsp;Filip K. Knop ,&nbsp;Tor Biering-Sørensen ,&nbsp;Christian Torp-Pedersen ,&nbsp;Charlotte Andersson ,&nbsp;Morten Schou ,&nbsp;Gunnar Gislason","doi":"10.1016/j.ijcard.2025.133174","DOIUrl":"10.1016/j.ijcard.2025.133174","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure with reduced ejection fraction (HFrEF) and metabolic dysfunction-associated steatotic liver disease (MASLD) are both associated with liver fibrosis. HFrEF patients may develop liver fibrosis due to hepatic congestion, MASLD, or a combination of both. The Fibrosis-4 (FIB-4) score calculated using age, aspartate aminotransferase, alanine aminotransferase, and platelet count, serves as a screening tool for advanced liver fibrosis. This study examines the association between the FIB-4 score and all-cause mortality, cardiovascular mortality, and major adverse liver outcomes (MALO) in patients with HFrEF.</div></div><div><h3>Method and results</h3><div>This study included 4523 HFrEF patients from the Danish Heart Failure Registry. Based on FIB-4 score, 25.5 % were low-risk, 45.7 % were indeterminate-risk, and 28.8 % were high-risk for advanced liver fibrosis. After five years, the cumulative incidence of all-cause mortality was 43 % for the high-risk group, 36 % for the indeterminate-risk group, and 23 % for the low-risk group. The indeterminate-risk and high-risk group had an increased hazard ratio (HR) for all-cause mortality (HR 1.33, 95 % confidence interval [CI] 1.16–1.52; HR 1.51, 95 % CI 1.31–1.74) compared to the low-risk group. Similarly, HRs were elevated for cardiovascular mortality (HR 1.61, 95 % CI 1.27–2.05; HR 2.14, 95 % CI 1.67–2.74) and MALO (HR 1.77, 95 % CI 1.01–3.31; HR 2.54, 95 % CI 1.43–4.52).</div></div><div><h3>Conclusion</h3><div>A high FIB-4 score in patients with HFrEF is associated with increased mortality and MALO.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"429 ","pages":"Article 133174"},"PeriodicalIF":3.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parameters of speckle tracking echocardiography in right atrial fibrosis of patients with rheumatic mitral stenosis: Focusing on right atrial stiffness","authors":"Yongzhi Cai ,&nbsp;Mengqian Ou ,&nbsp;Yue Li ,&nbsp;Xiaofeng Zhang ,&nbsp;Tongtong Huang ,&nbsp;Decai Zeng ,&nbsp;Shuai Chang ,&nbsp;Xiaoyong Xie ,&nbsp;Wei Lu ,&nbsp;Xiongwei Cai ,&nbsp;Haitao Song ,&nbsp;Yugui Li ,&nbsp;Binling Wu ,&nbsp;Baoshi Zheng ,&nbsp;Ji Wu","doi":"10.1016/j.ijcard.2025.133170","DOIUrl":"10.1016/j.ijcard.2025.133170","url":null,"abstract":"<div><h3>Background</h3><div>In rheumatic mitral stenosis (RMS), left atrial pressure elevation can lead to right heart dysfunction and fibrosis. The relationship between speckle-tracking echocardiography (STE) right-heart parameters, right atrial fibrosis, and its histological confirmation, remains unclear.</div></div><div><h3>Methods</h3><div>46 RMS patients (mean age of 53.0 ± 8.9 years, 67 % females) were enrolled. The exclusion criteria were the presence of moderate or severe aortic valve diseases, rheumatic tricuspid lesions and poor acoustic windows. RA tissue specimens were collected during the operation in RMS patients to analyze the degree of myocardial fibrosis. Echocardiographic evaluations and histological analysis of right atrial (RA) tissue were performed. Correlations between parameters and RA fibrosis were analyzed.</div></div><div><h3>Results</h3><div>RA fibrosis was strongly correlation with RAsr (r = −0.860, P &lt; 0.001). ROC analysis confirmed that RA stiffness (<em>E/e'/RAsr</em>) (AUC = 0.934, 95 %CI: 0.843–1.000) and STREI index (<em>2 × RVFLWS + RAsr</em>) (AUC = 0.802, 95 %CI: 0.672–0.933) had good diagnostic efficacy. RA fibrosis was verified histologically.</div></div><div><h3>Conclusion</h3><div>To a certain degree, RAsr serves as an indicator mirroring the extent of right atrial fibrosis. In the context of RMS patients, both RA stiffness and the STREI index emerge as potential harbingers of RA fibrosis, playing a significant role in unravelling the underlying mechanisms of disease progression and informing the formulation of efficacious treatment strategies.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"429 ","pages":"Article 133170"},"PeriodicalIF":3.2,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657321","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":"The passability of delivery catheter system during self-expanding transcatheter aortic valve replacement: A CT-based prediction model","authors":"Qianyao Lai ,&nbsp;Zhixiong Wei ,&nbsp;Xiang Zhang ,&nbsp;Qianzhen Li ,&nbsp;Shuang Liang ,&nbsp;Liyun Su ,&nbsp;Lianglong Chen ,&nbsp;Jun Fang","doi":"10.1016/j.ijcard.2025.133168","DOIUrl":"10.1016/j.ijcard.2025.133168","url":null,"abstract":"<div><h3>Objective</h3><div>Aortic anatomy may pose challenges to the advancement of the delivery catheter system (DCS) and affect the outcome of self-expanding transcatheter aortic valve replacement (SE-TAVR). This study aimed to develop a preprocedural CT-based nomogram to predict the passability of DCS and clinical SE-TAVR outcomes.</div></div><div><h3>Methods and results</h3><div>Data of 348 patients who underwent transfemoral SE-TAVR were retrospectively collected from May 2018 to December 2023. A number of 118 patients received snare catheter, indicating poor DCS passaibility. All patients were randomized to development (<em>n</em> = 244) and validation (<em>n</em> = 104) sets. A predictive model was constructed by logistic regression and presented as a nomogram, which indicated that larger aortic angle, severe calcification, larger ascending aorta diameter, coronary ostial height of ≤10 mm, and bicuspid aortic valve were independent anatomical risk factors for poor DCS passability during SE-TAVR. Subsequently, the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were depicted to assess the performance of the nomogram, revealing its good accuracy and concordance. This model also showed that patients with poor DCS passability were more likely to develop significant postprocedural paravalvular leak (PVL).</div></div><div><h3>Conclusions</h3><div>The model adequately predicts the DCS passability during SE-TAVR, which provides a comprehensive profile of risk factors for poor DCS passability and indicates coronary ostial height of ≤10 mm as a novel anatomical risk factor, in addition to the larger aortic angle, severe calcification, larger ascending aorta diameter, and bicuspid aortic valve. Patients with poor DCS passability are more likely to develop significant PVL.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"429 ","pages":"Article 133168"},"PeriodicalIF":3.2,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657323","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}