International journal of cardiology最新文献

{"title":"Coronary CT angiography instead of invasive angiography before TAVI: Feasibility and outcomes","authors":"Rebekka Vibjerg Jensen ,&nbsp;Jesper Møller Jensen ,&nbsp;Nadia Iraqi ,&nbsp;Erik Lerkevang Grove ,&nbsp;Ole Norling Mathiassen ,&nbsp;Kamilla Bech Pedersen ,&nbsp;Erik Parner ,&nbsp;Jonathon Leipsic ,&nbsp;Christian Juhl Terkelsen ,&nbsp;Bjarne Linde Nørgaard","doi":"10.1016/j.ijcard.2024.132694","DOIUrl":"10.1016/j.ijcard.2024.132694","url":null,"abstract":"<div><h3>Aims</h3><div>Concomitant coronary artery disease (CAD) is frequent in transcatheter aortic valve implantation (TAVI) candidates. Despite societal recommendations of performing invasive coronary angiography (ICA) for coronary assessment in the pre-TAVI diagnostic workup, the prognostic value of ICA and beneficial effect of revascularization in these patients remains unclear.</div><div>We aimed to determine feasibility and outcomes following a strategy of cardiac CT + coronary CT angiography (cCTA) rather than cardiac CT + ICA before TAVI.</div></div><div><h3>Methods and results</h3><div>We performed a single-center, observational cohort study including all patients, without previous coronary intervention, referred to TAVI between April 2020 and November 2021. CAD was assessed by cCTA, and only patients with proximal stenosis &gt;70 %, or left main stenosis &gt;50 %, or cCTA was non-evaluable regarding proximal segments were subsequently referred to ICA.</div><div>240 patients were included in the study. No adverse effects to pre-cCTA-scan nitroglycerin administration were observed. On cCTA, 92 % of the patients had atheroscerosis. 191 (80 %) patients had cCTA only performed, while 49 (20 %) patients underwent subsequent ICA. During a median (range) follow-up of 15 (6-25) months, no difference in procedural complication rates, mortality rates, or number of unplanned ICA was observed between patients evaluated with only cCTA vs cCTA+ICA.</div></div><div><h3>Conclusions</h3><div>Upfront cCTA instead of ICA for assessment of obstructive CAD in the diagnostic workup of patients with severe aortic stenosis referred to TAVI is feasible, safe, and with similar procedural and clinical outcomes. Randomized studies are warranted to further validate the safety of using CTA rather than ICA for coronary assessment in TAVI candidates.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568438","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":"Mechanisms of pathogenicity in the hypertrophic cardiomyopathy-associated TNNI3 c.235C > T variant","authors":"Lai Zhang ,&nbsp;Fengzhi Ding ,&nbsp;Zhongyuan Ren ,&nbsp;Weili Cheng ,&nbsp;He Dai ,&nbsp;Qing Liang ,&nbsp;Fanling Kong ,&nbsp;Wenjing Xu ,&nbsp;Minghui Wang ,&nbsp;Yuqing Zhang ,&nbsp;Qin Tao","doi":"10.1016/j.ijcard.2024.132627","DOIUrl":"10.1016/j.ijcard.2024.132627","url":null,"abstract":"<div><h3>Background</h3><div>Hypertrophic cardiomyopathy (HCM) is typically manifested as a hereditary disorder, with 30 %–60 % of cases linked to cardiac sarcomere gene mutations. Despite numerous identified <em>TNNI3</em> mutations associated with HCM, their severity, prevalence, and disease progression vary. The link between <em>TNNI3</em> variants and phenotypes remains largely unexplored. This study aims to elucidate the impact of the <em>TNNI3</em> c.235C &gt; T mutation on HCM through clinical research and cell experiments and to explore its mechanism in HCM development.</div></div><div><h3>Methods</h3><div>We screened an HCM family for pathogenic gene mutations using gene sequencing. The proband and family members were assessed through electrocardiography, echocardiography, and cardiac MRI, and a pedigree map was created for disease prediction analysis. Mutant plasmids were constructed with the <em>TNNI3</em> c.235C &gt; T mutation and transfected into the AC16 human cardiomyocyte cell line to investigate the mutation's effects.</div></div><div><h3>Results</h3><div>The <em>TNNI3</em> c.235C &gt; T mutation was identified as the disease-causing variant in the family. This mutation led to the upregulation of hypertrophy-associated genes <em>ANP, BNP</em>, and <em>MYH7</em>, increased cardiomyocyte size, and activation of the ERK signaling pathway. Further investigations revealed that the <em>TNNI3</em> c.235C &gt; T mutation impaired mitochondrial function, disrupted cardiomyocyte metabolism, and increased cellular autophagy and apoptosis.</div></div><div><h3>Conclusions</h3><div>The <em>TNNI3</em> c.235C &gt; T gene mutation may be a pathogenic factor for HCM, showing heterogeneous features and clinical phenotypes. This mutation induces myocardial hypertrophy, activates the ERK signaling pathway, and exacerbates mitochondrial dysfunction, apoptosis, and autophagy in cardiomyocytes. These findings provide insights into the mechanism of HCM caused by gene mutations and may inform HCM treatment strategies.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464432","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":"Combined left atrial appendage occlusion and catheter ablation for atrial fibrillation versus isolated left atrial appendage occlusion: A systematic review and meta-analysis.","authors":"Mariana R C Clemente, Denilsa D P Navalha, Vinicius Bittar, Thomaz Alexandre Costa, Gabriel Prusch Fernandes, Livia Teixeira Martins Silva","doi":"10.1016/j.ijcard.2024.132597","DOIUrl":"https://doi.org/10.1016/j.ijcard.2024.132597","url":null,"abstract":"<p><strong>Background: </strong>Data on the effects of combined left atrial appendage occlusion (LAAO) and catheter ablation (CA) for atrial fibrillation (AF) remain limited. We aimed to perform a systematic review and meta-analysis comparing LAAO and CA versus isolated LAAO.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Cochrane Library for studies comparing combined LAAO and CA versus isolated LAAO in patients with atrial fibrillation. Statistical analyses were performed using R software version 4.3.1. We pooled odds ratios (OR) with 95 % confidence intervals (CI) for binary outcomes.</p><p><strong>Results: </strong>We included eight studies comprising 51,802 patients, of whom 1375 (2.6 %) underwent combined LAAO and CA. There were no significant differences between combined LAAO and CA versus isolated LAAO in terms of major bleeding (OR 0.55; 95 % CI 0.09, 3.41; p = 0.52; I² = 0 %), major adverse cardiovascular events (OR 0.88; 95 % CI 0.40, 1.93; p = 0.74; I² = 0 %), stroke (OR 1.03; 95 % CI 0.35, 3.00; p = 0.96; I² = 0 %), thromboembolism (OR 0.60; 95 % CI 0.18, 1.98; p = 0.40; I² = 0 %), minor bleeding (OR 1.32; 95 % CI 0.63, 2.80; p = 0.46; I² = 0 %), or pericardial effusion (OR 1.18; 95 % CI 0.60, 2.33; p = 0.63; I² = 24 %).</p><p><strong>Conclusion: </strong>In this meta-analysis of observational studies, combined LAAO and CA for AF was similar to isolated LAAO in terms of efficacy and safety. Further large randomized controlled trials are needed to explore the long-term effects of combining these procedures.</p>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619774","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}