JAMA cardiology最新文献

{"title":"Polygenic Susceptibility in Peripartum, Alcohol-Induced, and Cancer Therapy-Related Cardiomyopathies.","authors":"Dimitri J Maamari,Kiran J Biddinger,Sean J Jurgens,Joel T Rämö,Liam Gaziano,Alice Zheng,Saketh P Challa,Dolphurs Hayes,Carlos A Gongora,Seung Hoan Choi,Kyong-Mi Chang,Philip S Tsao,Zoltan Arany,Paaladinesh Thavendiranathan,Jennifer E Huffman,Akl C Fahed,Amy A Sarma,Tomas G Neilan,Amit V Khera,Patrick T Ellinor,Krishna G Aragam","doi":"10.1001/jamacardio.2025.3248","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.3248","url":null,"abstract":"ImportanceRare monogenic variants linked to nonischemic dilated cardiomyopathy (DCM) are enriched among individuals with secondary cardiomyopathies, such as peripartum (PPCM), alcohol-induced (ACM), and cancer therapy-related (CCM) cardiomyopathies. However, it remains unclear whether a polygenic predisposition to DCM also contributes to these conditions.ObjectiveTo assess the association of a DCM polygenic score with PPCM, ACM, and CCM, and to evaluate the contributions of monogenic and polygenic susceptibilities to these secondary cardiomyopathies.Design, Setting, and ParticipantsThis was a retrospective genetic association analysis of data from the Mass General Brigham (MGB) Biobank (n = 42 137, 2008-2025), with replication in the UK Biobank (n = 295 160, 2005-2010), FinnGen (n = 417 950, 2017-2025), and the Veterans Affairs Million Veteran Program (n = 516 066, 2011-2025). In MGB Biobank, medical records were reviewed to ascertain secondary cardiomyopathy cases and antecedent clinical risk factors.ExposuresDCM polygenic risk score and DCM monogenic variants.Main Outcomes and MeasuresThe primary outcomes were the association of the DCM polygenic risk score with PPCM, ACM, and CCM and the prevalence of monogenic variants and a high polygenic score among individuals with cardiomyopathy.ResultsThe mean (SD) age in the MGB Biobank was 55.7 (17.0) years at enrollment, and 24 551 (58.3%) were female. Across the 4 study cohorts, 3414 individuals with secondary cardiomyopathy were identified, including 70 with PPCM, 2281 with ACM, and 1063 with CCM. The DCM polygenic score was associated with PPCM (odds ratio [OR], 1.82 per SD; 95% CI, 1.43-2.30), ACM (OR, 1.56; 95% CI,1.34-1.82), and CCM (OR, 1.64; 95% CI,1.24-2.15) (all with P < .001). Monogenic variants were enriched but present in 7 of 113 individuals with medical record-reviewed cardiomyopathy in MGB, while 66 had a high polygenic score, which conferred an approximately 3-fold increased odds of cardiomyopathy. Most individuals with cardiomyopathy lacked antecedent clinical risk factors.Conclusions and RelevanceIn this cohort study, individuals with PPCM, ACM, and CCM were enriched for monogenic DCM variants and a high DCM polygenic score, suggesting a shared genetic susceptibility influenced by distinct environmental precipitants. These findings support a shared genetic architecture between secondary cardiomyopathies and DCM, although additional work with larger numbers of individuals with cardiomyopathy is needed to confirm these findings.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"78 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative Cardiovascular Health Score Through Young Adulthood and Cardiovascular and Kidney Outcomes in Midlife.","authors":"Jong Hyun Jhee,Kyoung Hwa Ha,Dasom Son,Hyeok-Hee Lee,Eun-Jin Kim,Hyeon Chang Kim,Hokyou Lee","doi":"10.1001/jamacardio.2025.3269","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.3269","url":null,"abstract":"ImportancePositive health outcomes of a high cardiovascular health (CVH) score have been demonstrated largely with single CVH assessments in midlife, whereas the association of cumulative CVH during young adulthood with premature cardiovascular disease (CVD) and particularly kidney outcomes remains unclear.ObjectiveTo examine the association of cumulative CVH from 30 to 40 years of age with the risk of CVD and kidney events in midlife.Design, Setting, and ParticipantsThis population-based cohort study used Korean National Health Insurance health screening and claims data on adults aged 40 years without prior CVD or chronic kidney disease (CKD). Data were analyzed from May 1, 2024, to April 30, 2025.ExposureTen-year cumulative CVH score, calculated as the area under the CVH score curve from 30 to 40 years of age (range, 0-100 per visit; cumulative range, 0-1000 points × years), based on the American Heart Association's Life's Essential 8 construct.Main Outcomes and MeasuresThe primary outcomes were CVD events (myocardial infarction, ischemic stroke, heart failure, or cardiovascular death) and kidney events (incident CKD, kidney replacement therapy, or kidney-related death) after 40 years of age among participants.ResultsAmong 241 924 adults (78.1% male [n = 188 871]; all aged 40 years) with 3 or more examination visits (at 30 and 40 years of age and ≥1 visits in between; median number of visits, 8 [IQR, 6-10]), 2748 CVD events and 2085 kidney events occurred over a median follow-up of 9.2 years (IQR, 8.4-10.1). The highest quintile (quintile 5 [Q5]; ≥735 points × years) of cumulative CVH from 30 to 40 years of age was associated with a very low incidence of CVD (0.05% per year; adjusted hazard ratio [HR], 0.27 [95% CI, 0.22-0.32] vs Q1) and kidney events (0.05% per year; adjusted HR, 0.25 [95% CI, 0.21-0.31] vs Q1) in midlife. Each 100-point × year higher cumulative CVH (eg, 10-point higher CVH score × 10 years) was associated with a 34% lower hazard of CVD events and a 35% lower hazard of kidney events. The associations were similar by sex and for event subtypes and remained significant after adjustment for CVH score at 40 years of age or the slope of CVH change.Conclusions and RelevanceThese findings suggest that a higher cumulative CVH score from 30 to 40 years of age was associated with markedly lower risks of CVD and kidney events in midlife, highlighting the importance of sustained primordial prevention efforts throughout early life.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"31 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Cardiovascular Health in Young Adulthood Affects Kidney and Cardiovascular Risk Later in Life-Lifespan Lessons.","authors":"Sarah Haeger,Nisha Bansal","doi":"10.1001/jamacardio.2025.3276","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.3276","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"23 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathway to Risk Stratification in Tricuspid Regurgitation.","authors":"Rohan G Reddy,David A Danford,Shelby Kutty","doi":"10.1001/jamacardio.2025.3168","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.3168","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"24 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrocardiogram vs Electrophysiological Study and Major Conduction Delays in Myotonic Dystrophy Type 1.","authors":"Nicolas Clementy,Fabien Labombarda,François Grolleau,Vincent Algalarrondo,Guillaume Bassez,Henri-Marc Bécane,Anthony Béhin,Françoise Chapon,Mohamed El Hachmi,Abdallah Fayssoil,Bertrand Fontaine,Rodrigue Garcia,Pascal Laforêt,Arnaud Lazarus,Marion Masingue,Armelle Magot,Yann Pereon,Vincent Probst,Leslie Motté,Malika Saadi,Denis Duboc,Tanya Stojkovic,Raphaël Porcher,Karim Wahbi","doi":"10.1001/jamacardio.2025.3055","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.3055","url":null,"abstract":"ImportanceFor the prevention of sudden cardiac death in myotonic dystrophy type 1 (dystrophia myotonica; DM1), professional practice guidelines recommend pacemaker implantation in asymptomatic patients with a PR interval greater than or equal to 240 milliseconds and/or QRS duration greater than or equal to 120 milliseconds on electrocardiogram (ECG), or a His-ventricular (HV) interval greater than or equal to 70 milliseconds during electrophysiological study (EPS), as class IIa indications.ObjectiveTo determine which of these strategies-ECG or EPS based-is more effective in predicting major bradyarrhythmic events (MBAEs).Design, Setting, and ParticipantsThis was a cohort analysis of retrospectively collected longitudinal data from the DM1 Heart Registry. The setting included cardiology and neurology departments of 6 French university hospitals. Study participants were selected from individuals enrolled in the DM1 Heart Registry between 2000 and 2020. The DM1 Heart Registry includes adults with genetically confirmed DM1. Included patients had a history of first EPS after 1999 and no personal history of advanced atrioventricular block or sustained ventricular tachycardia. Study data were analyzed from January to July 2025.ExposuresECG- and EPS-based strategies.Main Outcomes and MeasuresThe primary outcome was MBAEs, defined as sudden cardiac death, resuscitated cardiac arrest, or second-degree type II or complete atrioventricular block.ResultsOf 1778 adults with genetically confirmed DM1 enrolled in the DM1 Heart Registry, a total of 706 patients (mean [SD] age, 42 [13] years; 359 male [51%]) were included in this study. At baseline, 273 patients (38%) had an HV interval greater than or equal to 70 milliseconds, and 232 (32%) met ECG criteria. Over a median (IQR) follow-up of 5.9 (2.3-9.7) years, 99 patients (14%) experienced an MBAE. In multivariable Cox and joint models incorporating baseline and time-varying values of PR and QRS durations, the HV interval was the only variable significantly associated with the incidence of MBAEs (hazard ratio [HR], 1.77; 95% CI, 1.46-2.16; P < .001 and HR, 1.78; 95% CI, 1.40-2.22; P = .001, respectively). Compared with ECG-based criteria, the EPS criterion proved to be a more reliable (HR, 2.89; 95% CI, 1.92-4.34 vs HR, 1.95; 95% CI, 1.31-2.89) and more sensitive (performance index [SE], 68.35% [6.24%] vs 34.76% [6.47%]) predictor of MBAE and accurately reclassified 28.8% of patients with an MBAE. Lowering the threshold to HV greater than or equal to 65 milliseconds further improved sensitivity (performance index [SE], 90.18% [3.85%]) and net reclassification improvement (33.7%; 95% CI, 19.6%-48.2%) for MBAE prediction.Conclusions and RelevanceIn this cohort of patients with DM1, the HV interval outperformed ECG criteria in predicting MBAEs. An HV threshold greater than or equal to 65 milliseconds may enhance risk stratification for prophylactic pacing.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"21 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathway to Risk Stratification in Tricuspid Regurgitation.","authors":"Ioannis Skalidis,Panagiotis Antiochos","doi":"10.1001/jamacardio.2025.3165","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.3165","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"19 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Incidence and Procedural Volume of Transcatheter Aortic Valve Reintervention.","authors":"Maxwell C Braasch,Sophia R Pyeatte,June He,Mehran Rahimi,Alexander A Brescia,Puja Kachroo,Harold G Roberts,Nathan Frogge,Nishath Quader,Marc A Sintek,Alan Zajarias,Nicholas Kouchoukos,Tsuyoshi Kaneko","doi":"10.1001/jamacardio.2025.3224","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.3224","url":null,"abstract":"ImportanceTranscatheter aortic valve replacement (TAVR) reintervention is performed by either redo TAVR or TAVR explant. There is insufficient data on contemporary TAVR reintervention procedural incidence and volume.ObjectiveTo evaluate contemporary procedural volumes of redo TAVR and TAVR explant.Design, Setting, and ParticipantsThis retrospective analysis of redo TAVR and TAVR explant annual incidence and procedural volume was performed from January 2012 to June 2024. For comprehensive assessment of aortic valve replacement, analysis of SAVR reintervention annual incidence and procedural volume was also performed. Data were obtained through the US Centers for Medicare & Medicaid Services Virtual Research Data Center. Patients with prior TAVR or SAVR who underwent subsequent TAVR or SAVR were included.ExposuresPatients who underwent a TAVR after TAVR defined the redo TAVR group, while patients who underwent SAVR after TAVR defined the TAVR explant group. Patients who underwent a TAVR after SAVR defined the valve-in-valve (ViV) TAVR group, while patients who underwent SAVR after SAVR defined the redo SAVR group. Analysis of annual incidences and procedural volumes of all groups at different time intervals was conducted.Main Outcomes and MeasuresThe primary outcome was annual incidence and procedural volume of both redo TAVR and TAVR explant. The secondary outcome was annual incidence and procedural volume of both ViV TAVR and redo SAVR.ResultsOf 410 720 total TAVRs from 2012 to 2024, 2374 redo TAVRs and 1346 TAVR explants were identified. Of 299 780 total SAVRs from 2012 to 2024, 5044 ViV-TAVRs and 4202 redo SAVRs were identified. Since 2020, there have been 1518 redo TAVRs and 1007 TAVR explants. The annual incidence of TAVR reintervention has changed from 0.17% in 2019 to 0.28% in 2023. Although the most common time interval for redo TAVR after index TAVR was within 3 months (410 of 2374 [17.3%]) and for TAVR explant after index TAVR was 1 to 2 years (259 of 1346 [19.2%]), redo TAVR was the predominant procedure beyond 5 years from the index TAVR (725 of 819 [88.5%]).Conclusions and RelevanceIn this study, annual volumes of both redo TAVR and TAVR explant continued to increase, particularly in recent years. Redo TAVR is frequently performed over 5 years from the index TAVR. Future analysis to determine the appropriate TAVR reintervention strategy for individual patients is needed.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"315 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discontinuation of Semaglutide Among Older Adults With Diabetes in the US and Japan.","authors":"Kosuke Inoue, Sérgio R R Decker, Ivy Shi, Lichen Liang, Yang Song, Sadiya S Khan, Dhruv S Kazi","doi":"10.1001/jamacardio.2025.3109","DOIUrl":"10.1001/jamacardio.2025.3109","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":""},"PeriodicalIF":14.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asymptomatic Grade 6 Diastolic Murmur in an Adult.","authors":"Meliksah Arslan,Elizabeth C Fogelson,Jeffrey B Geske","doi":"10.1001/jamacardio.2025.3011","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.3011","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"90 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathway to Risk Stratification in Tricuspid Regurgitation-Reply.","authors":"Amey Vrudhula,David Ouyang","doi":"10.1001/jamacardio.2025.3171","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.3171","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"156 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}