JAMA cardiology最新文献

{"title":"Implantable Cardioverter-Defibrillators in Chagas Cardiomyopathy.","authors":"Xiaoping Li, Yu Zhang, Xiangyu Chen","doi":"10.1001/jamacardio.2025.1276","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.1276","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":""},"PeriodicalIF":14.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159090","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":"Implantable Cardioverter-Defibrillators in Chagas Cardiomyopathy-Reply.","authors":"Martino Martinelli-Filho, Mauricio Ibrahim Scanavacca, Sergio Freitas de Siqueira","doi":"10.1001/jamacardio.2025.1279","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.1279","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":""},"PeriodicalIF":14.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159141","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":"Implantable Cardioverter-Defibrillators in Chagas Cardiomyopathy.","authors":"Sergio J Dubner","doi":"10.1001/jamacardio.2025.1273","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.1273","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":""},"PeriodicalIF":14.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159093","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":"Association of Endothelial Dysfunction With Chronic Marijuana Smoking and THC-Edible Use.","authors":"Leila Mohammadi, Mina Navabzadeh, Nerea Jiménez-Téllez, Daniel D Han, Emma Reagan, Jordan Naughton, Lylybell Y Zhou, Rahul Almeida, Leslie M Castaneda, Shadi A Abdelaal, Kathryn S Park, Keith Uyemura, Christian P Cheung, Mehmet Nur Onder, Natasha Goyal, Poonam Rao, Judith Hellman, Jing Cheng, Joseph C Wu, Gregory M Marcus, Matthew L Springer","doi":"10.1001/jamacardio.2025.1399","DOIUrl":"10.1001/jamacardio.2025.1399","url":null,"abstract":"<p><strong>Importance: </strong>Recreational and medicinal cannabis legalization has led to increased cannabis use. To understand the consequences for vascular health, we initiated the CANnabis: Does It Damage Endothelium (CANDIDE) study.</p><p><strong>Objective: </strong>To investigate whether cannabis use is associated with vascular endothelial dysfunction.</p><p><strong>Design, setting, and participants: </strong>In this cross-sectional study, sex- and age- matched healthy adults, aged 18 to 50 years, living in the San Francisco Bay Area, California, who neither smoke tobacco nor vape and were not frequently exposed to secondhand smoke were recruited into 3 cohorts: 2 chronic cannabis user groups (marijuana smokers and tetrahydrocannabinol [THC]-edible users) and 1 nonuser group. Participants were recruited from October 25, 2021, through August 1, 2024; analysis was completed September 2024. Participants' arterial flow-mediated dilation (FMD) and carotid-femoral pulse wave velocity (PWV) were measured. Human umbilical vein endothelial cells (HUVECs) were exposed to participant sera with and without vascular endothelial growth factor (VEGF) to assess the effects of user serum on endothelial nitric oxide production.</p><p><strong>Main outcomes and measures: </strong>FMD and PWV were direct physiological measurements, and VEGF-stimulated nitric oxide production was measured from HUVECs incubated in user serum samples.</p><p><strong>Results: </strong>Among 55 participants (20 female [37%]; 35 male [63%], mean age, 31.3 [SD, 8.4] years) arterial FMD was significantly lower among the marijuana smokers (mean, 6.0% [SD, 2.6%]; P = .004) and lower among THC-edible users (mean, 4.6% [SD, 3.7%]; P = .003) than among nonusers (mean, 10.4% [SD, 5.2%]). VEGF-stimulated nitric oxide levels in endothelial cells treated with participants' sera were significantly lower for the marijuana smoker group (mean, 1.1 nmol/L [SD, 0.3 nmol/L] ) than for the nonuser group (mean, 1.5 nmol/L [SD, 0.3 nmol/L]; P = .004) but were unaffected among the THC-edible users group compared with the nonusers (mean, 1.5 nmol/L [SD, 0.3 nmol/L]; P = .81). FMD was inversely correlated with smoking frequency (r = -0.7; P < .001) and the amount of THC ingested (r = -0.7; P = .03). Other vascular properties showed no differences.</p><p><strong>Conclusions: </strong>This cross-sectional study found that chronic cannabis smoking and THC ingestion were associated with endothelial dysfunction similar to that observed in tobacco smokers, although apparently occurring via distinct mechanisms.</p>","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":""},"PeriodicalIF":14.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159081","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":"One-Year Outcomes of Coronary Angiography After Out-of-Hospital Cardiac Arrest Without ST Elevation: An Individual Patient Data Meta-Analysis.","authors":"Eva Marie Spoormans, Tharusan Thevathasan, Niels van Royen, Aeilko H Zwinderman, Anne Freund, Holger Thiele, Kirsten Ziesemer, Steffen Desch, Jorrit S Lemkes","doi":"10.1001/jamacardio.2025.1194","DOIUrl":"10.1001/jamacardio.2025.1194","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Several randomized clinical trials (RCTs) assessed the effect of immediate vs delayed coronary angiography in patients with out-of-hospital cardiac arrest (OHCA) without ST-segment elevations and found no difference in short-term survival. However, the association of these strategies with long-term outcomes and the identification of patient subgroups that might benefit from tailored approaches remain unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare immediate vs delayed or selective coronary angiography treatment strategies for patients with OHCA without ST elevation and the effect on 1-year survival, and identify subgroups that may differ in treatment effect based on patient or clinical features.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;Ovid MEDLINE, Embase, and Clarivate/Web of Science Core Collection were searched for relevant literature from inception to September 8, 2022.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study selection: &lt;/strong&gt;RCTs investigating immediate vs delayed or selective coronary angiography after OHCA without ST-segment elevations and a minimum follow-up period of 1 year. Data were combined using the 1-stage individual participant data meta-analysis (IPDMA) approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data extraction and synthesis: &lt;/strong&gt;Individual patient data were obtained from RCTs that met the eligibility criteria: COACT (Coronary Angiography After Cardiac Arrest) and TOMAHAWK (Immediate Unselected Coronary Angiography vs Delayed Triage in Survivors of Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The primary end point was 1-year survival. Secondary outcomes included the identification of variations in treatment effect using subgroup analysis (based on age, sex, arrest rhythm, witnessed arrest, time to basic life support, time to return of spontaneous circulation, and history of coronary artery disease, diabetes, and hypertension) and clinical outcomes (eg, myocardial infarction and heart failure) at 1 year.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For the IPDMA, data were derived from 2 RCTs comprising a total of 1031 patients. In the immediate angiography group, 259 of 522 (49.6%) survived until 1 year vs 272 of 509 (53.4%) in the delayed or selective angiography group (stratified by randomized trial; hazard ratio, 1.15 [95% CI, 0.96-1.37). No treatment-by-subgroup interactions were identified that suggested heterogeneity between the 2 groups (P values for interaction ranged from P = .26 to P = .91 across subgroups).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In this IPDMA of 2 RCTs, there was no benefit of immediate coronary angiography compared with a delayed or selective strategy during 1-year follow-up in successfully resuscitated patients with OHCA without ST-segment elevations. No subgroup of patients was identified that showed a differential treatment effect.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;PROSPERO Identifier: CRD42022346559; COACT Netherlands Tr","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":""},"PeriodicalIF":14.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159142","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":"Polygenic Prediction of Peripheral Artery Disease and Major Adverse Limb Events.","authors":"Alyssa M Flores,Yunfeng Ruan,Anika Misra,So Mi Jemma Cho,Margaret S Selvaraj,Tiffany R Bellomo,Tetsushi Nakao,Kenneth Rosenfield,Matthew Eagleton,Whitney Hornsby,Aniruddh P Patel,Pradeep Natarajan","doi":"10.1001/jamacardio.2025.1182","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.1182","url":null,"abstract":"ImportancePeripheral artery disease (PAD) is a heritable atherosclerotic condition associated with functional decline and high risk for limb loss. With growing knowledge of the genetic basis for PAD and related risk factors, there is potential opportunity to identify individuals at high risk using polygenic risk scores (PRSs).ObjectiveTo develop a novel integrated, multiancestry polygenic score for PAD (PRS-PAD) and evaluate its risk estimation for PAD and major adverse limb events in 3 populations.Design, Setting, and ParticipantsThis longitudinal cohort study was conducted among individuals with genotyping and electronic health record data in the UK Biobank (2006-2021), All of Us (AoU, 2018-2022), and the Mass General Brigham Biobank (MGBB, 2010-2023). Data were analyzed from July 2023 to February 2025.ExposuresPRS-PAD, previously published PAD polygenic scores, and clinical risk factors.Main Outcomes and MeasuresThe primary outcomes were PAD and major adverse limb events, defined as a surrogate of major amputation and acute limb ischemia.ResultsThe study populations included 400 533 individuals from the UK Biobank (median [IQR] age, 58.2 [45.0-71.4] years; 216 215 female participants [53.9%]), 218 500 from AoU (median [IQR] age, 53.6 [37.7-65.0] years; 132 647 female participants [60.7%]), and 32 982 from MGBB (median [IQR] age, 56.0 [32.0-80.0] years; 18 277 female participants [55.4%]). In the UK Biobank validation cohort, PRS-PAD was associated with an odds ratio [OR] per SD increase of 1.63 (95% CI, 1.60-1.68; P < .001). After adjusting for clinical risk factors, the OR for the top 20% of PRS-PAD was 1.68 (95% CI, 1.62-1.74; P < .001) compared to the remainder of the population. Among PAD cases without a history of diabetes, smoking, or chronic kidney disease (n = 3645), 1097 individuals (30.1%) had a high PRS-PAD (top 20%). In incident disease analysis, PRS-PAD improved discrimination (C statistic, 0.761), which was nearly equivalent to the performances of diabetes (C statistic, 0.760) and smoking (C statistic, 0.765). Among individuals with prevalent PAD, high PRS-PAD was associated with an increased risk of incident major adverse limb events in the UK Biobank (hazard ratio [HR], 1.75; 95% CI, 1.18-2.57; P = .005), MGBB (HR, 1.56; 95% CI, 1.06-2.30; P = .02), and AoU (HR, 1.57; 95% CI, 1.06-2.33; P = .03).Conclusions and RelevanceThis cohort study develops a new PRS that stratifies risk of PAD and adverse limb outcomes. Incorporating polygenic risk into PAD care warrants further investigation to guide screening and tailor management to prevent major adverse limb events.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"135 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103739","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":"Regulatory Approval vs Guideline Endorsement of Novel BP-Lowering Treatments.","authors":"Ritika Revoori,John W McEvoy,Cian P McCarthy","doi":"10.1001/jamacardio.2025.1365","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.1365","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"14 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103780","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":"Finerenone in Heart Failure With Improved Ejection Fraction: The FINEARTS-HF Randomized Clinical Trial.","authors":"Maria A Pabon,Orly Vardeny,Muthiah Vaduganathan,Akshay S Desai,Brian L Claggett,Ian J Kulac,Pardeep S Jhund,Carolyn S P Lam,Michele Senni,Sanjiv J Shah,Adriaan A Voors,Faiez Zannad,Bertram Pitt,Clara I Saldarriaga,Mark C Petrie,Béla Merkely,Maria Borentain,Katharina Mueller,Prabhakar Viswanathan,Flaviana Amarante,Alanna Morris,John J V McMurray,Scott D Solomon","doi":"10.1001/jamacardio.2025.1101","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.1101","url":null,"abstract":"ImportancePatients with chronic heart failure (HF) and left ventricular ejection fraction (LVEF) less than 40% who experience LVEF improvement to 40% or higher (HFimpEF) may still face residual risks.ObjectiveTo assess the clinical profiles, risk, and treatment response to finerenone in participants with HFimpEF.Design, Setting, and ParticipantsA total of 6001 patients with HE, LVEF of 40% or higher, New York Heart Association class II to IV symptoms, and elevated natriuretic peptide levels, were enrolled between September 14, 2020, and January 10, 2023. Patients with a prior history of LVEF less than 40% were included. Data analysis was conducted between September 1 to December 10, 2024.InterventionParticipants received finerenone (titrated to 20 mg or 40 mg) or placebo.Main Outcomes and MeasuresThe primary end point was the composite of cardiovascular (CV) death and total (first and recurrent) worsening HF events.ResultsOf the 6001 participants (mean [SD] age, 72 [9.7], years; 3269 male [55%]), 273 (5%) had a prior LVEF less than 40%. Among those with a prior LVEF of less than 40%, the median recorded prior LVEF was 35% [IQR, 30%-37%], with a median improvement of 12% [IQR, 8%-17%]. Over a median follow-up of 2.6 years, those with a history of LVEF of less than 40% experienced higher rates of the primary outcome of a composite of CV death and worsening of HF events (21.4 per 100 patient-years vs 16.0 per 100 patient-years) than did those whose LVEF was consistently 40% or higher. After adjustment for clinically relevant covariates; however, this rate ratio (RR) was not statistically different (absolute RR, 1.13; 95% CI, 0.85-1.49, P = .39). The treatment effect of finerenone on the primary outcome was consistent among those with a history of LVEF less than 40% and those with LVEF that was consistently 40% or higher (P for interaction = .36). Owing to higher baseline risk, the absolute risk reduction was greater among those with HFimpEF (9.2 vs 2.5 per 100 patient-years). Patients with HFimpEF tended to develop more hypotension with finerenone treatment, but otherwise, the safety profile of finerenone was similar in patients with and without previous LVEF less than 40%.Conclusions and RelevanceIn this prespecified analysis of a randomized clinical trial, patients with HFimpEF remained at high risk of CV events, underscoring the need for continued management despite LVEF improvement. The treatment benefits of finerenone observed among the overall population of patients with HF with preserved EF were consistent among patients with HFimpEF.Trial RegistrationClinicalTrials.gov Identifier: NCT04435626.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"31 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103734","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":"Left Ventricular Noncompaction Cardiomyopathy","authors":"Muhammad Adnan Zaman, Sidra Kalsoom, Lou Mastrine","doi":"10.1001/jamacardio.2025.1368","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.1368","url":null,"abstract":"This case report describes an echocardiography-based diagnosis of left ventricular noncompaction cardiomyopathy in a male patient in his 40s who presented with sudden-onset dyspnea.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"19 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144104687","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":"The Limitations and Risks Associated With Semaglutide Treatment.","authors":"Vanita Rahman","doi":"10.1001/jamacardio.2025.1095","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.1095","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"96 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945470","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}