JAMA cardiology最新文献

{"title":"JAMA Cardiology.","authors":"","doi":"10.1001/jamacardio.2023.3683","DOIUrl":"https://doi.org/10.1001/jamacardio.2023.3683","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"9 11","pages":"954"},"PeriodicalIF":14.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620564","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":"Errors in Percentage Values.","authors":"","doi":"10.1001/jamacardio.2024.3111","DOIUrl":"10.1001/jamacardio.2024.3111","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"1063"},"PeriodicalIF":14.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287487","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":"Aficamten and Cardiopulmonary Exercise Test Performance: A Substudy of the SEQUOIA-HCM Randomized Clinical Trial.","authors":"Matthew M Y Lee, Ahmad Masri, Michael E Nassif, Roberto Barriales-Villa, Theodore P Abraham, Brian L Claggett, Caroline J Coats, Juan Ramón Gimeno, Ian J Kulac, Isabela Landsteiner, Changsheng Ma, Martin S Maron, Iacopo Olivotto, Anjali T Owens, Scott D Solomon, Josef Veselka, Daniel L Jacoby, Stephen B Heitner, Stuart Kupfer, Fady I Malik, Lisa Meng, Amy Wohltman, Gregory D Lewis","doi":"10.1001/jamacardio.2024.2781","DOIUrl":"10.1001/jamacardio.2024.2781","url":null,"abstract":"<p><strong>Importance: </strong>Impaired exercise capacity is a cardinal manifestation of obstructive hypertrophic cardiomyopathy (HCM). The Phase 3 Trial to Evaluate the Efficacy and Safety of Aficamten Compared to Placebo in Adults With Symptomatic Obstructive HCM (SEQUOIA-HCM) is a pivotal study characterizing the treatment effect of aficamten, a next-in-class cardiac myosin inhibitor, on a comprehensive set of exercise performance and clinical measures.</p><p><strong>Objective: </strong>To evaluate the effect of aficamten on exercise performance using cardiopulmonary exercise testing with a novel integrated measure of maximal and submaximal exercise performance and evaluate other exercise measures and clinical correlates.</p><p><strong>Design, setting, and participants: </strong>This was a prespecified analysis from SEQUOIA-HCM, a double-blind, placebo-controlled, randomized clinical trial. Patients were recruited from 101 sites in 14 countries (North America, Europe, Israel, and China). Individuals with symptomatic obstructive HCM with objective exertional intolerance (peak oxygen uptake [pVO2] ≤90% predicted) were included in the analysis. Data were analyzed from January to March 2024.</p><p><strong>Interventions: </strong>Randomized 1:1 to aficamten (5-20 mg daily) or matching placebo for 24 weeks.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was change from baseline to week 24 in integrated exercise performance, defined as the 2-component z score of pVO2 and ventilatory efficiency throughout exercise (minute ventilation [VE]/carbon dioxide output [VCO2] slope). Response rates for achieving clinically meaningful thresholds for change in pVO2 and correlations with clinical measures of treatment effect (health status, echocardiographic/cardiac biomarkers) were also assessed.</p><p><strong>Results: </strong>Among 282 randomized patients (mean [SD] age, 59.1 [12.9] years; 115 female [40.8%], 167 male [59.2%]), 263 (93.3%) had core laboratory-validated exercise testing at baseline and week 24. Integrated composite exercise performance improved in the aficamten group (mean [SD] z score, 0.17 [0.51]) from baseline to week 24, whereas the placebo group deteriorated (mean [SD] z score, -0.19 [0.45]), yielding a placebo-corrected improvement of 0.35 (95% CI, 0.25-0.46; P <.001). Further, aficamten treatment demonstrated significant improvements in total workload, circulatory power, exercise duration, heart rate reserve, peak heart rate, ventilatory efficiency, ventilatory power, and anaerobic threshold (all P <.001). In the aficamten group, large improvements (≥3.0 mL/kg per minute) in pVO2 were more common than large reductions (32% and 2%, respectively) compared with placebo (16% and 11%, respectively). Improvements in both components of the primary outcome, pVO2 and VE/VCO2 slope throughout exercise, were significantly correlated with improvements in symptom burden and hemodynamics (all P <.05).</p><p><strong>Conclusions","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"990-1000"},"PeriodicalIF":14.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125725","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":"Genome-Wide Association Study of Accessory Atrioventricular Pathways.","authors":"Hildur M Aegisdottir, Laura Andreasen, Rosa B Thorolfsdottir, Gardar Sveinbjornsson, Andrea B Jonsdottir, Lilja Stefansdottir, Gudmar Thorleifsson, Asgeir Sigurdsson, Gisli H Halldorsson, Julien Barc, Floriane Simonet, Vinicius Tragante, Asmundur Oddsson, Egil Ferkingstad, Jesper Hastrup Svendsen, Jonas Ghouse, Gustav Ahlberg, Christian Paludan-Müller, Katra Hadji-Turdeghal, Mariana Bustamante, Magnus O Ulfarsson, Anna Helgadottir, Solveig Gretarsdottir, Saedis Saevarsdottir, Ingileif Jonsdottir, Christian Erikstrup, Henrik Ullum, Erik Sørensen, Søren Brunak, Christian Jøns, Chaoqun Zheng, Connie R Bezzina, Kirk U Knowlton, Lincoln D Nadauld, Patrick Sulem, Sisse R Ostrowski, Ole B Pedersen, David O Arnar, Daniel F Gudbjartsson, Morten S Olesen, Henning Bundgaard, Hilma Holm, Kari Stefansson","doi":"10.1001/jamacardio.2024.2684","DOIUrl":"10.1001/jamacardio.2024.2684","url":null,"abstract":"<p><strong>Importance: </strong>Understanding of the genetics of accessory atrioventricular pathways (APs) and affiliated arrhythmias is limited.</p><p><strong>Objective: </strong>To investigate the genetics of APs and affiliated arrhythmias.</p><p><strong>Design, setting, and participants: </strong>This was a genome-wide association study (GWAS) of APs, defined by International Classification of Diseases (ICD) codes and/or confirmed by electrophysiology (EP) study. Genome-wide significant AP variants were tested for association with AP-affiliated arrhythmias: paroxysmal supraventricular tachycardia (PSVT), atrial fibrillation (AF), ventricular tachycardia, and cardiac arrest. AP variants were also tested in data on other heart diseases and measures of cardiac physiology. Individuals with APs and control individuals from Iceland (deCODE Genetics), Denmark (Copenhagen Hospital Biobank, Danish Blood Donor Study, and SupraGen/the Danish General Suburban Population Study [GESUS]), the US (Intermountain Healthcare), and the United Kingdom (UK Biobank) were included. Time of phenotype data collection ranged from January 1983 to December 2022. Data were analyzed from August 2022 to January 2024.</p><p><strong>Exposures: </strong>Sequence variants.</p><p><strong>Main outcomes and measures: </strong>Genome-wide significant association of sequence variants with APs.</p><p><strong>Results: </strong>The GWAS included 2310 individuals with APs (median [IQR] age, 43 [28-57] years; 1252 [54.2%] male and 1058 [45.8%] female) and 1 206 977 control individuals (median [IQR] year of birth, 1955 [1945-1970]; 632 888 [52.4%] female and 574 089 [47.6%] male). Of the individuals with APs, 909 had been confirmed in EP study. Three common missense variants were associated with APs, in the genes CCDC141 (p.Arg935Trp: adjusted odds ratio [aOR], 1.37; 95% CI, 1.24-1.52, and p.Ala141Val: aOR, 1.55; 95% CI 1.34-1.80) and SCN10A (p.Ala1073Val: OR, 1.22; 95% CI, 1.15-1.30). The 3 variants associated with PSVT and the SCN10A variant associated with AF, supporting an effect on AP-affiliated arrhythmias. All 3 AP risk alleles were associated with higher heart rate and shorter PR interval, and have reported associations with chronotropic response.</p><p><strong>Conclusions and relevance: </strong>Associations were found between sequence variants and APs that were also associated with risk of PSVT, and thus likely atrioventricular reentrant tachycardia, but had allele-specific associations with AF and conduction disorders. Genetic variation in the modulation of heart rate, chronotropic response, and atrial or atrioventricular node conduction velocity may play a role in the risk of AP-affiliated arrhythmias. Further research into CCDC141 could provide insights for antiarrhythmic therapeutic targeting in the presence of an AP.</p>","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"1053-1058"},"PeriodicalIF":14.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125726","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":"Comment on Risk of Cardiac Arrhythmias Among Climbers on Mount Everest.","authors":"Stefano Savonitto, Patrizio Sarto","doi":"10.1001/jamacardio.2024.2574","DOIUrl":"10.1001/jamacardio.2024.2574","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"1061"},"PeriodicalIF":14.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080282","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":"Comment on Risk of Cardiac Arrhythmias Among Climbers on Mount Everest-Reply.","authors":"Thomas Pilgrim, Martina Rothenbühler, Kunjang Sherpa","doi":"10.1001/jamacardio.2024.2577","DOIUrl":"10.1001/jamacardio.2024.2577","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"1061-1062"},"PeriodicalIF":14.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080283","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":"Genotype- vs Phenotype-Guided Approaches to Improve ATTR Detection.","authors":"Jessica A Regan, Marianna Fontana, Senthil Selvaraj","doi":"10.1001/jamacardio.2024.2654","DOIUrl":"10.1001/jamacardio.2024.2654","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"957-959"},"PeriodicalIF":14.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080284","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":"Echoes of Concern-AI and Moral Agency in Medicine.","authors":"Sarah C Hull, Joseph J Fins","doi":"10.1001/jamacardio.2024.3512","DOIUrl":"10.1001/jamacardio.2024.3512","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"955-956"},"PeriodicalIF":14.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107472","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":"Progressive Cardiogenic Shock After Catheter Ablation in a Man Aged 78 Years.","authors":"Karim Benali, Benjamin Seguy, Frederic Sacher","doi":"10.1001/jamacardio.2024.2199","DOIUrl":"10.1001/jamacardio.2024.2199","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"1059"},"PeriodicalIF":14.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897446","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":"Addressing Evidence Gaps in Coronary Revascularization Trials.","authors":"Gregg W Stone, Clyde W Yancy, Mario Gaudino","doi":"10.1001/jamacardio.2024.2778","DOIUrl":"10.1001/jamacardio.2024.2778","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"1062-1063"},"PeriodicalIF":14.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125724","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}