JACC. Cardiovascular interventions最新文献

{"title":"Diagnostic Performance of Fractional Flow Reserve Derived From Coronary CT Angiography","authors":"Changling Li MD ,&nbsp;Yumeng Hu MSc ,&nbsp;Jun Jiang MD ,&nbsp;Liang Dong MD ,&nbsp;Yong Sun MD ,&nbsp;Lijiang Tang MD ,&nbsp;Changqing Du MD ,&nbsp;Da Yin MD ,&nbsp;Wenbing Jiang MD ,&nbsp;Xiaochang Leng PhD ,&nbsp;Fan Jiang MD ,&nbsp;Yibin Pan MD ,&nbsp;Xuejun Jiang MD ,&nbsp;Zhong Zhou MD ,&nbsp;Bon-Kwon Koo MD ,&nbsp;Jianping Xiang PhD ,&nbsp;Jian’an Wang MD ,&nbsp;the ACCURATE-CT Investigators","doi":"10.1016/j.jcin.2024.06.027","DOIUrl":"10.1016/j.jcin.2024.06.027","url":null,"abstract":"<div><h3>Background</h3><p>AccuFFRct (ArteryFlow Technology) is a novel noninvasive method for calculating fractional flow reserve (FFR) from coronary computed tomography angiography (CCTA). The accuracy of AccuFFRct has not been adequately assessed.</p></div><div><h3>Objectives</h3><p>This study sought to evaluate the diagnostic performance of AccuFFRct in detecting lesion-specific ischemia.</p></div><div><h3>Methods</h3><p>This prospective study enrolled 339 patients with 404 vessels. CCTA-derived FFR was calculated using an on-site computational fluid dynamics–based method and compared with invasive FFR. The performance of AccuFFRct was comprehensively analyzed in all lesions and subgroups, including “gray zone” lesions, various lesion classifications, clinical presentations, stenosis severities, and lesion locations.</p></div><div><h3>Results</h3><p>Using FFR ≤0.80 as a reference standard, the overall diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for AccuFFRct were 90.6% (95% CI: 87.3%-93.3%), 90.9% (95% CI: 85.1%-94.9%), 90.4% (95% CI: 86.1%-93.8%), 85.3% (95% CI: 79.8%-89.5%), and 94.2% (95% CI: 90.8%-96.4%), respectively. Good correlation and agreement were found between the computed AccuFFRct and measured FFR. AccuFFRct showed superior discrimination ability to CCTA (AUC: 0.93 [95% CI: 0.89-0.95] vs 0.77 [95% CI: 0.72-0.81]; <em>P</em> &lt; 0.001) and quantitative coronary angiography (AUC: 0.93 [95% CI: 0.89-0.95] vs 0.89 [95% CI: 0.85-0.92]; <em>P =</em> 0.048) for identifying functionally significant stenosis. Notably, AccuFFRct maintained high diagnostic accuracy across the spectrum of lesion classifications, clinical presentations, stenosis severities, lesion locations, and in the “gray zone”. Furthermore, in the cohort with ≥70% stenosis, AccuFFRct could significantly reduce the rate of un-necessary invasive tests (33.1% vs 6.6%; <em>P</em> &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>The study confirms the potential of AccuFFRct as a noninvasive alternative to invasive FFR for detecting ischemia in coronary artery disease and to risk stratify patients. The results highlight AccuFFRct’s robust diagnostic ability across a wide range of lesion classifications, clinical presentations, stenosis severities, lesion locations, and in the “gray zone”. (Diagnostic Performance of Fractional Flow Reserve Derived From Coronary CT Angiography [ACCURATE-CT]; <span><span>NCT04426396</span><svg><path></path></svg></span>)</p></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S193687982400952X/pdfft?md5=fe4b69f177ce630c28908860b6b9c66d&pid=1-s2.0-S193687982400952X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035886","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":"Temporal Trends in Prevalence of Bicuspid Aortic Valves in Patients Undergoing Surgical Aortic Valve Replacement","authors":"Faysal Massad MD,&nbsp;Shriya N. Bavishi MD,&nbsp;Christopher G. Scott MS,&nbsp;Susan L. Holtegaard,&nbsp;Juan A. Crestanello MD,&nbsp;Melanie C. Bois MD,&nbsp;Patricia A. Pellikka MD","doi":"10.1016/j.jcin.2024.07.024","DOIUrl":"10.1016/j.jcin.2024.07.024","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1936879824010100/pdfft?md5=52ac5951186ec9779cbb00c9a9e0c579&pid=1-s2.0-S1936879824010100-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142163341","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":"Angiographic FFR in the Assessment of Spontaneous Epicardial Coronary Spasm in INOCA","authors":"Neha Panigrahy MD,&nbsp;Anais Hausvater MD,&nbsp;Nathaniel R. Smilowitz MD, MS","doi":"10.1016/j.jcin.2024.07.022","DOIUrl":"10.1016/j.jcin.2024.07.022","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035885","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":"Kissing Stenting for Left Main Carina Perforation","authors":"Ottavia Cozzi MD ,&nbsp;Matteo Maurina MD ,&nbsp;Bernhard Reimers MD ,&nbsp;Gabriele Gasparini MD ,&nbsp;Giulio G. Stefanini MD ,&nbsp;Antonio Colombo MD ,&nbsp;Antonio Mangieri MD ,&nbsp;Damiano Regazzoli MD","doi":"10.1016/j.jcin.2024.06.021","DOIUrl":"10.1016/j.jcin.2024.06.021","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035887","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":"Full Issue PDF","authors":"","doi":"10.1016/S1936-8798(24)01094-X","DOIUrl":"10.1016/S1936-8798(24)01094-X","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S193687982401094X/pdfft?md5=536fd72611383f272b1e3ec9d37552e9&pid=1-s2.0-S193687982401094X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142163340","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":"Emerging Hybrid Intracoronary Imaging Technologies and Their Applications in Clinical Practice and Research","authors":"Vincenzo Tufaro MD ,&nbsp;Farouc A. Jaffer MD, PhD ,&nbsp;Patrick W. Serruys MD, PhD ,&nbsp;Yoshinobu Onuma MD, PhD ,&nbsp;Antonius F.W. van der Steen MD, PhD ,&nbsp;Gregg W. Stone MD, PhD ,&nbsp;James E. Muller MD, PhD ,&nbsp;Laura Marcu PhD ,&nbsp;Gijs Van Soest PhD ,&nbsp;Brian K. Courtney MD, MSEE ,&nbsp;Guillermo J. Tearney MD, PhD ,&nbsp;Christos V. Bourantas MD, PhD","doi":"10.1016/j.jcin.2024.07.007","DOIUrl":"10.1016/j.jcin.2024.07.007","url":null,"abstract":"<div><p>Intravascular ultrasound and optical coherence tomography are used with increasing frequency for the care of coronary patients and in research studies. These imaging tools can identify culprit lesions in acute coronary syndromes, assess coronary stenosis severity, guide percutaneous coronary intervention (PCI), and detect vulnerable plaques and patients. However, they have significant limitations that have stimulated the development of multimodality intracoronary imaging catheters, which provide improvements in assessing vessel wall pathology and guiding PCI. Prototypes combining 2 or even 3 imaging probes with complementary attributes have been developed, and several multimodality systems have already been used in patients, with near-infrared spectroscopy intravascular ultrasound–based studies showing promising results for the identification of high-risk plaques. Moreover, postmortem histology studies have documented that hybrid imaging catheters can enable more accurate characterization of plaque morphology than standalone imaging. This review describes the evolution in the field of hybrid intracoronary imaging; presents the available multimodality catheters; and discusses their potential role in PCI guidance, vulnerable plaque detection, and the assessment of endovascular devices and emerging pharmacotherapies targeting atherosclerosis.</p></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162704","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-Guided De-Escalation of DAPT","authors":"Larisa H. Cavallari PharmD ,&nbsp;Francesco Franchi MD","doi":"10.1016/j.jcin.2024.07.014","DOIUrl":"10.1016/j.jcin.2024.07.014","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107496","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":"Impact of Balloon-Expandable TAVR Valve Deformation and Calcium Distribution on Outcomes in Bicuspid Aortic Valve","authors":"Takashi Nagasaka MD ,&nbsp;Vivek Patel MS ,&nbsp;Alon Shechter MD, MHA ,&nbsp;Kazuki Suruga MD ,&nbsp;Ofir Koren MD ,&nbsp;Tarun Chakravarty MD ,&nbsp;Wen Cheng MD ,&nbsp;Hideki Ishii MD ,&nbsp;Hasan Jilaihawi MD ,&nbsp;Mamoo Nakamura MD ,&nbsp;Raj R. Makkar MD","doi":"10.1016/j.jcin.2024.07.018","DOIUrl":"10.1016/j.jcin.2024.07.018","url":null,"abstract":"<div><h3>Background</h3><p>Research on the role of transcatheter heart valve (THV) deformation and calcium distribution in patients with bicuspid aortic valves (BAVs) undergoing transcatheter aortic valve replacement (TAVR) remains limited.</p></div><div><h3>Objectives</h3><p>The aim of this study was to evaluate the impact of THV deformation on clinical outcomes in individuals with BAVs undergoing TAVR and the influence of calcium on these outcomes.</p></div><div><h3>Methods</h3><p>In total, 229 consecutive patients with BAVs who underwent TAVR with balloon-expandable valves and had computed tomography (CT) performed 30 days post-TAVR were analyzed. Patients were stratified into 3 groups: group 1 (n = 125), with no THV underexpansion or eccentricity; group 2 (n = 69), with underexpansion or eccentricity; and group 3 (n = 35), with both. Calcium distribution was assessed using CT, and its associations with clinical outcomes, including all-cause mortality at 3 years and leaflet thrombosis at 30 days, were determined. A subgroup analysis of patients with type 1 BAVs was conducted.</p></div><div><h3>Results</h3><p>Group 3 exhibited higher rates of all-cause mortality than the other groups, along with the highest risk for hypoattenuated leaflet thickening at 30 days. Multivariate analysis identified annular and left ventricular outflow tract calcification as independent predictors of all-cause mortality and hypoattenuated leaflet thickening. In patients with type 1 BAVs, excessive calcification at the raphe and opposite leaflet were associated with all-cause mortality at 3 years.</p></div><div><h3>Conclusions</h3><p>THV deformation post-TAVR was significantly linked to all-cause mortality in patients with BAVs. Annular and left ventricular outflow tract calcification correlated with increased risks for all-cause mortality and leaflet thrombosis. (Assessment of Transcatheter and Surgical Aortic Bioprosthetic Valve Thrombosis and Its Treatment With Anticoagulation [RESOLVE]; <span><span>NCT02318342</span><svg><path></path></svg></span>)</p></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1936879824009828/pdfft?md5=7b22d954486a0d75ec84a64281cc0207&pid=1-s2.0-S1936879824009828-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142163251","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":"AccuFFRct","authors":"Júlia Karády MD, PhD, MPH","doi":"10.1016/j.jcin.2024.07.023","DOIUrl":"10.1016/j.jcin.2024.07.023","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035884","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":"Optimizing Stent Placement in Aorto-Ostial Lesions","authors":"Franck Digne MD,&nbsp;Arthur Darmon MD,&nbsp;Mohammed Nejjari MD","doi":"10.1016/j.jcin.2024.06.025","DOIUrl":"10.1016/j.jcin.2024.06.025","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035889","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}