Maria Concetta Pastore MD , Andrea Stefanini MD , Giulia Elena Mandoli MD , Pietro Piu PhD , Enrico Emilio Diviggiano MD , Maria Alma Iuliano MD , Leonardo Carli MD , Andrea Marchese MD , Luca Martini MD , Alessio Pecere MD , Luna Cavigli MD, PhD , Elisa Giacomin MD , Antonio Pagliaro MD , Francesca Maria Righini MD , Carlotta Sorini Dini MD , Hatem Soliman Aboumarie MD , Marta Focardi MD, PhD , Flavio D’Ascenzi MD, PhD , Serafina Valente MD , Matteo Cameli MD, PhD
{"title":"Dapagliflozin Effects on Cardiac Deformation in Heart Failure and Secondary Clinical Outcome","authors":"Maria Concetta Pastore MD , Andrea Stefanini MD , Giulia Elena Mandoli MD , Pietro Piu PhD , Enrico Emilio Diviggiano MD , Maria Alma Iuliano MD , Leonardo Carli MD , Andrea Marchese MD , Luca Martini MD , Alessio Pecere MD , Luna Cavigli MD, PhD , Elisa Giacomin MD , Antonio Pagliaro MD , Francesca Maria Righini MD , Carlotta Sorini Dini MD , Hatem Soliman Aboumarie MD , Marta Focardi MD, PhD , Flavio D’Ascenzi MD, PhD , Serafina Valente MD , Matteo Cameli MD, PhD","doi":"10.1016/j.jcmg.2024.05.014","DOIUrl":"10.1016/j.jcmg.2024.05.014","url":null,"abstract":"<div><h3>Background</h3><div>Sodium-glucose cotransporter 2 inhibitors were shown to reduce morbidity and mortality in patients with heart failure.</div></div><div><h3>Objectives</h3><div>This study aims to assess potential effects of dapagliflozin in nondiabetic patients with heart failure with reduced ejection fraction (HFrEF) and heart failure with mildly reduced ejection fraction (HFmrEF) on cardiac function assessed by speckle tracking echocardiography (STE).</div></div><div><h3>Methods</h3><div>This randomized, prospective, single-center, open-label trial compared consecutive nondiabetic outpatients with HFrEF or HFmrEF receiving dapagliflozin with patients treated with optimal medical therapy (OMT) except sodium-glucose cotransporter type 2 inhibitors. Primary endpoint was the presence of a significant modification of left ventricular global longitudinal strain, diastolic function (as peak atrial longitudinal strain) and right ventricular function by STE from baseline to 6 months. Cardiovascular events and parameters of congestion were assessed as safety-exploratory endpoints.</div></div><div><h3>Results</h3><div>Overall, 88 patients (38% HFmrEF) were enrolled and randomized to start dapagliflozin on top of OMT (n = 44) or to continue with OMT (n = 44). All STE values improved in the dapagliflozin group after 6 months, whereas there was a nonsignificant improvement in OMT group. Moreover, when comparing the modification of STE parameters at follow-up in patients with HFrEF and HFmrEF, only the main treatment effect resulted statistically significant in both groups (<em>P <</em> 0.0001), indicating a significant difference between dapagliflozin and OMT.</div></div><div><h3>Conclusions</h3><div>This study provided randomized data on the beneficial effect of dapagliflozin in nondiabetic patients with HFrEF and HFmrEF in terms of myocardial performance measured by the most sensitive echocardiographic technique, ie, STE. This suggests its usefulness for left ventricular reverse remodeling and better quality of life in patients with HFrEF and HFmrEF. (Effects of Dapagliflozin on cardiac deformation and clinical outcomes in heart failure with reduced and mildly reduced ejection fraction [DAPA ECHO trial]; <span><span>EudraCT number: 2021-005394-66</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 12","pages":"Pages 1399-1408"},"PeriodicalIF":12.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633553","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}
Nick S. Nurmohamed MD , Injeong Shim PhD , Emilie L. Gaillard MD , Shirin Ibrahim MD , Michiel J. Bom MD, PhD , James P. Earls MD , James K. Min MD , R. Nils Planken MD, PhD , Andrew D. Choi MD , Pradeep Natarajan MD, MMsc , Erik S.G. Stroes MD, PhD , Paul Knaapen MD, PhD , Laurens F. Reeskamp MD, PhD , Akl C. Fahed MD, MPH
{"title":"Polygenic Risk Is Associated With Long-Term Coronary Plaque Progression and High-Risk Plaque","authors":"Nick S. Nurmohamed MD , Injeong Shim PhD , Emilie L. Gaillard MD , Shirin Ibrahim MD , Michiel J. Bom MD, PhD , James P. Earls MD , James K. Min MD , R. Nils Planken MD, PhD , Andrew D. Choi MD , Pradeep Natarajan MD, MMsc , Erik S.G. Stroes MD, PhD , Paul Knaapen MD, PhD , Laurens F. Reeskamp MD, PhD , Akl C. Fahed MD, MPH","doi":"10.1016/j.jcmg.2024.06.015","DOIUrl":"10.1016/j.jcmg.2024.06.015","url":null,"abstract":"<div><h3>Background</h3><div>The longitudinal relation between coronary artery disease (CAD) polygenic risk score (PRS) and long-term plaque progression and high-risk plaque (HRP) features is unknown.</div></div><div><h3>Objectives</h3><div>The goal of this study was to investigate the impact of CAD PRS on long-term coronary plaque progression and HRP.</div></div><div><h3>Methods</h3><div>Patients underwent CAD PRS measurement and prospective serial coronary computed tomography angiography (CTA) imaging. Coronary CTA scans were analyzed with a previously validated artificial intelligence–based algorithm (atherosclerosis imaging–quantitative computed tomography imaging). The relationship between CAD PRS and change in percent atheroma volume (PAV), percent noncalcified plaque progression, and HRP prevalence was investigated in linear mixed-effect models adjusted for baseline plaque volume and conventional risk factors.</div></div><div><h3>Results</h3><div>A total of 288 subjects (mean age 58 ± 7 years; 60% male) were included in this study with a median scan interval of 10.2 years. At baseline, patients with a high CAD PRS had a more than 5-fold higher PAV than those with a low CAD PRS (10.4% vs 1.9%; <em>P <</em> 0.001). Per 10 years of follow-up, a 1 SD increase in CAD PRS was associated with a 0.69% increase in PAV progression in the multivariable adjusted model. CAD PRS provided additional discriminatory benefit for above-median noncalcified plaque progression during follow-up when added to a model with conventional risk factors (AUC: 0.73 vs 0.69; <em>P =</em> 0.039). Patients with high CAD PRS had an OR of 2.85 (95% CI: 1.14-7.14; <em>P =</em> 0.026) and 6.16 (95% CI: 2.55-14.91; <em>P <</em> 0.001) for having HRP at baseline and follow-up compared with those with low CAD PRS.</div></div><div><h3>Conclusions</h3><div>Polygenic risk is strongly associated with future long-term plaque progression and HRP in patients suspected of having CAD.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 12","pages":"Pages 1445-1459"},"PeriodicalIF":12.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995760","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":"A Home for the Orphan?","authors":"Wojciech Kosmala MD, PhD","doi":"10.1016/j.jcmg.2024.07.006","DOIUrl":"10.1016/j.jcmg.2024.07.006","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 12","pages":"Pages 1425-1427"},"PeriodicalIF":12.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035909","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}
Claire B. Ren MD, PhD , Danielle Tardif BS , Hans-Jelle Brandenburg BS , Mathieu Roux BS , Blaz Mrevlje MD, PhD , Marcel L. Geleijnse MD, PhD , Nicolas M. Van Mieghem MD, PhD , Ernest Spitzer MD , Philippe Pibarot DVM, PhD
{"title":"Echocardiography Core Laboratory Methodology for TAVR","authors":"Claire B. Ren MD, PhD , Danielle Tardif BS , Hans-Jelle Brandenburg BS , Mathieu Roux BS , Blaz Mrevlje MD, PhD , Marcel L. Geleijnse MD, PhD , Nicolas M. Van Mieghem MD, PhD , Ernest Spitzer MD , Philippe Pibarot DVM, PhD","doi":"10.1016/j.jcmg.2024.04.014","DOIUrl":"10.1016/j.jcmg.2024.04.014","url":null,"abstract":"<div><div>Inter-echocardiography core laboratory (ECL) harmonization is pivotal to consider data from different ECLs interchangeable. On the basis of the experience of the first trans-Atlantic harmonization of 2 established ECLs in the field of transcatheter aortic valve replacement (TAVR) trials, this review describes the harmonized ECL methodology in analyzing and adjudicating the post-TAVR echocardiographic endpoints according to Valve Academic Research Consortium 3 definitions. This review presents the feasibility and intra- and inter-ECL reproducibility, explains the root cause of potential important inter-ECL variability, and formulates ECL recommendations for optimal post-TAVR echocardiographic image acquisition. The implementation of inter-ECL harmonization may further define the best practice of ECLs and have logistic and regulatory implications for the realization of future TAVR trials.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 12","pages":"Pages 1480-1500"},"PeriodicalIF":12.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544848","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}