Omar M. Abdelfattah MD, Xander Jacquemyn BSc, Amro Aglan MD, Ethan Rowin MD, Martin Maron MD, Matthew W. Martinez MD
{"title":"Clinical Outcomes in Hypertrophic Cardiomyopathy and No Late Gadolinium Enhancement","authors":"Omar M. Abdelfattah MD, Xander Jacquemyn BSc, Amro Aglan MD, Ethan Rowin MD, Martin Maron MD, Matthew W. Martinez MD","doi":"10.1016/j.jcmg.2024.06.004","DOIUrl":"10.1016/j.jcmg.2024.06.004","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1387-1388"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788114","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}
Adrian Chong MBBS, BPharm , Jonathan Sen MBBS, BHSc , Reza Reyaldeen MBBS, BSc , Sudhir Wahi MBBS, MD , Quan Huynh BMed, PhD , William Y.S. Wang MBBS, PhD , Thomas H. Marwick MBBS, PhD, MPH
{"title":"Prognostication and Interventional Guidance Using Acceleration-Ejection Time Ratio in Undifferentiated Paradoxical Low-Flow Low-Gradient Aortic Stenosis","authors":"Adrian Chong MBBS, BPharm , Jonathan Sen MBBS, BHSc , Reza Reyaldeen MBBS, BSc , Sudhir Wahi MBBS, MD , Quan Huynh BMed, PhD , William Y.S. Wang MBBS, PhD , Thomas H. Marwick MBBS, PhD, MPH","doi":"10.1016/j.jcmg.2024.05.015","DOIUrl":"10.1016/j.jcmg.2024.05.015","url":null,"abstract":"<div><h3>Background</h3><div>Studies in paradoxical low-flow low-gradient aortic stenosis (PLFAS) have demonstrated conflicting outcomes with variable survival advantage from aortic valve replacement (AVR). PLFAS is a heterogeneous composition of patients with uncertainty regarding true stenosis severity that continues to confound decision-making for AVR.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to investigate the utility of the Doppler acceleration (AT) to ejection (ET) time ratio (AT:ET) for prediction of prognosis and benefit from AVR in undifferentiated PLFAS.</div></div><div><h3>Methods</h3><div>Patients with echocardiographic findings of PLFAS (aortic valve area <1.0 cm<sup>2</sup> or indexed aortic valve area <0.6 cm<sup>2</sup>/m<sup>2</sup>, mean gradient <40 mm Hg, indexed stroke volume <35 mL/m<sup>2</sup>, and left ventricular ejection fraction ≥50%) were identified and grouped according to an AT:ET cutoff of 0.35. The primary outcome was a 5-year composite of cardiac mortality or AVR. Secondary outcomes included the individual components of the primary endpoint and all-cause mortality at 5 years. Effect of AVR was analyzed in the AT:ET <0.35 and ≥0.35 groups.</div></div><div><h3>Results</h3><div>A total of 171 PLFAS patients (median age 77.0 years, 57% women) were followed for a median of 8.9 years. AT:ET ≥0.35 was an independent predictor of the primary outcome (HR: 4.77 [95% CI: 2.94-7.75]; <em>P <</em> 0.001) with incremental value over standard indices of stenosis severity (net reclassification improvement: 0.57 [95% CI: 0.14-0.84]). AT:ET ≥0.35 also remained predictive of increased cardiac death (HR: 2.91 [95% CI: 1.47-5.76]; <em>P =</em> 0.002) and AVR (HR: 8.45 [95% CI: 4.16-17.1]; <em>P <</em> 0.001), respectively, following competing risk analysis. No difference in all-cause mortality was observed. AVR in the AT:ET ≥0.35 group was associated with significant reductions in 5-year cardiac (HR: 0.09 [95% CI: 0.02-0.36]; <em>P <</em> 0.001) and all-cause mortality (HR: 0.16 [95% CI: 0.07-0.38]; <em>P <</em> 0.001). No improvement in survival from AVR was demonstrated in AT:ET <0.35 patients.</div></div><div><h3>Conclusions</h3><div>AT:ET ≥0.35 in PLFAS predicts poorer outcomes and/or need for AVR. In undifferentiated PLFAS patients, AT:ET may have a potential role in improving patient selection for prognostic AVR.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1290-1301"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995761","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}
Jacob A. Martin MD, MSCR, Theodore Hill BA, Muhamed Saric MD, PhD, Alan F. Vainrib MD, Daniel Bamira MD, Samuel Bernard MD, Richard Ro MD, Hao Zhang MS, Jonathan S. Austrian MD, Yindalon Aphinyanaphongs MD, PhD, Vidya Koesmahargyo MS, Mathew R. Williams MD, Larry A. Chinitz MD, Lior Jankelson MD, PhD
{"title":"Evaluating Patient-Oriented Echocardiogram Reports Augmented by Artificial Intelligence","authors":"Jacob A. Martin MD, MSCR, Theodore Hill BA, Muhamed Saric MD, PhD, Alan F. Vainrib MD, Daniel Bamira MD, Samuel Bernard MD, Richard Ro MD, Hao Zhang MS, Jonathan S. Austrian MD, Yindalon Aphinyanaphongs MD, PhD, Vidya Koesmahargyo MS, Mathew R. Williams MD, Larry A. Chinitz MD, Lior Jankelson MD, PhD","doi":"10.1016/j.jcmg.2024.05.021","DOIUrl":"10.1016/j.jcmg.2024.05.021","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1381-1383"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874846","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}
Hunain Shiwani BMBS , Jessica Artico MD , James C. Moon MD , Miroslawa Gorecka MB , Gerry P. McCann MD , Giles Roditi MD , Andrew Morrow MBChB , Kenneth Mangion PhD , Elena Lukaschuk MSc , Mayooran Shanmuganathan MBBS , Christopher A. Miller PhD , Amedeo Chiribiri PhD , Mohammed Alzahir MBBS , Sara Ramirez MD , Andrew Lin MBBS , Peter P. Swoboda PhD , Adam K. McDiarmid PhD , Robert Sykes MBChB , Trisha Singh MBBS , Chiara Bucciarelli-Ducci PhD , Ifza Hussain
{"title":"Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19","authors":"Hunain Shiwani BMBS , Jessica Artico MD , James C. Moon MD , Miroslawa Gorecka MB , Gerry P. McCann MD , Giles Roditi MD , Andrew Morrow MBChB , Kenneth Mangion PhD , Elena Lukaschuk MSc , Mayooran Shanmuganathan MBBS , Christopher A. Miller PhD , Amedeo Chiribiri PhD , Mohammed Alzahir MBBS , Sara Ramirez MD , Andrew Lin MBBS , Peter P. Swoboda PhD , Adam K. McDiarmid PhD , Robert Sykes MBChB , Trisha Singh MBBS , Chiara Bucciarelli-Ducci PhD , Ifza Hussain","doi":"10.1016/j.jcmg.2024.06.008","DOIUrl":"10.1016/j.jcmg.2024.06.008","url":null,"abstract":"<div><h3>Background</h3><div>Hospitalized COVID-19 patients with troponin elevation have a higher prevalence of cardiac abnormalities than control individuals. However, the progression and impact of myocardial injury on COVID-19 survivors remain unclear.</div></div><div><h3>Objectives</h3><div>This study sought to evaluate myocardial injury in COVID-19 survivors with troponin elevation with baseline and follow-up imaging and to assess medium-term outcomes.</div></div><div><h3>Methods</h3><div>This was a prospective, longitudinal cohort study in 25 United Kingdom centers (June 2020 to March 2021). Hospitalized COVID-19 patients with myocardial injury underwent cardiac magnetic resonance (CMR) scans within 28 days and 6 months postdischarge. Outcomes were tracked for 12 months, with quality of life surveys (EuroQol-5 Dimension and 36-Item Short Form surveys) taken at discharge and 6 months.</div></div><div><h3>Results</h3><div>Of 342 participants (median age: 61.3 years; 71.1% male) with baseline CMR, 338 had a 12-month follow-up, 235 had a 6-month CMR, and 215 has baseline and follow-up quality of life surveys. Of 338 participants, within 12 months, 1.2% died; 1.8% had new myocardial infarction, acute coronary syndrome, or coronary revascularization; 0.8% had new myopericarditis; and 3.3% had other cardiovascular events requiring hospitalization. At 6 months, there was a minor improvement in left ventricular ejection fraction (1.8% ± 1.0%; <em>P <</em> 0.001), stable right ventricular ejection fraction (0.4% ± 0.8%; <em>P =</em> 0.50), no change in myocardial scar pattern or volume (<em>P =</em> 0.26), and no imaging evidence of continued myocardial inflammation. All pericardial effusions (26 of 26) resolved, and most pneumonitis resolved (95 of 101). EuroQol-5 Dimension scores indicated an overall improvement in quality of life (<em>P <</em> 0.001).</div></div><div><h3>Conclusions</h3><div>Myocardial injury in severe hospitalized COVID-19 survivors is nonprogressive. Medium-term outcomes show a low incidence of major adverse cardiovascular events and improved quality of life. (COVID-19 Effects on the Heart; <span><span>ISRCTN58667920</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1320-1331"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107563","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}