Journal of Cardiovascular Development and Disease最新文献

{"title":"Spontaneous Intracranial Vertebral Artery Dissection: A Rare Cause of Ischemic Stroke.","authors":"Marialuisa Zedde, Rosario Pascarella","doi":"10.3390/jcdd12050187","DOIUrl":"10.3390/jcdd12050187","url":null,"abstract":"<p><p>The dissection of the V4 vertebral artery (VA) is the most prevalent form of intracranial dissection, which can manifest either as ischemia or as a subarachnoid hemorrhage (SAH). Patient outcomes are significantly affected by their initial presentation; ischemic symptoms often indicate that the dissection remains primarily subintimal or within the medial layer, though it can occasionally extend to the basilar artery. In contrast, patients with ruptured VA dissection (VAD) experience a considerably higher mortality rate, as the dissection can reach the adventitial layer, heightening the risk of recurrent hemorrhage. It can show fluctuating imaging findings, making an accurate diagnosis and timely treatment essential. Currently, there are no established diagnostic criteria for VAD, and its diagnosis largely depends on imaging. The presence of intramural hematoma, identified via three-dimensional, black-blood, T1-weighted imaging, has been recognized as the most reliable indicator for diagnosing VAD and is crucial for establishing a definitive diagnosis. DSA remains a fundamental diagnostic technique not only in hemorrhagic patients but also in ischemic patients. The medical treatment of ischemic patients has not yet been well defined, and evidence-based data are lacking. This review aims to summarize the main clinical, pathophysiological, and neuroradiological features of intracranial VAD presenting with ischemic stroke, providing to clinicians the available information in order to individualize the treatment.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Cardiac Magnetic Resonance Imaging in the Management of Hypertrophic Cardiomyopathy.","authors":"Luca Pugliese, Alessandra Luciano, Marcello Chiocchi","doi":"10.3390/jcdd12050189","DOIUrl":"10.3390/jcdd12050189","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiomyopathy, caused by either sarcomere protein or other gene mutations. It is a complex and highly heterogeneous disorder, with phenotypes ranging from asymptomatic to severe disease, characterized by asymmetric left ventricular (LV) hypertrophy unexplained by loading conditions, which is also associated with myocardial fiber disarray, and preserved or increased ejection fraction without LV dilation. Comprehensive personal and family history, physical examination, and ECG testing raise suspicion of HCM, and echocardiogram represents the first-line imaging modality for confirming a diagnosis. Moreover, contrast-enhanced cardiac magnetic resonance (CMR) imaging has increasingly emerged as a fundamental diagnostic and prognostic tool in HCM management. This article reviews the role of CMR in HCM identification and differentiation from phenotypic mimics, characterization of HCM phenotypes, monitoring of disease progression, evaluation of pre- and post-septal reduction treatments, and selection of candidates for implantable cardioverter-defibrillator. By providing information on cardiac morphology and function and tissue characterization, CMR is particularly helpful in the quantification of myocardial wall thickness, the detection of hypertrophy in areas blind to echocardiogram, subtle morphologic features in the absence of LV hypertrophy, myocardial fibrosis, and apical aneurysm, the evaluation of LV outflow tract obstruction, and the assessment of LV function in end-stage dilated HCM.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Ross Procedure in Children with Congenital Heart Disease.","authors":"Nabil Dib, Nancy Poirier, Ismail Bouhout, Paul Khairy","doi":"10.3390/jcdd12050186","DOIUrl":"10.3390/jcdd12050186","url":null,"abstract":"<p><p>Aortic valve disease accounts for approximately 5% of all congenital heart defects in children. Choosing the optimal valve replacement in this population is challenging, as it must ensure durability, accommodate growth, and minimize the need for long-term anticoagulation. Biological valves do not require anticoagulation but lack durability and growth potential, leading to frequent reoperations. Mechanical valves offer longevity but necessitate lifelong anticoagulation and do not grow with the child. Among the available surgical options, the Ross procedure has emerged as a preferred approach due to its favorable hemodynamic performance, growth potential, and freedom from anticoagulation. First described in 1967, this technique involves replacing the diseased aortic valve with a pulmonary autograft and reconstructing the right ventricular outflow tract using a human or non-human valve substitute. Despite its advantages, the procedure is technically demanding, has a considerable learning curve, and transforms a single-valve pathology into a bivalvular condition. This narrative review provides an updated perspective on the Ross procedure in children, focusing on long-term survival, reoperation rates, and the role of percutaneous valve replacement in delaying surgical reintervention. By synthesizing the latest evidence, we aim to clarify the current standing of the Ross procedure as a durable and effective solution for pediatric aortic valve disease.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-Hospital Mortality and Costs of Added Morbidity in Heart Failure Patients at a University Hospital: A Retrospective Cross-Sectional Study.","authors":"Lourdes Raya Ortega, Jesús Martínez Tapias, María José Ferreras Fernández, Manuel Jiménez-Navarro, Almudena Ortega-Gómez, Miguel Romero-Cuevas, Juan José Gómez-Doblas","doi":"10.3390/jcdd12050185","DOIUrl":"10.3390/jcdd12050185","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a leading cause of hospital admissions and in-hospital mortality among the elderly. This study aims to characterize HF patients admitted to Virgen de la Victoria University Hospital (HUVV), identify factors associated with in-hospital mortality and analyze the impact of added morbidity on healthcare costs.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using data from the Minimum Basic Data Set (MBDS) at HUVV. We included all discharges with a primary diagnosis of HF in 2021. Logistic regression analysis was employed to identify factors associated with mortality, and cost analysis was performed to assess the economic impact of added morbidity.</p><p><strong>Results: </strong>A total of 731 hospital discharges for HF were analyzed, with a mortality rate of 14.77%. Mortality was significantly associated with age ≥ 75 years (OR = 4.12; <i>p</i> < 0.001), high or extreme severity (OR = 2.26 and 8.10, respectively; <i>p</i> < 0.001), and more than 10 diagnoses at discharge (OR = 2.95; <i>p</i> < 0.01). Treatment with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) was associated with a reduced risk of death (OR = 0.29; <i>p</i> < 0.001). Hospital-acquired morbidity occurred in 27.22% of patients, resulting in an additional cost of EUR 152,780.61, representing a 3.8% increase over the total hospitalization costs.</p><p><strong>Conclusions: </strong>In-hospital mortality in HF patients at HUVV is strongly associated with advanced age, disease severity, and multiple comorbidities. Treatment with ACEIs or ARBs was associated with a lower likelihood of in-hospital mortality. Preventable added morbidity was associated with increased healthcare costs, highlighting the importance of infection control measures and multidisciplinary management to potentially improve outcomes and reduce costs.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Risk Factors of Acute Ischemic Stroke in Patients with Antiphospholipid Syndrome: A Retrospective Monocenter Analysis.","authors":"Paschalis Evangelidis, Nikolaos Kotsiou, Panagiotis Kalmoukos, Zacharo Ntova, Theodosia Papadopoulou, Sofia Chissan, Anastasia Sarvani, Styliani Kokoris, Elisavet Grouzi, Michael Doumas, Sofia Vakalopoulou, Eleni Gavriilaki","doi":"10.3390/jcdd12050183","DOIUrl":"10.3390/jcdd12050183","url":null,"abstract":"<p><p>(1) Background: Antiphospholipid syndrome (APS) is associated with thrombotic events and the laboratory identification of antiphospholipid antibodies (aPL), in which lupus anticoagulant (LA), anticardiolipin (aCL), and anti-β2 glycoprotein I antibodies are included. The aim of the current retrospective study is to examine clinical characteristics and risk factors of ischemic stroke as a clinical manifestation of APS. (2) Methods: Adult patients diagnosed with APS between 1 January 2009 and 1 June 2024 were retrospectively enrolled in this study. Sydney-revised Sapporo criteria were used for the diagnosis of APS, while ischemic stroke was diagnosed based on the acute onset of focal neurologic deficits and confirmed with radiological findings. (3) Results: We studied 115 patients with APS. Specifically, 28 (24.35%) patients, with a mean age (standard deviation) of 54 (±12.5), had ischemic stroke as a clinical manifestation of APS. In univariate analysis, stroke development was associated with the following factors: age (<i>p</i> < 0.001), livedo reticularis (<i>p</i> = 0.046), avascular necrosis (AVN) (<i>p</i> = 0.046), hypertension (<i>p</i> < 0.001), dyslipidemia (<i>p</i> = 0.013), aCL IgG (U/L) antibodies title (<i>p</i> = 0.035), and adjusted global APS score (aGAPSS) (<i>p</i> = 0.047), while in multivariate analysis, it was associated with age (<i>p</i> = 0.006), hypertension (<i>p</i> < 0.001), AVN (<i>p</i> = 0.006), livedo reticularis (<i>p</i> = 0.035), aCL IgG title (<i>p</i> = 0.004), and aGAPSS (<i>p</i> = 0.002). (4) Conclusions: Stroke is a common initial manifestation of APS, with cardiovascular risk factors, particularly hypertension, being highly prevalent.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 Outcome of Patients Undergoing Transcatheter Aortic Valve Replacement with Concomitant SignificantTricuspid Regurgitation.","authors":"Enrico Ferrari, Alberto Pozzoli, Catherine Klersy, Elena Caporali, Stefanos Demertzis, Giovanni Pedrazzini","doi":"10.3390/jcdd12050184","DOIUrl":"10.3390/jcdd12050184","url":null,"abstract":"<p><p><b>Background</b>: The outcome of patients undergoing transcatheter aortic valve replacement (TAVR) can be affected by coexisting tricuspid regurgitation (TR). The aim of the study is to investigate the clinical results of patients undergoing TAVR with or without concomitant significant TR. <b>Methods</b>: Patients undergoing TAVR were divided into two groups according to TR severity: none/mild TR (low-grade) and moderate/severe TR (significant). Data were analysed and compared. Primary endpoint was the mortality 1-year. Secondary endpoints were re-hospitalization and the degree of postoperative and 1-year TR. <b>Results</b>: TAVR procedures were performed in 345 patients between September 2011 and February 2020. Median STS score was 4.3% (IQR: 2.6-7.2), median LVEF was 59.0% (IQR: 45.0-62.0), median aortic area was 0.70cm² (IQR: 0.60-0.86), median mean gradient was 43.0mmHg (IQR: 36.0-53.0). Before TAVR, 297 patients (86.1%) had low-grade TR and 48 (13.9%) significant TR. Mean age was 82.4 ± 5.7 and 83.8 ± 6.2 years in low-grade and significant TR group, respectively (<i>p</i> = 0.109), with 47.5% (low-grade TR) and 56.3% (significant TR) of female patients (<i>p</i> = 0.279). Patients showed differences in EuroSCORE-II (3.2% (IQR: 1.9-5.7) in low-grade TR vs. 5.6% (IQR: 3.7-8.1) in significant TR; <i>p</i> < 0.001), impaired right ventricular function (3.0% vs. 20.8%; <i>p</i> < 0.001) and pulmonary hypertension (9.1% vs. 39.6%; <i>p</i> < 0.001). Mean valve size was 27.7 ± 2.9 mm. Hospital mortality was 2.0% in low-grade TR and 4.2% in significantTR patients (<i>p</i> = 0.308). Among discharged patients (<i>n</i> = 337), seven patients died within 30 days (2.0% low-grade TR; 2.1% significant TR; logrank test <i>p</i> = 0.154) and 40 were re-hospitalized for heart failure (11.1% low-grade TR; 14.6% significant TR; <i>p</i> = 0.470). After one year, 26 patients died, corresponding to a mortality of 7.9 deaths per 100-person year (95% CI 5.2-12.0) in low-grade TR group and 9.1 deaths per 100-person year (95% CI 3.4-24.3) in significant TR group (logrank test <i>p</i> = 0.815), with HR (low grade vs. significant TR) of 0.87, 95% CI 0.26-2.89. Re-hospitalization for heart failure was 16.5% and 19.6% for low-grade and significant TR, respectively (<i>p</i> = 0.713). Echocardiographic and functional changes over time showed no significant interaction between TR and time. <b>Conclusions</b>: In our experience, patients undergoing TAVR showed similar 30-day and 1-year outcome and re-hospitalization rate, regardless of the degree of concomitant tricuspid regurgitation.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Specific Premature Ventricular Complex Characteristics in Women: Insights from a Patient Cohort.","authors":"Ștefan Ailoaei, Laurențiu Șorodoc, Carina Ureche, Nicolae Sîtari, Alexandr Ceasovschih, Mihaela Grecu, Radu Andy Sascău, Cristian Stătescu","doi":"10.3390/jcdd12050181","DOIUrl":"10.3390/jcdd12050181","url":null,"abstract":"<p><strong>Background: </strong>Premature ventricular complexes (PVCs) are common arrhythmias that can range from benign to clinically significant. While PVCs have been extensively studied in the general population, gender-specific differences in their characteristics, prevalence, and clinical impact remain underexplored. This study aims to investigate the unique features of PVCs in women and their potential implications for diagnosis and management.</p><p><strong>Methods: </strong>We analyzed a cohort of female patients diagnosed with PVCs, assessing their electrocardiographic patterns, symptomatology, and clinical outcomes. Data were collected from medical records, including Holter monitoring, electrocardiograms (ECGs), and echocardiographic findings. The study also evaluated the association between PVC burden and underlying cardiac conditions.</p><p><strong>Results: </strong>This study analyzed 161 patients (59 females, 91 males) with PVCs, revealing significant sex-based differences. Males were older, had higher BMI, and smoked more, while females experienced more presyncope. ECGs showed greater QRS fragmentation in males. TTE and CMR found males had larger ventricles, lower EF, and more myocardial fibrosis (LGE: 59.34% vs. 37.93%). Patients with LGE were older and had worse clinical outcomes, including higher ICD implantation and hospitalization rates. Despite these structural differences, treatment efficacy was similar across groups.</p><p><strong>Conclusion: </strong>This study highlights key differences in PVC characteristics among women, underscoring the need for gender-specific approaches in clinical evaluation and management. Recognizing these distinctions may aid in early diagnosis, reduce unnecessary interventions, and improve patient outcomes. Further research is warranted to explore the long-term implications of PVCs in women and optimize therapeutic strategies.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Systolic Function in Asymptomatic Men Aged 65-75 Years, Relation to Insulin Resistance and Pre-Diabetes: A DANCAVAS Cross-Sectional Sub-Study.","authors":"Johanna Larsson, Søren Auscher, Freja Sønder Madsen, Katrine Schultz Overgaard, Gokulan Pararajasingam, Laurits Juhl Heinsen, Thomas Rueskov Andersen, Jes Sanddal Lindholt, Jess Lambrechtsen, Kenneth Egstrup","doi":"10.3390/jcdd12050180","DOIUrl":"10.3390/jcdd12050180","url":null,"abstract":"<p><strong>Aim: </strong>Insulin resistance (IR) and hyperglycemia have been associated with increased risk of heart failure (HF) in patients with and without diabetes. Global longitudinel strain (GLS) has been shown to be superior in the detection of left ventricular (LV) systolic dysfunction when compared to ejection fraction (EF). In this study, we aimed to assess GLS in relation to IR and pre-diabetes.</p><p><strong>Method: </strong>All participants underwent an echocardiography to assess LV systolic function using GLS. IR was evaluated using homeostatic model assessment for IR (HOMA-IR), and the participants were divided into tertiles based on their HOMA-IR values. An oral glucose tolerance test (OGTT) was performed to divide participants into normal glucose tolerance (NGT) and pre-diabetes. A multivariable linear regression model was used to assess GLS in relation to IR and glycemic groups.</p><p><strong>Results: </strong>In total, 359 men without significant coronary artery disease (CAD) and without diabetes were enrolled. Participants in the higher HOMA-IR tertile had significantly reduced GLS when compared with participants in the lower HOMA-IR tertile (-17.9% vs. -18.7%, <i>p</i> < 0.01). A significant trend was observed towards reduced GLS with increasing HOMA-IR tertile (<i>p</i>-trend 0.005). However, in the multivariable regression model, only waist-to-height-ratio (WH) (β 7.1 [95% CI 3.1-11.1, <i>p</i> = 0.001) remained significantly associated with GLS, whereas HOMA-IR tertile and pre-diabetes were not.</p><p><strong>Conclusions: </strong>In asymptomatic elderly men with no diabetes or CAD, neither IR nor pre-diabetes was associated with GLS in the adjusted regression model. Increased WH seems to be associated with reduced systolic function by GLS measurement.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote Heart Failure Patients Telemonitoring: Results of the TreC Heart Failure Study.","authors":"Massimiliano Maines, Annachiara Benini, Annalisa Vinci, Anna Manica, Elisa Erbogasto, Giancarlo Tomasi, Luisa Poian, Luigi Martinelli, Lorenzo Gios, Stefano Forti, Luigi Patil, William Mantovani, Maurizio Del Greco","doi":"10.3390/jcdd12050182","DOIUrl":"10.3390/jcdd12050182","url":null,"abstract":"<p><p>(1) <b>Aims:</b> In our study, we evaluated the effectiveness of a telemonitoring program based on a nursing clinic, supported by a physician who remotely monitors patients via a dedicated application (TreC Cardiology), in reducing visits and hospitalizations for HF in patients affected by HF living in Trentino in Italy. (2) <b>Methods and Results:</b> The TreC Heart Failure (TreC HF) study prospectively enrolled consecutive patients diagnosed with HF who attended our outpatient clinic and who were provided with the TreC Cardiology application. We analyzed primarily the number of visits and hospitalizations, comparing the year before and after the enrollment. From March 2021 to June 2023, we enrolled 211 patients, predominantly male (70.1%) and with a mean age of 71.5 ± 12.6 years. At baseline, 43.6% of patients were diagnosed with HFrEF, 28% with HFmrEF, and 28.4% with HFpEF. The mean left-ventricular ejection fraction (LV-EF) was 43.2 ± 11.9%. Outpatient visits in the year before the enrollment were on average 2.0 ± 1.2 vs. 1.6 ± 1.3 (<i>p</i> = 0.002) in the same following period. The percentage of patients who were hospitalized for heart failure went from 25.6% to 4.7% (<i>p</i> < 0.001). Analyzing HF categories separately, we found that, in the HFrEF population, after the enrollment, hospitalization for HF significantly decreased (32.6% vs. 7.6%, <i>p</i> < 0.001), while the number of outpatient visits did not vary (2.1 ± 1.4 vs. 2.1 ± 1.3, <i>p</i> = 0.795). In HFmrEF patients, both hospitalization for HF and outpatient visits significantly decreased (respectively, 30.5% vs. 1.7%, <i>p</i> < 0.001 and 2.0 ± 1.0 vs. 1.5 ± 1.3, <i>p</i> = 0.025). Finally, in the HFpEF population, only the number of outpatient visits significantly decreased after the enrollment (2.0 ± 1.1 vs. 1.0 ± 0.8, <i>p</i> < 0.001). (3) <b>Conclusions:</b> Our results confirm the enormous potential of telemonitoring, since in a real-world population affected by heart failure, it resulted in a significant reduction in hospitalization for HF and the number of outpatient visits.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12111988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Coronary Intervention for Left Main Disease in High Bleeding Risk: Outcomes from a Subanalysis of the Delta 2 Registry.","authors":"Giulia Botti, Francesco Federico, Emanuele Meliga, Joost Daemen, Fabrizio D'Ascenzo, Davide Capodanno, Nicolas Dumonteil, Didier Tchetche, Nicolas M Van Mieghem, Sunao Nakamura, Philippe Garot, Andrejs Erglis, Ciro Vella, Corrado Tamburino, Marie Claude Morice, Roxana Mehran, Matteo Montorfano, Alaide Chieffo","doi":"10.3390/jcdd12050179","DOIUrl":"10.3390/jcdd12050179","url":null,"abstract":"<p><p>High bleeding risk (HBR) is a challenge in patients with complex coronary lesions undergoing percutaneous coronary intervention (PCI). This study investigates HBR in a wide and comprehensive cohort of patients undergoing left main (LM) PCI and reports in-hospital and follow-up outcomes. The analysis was performed on data from the DELTA (Drug Eluting Stent for Left Main Coronary Artery) 2 Registry, which included patients who underwent LM PCI at 19 centres worldwide. The patients were defined to be at HBR if ≥1 major criterion or ≥2 minor criteria from the Academic Research Consortium (ARC) were met. The primary endpoint was a composite of all-cause death, myocardial infarction (MI) or cerebrovascular accident (CVA) at median follow-up. A total of 1531 patients were included, and the rate of HBR was 65.8%. Besides the different clinical characteristics embedded in the ARC definition, HBR patients had higher prevalence of acute coronary syndrome (ACS) at presentation (49.2% vs. 26.8%, <i>p</i> < 0.001) and experienced higher in-hospital mortality (1.8% vs. 0.2%; <i>p</i> = 0.029) and MI (5.0% vs. 2.1%, <i>p</i> = 0.009). The median follow-up was 473 days. The rate of the primary endpoint was more than three times higher in HBR patients (20.8% vs. 6.1%; HR 3.3; 95%CI: 2.2-4.8) and driven by all-cause death at multivariate regression analysis. Conversely, no significant difference in target lesion revascularization and probable or defined stent thrombosis was reported. HBR patients undergoing LM PCI experienced higher rates of all-cause death at follow-up; similar outcomes were also reported in-hospital.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 5","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}