Journal of cardiology最新文献

{"title":"Milestones in therapeutic and antithrombotic strategies for chronic thromboembolic pulmonary hypertension.","authors":"Kazuya Hosokawa, Kohtaro Abe","doi":"10.1016/j.jjcc.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.jjcc.2025.03.006","url":null,"abstract":"<p><p>Chronic thromboembolic pulmonary hypertension (CTEPH) is a condition caused by persistent thrombus obstructing the pulmonary arteries, resulting in pulmonary hypertension. Pulmonary endarterectomy remains the gold standard treatment and can provide dramatic improvement in eligible patients. However, approximately 40 % of patients are inoperable. Over the past years, several randomized controlled trials have explored pulmonary vasodilators and balloon pulmonary angioplasty. Based on these trials, a multimodal treatment approach has been established. Balloon pulmonary angioplasty has shown hemodynamic improvement rather than pulmonary vasodilators in randomized controlled trials. Similarly, lifelong anticoagulation therapy is the cornerstone of CTEPH management. While vitamin K antagonists such as warfarin have been the standard recommended by CTEPH guidelines, recent studies, including the CTEPH AC Registry and the KABUKI trial, suggest that direct oral anticoagulants may be safe and effective alternatives. Several ongoing randomized controlled trials aim to refine treatment strategies. The IMPACT-CTEPH trial is investigating whether the initial combination therapy (riociguat + macitentan) is superior to monotherapy before balloon pulmonary angioplasty. The GO-CTEPH trial compares the efficacy of pulmonary endarterectomy and balloon pulmonary angioplasty in eligible patients. The THERAPY-HYBRID-BPA trial is evaluating the need for continued riociguat after balloon pulmonary angioplasty. The FIND-DCR study is evaluating a new imaging modality for the early detection of CTEPH. As research advances, multimodal approaches combining surgical, interventional, and pharmacological treatments are expected to improve patient outcomes and shape the future of CTEPH management.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tricuspid regurgitation: Innovation, current landscape, and future perspective of transcatheter tricuspid valve interventions.","authors":"Atsushi Sugiura, Tetsu Tanaka, Refik Kavsur, Can Öztürk, Johanna Vogelhuber, Miriam Silaschi, Marcel Weber, Sebastian Zimmer, Georg Nickenig","doi":"10.1016/j.jjcc.2025.03.009","DOIUrl":"https://doi.org/10.1016/j.jjcc.2025.03.009","url":null,"abstract":"<p><p>Tricuspid regurgitation (TR) is a prevalent cardiovascular disease necessitating innovative treatments. Assessing comorbidities, such as right ventricular dysfunction, is pivotal for the therapeutic strategy. Preprocedural echocardiographic assessments are crucial for achieving optimal TR reduction. Transcatheter interventions have emerged as less invasive therapies. Tricuspid transcatheter edge-to-edge repair is the predominant technology, proven safe and effective in reducing TR. Additionally, transcatheter tricuspid valve replacement and direct annuloplasty technologies have been developed and recognized as attractive alternatives, each with unique advantages. This review discusses the innovation, current landscape, and future perspective of transcatheter tricuspid valve interventions for treating TR.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Future perspective regarding the clinical impact of very severe aortic stenosis following trans-catheter aortic valve implantation.","authors":"Hiroshi Onoda, Teruhiko Imamura","doi":"10.1016/j.jjcc.2025.03.003","DOIUrl":"10.1016/j.jjcc.2025.03.003","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and effectiveness of self-expanding TAVR in Japanese Dialysis patients with severe aortic stenosis: 1-year outcomes.","authors":"Koki Shishido, Futoshi Yamanaka, Noriaki Moriyama, Tomoki Ochiai, Hirokazu Miyashita, Tsuyoshi Yamabe, Kenichiro Noguchi, Tohru Asai, Shuzo Kobayashi, Yu Jung Yeh, Shigeru Saito","doi":"10.1016/j.jjcc.2025.03.008","DOIUrl":"https://doi.org/10.1016/j.jjcc.2025.03.008","url":null,"abstract":"<p><strong>Background: </strong>In Japan, transcatheter aortic valve replacement (TAVR) with self-expanding valves (SEV) was approved for patients with severe aortic stenosis (AS) and on chronic maintenance dialysis in May 2023. This study assessed the safety and efficacy of TAVR with SEVs in this patient population.</p><p><strong>Methods: </strong>This prospective, non-randomized, single-center study evaluated the safety and effectiveness of TAVR using a supra-annular SEV in Japanese patients with severe AS on chronic maintenance dialysis. The primary endpoint of all-cause mortality or disabling stroke and several secondary endpoints were assessed at 12 months.</p><p><strong>Results: </strong>Ten patients underwent TAVR using the Evolut platform (Medtronic, Minneapolis, MN, USA) between June 2020 and August 2022. Mean patient age was 80.0 ± 5.5 years and 70 % were male. Mean Society of Thoracic Surgeons Predicted Risk of Mortality score was 7.4 ± 2.2 %. At 1 year, the primary endpoint occurred in two patients (20 %), and there were no strokes, aortic valve reinterventions, or new permanent pacemaker implantations. Valve hemodynamics improved postprocedure and were maintained in all patients reaching 12-month follow-up (mean effective orifice area 2.1 ± 0.4 cm², mean gradient 6.8 ± 1.6 mmHg), and no patients had moderate or severe aortic regurgitation.</p><p><strong>Conclusions: </strong>Japanese dialysis patients with severe AS who underwent TAVR using SEVs experienced favorable clinical and hemodynamic outcomes at 1-year follow-up. Further investigations are needed to assess long-term outcomes in this patient population.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal trends in management strategies and clinical outcomes of venous thromboembolism in Japan from 2017 to 2023.","authors":"Wei Xiong, Yugo Yamashita, Toshiki Fukasawa, Chikashi Takeda, Hiroki Shiomi, Takahiro Horie, Koh Ono","doi":"10.1016/j.jjcc.2025.03.007","DOIUrl":"https://doi.org/10.1016/j.jjcc.2025.03.007","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) is a major health problem worldwide. There are scarce data on the recent temporal trends of patients with VTE after the widespread use of direct oral anticoagulants (DOACs).</p><p><strong>Methods and results: </strong>In a Japanese nationwide hospital administrative database, we identified 20,217 patients with VTE from 2017 to 2023, and evaluated their temporal trends in management strategies and clinical outcomes. The proportions of outpatient treatment among patients with out-of-hospital isolated deep vein thrombosis increased significantly (p trend <0.001, Pearson's R = 0.046) over time from 2017 to 2023. The proportions of warfarin use decreased significantly over time from 2017 to 2023 (p trend <0.001, Pearson's R = -0.053), whereas the use of most DOACs increased. The proportions of thrombolysis (p trend <0.001, Pearson's R = -0.046) and inferior vena cave filter (p trend <0.001, Pearson's R = -0.048) use decreased significantly over time from 2017 to 2023. The incidence of 6-month all-cause death, VTE recurrence, and bleeding was 9.1 %, 2.1 %, and 4.4 %, respectively. The incidence decreased in 6-month all-cause death (p trend = 0.018, Pearson's R = -0.017) and bleeding (p trend <0.001, Pearson's R = -0.029) over time from 2017 to 2023.</p><p><strong>Conclusions: </strong>The current Japanese nationwide hospital administrative database provided the recent temporal trends in the real-world management strategies and clinical outcomes of VTE, which revealed several temporal changes in these aspects after the widespread use of DOACs.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel tailored very-high-power short-duration radiofrequency ablation around the esophagus guided by left atrial voltage.","authors":"Yasuharu Matsunaga-Lee, Yasuyuki Egami, Mizuki Ohsuga, Masaru Abe, Hiroaki Nohara, Shodai Kawanami, Kohei Ukita, Akito Kawamura, Koji Yasumoto, Naotaka Okamoto, Masamichi Yano, Masami Nishino","doi":"10.1016/j.jjcc.2025.03.005","DOIUrl":"10.1016/j.jjcc.2025.03.005","url":null,"abstract":"<p><strong>Background: </strong>Very-high-power short-duration (vHPSD) radiofrequency (RF) ablation is expected to make shallow lesions and reduce collateral damage. This study investigated the power setting and quality of acute lesions performed by a modified vHPSD RF ablation guided by left atrial (LA) voltage around the esophagus.</p><p><strong>Methods: </strong>A voltage map was obtained by an OCTARAY catheter (3-mm spacing) during pacing from the high right atrium. The power setting of the vHPSD was modified according to the LA voltage around the esophagus: 65 W for <1.8 mV, 75 W for <2.7 mV, and 90 W for ≥2.7 mV. The incidence of gaps after the 1st pass and spontaneous, isoproterenol-induced, and adenosine-induced reconnections were evaluated. The limit of esophagus temperature rise was set at 40 °C. Gastric hypomotility was assessed.</p><p><strong>Results: </strong>A modified vHPSD RF ablation guided by the LA voltage was performed for 450 lesions in 32 patients (median age 73 years, 15 females). The RF setting was 65 W for 221 lesions (49 %), 75 W for 104 lesions (23 %), and 90 W for 125 lesions (28 %). Gaps after the 1st pass were observed in 3 patients (9.4 %). Any reconnections were observed in 6 patients (19 %). Esophageal temperature rises of >40 °C were observed at 39 lesions. RF ablation at the areas modified to 65 W more frequently resulted in esophageal temperature rise of >40 °C than the areas modified to 75 W or 90 W (12 % vs. 5.2 %, p = 0.017). No-gap-no-reconnection lesions were more frequently achieved for lesions ablated with 65 W (216/221 lesions, 98 %) than for lesions ablated with 90 W (113/125 lesions, 90 %, p = 0.004). No gastric hypomotility and atrio-esophageal fistulae were observed.</p><p><strong>Conclusions: </strong>The modified vHPSD RF ablation guided by the LA voltage was a reasonable option for reducing the power setting without compromising the acute pulmonary vein isolation quality.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical implications of malnutrition on 30-day adverse events in patients with Takotsubo syndrome.","authors":"Kyohei Onishi, Koichiro Matsumura, Eijiro Yagi, Nobuhiro Yamada, Yohei Funauchi, Kazuyoshi Kakehi, Ayano Yoshida, Kosuke Fujita, Takayuki Kawamura, Hiroki Matsuzoe, Masafumi Ueno, Gaku Nakazawa","doi":"10.1016/j.jjcc.2025.03.004","DOIUrl":"10.1016/j.jjcc.2025.03.004","url":null,"abstract":"<p><strong>Background: </strong>The impact of malnutrition on clinical outcomes in patients with takotsubo syndrome (TTS) is poorly understood. The purpose of this study was to investigate the relationship between malnutrition on admission and 30-day adverse events in patients with TTS.</p><p><strong>Methods: </strong>We retrospectively evaluated 124 consecutive patients admitted for TTS at our hospital from April 2013 to July 2023. Malnutrition was assessed at admission using the Geriatric Nutritional Risk Index (GNRI), which is an objective and simple nutritional assessment method. Malnutrition was defined as GNRI <92. We defined 30-day adverse events as the composite of all-cause death, acute heart failure, cardiogenic shock, life-threatening arrhythmia, thrombotic events, and stroke. The primary endpoint was the comparison of the 30-day adverse event rates between patients with and without malnutrition.</p><p><strong>Results: </strong>The median age was 78.0 (70.0-83.0) years, and 77 % of the patients were women. The median GNRI was 90.8 (81.5-98.0) and 55 % had malnutrition. The 30-day adverse events were shown in 64 patients. Compared with patients without malnutrition, the 30-day adverse event rate was significantly higher in those with malnutrition (32 % vs. 68 %, respectively; log-rank test p = 0.0001). The multivariable Cox proportional hazards model revealed that malnutrition was independently associated with high 30-day adverse event rates adjusted by age, female sex, malignancy, B-type natriuretic peptide, and high-sensitivity C-reactive protein (hazard ratio: 1.97, 95 % confidence interval: 1.08-3.58; p = 0.02).</p><p><strong>Conclusions: </strong>Malnutrition at admission was associated with high 30-day adverse event rates. Early identification and a considered treatment strategy for malnutrition are important in patients with TTS.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances and clinical implications of intravascular imaging.","authors":"Masahiko Noguchi, Tomotaka Dohi","doi":"10.1016/j.jjcc.2025.03.001","DOIUrl":"10.1016/j.jjcc.2025.03.001","url":null,"abstract":"<p><p>Coronary artery disease (CAD) remains a major contributor to the global mortality rate. Accurate and detailed evaluation of atherosclerotic plaque characteristics is essential for effective risk assessment and treatment planning. Although conventional coronary angiography excels at quantifying luminal stenosis, information on plaque composition and structure remains limited. Recent advances in intravascular imaging (IVI) have bridged this gap by enabling high-resolution visualization of the vessel wall and plaque morphology, thereby enhancing treatment strategies and facilitating comprehensive risk stratification. Among the principal IVI modalities, intravascular ultrasound (IVUS), optical coherence tomography (OCT), and near-infrared spectroscopy (NIRS) provide distinct benefits. IVUS accurately measures vessel diameter and plaque burden, offering critical guidance for managing complex lesions and left main artery disease. The extremely high spatial resolution of OCT allows precise identification of high-risk plaque features, such as thin fibrous caps. NIRS complements these techniques by quantitatively assessing lipid components within plaques, making it particularly useful in predicting future cardiovascular events. In this review, we summarize the latest evidence on applying IVI modalities to the evaluation and treatment of CAD. We focus on the assessment of plaque morphology, identification of high-risk lesions, and the role of IVI-guided percutaneous coronary intervention (PCI). The continued development of hybrid imaging systems and artificial intelligence-based image analysis may produce more precise and safer PCI approaches. Consequently, IVI is poised to become indispensable in managing CAD, paving the way for more personalized treatment strategies tailored to the specific lesion characteristics of each patient.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's reply.","authors":"Hiroki Matsushita, Keita Saku","doi":"10.1016/j.jjcc.2025.02.020","DOIUrl":"10.1016/j.jjcc.2025.02.020","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of left atrium posterior wall isolation in patients undergoing catheter ablation for atrial fibrillation","authors":"Zheng-Qi Song MD ,&nbsp;Xin-Yu Lu MD ,&nbsp;Yu-Peng Xu MD ,&nbsp;Hui Lin MD ,&nbsp;Yi-He Chen MD, PhD","doi":"10.1016/j.jjcc.2024.09.008","DOIUrl":"10.1016/j.jjcc.2024.09.008","url":null,"abstract":"<div><div>The posterior left atrium (LAPW) is an important substrate for initiation and maintenance of atrial fibrillation (AF). While it has been proposed as a potential target for preventing recurrence of atrial tachyarrhythmias, it remains unclear whether electrical silence of LAPW offers additional benefits over pulmonary vein isolation (PVI) alone. We conducted a systematic review of PubMed, Medline, Embase, and Cochrane databases and identified 21 eligible studies, encompassing 1514 patients assigned to PVI + posterior wall isolation (PWI) group and 1629 patients assigned to PVI group. Over a median follow-up of 12 months, adjunctive PWI significantly improved the atrial tachyarrhythmia-free survival by 14 % in comparison to PVI alone [relative risk (RR): 1.14, 95 % confidence interval (CI): 1.04 to 1.25, <em>p</em> = 0.004]. This improvement was mainly attributed to a pronounced benefit for patients with persistent AF. In addition, patients undergoing PVI + PWI had a longer procedure time [weighted mean difference (WMD): 23.85, 95 % CI: 12.68 to 35.01, <em>p</em> &lt; 0.001], ablation time (WMD: 9.27, 95 % CI: 5.19 to 13.54, <em>p</em> &lt; 0.001), and a nearly negligible increase in fluoroscopic exposure (WMD: 2.69, 95 % CI: −0.23 to 5.62, <em>p</em> = 0.071). There was no increased risk of procedure-related complications between these approaches (RR: 1.06, 95 % CI: 0.71 to 1.57, <em>p</em> = 0.787). Compared with PVI alone, PWI adjunctive to PVI exhibited a higher procedure success of sinus rhythm maintenance in persistent AF during an index catheter ablation. Meanwhile, elongated procedure time and ablation time did not compromise the safety of extensive ablation strategy with additional PWI.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 3","pages":"Pages 213-219"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}