Journal of cardiology最新文献

{"title":"Comparison of the treatment status of patients with acute heart failure before and during the COVID-19 pandemic – Observational cohort study using Japanese administrative data","authors":"Tatsuhiro Shibata MD, PhD ,&nbsp;Shingo Matsumoto MD, PhD ,&nbsp;Tomoki Muramoto MS ,&nbsp;Miyuki Matsukawa MS","doi":"10.1016/j.jjcc.2024.01.004","DOIUrl":"10.1016/j.jjcc.2024.01.004","url":null,"abstract":"<div><h3>Background</h3><p>There is a concern that the coronavirus disease 2019 (COVID-19) pandemic has led to underutilization of non-invasive positive pressure ventilation (NPPV) in patients with acute heart failure (HF). We investigated the alterations in clinical management of acute HF during the COVID-19 pandemic.</p></div><div><h3>Methods and results</h3><p>This study was an observational study of patients treated in emergency care with acute HF, using a Japanese Administrative database for a period before and during the COVID-19 pandemic. Of the 9081 overall eligible patients, the ratio of patients receiving NPPV and tracheal intubation during to before the COVID-19 pandemic were 0.88 [95 % confidence interval (CI): 0.80, 0.96] and 1.38 (95 % CI: 1.11, 1.71), respectively. Propensity score matching in patients treated in COVID-19 receiving facilities and emergency declaration response areas showed that ratio of NPPV and tracheal intubation during to before the COVID-19 pandemic were 0.88 (95 % CI: 0.76, 1.03), and 1.65 (95 % CI: 1.19, 2.28), respectively.</p></div><div><h3>Conclusions</h3><p>The implementation rate of NPPV decreased significantly in eligible patients, with a decreasing trend observed in patient populations in COVID-19 receiving facilities and emergency declaration response areas. Tracheal intubation increased in all populations.</p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S091450872400011X/pdfft?md5=41412120cfc203a151a2013b7dfbe374&pid=1-s2.0-S091450872400011X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139667359","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}

{"title":"Transcatheter aortic valve replacement in Germany with need for a surgical bailout","authors":"Vera Oettinger MD, MSc ,&nbsp;Ingo Hilgendorf MD ,&nbsp;Dennis Wolf MD ,&nbsp;Peter Stachon MD ,&nbsp;Adrian Heidenreich MD ,&nbsp;Manfred Zehender MD, PhD ,&nbsp;Dirk Westermann MD ,&nbsp;Klaus Kaier PhD ,&nbsp;Constantin von zur Mühlen MD","doi":"10.1016/j.jjcc.2024.01.003","DOIUrl":"10.1016/j.jjcc.2024.01.003","url":null,"abstract":"<div><h3>Background</h3><p>In transcatheter aortic valve replacement (TAVR), complications may force the need for a surgical bailout, but knowledge is rare about outcomes in Germany.</p></div><div><h3>Methods</h3><p>Using national health records, we investigated all TAVR in German hospitals between 2007 and 2020, focusing on 2018–2020. We extracted data on those interventions with need for a surgical bailout.</p></div><div><h3>Results</h3><p>A total of 159,643 TAVR were analyzed, with an overall rate of surgical bailout of 2.30 %, an overall in-hospital mortality of 3.85 %, and in-hospital mortality in case of bailout of 16.51 %. The number of all annual TAVR procedures increased substantially (202 to 22,972), with the rate of surgical bailout declining from 27.23 to 0.61 % and overall mortality from 11.39 to 2.29 %. However, in-hospital mortality after bailout was still high (28.37 % in 2020). The standardized rates of overall mortality and surgical bailout between 2018 and 2020 were significantly lower for balloon-expandable and self-expanding transfemoral TAVR than for transapical TAVR after risk adjustment [transapical/transfemoral balloon-expandable/transfemoral self-expanding TAVR: in-hospital mortality: 5.66 % (95 % CI 4.81 %; 6.52 %)/2.30 % (2.03 %; 2.57 %)/2.32 % (2.07 %; 2.57 %); surgical bailout: 2.33 % (1.68 %; 2.97 %)/0.79 % (0.60 %; 0.98 %)/0.42 % (0.31 %; 0.53 %)]. Coronary artery disease [risk-adjusted OR = 1.50 (1.21; 1.85), <em>p</em> &lt; 0.001] and atrial fibrillation [OR = 1.29 (1.07; 1.57), <em>p</em> = 0.009] were found to be the main risk factors for bailout.</p></div><div><h3>Conclusions</h3><p>Rates of TAVR with need for a surgical bailout and overall in-hospital mortality have declined noticeably over the years in Germany. However, the outcomes are still unfavorable after surgical bailout, as in-hospital mortality is continuously high. We present risk factors for surgical bailout to improve preparation of subsequent measures. It must be a major goal to further reduce the rate of surgical bailouts in the future.</p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0914508724000091/pdfft?md5=048b348e038f7318b7d50922566e8e36&pid=1-s2.0-S0914508724000091-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139666831","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}

{"title":"Regulation of myocardial glucose metabolism by YAP/TAZ signaling","authors":"Toshihide Kashihara (PhD) ,&nbsp;Junichi Sadoshima (MD, PhD)","doi":"10.1016/j.jjcc.2024.01.002","DOIUrl":"10.1016/j.jjcc.2024.01.002","url":null,"abstract":"<div><p><span><span>The heart utilizes glucose and its metabolites as both energy sources and building blocks for cardiac growth and survival under both physiological and pathophysiological conditions. YAP/TAZ, transcriptional co-activators of the Hippo pathway, are key regulators of cell proliferation<span><span>, survival, and metabolism in many cell types. Increasing lines of evidence suggest that the Hippo-YAP/TAZ signaling pathway is involved in the regulation of both physiological and pathophysiological processes in the heart. In particular, YAP/TAZ play a critical role in mediating </span>aerobic glycolysis, the </span></span>Warburg effect, in </span>cardiomyocytes<span>. Here, we summarize what is currently known about YAP/TAZ signaling in the heart by focusing on the regulation of glucose metabolism and its functional significance.</span></p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546363","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":"Minimum-incision transsubclavian transcatheter aortic valve replacement with balloon-expandable valve for dialysis patients","authors":"Satoru Domoto MD, PhD ,&nbsp;Junichi Yamaguchi MD, PhD, FJCC ,&nbsp;Ken Tsuchiya MD, PhD ,&nbsp;Yusuke Inagaki MD, PhD ,&nbsp;Kosuke Nakamae MD ,&nbsp;Masataka Hirota MD ,&nbsp;Hiroyuki Arashi MD, PhD ,&nbsp;Norio Hanafusa MD, PhD ,&nbsp;Junichi Hoshino MD, PhD ,&nbsp;Hiroshi Niinami MD, PhD","doi":"10.1016/j.jjcc.2024.01.001","DOIUrl":"10.1016/j.jjcc.2024.01.001","url":null,"abstract":"<div><h3>Background</h3><p>Dialysis patients undergoing transcatheter aortic valve replacement (TAVR) face increased risk and have poorer outcomes than non-dialysis patients. Moreover, TAVR in dialysis patients using an alternative approach is considered extremely risky and little is known about the outcomes. We routinely perform minimum-incision transsubclavian TAVR (MITS-TAVR), which is contraindicated for transfemoral (TF) TAVR. This study aimed to evaluate the outcomes of MITS-TAVR compared with those of TF-TAVR in dialysis patients.</p></div><div><h3>Methods</h3><p>This single-center, observational study included 79 consecutive dialysis patients who underwent MITS-TAVR (MITS group, n = 22) or TF-TAVR (TF group, n = 57) under regional anesthesia.</p></div><div><h3>Results</h3><p>The rates of peripheral artery disease (MITS vs. TF, 72.7 % vs. 26.3 %; <em>p</em> &lt; 0.01), shaggy aortas (MITS vs. TF, 63.6 % vs. 5.26 %; <em>p</em> &lt; 0.01), and tortuous aortas (MITS vs. TF, 13.6 % vs. 1.75 %; <em>p</em> = 0.031) were significantly higher in the MITS group. The 30-day mortality was 2.53 % and comparable between the two groups (MITS vs. TF, 4.54 % vs. 1.75 %; <em>p</em> = 0.479). In the MITS group, 14 patients had ipsilateral dialysis fistulas, and three patients had patent in situ ipsilateral internal thoracic artery grafts; however, no vascular complications were observed. Kaplan–Meier survival curves for the two groups showed no significant difference in the survival rate (at 2 years; MITS vs. TF, 77.3 % vs. 68.8 %; <em>p</em> = 0.840) and freedom from cardiovascular mortality (at 2 years; MITS vs. TF, 90.9 % vs. 96.5 %; <em>p</em> = 0.898). The multivariable Cox proportional hazard model also indicated that survival in the MITS group was not significantly different from that in the TF group (hazard ratio 1.48; 95 % confidence interval, 0.77–2.85, <em>p</em> = 0.244). The patency rate of ipsilateral dialysis fistula was 100 % during follow-up.</p></div><div><h3>Conclusion</h3><p>The outcome of MITS-TAVR was comparable to that of TF-TAVR in dialysis patients, despite the higher risk of patient characteristics.</p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139411789","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":"Association of sarcopenia defined by different skeletal muscle mass measurements with prognosis and quality of life in older patients with heart failure","authors":"Kaoru Sato PT ,&nbsp;Kentaro Kamiya PT, PhD, FJCC ,&nbsp;Nobuaki Hamazaki PT, PhD ,&nbsp;Kohei Nozaki PT, PhD ,&nbsp;Takafumi Ichikawa PT ,&nbsp;Shota Uchida PT, PhD ,&nbsp;Kensuke Ueno PT, MSc ,&nbsp;Masashi Yamashita PT, PhD ,&nbsp;Takumi Noda PT, MSc ,&nbsp;Ken Ogura PT, MSc ,&nbsp;Takashi Miki PT, MSc ,&nbsp;Kazuki Hotta PT, PhD ,&nbsp;Emi Maekawa MD, PhD ,&nbsp;Minako Yamaoka-Tojo MD, PhD, FJCC ,&nbsp;Atsuhiko Matsunaga PT, PhD ,&nbsp;Junya Ako MD, PhD, FJCC","doi":"10.1016/j.jjcc.2023.12.003","DOIUrl":"10.1016/j.jjcc.2023.12.003","url":null,"abstract":"<div><h3>Background</h3><p><span>Diagnosing sarcopenia in heart failure (HF) patients is important, but how to assess </span>skeletal muscle mass in HF patients with fluid retention is controversial. We aimed to examine the association between sarcopenia, defined by different skeletal muscle mass measurements, and clinical outcomes in older HF patients.</p></div><div><h3>Methods</h3><p><span>We included 546 older HF patients (≥ 65 years) who were assessed for sarcopenia at discharge (median age 77 years, 309 males). Sarcopenia was diagnosed using grip strength, usual gait speed, and skeletal muscle mass according to international criteria. We used mid-upper arm circumference (MUAC), mid-upper arm muscle circumference (MAMC), calf circumference (CC), and skeletal muscle mass index (SMI) assessed by bioelectrical impedance analysis to assess skeletal muscle mass and defined sarcopenia in each of these measurements. Prognostic outcomes were composite events (all-cause death and HF rehospitalization) and cardiovascular disease (CVD) events (CVD death and CVD rehospitalization). </span>Quality of life (QOL) was assessed using the 36-item Short-Form Health Survey physical functioning (SF-36PF) score.</p></div><div><h3>Results</h3><p>The sarcopenia defined by MUAC [hazard ratio (HR): 2.50; 95 % confidence interval (95 % CI): 1.64–3.81; <em>p</em> &lt; 0.001] or MAMC (HR: 1.98; 95 % CI: 1.35–2.92; <em>p</em> = 0.001) were associated with higher composite event rates than the non-sarcopenia. The sarcopenia defined by MUAC (HR: 1.88; 95 % CI: 1.25–2.83; <em>p</em> = 0.002) or MAMC (HR: 1.70; 95 % CI: 1.16–2.49; <em>p</em> = 0.007) were associated with higher CVD event rates than the non-sarcopenia. The sarcopenia defined by CC or SMI were not associated with prognoses. The sarcopenia defined by MUAC, MAMC, or CC were associated with low SF-36PF scores (all <em>p</em> &lt; 0.05).</p></div><div><h3>Conclusions</h3><p>These results suggest that a diagnosis of sarcopenia based on MUAC or MAMC rather than CC or SMI reflects prognosis and QOL in older HF patients.</p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138824344","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":"Effects of peripheral artery disease on long-term outcomes after percutaneous coronary intervention versus coronary artery bypass grafting in patients with severe coronary artery disease","authors":"","doi":"10.1016/j.jjcc.2023.12.004","DOIUrl":"10.1016/j.jjcc.2023.12.004","url":null,"abstract":"<div><h3>Background</h3><p><span>There is a scarcity of data evaluating the effect of peripheral artery disease (PAD) on long-term mortality after percutaneous coronary intervention (PCI) relative to </span>coronary artery bypass grafting<span> (CABG) in patients with severe coronary artery disease in real-world practice.</span></p></div><div><h3>Methods</h3><p><span><span><span>Among 14,867 consecutive patients who underwent their first coronary revascularization with PCI or isolated CABG between 2011 and 2013 in the CREDO-Kyoto PCI/CABG registry Cohort-3, the current study population consisted of 3380 patients with three-vessel </span>coronary artery disease or </span>left main coronary artery disease. Long-term clinical outcomes were compared between PCI and CABG stratified by the presence or </span>absence of PAD. Median clinical follow-up was 5.9 (IQR: 5.1–6.8) years.</p></div><div><h3>Results</h3><p>There were 461 patients with PAD (PCI: N = 307, CABG: N = 154), and 2919 patients without PAD (PCI: N = 1823, CABG: N = 1096). The cumulative 5-year mortality after coronary revascularization was 31.2 % in patients with PAD and 16.2 % in those without PAD (<em>p</em> &lt; 0.0001). There was a higher risk of PCI relative to CABG for all-cause death in patients with and without PAD (adjusted HR, 1.59; 95%CI, 0.99–2.53; <em>p</em> = 0.054, and HR, 1.25; 95%CI, 1.01–1.56; <em>p</em> = 0.04) without interaction (<em>p</em> interaction <em>p</em> = 0.48); Nevertheless, there was no excess risk of PCI relative to CABG for cardiovascular death regardless of PAD.</p></div><div><h3>Conclusions</h3><p>The long-term mortality after coronary revascularization was significantly higher in severe CAD patients with PAD than those without PAD. There was a higher mortality risk of PCI relative to CABG in patients with and without PAD without interaction, which was mainly driven by excess non-cardiovascular deaths.</p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138824297","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":"Digitalomics, digital intervention, and designing future: The next frontier in cardiology","authors":"Yuichi Tamura MD, PhD, FJCC ,&nbsp;Akihiro Nomura MD, PhD ,&nbsp;Nobuyuki Kagiyama MD, PhD ,&nbsp;Atsushi Mizuno MD, PhD, FJCC ,&nbsp;Koichi Node MD, PhD, FJCC","doi":"10.1016/j.jjcc.2023.12.002","DOIUrl":"10.1016/j.jjcc.2023.12.002","url":null,"abstract":"<div><p>The discipline of cardiology stands at a transformative juncture, primarily influenced by the surge in digital health technologies. These innovations hold the promise to redefine the realms of cardiovascular research and patient care, ushering in an era of individualized and data-driven treatments. This review delves into the heart of this evolution, introducing a comprehensive design for the future of cardiology. Emphasizing the emerging domains of “digitalomics” and “digital intervention”, it explores how the integration of patient data, artificial intelligence-enabled diagnostics, and telehealth can lead to more streamlined and personalized cardiovascular health. The “digital-twin” model, a highlight of this approach, encapsulates individual patient characteristics, allowing for targeted treatments. The role of interdisciplinary collaboration in cardiovascular medicine is also underlined, emphasizing the importance of merging traditional cardiology with technological advancements. The convergence of traditional cardiology methods and digital health technologies, facilitated by a transdisciplinary approach, is set to chart a new course in cardiovascular health, emphasizing individualized care and improved clinical outcomes.</p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0914508723003040/pdfft?md5=177d2eddbfc2d08b4aa9514fbd45ebf1&pid=1-s2.0-S0914508723003040-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138885081","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}

{"title":"Mitral regurgitation in atrial fibrillation: Is a simple repair enough to tackle a complex problem?","authors":"Anton Tomšič MD, PhD ,&nbsp;Maria Chiara Meucci MD ,&nbsp;Anne R. de Jong MD ,&nbsp;Jerry Braun MD, PhD ,&nbsp;Nina Ajmone Marsan MD, PhD ,&nbsp;Robert J.M. Klautz MD, PhD ,&nbsp;Meindert Palmen MD, PhD","doi":"10.1016/j.jjcc.2023.12.001","DOIUrl":"10.1016/j.jjcc.2023.12.001","url":null,"abstract":"<div><h3>Background</h3><p>Clinical and echocardiographic results of valve repair for mitral regurgitation in the setting of atrial fibrillation are poorly studied.</p></div><div><h3>Methods</h3><p>Between January 2008 and December 2020, 89 patients underwent valve repair for mitral regurgitation in the setting of atrial fibrillation. Clinical and echocardiographic follow-up data were collected and studied. The primary composite endpoint consisted of all-cause mortality or hospitalization for heart failure.</p></div><div><h3>Results</h3><p>Valve repair with true-sized annuloplasty was performed in 83 (93 %) and restrictive annuloplasty in 6 (7 %) patients. Early mortality occurred in 3 (3 %) and residual mitral regurgitation in 1 (1 %) patient. During a median follow-up of 5.4 years (interquartile range 3.4–9.5), 25 patients died, 6 due to end-stage heart failure. Ten patients were hospitalized for heart failure. The estimated event-free survival rate at 10 years was 48.2 % (95 % CI 33.5 %–62.9 %). Recurrent mitral regurgitation was observed in 14 patients and most often caused by leaflet tethering. When analyzed as a time-dependent variable, recurrent regurgitation was related to the occurrence of the primary endpoint (hazard ratio 3.192, 95 % CI 1.219–8.359, <em>p</em> = 0.018). On exploratory sub-analyses, no recurrent regurgitation was observed after restrictive annuloplasty or in patients with paroxysmal atrial fibrillation. Moreover, recurrent regurgitation was observed more often when signs of left ventricular impairment were present preoperatively.</p></div><div><h3>Conclusions</h3><p>Despite good initial results, recurrent regurgitation was a frequent observation after valve repair for mitral regurgitation in atrial fibrillation and had an effect on heart failure related morbidity and mortality. Refinements in the timing of surgery and surgical technique might help improve outcomes.</p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0914508723002952/pdfft?md5=5cbbb673adb35b7c1eeefcd54a2634f6&pid=1-s2.0-S0914508723002952-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138632221","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}

{"title":"Clinical outcomes of ST elevation myocardial infarction patients without standard modifiable risk factors","authors":"Yu Suresvar Singh MD ,&nbsp;Hideki Wada MD, PhD ,&nbsp;Manabu Ogita MD, PhD ,&nbsp;Yuta Takamura MD ,&nbsp;Takuya Onozato MD ,&nbsp;Wataru Fujita MD ,&nbsp;Keiki Abe MD ,&nbsp;Jun Shitara MD, PhD ,&nbsp;Hirohisa Endo MD, PhD ,&nbsp;Shuta Tsuboi MD, PhD ,&nbsp;Satoru Suwa MD ,&nbsp;Katsumi Miyauchi MD, FJCC ,&nbsp;Tohru Minamino MD, PhD, FJCC","doi":"10.1016/j.jjcc.2023.11.007","DOIUrl":"10.1016/j.jjcc.2023.11.007","url":null,"abstract":"<div><h3>Background</h3><p>Standard modifiable cardiovascular risk factors (SMuRFs; hypertension, diabetes mellitus, dyslipidemia<span>, and smoking) are widely recognized as risk factors for coronary artery disease. However, the associations between absence of SMuRFs and long-term clinical outcomes in ST-segment elevation myocardial infarction (STEMI) patients are unclear.</span></p></div><div><h3>Methods</h3><p>Consecutive STEMI patients who underwent primary percutaneous coronary intervention (PCI) between 1999 and 2015 were retrospectively analyzed. The primary endpoint was up to 5-year all-cause mortality. Clinical characteristics and outcomes were compared between patients with at least one of the SMuRFs and those without any SMuRFs.</p></div><div><h3>Results</h3><p><span>Of 1963 STEMI patients, 126 (6.4 %) did not have any SMuRFs. Patients without SMuRFs were significantly older, had lower body mass index<span>, and were more likely to be female. During a median follow-up period of 4.9 years, the cumulative incidence of death was significantly higher in patients without SMuRFs than in those with SMuRFs (log-rank </span></span><em>p</em> &lt; 0.0001). Landmark analysis showed that patients without SMuRFs had higher mortality within 30 days of STEMI onset (log-rank <em>p</em> = 0.0045) and &gt;30 days after STEMI onset (log-rank <em>p</em> = 0.0004). Multivariable Cox hazards analysis showed that absence of SMuRFs was associated with a higher risk of mortality (hazard ratio, 1.59; 95 % confidence interval, 1.14–2.21; <em>p</em> = 0.006).</p></div><div><h3>Conclusions</h3><p>Of STEMI patients undergoing primary PCI, patients without any SMuRFs had higher mortality than those with at least one of the SMuRFs. Patients without any SMuRFs have a poor prognosis and require more attention.</p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138477824","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":"Prognostic value of right ventricular free-wall longitudinal strain in aortic stenosis: A systematic review and meta-analysis","authors":"Chung-Yen Lee MS ,&nbsp;Yosuke Nabeshima MD, PhD ,&nbsp;Tetsuji Kitano MD, PhD ,&nbsp;Catalina A. Parasca MD ,&nbsp;Andreea Calin MD ,&nbsp;Bogdan A. Popescu MD ,&nbsp;Masaaki Takeuchi MD, PhD","doi":"10.1016/j.jjcc.2023.11.008","DOIUrl":"10.1016/j.jjcc.2023.11.008","url":null,"abstract":"<div><h3>Background</h3><p>Assessment of right ventricular (RV) function in aortic stenosis<span> (AS) may improve risk stratification<span>. However, whether the prognostic value of RV free-wall longitudinal strain (RVfwLS) is better than that of other right heart or pulmonary circulation<span> parameters remains uncertain. This study assessed and compared the prognostic value of RVfwLS with traditional parameters in the AS population using a systematic review and meta-analysis.</span></span></span></p></div><div><h3>Methods</h3><p>We selected studies reporting the hazard ratio (HR) of RVfwLS in patients<span> with AS. We also collected data regarding the HR of systolic pulmonary arterial pressure (SPAP), fractional area change (FAC), and tricuspid annulus plane systolic excursion (TAPSE). To ensure comparability, we standardized the HR using within-study standard deviations. The comparison between the prognostic value of RVfwLS and other parameters was conducted as a ratio of HR.</span></p></div><div><h3>Results</h3><p>This meta-analysis included 9 studies comprising a total of 2547 patients, with 679 events. The pooled HR of RVfwLS was 1.56 (95 % CI: 1.39–1.75, <em>p</em> &lt; 0.001). When examining the ratio of HR between RVfwLS and conventional parameters, all comparisons were statistically non-significant [RVfwLS/SPAP: 1.28 (95 % CI: 0.99–1.65, <em>p</em> = 0.06); RVfwLS/FAC: 1.24 (95 % CI: 0.90–1.72, <em>p</em> = 0.14); and RVfwLS/TAPSE:1.07 (95 % CI: 0.75–1.52, <em>p</em> = 0.60)].</p></div><div><h3>Conclusions</h3><p>This meta-analysis establishes a substantial association between RVfwLS and adverse outcomes in the AS population. However, comparative analysis between RVfwLS and SPAP, FAC, or TAPSE did not support the prognostic superiority of RVfwLS.</p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138477826","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}