Journal of cardiology最新文献

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Hydrophilic polymer embolization after TAVI TAVI 术后的亲水性聚合物栓塞。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-02-18 DOI: 10.1016/j.jjcc.2024.02.008
Massimo Baudo MD , Elena Magrini MS , Mathieu Pernot MD , Serge Sicouri MD , Gianluca Torregrossa MD , Antoine Beurton MD , Basel Ramlawi MD , Lionel Leroux MD, PhD , Thomas Modine MD, PhD , Besart Cuko MD
{"title":"Hydrophilic polymer embolization after TAVI","authors":"Massimo Baudo MD , Elena Magrini MS , Mathieu Pernot MD , Serge Sicouri MD , Gianluca Torregrossa MD , Antoine Beurton MD , Basel Ramlawi MD , Lionel Leroux MD, PhD , Thomas Modine MD, PhD , Besart Cuko MD","doi":"10.1016/j.jjcc.2024.02.008","DOIUrl":"10.1016/j.jjcc.2024.02.008","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"84 2","pages":"Pages 141-142"},"PeriodicalIF":2.5,"publicationDate":"2024-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905699","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}
引用次数: 0
Effects of ipragliflozin on left ventricular diastolic function in patients with type 2 diabetes: A sub-analysis of the PROTECT trial ipragliflozin对2型糖尿病患者左心室舒张功能的影响:PROTECT 试验的子分析。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-02-18 DOI: 10.1016/j.jjcc.2024.02.002
{"title":"Effects of ipragliflozin on left ventricular diastolic function in patients with type 2 diabetes: A sub-analysis of the PROTECT trial","authors":"","doi":"10.1016/j.jjcc.2024.02.002","DOIUrl":"10.1016/j.jjcc.2024.02.002","url":null,"abstract":"<div><h3>Background</h3><p><span>We hypothesized that the beneficial effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors on diastolic function might depend on baseline left ventricular (LV) </span>systolic function.</p></div><div><h3>Methods</h3><p><span><span>To investigate the effects of SGLT2 inhibitors on LV diastolic function in patients with type 2 diabetes mellitus (T2DM), we conducted a post-hoc sub-study of the PROTECT trial, stratifying the data according to </span>LV ejection fraction<span> (LVEF) at baseline. After excluding patients without echocardiographic data at baseline or 24 months into the PROTECT trial, 31 and 38 patients with T2DM from the full analysis dataset of the PROTECT trial who received ipragliflozin or no SGLT2 inhibitor (control), respectively, were included. The primary endpoint was a comparison of the changes in echocardiographic parameters and N-terminal pro-brain natriuretic peptide levels from baseline to 24 months between the two groups stratified according to baseline </span></span>LVEF.</p></div><div><h3>Results</h3><p><span>Differences in diastolic functional parameters (e' and E/e') were noted between the two groups. Among the subgroups defined according to median LVEF values, those with higher LVEF (≥60 %) who received ipragliflozin appeared to have a higher e' and lower E/e' than did those who received the standard of care with no SGLT2 inhibitor, indicating longitudinal improvements between baseline and follow up (</span><em>p</em> = 0.001 and 0.016, respectively).</p></div><div><h3>Conclusions</h3><p>Ipragliflozin generally improved LV diastolic function in patients with type 2 diabetes, the extent of this improvement might appear to vary with LV systolic function.</p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"84 4","pages":"Pages 246-252"},"PeriodicalIF":2.5,"publicationDate":"2024-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139912676","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}
引用次数: 0
Role of splanchnic circulation in the pathogenesis of heart failure: State-of-the-art review 脾循环在心力衰竭发病机制中的作用:最新进展回顾。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-02-17 DOI: 10.1016/j.jjcc.2024.02.004
Hidenori Yaku MD, PhD , Marat Fudim MD, MHS , Sanjiv J. Shah MD
{"title":"Role of splanchnic circulation in the pathogenesis of heart failure: State-of-the-art review","authors":"Hidenori Yaku MD, PhD ,&nbsp;Marat Fudim MD, MHS ,&nbsp;Sanjiv J. Shah MD","doi":"10.1016/j.jjcc.2024.02.004","DOIUrl":"10.1016/j.jjcc.2024.02.004","url":null,"abstract":"<div><p>A hallmark of heart failure (HF), whether it presents itself during rest or periods of physical exertion, is the excessive elevation of intracardiac filling pressures at rest or with exercise. Many mechanisms contribute to the elevated intracardiac filling pressures, and notably, the concept of volume redistribution has gained attention as a cause of the elevated intracardiac filling pressures in patients with HF, particularly HF with preserved ejection fraction, who often present without symptoms at rest, with shortness of breath and fatigue appearing only during exertion. This phenomenon suggests cardiopulmonary system non-compliance and inappropriate volume distribution between the stressed and unstressed blood volume components. A substantial proportion of the intravascular blood volume is in the splanchnic vascular compartment in the abdomen. Preclinical and clinical investigations support the critical role of the sympathetic nervous system in modulating the capacitance and compliance of the splanchnic vascular bed via modulation of the greater splanchnic nerve (GSN). The GSN activation by stressors such as exercise causes excessive splanchnic vasoconstriction, which may contribute to the decompensation of chronic HF via volume redistribution from the splanchnic vascular bed to the central compartment. Accordingly, for example, GSN ablation for volume management has been proposed as a potential therapeutic intervention to increase unstressed blood volume. Here we provide a comprehensive review of the role of splanchnic circulation in the pathogenesis of HF and potential novel treatment options for redistributing blood volume to improve symptoms and prognosis in patients with HF.</p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"83 5","pages":"Pages 330-337"},"PeriodicalIF":2.5,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139899973","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}
引用次数: 0
Outcome after primary percutaneous coronary intervention for ST-segment-elevation myocardial infarction complicated by cardiogenic shock ST段抬高型心肌梗死并发心源性休克的经皮冠状动脉介入治疗后的预后。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-02-17 DOI: 10.1016/j.jjcc.2024.02.005
{"title":"Outcome after primary percutaneous coronary intervention for ST-segment-elevation myocardial infarction complicated by cardiogenic shock","authors":"","doi":"10.1016/j.jjcc.2024.02.005","DOIUrl":"10.1016/j.jjcc.2024.02.005","url":null,"abstract":"<div><h3>Background</h3><p><span>Primary percutaneous coronary intervention (PCI) for ST-segment-elevation myocardial infarction (STEMI) complicated by </span>cardiogenic shock (CS) may reduce the risk of subsequent cardiovascular events but remains challenging. The study aim was to evaluate the clinical characteristics and long-term outcomes of patients undergoing primary PCI for STEMI with CS.</p></div><div><h3>Methods</h3><p>We conducted an observational cohort study of patients with STEMI who underwent primary PCI between April 2004 and December 2017 at Juntendo University Shizuoka Hospital. The primary outcome was cardiovascular death (CVD) during the median 3-year follow-up. We performed a landmark analysis for the incidence of CVD from 0 day to 1 year and from 1 to 10 years.</p></div><div><h3>Results</h3><p><span>Among the 1758 STEMI patients in the cohort, 212 (12.1 %) patients with CS showed significantly higher 30-day CVD rate on admission than those without (26.4 % vs 2.9 %). Landmark Kaplan–Meier analysis showed that CVD from day 0 to year 1 was significantly higher in the patients with CS (log-rank </span><em>p</em><span> &lt; 0.0001). Multivariate Cox regression<span> analysis showed that CS was significantly associated with higher cardiovascular mortality (adjusted hazard ratio, 11.8; 95%confidence intervals, 7.78–18.1; </span></span><em>p</em> &lt; 0.0001), but the mortality rates from 1 to 10 years were comparable (log-rank <em>p</em> = 0.68).</p></div><div><h3>Conclusion</h3><p>The cardiovascular 1-year mortality rate for patients with STEMI was higher for those with CS on admission than without, but the mortality rates of &gt;1 year were comparable. Surviving the early phase is essential for patients with STEMI and CS to improve long-term outcomes.</p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"84 3","pages":"Pages 189-194"},"PeriodicalIF":2.5,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905717","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}
引用次数: 0
African Americans have worse outcomes after transcatheter and surgical aortic valve replacement: A national inpatient sample analysis from 2015 to 2020 经导管主动脉瓣置换术和外科主动脉瓣置换术后,非裔美国人的预后更差:2015年至2020年全国住院患者样本分析》。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-02-17 DOI: 10.1016/j.jjcc.2024.02.003
Renxi Li BS , Qianyun Luo BS , Stephen J. Huddleston MD, PhD
{"title":"African Americans have worse outcomes after transcatheter and surgical aortic valve replacement: A national inpatient sample analysis from 2015 to 2020","authors":"Renxi Li BS ,&nbsp;Qianyun Luo BS ,&nbsp;Stephen J. Huddleston MD, PhD","doi":"10.1016/j.jjcc.2024.02.003","DOIUrl":"10.1016/j.jjcc.2024.02.003","url":null,"abstract":"<div><h3>Background</h3><p>Racial disparities in transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) are controversial among African Americans (AA). This study investigated racial disparities comparing AA and Caucasians undergoing aortic valve replacement.</p></div><div><h3>Methods</h3><p>Patients who underwent SAVR and TAVR for aortic stenosis were identified in National Inpatient Sample from Q4 2015–2020. In-hospital perioperative outcomes, length of stay, days from admission to operation, and total hospital charge, were compared between AA and Caucasians using multivariable analysis, adjusting for sex, age, socioeconomic status, comorbidity, and hospital characteristics.</p></div><div><h3>Results</h3><p>In TAVR, 51,394 (84.41 %) were Caucasians and 2433 (4.00 %) were AA. In SAVR, there were 50,080 (78.52 %) Caucasians and 3565 (5.59 %) AA. Compared to Caucasians, AA underwent TAVR had a higher risk of complications such as major adverse cardiovascular events (MACE) [adjusted odds ratio (aOR) = 1.335, <em>p</em> = 0.02)], respiratory complications (aOR = 1.363, <em>p</em> = 0.01), acute kidney injury (AKI) (aOR = 1.468, <em>p</em> &lt; 0.01), pulmonary embolism (aOR = 4.65, <em>p</em> = 0.05), hemorrhage/hematoma (aOR = 1.202, <em>p</em> &lt; 0.01), or superficial wound complication (aOR = 1.414, <em>p</em> = 0.04). AA who underwent SAVR had higher risks of morality (aOR = 1.184, <em>p</em> &lt; 0.05) and surgical complications including MACE (aOR = 1.263, <em>p</em> &lt; 0.01), pericardial complications (aOR = 1.563, <em>p</em> &lt; 0.01), cardiogenic shock (aOR = 1.578, <em>p</em> &lt; 0.01), respiratory complications (aOR = 1.261, <em>p</em> &lt; 0.01), AKI (aOR = 1.642, <em>p</em> &lt; 0.01), venous thromboembolism (aOR = 1.613, <em>p</em> &lt; 0.01), hemorrhage/hematoma (aOR = 1.129, <em>p</em> &lt; 0.01), infection (aOR = 1.234, <em>p</em> &lt; 0.01), superficial wound complications (aOR = 1.756, <em>p</em> &lt; 0.01), vascular complications (aOR = 1.592, <em>p</em> &lt; 0.01), and diaphragmatic paralysis (aOR = 2.181, <em>p</em> = 0.02). In both TAVR and SAVR, AA had longer waiting times from admission to operation (<em>p</em> &lt; 0.01), longer hospital stays (<em>p</em> &lt; 0.01), and higher hospital charges (<em>p</em> &lt; 0.01).</p></div><div><h3>Conclusion</h3><p>AA were underrepresented, especially in TAVR. AA experienced higher in-hospital mortality post-SAVR, but not after TAVR. Furthermore, AA had more complications for both TAVR and SAVR. These findings underscore the pronounced disparities among AA in aortic valve replacement.</p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"84 2","pages":"Pages 105-112"},"PeriodicalIF":2.5,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905698","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}
引用次数: 0
Impact of postoperative hyperlactatemia in orthotopic heart transplantation 正位心脏移植术后高乳酸血症的影响。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-02-12 DOI: 10.1016/j.jjcc.2024.02.001
{"title":"Impact of postoperative hyperlactatemia in orthotopic heart transplantation","authors":"","doi":"10.1016/j.jjcc.2024.02.001","DOIUrl":"10.1016/j.jjcc.2024.02.001","url":null,"abstract":"<div><h3>Background</h3><p>Hyperlactatemia<span><span> (HL) is a common phenomenon after cardiac surgery which is related to tissue hypoperfusion and hypoxia and associated with poor outcomes. It is also often seen in the </span>postoperative period<span> after orthotopic heart transplantation (OHTx), but the association between HL and outcomes after OHTx is not well known. We evaluated the incidence and outcome of HL after OHTx.</span></span></p></div><div><h3>Methods</h3><p><span>This was a retrospective study of 209 patients who underwent OHTx between January 2011 and December 2020. Patients were classified into 3 groups according to their peak lactate levels within the first 72 h postoperatively: group 1, normal to mild hyperlactatemia (&lt;5 mmol/L, n = 42); group 2, moderate hyperlactatemia (5–10 mmol/L, n = 110); and group 3, severe hyperlactatemia (&gt;10 mmol/L, n = 57). The primary composite endpoint was all-cause mortality or postoperative initiation of veno-arterial extracorporeal membrane oxygenation (VA ECMO) within 30 days. Secondary endpoints included duration of </span>mechanical ventilation<span>, intensive care unit length of stay, and hospital length of stay.</span></p></div><div><h3>Results</h3><p><span>Patients with higher postoperative peak lactate levels were more commonly transplanted from left ventricular assist device support (33.3 % vs 50.9 % vs 64.9, </span><em>p</em><span> &lt; 0.01) and had longer cardiopulmonary bypass time [127 min (109–148) vs 141 min (116–186) vs 153 min (127–182), </span><em>p</em> = 0.02]. Composite primary endpoint was met in 18 patients (8.6 %) and was significantly more common in patients with higher postoperative peak lactate levels (0.0 % vs 6.4 % vs 19.3 %, <em>p</em> &lt; 0.01).</p></div><div><h3>Conclusions</h3><p>Severe hyperlactatemia following orthotopic heart transplant was associated with an increased risk of post-transplant VA ECMO initiation and mortality at 30 days.</p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"84 4","pages":"Pages 239-245"},"PeriodicalIF":2.5,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139735316","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}
引用次数: 0
Innervation of the coronary arteries and its role in controlling microvascular resistance 冠状动脉的神经支配及其在控制微血管阻力中的作用。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-02-10 DOI: 10.1016/j.jjcc.2024.01.005
Takanori Sato MD, PhD, Peter Hanna MD, PhD, Shumpei Mori MD, PhD
{"title":"Innervation of the coronary arteries and its role in controlling microvascular resistance","authors":"Takanori Sato MD, PhD,&nbsp;Peter Hanna MD, PhD,&nbsp;Shumpei Mori MD, PhD","doi":"10.1016/j.jjcc.2024.01.005","DOIUrl":"10.1016/j.jjcc.2024.01.005","url":null,"abstract":"<div><p>The coronary circulation plays a crucial role in balancing myocardial perfusion and oxygen demand to prevent myocardial ischemia. Extravascular compressive forces, coronary perfusion pressure, and microvascular resistance are involved to regulate coronary blood flow throughout the cardiac cycle. Autoregulation of the coronary blood flow through dynamic adjustment of microvascular resistance is maintained by complex interactions among mechanical, endothelial, metabolic, neural, and hormonal mechanisms. This review focuses on the neural mechanism. Anatomy and physiology of the coronary arterial innervation have been extensively investigated using animal models. However, findings in the animal heart have limited applicability to the human heart as cardiac innervation is generally highly variable among species. So far, limited data are available on the human coronary artery innervation, rendering multiple questions unresolved. Recently, the clinical entity of ischemia with non-obstructive coronary arteries has been proposed, characterized by microvascular dysfunction involving abnormal vasoconstriction and impaired vasodilation. Thus, measurement of microvascular resistance has become a standard diagnostic for patients without significant stenosis in the epicardial coronary arteries. Neural mechanism is likely to play a pivotal role, supported by the efficacy of cardiac sympathetic denervation to control symptoms in patients with angina. Therefore, understanding the coronary artery innervation and control of microvascular resistance of the human heart is increasingly important for cardiologists for diagnosis and to select appropriate therapeutic options. Advancement in this field can lead to innovations in diagnostic and therapeutic approaches for coronary artery diseases.</p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"84 1","pages":"Pages 1-13"},"PeriodicalIF":2.5,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0914508724000108/pdfft?md5=9879e829da6e24fff7095fe829667472&pid=1-s2.0-S0914508724000108-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139722799","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}
引用次数: 0
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 COVID-19 大流行之前和期间急性心力衰竭患者治疗状况的比较--利用日本行政数据进行的观察性队列研究
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-02-02 DOI: 10.1016/j.jjcc.2024.01.004
Tatsuhiro Shibata MD, PhD , Shingo Matsumoto MD, PhD , Tomoki Muramoto MS , Miyuki Matsukawa MS
{"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":"84 1","pages":"Pages 47-54"},"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}
引用次数: 0
Transcatheter aortic valve replacement in Germany with need for a surgical bailout 德国的经导管主动脉瓣置换术需要手术保驾护航
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-02-01 DOI: 10.1016/j.jjcc.2024.01.003
Vera Oettinger MD, MSc , Ingo Hilgendorf MD , Dennis Wolf MD , Peter Stachon MD , Adrian Heidenreich MD , Manfred Zehender MD, PhD , Dirk Westermann MD , Klaus Kaier PhD , Constantin von zur Mühlen MD
{"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":"84 2","pages":"Pages 99-104"},"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}
引用次数: 0
Regulation of myocardial glucose metabolism by YAP/TAZ signaling 通过 YAP/TAZ 信号调节心肌葡萄糖代谢。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-01-23 DOI: 10.1016/j.jjcc.2024.01.002
Toshihide Kashihara (PhD) , Junichi Sadoshima (MD, PhD)
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