Journal of cardiology最新文献

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Association between complementary use of Goreisan (a Japanese herbal Kampo medicine) and heart failure readmission: A nationwide propensity score-matched study. Goreisan(一种日本草本锦囊药)的辅助使用与心衰再入院之间的关系:一项全国范围的倾向得分匹配研究。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-09-26 DOI: 10.1016/j.jjcc.2024.09.010
Toshiaki Isogai, Kojiro Morita, Akira Okada, Nobuaki Michihata, Hiroki Matsui, Atsushi Miyawaki, Taisuke Jo, Hideo Yasunaga
{"title":"Association between complementary use of Goreisan (a Japanese herbal Kampo medicine) and heart failure readmission: A nationwide propensity score-matched study.","authors":"Toshiaki Isogai, Kojiro Morita, Akira Okada, Nobuaki Michihata, Hiroki Matsui, Atsushi Miyawaki, Taisuke Jo, Hideo Yasunaga","doi":"10.1016/j.jjcc.2024.09.010","DOIUrl":"10.1016/j.jjcc.2024.09.010","url":null,"abstract":"<p><strong>Background: </strong>Goreisan, a Japanese herbal medicine, possesses aquaretic properties to regulate body fluid homeostasis and may therefore be effective as a complement to standard therapy in improving outcomes in patients with heart failure (HF).</p><p><strong>Methods: </strong>We retrospectively identified 431,393 patients (mean age 79.2 ± 12.6 years; male 52.3 %) who were admitted for HF for the first time and were discharged alive with standard HF medications between April 2016 and March 2022, using the Japanese Diagnosis Procedure Combination database. We divided patients into two groups according to the prescription of Goreisan at discharge: patients who received standard HF medications plus Goreisan and those who received standard medications alone. We compared the incidence of HF readmission within 1 year after discharge between the groups using propensity score matching.</p><p><strong>Results: </strong>Overall, Goreisan was prescribed in 1957 (0.45 %) patients at discharge. Patients who received Goreisan were older and received diuretics more frequently than those who did not. One-to-four propensity score matching created a cohort of 1957 and 7828 patients treated with and without Goreisan, respectively. No significant difference was found in the incidence of 1-year HF readmission between the groups [22.1 % vs. 21.7 %; hazard ratio (HR) = 1.02, 95 % confidence interval (CI) = 0.92-1.13]. This result was consistent with that from competing risk analysis (subdistribution HR = 1.02, 95 % CI = 0.92-1.13) and across clinically relevant subgroups except for renal disease. Goreisan use was associated with a lower incidence of HF readmission among patients with renal disease (HR = 0.77, 95 % CI = 0.60-0.97), but not among those without (HR = 1.09, 95 % CI = 0.97-1.23; p for interaction = 0.009).</p><p><strong>Conclusions: </strong>This nationwide propensity score-matched analysis did not demonstrate that complementary Goreisan use at discharge was associated with a lower incidence of 1-year HF readmission in patients with HF receiving standard medications. An ongoing randomized trial is awaited to establish the effectiveness of Goreisan use in patients with HF.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347435","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 diabetes mellitus on post-CABG outcomes in veterans: Insights from the REGROUP trial. 糖尿病对退伍军人心血管造影术后结果的影响:REGROUP试验的启示。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-09-21 DOI: 10.1016/j.jjcc.2024.09.007
Thais Faggion Vinholo, Eileen Stock, Jordan Bloom, Sameer Hirji, Ellen DeMatt, Kousick Biswas, Jacquelyn A Quin, Miguel Haime, Marco A Zenati
{"title":"Impact of diabetes mellitus on post-CABG outcomes in veterans: Insights from the REGROUP trial.","authors":"Thais Faggion Vinholo, Eileen Stock, Jordan Bloom, Sameer Hirji, Ellen DeMatt, Kousick Biswas, Jacquelyn A Quin, Miguel Haime, Marco A Zenati","doi":"10.1016/j.jjcc.2024.09.007","DOIUrl":"10.1016/j.jjcc.2024.09.007","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307848","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
Clinical outcomes of patients from older community hospitalized for heart failure in guideline-directed medical therapy era: Insights from the COMPASS-HF registry. 在指南指导医疗时代,因心力衰竭住院的老年社区患者的临床疗效:COMPASS-HF 登记的启示。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-09-17 DOI: 10.1016/j.jjcc.2024.09.006
Daisuke Sueta, Satoshi Araki, Hiroki Usuku, Tomohiro Fujisaki, Takuya Kiyama, Masanobu Ishii, Noriaki Tabata, Koichiro Fujisue, Hiroaki Kusaka, Shinsuke Hanatani, Eiichiro Yamamoto, Hiroshi Haruguchi, Hiroshi Takamori, Kenichi Tsujita
{"title":"Clinical outcomes of patients from older community hospitalized for heart failure in guideline-directed medical therapy era: Insights from the COMPASS-HF registry.","authors":"Daisuke Sueta, Satoshi Araki, Hiroki Usuku, Tomohiro Fujisaki, Takuya Kiyama, Masanobu Ishii, Noriaki Tabata, Koichiro Fujisue, Hiroaki Kusaka, Shinsuke Hanatani, Eiichiro Yamamoto, Hiroshi Haruguchi, Hiroshi Takamori, Kenichi Tsujita","doi":"10.1016/j.jjcc.2024.09.006","DOIUrl":"10.1016/j.jjcc.2024.09.006","url":null,"abstract":"<p><strong>Background: </strong>Despite strong recommendations in the latest guidelines for implementing guideline-directed medical therapy (GDMT) before discharge, there is a lack of data on the clinical characteristics and outcomes of older patients with heart failure (HF). Therefore, this study aimed to investigate the clinical characteristics and outcomes of patients with HF in a super-aging society during the GDMT era.</p><p><strong>Methods and results: </strong>In the COMPASS-HF study including 305 consecutive hospitalized patients, 177 with acute HF were identified through a medical record review. The mean age of the enrolled patients was 86.2 years, and 46.3 % were men. The mean simple GDMT score, which is recognized as a useful prognostic tool for Japanese patients with HF, was 5.0. The incidences of all-cause death and HF hospitalization were 46.5 % and 19.4 %, respectively. The incidences of all-cause death and cardiovascular death were significantly lower in the high simple GDMT score group (≥5 points) than in the low simple GDMT score group (≤4 points) (p = 0.049 and p = 0.044, respectively). However, no significant differences were noted in HF hospitalization and composite events (cardiovascular death and HF hospitalization) between the groups (p = 0.564 and p = 0.086, respectively).</p><p><strong>Conclusions: </strong>While GDMT was well-implemented in the older community, the mortality rate among hospitalized patients with HF remained high. Although GDMT appears to have reduced the HF hospitalization rate, further validation and development of an optimal predictive model for elderly patients with HF are essential.</p><p><strong>X (formerly twitter): </strong>In the older community, although the short- and long-term mortality of hospitalized patients with HF is still high even in the GDMT era, the HF hospitalization rate is suppressed, probably due to GDMT. A simple GDMT score may also be useful for stratifying the prognosis of older patients with HF. #HeartFailure#Mortality#GDMT#Fantastic4.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288048","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
Incidence and risk factors of hypotension-related adverse events among Japanese patients with heart failure receiving sacubitril/valsartan or enalapril: Results from the PARALLEL-HF study. 接受沙库比妥/缬沙坦或依那普利治疗的日本心力衰竭患者发生低血压相关不良事件的几率和风险因素:PARALLEL-HF 研究结果。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-09-14 DOI: 10.1016/j.jjcc.2024.09.002
Hiroyuki Tsutsui, Shin-Ichi Momomura, Yoshihiko Saito, Hiroshi Ito, Kazuhiro Yamamoto, Yasushi Sakata, Tomomi Ohishi, Takayuki Iimori, Toshihito Kitamura
{"title":"Incidence and risk factors of hypotension-related adverse events among Japanese patients with heart failure receiving sacubitril/valsartan or enalapril: Results from the PARALLEL-HF study.","authors":"Hiroyuki Tsutsui, Shin-Ichi Momomura, Yoshihiko Saito, Hiroshi Ito, Kazuhiro Yamamoto, Yasushi Sakata, Tomomi Ohishi, Takayuki Iimori, Toshihito Kitamura","doi":"10.1016/j.jjcc.2024.09.002","DOIUrl":"10.1016/j.jjcc.2024.09.002","url":null,"abstract":"<p><strong>Background: </strong>The PARALLEL-HF trial showed that treatment with sacubitril/valsartan resulted in more symptomatic hypotension versus enalapril in Japanese patients with heart failure (HF) and reduced ejection fraction, similar to PARADIGM-HF. Use of sacubitril/valsartan in these patients may be limited by concerns regarding hypotension.</p><p><strong>Methods: </strong>This post-hoc analysis characterized hypotension-related adverse events (AEs) and their effects on efficacy using data from PARALLEL-HF, in which patients received sacubitril/valsartan 200 mg twice daily or enalapril 10 mg twice daily.</p><p><strong>Results: </strong>Of 223 patients, 28.2 % experienced hypotension-related AEs and incidence was higher with sacubitril/valsartan versus enalapril (hazard ratio, 2.2; 95 % CI, 1.3-3.8; p = 0.0027). However, reduction in mean systolic blood pressure from baseline to study end did not significantly differ (sacubitril/valsartan: -2.2 mmHg vs enalapril: -1.3 mmHg; p = 0.6895). Patients who experienced hypotension-related AEs had lower mean body mass index, higher median N-terminal pro-brain natriuretic peptide at randomization, and more frequent history of stroke. Hypotension-related AEs leading to treatment discontinuation were not significantly different for sacubitril/valsartan versus enalapril (3.4 % vs 6.9 %, p = 0.5957). Reduction in risk of cardiovascular death or HF hospitalization was similar with sacubitril/valsartan versus enalapril in patients with or without hypotension-related AEs.</p><p><strong>Conclusions: </strong>Incidence of hypotension-related AEs was higher in the sacubitril/valsartan versus enalapril group but did not affect risk of cardiovascular death or HF hospitalization, which was similar between treatment groups.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288097","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 on ventricular arrhythmic burden of SGLT2 inhibitors in patients with chronic heart failure evaluated with cardiac implantable electronic device monitoring. 通过心脏植入式电子设备监测评估 SGLT2 抑制剂对慢性心力衰竭患者室性心律失常负荷的影响。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-09-13 DOI: 10.1016/j.jjcc.2024.09.005
Paolo Basile, Francesco Monitillo, Daniela Santoro, Giorgia Falco, Maria Cristina Carella, Yamna Khan, Arcangelo Moretti, Vincenzo Ezio Santobuono, Riccardo Memeo, Gianluca Pontone, Cinzia Forleo, Marco Matteo Ciccone, Andrea Igoren Guaricci
{"title":"Impact on ventricular arrhythmic burden of SGLT2 inhibitors in patients with chronic heart failure evaluated with cardiac implantable electronic device monitoring.","authors":"Paolo Basile, Francesco Monitillo, Daniela Santoro, Giorgia Falco, Maria Cristina Carella, Yamna Khan, Arcangelo Moretti, Vincenzo Ezio Santobuono, Riccardo Memeo, Gianluca Pontone, Cinzia Forleo, Marco Matteo Ciccone, Andrea Igoren Guaricci","doi":"10.1016/j.jjcc.2024.09.005","DOIUrl":"https://doi.org/10.1016/j.jjcc.2024.09.005","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter 2 (SGLT2) inhibitors have revolutionized the therapeutic scenario of heart failure, demonstrating favorable effects on mortality and quality of life. Previous studies have yielded conflicting data regarding the effects on ventricular arrhythmias.</p><p><strong>Methods: </strong>A prospective observational study was conducted to investigate the anti-arrhythmic properties of SGLT2 inhibitors evaluating the intra-patient difference in major adverse arrhythmic cardiac events (MAACE) over a six-month period in patients with chronic heart failure who were undergoing continuous monitoring using a cardiac implantable electronic device.</p><p><strong>Results: </strong>From January 2022 to January 2023, 82 patients [median age 63 years (IQR 15), male 87 %] were enrolled in the study, with a median follow-up of 28 weeks (IQR 5). The rate of MAACE at baseline was 11 %, without relevant differences in the follow up in terms of major and minor arrhythmic events. In patients with an arrhythmic phenotype at baseline, a mild but non statistically significant reduction of MAACE (from 36 % to 28 %, p = 0.727) was observed and a significant decrease of non-sustained ventricular tachycardia (from 68 % to 32 %, p = 0.022).</p><p><strong>Conclusions: </strong>Our findings suggest potential anti-arrhythmic properties of SGLT2 inhibitors, evident in patients with arrhythmic events before the initiation of the drug.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288049","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
The impact of liver cirrhosis on in-hospital outcomes among patients hospitalized for cardiogenic shock: A propensity score matched retrospective cohort study. 肝硬化对心源性休克住院患者院内预后的影响:倾向评分匹配回顾性队列研究。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-09-12 DOI: 10.1016/j.jjcc.2024.09.004
Bekure B Siraw, Mohamed A Ebrahim, Shahin Isha, Parth Patel, Abdulrahim Y Mehadi, Eli A Zaher, Yordanos T Tafesse, Biruk Siraw
{"title":"The impact of liver cirrhosis on in-hospital outcomes among patients hospitalized for cardiogenic shock: A propensity score matched retrospective cohort study.","authors":"Bekure B Siraw, Mohamed A Ebrahim, Shahin Isha, Parth Patel, Abdulrahim Y Mehadi, Eli A Zaher, Yordanos T Tafesse, Biruk Siraw","doi":"10.1016/j.jjcc.2024.09.004","DOIUrl":"https://doi.org/10.1016/j.jjcc.2024.09.004","url":null,"abstract":"<p><strong>Background: </strong>Cardiogenic shock poses a critical challenge characterized by diminished cardiac output and organ perfusion. Timely recognition and risk stratification are essential for effective intervention. Liver cirrhosis adds complexity due to its diverse systemic manifestations. The effect of liver cirrhosis on in-hospital outcomes in cardiogenic shock remains underexplored.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the National Inpatient Sample database from 2016 to 2020, matching cirrhotic patients with non-cirrhotic counterparts using propensity scores. The Cochran-Mantel-Haenszel method was used to assess the impact of cirrhosis on in-hospital mortality and complications. Simple linear regression models were used to assess differences in length of stay and cost of hospitalization.</p><p><strong>Results: </strong>There were a total of 44,288 patients in the cohort, evenly distributed between the group with and without liver cirrhosis. Mean age of the cohort was 64 years (SD 12.5), 69.7 % were males, and 61.3 % were white. The overall in-hospital mortality rate in the cohort was 37.2 % with higher odds of in-hospital mortality in cirrhotic patients [OR = 1.3; 95 % CI (1.25, 1.35)]. Patients with cirrhosis exhibited increased risks of bowel ischemia, acute kidney injury, and sepsis compared to those without cirrhosis. Additionally, they had a heightened overall risk of major bleeding, particularly gastrointestinal bleeding, but a lower risk of intracranial hemorrhage and access site bleeding. Conversely, patients with cirrhosis had lower odds of deep vein thrombosis and pulmonary embolism, as well as arterial access site thrombosis and dissection, leading to reduced odds of peripheral angioplasty, thrombectomy, and amputation. Cirrhotic patients also had increased length of stay and cost of hospitalization.</p><p><strong>Conclusion: </strong>Liver cirrhosis exacerbates outcomes in cardiogenic shock, necessitating tailored management strategies. Further research is warranted to optimize patient care and understand the underlying mechanisms.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288098","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
Relationship between left atrial/left ventricular diameter ratio and outcomes in patients with hypertrophic cardiomyopathy 肥厚型心肌病患者左心房/左心室直径比与预后之间的关系
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-09-10 DOI: 10.1016/j.jjcc.2024.09.003
Keigo Kanbayashi MD, Yuichiro Minami MD PhD FJCC, Shintaro Haruki MD PhD, Chihiro Saito MD PhD, Junichi Yamaguchi MD PhD FJCC
{"title":"Relationship between left atrial/left ventricular diameter ratio and outcomes in patients with hypertrophic cardiomyopathy","authors":"Keigo Kanbayashi MD, Yuichiro Minami MD PhD FJCC, Shintaro Haruki MD PhD, Chihiro Saito MD PhD, Junichi Yamaguchi MD PhD FJCC","doi":"10.1016/j.jjcc.2024.09.003","DOIUrl":"https://doi.org/10.1016/j.jjcc.2024.09.003","url":null,"abstract":"Although diastolic dysfunction is the main pathophysiological feature of hypertrophic cardiomyopathy (HCM), it remains to be clarified whether parameters of diastolic function can reliably determine HCM prognosis. In patients with reduced left ventricular (LV) distensibility, chronic elevation of LV diastolic pressure is seen with a smaller than expected LV size. Accordingly, patients with HCM with severe LV diastolic dysfunction typically demonstrate left atrial (LA) dilation and a disproportionately smaller left ventricle. Therefore, we investigated the relationship between LA/LV diameter ratio, as a potential indicator of disease progression, and outcomes in patients with HCM. We included 468 patients in whom LA and LV end-diastolic diameter were successfully evaluated by echocardiography at the initial assessment. We divided the patients into two groups: those with an LA/LV diameter ratio > 1 and those with an LA/LV diameter ratio ≤ 1. We compared the HCM-related death rates between the two groups. Of the 468 patients, 96 patients (20.5 %) with HCM showed an LA/LV diameter ratio > 1. In the univariate analysis, patients with an LA/LV diameter ratio > 1 had a significantly greater likelihood of HCM-related death than patients with an LA/LV diameter ratio ≤ 1 (log-rank = 0.002). In the multivariate Cox proportional hazards analysis, when including LA/LV diameter ratio > 1 and imbalanced baseline variables, an LA/LV diameter ratio > 1 was an independent determinant of HCM-related death (adjusted hazard ratio: 1.87, 95 % confidence interval: 1.08–3.24; = 0.024). LA/LV diameter ratio can be easily evaluated and may be useful for risk stratification of HCM-related death in patients with HCM.","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"32 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265371","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
Extensive ablation for elderly patients with persistent atrial fibrillation: insights from the EARNEST-PVI prospective randomized trial 对老年持续性心房颤动患者进行广泛消融:EARNEST-PVI 前瞻性随机试验的启示
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-09-07 DOI: 10.1016/j.jjcc.2024.09.001
Yuki Matsuoka MD, Yohei Sotomi MD PhD, Shungo Hikoso MD PhD, Akihiro Sunaga MD PhD, Daisaku Nakatani MD PhD, Katsuki Okada MD PhD, Tomoharu Dohi MD PhD, Taiki Sato MD PhD, Hirota Kida MAS, Daisuke Sakamoto MD, Tetsuhisa Kitamura MD MSc DrPH, Nobuaki Tanaka MD, Masaharu Masuda MD PhD, Tetsuya Watanabe MD PhD, Hitoshi Minamiguchi MD, Yasuyuki Egami MD, Takafumi Oka MD PhD, Miwa Miyoshi MD PhD, Masato Okada MD, Yasuhiro Matsuda MD, Masato Kawasaki MD, Koichi Inoue MD PhD, Yasushi Sakata MD PhD FJCC, OCVC-Arrhythmia Investigators
{"title":"Extensive ablation for elderly patients with persistent atrial fibrillation: insights from the EARNEST-PVI prospective randomized trial","authors":"Yuki Matsuoka MD, Yohei Sotomi MD PhD, Shungo Hikoso MD PhD, Akihiro Sunaga MD PhD, Daisaku Nakatani MD PhD, Katsuki Okada MD PhD, Tomoharu Dohi MD PhD, Taiki Sato MD PhD, Hirota Kida MAS, Daisuke Sakamoto MD, Tetsuhisa Kitamura MD MSc DrPH, Nobuaki Tanaka MD, Masaharu Masuda MD PhD, Tetsuya Watanabe MD PhD, Hitoshi Minamiguchi MD, Yasuyuki Egami MD, Takafumi Oka MD PhD, Miwa Miyoshi MD PhD, Masato Okada MD, Yasuhiro Matsuda MD, Masato Kawasaki MD, Koichi Inoue MD PhD, Yasushi Sakata MD PhD FJCC, OCVC-Arrhythmia Investigators","doi":"10.1016/j.jjcc.2024.09.001","DOIUrl":"https://doi.org/10.1016/j.jjcc.2024.09.001","url":null,"abstract":"In patients with persistent atrial fibrillation (AF), extensive ablation for substrate modification, such as linear ablation or complex fractionated atrial electrogram ablation in addition to pulmonary vein isolation (PVI) remains controversial. Previous studies investigating extensive ablation have demonstrated its varying efficacy, suggesting the possible heterogeneity of its efficacy. Aging is a major risk factor for AF and is associated with atrial remodeling. We aimed to compare the efficacy and safety of the extensive ablation strategy compared with PVI alone strategy between young and elderly patients. This study is a post-hoc analysis of the multicenter, randomized controlled, noninferiority trial investigating the efficacy and safety of PVI-only (PVI-alone arm) compared with extensive ablation (PVI-plus arm) in patients with persistent AF (EARNEST-PVI trial). We divided the overall population into 2 groups based on age and assessed treatment effects. In the young group (age <65 years, = 206), there was no significant difference in the recurrence rate between the PVI-alone group and PVI-plus group [hazard ratio (HR): 1.00, 95 % CI: 0.57–1.73, = 0.987], whereas the recurrence rate was significantly lower in the PVI-plus group compared to the PVI-alone group in the elderly group (age ≥65 years, = 291) (HR: 0.47, 95 % CI: 0.29–0.76, = 0.0021) ( for interaction = 0.0446). There were no fatal procedural complications. In patients with persistent AF, the extensive ablation strategy was more effective than the PVI-alone strategy in elderly patients, while the effectiveness of both approaches was comparable in young patients. URL: ; Unique identifier: .","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"20 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265370","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
Aortic tortuosity and pacemaker requirement after transcatheter aortic valve replacement: Mediating effects of anatomical variations. 经导管主动脉瓣置换术后的主动脉迂曲和起搏器需求:解剖变异的中介效应。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-09-05 DOI: 10.1016/j.jjcc.2024.08.012
Kazuyuki Yamaguchi, Takamitsu Nakamura, Tsuyoshi Kobayashi, Toru Yoshizaki, Manabu Uematsu, Takeo Horikoshi, Kazuto Nakamura, Akira Sato
{"title":"Aortic tortuosity and pacemaker requirement after transcatheter aortic valve replacement: Mediating effects of anatomical variations.","authors":"Kazuyuki Yamaguchi, Takamitsu Nakamura, Tsuyoshi Kobayashi, Toru Yoshizaki, Manabu Uematsu, Takeo Horikoshi, Kazuto Nakamura, Akira Sato","doi":"10.1016/j.jjcc.2024.08.012","DOIUrl":"10.1016/j.jjcc.2024.08.012","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145725","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
Usefulness of hypochloremia at the time of discharge to predict prognosis in patients with chronic heart failure after hospitalization. 出院时的低氯血症对慢性心力衰竭患者住院后预后的预测作用。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-08-31 DOI: 10.1016/j.jjcc.2024.08.011
Kayo Misumi, Yuya Matsue, Kazutaka Nogi, Yudai Fujimoto, Nobuyuki Kagiyama, Takatoshi Kasai, Takeshi Kitai, Shogo Oishi, Eiichi Akiyama, Satoshi Suzuki, Masayoshi Yamamoto, Keisuke Kida, Takahiro Okumura, Maki Nogi, Satomi Ishihara, Tomoya Ueda, Rika Kawakami, Yoshihiko Saito, Tohru Minamino
{"title":"Usefulness of hypochloremia at the time of discharge to predict prognosis in patients with chronic heart failure after hospitalization.","authors":"Kayo Misumi, Yuya Matsue, Kazutaka Nogi, Yudai Fujimoto, Nobuyuki Kagiyama, Takatoshi Kasai, Takeshi Kitai, Shogo Oishi, Eiichi Akiyama, Satoshi Suzuki, Masayoshi Yamamoto, Keisuke Kida, Takahiro Okumura, Maki Nogi, Satomi Ishihara, Tomoya Ueda, Rika Kawakami, Yoshihiko Saito, Tohru Minamino","doi":"10.1016/j.jjcc.2024.08.011","DOIUrl":"10.1016/j.jjcc.2024.08.011","url":null,"abstract":"<p><strong>Background: </strong>Hypochloremia has been suggested as a strong marker of mortality in hospitalized patients with heart failure (HF). This study aimed to clarify whether incorporating hypochloremia into pre-existing prognostic models improved the performance of the models.</p><p><strong>Methods: </strong>We tested the prognostic value of hypochloremia (<97 mEq/L) measured at discharge in hospitalized patients with HF registered in the REALITY-AHF and NARA-HF studies. The primary outcome was 1-year mortality after discharge.</p><p><strong>Results: </strong>Among 2496 patients with HF, 316 (12.6 %) had hypochloremia at the time of discharge, and 387 (15.5 %) deaths were observed within 1 year of discharge. The presence of hypochloremia was strongly associated with higher 1-year mortality compared to those without hypochloremia (log-rank: p < 0.001), and this association remained even after adjustment for the Get With the Guideline-HF risk model (GWTG-HF), anemia, New York Heart Association (NYHA) classification, and log-brain natriuretic peptide (BNP) [hazard ratio (HR) 1.64; p < 0.001]. Furthermore, adding hypochloremia to the prediction model composed of GWTG-HF + anemia + NYHA class + log-BNP yielded a numerically larger area under the curve (0.740 vs 0.749; p = 0.059) and significant improvement in net reclassification (0.159, p = 0.010).</p><p><strong>Conclusions: </strong>Incorporating the presence of hypochloremia at discharge into pre-existing risk prediction models provides incremental prognostic information for hospitalized patients with HF.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119910","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}
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