Journal of cardiology最新文献

{"title":"Early experience with daratumumab-containing regimens in patients with light-chain cardiac amyloidosis","authors":"Kei Morikawa MD ,&nbsp;Yasuhiro Izumiya MD, PhD, FJCC ,&nbsp;Seiji Takashio MD, PhD, FJCC ,&nbsp;Yawara Kawano MD, PhD ,&nbsp;Tetsuya Oguni MD ,&nbsp;Naoto Kuyama MD, PhD ,&nbsp;Fumi Oike MD, PhD ,&nbsp;Masahiro Yamamoto MD, PhD ,&nbsp;Noriaki Tabata MD, PhD ,&nbsp;Masanobu Ishii MD, PhD ,&nbsp;Shinsuke Hanatani MD, PhD ,&nbsp;Tadashi Hoshiyama MD, PhD ,&nbsp;Hisanori Kanazawa MD, PhD ,&nbsp;Yasushi Matsuzawa MD, PhD ,&nbsp;Hiroki Usuku MD, PhD, FJCC ,&nbsp;Eiichiro Yamamoto MD, PhD, FJCC ,&nbsp;Mitsuharu Ueda MD, PhD ,&nbsp;Kenichi Tsujita MD, PhD, FJCC","doi":"10.1016/j.jjcc.2024.11.003","DOIUrl":"10.1016/j.jjcc.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Immunoglobulin light-chain (AL) amyloidosis is a lethal condition resulting from misfolded immunoglobulin ALs produced by clonal CD38-positive plasma cells. Treatment with daratumumab, an anti-human CD38 monoclonal antibody, led to higher frequencies of complete hematologic response and better clinical outcomes compared with conventional treatment. This study sought to evaluate the survival benefit of daratumumab-containing regimens in patients with AL cardiac amyloidosis.</div></div><div><h3>Methods and results</h3><div>We examined 65 consecutive patients with AL cardiac amyloidosis (mean age: 67.2 ± 10.4 years, male: 69 %) who underwent chemotherapy. We divided patients into a daratumumab group, which used daratumumab-containing regimens before second-line treatment (<em>n</em> = 32), and a conventional treatment group (<em>n</em> = 33). Compared with the conventional treatment group, the daratumumab group tended to be older, but there were no significant differences between groups in biomarkers and echocardiographic parameters. A total of 26 patients (40 %) died (median follow-up duration: 395 days). Kaplan–Meier survival analysis showed that the daratumumab group had significantly lower mortality compared with the conventional treatment group (<em>p</em> = 0.04; log-rank test). Cox hazard analysis revealed that use of daratumumab-containing regimens was associated with lower mortality after adjustment for the revised Mayo staging of AL amyloidosis (hazard ratio: 0.32; 95 % confidence interval: 0.12 to 0.85; <em>p</em> = 0.02).</div></div><div><h3>Conclusion</h3><div>Daratumumab-containing regimens may be associated with improved survival in patients with AL cardiac amyloidosis.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 6","pages":"Pages 440-446"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692972","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":"Effect of tafamidis therapy on physical function in patients with wild-type transthyretin cardiac amyloidosis","authors":"Atsushi Shibata MD, PhD,&nbsp;Yasuhiro Izumiya MD, PhD, FJCC ,&nbsp;Toshitake Yoshida MD, PhD,&nbsp;Akiko Tanihata MD, PhD,&nbsp;Ryoko Kitada MD, PhD,&nbsp;Kenichiro Otsuka MD, PhD, FJCC,&nbsp;Asahiro Ito MD, PhD,&nbsp;Takanori Yamazaki MD, PhD,&nbsp;Daiju Fukuda MD, PhD, FJCC","doi":"10.1016/j.jjcc.2024.11.004","DOIUrl":"10.1016/j.jjcc.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Tafamidis is used as disease-modifying treatment for patients with wild-type transthyretin cardiac amyloidosis (ATTRwt CA). However, the effects of tafamidis on exercise tolerance are unclear.</div></div><div><h3>Methods</h3><div>This single-center, prospective, observational study aimed to assess the effect of tafamidis on exercise tolerance in 36 patients with ATTRwt CA. Exercise tolerance was evaluated by the peak oxygen uptake (peak VO₂) measured by the cardiopulmonary exercise test (CPX).</div></div><div><h3>Results</h3><div>The baseline CPX showed a mean anaerobic threshold value of 11.6 ± 2.2 ml/kg/min and peak VO₂ of 15.6 ± 4.1 ml/kg/min. Twenty-eight of the 36 patients underwent a follow-up CPX after 6 months. There was no significant change in peak VO₂ before and 6 months after tafamidis therapy (16.0 ± 4.2 vs. 14.7 ± 4.0 ml/kg/min). The baseline CPX data showed that the mean peak VO₂ was significantly lower in the increased peak VO₂ group than in the non-increased peak VO₂ group (13.7 ± 3.1 vs. 17.7 ± 4.1 ml/kg/min, <em>p</em> = 0.008). A multivariate logistic regression analysis showed that the baseline peak VO₂ value was an independent predictor of improved exercise tolerance by tafamidis therapy (odds ratio: 0.646, 95 % confidence interval: 0.449–0.930, <em>p</em> = 0.019).</div></div><div><h3>Conclusions</h3><div>Tafamidis prevents deterioration of exercise tolerance in patients with ATTRwt CA. In some patients with ATTRwt CA, exercise tolerance may improve with the use of tafamidis, and those with lower exercise tolerance before tafamidis administration are likely to show improved exercise tolerance.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 6","pages":"Pages 433-439"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755175","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 impact of ventricular remodeling on quality-of-life outcomes after Transcatheter aortic valve replacement","authors":"Pavan Reddy MD ,&nbsp;Kalyan R. Chitturi DO ,&nbsp;Ilan Merdler MD, MHA ,&nbsp;Cheng Zhang PhD ,&nbsp;Matteo Cellamare PhD ,&nbsp;Itsik Ben-Dor MD ,&nbsp;Lowell F. Satler MD ,&nbsp;Toby Rogers MD, PhD ,&nbsp;William S. Weintraub MD ,&nbsp;Ron Waksman MD","doi":"10.1016/j.jjcc.2024.10.001","DOIUrl":"10.1016/j.jjcc.2024.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Among patients with aortic stenosis, ventricular remodeling by hypertrophy can limit the augmentation of flow with exertion, even after valve intervention. However, the effect of hypertrophy on quality of life (QoL) improvement has not been studied. We aimed to determine the effect of ventricular hypertrophy on QoL outcomes after transcatheter aortic valve replacement (TAVR).</div></div><div><h3>Methods</h3><div>All patients undergoing TAVR from 2011 to 2021 at our institution were included. Groups were divided into none/mild ventricular hypertrophy (non-remodeled, NR) and moderate/severe left ventricular hypertrophy (VH) according to guideline-recommended cut-offs for left ventricular (LV) wall thickness. The Kansas City Cardiomyopathy Questionnaire (KCCQ) was utilized to assess QoL; primary outcome was KCCQ change &lt;5 from baseline to 30 days and 1 year.</div></div><div><h3>Results</h3><div>We analyzed 679 patients (NR: <em>N</em> = 389, VH: <em>N</em> = 290). Groups differed by septal thickness (1.12 cm vs. 1.44 cm, <em>p</em> &lt; 0.001), posterior wall thickness (1.08 cm vs. 1.33 cm, <em>p</em> &lt; 0.001), and LV internal diastolic diameter (4.34 cm vs. 4.19 cm, <em>p</em> = 0.006). The primary outcome was similar between NR and VH at 30 days (31.6 % vs. 28.6 %, <em>p</em> = 0.449) and 1 year (27.7 % vs. 21.5 %, <em>p</em> = 0.217). NR and VH experienced similar proportions of worsening, no change, or small, moderate, and large improvements in KCCQ score. Both groups experienced similar domain score changes and New York Heart Association class improvement. A subgroup analysis of VH patients did not reveal interaction with cavity size or stroke volume.</div></div><div><h3>Conclusion</h3><div>Patients with significant ventricular remodeling by hypertrophy and aortic stenosis have similar QoL changes after intervention compared to patients without significant remodeling.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 6","pages":"Pages 494-499"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466383","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":"Incidence, predictors, and sex differences in acute coronary syndrome overdiagnosis among patients presenting to the emergency department with acute chest pain","authors":"Giorgio Fiore MD ,&nbsp;Giuseppe Pinto MD ,&nbsp;Michele Oppizzi MD ,&nbsp;Massimo Slavich MD ,&nbsp;Carlo Gaspardone MD ,&nbsp;Federico Furlan MD ,&nbsp;Davide Valsecchi MD ,&nbsp;Alberto Margonato MD ,&nbsp;Gabriele Fragasso MD","doi":"10.1016/j.jjcc.2025.02.008","DOIUrl":"10.1016/j.jjcc.2025.02.008","url":null,"abstract":"<div><h3>Background</h3><div>In the era of high-sensitivity troponin assays, overdiagnosis of acute coronary syndrome (ACS) has become increasingly common, overriding underdiagnosis and carrying a burden of healthcare issues. This study aimed to assess the incidence, predictors, and sex differences in ACS overdiagnosis among patients presenting with chest pain (CP) to the emergency department (ED).</div></div><div><h3>Methods</h3><div>Consecutive CP patients presenting at the ED were included. Patients with other causes of CP, non-suspicious for ACS, were excluded. Six-month ACS rate was assessed in discharged patients. In ACS hospitalized patients, clinical records were analyzed to evaluate true-ACS incidence. Patients inappropriately hospitalized for ACS (ACS-overdiagnosis, false-positives) were compared to correctly discharged (true-negatives) and actual ACS patients (true-positives and false-negatives).</div></div><div><h3>Results</h3><div>From 7040 CP patients, a random sample of 1025 was included. ACS was initially diagnosed in 237 (23.1 %) patients who were hospitalized, while 788 (76.9 %) were discharged from the ED. ACS misdiagnosis occurred in 30 (2.9 %) patients: 8 (1 %) discharged patients experienced ACS at follow-up (false-negatives) while 22 (9.3 %) hospitalized for ACS were considered not to have ACS (ACS-overdiagnosis). True incident ACS at 6 months was 223 (21.8 %). Independent predictors of ACS overdiagnosis were electrocardiographic alterations, troponin <em>T</em> &gt; 99° percentile, and male sex, while women were older with lower pre-test likelihood of ACS according to ED physicians, with a higher rate of early discharge but similar outcomes.</div></div><div><h3>Conclusions</h3><div>ACS overdiagnosis is more frequent than underdiagnosis, carrying potential issues for the healthcare system. Patients with ACS overdiagnosis were more commonly men with elevated high-sensitivity troponin, often indistinguishable from true-ACS patients according to standard care.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 6","pages":"Pages 507-509"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425575","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":"Characteristics of anxiety about returning to work after implantable cardioverter defibrillator implantation in Japan.","authors":"Yasunobu Yamagishi, Taichi Watabe, Daiki Nakahara, Kazunari Taniguchi, Yasushi Oginosawa, Masaharu Kataoka","doi":"10.1016/j.jjcc.2025.05.019","DOIUrl":"10.1016/j.jjcc.2025.05.019","url":null,"abstract":"<p><strong>Background: </strong>Implantable cardioverter defibrillator (ICD) implantation is an established treatment that reduces the risk of sudden cardiac death; however, patients with ICD have been shown to be anxious. This study aimed to identify the characteristics of anxiety about returning to work after ICD implantation and to explore reemployment support.</p><p><strong>Methods: </strong>Data from 56,002 patients who worked before admission to the cardiology department were analyzed using the Inpatient Clinico-Occupational Database of the Rosai Hospital Group (2011-2022). The patients were further categorized into two groups depending on whether ICD surgery was performed during hospitalization. Among patients who had undergone ICD surgery, multivariable logistic regression models were used to estimate the relationships between the prehospitalization occupational data, clinical data, and anxiety about returning to work.</p><p><strong>Results: </strong>The ICD group had a higher rate of anxiety about returning to work than the non-ICD group (26.2 % vs. 16.1 %; p < 0.001). In the ICD group, younger age at discharge, female sex, self-employed, and longer working hours per day were independently associated with anxiety about returning to work. Among patients experiencing anxiety about returning to work, compared with the non-ICD group, the ICD group had a lower rate of anxiety about workplace understanding (17.9 % vs. 35.0 %; p = 0.008); but a higher rate of anxiety about workplace life (37.5 % vs. 18.3 %; p < 0.001).</p><p><strong>Conclusions: </strong>The ICD group had a higher rate of anxiety about returning to work. This study suggests that interventions for anxiety about returning to work, especially regarding life in the workplace, are important for working populations with ICDs.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199236","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":"Echocardiographic parameters and risk factors for cardiomyopathy in Japanese childhood cancer survivors: a report from St. Luke's lifetime cohort study.","authors":"Naoko Ichikawa, Daisuke Hasegawa, Kyoko Nagase, Michiyo Gunji, Kyoko Kobayashi, Yosuke Hosoya, Miwa Ozawa, Ken Takahashi","doi":"10.1016/j.jjcc.2025.05.018","DOIUrl":"https://doi.org/10.1016/j.jjcc.2025.05.018","url":null,"abstract":"<p><strong>Background: </strong>Cardiac dysfunction is a life-threatening late complication among childhood cancer survivors (CCSs), with incidence rates only increasing over time, highlighting the importance of long-term follow-up. Nevertheless, detailed investigations in Japanese CCSs have been lacking.</p><p><strong>Methods: </strong>This study targeted CCSs aged 18 years or older who were diagnosed with childhood cancer ≥10 years prior to recruitment and survived without cancer for ≥5 years, and included their siblings. CCSs were divided into two groups: those with cancer therapy-related cardiac dysfunction (CTRCD) [left ventricular ejection fraction (LVEF) ≤53 %] and those without CTRCD. We analyzed cardiac function and investigated the risk factors for CTRCD. The cut-off value for the total cumulative dose of anthracycline that induced CTRCD was determined using the receiver operating characteristic curve.</p><p><strong>Results: </strong>A total of 108 CCSs (median age, 25 years) and 26 siblings (median age, 23 years) were included in the analysis. Among the CCSs, 15 (14 %) were classified as having CTRCD (mean LVEF, 51.9 % ± 4.7 %). The CTRCD group exhibited a significantly decreased left ventricular global longitudinal strain (mean, 18.4 ± 2.9 %; p < 0.01). In particular, local strain values at the basal septal (p = 0.03), anteroseptal (p < 0.01), and mid anteroseptal (p = 0.03) segments were significantly reduced. A cumulative anthracycline dose exceeding 150 mg/m² significantly increased the risk of developing CTRCD (p < 0.01).</p><p><strong>Conclusions: </strong>Given that 14 % of CCSs developed cardiomyopathy during young adulthood, regular follow-up observations, especially among those who received anthracycline >150 mg/m², are imperative.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199237","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":"Performance of convolutional neural network-enhanced electrocardiography in detecting acute coronary syndrome: focusing on subtypes and reduced leads.","authors":"Koichiro Hori, Shinya Suzuki, Naomi Hirota, Jun Motogi, Takuya Umemoto, Hiroshi Nakai, Wataru Matsuzawa, Tsuneo Takayanagi, Akira Hyodo, Keiichi Satoh, Takuto Arita, Naoharu Yagi, Mikio Kishi, Hiroto Kano, Shunsuke Matsuno, Yuko Kato, Takayuki Otsuka, Tokuhisa Uejima, Junji Yajima, Yasuo Okumura, Yuji Oikawa, Takeshi Yamashita","doi":"10.1016/j.jjcc.2025.05.014","DOIUrl":"10.1016/j.jjcc.2025.05.014","url":null,"abstract":"<p><strong>Background: </strong>Early and accurate diagnosis of acute coronary syndrome (ACS), particularly non-ST-elevation ACS (NSTE-ACS), remains a critical challenge in emergency settings. Despite advancements in diagnostic modalities, conventional electrographic (ECG) interpretation often fails to detect subtle ischemic changes, particularly in NSTE-ACS, highlighting the need for artificial intelligence (AI)-driven approaches.</p><p><strong>Methods: </strong>This study retrospectively analyzed data from a single-center cohort (Shinken Database 2010-2022, n = 32,167) to develop AI-driven ECG models for ACS detection. A convolutional neural network (CNN) model and an integrated neural network (INN) model, which incorporated diagnostic probabilities for ACS subtypes and target vessels, were evaluated using area under the receiver operating characteristics curve (AUROC), area under the precision-recall curve (AUPRC), sensitivity, and F1 scores for all‑lead ECG and reduced‑lead ECG models.</p><p><strong>Results: </strong>The CNN model using all‑lead ECG achieved an AUROC of 0.877, an AUPRC of 0.391, and an F1 score of 0.184, while the INN model showed similar results (AUROC 0.889, AUPRC 0.356, and F1 score 0.188). For subtypes related to NSTE-ACS, the CNN model using all‑lead ECG (CNN model using double‑lead ECG) model achieved an AUROC of 0.785 (0.783), sensitivity of 0.723 (0.672), and specificity of 0.699 (0.768) for unstable angina, and an AUROC of 0.795 (0.786), sensitivity of 0.527 (0.567), and specificity of 0.878 (0.849) for NSTE-myocardial infarction. Among patients with troponin testing (n = 4169), the CNN model achieved a sensitivity of 76 %, a positive predictive rate (PPR) of 32 %, and an F1 score of 0.452, while the INN model achieved 78 %, 35 %, and 0.483, respectively. The leads I and II model demonstrated the highest AUROC among reduced‑lead models (0.866), with F1 scores in patients with troponin testing of 0.395 and 0.390 for the CNN and INN models, respectively.</p><p><strong>Conclusion: </strong>Both CNN and INN-enhanced ECGs demonstrated good performance in detecting ACS including NSTE-ACS with subtle ischemic ECG changes. However, low PPR limit these models' standalone diagnostic utility. Instead, they hold promise as supportive tools, especially in resource-limited settings where reduced‑lead ECGs may be beneficial.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187098","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":"Beyond perfusion imaging: the growing clinical role of myocardial blood flow quantification by SPECT.","authors":"Yuka Otaki","doi":"10.1016/j.jjcc.2025.05.012","DOIUrl":"10.1016/j.jjcc.2025.05.012","url":null,"abstract":"<p><p>Although perfusion imaging is effective for evaluating relative myocardial blood flow (MBF) distribution, it has a well-known limitation in single photon emission computed tomography (SPECT): it often underestimates ischemia, particularly in patients with three-vessel coronary artery disease or left main trunk disease. In such cases, global reductions in MBF may not create significant perfusion defects, complicating the accurate detection of ischemia. In contrast, positron emission tomography (PET) has long offered absolute MBF quantification through dynamic imaging, allowing for a more precise assessment of coronary artery disease and microvascular dysfunction. By integrating absolute MBF quantification with perfusion imaging, PET has significantly improved diagnostic accuracy in ischemia evaluation. Relative to PET, traditional SPECT has struggled to achieve comparable MBF quantification due to its lower sensitivity and spatial resolution. However, recent advancements in semiconductor-based detector technology have enabled SPECT to approximate PET's quantification accuracy. Emerging studies indicate that modern SPECT systems can now deliver absolute MBF values with enhanced reliability, opening new possibilities for clinical application. Despite PET's superior quantification capability, its availability remains confined to specialized facilities, limiting its broader clinical use. In this context, the implementation of SPECT to quantify MBF presents a promising avenue for expanding access to more accurate ischemia assessment. Enhancing the diagnostic precision of SPECT could improve patient stratification and treatment planning, particularly in environments where PET is not readily available. This review summarizes recent advancements in MBF quantification using SPECT, discusses its clinical implications, and explores the prospects for its integration into routine cardiovascular imaging.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182188","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":"Quantitative flow ratio-based revascularization on clinical outcomes in multivessel disease STEMI patients with chronic kidney disease.","authors":"Huimin Xian, Yanzong Liu, Yongpeng Zou, Dandan Zhang, Wei Xu, Xinxin Liu, Jincai Fu, Jianjun Wu, Fan Yang, Ruoxi Zhang","doi":"10.1016/j.jjcc.2025.05.016","DOIUrl":"10.1016/j.jjcc.2025.05.016","url":null,"abstract":"<p><strong>Background: </strong>Patients with multivessel disease and ST-elevation myocardial infarction (MVD-STEMI) have a poor prognosis but benefit from quantitative flow ratio (QFR)-based revascularization. The influence of chronic kidney disease (CKD) on this benefit is unclear. This study aimed to evaluate differences in clinical outcomes of QFR-based revascularization in MVD-STEMI patients with or without CKD.</p><p><strong>Methods: </strong>A total of 495 patients with MVD-STEMI who underwent primary percutaneous coronary intervention (PCI) were included in the study. Patients were divided into nonCKD and CKD cohort, and were further stratified into functional complete revascularization (FCR) and functional incomplete revascularization (FIR) layer based on QFR assessments. The primary outcomes were 3-year major adverse cardiovascular events (MACEs).</p><p><strong>Results: </strong>The incidence of MACEs was lower in FCR than FIR layers in both nonCKD and CKD cohorts (p = 0.014, p = 0.008), but the percentage decrease in MACEs from FIR to FCR in CKD was greater than that in nonCKD cohort (53.1 % vs 49.7 %). The baseline QFR measurements were significantly lower in FIR patients with CKD than with nonCKD (p < 0.001). The residual SYNTAX score derived from QFR (RSS_QFR) was significantly associated with the increased risk of MACEs in both cohorts (p < 0.001). Incorporating RSS_QFR into prognostic models improved MACE prediction, especially in CKD cohort than in nonCKD cohort (difference in area under the curve = -0.143 vs difference in area under the curve = -0.133).</p><p><strong>Conclusions: </strong>In MVD-STEMI patients, the CKD population showed greater absolute risk reduction, which could be attributed to either their higher baseline risk or possible enhanced QFR efficacy. The ability of the QFR-based scoring system to predict prognosis was stronger in the CKD population than in the nonCKD population.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187099","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":"Current findings and challenges on frailty, sarcopenia, and cachexia in older patients with heart failure: insights from the FRAGILE-HF study.","authors":"Shota Uchida, Kentaro Kamiya, Masashi Yamashita, Takumi Noda, Nobuyuki Kagiyama, Yuya Matsue","doi":"10.1016/j.jjcc.2025.05.013","DOIUrl":"10.1016/j.jjcc.2025.05.013","url":null,"abstract":"<p><p>Frailty has increasingly been recognized as an important factor influencing the prognosis of older patients with heart failure (HF). While previous studies have primarily focused on physical frailty, the need for comprehensive frailty assessments, including assessments of cognitive and social aspects, has been emphasized for effective HF management. Although the importance of multidimensional frailty assessment has been highlighted in the past, specific indicators for defining multidimensional frailty and its relationship with prognosis have not been clearly established to date. The FRAGILE-HF cohort study is a multicenter prospective cohort study that investigates the prevalence, overlap, and prognostic impact of multidimensional frailty in older patients with HF. The primary objective of this project was to address issues related to multidimensional frailty in older patients with HF. Additionally, this study provides extensive foundational data not only on frailty but also on sarcopenia and cachexia, which are commonly observed in older patients with HF. This review summarizes the current understanding of physical and non-physical frailty, sarcopenia, and cachexia in patients with HF, with a focus on insights from the FRAGILE-HF registry.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187097","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}