{"title":"Letter to the Editor.","authors":"Ahmed Smman, Mahmood Ahmad","doi":"10.1016/j.jjcc.2025.09.001","DOIUrl":"10.1016/j.jjcc.2025.09.001","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029911","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":"Approach to contrast agent-induced acute kidney injury after elective percutaneous coronary intervention in patients with diabetes.","authors":"Sefa Erdi Ömür, Çağrı Zorlu","doi":"10.1016/j.jjcc.2025.08.016","DOIUrl":"10.1016/j.jjcc.2025.08.016","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015465","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":"Impact of preoperative beta-hydroxy-beta-methylbutyrate, arginine, and glutamine supplementation on inflammation in patients with cardiac surgery: A secondary analysis of a randomized controlled trial.","authors":"Masato Ogawa, Seimi Satomi-Kobayashi, Naofumi Yoshida, Kodai Komaki, Takumi Hirabayashi, Kumiko Wakida, Saori Saitoh, Takeshi Inoue, Tomoya Yamashita, Yoshitada Sakai, Michiko Takahashi, Ken-Ichi Hirata","doi":"10.1016/j.jjcc.2025.08.017","DOIUrl":"10.1016/j.jjcc.2025.08.017","url":null,"abstract":"<p><strong>Background: </strong>Preoperative physical frailty is a significant predictor of adverse postoperative outcomes in older patients undergoing cardiac surgery. Inflammation plays a crucial role in the development of frailty and contributes to postoperative complications. This study investigated the effects of preoperative beta-hydroxy-beta-methylbutyrate (HMB), arginine, and glutamine supplementation on inflammatory markers, nutritional status, and renal function in older patients undergoing cardiac surgery.</p><p><strong>Methods: </strong>This was a secondary analysis of a single-center, open-label, randomized controlled trial. Patients aged ≥65 years scheduled for elective cardiac surgery were randomized to receive either HMB supplementation (1200 mg HMB, 7000 mg l-glutamine, and 7000 mg L-arginine, twice daily) or routine care for at least two weeks before surgery. Serum levels of tumor necrosis factor-alpha (TNF-α), and other biochemical markers were measured at baseline, pre-surgery, and two weeks post-surgery.</p><p><strong>Results: </strong>Forty-four patients (mean age 72.5 years, 36 % women) were analyzed. Preoperative HMB supplementation significantly reduced pre-surgery serum TNF-α levels compared to the control group (0.85 ± 0.28 pg/mL vs. 1.10 ± 0.44 pg/mL, p = 0.039). However, this difference was not observed two weeks post-surgery. No significant differences were observed in C-reactive protein levels or other nutritional markers between the two groups at any time point.</p><p><strong>Conclusions: </strong>Preoperative supplementation with a combination of HMB, glutamine, and arginine was effective in reducing preoperative TNF-α levels in older patients undergoing cardiac surgery, suggesting a potential anti-inflammatory effect. This anti-inflammatory effect suggests a potential mechanism for improving postoperative outcomes and warrants further investigation. Registration number of Clinical Trial: UMIN000030490 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034773).</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008296","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":"Biomarker-based pre-heart failure screening in a middle-aged rural population.","authors":"Yuichiro Mori, Shunsuke Natori, Toshio Arai, Fujio Kakuya, Shingo Fukuma","doi":"10.1016/j.jjcc.2025.08.019","DOIUrl":"10.1016/j.jjcc.2025.08.019","url":null,"abstract":"<p><strong>Background: </strong>Guidelines recommend biomarker-based screening for pre-heart failure (pre-HF) among at-risk populations. Although the asymptomatic nature of pre-HF necessitates proactive screening, real-world implementation remains understudied. This retrospective study analyzed data from a regional pre-HF screening initiative, integrated into annual health screenings, to evaluate: (1) the prevalence of elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, (2) associated echocardiographic findings, and (3) adherence across the screening-to-consultation pathway.</p><p><strong>Methods: </strong>This study included individuals aged 40-74 years who received pre-HF screening in Furano City, Japan, from October 2023 to March 2024. During the study period, NT-proBNP testing was incorporated into an existing annual health screening program. Participants with elevated NT-proBNP levels (≥125 pg/mL) were referred for cardiology consultation and echocardiography.</p><p><strong>Results: </strong>Among 1585 screening attendees (mean age, 54.5 years; females, 57.0 %), 1579 (99.6 %) underwent NT-proBNP testing. Elevated levels were found in 118 (7.5 %) individuals. These individuals were older, female, and had a higher blood pressure. Of these 118 individuals, only 55 (46.6 %) attended the follow-up cardiology consultation. Among those evaluated with echocardiography, 22 (40.0 %) had abnormal findings (increased left atrial volume index and left ventricular end-diastolic volume index being the most common).</p><p><strong>Conclusions: </strong>Integrating NT-proBNP testing into a public health screening program achieved near-perfect testing adherence. The program identified 7.5 % of the general middle-aged population as having pre-HF with predominantly benign echocardiographic changes, highlighting important prevention opportunities. However, a critical drop-off in adherence to specialist consultation highlights a major implementation gap. Optimizing the post-screening pathway is essential to maximize the potential benefits of population-wide pre-HF screening.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008246","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":"Artificial intelligence in HFpEF: Diagnosis, prognosis, and management strategies.","authors":"Jeong-Eun Yi, Jung Sun Cho","doi":"10.1016/j.jjcc.2025.08.018","DOIUrl":"10.1016/j.jjcc.2025.08.018","url":null,"abstract":"<p><p>Heart failure with preserved ejection fraction (HFpEF) accounts for more than half of all HF cases and its incidence and prevalence continue to increase, with a substantial burden of morbidity and mortality. Despite advances in our understanding of heterogeneous pathophysiology underlying HFpEF, the diagnosis, risk assessment, and management of this disease entity remain challenging in everyday practice. Artificial intelligence (AI) algorithm can handle large amounts of complex data and machine learning (ML), a subfield of AI, allows for the identification of relevant patterns by learning from big data. Considering the vast datasets generated from patients with HFpEF over the course of their illness, the application of AI and ML algorithms in HFpEF has the potential to improve patient care through enhancing early and precise diagnosis, personalized treatment based on phenotypes, and efficient monitoring. In this review, we provide an overview of the use of AI and ML in patients with HFpEF, focusing on diagnosis, phenotyping, risk stratification and prognosis, and management. Additionally, we discuss the limitations in the clinical adaptability of AI and suggest the future research directions for developing novel and feasible AI-based HFpEF model.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008283","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":"Predictive value of speckle tracking echocardiography for left ventricular thrombus formation.","authors":"Macit Kalçık","doi":"10.1016/j.jjcc.2025.08.014","DOIUrl":"10.1016/j.jjcc.2025.08.014","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Novel tailored very-high-power short-duration radiofrequency ablation around the esophagus guided by left atrial voltage","authors":"Yasuharu Matsunaga-Lee MD, Yasuyuki Egami MD, Mizuki Ohsuga MD, Masaru Abe MD, Hiroaki Nohara MD, Shodai Kawanami MD, Kohei Ukita MD, Akito Kawamura MD, Koji Yasumoto MD, Naotaka Okamoto MD, Masamichi Yano MD, Masami Nishino MD, PhD, FJCC","doi":"10.1016/j.jjcc.2025.03.005","DOIUrl":"10.1016/j.jjcc.2025.03.005","url":null,"abstract":"<div><h3>Background</h3><div>Very-high-power short-duration (vHPSD) radiofrequency (RF) ablation is expected to make shallow lesions and reduce collateral damage. This study investigated the power setting and quality of acute lesions performed by a modified vHPSD RF ablation guided by left atrial (LA) voltage around the esophagus.</div></div><div><h3>Methods</h3><div>A voltage map was obtained by an OCTARAY catheter (3-mm spacing) during pacing from the high right atrium. The power setting of the vHPSD was modified according to the LA voltage around the esophagus: 65 W for <1.8 mV, 75 W for <2.7 mV, and 90 W for ≥2.7 mV. The incidence of gaps after the 1st pass and spontaneous, isoproterenol-induced, and adenosine-induced reconnections were evaluated. The limit of esophagus temperature rise was set at 40 °C. Gastric hypomotility was assessed.</div></div><div><h3>Results</h3><div>A modified vHPSD RF ablation guided by the LA voltage was performed for 450 lesions in 32 patients (median age 73 years, 15 females). The RF setting was 65 W for 221 lesions (49 %), 75 W for 104 lesions (23 %), and 90 W for 125 lesions (28 %). Gaps after the 1st pass were observed in 3 patients (9.4 %). Any reconnections were observed in 6 patients (19 %). Esophageal temperature rises of >40 °C were observed at 39 lesions. RF ablation at the areas modified to 65 W more frequently resulted in esophageal temperature rise of >40 °C than the areas modified to 75 W or 90 W (12 % vs. 5.2 %, <em>p</em> = 0.017). No-gap-no-reconnection lesions were more frequently achieved for lesions ablated with 65 W (216/221 lesions, 98 %) than for lesions ablated with 90 W (113/125 lesions, 90 %, <em>p</em> = 0.004). No gastric hypomotility and atrio-esophageal fistulae were observed.</div></div><div><h3>Conclusions</h3><div>The modified vHPSD RF ablation guided by the LA voltage was a reasonable option for reducing the power setting without compromising the acute pulmonary vein isolation quality.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"86 3","pages":"Pages 249-255"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Safety and effectiveness of self-expanding TAVR in Japanese dialysis patients with severe aortic stenosis: 1-year outcomes","authors":"Koki Shishido MD , Futoshi Yamanaka MD, PhD , Noriaki Moriyama MD , Tomoki Ochiai MD , Hirokazu Miyashita MD , Tsuyoshi Yamabe MD , Kenichiro Noguchi MD , Tohru Asai MD, PhD , Shuzo Kobayashi MD, PhD , Yu Jung Yeh MS , Shigeru Saito MD, FJCC","doi":"10.1016/j.jjcc.2025.03.008","DOIUrl":"10.1016/j.jjcc.2025.03.008","url":null,"abstract":"<div><h3>Background</h3><div>In Japan, transcatheter aortic valve<span> replacement (TAVR) with self-expanding valves (SEV) was approved for patients with severe aortic stenosis (AS) and on chronic maintenance dialysis in May 2023. This study assessed the safety and efficacy of TAVR with SEVs in this patient population.</span></div></div><div><h3>Methods</h3><div>This prospective, non-randomized, single-center study evaluated the safety and effectiveness of TAVR using a supra-annular SEV in Japanese patients with severe AS on chronic maintenance dialysis. The primary endpoint of all-cause mortality or disabling stroke and several secondary endpoints were assessed at 12 months.</div></div><div><h3>Results</h3><div><span><span><span>Ten patients underwent TAVR using the Evolut platform (Medtronic, Minneapolis, MN, USA) between June 2020 and August 2022. Mean patient age was 80.0 ± 5.5 years and 70 % were male. Mean Society of Thoracic Surgeons Predicted Risk of Mortality score was 7.4 ± 2.2 %. At 1 year, the primary endpoint occurred in two patients (20 %), and there were no strokes, aortic valve reinterventions, or new </span>permanent pacemaker implantations. Valve </span>hemodynamics improved postprocedure and were maintained in all patients reaching 12-month follow-up (mean effective orifice area 2.1 ± 0.4 cm</span><sup>2</sup><span>, mean gradient 6.8 ± 1.6 mmHg), and no patients had moderate or severe aortic regurgitation.</span></div></div><div><h3>Conclusions</h3><div>Japanese dialysis patients with severe AS who underwent TAVR using SEVs experienced favorable clinical and hemodynamic outcomes at 1-year follow-up. Further investigations are needed to assess long-term outcomes in this patient population.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"86 3","pages":"Pages 272-279"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Finerenone and cardiovascular outcomes in heart failure with mildly reduced and preserved ejection fraction: A propensity-matched analysis","authors":"Tess Calcagno PharmD, MD , Rochell Issa MD , Faysal Massad MD , David Kaelber MD , Trejeeve Martyn MD , Arianne Agdamag MD","doi":"10.1016/j.jjcc.2025.06.013","DOIUrl":"10.1016/j.jjcc.2025.06.013","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure with preserved and mildly reduced ejection fraction (HFpEF/HFmrEF) lacks effective therapies. Finerenone<span>, a non-steroidal mineralocorticoid receptor antagonist, may offer cardiovascular benefits in this population.</span></div></div><div><h3>Methods</h3><div>We conducted a retrospective, propensity-matched cohort study using the TriNetX network to compare outcomes in HFpEF/HFmrEF patients treated with finerenone versus no MRA. Primary outcomes included all-cause mortality, acute heart failure hospitalization, and major adverse cardiovascular events (MACE).</div></div><div><h3>Results</h3><div>Among 304 matched patients (<em>n</em> = 152 per group), finerenone was associated with significantly lower 1-year mortality (6.6 % vs. 19.7 %, HR 0.24, <em>p</em> = 0.001) and heart failure hospitalization (10.5 % vs. 21.7 %, HR 0.47, <em>p</em> = 0.01). MACE was also reduced at 1 year (35.5 % vs. 47.4 %, HR 0.67, <em>p</em> = 0.022).</div></div><div><h3>Conclusion</h3><div>Finerenone use was linked to improved short-term cardiovascular outcomes in patients with HFpEF and HFmrEF, supporting its potential role in this highrisk population.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"86 3","pages":"Pages 314-315"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540345","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}