Journal of cardiology最新文献

{"title":"Mitral valve prolapse: New clinical and scientific insights in 2026.","authors":"Masashi Yamaguchi, Radha Madhyastha, Koji Furukawa, Koichi Kaikita, Nozomi Watanabe","doi":"10.1016/j.jjcc.2026.09.004","DOIUrl":"10.1016/j.jjcc.2026.09.004","url":null,"abstract":"<p><p>Mitral valve prolapse (MVP) is a prevalent valvular abnormality affecting 2-3% of the general population. MVP has two distinct anatomical subtypes: Barlow's disease and fibroelastic deficiency; each reflects different underlying structural and pathological processes. While most individuals generally remain asymptomatic with subclinical regurgitation, some develop significant mitral regurgitation followed by heart failure. A malignant form of MVP, marked by bileaflet prolapse, mitral annular disjunction (MAD), and myocardial fibrosis, is increasingly recognized as a substrate for ventricular arrhythmias and sudden cardiac death. In addition to transthoracic/transesophageal echocardiography, cardiac magnetic resonance is expected to contribute to risk stratification, particularly in identifying high-risk features such as MAD and fibrosis. As diagnostic capabilities continue to advance, integrating phenotypic, imaging, and electrophysiological insights will be key to optimizing outcomes in patients with MVP. This review provides a comprehensive overview of MVP, encompassing its epidemiology, molecular mechanisms, imaging evaluation, and current therapeutic strategies.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943974","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":"Discharge use of mineralocorticoid receptor antagonists and long-term outcomes in HFpEF.","authors":"Takashi Morinaga, Masahiro Natsuaki, Akihiro Isotani, Kenji Kanenawa, Ko Yamamoto, Masato Fukunaga, Ayumu Yajima, Makoto Hyodo, Shinichi Shirai, Kenji Ando, Koichi Node","doi":"10.1016/j.jjcc.2026.09.003","DOIUrl":"10.1016/j.jjcc.2026.09.003","url":null,"abstract":"<p><strong>Background: </strong>To examine whether mineralocorticoid receptor antagonist (MRA) use at discharge after hospitalization for acute decompensated heart failure (ADHF) with preserved ejection fraction is associated with long-term clinical outcomes.</p><p><strong>Methods: </strong>We conducted a single-center retrospective study of adults hospitalized with ADHF in 2015. Patients with left ventricular ejection fraction ≥50% who were discharged alive were included (time zero at discharge). Exposure was MRA (spironolactone or eplerenone) prescribed at discharge. The primary endpoint was time to first occurrence of all-cause death or rehospitalization for heart failure (HF); secondary endpoints were each component.</p><p><strong>Results: </strong>Among 194 patients, 93 (47.9%) received an MRA at discharge. Median follow-up was 3.5 years (IQR, 1.4-5.1). The 3-year cumulative incidence of the primary composite was lower with MRA than without MRA (50.5% vs 72.2%; log-rank p = 0.02). The 3-year cumulative incidences of all-cause death and HF rehospitalization were numerically lower with MRA (31.1% vs 44.5%, p = 0.055; and 31.1% vs 44.5%, p = 0.09, respectively). After multivariable adjustment, MRA use was associated with lower hazard of the primary composite [hazard ratio (HR) 0.55, 95% confidence interval (CI) 0.38-0.81; p = 0.002], all-cause death (HR 0.58, 95% CI 0.36-0.92; p = 0.02), and HF rehospitalization (HR 0.56, 95% CI 0.34-0.91; p = 0.02).</p><p><strong>Conclusions: </strong>In patients with preserved ejection fraction discharged after ADHF, MRA use at discharge was associated with a lower hazard of the composite of all-cause death or HF rehospitalization.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944966","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":"Frailty disproportionately amplifies in-hospital mortality in STEMI compared to NSTEACS following an invasive strategy.","authors":"Francisco Buendia-Santiago, Antonio Meseguer-Hernández, José Manuel Andreu-Cayuelas, Jaime Merino-Romero, María Isabel Baños-Maturano, Claudia Azcondo-San Segundo, Irene González-Fernández, Leticia Risco-Eres, María Belén Villamarín-Heredia, Leticia Jaulent-Huertas, Irene Azenaia Garcia-Escribano-García, José Manuel Cubillas-Para, Pedro Cano-Vivar, Rosario Mármol-Lozano, Juan Antonio Castillo-Moreno","doi":"10.1016/j.jjcc.2026.09.001","DOIUrl":"10.1016/j.jjcc.2026.09.001","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic effect of liver fibrosis marker in systolic heart failure with cardiac nerve denervation and renal dysfunction.","authors":"Ryosuke Hatano, Takahiro Doi, Satoshi Kimura, Rintaro Furuoka, Kosuke Uruno, Koki Morishita, Ken Masuda, Ryo Nishikawa, Kaoru Komuro, Hiroyuki Iwano, Daigo Nagahara, Satoshi Yuda, Akiyoshi Hashimoto, Tomoaki Nakata","doi":"10.1016/j.jjcc.2026.09.002","DOIUrl":"10.1016/j.jjcc.2026.09.002","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the prognostic impact of liver fibrosis on cardiac sympathetic innervation and renal function in patients with heart failure (HF) compared with the well-established prognostic value of cardiorenal and hepatorenal linkage.</p><p><strong>Methods: </strong>In 525 consecutive patients with HF with left ventricular ejection fraction <50%, the fibrosis-5 index (Fib-5) was calculated to evaluate hepatic dysfunction and liver fibrosis. After ¹²³I-metaiodobenzylguanidine (MIBG) scintigraphy, patient outcomes, with lethal cardiac events (CEs) as the primary endpoint, were evaluated for a mean interval of 36.1 ± 26.8 months. CEs were defined as sudden cardiac death, death from heart failure, detection of fatal ventricular arrhythmia, and appropriate implantable cardioverter defibrillator therapy for fatal ventricular arrhythmia.</p><p><strong>Results: </strong>During follow-up, CEs were documented in 139 patients with HF. Fib-5, estimated glomerular filtration rate (eGFR), and the standardized heart-to-mediastinum ratio of MIBG activity (sHMR) were significantly reduced in CEs group compared with those in the non-CEs group. The overall multivariate analysis revealed that these parameters were significant independent determinants of CEs. Combining the cut-off values of Fib-5 (<-13.6), eGFR (<41.0 mL/min/1.73 m²), and late sHMR (<1.83), determined by receiver operating characteristic curve analysis further successfully differentiated patients with HF at higher risk for CEs from other patients with HF.</p><p><strong>Conclusions: </strong>Liver fibrosis parameters are also independent prognostic factors along with cardiac sympathetic nervous function and renal dysfunction in patients with HF, potentially enabling additive risk stratification of these patients.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905990","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":"Uric Acid and the Risk of Aortic Aneurysm and Dissection: Insights from a Long-Term Prospective Cohort Study of 468,223 Participants in the UK Biobank","authors":"Peng Yang MSc,&nbsp;Xiaoyang Zhang MSc,&nbsp;Wentao Dong MSc,&nbsp;Suwei Chen PhD,&nbsp;Haiou Hu PhD,&nbsp;Zhiyu Qiao PhD,&nbsp;Chengnan Li PhD,&nbsp;Yipeng Ge PhD,&nbsp;Junming Zhu PhD","doi":"10.1016/j.jjcc.2026.01.017","DOIUrl":"10.1016/j.jjcc.2026.01.017","url":null,"abstract":"<div><h3>Background</h3><div>Uric acid (UA) is a routinely measured biomarker linked to cardiovascular and metabolic disorders, but its role in the development of aortic aneurysm (AA) and aortic dissection (AD) remains unclear. This study aimed to evaluate the association between UA levels and incident AA/AD.</div></div><div><h3>Methods</h3><div>We included 468,223 participants without baseline AA/AD from the UK Biobank prospective cohort. Baseline UA was measured and categorized by quartiles. The primary outcome was incident AA/AD. Cox proportional hazards models and restricted cubic spline (RCS) analyses were employed. Subgroup analyses were performed by age, sex, smoking status, blood pressure status, and history of coronary artery or cerebrovascular disease.</div></div><div><h3>Results</h3><div>During a median follow-up of 15.1 years, 4,504 AA/AD events were recorded. At baseline, elevated UA levels were significantly associated with decreased estimated glomerular filtration rate and increased C-reactive protein levels. AA/AD incidence increased across UA quartiles. In fully adjusted models, hazard ratios (HRs) for AA/AD were 1.00 (reference), 1.03 (95% CI 0.92-1.15), 1.04 (95% CI 0.92-1.16), and 1.17 (95% CI 1.04-1.31) from lowest to highest UA quartile. RCS analyses indicated a linear association between UA and AA/AD risk. The association was significant for AA (Q4 vs Q1: HR 1.15, 95% CI 1.02-1.31), but not for AD (Q4 vs Q1: HR 1.30, 95% CI 0.90-1.86). Subgroup analyses showed stronger associations in participants younger than 60 years, previous smokers, and those without prior coronary artery or cerebrovascular disease. Notably, the association remained statistically significant even in participants with clinically normal blood pressure.</div></div><div><h3>Conclusions</h3><div>Elevated UA levels are independently associated with a higher risk of AA/AD, particularly AA. This association persists independently of hypertension and may be linked to inflammatory mechanisms and renal dysfunction. These findings support the role of UA as a potential biomarker for risk assessment and prevention of AA, especially in high-risk populations.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"88 3","pages":"Pages 159-165"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137466","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":"Comments on: “Genotype-phenotype associations in sarcomeric hypertrophic cardiomyopathy associated with mutations in the MYBPC3 gene: Systematic review and meta-analysis”","authors":"Zhenxing Deng MD,&nbsp;Shuangqi Long MD,&nbsp;Bin Cao MD","doi":"10.1016/j.jjcc.2026.01.015","DOIUrl":"10.1016/j.jjcc.2026.01.015","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"88 3","pages":"Pages 228-229"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132109","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":"Cheyne-Stokes respiration screening using cyclic variation in heart rate detected by Holter electrocardiogram","authors":"Mai Kobayashi MS,&nbsp;Eriko Yoshioka MS,&nbsp;Tsuyoshi Yamauchi BS,&nbsp;Fusae Kawana MS,&nbsp;Mitsue Kato RT,&nbsp;Jun Shitara MD, PhD,&nbsp;Hiroki Matsumoto MD, PhD,&nbsp;Azusa Murata MD, PhD,&nbsp;Megumi Shimizu MD, PhD,&nbsp;Shoichiro Yatsu MD, PhD,&nbsp;Takatoshi Kasai MD, PhD, FJCC","doi":"10.1016/j.jjcc.2026.05.010","DOIUrl":"10.1016/j.jjcc.2026.05.010","url":null,"abstract":"<div><h3>Background</h3><div>Cheyne-Stokes respiration (CSR) is a major form of central sleep apnea in patients with heart failure and is associated with mortality in these patients. Although full polysomnography is required for CSR diagnosis, access may be limited. Cyclic variation of heart rate (CVHR) detected by Holter electrocardiogram reflects changes in cardiac autonomic activity associated with apnea–hypopnea events and is easier to perform than polysomnography.</div></div><div><h3>Methods</h3><div>We examined whether RR interval shortening time in the CVHR analysis could be useful for screening CSR. In this study, 41 patients were analyzed. Holter electrocardiogram and polysomnography were simultaneously performed. CVHR events were classified as CSR or not based on RR interval shortening time, and the percentage of CSR (%CSR), defined as the ratio of total CSR duration to time in bed, was measured.</div></div><div><h3>Results</h3><div>There were 27 patients with heart failure. The patients tended to have severe sleep-disordered breathing and an apnea–hypopnea index of 38.9 (24.7), and seven patients had predominantly central events. Based on %CSR determined by polysomnography with manual scoring ≧20%, 10 patients were labeled as CSR-positive and 31 as CSR-negative. There was moderate-to-good reliability between the percentage of CSR determined via CVHR analysis and the percentage of CSR determined via polysomnography [intraclass correlation coefficient = 0.74 (0.56, 0.85); <em>p</em> &lt; 0.001].</div></div><div><h3>Conclusions</h3><div>Holter electrocardiograms are performed for many patients with heart failure and are better tolerated than overnight polysomnography. Our method of using CVHR detected by Holter electrocardiogram could be helpful for CSR screening.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"88 3","pages":"Pages 205-212"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015630","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 frequency and impact of previous admissions within 90 days of subsequent hospitalization for acute myocarditis: An analysis of the Nationwide Readmission Database","authors":"Azreen Afzal MBChB,&nbsp;Adnan Qureshi MD,&nbsp;Bikem Bozkurt MD,&nbsp;Gregg C. Fonarow MD,&nbsp;Gregory Y.H. Lip MD,&nbsp;Chun Shing Kwok MBBS, PhD, MSc, BSc","doi":"10.1016/j.jjcc.2026.03.001","DOIUrl":"10.1016/j.jjcc.2026.03.001","url":null,"abstract":"<div><ul><li><span>•</span><span><div>12.4% of acute myocarditis admissions were in the prior 90-day period.</div></span></li><li><span>•</span><span><div>Prior admissions were more common among older and comorbid patients.</div></span></li><li><span>•</span><span><div>Common reasons for prior admission were COVID, sepsis, and myocardial infarction.</div></span></li><li><span>•</span><span><div>Prior admission increased mortality on any diagnosis of acute myocarditis.</div></span></li></ul></div><div><span><figure><span><img><ol><li><span><span>Download: <span>Download high-res image (236KB)</span></span></span></li><li><span><span>Download: <span>Download full-size image</span></span></span></li></ol></span></figure></span></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"88 3","pages":"Pages 223-225"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444083","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 catheter-based renal denervation on orthostatic blood pressure adaptation in patients with uncontrolled hypertension","authors":"Zhipeng Zhang MD,&nbsp;Rufeng Shi MD,&nbsp;Xin Zhang MD,&nbsp;Jun Ma MD,&nbsp;Runyu Ye MD,&nbsp;Xianghao Zuo MD Candidate,&nbsp;Hongde Hu MD,&nbsp;Yong Peng MD,&nbsp;Kai Liu MD,&nbsp;Xiaoping Chen MS","doi":"10.1016/j.jjcc.2026.05.009","DOIUrl":"10.1016/j.jjcc.2026.05.009","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the effect of catheter-based renal denervation (RDN) on orthostatic blood pressure (BP) adaptation in patients with uncontrolled hypertension.</div></div><div><h3>Methods</h3><div>This prospective observational study enrolled patients who had been previously included in the multicenter Iberis-HTN trial and Netrod™-HTN trial. Eligible patients were randomly assigned to undergo either radiofrequency RDN or a sham procedure. BP and heart rate (HR) changes during a 3-min orthostatic challenge from supine to standing were measured at baseline and 6 months after randomization.</div></div><div><h3>Results</h3><div>At 6 months, the RDN group exhibited a significantly greater reduction in ambulatory BP, office systolic blood pressure (SBP) and BP in both supine and standing positions compared to the sham group. After adjusting for baseline values, the magnitude of changes in orthostatic SBP and diastolic blood pressure (DBP) at the 3-min timepoint, along with the maximum changes observed throughout the 3-min orthostatic test, was significantly smaller in the RDN group at 6 months (3 min: SBP/DBP, <em>p</em> = 0.008/0.010; Maximum: SBP/DBP, <em>p</em> = 0.041/0.004). The changes in orthostatic HR at 6 months were comparable between the RDN and the sham group.</div></div><div><h3>Conclusions</h3><div>Catheter-based radiofrequency RDN significantly reduced BP in both supine and standing positions during active standing at 6 months compared to the sham group. Additionally, RDN attenuated BP elevation during postural changes, and the response pattern to orthostatic stress was partially restored toward the range of normal physiological variation. This observation may be related to the reduction in excessive vascular tone in response to orthostatic stress after RDN.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"88 3","pages":"Pages 213-219"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148030925","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":"Selexipag or parenteral prostacyclin? Untangling treatment selection in observational PAH data","authors":"Abdülmelik Birgün MD,&nbsp;Mehmet Mustafa Yılmaz MD,&nbsp;Macit Kalçık MD","doi":"10.1016/j.jjcc.2026.02.004","DOIUrl":"10.1016/j.jjcc.2026.02.004","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"88 3","pages":"Page 233"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197497","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}