Journal of cardiology最新文献_第5页

Prediction of cardiac allograft vasculopathy using splenic switch-off on myocardial PET. 利用心肌 PET 上的脾脏开关预测心脏同种异体移植血管病变

IF 2.5 3区医学

Journal of cardiology Pub Date : 2024-07-02 DOI: 10.1016/j.jjcc.2024.06.010

Atsushi Yamamoto, Michinobu Nagao, Michiru Nomoto, Akihiro Inoue, Risa Imakado, Risako Nakao, Yuka Matsuo, Akiko Sakai, Hidetoshi Hattori, Noriko Kikuchi, Shinichi Nunoda, Koichiro Kaneko, Mitsuru Momose, Shuji Sakai, Junichi Yamaguchi

{"title":"Prediction of cardiac allograft vasculopathy using splenic switch-off on myocardial PET.","authors":"Atsushi Yamamoto, Michinobu Nagao, Michiru Nomoto, Akihiro Inoue, Risa Imakado, Risako Nakao, Yuka Matsuo, Akiko Sakai, Hidetoshi Hattori, Noriko Kikuchi, Shinichi Nunoda, Koichiro Kaneko, Mitsuru Momose, Shuji Sakai, Junichi Yamaguchi","doi":"10.1016/j.jjcc.2024.06.010","DOIUrl":"10.1016/j.jjcc.2024.06.010","url":null,"abstract":"<p><strong>Background: </strong>Heart transplantation (HTx) is a definitive therapy for refractory heart failure. Cardiac allograft vasculopathy (CAV), characterized by diffuse arteriopathy involving the epicardial coronary arteries and microvasculature, is the major cause of death for patients with HTx. <sup>13</sup>N-ammonia positron emission tomography (NH<sub>3</sub>-PET) can offer diagnostic and prognostic utility for CAV. The splenic switch-off (SSO) detected in NH3-PET is a hemodynamic indicator of favorable response to adenosine. We hypothesized that both CAV and SSO reflected a pathology that progresses in parallel with systemic vascular endothelial dysfunction. Therefore, we quantitatively evaluated splenic adenosine reactivity measured using NH3-PET as an index of endothelial function, and examined its predictability for CAV.</p><p><strong>Methods: </strong>Forty-eight patients who underwent NH<sub>3</sub>-PET after HTx were analyzed. The spleen ratio was calculated as the mean standardized uptake value, measured by placing an ROI on the spleen, at stress divided by that at rest. SSO was defined by a cutoff determined using receiver operating characteristic (ROC) analysis for the spleen ratio. The endpoint was appearance or progression of CAV. Predictability of SSO was analyzed using Kaplan-Meier analysis.</p><p><strong>Results: </strong>The endpoint occurred in 9 patients during a mean follow-up of 45 ± 17 months. ROC curve analysis demonstrated a cutoff of 0.94 for spleen ratio. Patients without SSO displayed a significantly higher CAV rate than those with SSO (p = 0.022).</p><p><strong>Conclusions: </strong>SSO reflects the endothelial function of systemic blood vessels and was a predictor of CAV in patients with HTx.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534527","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

Association of door-to-balloon time and one-year outcomes in hospital survivors of ST-elevation myocardial infarction. ST段抬高型心肌梗死住院幸存者的 "门到气球时间 "与一年预后的关系。

IF 2.5 3区医学

Journal of cardiology Pub Date : 2024-07-02 DOI: 10.1016/j.jjcc.2024.06.009

Mitsuaki Sawano, Shun Kohsaka, Karthik Murugiah, Hideki Ishii, Kyohei Yamaji, Jun Takahashi, Kazuyuki Ozaki, Tetsuya Amano, Ken Kozuma

{"title":"Association of door-to-balloon time and one-year outcomes in hospital survivors of ST-elevation myocardial infarction.","authors":"Mitsuaki Sawano, Shun Kohsaka, Karthik Murugiah, Hideki Ishii, Kyohei Yamaji, Jun Takahashi, Kazuyuki Ozaki, Tetsuya Amano, Ken Kozuma","doi":"10.1016/j.jjcc.2024.06.009","DOIUrl":"10.1016/j.jjcc.2024.06.009","url":null,"abstract":"<p><p>In this study of 19,824 ST-elevated myocardial infarction (STEMI) patients from the J-PCI OUTCOME registry (January 1, 2017, to December 31, 2018), we investigated the association between door-to-balloon time (DTB) and 1-year post-discharge cardiovascular outcomes. Patients with DTB >90 min were older and had higher comorbidities. The incidence of 1-year major adverse cardiovascular events (MACE) showed an incremental increase: 3.7 %, 4.8 %, and 7.7 % for DTB ≤60, DTB 60-90, and DTB >90 groups, respectively. Adjusted hazard ratios (aHR) compared to the DTB 60-90 group were 0.83 (DTB ≤60, p = 0.03) and 1.25 (DTB >90, p = 0.005). Subgroup analysis revealed higher risk for MACE in DTB >90 group for patients aged <70, men, no history of coronary revascularization, and those with cardiac arrest or cardiogenic shock. Conversely, DTB ≤60 group without previous history had a lower MACE risk (aHR 0.80, p = 0.02). This study, the largest of its kind, demonstrates that a DTB below 90 min is associated with lower 1-year MACE risk, supporting current guidelines, and indicating additional benefits for specific patient subgroups, especially those experiencing their first acute coronary event. The findings suggest the importance of early intervention in primary prevention and emphasize the need for prompt detection of vulnerable plaque.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534525","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 hyper-polypharmacy due to non-cardiovascular medications on long-term clinical outcomes following endovascular treatment for lower limb artery disease: A sub-analysis of the I-PAD Nagano registry 下肢动脉疾病血管内治疗后，非心血管药物导致的过度用药对长期临床疗效的影响：I-PAD长野登记的子分析。

IF 2.5 3区医学

Journal of cardiology Pub Date : 2024-07-02 DOI: 10.1016/j.jjcc.2024.06.011

{"title":"Impact of hyper-polypharmacy due to non-cardiovascular medications on long-term clinical outcomes following endovascular treatment for lower limb artery disease: A sub-analysis of the I-PAD Nagano registry","authors":"","doi":"10.1016/j.jjcc.2024.06.011","DOIUrl":"10.1016/j.jjcc.2024.06.011","url":null,"abstract":"<div><h3>Background</h3><div>Lower limb artery disease (LEAD) is accompanied by multiple comorbidities; however, the effect of hyperpolypharmacy on patients with LEAD has not been established. This study investigated the associations between hyperpolypharmacy, medication class, and adverse clinical outcomes in patients with LEAD.</div></div><div><h3>Methods</h3><div>This study used data from a prospective multicenter observational Japanese registry. A total of 366 patients who underwent endovascular treatment (EVT) for LEAD were enrolled in this study. The primary endpoints were major adverse cardiac events (MACE), including myocardial infarction, stroke, and all-cause death.</div></div><div><h3>Results</h3><div><span>Of 366 patients with LEAD, 12 with missing medication information were excluded. Of the 354 remaining patients, 166 had hyperpolypharmacy (≥10 medications, 46.9 %), 162 had polypharmacy (5–9 medications, 45.8 %), and 26 had nonpolypharmacy (<5 medications, 7.3 %). Over a 4.7-year median follow-up period, patients in the hyperpolypharmacy group showed worse outcomes than those in the other two groups (log-rank test, </span><em>p</em><span> < 0.001). Multivariate analysis revealed that the total number of medications was significantly associated with an increased risk of MACE (hazard ratio per medication increase 1.07, 95 % confidence interval 1.02–1.13 </span><em>p</em> = 0.012). Although an increased number of non-cardiovascular medications was associated with an elevated risk of MACE, the increase in cardiovascular medications was not statistically significant (log-rank test, <em>p</em> = 0.002 and 0.35, respectively).</div></div><div><h3>Conclusions</h3><div>Hyperpolypharmacy due to non-cardiovascular medications was significantly associated with adverse outcomes in patients with LEAD who underwent EVT, suggesting the importance of medication reviews, including non-cardiovascular medications.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"84 6","pages":"Pages 379-387"},"PeriodicalIF":2.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534526","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

Efficacy and safety of intravenous versus oral tolvaptan in the acute phase of acute decompensated heart failure. 急性失代偿性心力衰竭急性期静脉注射与口服托伐普坦的疗效和安全性。

IF 2.5 3区医学

Journal of cardiology Pub Date : 2024-06-23 DOI: 10.1016/j.jjcc.2024.06.008

Tomoaki Okada, Wataru Takagi, Toru Miyoshi, Akihiro Oka, Kosuke Seiyama, Satoko Ugawa, Kazumasa Nosaka, Masayuki Doi

引用次数: 0

Effect of change in hepato-renal function and cardiac rehabilitation on mortality in patients with heart failure 肝肾功能变化和心脏康复对心力衰竭患者死亡率的影响。

IF 2.5 3区医学

Journal of cardiology Pub Date : 2024-06-23 DOI: 10.1016/j.jjcc.2024.06.006

{"title":"Effect of change in hepato-renal function and cardiac rehabilitation on mortality in patients with heart failure","authors":"","doi":"10.1016/j.jjcc.2024.06.006","DOIUrl":"10.1016/j.jjcc.2024.06.006","url":null,"abstract":"<div><h3>Background</h3><div>Patients with heart failure (HF) often suffer from hepato-renal dysfunction. The associations between hepato-renal function changes and mortality remain unclear. Further, the effect of cardiac rehabilitation (CR) on mortality and motor functions in patients with HF and hepato-renal dysfunction requires investigation.</div></div><div><h3>Methods</h3><div>We reviewed 2522 patients with HF (63.2 % male; median age: 74 years). The association between changes in hepato-renal function assessed by the Model for End-stage Liver Disease eXcluding INR (MELD-XI) score and mortality was examined. The association of CR participation with mortality and physical functions was investigated in patients with HF with decreased, unchanged, and increased MELD-XI scores.</div></div><div><h3>Results</h3><div>During the follow-up period, 519 (20.6 %) patients died. Worsened MELD-XI score was independently associated with all-cause death [adjusted hazard ratio (aHR): 1.099; 95 % confidence interval (CI): 1.061–1.138; <em>p</em> < 0.001]. CR participation was associated with low mortality, even in the increased MELD-XI score group (aHR: 0.498; 95 % CI: 0.333–0.745; <em>p</em> < 0.001). Trajectory of the MELD-XI score was not associated with physical function changes. There were no time by MELD-XI score interaction effects on handgrip strength (<em>p</em> = 0.084), leg strength (<em>p</em> = 0.082), walking speed (<em>p</em> = 0.583), and 6-min walking distance (<em>p</em> = 0.833) in patients participating in outpatient CR.</div></div><div><h3>Conclusions</h3><div>Hepato-renal dysfunction predicts high mortality. CR participation may be helpful for a better prognosis of patients with HF and hepato-renal dysfunction.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"84 6","pages":"Pages 355-361"},"PeriodicalIF":2.5,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450565","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

Treatment strategies for diuretic resistance in patients with heart failure. 心力衰竭患者利尿剂耐药性的治疗策略。

IF 2.5 3区医学

Journal of cardiology Pub Date : 2024-06-22 DOI: 10.1016/j.jjcc.2024.06.005

Yu Horiuchi, Nicholas Wettersten

{"title":"Treatment strategies for diuretic resistance in patients with heart failure.","authors":"Yu Horiuchi, Nicholas Wettersten","doi":"10.1016/j.jjcc.2024.06.005","DOIUrl":"10.1016/j.jjcc.2024.06.005","url":null,"abstract":"<p><p>Improving congestion with diuretic therapy is crucial in the treatment of heart failure (HF). However, despite the use of loop diuretics, diuresis may be inadequate and congestion persists, which is known as diuretic resistance. Diuretic resistance and residual congestion are associated with a higher risk of rehospitalization and mortality. Causes of diuretic resistance in HF include diuretic pharmacokinetic changes, renal hemodynamic perturbations, neurohumoral activations, renal tubular remodeling, and use of nephrotoxic drugs as well as patient comorbidities. Combination diuretic therapy (CDT) has been advocated for the treatment of diuretic resistance. Thiazides, acetazolamides, tolvaptan, mineralocorticoid receptor antagonist, and sodium-glucose co-transporter-2 inhibitors are among the candidates, but none of these treatments has yet demonstrated significant diuretic efficacy or improved prognosis. At present, it is essential to identify and treat the causes of diuretic resistance in individual patients and to use CDT based on a better understanding of the characteristics of each drug to achieve adequate diuresis. Further research is needed to effectively assess and manage diuretic resistance and ultimately improve patient outcomes.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446249","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 predictors of persistent iatrogenic atrial septal defect following catheter ablation 导管消融术后持续性先天性房间隔缺损的发生率和预测因素。

IF 2.5 3区医学

Journal of cardiology Pub Date : 2024-06-22 DOI: 10.1016/j.jjcc.2024.06.007

{"title":"Incidence and predictors of persistent iatrogenic atrial septal defect following catheter ablation","authors":"","doi":"10.1016/j.jjcc.2024.06.007","DOIUrl":"10.1016/j.jjcc.2024.06.007","url":null,"abstract":"<div><h3>Background</h3><div>The left atrium approach for atrial fibrillation (AF) ablation requires an atrial transseptal puncture that may cause an iatrogenic atrial septal defect (iASD). This study aimed to investigate the incidence and predictors of iASD in catheter ablation, assessed by transthoracic echocardiography (TTE), a relatively non-invasive technique frequently employed in follow-up.</div></div><div><h3>Methods</h3><div>This retrospective study included 639 patients (489 male; 60.2±10.7years) who underwent initial catheter ablation for AF between May 2005 and June 2018. All patients underwent preprocedural transesophageal echocardiography (pre-TEE), preprocedural TTE (pre-TTE), and TTE one day after the procedure (post-TTE). iASD incidence after 6months (6M), preprocedural characteristics, and procedure methods were evaluated.</div></div><div><h3>Results</h3><div>Patent foramen ovale (PFO) was diagnosed in 42 patients (6.6%) using pre-TEE and in 11 patients using pre-TTE (26.2% of the patients with PFO in pre-TEE). Among the 597 patients without PFO, 497 underwent 6M-TTE. iASD was observed in 59.6% of patients using post-TTE and 4.6% using 6M-TTE. In the univariate logistic regression analysis, the total diameter of the sheath through the septum (odds ratio 1.15, <em>p</em>  =0.001) were independent risk factors on iASD incidence in 6M-TTE. iASD was also more likely to occur via cryoballoon ablation using a larger sheath than radiofrequency catheter ablation.</div></div><div><h3>Conclusions</h3><div>iASD was not a rare complication. A larger sheath diameter or two sheaths through a single puncture were associated with the incidence of iASD.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"84 6","pages":"Pages 372-378"},"PeriodicalIF":2.5,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

McConnell's sign predicts normotensive shock in patients with acute pulmonary embolism 麦康奈尔征兆可预测急性肺栓塞患者的正常血压休克。

IF 2.5 3区医学

Journal of cardiology Pub Date : 2024-06-19 DOI: 10.1016/j.jjcc.2024.06.004

{"title":"McConnell's sign predicts normotensive shock in patients with acute pulmonary embolism","authors":"","doi":"10.1016/j.jjcc.2024.06.004","DOIUrl":"10.1016/j.jjcc.2024.06.004","url":null,"abstract":"<div><h3>Background</h3><div><span><span>Patients with intermediate-risk pulmonary embolism (PE) and normotensive </span>shock may have worse outcomes. However, diagnosis of normotensive shock requires invasive </span>hemodynamics. Our objective was to assess the predictive value of McConnell's sign in identifying normotensive shock in patients with intermediate-risk PE.</div></div><div><h3>Methods</h3><div><span>Patients with intermediate-risk PE who underwent percutaneous mechanical thrombectomy<span> between August 2020 and April 2023 at a large academic public hospital were included in the study. Normotensive shock was defined as systolic blood pressure ≥ 90 mmHg without vasopressor support with pre-procedural invasive measures of cardiac index ≤2.2 L/min/m</span></span><sup>2</sup> and clinical evidence of hypoperfusion (i.e. elevated lactate, oliguria). The primary outcome was the association between McConnell's sign and normotensive shock.</div></div><div><h3>Results</h3><div>Those with McConnell's sign (29/40, 72.5 %) had higher heart rate (114 vs 99 beats/min, <em>p</em> = 0.008), higher rates of elevated lactate (86 % vs 55 %, <em>p</em> = 0.038), lower cardiac index (1.9 vs 3.1 L/min/m<sup>2</sup>, <em>p</em> = 0.003), and higher rates of normotensive shock (76 % vs 27 %, <em>p</em> = 0.005). McConnell's sign had a sensitivity of 88 % and specificity of 53 % for identifying intermediate-risk PE patients with normotensive shock. Patients with McConnell's sign had an increased odds (odds ratio 8.38, confidence interval: 1.73–40.53, <em>p</em> = 0.008; area under the curve 0.70, 95 % confidence interval: 0.56–0.85) of normotensive shock.</div></div><div><h3>Conclusion</h3><div>This is the first study to suggest that McConnell's sign may identify those in the intermediate-risk group who are at risk for normotensive shock. Larger cohorts are needed to validate our findings.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"84 6","pages":"Pages 404-405"},"PeriodicalIF":2.5,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436927","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

Ten-year trends in non-surgical patients requiring intensive care: Long-term prognostic differences by year of admission 需要重症监护的非手术病人的十年趋势：按入院年份划分的长期预后差异。

IF 2.5 3区医学

Journal of cardiology Pub Date : 2024-06-18 DOI: 10.1016/j.jjcc.2024.06.003

{"title":"Ten-year trends in non-surgical patients requiring intensive care: Long-term prognostic differences by year of admission","authors":"","doi":"10.1016/j.jjcc.2024.06.003","DOIUrl":"10.1016/j.jjcc.2024.06.003","url":null,"abstract":"<div><h3>Background</h3><div>The aim of the present study is to elucidate prognostic impact of temporal trends of non-surgical patients requiring intensive care over a 10-year period.</div></div><div><h3>Methods and Results</h3><div>A total of 4276 non-surgical patients requiring intensive care from 2012 to 2021 were enrolled. Patients' backgrounds, in-hospital management, and prognoses were compared between five groups [2012–2013 (<em>n</em> = 825), 2014–2015 (<em>n</em> = 784), 2016–2017 (<em>n</em> = 864), 2018–2019 (<em>n</em> = 939), and 2020–2021 (<em>n</em> = 867)]. During the study period, mean age significantly increased from 69 years in 2012–2013 to 72 years in 2020–2021. Mean Acute Physiology and Chronic Health Evaluation scores significantly increased from 10 points in 2012–2013 to 12 points in 2020–2021. The median duration of intensive care unit stays increased from 3 to 4 days. Kaplan-Meier survival curve analysis showed that survival rates during 30- and 365-days were significantly lower in 2020–2021 than in 2012–2013, but it was not significantly different by a Cox proportional hazards regression model in 30 days. A Cox proportional hazards regression model revealed that the risks of 365-day all-cause death were significantly higher in patients enrolled in 2016–2017 (HR: 1.324, 95 % CI: 1.042–1.680, <em>p</em> = 0.021), in 2018–2019 (HR: 1.329, 95 % CI: 1.044–1.691, <em>p</em> = 0.021), and in 2020–2021 (HR: 1.409, 95 % CI: 1.115–1.779, <em>p</em> = 0.004).</div></div><div><h3>Conclusion</h3><div>The condition of patients requiring intensive care is becoming more critical year by year, leading to poorer long-term prognoses despite improvements in treatment strategies. These findings emphasize the importance of additional care management after admission into non-surgical intensive care units, particularly for the aging society of Japan.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"84 5","pages":"Pages 347-354"},"PeriodicalIF":2.5,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Additional prognostic impact of plaque characterization with on-site CT-derived fractional flow reserve in coronary CT angiography 冠状动脉 CT 血管造影中利用现场 CT 导出的分数血流储备对斑块特征描述的额外预后影响。

IF 2.5 3区医学

Journal of cardiology Pub Date : 2024-06-12 DOI: 10.1016/j.jjcc.2024.05.009

{"title":"Additional prognostic impact of plaque characterization with on-site CT-derived fractional flow reserve in coronary CT angiography","authors":"","doi":"10.1016/j.jjcc.2024.05.009","DOIUrl":"10.1016/j.jjcc.2024.05.009","url":null,"abstract":"<div><h3>Background</h3><div><span>On-site computed tomography-derived fractional flow reserve (CT-FFR) is a feasible method for examining lesion-specific </span>ischemia<span>, and plaque analysis of coronary CT angiography (CCTA) is useful for predicting future cardiac events. However, their utility and association on a per-vessel level remain unclear.</span></div></div><div><h3>Methods</h3><div><span>We analyzed vessels showing 50–90 % stenosis on CCTA where planned </span>revascularization was not performed after CCTA within 90 days. Relevant features, including CT-FFR and the plaque burden [necrotic core to the total plaque volume (% necrotic core), and non-calcified plaque (NCP) to vessel volume (% NCP)] using a novel algorithm for analyzing plaque to predict vessel-oriented composite outcomes (VOCO), including cardiac death, non-fatal myocardial infarction, and unplanned vessel-related revascularization, were assessed.</div></div><div><h3>Results</h3><div>In 256 patients (68.7 ± 9.4 years; 73.8 % male) with 354 vessels (10.5 % CT-FFR ≤ 0.80), VOCO occurred in 24 vessels (6.8 %) during a median follow-up of 3.6 years. Multivariable Cox analysis revealed CT-FFR ≤ 0.80 had the pronounced impact on VOCO, and moreover, higher % necrotic core and % NCP were independently associated with VOCO [adjusted hazard ratio 3.43 (95 % confidence interval 1.42–8.29) and 4.05 (1.19–13.71), respectively], especially for vessels with CT-FFR > 0.80.</div></div><div><h3>Conclusions</h3><div>In vessels without planned revascularization, per-vessel CT-FFR ≤ 0.80 was the notable predictor of future cardiac events. Additionally, necrotic core volume and NCP were identified as independent predictors along with CT-FFR.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"84 5","pages":"Pages 336-341"},"PeriodicalIF":2.5,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141320896","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