Journal of cardiology最新文献

{"title":"Prognosis of low-flow low-gradient aortic valve stenosis with atrial fibrillation","authors":"Ryo Nishinarita MD, PhD ,&nbsp;Jun Oikawa MD, PhD ,&nbsp;Kenshiro Arao MD, PhD, FJCC ,&nbsp;Kenichi Sugisaki MD ,&nbsp;Takahiro Yamashita MD ,&nbsp;Ayane Yozawa MD ,&nbsp;Yae Ota MD ,&nbsp;Hisashi Sato MD ,&nbsp;Uiri Ooki MD ,&nbsp;Yusuke Tamanaha MD ,&nbsp;Taku Kasahara MD ,&nbsp;Takaaki Mase MD ,&nbsp;Akira Satoh MD, PhD ,&nbsp;Junya Ako MD, PhD, FJCC","doi":"10.1016/j.jjcc.2025.03.017","DOIUrl":"10.1016/j.jjcc.2025.03.017","url":null,"abstract":"<div><h3>Background</h3><div><span>The prognosis for patients with low-flow low-gradient (LFLG) aortic valve stenosis (AS) remains controversial. In general, </span>atrial fibrillation (AF) is one factor determining the LF status in patients with severe AS (SAS). However, the association between concomitant AF in LFLG AS and the risk of heart failure (HF) remains unclear.</div></div><div><h3>Methods</h3><div>This study evaluated 278 consecutive patients with SAS (indexed aortic valve area &lt; 0.6 cm²/m²). Among them, we enrolled patients with high-gradient (HG) SAS [mean pressure gradient (mPG) ≥40 mmHg] and LFLG AS (stroke volume index ≤35 ml/m²<span>, mPG &lt;40 mmHg). The two groups were further categorized into four subgroups following the presence or absence<span> of AF as HG SAS with AF (n = 27), HG SAS without AF (n = 68), LFLG AS with AF (n = 30), and LFLG AS without AF (n = 67). The primary endpoint was worsening HF that required unplanned hospitalization or HF drug therapy.</span></span></div></div><div><h3>Results</h3><div>We observed worsening HF in 65 patients. The Kaplan–Meier curve revealed a higher rate of worsening HF in LFLG AS with AF than that in HG SAS without AF (log-rank <em>p</em> &lt; 0.001) without any significant difference compared to HG SAS with AF. The Cox hazard analysis among LFLG AS patients identified the presence of AF as an independent predictor for worsening HF [hazard ratio (HR): 2.79; 95 % confidence interval (CI): 1.17–6.96; <em>p</em><span> = 0.021]. In addition, the Kaplan–Meier analysis curve revealed a higher risk of worsening HF in patients with LFLG AS and paroxysmal AF<span> (PAF) or chronic AF (CAF) than in those without AF (PAF: HR: 4.71, 95 % CI: 1.79–11.9, </span></span><em>p</em> = 0.0024; CAF: HR: 3.22, 95 % CI: 1.29–7.83, <em>p</em> = 0.013, respectively).</div></div><div><h3>Conclusions</h3><div>Patients with LFLG AS and concomitant AF exhibited an unfavorable prognosis for HF, with no significantly different rate of worsening HF compared with patients with HG SAS and conc.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"86 3","pages":"Pages 286-293"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787895","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":"Extensive ablation in elderly patients with persistent AF: Insights and considerations","authors":"Cheng Xue","doi":"10.1016/j.jjcc.2025.05.006","DOIUrl":"10.1016/j.jjcc.2025.05.006","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"86 3","pages":"Page 318"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173845","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":"Association between partial smoking ban legislation and acute coronary syndrome: A nationwide analysis","authors":"Michikazu Nakai (PhD) ,&nbsp;Yoshitaka Iwanaga (MD, PhD, FJCC) ,&nbsp;Hisayoshi Fujiwara (MD, PhD, FJCC)","doi":"10.1016/j.jjcc.2025.06.023","DOIUrl":"10.1016/j.jjcc.2025.06.023","url":null,"abstract":"<div><h3>Background</h3><div>Tobacco smoking is a major risk factor<span><span> for acute coronary syndrome (ACS) and acute </span>myocardial infarction (AMI). While comprehensive smoking bans reduce cardiovascular events, the effectiveness of partial smoking ban legislation (pSBL) remains uncertain. In April 2020, Japan implemented a pSBL targeting certain public facilities. This study aimed to evaluate the impact of this nationwide pSBL on ACS and AMI hospitalizations.</span></div></div><div><h3>Methods</h3><div>We conducted an interrupted time series analysis using data from the JROAD-DPC database, covering hospitalizations for ACS and AMI across Japan and the Tokyo area from April 2018 to March 2022. Ordinary least-squares regression was used to assess hospitalization trends before and after pSBL implementation. Seasonal adjustments were applied.</div></div><div><h3>Results</h3><div>No significant changes were observed in ACS hospitalizations nationwide [slope difference (95 % CI): 19.97 (−16.54, 86.48)] or in the Tokyo area [2.43 (−5.10, 9.97)]. Similar findings were noted for AMI nationwide [9.18 (−38.95, 57.31)] and in Tokyo [1.48 (−3.60, 6.55)].</div></div><div><h3>Conclusions</h3><div>The nationwide pSBL in Japan did not significantly reduce ACS or AMI hospitalizations. These findings highlight the limited effectiveness of partial smoking bans and underscore the need for more comprehensive tobacco control policies to achieve meaningful reductions in cardiovascular events.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"86 3","pages":"Pages 316-317"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600577","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":"Paradoxical relationship between resting full-cycle ratio and fractional flow reserve","authors":"Yuya Tanabe MD,&nbsp;Yuichi Saito MD,&nbsp;Shunsuke Nakamura MD,&nbsp;Tatsuro Yamazaki MD,&nbsp;Hideki Kitahara MD,&nbsp;Yoshio Kobayashi MD, FJCC","doi":"10.1016/j.jjcc.2025.06.021","DOIUrl":"10.1016/j.jjcc.2025.06.021","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"86 3","pages":"Pages 312-313"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564816","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":"Cardiopulmonary neuro-immune reflex: From afferent stress signaling to peripheral myeloid memory.","authors":"Junichi Sugita, Ziyu Chen, Naoto Setoguchi, Kohsaku Goto, Atsushi Kobayashi, Kunihiko Kani, Yiyi Yang, Jiaxin Ku, Kensuke Ueno, Ryoko Uchida, Eriko Hasumi, Tsukasa Oshima, Yukiteru Nakayama, Katsuhito Fujiu","doi":"10.1016/j.jjcc.2025.08.013","DOIUrl":"10.1016/j.jjcc.2025.08.013","url":null,"abstract":"<p><p>The cardiopulmonary system is not only a pump-respirator network but also a sophisticated sensor-effector circuit. Recent findings have highlighted how mechanical and inflammatory stress in the heart and lungs is transmitted via afferent nerves-including vagal, glossopharyngeal, and spinal fibers-to the brainstem and higher autonomic centers. These afferent signals trigger adaptive or maladaptive efferent responses via the sympathetic nervous system, which in turn modulate immune cell dynamics in the bone marrow and peripheral organs. This review discusses the cardiopulmonary afferent-efferent axis, focusing on three major components: (1) the molecular and functional basis of afferent pathways linking the heart and lungs to the brain; (2) the impact of these inputs on central autonomic regulation; (3) the downstream effects of sympathetic outflow on hematopoietic stem cells, leading to myeloid skewing, epigenetic memory, and inflammatory macrophage expansion. Finally, we explore how this axis contributes to cardiovascular disease progression and multimorbidity, and how recent studies-especially those on innate immune memory-open new therapeutic avenues targeting neuro-immune crosstalk.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955645","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":"Pressure-volume loop analysis in heart failure with preserved ejection fraction: Implications for cardiac mechanics, diagnosis, and treatment strategy.","authors":"Naoki Fujimoto, Taku Omori, Keishi Moriwaki, Shiro Nakamori, Kaoru Dohi","doi":"10.1016/j.jjcc.2025.08.011","DOIUrl":"10.1016/j.jjcc.2025.08.011","url":null,"abstract":"<p><p>Heart failure with preserved ejection fraction (HFpEF), previously referred to as diastolic heart failure, accounts for more than half of heart failure hospitalizations in patients over 65 years of age. Although the prevalence of heart failure with reduced ejection fraction has declined, HFpEF is increasingly prevalent in Japan and worldwide. Traditionally, HFpEF was primarily thought to be caused by diastolic dysfunction, characterized by impaired left ventricular (LV) relaxation and increased LV stiffness. Analysis of LV pressure-volume (PV) loop is an invasive method that allows for the simultaneous and detailed evaluation of intrinsic LV systolic and diastolic function, as well as effective arterial elastance (Ea). LV systolic function is assessed by end-systolic elastance, derived from end-systolic PV relations, while diastolic stiffness is evaluated by LV stiffness constant (β), determined from the slope of the end-diastolic pressure-volume relation. Ea, representing LV afterload, is calculated as end-systolic pressure divided by stroke volume. Furthermore, PV loop analysis provides insights into LV mechanics through measurements of stroke work, PV area, and ventricular-arterial coupling. These parameters enable clinicians to more precisely characterize the mechanical properties of the LV than conventional echocardiography or imaging modalities. In HFpEF, where accurate assessments of LV function and hemodynamics is essential, understanding PV loop data provides valuable insight into the pathophysiology of HFpEF. PV loop analysis has the potential to facilitate in-depth assessment and monitoring of treatment strategies. In this review, we introduce LV PV loop analysis in our patients with HFpEF and explore its correlation with PV loop parameters obtained from the other imaging modalities, such as echocardiography and cardiac magnetic resonance imaging. By highlighting the clinical relevance of PV loop analysis, we aim to advance therapeutic decision-making and promote a personalized approach in this heterogenous HFpEF population.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955673","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 paradox: A physiological and methodological perspective on RFR-FFR discordance.","authors":"Artur Dziewierz, Barbara Zdzierak, Wojciech Zasada","doi":"10.1016/j.jjcc.2025.08.012","DOIUrl":"https://doi.org/10.1016/j.jjcc.2025.08.012","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955597","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":"Letter to the Editor: Impact of congestive heart failure on early fluid administration and mortality in patients with sepsis.","authors":"Songsong Luo","doi":"10.1016/j.jjcc.2025.08.010","DOIUrl":"https://doi.org/10.1016/j.jjcc.2025.08.010","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955628","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 histologically proven fulminant myocarditis managed with venoarterial extracorporeal membrane oxygenation: A post-hoc analysis of a Japanese nationwide study.","authors":"Kenichiro Sawada, Soshiro Ogata, Koshiro Kanaoka, Kenji Onoue, Yasuhide Asaumi, Kunihiro Nishimura, Yoshihiko Saito, Teruo Noguchi","doi":"10.1016/j.jjcc.2025.08.009","DOIUrl":"10.1016/j.jjcc.2025.08.009","url":null,"abstract":"<p><strong>Background: </strong>Characteristics of histologically proven fulminant myocarditis (FM) managed with venoarterial extracorporeal membrane oxygenation (VA-ECMO) remain poorly understood. We aimed to identify factors associated with receiving VA-ECMO in patients with FM and with a composite endpoint (90-day mortality or heart transplantation) among VA-ECMO recipients.</p><p><strong>Methods: </strong>This study used data from the Japanese Registry of Fulminant Myocarditis in a nationwide retrospective cohort of patients with histologically proven FM. Given the competing risk of death, admission factors associated with receiving VA-ECMO were analyzed using the Fine and Gray model. Among VA-ECMO recipients, factors associated with the composite endpoint were assessed by Cox proportional hazards regression.</p><p><strong>Results: </strong>Of 337 patients (median age, 54 years; 40 % female), 177 (53 %) received VA-ECMO. The composite endpoint occurred in 44 % of VA-ECMO recipients, consisting entirely of mortality events. Female sex [subdistribution hazard ratio (SHR), 1.36; 95 % confidence interval (CI), 1.002-1.84], left ventricular ejection fraction <30 % (SHR, 1.66; 95 % CI, 1.21-2.28), ventricular tachycardia or ventricular fibrillation (SHR, 2.25; 95 % CI, 1.61-3.14), use of more vasopressors and inotropes (SHR, 1.28; 95 % CI, 1.10-1.48), or lactate level ≥ 2 mmol/L (adjusted risk ratio, 1.61; 95 % CI, 1.03-2.51) were associated with a higher risk of receiving VA-ECMO. Among VA-ECMO recipients, older age (HR, 1.20; 95 % CI, 1.0001-1.43), higher peak creatine kinase-MB level (HR, 1.24; 95 % CI, 1.13-1.36), and giant cell myocarditis (HR, 3.71; 95 % CI, 1.63-8.45) were associated with a higher risk of 90-day mortality.</p><p><strong>Conclusions: </strong>This study characterized key factors associated with receiving VA-ECMO and 90-day mortality among VA-ECMO recipients, enhancing understanding of patient profiles and clinical courses in this high-risk population.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955590","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":"Chronic kidney disease and contemporary guideline-directed medical therapy during hospitalization in patients with heart failure: Insights from PRE-UPFRONT-HF.","authors":"Yudai Fujimoto, Takeshi Kitai, Yu Horiuchi, Toru Kondo, Ryosuke Murai, Ryuichi Matsukawa, Takuro Abe, Kentaro Jujo, Ayane Kanai, Yuya Matsue","doi":"10.1016/j.jjcc.2025.08.007","DOIUrl":"10.1016/j.jjcc.2025.08.007","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) strongly affects prognosis in patients with heart failure (HF). However, the difference in the implementation of guideline-directed medical therapy (GDMT) during HF-related hospitalization between patients with and without CKD and its association with worsening heart failure (WHF) events remain unclear.</p><p><strong>Methods: </strong>A post-hoc analysis was conducted using data from a retrospective, multicenter, observational registry of patients hospitalized for HF with a left ventricular ejection fraction (LVEF) of <50 %. The primary endpoint was a composite of outpatient WHF, HF-related hospitalization, and all-cause mortality.</p><p><strong>Results: </strong>Of the 442 patients, 246 had CKD (56 %). These patients were older and had a higher prevalence of HF. At admission, the GDMT score was higher in patients with CKD than in those without CKD [3 (interquartile range, 1-5) vs. 1 (0-4)]; at discharge, the GDMT score was lower in patients with CKD [5 (3-7) vs. 6 (4.5-8)]. Optimized GDMT implementation at discharge, defined as a GDMT score of ≥6, was independently associated with improved prognosis in both groups.</p><p><strong>Conclusions: </strong>In-hospital GDMT implementation was less optimized in patients with CKD compared with those without. Nevertheless, optimized GDMT implementation at discharge was associated with a lower incidence of adverse events, regardless of CKD status, among patients hospitalized with HF.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955631","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}