Journal of cardiology最新文献

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Efficacy of sodium-glucose cotransporter 2 inhibitors on preventing atrial arrhythmia recurrences after atrial fibrillation ablation in patients with heart failure. 钠-葡萄糖共转运蛋白2抑制剂预防心力衰竭患者房颤消融后房性心律失常复发的疗效
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2025-03-19 DOI: 10.1016/j.jjcc.2025.03.013
Takashi Okajima, Shinji Ishikawa, Yusuke Uemura, Yuta Ozaki, Shogo Yamaguchi, Takayuki Mitsuda, Kenji Takemoto, Yasuya Inden, Toyoaki Murohara, Masato Watarai
{"title":"Efficacy of sodium-glucose cotransporter 2 inhibitors on preventing atrial arrhythmia recurrences after atrial fibrillation ablation in patients with heart failure.","authors":"Takashi Okajima, Shinji Ishikawa, Yusuke Uemura, Yuta Ozaki, Shogo Yamaguchi, Takayuki Mitsuda, Kenji Takemoto, Yasuya Inden, Toyoaki Murohara, Masato Watarai","doi":"10.1016/j.jjcc.2025.03.013","DOIUrl":"10.1016/j.jjcc.2025.03.013","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is frequently observed in patients with heart failure (HF), and the efficacy of catheter ablation for AF treatment has been established; however, recurrence of atrial arrhythmia is possible. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been reported to suppress AF recurrence in patients with diabetes; however, the efficacy of SGLT2i after AF ablation in patients with HF has not been fully elucidated.</p><p><strong>Methods: </strong>A total of 141 consecutive patients with HF aged ≤75 years who underwent AF ablation were analyzed. Patients with follow-up shorter than six months were excluded. The primary endpoint was atrial arrhythmia recurrence after a 3-month blanking period. The type of recurrence, incidence of hospitalization for HF, and mortality rates were also evaluated.</p><p><strong>Results: </strong>Forty-five patients used SGLT2i, and the median follow-up period was 372 days. The incidence of atrial arrhythmia recurrence was significantly lower in patients taking SGLT2i than in those that were not taking SGLT2i (20.0 % vs. 38.5 %, p = 0.029; log-rank test, p = 0.034). In the multivariate analysis, intake of SGLT2i was associated with a low risk of atrial arrhythmia recurrence (hazard ratio: 0.38, 95 % confidence interval: 0.18-0.80, p = 0.010). The rate of AF recurrence was significantly lower than the rate of atrial tachycardia/flutter recurrence in the SGLT2i group (44.4 % vs. 83.8 %; p = 0.013). The incidence of hospitalization for HF and/or death was low in both groups (0 % in the SGLT2i group and 1.0 % in the non-SGLT2i group). In 24 propensity score-matched pairs, the SGLT2i group had a lower recurrence rate (16.7 % vs. 45.8 %, p = 0.029, log-rank test, p = 0.047) than the non-SGLT2i group.</p><p><strong>Conclusions: </strong>SGLT2i use in patients with HF was associated with a lower atrial arrhythmia recurrence after AF ablation; hence, SGLT2i administration for patients with HF who will undergo AF ablation may be beneficial.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673919","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 leadless cardiac resynchronization therapy: An updated meta-analysis. 无铅心脏再同步化治疗的有效性和安全性:一项最新的荟萃分析。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2025-03-19 DOI: 10.1016/j.jjcc.2025.03.010
Konstantinos Kolokathis, Ioannis Doundoulakis, Dimitrios Tsiachris, Athanasios Kordalis, Konstantinos Tsioufis
{"title":"Efficacy and safety of leadless cardiac resynchronization therapy: An updated meta-analysis.","authors":"Konstantinos Kolokathis, Ioannis Doundoulakis, Dimitrios Tsiachris, Athanasios Kordalis, Konstantinos Tsioufis","doi":"10.1016/j.jjcc.2025.03.010","DOIUrl":"10.1016/j.jjcc.2025.03.010","url":null,"abstract":"<p><strong>Background: </strong>The WiSE cardiac resynchronization therapy (CRT) system (EBR Systems Inc., Sunnyvale, CA, USA) is an innovative technique consisting of an electrode implanted in the endocardium of the left ventricle as an alternative to the conventional CRT for symptomatic patients with heart failure and reduced ejection fraction (EF) despite optimal medical treatment. The objective of this study was to evaluate the efficacy of the Wise CRT.</p><p><strong>Methods: </strong>We searched two electronic databases from inception until November 2024.The primary outcomes were defined as the mean difference (MD) of left ventricular (LV) EF (%) and QRS (milliseconds) from baseline to 6 months post-procedure.</p><p><strong>Results: </strong>Our analysis included six studies (n = 281 patients). A meta-analysis was performed with the primary endpoints being the MD between baseline LVEF and 6-month follow-up and b) the MD between baseline QRS and 6-month follow-up. There was a mean increase in LVEF of 5.78 % (MD 5.78 %; CI 4.37-7.19; p < 0.01) and a mean reduction in QRS duration of 37.08 ms (MD -37.08 ms; CI -45.72 to -28.44; p < 0.01).</p><p><strong>Conclusion: </strong>The WiSE CRT showed impressive electrocardiographic and echocardiographic responses in high-risk patients for whom conventional CRT implantation was impossible or resulted in suboptimal treatment.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673915","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
Evaluating feasibility, health impact, and participant feedback of the Utah South Asian Cardiovascular Health Initiative (U-SACHI): A community-based screening and intervention program. 评估犹他州南亚心血管健康倡议(U-SACHI)的可行性、健康影响和参与者反馈:一个基于社区的筛查和干预计划。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2025-03-19 DOI: 10.1016/j.jjcc.2025.03.011
Kevin S Shah, Hafsa Zahid, Nagesh Gullapalli, Harini Krishnan, Korak Chakraborti, Elizabeth Dranow, Amy B Locke, Sarath Satheesan, Krishna M Sundar
{"title":"Evaluating feasibility, health impact, and participant feedback of the Utah South Asian Cardiovascular Health Initiative (U-SACHI): A community-based screening and intervention program.","authors":"Kevin S Shah, Hafsa Zahid, Nagesh Gullapalli, Harini Krishnan, Korak Chakraborti, Elizabeth Dranow, Amy B Locke, Sarath Satheesan, Krishna M Sundar","doi":"10.1016/j.jjcc.2025.03.011","DOIUrl":"10.1016/j.jjcc.2025.03.011","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) is the leading cause of death globally. In the United States, South Asians have a higher prevalence and earlier onset of atherosclerotic cardiovascular disease (ASCVD) compared to other ethnic groups. This study assessed the feasibility, health impact, and feedback of a community-based screening and intervention program focused on South Asians in Utah.</p><p><strong>Methods: </strong>We conducted a feasibility study of the Utah South Asian Cardiovascular Health Initiative (U-SACHI) using the University of Utah Wellness Bus to perform cardiovascular screenings at the India Cultural Center (ICC) in Utah. Participants were South Asian adults aged 30+ without known severe cardiovascular disease. The screening included measurements of waist circumference, LDL, HDL, hemoglobin A1c, and lipoprotein(A). A monthly intervention program was offered to those who had at least one increased risk marker on a monthly basis. Metrics were measured before and after the intervention, and qualitative input was obtained.</p><p><strong>Results: </strong>The combined screening events participant cohort consisted of 179 adults of South Asian descent. Based on desirable levels for South Asians as set out by the National Lipid Association, elevated waist circumference, BMI, LDL, and total cholesterol were confirmed in this cohort. At least one increased risk marker was present in 70 % of the subjects. The intervention program involved forty participants, of whom twenty-one finished most sessions. After completion, participants showed small improvements in some risk measures. Qualitative feedback highlighted that individuals reported more physical activity, made healthier food choices, and had higher levels of awareness.</p><p><strong>Conclusion: </strong>The U-SACHI program is a feasible and effective model for improving cardiovascular health in South Asians through community-based screenings and culturally tailored interventions. This approach enhances early detection of CVD risk factors and also encourages sustainable lifestyle changes. Further research is necessary to explore strategies for improving long-term outcomes.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673924","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
Milestones in therapeutic and antithrombotic strategies for chronic thromboembolic pulmonary hypertension. 慢性血栓栓塞性肺动脉高压治疗和抗血栓策略的里程碑。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2025-03-18 DOI: 10.1016/j.jjcc.2025.03.006
Kazuya Hosokawa, Kohtaro Abe
{"title":"Milestones in therapeutic and antithrombotic strategies for chronic thromboembolic pulmonary hypertension.","authors":"Kazuya Hosokawa, Kohtaro Abe","doi":"10.1016/j.jjcc.2025.03.006","DOIUrl":"10.1016/j.jjcc.2025.03.006","url":null,"abstract":"<p><p>Chronic thromboembolic pulmonary hypertension (CTEPH) is a condition caused by persistent thrombus obstructing the pulmonary arteries, resulting in pulmonary hypertension. Pulmonary endarterectomy remains the gold standard treatment and can provide dramatic improvement in eligible patients. However, approximately 40 % of patients are inoperable. Over the past years, several randomized controlled trials have explored pulmonary vasodilators and balloon pulmonary angioplasty. Based on these trials, a multimodal treatment approach has been established. Balloon pulmonary angioplasty has shown hemodynamic improvement rather than pulmonary vasodilators in randomized controlled trials. Similarly, lifelong anticoagulation therapy is the cornerstone of CTEPH management. While vitamin K antagonists such as warfarin have been the standard recommended by CTEPH guidelines, recent studies, including the CTEPH AC Registry and the KABUKI trial, suggest that direct oral anticoagulants may be safe and effective alternatives. Several ongoing randomized controlled trials aim to refine treatment strategies. The IMPACT-CTEPH trial is investigating whether the initial combination therapy (riociguat + macitentan) is superior to monotherapy before balloon pulmonary angioplasty. The GO-CTEPH trial compares the efficacy of pulmonary endarterectomy and balloon pulmonary angioplasty in eligible patients. The THERAPY-HYBRID-BPA trial is evaluating the need for continued riociguat after balloon pulmonary angioplasty. The FIND-DCR study is evaluating a new imaging modality for the early detection of CTEPH. As research advances, multimodal approaches combining surgical, interventional, and pharmacological treatments are expected to improve patient outcomes and shape the future of CTEPH management.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670014","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
Tricuspid regurgitation: Innovation, current landscape, and future perspective of transcatheter tricuspid valve interventions. 三尖瓣反流:经导管三尖瓣干预的创新、现状和未来展望。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2025-03-17 DOI: 10.1016/j.jjcc.2025.03.009
Atsushi Sugiura, Tetsu Tanaka, Refik Kavsur, Can Öztürk, Johanna Vogelhuber, Miriam Silaschi, Marcel Weber, Sebastian Zimmer, Georg Nickenig
{"title":"Tricuspid regurgitation: Innovation, current landscape, and future perspective of transcatheter tricuspid valve interventions.","authors":"Atsushi Sugiura, Tetsu Tanaka, Refik Kavsur, Can Öztürk, Johanna Vogelhuber, Miriam Silaschi, Marcel Weber, Sebastian Zimmer, Georg Nickenig","doi":"10.1016/j.jjcc.2025.03.009","DOIUrl":"10.1016/j.jjcc.2025.03.009","url":null,"abstract":"<p><p>Tricuspid regurgitation (TR) is a prevalent cardiovascular disease necessitating innovative treatments. Assessing comorbidities, such as right ventricular dysfunction, is pivotal for the therapeutic strategy. Preprocedural echocardiographic assessments are crucial for achieving optimal TR reduction. Transcatheter interventions have emerged as less invasive therapies. Tricuspid transcatheter edge-to-edge repair is the predominant technology, proven safe and effective in reducing TR. Additionally, transcatheter tricuspid valve replacement and direct annuloplasty technologies have been developed and recognized as attractive alternatives, each with unique advantages. This review discusses the innovation, current landscape, and future perspective of transcatheter tricuspid valve interventions for treating TR.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663525","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
Safety and effectiveness of self-expanding TAVR in Japanese dialysis patients with severe aortic stenosis: 1-year outcomes. 自扩式TAVR治疗严重主动脉瓣狭窄日本透析患者的安全性和有效性:1年预后
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2025-03-15 DOI: 10.1016/j.jjcc.2025.03.008
Koki Shishido, Futoshi Yamanaka, Noriaki Moriyama, Tomoki Ochiai, Hirokazu Miyashita, Tsuyoshi Yamabe, Kenichiro Noguchi, Tohru Asai, Shuzo Kobayashi, Yu Jung Yeh, Shigeru Saito
{"title":"Safety and effectiveness of self-expanding TAVR in Japanese dialysis patients with severe aortic stenosis: 1-year outcomes.","authors":"Koki Shishido, Futoshi Yamanaka, Noriaki Moriyama, Tomoki Ochiai, Hirokazu Miyashita, Tsuyoshi Yamabe, Kenichiro Noguchi, Tohru Asai, Shuzo Kobayashi, Yu Jung Yeh, Shigeru Saito","doi":"10.1016/j.jjcc.2025.03.008","DOIUrl":"10.1016/j.jjcc.2025.03.008","url":null,"abstract":"<p><strong>Background: </strong>In Japan, transcatheter aortic valve 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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 permanent pacemaker implantations. Valve hemodynamics improved postprocedure and were maintained in all patients reaching 12-month follow-up (mean effective orifice area 2.1 ± 0.4 cm<sup>2</sup>, mean gradient 6.8 ± 1.6 mmHg), and no patients had moderate or severe aortic regurgitation.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-15","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}
引用次数: 0
Temporal trends in management strategies and clinical outcomes of venous thromboembolism in Japan from 2017 to 2023. 2017 - 2023年日本静脉血栓栓塞管理策略和临床结果的时间趋势
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2025-03-15 DOI: 10.1016/j.jjcc.2025.03.007
Wei Xiong, Yugo Yamashita, Toshiki Fukasawa, Chikashi Takeda, Hiroki Shiomi, Takahiro Horie, Koh Ono
{"title":"Temporal trends in management strategies and clinical outcomes of venous thromboembolism in Japan from 2017 to 2023.","authors":"Wei Xiong, Yugo Yamashita, Toshiki Fukasawa, Chikashi Takeda, Hiroki Shiomi, Takahiro Horie, Koh Ono","doi":"10.1016/j.jjcc.2025.03.007","DOIUrl":"10.1016/j.jjcc.2025.03.007","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) is a major health problem worldwide. There are scarce data on the recent temporal trends of patients with VTE after the widespread use of direct oral anticoagulants (DOACs).</p><p><strong>Methods and results: </strong>In a Japanese nationwide hospital administrative database, we identified 20,217 patients with VTE from 2017 to 2023, and evaluated their temporal trends in management strategies and clinical outcomes. The proportions of outpatient treatment among patients with out-of-hospital isolated deep vein thrombosis increased significantly (p trend <0.001, Pearson's R = 0.046) over time from 2017 to 2023. The proportions of warfarin use decreased significantly over time from 2017 to 2023 (p trend <0.001, Pearson's R = -0.053), whereas the use of most DOACs increased. The proportions of thrombolysis (p trend <0.001, Pearson's R = -0.046) and inferior vena cave filter (p trend <0.001, Pearson's R = -0.048) use decreased significantly over time from 2017 to 2023. The incidence of 6-month all-cause death, VTE recurrence, and bleeding was 9.1 %, 2.1 %, and 4.4 %, respectively. The incidence decreased in 6-month all-cause death (p trend = 0.018, Pearson's R = -0.017) and bleeding (p trend <0.001, Pearson's R = -0.029) over time from 2017 to 2023.</p><p><strong>Conclusions: </strong>The current Japanese nationwide hospital administrative database provided the recent temporal trends in the real-world management strategies and clinical outcomes of VTE, which revealed several temporal changes in these aspects after the widespread use of DOACs.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639629","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
Future perspective regarding the clinical impact of very severe aortic stenosis following trans-catheter aortic valve implantation. 经导管主动脉瓣置入术后非常严重主动脉狭窄的临床影响的未来展望。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2025-03-14 DOI: 10.1016/j.jjcc.2025.03.003
Hiroshi Onoda, Teruhiko Imamura
{"title":"Future perspective regarding the clinical impact of very severe aortic stenosis following trans-catheter aortic valve implantation.","authors":"Hiroshi Onoda, Teruhiko Imamura","doi":"10.1016/j.jjcc.2025.03.003","DOIUrl":"10.1016/j.jjcc.2025.03.003","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633963","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
Novel tailored very-high-power short-duration radiofrequency ablation around the esophagus guided by left atrial voltage. 新型定制的高功率短时间射频消融食管周围由左心房电压引导。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2025-03-13 DOI: 10.1016/j.jjcc.2025.03.005
Yasuharu Matsunaga-Lee, Yasuyuki Egami, Mizuki Ohsuga, Masaru Abe, Hiroaki Nohara, Shodai Kawanami, Kohei Ukita, Akito Kawamura, Koji Yasumoto, Naotaka Okamoto, Masamichi Yano, Masami Nishino
{"title":"Novel tailored very-high-power short-duration radiofrequency ablation around the esophagus guided by left atrial voltage.","authors":"Yasuharu Matsunaga-Lee, Yasuyuki Egami, Mizuki Ohsuga, Masaru Abe, Hiroaki Nohara, Shodai Kawanami, Kohei Ukita, Akito Kawamura, Koji Yasumoto, Naotaka Okamoto, Masamichi Yano, Masami Nishino","doi":"10.1016/j.jjcc.2025.03.005","DOIUrl":"10.1016/j.jjcc.2025.03.005","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 %, p = 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 %, p = 0.004). No gastric hypomotility and atrio-esophageal fistulae were observed.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","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}
引用次数: 0
Clinical implications of malnutrition on 30-day adverse events in patients with Takotsubo syndrome. 营养不良对Takotsubo综合征患者30天不良事件的临床意义
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2025-03-13 DOI: 10.1016/j.jjcc.2025.03.004
Kyohei Onishi, Koichiro Matsumura, Eijiro Yagi, Nobuhiro Yamada, Yohei Funauchi, Kazuyoshi Kakehi, Ayano Yoshida, Kosuke Fujita, Takayuki Kawamura, Hiroki Matsuzoe, Masafumi Ueno, Gaku Nakazawa
{"title":"Clinical implications of malnutrition on 30-day adverse events in patients with Takotsubo syndrome.","authors":"Kyohei Onishi, Koichiro Matsumura, Eijiro Yagi, Nobuhiro Yamada, Yohei Funauchi, Kazuyoshi Kakehi, Ayano Yoshida, Kosuke Fujita, Takayuki Kawamura, Hiroki Matsuzoe, Masafumi Ueno, Gaku Nakazawa","doi":"10.1016/j.jjcc.2025.03.004","DOIUrl":"10.1016/j.jjcc.2025.03.004","url":null,"abstract":"<p><strong>Background: </strong>The impact of malnutrition on clinical outcomes in patients with takotsubo syndrome (TTS) is poorly understood. The purpose of this study was to investigate the relationship between malnutrition on admission and 30-day adverse events in patients with TTS.</p><p><strong>Methods: </strong>We retrospectively evaluated 124 consecutive patients admitted for TTS at our hospital from April 2013 to July 2023. Malnutrition was assessed at admission using the Geriatric Nutritional Risk Index (GNRI), which is an objective and simple nutritional assessment method. Malnutrition was defined as GNRI <92. We defined 30-day adverse events as the composite of all-cause death, acute heart failure, cardiogenic shock, life-threatening arrhythmia, thrombotic events, and stroke. The primary endpoint was the comparison of the 30-day adverse event rates between patients with and without malnutrition.</p><p><strong>Results: </strong>The median age was 78.0 (70.0-83.0) years, and 77 % of the patients were women. The median GNRI was 90.8 (81.5-98.0) and 55 % had malnutrition. The 30-day adverse events were shown in 64 patients. Compared with patients without malnutrition, the 30-day adverse event rate was significantly higher in those with malnutrition (32 % vs. 68 %, respectively; log-rank test p = 0.0001). The multivariable Cox proportional hazards model revealed that malnutrition was independently associated with high 30-day adverse event rates adjusted by age, female sex, malignancy, B-type natriuretic peptide, and high-sensitivity C-reactive protein (hazard ratio: 1.97, 95 % confidence interval: 1.08-3.58; p = 0.02).</p><p><strong>Conclusions: </strong>Malnutrition at admission was associated with high 30-day adverse event rates. Early identification and a considered treatment strategy for malnutrition are important in patients with TTS.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630524","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}
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