Journal of cardiology最新文献

{"title":"Impact of right ventricular and pulmonary vascular characteristics on Impella hemodynamic support in biventricular heart failure: A simulation study","authors":"Hiroki Matsushita MD ,&nbsp;Keita Saku MD, PhD ,&nbsp;Takuya Nishikawa MD, PhD ,&nbsp;Takashi Unoki MD ,&nbsp;Shohei Yokota MD ,&nbsp;Kei Sato MD ,&nbsp;Hidetaka Morita MD, PhD ,&nbsp;Yuki Yoshida BE ,&nbsp;Masafumi Fukumitsu MD, PhD ,&nbsp;Kazunori Uemura MD, PhD ,&nbsp;Toru Kawada MD, PhD ,&nbsp;Atsushi Kikuchi MD ,&nbsp;Ken Yamaura MD, PhD","doi":"10.1016/j.jjcc.2024.07.008","DOIUrl":"10.1016/j.jjcc.2024.07.008","url":null,"abstract":"<div><h3>Background</h3><div>Impella (Abiomed, Danvers, MA, USA) is a percutaneous ventricular assist device commonly used in cardiogenic shock, providing robust hemodynamic support, improving the systemic circulation, and relieving pulmonary congestion. Maintaining adequate left ventricular (LV) filling is essential for optimal hemodynamic support by Impella. This study aimed to investigate the impact of pulmonary vascular resistance (PVR) and right ventricular (RV) function on Impella-supported hemodynamics in severe biventricular failure using cardiovascular simulation.</div></div><div><h3>Methods</h3><div>We used Simulink® (Mathworks, Inc., Natick, MA, USA) for the simulation, incorporating pump performance of Impella CP determined using a mock circulatory loop. Both systemic and pulmonary circulation were modeled using a 5-element resistance–capacitance network. The four cardiac chambers were represented by time-varying elastance with unidirectional valves. In the scenario of severe LV dysfunction (LV end-systolic elastance set at a low level of 0.4 mmHg/mL), we compared the changes in right (RAP) and left atrial pressures (LAP), total systemic flow, and pressure–volume loop relationship at varying degrees of RV function, PVR, and Impella flow rate.</div></div><div><h3>Results</h3><div>The simulation results showed that under low PVR conditions, an increase in Impella flow rate slightly reduced RAP and LAP and increased total systemic flow, regardless of RV function. Under moderate RV dysfunction and high PVR conditions, an increase in Impella flow rate elevated RAP and excessively reduced LAP to induce LV suction, which limited the increase in total systemic flow.</div></div><div><h3>Conclusions</h3><div>PVR is the primary determinant of stable and effective Impella hemodynamic support in patients with severe biventricular failure.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 2","pages":"Pages 100-107"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889375","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":"Coronary bioresorbable metallic stents: Advancements and future perspectives","authors":"Junyan Zhang MD ,&nbsp;Zhongxiu Chen MD ,&nbsp;Li Rao MD,&nbsp;Yong He MD","doi":"10.1016/j.jjcc.2024.08.003","DOIUrl":"10.1016/j.jjcc.2024.08.003","url":null,"abstract":"<div><div>Percutaneous coronary intervention is a critical treatment for coronary artery disease, particularly myocardial infarction, and is highly recommended in clinical guidelines. Traditional metallic stents, although initially effective, remain permanently in the artery and can lead to complications such as in-stent restenosis, late thrombosis, and chronic inflammation. Given the temporary need for stenting and the potential for late complications, bioresorbable stents have emerged as a promising alternative. However, bioresorbable polymeric stents have encountered significant clinical challenges due to their low mechanical strength and ductility, which increase the risks of thrombosis and local inflammation. Consequently, bioresorbable metals are being considered as a superior option for coronary stents. This review examines the progress of bioresorbable metallic stents from both preclinical and clinical perspectives, aiming to provide a theoretical foundation for future research. Iron, zinc, and magnesium are the primary materials used for these stents. Zinc-based bioresorbable stents have shown promise in preclinical studies due to their biocompatibility and vascular protective properties, although human clinical studies are still limited. Magnesium-based stents have demonstrated positive clinical outcomes, being fully absorbed within 12 months and showing low rates of late lumen loss and target lesion failure at 6- and 12-months post-implantation. Initial trials of iron-based stents have indicated favorable mid-term safety and efficacy, with complete absorption by the body within three years and consistent luminal expansion beyond six months post-implantation. Despite these advancements, further trials are needed for comprehensive validation. In conclusion, while current materials do not fully meet the ideal requirements, ongoing research should focus on developing bioresorbable stents with enhanced performance characteristics to better meet clinical needs.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 2","pages":"Pages 69-78"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971163","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":"Temporal Trends in Race and Sex Differences in Cardiac Arrest Mortality in the USA, 1999–2020","authors":"Karthik Gonuguntla MD ,&nbsp;Muchi Ditah Chobufo MD, MPH ,&nbsp;Ayesha Shaik MD ,&nbsp;Nicholas Roma MD ,&nbsp;Mouna Penmetsa MD ,&nbsp;Harshith Thyagaturu MD ,&nbsp;Neel Patel MD ,&nbsp;Amro Taha MD ,&nbsp;Waleed Alruwaili MD, MPH ,&nbsp;Raahat Bansal MD ,&nbsp;Muhammad Zia Khan MD, MS ,&nbsp;Yasar Sattar MD ,&nbsp;Sudarshan Balla MD","doi":"10.1016/j.jjcc.2024.08.006","DOIUrl":"10.1016/j.jjcc.2024.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac arrest (CA) affects over 600,000 patients in the USA annually. Despite large-scale public health and educational initiatives, survival rates are lower in certain racial and socioeconomic groups.</div></div><div><h3>Methods</h3><div>A county-level cross-sectional longitudinal study using death data of patients aged 15 years or more from the US Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (WONDER) database from 1999 to 2020. CAs were identified using the International Classification of Diseases, tenth revision, clinical modification codes.</div></div><div><h3>Results</h3><div>The CA-related deaths between 1999 and 2020 were 7,710,211 in the entire USA. The annual CA related age-adjusted mortality rates (CA-MR) declined through 2019 (132.9 to 89.7 per 100,000 residents), followed by an increase in 2020 (104.5 per 100,000). White patients constituted 82 % of all deaths and 51 % were female. The overall CA-MR during the study period was 104.48 per 100,000 persons. The CA-MR was higher for men as compared with women (123.5 vs. 89.7 per 100,000) and higher for Black as compared with White adults (154.4 vs. 99.1 per 100,000).</div></div><div><h3>Conclusions</h3><div>CA-MR in the overall population has declined, followed by an increase in 2020, which is likely the impact of the COVID-19 pandemic. There were also significant racial and sex differences in mortality rates.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 2","pages":"Pages 63-68"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000054","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":"Comparison of clinical outcomes between proximal and non-proximal right coronary artery occlusion in patients with inferior ST-segment elevation myocardial infarction","authors":"Koudai Hamaguchi MD,&nbsp;Kenichi Sakakura MD,&nbsp;Hiroyuki Jinnouchi MD,&nbsp;Yousuke Taniguchi MD,&nbsp;Kei Yamamoto MD,&nbsp;Takunori Tsukui MD,&nbsp;Masashi Hatori MD,&nbsp;Taku Kasahara MD,&nbsp;Yusuke Watanabe MD,&nbsp;Shun Ishibashi MD,&nbsp;Masaru Seguchi MD,&nbsp;Hideo Fujita MD, FJCC","doi":"10.1016/j.jjcc.2024.07.007","DOIUrl":"10.1016/j.jjcc.2024.07.007","url":null,"abstract":"<div><h3>Background</h3><div>The clinical outcomes of ST-segment elevation myocardial infarction (STEMI) due to the occlusion of left coronary artery are worse in patients with proximal occlusion than in those with non-proximal occlusion. However, there are few reports that focus on the comparison of clinical outcomes in patients with STEMI between proximal and non-proximal right coronary artery (RCA) occlusions.</div></div><div><h3>Methods</h3><div>We included 356 patients with STEMI whose infarct-related artery is RCA and divided them into the proximal group (<em>n</em> = 129) and the non-proximal group (<em>n</em> = 227). We defined segment 1 of RCA as proximal, and segments 2, 3, and 4 as non-proximal according to the reporting system of the American Heart Association. The primary endpoint was major cardiovascular events (MACE), which was defined as the composite of all-cause death, non-fatal myocardial infarction, readmission for heart failure, and ischemia-driven target vessel revascularization.</div></div><div><h3>Results</h3><div>Incidence of shock at admission, requirement for catecholamine during percutaneous coronary intervention (PCI), or mechanical support during PCI tended to be higher in the proximal group (42.6 %) than in the non-proximal group (33.5 %) (<em>p</em> = 0.088). Although the incidence of right ventricular infarction tended to be higher in the proximal group (17.8 %) than in the non-proximal group (10.6 %) without reaching statistical significance (<em>p</em> = 0.072), the incidence of in-hospital death was similar between the 2 groups (1.6 % versus 1.8 %, <em>p</em> = 1.000). The MACE-free survival curves were not different between the 2 groups (<em>p</em> = 0.400). Multivariate Cox hazard analysis revealed that proximal RCA occlusion was not associated with MACE (HR 1.095, 95%CI 0.691–1.737, <em>p</em> = 0.699).</div></div><div><h3>Conclusions</h3><div>Although the acute phase conditions such as shock or right ventricular infarction tended to be more severe in patients with proximal occlusion, overall clinical outcomes including long-term outcomes were comparable between the proximal and distal RCA occlusions. Furthermore, multivariate analysis showed that the proximal RCA occlusion was not associated with MACE after hospital discharge.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 2","pages":"Pages 88-95"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889374","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":"Author's reply to the Letter to the Editor \"How to demonstrate the causal relationship between sodium-glucose cotransporter 2 receptor and prevention of ventricular arrhythmia in heart failure cohorts\".","authors":"Paolo Basile, Andrea Igoren Guaricci","doi":"10.1016/j.jjcc.2025.01.012","DOIUrl":"10.1016/j.jjcc.2025.01.012","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080081","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":"Current evidence and indications for left atrial appendage closure.","authors":"Masaya Shinohara, Mike Saji, Hideki Koike, Hiroshi Ohara, Yoshinari Enomoto, Rine Nakanishi, Tadashi Fujino, Takanori Ikeda","doi":"10.1016/j.jjcc.2025.01.014","DOIUrl":"10.1016/j.jjcc.2025.01.014","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is the most common arrhythmia worldwide and its prevalence increases with age. The main and most severe complication of AF is ischemic stroke, yet an estimated 50 % of eligible patients cannot tolerate or are contraindicated to receive oral anticoagulation (OAC). In patients with AF, the left atrial appendage (LAA) is the main source of thrombus formation. Percutaneous LAA closure (LAAC) has emerged over the past two decades as a valuable alternative to OAC for reducing the risk of strokes and systemic embolisms in patients with AF who cannot tolerate long-term OAC. With newer generation devices such as the Watchman (Boston Scientific, Natick, MA, USA) and Amulet (Abbott, Abbott Park, IL, USA) gaining approval from the US Food and Drug Administration in recent years, the safety and efficacy of LAAC in specific populations intolerant to OAC have increased and more patients are being treated. This systematic review provides the indications for LAAC and the evidence for evaluating the use of the currently available device therapies. We also examine the current unsolved problems with patient selection and postprocedural antithrombotic regimens.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080083","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":"Racial differences in diuretic therapy, B-type natriuretic peptide values, and prognosis in acute heart failure.","authors":"Yu Horiuchi, Yuya Matsue, Nicholas Wettersten, Shogo Oishi, Eiichi Akiyama, Satoshi Suzuki, Masayoshi Yamamoto, Keisuke Kida, Takahiro Okumura, Takeshi Kitai, Dirk J van Veldhuisen, Alan Maisel, Patrick T Murray, Tohru Minamino","doi":"10.1016/j.jjcc.2025.01.013","DOIUrl":"10.1016/j.jjcc.2025.01.013","url":null,"abstract":"<p><strong>Background: </strong>Whether variability of B-type natriuretic peptide (BNP) values between races affects its clinical integration as a marker for congestion and predictor of prognosis in acute heart failure (AHF) remains unknown. We aimed to investigate the relationship between diuretic therapy, change in BNP value, and prognosis in AHF in relation to racial differences.</p><p><strong>Methods: </strong>This analysis combined data from the AKINESIS and REALITY-AHF studies. We included White, Black, and Asian individuals admitted with AHF requiring intravenous diuretic therapy. We examined the relative change in BNP values at 48 h post hospital admission, and its association with diuretic therapy and one-year mortality.</p><p><strong>Results: </strong>Of 1380 participants, 29 % were White, 12 % were Black, and 58 % were Asian. Admission BNP values were highest in Black, followed by Asian and White individuals. After adjusting for confounding factors, Black individuals had significantly higher admission BNP values compared to White individuals. During the first 48 h of hospitalization, Asian individuals received the lowest diuretic dose but demonstrated the greatest diuretic response and BNP decrease. After adjustment for confounding factors, Asian individuals were more likely to have a BNP decrease compared to White individuals. Higher admission BNP values predicted higher one-year mortality in White and Asian but not in Black individuals (p for interaction = 0.021). BNP decrease was associated with a lower one-year mortality without a significant interaction by race.</p><p><strong>Conclusions: </strong>In AHF patients, admission BNP was higher in Black, and its decrease after diuretic therapy was greater in Asian individuals. A BNP decrease predicted a better prognosis, regardless of race.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074677","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":"Clinical characteristics and outcomes in takotsubo syndrome -Review of insights from the InterTAK Registry.","authors":"Ken Kato, Davide Di Vece, Mari Kitagawa, Kayo Yamamoto, Ko Miyakoda, Shuhei Aoki, Hiroki Goto, Hideki Kitahara, Yoshio Kobayashi, Christian Templin","doi":"10.1016/j.jjcc.2025.01.009","DOIUrl":"10.1016/j.jjcc.2025.01.009","url":null,"abstract":"<p><p>Takotsubo syndrome (TTS) is a complex cardiovascular condition characterized by transient left and/or right ventricular dysfunction in the absence of a coronary artery culprit lesion. The InterTAK registry, a large international collaborative registry, has significantly advanced our understanding of TTS. This review summarizes key findings from the InterTAK registry, including epidemiology, clinical presentation, comorbidities, outcomes, and treatment. The registry has revealed the diverse clinical spectrum of TTS, including atypical presentations, and identified various risk factors associated with adverse outcomes. The InterTAK registry has been instrumental in shaping the current understanding of TTS and will continue to guide future research and clinical practice.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074639","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 values of proteinuria in patients with acute heart failure.","authors":"Yuka Akama, Yuya Matsue, Daichi Maeda, Taishi Dotare, Tsutomu Sunayama, Takashi Iso, Yudai Fujimoto, Taisuke Nakade, Shoichiro Yatsu, Sayaki Ishiwata, Yutaka Nakamura, Shoko Suda, Takao Kato, Masaru Hiki, Takatoshi Kasai, Tohru Minamino","doi":"10.1016/j.jjcc.2025.01.010","DOIUrl":"10.1016/j.jjcc.2025.01.010","url":null,"abstract":"<p><strong>Background: </strong>Renal dysfunction is significantly associated with poor prognosis in patients with heart failure. However, the prognostic significance of proteinuria as a potential marker of an impaired glomerular filtration barrier in acute heart failure (AHF) remains unclear. We aimed to investigate the prognostic value of urinary protein/creatinine ratio (PCR) in patients with AHF.</p><p><strong>Methods: </strong>Urinary protein levels measured at admission were adjusted for urinary creatinine concentrations in 346 patients (75 ± 13 years; 61 % men) with AHF. Patients were categorized based on urinary PCR, adhering to the Japanese chronic kidney disease (CKD) guideline cut-offs for CKD staging: A1 (<0.15 g/gCr), A2 (0.15-0.49 g/gCr), and A3 (≥0.5 g/gCr). The primary endpoint was all-cause mortality.</p><p><strong>Results: </strong>Overall, there were 85, 126, and 135 patients in the A1, A2, and A3 groups, respectively. Groups A2 and A3 were associated with lower hemoglobin levels, higher blood urea nitrogen and N-terminal pro-B-type natriuretic peptide levels, and poor renal function. Moreover, groups A2 and A3 had high cystatin C, alpha 1 microglobulin, and urinary liver-type fatty acid-binding protein (L-FABP) levels. Urinary PCR correlated more with tubular markers, alpha 1-microglobulin, and L-FABP than with the glomerular marker cystatin C. Over a median follow-up period of 434 (interquartile range: 89-753) days, 72 deaths occurred. Elevated urinary PCR was associated with higher mortality rates (log-rank test, p < 0.001), even after adjusting for other variables [A2 vs. A1: hazard ratio (HR) 2.59, 95 % confidence interval (CI) 0.71-9,55, p = 0.15; A3 vs. A1: HR 4.40, 95 % CI 1.17-16.6, p = 0.029].</p><p><strong>Conclusions: </strong>Elevated urinary PCR is more prevalent in patients with AHF and is associated with a higher risk of all-cause mortality, independent of covariates, including glomerular function. Thus, urinary PCR at admission should provide prognostic information independent of glomerular function.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065968","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":"Optimal ablation pattern on intraprocedural echocardiography is associated with favorable clinical outcomes of alcohol septal ablation for hypertrophic obstructive cardiomyopathy.","authors":"Junya Matsuda, Yukichi Tokita, Lisa Hoshika, Kentaro Koyama, Kakeru Ishihara, Serina Kobayashi, Saori Uchiyama, Yoichi Imori, Yoshiaki Kubota, Jun Nakata, Hideki Miyachi, Shuhei Tara, Takeshi Yamamoto, Hitoshi Takano, Mitsunobu Kitamura, Morimasa Takayama, Kuniya Asai","doi":"10.1016/j.jjcc.2025.01.007","DOIUrl":"10.1016/j.jjcc.2025.01.007","url":null,"abstract":"<p><strong>Background: </strong>Alcohol septal ablation (ASA) is used to treat drug-refractory hypertrophic obstructive cardiomyopathy (HOCM). Intraprocedural echocardiography is essential for identifying the septal area perfused by each septal branch; however, its role in determining the procedural endpoint of ASA remains unclear. This retrospective study aimed to evaluate the impact of intraprocedural echocardiographic findings on clinical outcomes and left ventricular pressure gradient (LVPG) after ASA.</p><p><strong>Methods: </strong>Overall, 120 patients with HOCM who underwent ASA at a single center were divided into two groups based on the presence of optimal ablation. Optimal ablation was defined as the ablated area fully covering the targeted septal myocardium from the point of contact with the onset of the accelerated flow to the basal septum and dense acoustic shadowing accompanying the ablated area. Clinical outcomes and LVPG changes were evaluated using inverse probability of treatment weighting.</p><p><strong>Results: </strong>Significantly more patients showed a New York Heart Association (NYHA) functional class improvement of ≥2 stages or achievement of class I in the optimal ablation group (n = 74) than in the non-optimal ablation group (94 % vs. 62 %; p < 0.001). The optimal ablation group had a significantly greater percentage reduction in LVPG at 1-year after ASA (82 ± 18 % vs. 64 ± 18 %; p = 0.001). Multivariate analyses revealed that optimal ablation was an independent predictor of a NYHA functional class improvement of ≥2 stages or achievement of class I (odds ratio, 11.3; 95 % confidence interval, 3.43-39.1; p < 0.001) and a percentage reduction in LVPG (p = 0.001).</p><p><strong>Conclusions: </strong>Intraprocedural echocardiographic findings of optimal ablation were associated with favorable clinical outcomes and a significant reduction in LVPG.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028844","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}