Journal of cardiology最新文献

{"title":"Efficacy and safety of intravenous versus oral tolvaptan in the acute phase of acute decompensated heart failure","authors":"Tomoaki Okada MD, PhD , Wataru Takagi MD, PhD , Toru Miyoshi MD, PhD, FJCC , Akihiro Oka MD , Kosuke Seiyama MD , Satoko Ugawa MD, PhD , Kazumasa Nosaka MD, PhD , Masayuki Doi MD, PhD","doi":"10.1016/j.jjcc.2024.06.008","DOIUrl":"10.1016/j.jjcc.2024.06.008","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 1","pages":"Pages 38-39"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450566","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":"Using electronic medical records to identify patients at risk for underlying cardiac amyloidosis","authors":"Michael A. Pascoe MD ,&nbsp;Andrew Kolodziej MD ,&nbsp;Emma J. Birks MD, PhD ,&nbsp;Gaurang Vaidya MD","doi":"10.1016/j.jjcc.2024.07.003","DOIUrl":"10.1016/j.jjcc.2024.07.003","url":null,"abstract":"<div><h3>Background</h3><div>Identification of transthyretin cardiac amyloidosis (ATTR-CA) patients is largely based on pattern recognition by providers, and this can be automated through electronic medical systems (EMR).</div></div><div><h3>Methods</h3><div>All patients in a large academic hospital with age &gt; 60, ICD-10 code for chronic diastolic heart failure and no previous diagnosis of any amyloidosis were included. An Epic EMR scoring logic assigned risk scores to patients for ICD-10 and CPT codes associated with ATTR-CA, as follows: carpal tunnel syndrome (score 5), aortic stenosis/TAVR (5), neuropathy (4), bundle branch block (4), etc. The individual patients' scores were added, and patients were arranged in descending order of total scores- ranging from 50 to 0. Data is reported as median (interquartile range) and analyzed with non-parametric tests.</div></div><div><h3>Results</h3><div>Of the total 11,648 patients identified, 132 consecutive patients with highest risk scores (score ≥ 30) were enrolled as cases, while 132 patients with scores between 10 and 19 with available echocardiography data served as age-matched controls. Strain echocardiography is not routinely performed. Patients with high scores were more likely to have CA associated findings- African-American race, higher left ventricular (LV) mass index and left atrial volume and lower LV ejection fraction. High score patients had higher troponin and a trend towards high NT-proBNP.</div></div><div><h3>Conclusion</h3><div>The modern EMR can be used to flag patients with high risk for ATTR-CA (score ≥ 30 using the proposed logic) through best practice advisory. This could encourage screening during echocardiography using strain or during unsuspected clinic visits.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 1","pages":"Pages 43-44"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590427","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":"Treatment strategies for diuretic resistance in patients with heart failure","authors":"Yu Horiuchi MD ,&nbsp;Nicholas Wettersten MD","doi":"10.1016/j.jjcc.2024.06.005","DOIUrl":"10.1016/j.jjcc.2024.06.005","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 1","pages":"Pages 1-7"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","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}

{"title":"Urinary sodium excretion for loop diuretic response in acute heart failure","authors":"Ly Quang Sang MD ,&nbsp;Duc Nguyen MD ,&nbsp;Tran Nguyen Phuong Hai MD ,&nbsp;Amjad S. AlMosa MD ,&nbsp;Abdelrahman Sherif Abdalla MD ,&nbsp;Abdelrahman M. Makram MBBCh, MPH ,&nbsp;Nguyen Tien Huy MD, PhD ,&nbsp;Hoang Van Sy MD, PhD","doi":"10.1016/j.jjcc.2024.07.001","DOIUrl":"10.1016/j.jjcc.2024.07.001","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 1","pages":"Pages 40-42"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554891","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":"How the trabecular layer impacts on left ventricular function","authors":"Ionela Simona Visoiu MD ,&nbsp;Bjarke Jensen MSc, PhD ,&nbsp;Roxana Cristina Rimbas MD, PhD ,&nbsp;Sorina Mihaila-Baldea MD, PhD ,&nbsp;Alina Ioana Nicula MD, PhD ,&nbsp;Dragos Vinereanu MD, PhD","doi":"10.1016/j.jjcc.2024.08.008","DOIUrl":"10.1016/j.jjcc.2024.08.008","url":null,"abstract":"<div><div>The ventricular trabecular layer is crucial in embryonic life. In adults, the proportion of trabecular-to-compact myocardium varies substantially between individuals, within individuals over time, and yet exhibits almost no correlation to pump function since most individuals with excessive trabeculation are asymptomatic. The question of how functional is the myocardium of the trabecular layer, relative to the myocardium of the compact layer, has been difficult to answer but it is often assumed to be inferior. An answer is now emerging from recent advances and it can improve our understanding of how the trabecular layer impacts on pathogenicity. This narrative review concerns natural variation in trabeculation, tissue organization, transcriptomics, immunohistochemistry, vascularization, electrical propagation, diastolic function and compliance, systolic function, and ejection fraction. There are no overt transcriptional differences in the adult stage, and the myocardium is equally equipped with sarcomeric proteins, mitochondria, and vascular supply. The similar structural features are consistent with myocardium with a similar stroke work per gram tissue, along with a high ejection fraction of the trabecular layer. In conclusion, the myocardium of the trabecular and compact layers is highly similar and this offers a logical explanation for the reproducible observations that most individuals with excessive trabeculation are asymptomatic.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 1","pages":"Pages 17-27"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107827","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}

{"title":"Echocardiographic factors associated with thromboembolic events in patients with cardiac amyloidosis without atrial fibrillation","authors":"Cristhian Espinoza Romero MD, MSc,&nbsp;Natalia Melo Pereira MD,&nbsp;Kevin De Paula Morales MD,&nbsp;Bruno V. Kerges Bueno MD,&nbsp;Georgina J. Luzuriaga MD,&nbsp;Vitor E. Egypto Rosa MD, PhD,&nbsp;Joao Henrique Rissato MD,&nbsp;Viviane T. Hotta MD, PhD,&nbsp;Fabio Fernandes MD, PhD","doi":"10.1016/j.jjcc.2024.08.001","DOIUrl":"10.1016/j.jjcc.2024.08.001","url":null,"abstract":"<div><h3>Aims</h3><div>Cardiac amyloidosis (CA) is associated with various complications, and one of them are thromboembolic events (TEEs), which can significantly impact patients' quality of life. Predicting and managing the risk of these TEEs in patients without atrial fibrillation (AF) pose significant challenges, as many occur independently of AF presence. Several predictors, particularly echocardiographic ones, have been linked to an increased risk, but there is no consensus on stratification or preventive treatment.</div><div>The main objective was to determine the prevalence of TEEs in a cohort of CA patients without AF and identify echocardiographic predictors.</div></div><div><h3>Methods</h3><div>A retrospective, single-center study including confirmed CA patients. A prespecified list of variables was defined, and only patients with at least 70 % of these variables were included. Risk rates were analyzed through binary logistic regression, with a significance level set at <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>75 patients were included. Baseline characteristics are depicted in Fig. 1.</div><div>Fifteen TEEs (20 %) were described, with 80 % being ischemic strokes. While diastolic dysfunction and pulmonary systolic arterial pressure (PSAP) were predictors in univariate analysis, the multivariate backward LR model identified interventricular septum diameter (IVSD) as the sole predictor, OR 1.280 (1.061–1.543), <em>p</em> = 0.010. It is also interesting to mention that analyzing the increase of every 3 mm in SIV, the chance of developing ETES was: OR = 2.095 (1.195–3.671), <em>p</em> = 0.010.</div></div><div><h3>Conclusions</h3><div>An IVSD evaluated by echocardiography demonstrated good performance capacity as a factor associated with TEEs in this cohort of patients with AC without AF. For every 3 mm increase in IVSD, the risk of developing TEEs doubles.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 1","pages":"Pages 45-46"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912848","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":"Left atrium as key player and essential biomarker in heart failure","authors":"Katsuji Inoue MD, PhD, FJCC ,&nbsp;Otto A. Smiseth MD, PhD","doi":"10.1016/j.jjcc.2024.07.006","DOIUrl":"10.1016/j.jjcc.2024.07.006","url":null,"abstract":"<div><div>This article reviews roles of the left atrium as regulator of left ventricular filling, as compensatory reserve in left ventricular dysfunction and as diagnostic marker in patients with cardiovascular disorders. Application of novel imaging tools to assess left atrial function and their integration with conventional clinical methods are discussed. This includes a review of clinical applications of left atrial strain as a method to quantify the reservoir and booster pump components of left atrial function. Emerging methods for assessing left atrial wall stiffness and active work by pressure-strain loop analysis are discussed. Recommendations for how to apply left atrial strain in clinical routine to diagnose elevated left ventricular filling pressure are provided. Furthermore, a role for left atrial strain in the diagnostic work-up in patients suspected of pre-capillary pulmonary hypertension is proposed. The article also reviews how to implement parameters of atrial structure and function in clinical routine as recommended by recent international guidelines for imaging of heart failure.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 1","pages":"Pages 8-16"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859863","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}

{"title":"Associations of cognitive decline with outcomes of cardiovascular rehabilitation in patients with cardiovascular disease.","authors":"Shoko Koseki, Kohei Nozaki, Nobuaki Hamazaki, Masashi Yamashita, Kentaro Kamiya, Shota Uchida, Takumi Noda, Kensuke Ueno, Ken Ogura, Takashi Miki, Emi Maekawa, Minako Yamaoka-Tojo, Atsuhiko Matsunaga, Junya Ako","doi":"10.1016/j.jjcc.2024.12.001","DOIUrl":"10.1016/j.jjcc.2024.12.001","url":null,"abstract":"<p><strong>Background: </strong>Patients with cardiovascular disease (CVD) are often contending with various comorbidities including cognitive decline. Cognitive decline is a risk marker for adverse outcomes in these patients. On the other hand, cardiovascular rehabilitation (CVR) improves clinical outcomes. However, it remains uncertain whether CVR is associated with favorable outcomes in patients with CVD and cognitive decline. Therefore, the present study aimed to investigate whether CVR is associated with favorable outcomes in patients with CVD and cognitive decline.</p><p><strong>Methods: </strong>We reviewed 4232 patients admitted for CVD. Cognitive function was assessed using the Mini-Cog at hospital discharge, and a score of <3 was defined as cognitive decline. We measured the 6-min walking distance (6MWD) at discharge and 5 months after CVR prescription for participants in outpatient CVR. The primary outcome was change in exercise tolerance (Δ6MWD), and the secondary outcome was composite events (all-cause death and/or re-admission due to CVD). We compared Δ6MWD between patients with and without cognitive decline and examined the association between outpatient CVR participation and composite events.</p><p><strong>Results: </strong>Of all patients, 768 had cognitive decline. There was no significant difference in Δ6MWD between the cognitive decline and non-cognitive decline groups, even after adjusting for confounders [estimated mean difference: 2.20 m; 95 % confidence interval (CI): -0.60-5.00 m]. Additionally, participation in outpatient CVR was associated with lower rate of composite events, regardless of cognitive decline [adjusted hazard ratio (aHR): 0.589; 95 % CI: 0.552-0.627 in the cognitive decline group and aHR: 0.767; 95 % CI: 0.742-0.793 in the non-cognitive decline group]. An interaction was observed based on the presence of cognitive decline (p = 0.011).</p><p><strong>Conclusion: </strong>Regardless of cognitive decline, participation in outpatient CVR was associated with increased exercise tolerance. Furthermore, outpatient CVR was linked to reduced composite events in both, with particularly potent association in cognitively impaired patients.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877278","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":"Impact of ECPELLA support on 1-year outcomes and myocardial damage in patients with acute myocardial infarction and refractory cardiogenic shock: A single-center retrospective observational study.","authors":"Takashi Unoki, Tomoko Nakayama, Keita Saku, Hiroki Matsushita, Taiji Inamori, Junya Matsuura, Takaaki Toyofuku, Tomohide Sato, Yutaka Konami, Hiroto Suzuyama, Masayuki Inoue, Eiji Horio, Kazuhisa Kodama, Eiji Taguchi, Takuya Nishikawa, Tadashi Sawamura, Koichi Nakao, Tomohiro Sakamoto, Ken Okumura, Junjiro Koyama","doi":"10.1016/j.jjcc.2024.12.003","DOIUrl":"10.1016/j.jjcc.2024.12.003","url":null,"abstract":"<p><strong>Background: </strong>Venoarterial-extracorporeal membrane oxygenation (VA-ECMO) is a vital mechanical circulatory support for treating patients with refractory cardiogenic shock (CS). VA-ECMO can improve end-organ perfusion; however, it increases left ventricular (LV) afterload, resulting in further myocardial damage. ECPELLA, a combination of VA-ECMO and Impella (Abiomed Inc., Danvers, MA, USA) treatments, is an emerging modality to optimize end-organ perfusion and LV unloading. The impact of ECPELLA in refractory CS has not been established. We aimed to investigate the effects of ECPELLA on acute-phase LV damage and outcomes in patients with acute myocardial infarction (AMI) and refractory CS and compare them with those of VA-ECMO with an intra-aortic balloon pump (IABP).</p><p><strong>Methods: </strong>This single-center retrospective observational study included 90 consecutive patients with AMI and refractory CS who received VA-ECMO between January 2012 and December 2022. Of these, 44 and 46 received ECPELLA and VA-ECMO with IABP, respectively. We assessed the serum creatine kinase myocardial band (CK-MB) levels and 1-year mortality.</p><p><strong>Results: </strong>No significant differences were observed in the baseline characteristics and time from onset to reperfusion between the two groups. Compared with VA-ECMO with IABP, ECPELLA produced lower peak CK-MB levels (265 IU/L vs. 500 IU/L, p = 0.016) and a smaller area under the curve of CK-MB during the first 3 days (274 IU/L × d vs. 534 IU/L × d, p = 0.025). ECPELLA was associated with significantly lower 1-year mortality (64% vs 91%; p = 0.001). Cox proportional hazards analysis revealed that ECPELLA was inversely and independently associated with 1-year mortality (hazard ratio: 0.38, 95% confidence interval: 0.23-0.64; p < 0.001).</p><p><strong>Conclusions: </strong>Our findings suggest that ECPELLA may offer myocardial protection and be associated with improved 1-year mortality in patients with AMI and refractory CS. Further prospective studies are needed to confirm these observations and better understand the potential benefits of ECPELLA in this population.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846679","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":"Mitral regurgitation in atrial fibrillation: Is a simple repair enough to tackle a complex problem?","authors":"Sohaihra Khan, Ruba Javed, Shafin Amin","doi":"10.1016/j.jjcc.2024.12.002","DOIUrl":"10.1016/j.jjcc.2024.12.002","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824152","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}