Journal of cardiology最新文献

{"title":"Implications of asymptomatic hypotension for patients prescribed sacubitril/valsartan: Insight from the REVIEW-HF registry.","authors":"Wataru Fujimoto, Shingo Matsumoto, Koshiro Kanaoka, Takahito Nasu, Keisuke Kida, Nobuyuki Kagiyama, Shunsuke Ishii, Yukihiro Watanabe, Atsushi Kikuchi, Takeshi Ijichi, Tatsuhiro Shibata, Hidekazu Tanaka","doi":"10.1016/j.jjcc.2025.02.012","DOIUrl":"10.1016/j.jjcc.2025.02.012","url":null,"abstract":"<p><strong>Background: </strong>Sacubitril/valsartan has unequivocally demonstrated prognostic improvement in patients with chronic heart failure in large-scale randomized controlled trials. However, it remains uncertain whether patients presenting with asymptomatic hypotension have distinct prognoses compared to those with symptomatic hypotension, and there is no consensus on the optimal strategy for managing asymptomatic hypotension.</p><p><strong>Methods and results: </strong>A multicenter retrospective study was conducted, analyzing data from patients initiated on sacubitril/valsartan therapy. The primary outcome was a composite of cardiovascular death or a hospitalization for heart failure. Among 992 patients, 72 patients (7.3 %) experienced symptomatic hypotension, and 122 patients (12.3 %) experienced asymptomatic hypotension within three months. The incidence of primary endpoint for patients who experienced hypotension, regardless of whether it was symptomatic or asymptomatic, was higher than for those who did not experience hypotension (Log-rank p < 0.05). Among patients who experienced asymptomatic hypotension, 23 patients discontinued sacubitril/valsartan within three days after the onset of asymptomatic hypotension. Patients who discontinued sacubitril/valsartan after the occurrence of asymptomatic hypotension experienced a significantly higher incidence of primary endpoints compared to those who continued sacubitril/valsartan therapy (Log-rank p = 0.01).</p><p><strong>Conclusion: </strong>The prognosis of patients who discontinued sacubitril/valsartan after the occurrence of asymptomatic hypotension during sacubitril/valsartan therapy was poor. It may be beneficial to aim for the continuation of sacubitril/valsartan therapy even after the occurrence of asymptomatic hypotension.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425573","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 atrial high-rate episodes on mortality risks in CIED patients.","authors":"Phuuwadith Wattanachayakul, Panat Yanpiset, Narathorn Kulthamrongsri, Vitchapong Prasitsumrit, Kevin Bryan Lo, Jakrin Kewcharoen, Sumeet Mainigi","doi":"10.1016/j.jjcc.2025.02.010","DOIUrl":"10.1016/j.jjcc.2025.02.010","url":null,"abstract":"<p><strong>Background: </strong>Recent data showed that patients with cardiac implantable electronic devices (CIEDs) who have atrial high-rate episodes (AHRE) have an increased risk of systemic thromboembolism even without a history of atrial fibrillation. However, data regarding the impact of AHRE on mortality outcomes remain conflicting. This study aims to elucidate this relationship by summarizing all available data via systematic review and meta-analysis.</p><p><strong>Methods: </strong>We systematically reviewed MEDLINE and EMBASE from inception to May 2024 to evaluate the association between AHRE and mortality risk in patients with CIED who did not have a history of atrial fibrillation at implantation. We compared all-cause and cardiovascular mortality in patients with AHRE to those without AHRE. Relative risk (RR) or hazard ratio and their 95 % confidence intervals (CIs) were extracted from each study and combined using the generic inverse variance method.</p><p><strong>Results: </strong>A total of 15 cohort studies were included in the meta-analysis. The pooled analysis showed that patients with AHRE had a higher risk of all-cause mortality compared to those without AHRE, with a pooled RR of 1.57 (95 % CI 1.21-2.03; I² = 67 %; p < 0.001). Similarly, AHRE was associated with higher cardiovascular mortality, with a pooled RR of 1.80 (95 % CI 1.06-3.05; I² = 49 %; p = 0.03).</p><p><strong>Conclusions: </strong>Our study found that patients with CIEDs who developed AHRE were at a higher risk of all-cause and cardiovascular mortality compared to those without AHRE.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425581","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":"Development of new anticoagulants targeting coagulation factor XI and prospects for clinical use.","authors":"Masahiro Ieko, Kazumasa Ohmura, Sumiyoshi Naito, Mika Yoshida, Osamu Kumano","doi":"10.1016/j.jjcc.2025.02.013","DOIUrl":"10.1016/j.jjcc.2025.02.013","url":null,"abstract":"<p><p>Thrombosis is a potentially fatal condition for which various anticoagulant therapies have been used for prevention and treatment. However, bleeding events remain a concern with all anticoagulant drugs. Recent evidence suggests that inhibiting coagulation factor XI (FXI) and activated FXI (FXIa) plays a greater role in the formation of pathological thrombi in thrombosis than in normal hemostatic thrombi, allowing for the potential to address these two events separately. Consequently, FXI/XIa inhibition has become the focus of anticoagulant drug research, leading to the development of numerous FXI-targeting compounds with diverse mechanisms of action. Herein, we aimed to review FXI/FXIa inhibitors under development, discussing the role of FXI in the coagulation reaction and the advantages and disadvantages associated with its deficiency. The results of a Phase II study showed that FXI/XIa inhibitors provide efficacy comparable to that of low molecular weight heparin therapy while reducing clinically significant bleeding events. Additionally, in a study of patients with atrial fibrillation, FXI/XIa inhibitors reduced bleeding events compared to those with direct oral anticoagulants. Furthermore, when combined with antiplatelet therapy, FXI/XIa inhibitors did not significantly increase bleeding risk in non-cardioembolic stroke or acute coronary syndrome. However, conflicting trial results have also been reported, highlighting the difficulty in assessing the clinical benefit of FXI/XIa inhibitors in different clinical settings, such as atrial fibrillation and acute myocardial infarction. Future large, well-designed Phase III studies are needed to evaluate the safety and efficacy of FXI/XIa inhibitors across diverse populations requiring antithrombotic therapy.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425555","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":"Hadisa Talpur, Ghulam Mustafa","doi":"10.1016/j.jjcc.2025.02.011","DOIUrl":"10.1016/j.jjcc.2025.02.011","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425577","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":"Cognitive impairment in patients with heart failure: Physiopathology, clinical implications, and therapeutic considerations.","authors":"Meng Li, Junping Zhang, Yue Hu, Yue Zhang","doi":"10.1016/j.jjcc.2025.02.007","DOIUrl":"10.1016/j.jjcc.2025.02.007","url":null,"abstract":"<p><p>Cognitive impairment (CI) is a significant comorbidity in individuals with heart failure (HF). A substantial number of patients with HF may experience CI, which can present as deficits in attention, memory, executive function, and processing speed. HF patients with CI tend to have reduced functional independence, self-care capabilities, medication adherence and decision-making ability, along with more frequent rehospitalizations, and an increased risk of mortality. Currently, there is no established gold standard diagnostic tool or follow-up strategy for assessing CI in patients with HF. There has been an increasing recognition of the complex bidirectional relationship between HF and CI. However, the exact pathological mechanisms of CI in HF need further in-depth investigation. This review aims to explore the current epidemiological status of CI in patients with HF, the relationship between HF and cognitive dysfunction, the pathological mechanisms involved, as well as the early screening, diagnosis, and management issues for HF patients with CI. It also discusses prevention and intervention strategies. The objective is to provide a scientific basis for the clinical diagnosis, management, and treatment of CI in HF, while proposing future research directions to advance this field.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425480","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 outcomes in very severe aortic stenosis following TAVI.","authors":"Mesut Gitmez, Mehmet Kadri Akboga","doi":"10.1016/j.jjcc.2025.02.014","DOIUrl":"10.1016/j.jjcc.2025.02.014","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425579","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":"Factors involved in discontinuation or dose reduction of angiotensin receptor-neprilysin inhibitor: A retrospective analysis in 200 patients.","authors":"Haruna Inoue, Kenzo Uzu, Yusuke Fukuyama, Yoshinori Nagasawa, Kiyohiro Hyogo, Yasushi Shimokawa, Hideaki Okubo, Hiroki Shimizu","doi":"10.1016/j.jjcc.2025.02.006","DOIUrl":"10.1016/j.jjcc.2025.02.006","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425558","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":"Imaging characteristics of patients with cardiac sarcoidosis who presented with ventricular arrhythmias.","authors":"Noor K Albakaa, Kimi Sato, Naoto Kawamatsu, Masayoshi Yamamoto, Tomoko Machino-Ohtsuka, Yuki Komatsu, Akihiko Nogami, Masaki Ieda, Tomoko Ishizu","doi":"10.1016/j.jjcc.2025.02.004","DOIUrl":"10.1016/j.jjcc.2025.02.004","url":null,"abstract":"<p><strong>Background: </strong>Ventricular arrhythmia (VA) is an ominous manifestation of cardiac sarcoidosis (CS). Hence, identifying specific characteristics associated with VA in imaging modalities may enhance risk stratification.</p><p><strong>Methods: </strong>Fifty-nine patients diagnosed with CS were retrospectively studied and grouped based on presenting symptoms as the VA group (sustained ventricular tachycardia and ventricular fibrillation) and the non-VA group (atrioventricular block, heart failure, and other symptoms). Thirty-nine patients underwent comprehensive evaluation by cardiac magnetic resonance imaging and ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) for comparing cardiac involvement distribution.</p><p><strong>Results: </strong>The VA group (n = 15) showed higher prevalence of right bundle branch block, basal interventricular thinning, and left ventricle wall motion abnormality. In Cox analysis, VA at baseline (hazard ratio 4.75, p = 0.008) was associated with poor outcomes. The VA group showed a larger extent of late gadolinium enhancement than the non-VA group, especially in the left ventricular mid inferoseptal, right ventricular (RV) basal lateral to mid lateral, and RV apical anterior lesions. FDG-PET accumulation was prominent in the RV basal lateral to basal inferior, and mid anterior lesions in the VA group.</p><p><strong>Conclusions: </strong>Patients who presented with VA had worse outcomes and a larger cardiac involvement predominant to the RV and ventricular septum; RV predominant scar pattern may serve as a surrogate in patients with CS and explain possible correlation with electrophysiological abnormalities.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425571","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":"Incidence, predictors, and sex differences in acute coronary syndrome overdiagnosis among patients presenting to the emergency department with acute chest pain.","authors":"Giorgio Fiore, Giuseppe Pinto, Michele Oppizzi, Massimo Slavich, Carlo Gaspardone, Federico Furlan, Davide Valsecchi, Alberto Margonato, Gabriele Fragasso","doi":"10.1016/j.jjcc.2025.02.008","DOIUrl":"10.1016/j.jjcc.2025.02.008","url":null,"abstract":"<p><strong>Background: </strong>In the era of high-sensitivity troponin assays, overdiagnosis of acute coronary syndrome (ACS) has become increasingly common, overriding underdiagnosis and carrying a burden of healthcare issues. This study aimed to assess the incidence, predictors, and sex differences in ACS overdiagnosis among patients presenting with chest pain (CP) to the emergency department (ED).</p><p><strong>Methods: </strong>Consecutive CP patients presenting at the ED were included. Patients with other causes of CP, non-suspicious for ACS, were excluded. Six-month ACS rate was assessed in discharged patients. In ACS hospitalized patients, clinical records were analyzed to evaluate true-ACS incidence. Patients inappropriately hospitalized for ACS (ACS-overdiagnosis, false-positives) were compared to correctly discharged (true-negatives) and actual ACS patients (true-positives and false-negatives).</p><p><strong>Results: </strong>From 7040 CP patients, a random sample of 1025 was included. ACS was initially diagnosed in 237 (23.1 %) patients who were hospitalized, while 788 (76.9 %) were discharged from the ED. ACS misdiagnosis occurred in 30 (2.9 %) patients: 8 (1 %) discharged patients experienced ACS at follow-up (false-negatives) while 22 (9.3 %) hospitalized for ACS were considered not to have ACS (ACS-overdiagnosis). True incident ACS at 6 months was 223 (21.8 %). Independent predictors of ACS overdiagnosis were electrocardiographic alterations, troponin T > 99° percentile, and male sex, while women were older with lower pre-test likelihood of ACS according to ED physicians, with a higher rate of early discharge but similar outcomes.</p><p><strong>Conclusions: </strong>ACS overdiagnosis is more frequent than underdiagnosis, carrying potential issues for the healthcare system. Patients with ACS overdiagnosis were more commonly men with elevated high-sensitivity troponin, often indistinguishable from true-ACS patients according to standard care.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425575","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":"Relationship between body mass index and traditional size-matching in heart transplantation.","authors":"Ahad Firoz, Huaqing Zhao, Eman Hamad","doi":"10.1016/j.jjcc.2025.02.001","DOIUrl":"10.1016/j.jjcc.2025.02.001","url":null,"abstract":"<p><strong>Background: </strong>Donor-recipient size matching is an important consideration for heart allocation, of which predicted heart mass (PHM) ratio has been found to be the most optimal metric. However, the PHM formula has not been validated in a cohort that included obese recipients. Therefore, our study seeks to add further granular data on this topic by investigating acute survival in PHM categories across multiple body mass index (BMI) groups.</p><p><strong>Methods: </strong>Adult heart transplant recipients were analyzed using the United Network for Organ Sharing database. BMI groups included: normal (18.5-24.9 kg/m²), overweight (25.0-29.9 kg/m²), obese class I (30.0-34.9 kg/m²), and obese class II+ (≥35.0 kg/m²). PHM ratio (PHMR) categories were: severely undersized (U2): <0.85, undersized (U1): 0.85-0.95, approximately equally sized (R): 0.95-1.05, oversized (O1): 1.05-1.25, and severely oversized (O2): ≥1.25. All-cause acute mortality was the primary outcome of interest.</p><p><strong>Results: </strong>A total of 46,141 recipients were included in our analysis. The percentage of obese patients and donors increased over the years, from 21.5 % and 17.2 % in 2000 to 34.4 % and 33.1 % in 2022, respectively. Survival analysis found a stepwise reduction in mortality risk for severely undersized grafts as BMI increased (normal: HR = 1.59, p < 0.001; overweight: HR = 1.20, p = 0.029), until ultimately reaching insignificant levels in obese groups across all PHMR categories.</p><p><strong>Conclusion: </strong>Patients with a normal to overweight BMI were susceptible to increased mortality with a severely undersized graft. Conversely, obese groups appeared to be resistant to the hazards of organ size mismatching by PHMR. The clinical implications of this study may enable recruitment from a larger donor pool and improve challenges in transplantation for obese patients.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390797","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}