Journal of Cardiovascular Medicine最新文献

{"title":"Severe aortic stenosis: a disease of the valve and the myocardium in the TAVI era.","authors":"Martina Setti, Flavio Luciano Ribichini","doi":"10.2459/JCM.0000000000001921","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001921","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 8","pages":"617-620"},"PeriodicalIF":2.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912144","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":"Durable ventricular assist device implantation after acute myocardial infarction: an analysis of the EUROMACS registry.","authors":"Marina Pieri, Savino Altizio, Domenico Pontillo, Felix Schoenrath, Filippo Consolo, Silvia Ajello, Anna Mara Scandroglio","doi":"10.2459/JCM.0000000000001911","DOIUrl":"10.2459/JCM.0000000000001911","url":null,"abstract":"<p><strong>Introduction: </strong>Patients undergoing durable ventricular assist device (VAD) implantation after acute myocardial infarction (AMI) present critical surgical and clinical challenges. Data on outcomes in this high-risk population remain limited. The aim of this study was to describe the clinical profile and identify predictors of long-term outcomes in AMI patients receiving durable VAD support.</p><p><strong>Methods: </strong>Retrospective analysis of patients included in the EUROMACS registry (1995-2024) was conducted.</p><p><strong>Results: </strong>Three hundred and thirty-five patients (4.8% of EUROMACS records) underwent VAD implantation post-AMI. Most patients presented with severe cardiogenic shock (82% INTERMACS class 1-2), and the median time from AMI hospitalization to VAD implantation was 9 (IQR 8-14) days. Surgical revision for bleeding was required in 20% of patients. Mortality risk was 31% at 1 year, 46% at 5 years and 56% at 10 years. At multivariable analysis, female sex [subdistribution hazard ratio (SHR): 2.70, 95% confidence interval (95% CI): 1.62-4.49, P  = 0.016], mechanical ventilation (SHR: 2.16, 95% CI: 1.44-3.26, P  < 0.001) and VAD implantation as destination therapy (SHR: 2.48, 95% CI: 1.69-3.64, P  < 0.001) were independent predictors of mortality, while a recent year of implant (SHR: 0.84, 95% CI: 0.73-0.97, P  = 0.016) increasing BMI (SHR: 0.96, 95% CI: 0.94-0.99, P  = 0.014), no previous history of heart failure (SHR: 0.61, 95% CI: 0.42-0.91, P  = 0.014) and the presence of sinus rhythm (SHR: 0.63, 95% CI: 0.43-0.92, P  = 0.017) were protective factors against mortality.</p><p><strong>Conclusion: </strong>AMI patients accounted for a small subset of durable VAD recipients in an all-comers international registry, with high cardiogenic shock severity and substantial mortality risk. These findings provide a rationale for future prospective studies aimed at optimizing management and outcomes in this vulnerable population.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":" ","pages":"579-586"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520544","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":"Midazolam-induced underestimation of mitral regurgitation severity and its pharmacological reversal with flumazenil.","authors":"Hatice Tolunay, Özge Kurmus Ferik, Fatih Cihat Büyükbaş, Yunus Öz, Filiz Banu Ethemoğlu, Belma Yaman, Funda Basyigit","doi":"10.2459/JCM.0000000000001910","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001910","url":null,"abstract":"<p><strong>Background: </strong>Sedative agents may alter hemodynamic status and influence the echocardiographic assessment of mitral regurgitation. Although anesthesia-related underestimation of mitral regurgitation has been reported in intraoperative transesophageal echocardiography (TEE), the effects of conscious sedation with midazolam and pharmacologic reversal with flumazenil on mitral regurgitation severity during routine clinical TEE remain incompletely defined.</p><p><strong>Methods: </strong>Seventy-four patients with moderate or greater mitral regurgitation (41 primary, 33 secondary) were included. Mitral regurgitation indices, including effective regurgitant orifice area (EROA), regurgitant volume, vena contracta width, and proximal isovelocity surface area (PISA), were assessed on transthoracic echocardiography (TTE) immediately before TEE, after midazolam administration during TEE, and after flumazenil reversal during the same TEE session.</p><p><strong>Results: </strong>Midazolam significantly reduced heart rate and blood pressure in both groups. In patients with primary mitral regurgitation, baseline, postmidazolam, and postflumazenil measurements were as follows: EROA 0.31 ± 0.14, 0.25 ± 0.12, and 0.36 ± 0.14 cm2; regurgitant volume 46.71 ± 14.95, 40.76 ± 16.90, and 59.44 ± 18.11 mL; vena contracta width 5.30 ± 1.06, 4.86 ± 1.05, and 5.82 ± 1.16 mm (all P < 0.001). In secondary mitral regurgitation, corresponding measurements were EROA 0.29 ± 0.06, 0.23 ± 0.08, and 0.34 ± 0.10 cm2; regurgitant volume 44.76 ± 11.95, 36.18 ± 11.96, and 57.18 ± 17.96 ml; and vena contracta width 5.24 ± 0.78, 4.61 ± 0.77, and 5.82 ± 0.87 mm, respectively (all P < 0.001). Following midazolam administration, mitral regurgitation severity decreased by half a grade in 61% of patients. After flumazenil administration, vital parameters returned to levels comparable to baseline, and mitral regurgitation severity increased by half a grade in 68% of patients.</p><p><strong>Conclusion: </strong>Midazolam is associated with reduced echocardiographic mitral regurgitation severity during TEE, likely through sedation-related changes in loading conditions, whereas flumazenil reverses these changes. Differences between baseline TTE and postflumazenil TEE measurements should be interpreted in light of both recovery from sedation and known modality-related differences between TTE and TEE. Sedation status should therefore be considered when interpreting mitral regurgitation severity during TEE, particularly in patients near clinical decision thresholds.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 7","pages":"568-578"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562218","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":"Wnt/β-catenin pathway in patients with acute myocardial infarction: a prospective cohort study (BETA-MI STUDY).","authors":"Roberto Licordari, Natasha Irrera, Francesca Lofrumento, Silvia Perfetti, Maria Cristina Procopio, Rosalba De Sarro, Roberta Manganaro, Concetta Zito, Giampiero Vizzari, Gabriele Carciotto, Francesco Saporito, Giuseppe Dattilo, Jose I Larrubia-Valle, Oscar Barquero Alegre, Fernando Puyol Ruiz, Maria Victoria Garcia Ruiz, Francisco Javier Pavon, Cesare De Gregorio, Giuseppe De Luca, Scipione Carerj, Gianluca Di Bella, Antonio Micari, Francesco Costa","doi":"10.2459/JCM.0000000000001917","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001917","url":null,"abstract":"<p><strong>Background: </strong>Myocardial infarction (MI) triggers fibrotic remodeling, impairing cardiac function and increasing the risk of heart failure. Although the Wnt/β-catenin signaling pathway modulates infarct healing and fibrosis in animal models, its role in human post-MI remodeling remains unexplored. This study investigates Wnt/β-catenin activation in acute MI and its association with clinical and laboratory markers of remodeling.</p><p><strong>Methods: </strong>Fifty patients were prospectively enrolled: 40 with ST-elevation MI (STEMI) and 10 matched controls with chronic coronary syndrome (CCS). Blood samples were collected at five time points: pre-percutaneous coronary intervention (PCI), post-PCI, day 3, discharge, and 45-day follow-up. Protein and transcript levels of β-catenin and DKK1 (encoded by CTNNB1 and DKK1) were measured. Echocardiographic, laboratory, and clinical outcomes were also assessed.</p><p><strong>Results: </strong>The mean patient age was 62 ± 8 years; 82% were men. STEMI patients had significantly higher β-catenin and DKK1 levels than CCS controls at all time points. In STEMI, β-catenin remained stable, while DKK1 showed a slight increase. Pre-PCI β-catenin protein levels independently predicted improved left-ventricular ejection fraction (LVEF) at follow-up.</p><p><strong>Conclusion: </strong>β-catenin is elevated in STEMI patients and correlates with better post-MI LVEF, suggesting a potential role in myocardial repair. These findings support further investigation of the Wnt/β-catenin pathway as a prognostic biomarker or therapeutic target in postinfarction cardiac recovery.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 7","pages":"538-548"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562163","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":"Long-term durability of self-expandable transcatheter heart valves in bicuspid versus tricuspid aortic valve stenosis: a matched-cohort analysis.","authors":"Mauro Massussi, Nicola Cristiano, Giuliano Chizzola, Claudia Fiorina, Giulia Costa, Marco Angelillis, Barbara Bellini, Giuseppe Bruschi, Bruno Merlanti, Riccardo Gorla, Marta Barletta, Massimo Fineschi, Diana Chin, Edoardo Pancaldi, Elisa Pezzola, Paolo Archetti, Luca Branca, Damiano Regazzoli, Matteo Montorfano, Marco De Carlo, Marianna Adamo","doi":"10.2459/JCM.0000000000001912","DOIUrl":"10.2459/JCM.0000000000001912","url":null,"abstract":"<p><strong>Background: </strong>A bicuspid aortic valve (BAV) presents unique challenges for transcatheter aortic valve implantation (TAVI), and evidence on long-term bioprosthetic durability in an BAV compared to a tricuspid aortic valve (TAV) remains limited. We aimed to compare the 5-year durability and hemodynamic performance of self-expandable TAVI in patients with BAV versus TAV stenosis, using propensity score-matched data from a large, real-world, multicentre registry.</p><p><strong>Methods: </strong>This retrospective, multicentre analysis included patients treated with self-expandable TAVI (2009-2020) from the Medtronic One Hospital ClinicalService registry. Patients with at least one echocardiographic follow-up were matched 1 : 1 (n = 106 BAV; n = 106 TAV) based on key clinical and procedural characteristics. Primary endpoints were structural valve deterioration (SVD) and bioprosthetic valve failure (BVF), defined by VARC-3 criteria, analysed as cumulative incidence functions accounting for competing risk of death. All-cause mortality was analysed using Kaplan-Meier estimates.</p><p><strong>Results: </strong>At 5 years, the cumulative incidence of SVD was 1.07% [95% confidence interval (CI): 0.09-5.26] in BAV and 1.79% (95% CI: 0.14-8.50) in TAV (P = 0.829). BVF occurred in 2.38% (95% CI: 0.44-7.62) of BAV and 2.8% (95% CI: 0.47-9.19) of TAV patients (P = 0.782). Hemodynamic performance remained stable over time, with no statistically significant differences between the mean gradients at 5 years (7.8 ± 2.8 mmHg BAV versus 9.5 ± 11.7 mmHg TAV, P = 0.304). All-cause mortality at 5 years was 41.7% (BAV) versus 51.5% (TAV, P = 0.09).</p><p><strong>Conclusion: </strong>In this propensity-matched, real-world multicentre cohort, BAV and TAV patients treated with self-expandable TAVI showed no statistically significant differences in 5-year durability and hemodynamic performance. These findings are hypothesis-generating and suggest TAVI may be a reasonable option for selected BAV patients, pending further validation from randomized controlled trials.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 7","pages":"587-596"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562194","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 atrial appendage agenesis: a rare diagnostic pitfall on cardiac computed tomography.","authors":"Hannah Hart, Tia Bimal, Vikram Agarwal","doi":"10.2459/JCM.0000000000001897","DOIUrl":"10.2459/JCM.0000000000001897","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":" ","pages":"606-607"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329813","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":"Phenotyping congestion in heart failure: that's the matter.","authors":"Stefania Paolillo, Federica Marzano","doi":"10.2459/JCM.0000000000001915","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001915","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 7","pages":"524-527"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562216","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":"Renal resistance index reveals 'driving effect' of vericiguat for heart failure therapy: the possible way for guideline-directed medical therapy implementation?","authors":"Francesco Natale, Francesco S Loffredo, Saverio D'Elia, Paolo Golino, Giovanni Cimmino","doi":"10.2459/JCM.0000000000001913","DOIUrl":"10.2459/JCM.0000000000001913","url":null,"abstract":"<p><strong>Background: </strong>Guideline-directed medical therapy (GDMT) improves outcomes in heart failure. Continuous dose titration of GDMT is mandatory to reduce heart failure morbidity and mortality. The renal resistive index (RRI) is a Doppler ultrasound marker that can be used to assess kidney health and predict outcomes in chronic kidney disease as well as in heart failure. Vericiguat is the latest approved drug for heart failure associated with cardiovascular clinical benefits as add-on therapy.</p><p><strong>Results: </strong>Vericiguat administration induces RRI improvement and a higher percentage of GDMT optimization.</p><p><strong>Major findings: </strong>Vericiguat could drive GDMT implementation via RRI reduction.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 7","pages":"601-605"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562143","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":"To reload or not to reload? Reassessing clopidogrel strategy after percutaneous coronary intervention in stable coronary disease.","authors":"Enrico Fabris, Francesca Di Lenarda, Gabor G Toth, Emanuele Barbato, Gianfranco Sinagra","doi":"10.2459/JCM.0000000000001914","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001914","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 7","pages":"597-600"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562132","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":"Triglyceride-glucose index as a predictor of adverse cardiovascular outcomes in a contemporary, diverse US population undergoing percutaneous coronary intervention.","authors":"Francesca Maria Di Muro, Mark Shneyderman, Samantha Sartori, Angelo Oliva, Kenneth Smith, Birgit Vogel, Prakash Krishnan, Joseph Sweeny, Pedro Moreno, Mauro Gitto, Benjamin Bay, Parasuram Krishnamoorthy, Ciro Indolfi, Deepak L Bhatt, George Dangas, Annapoorna Kini, Samin K Sharma, Roxana Mehran","doi":"10.2459/JCM.0000000000001916","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001916","url":null,"abstract":"<p><strong>Background and aims: </strong>The triglyceride-glucose (TyG) index has emerged as a powerful and accessible marker of insulin resistance and a predictor of adverse events in patients undergoing percutaneous coronary intervention (PCI). Yet, its prognostic relevance in large, demographically diverse populations remains unestablished. This study sought to evaluate the association between the TyG index and clinical outcomes in a broad cohort of patients undergoing PCI at a high-volume tertiary care center in the United States.</p><p><strong>Methods: </strong>We included consecutive patients undergoing PCI from 2012 to 2022. Quartiles of the TyG index, calculated as Ln(fasting triglycerides × fasting glucose/2), were derived and patients were stratified accordingly. The incidence of major adverse cardiovascular events (MACE), consisting of all-cause mortality, myocardial infarction (MI), or stroke, was assessed at 1 year. Multivariable Cox regression analyses were performed using the lowest TyG quartile as the reference.</p><p><strong>Results: </strong>A total of 21 124 patients were enrolled. Those with higher TyG index values were more likely to be female and to have cardiovascular risk factors or comorbidities. They also exhibited a greater extent of coronary artery disease (CAD) and more complex PCI features, while showing a lower prevalence of moderate-to-severe coronary calcifications. At 1 year, MACE incidence increased progressively across quartiles, with the highest risk observed in the fourth quartile compared with the first. After multivariable adjustment, this association remained significant and was primarily driven by spontaneous MI.</p><p><strong>Conclusion: </strong>In this large PCI cohort, the TyG index correlated with adverse cardiovascular outcomes, supporting its potential role in clinical practice.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 7","pages":"528-537"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562157","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}