Journal of the American College of Cardiology最新文献

{"title":"Challenges in Implementing a Demographic-Adjusted Approach to Hypertrophic Cardiomyopathy Diagnosis","authors":"Emanuele Monda MD, Giuseppe Limongelli MD, PhD","doi":"10.1016/j.jacc.2025.01.038","DOIUrl":"10.1016/j.jacc.2025.01.038","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 24","pages":"Page 2431"},"PeriodicalIF":21.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Utility of Demographic-Specific Thresholds for Left Ventricular Hypertrophy","authors":"Buba Marong MD , Austin Robinson MD , Dan Dyar MA","doi":"10.1016/j.jacc.2025.03.548","DOIUrl":"10.1016/j.jacc.2025.03.548","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 24","pages":"Page 2432"},"PeriodicalIF":21.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Arterial Aneurysms in Loeys-Dietz Syndrome","authors":"Andrew W. Koefoed BA ,&nbsp;Anna L. Huguenard MD ,&nbsp;Gabrielle W. Johnson MD, MSCI ,&nbsp;Elena Deych MS ,&nbsp;Dongchuan Guo PhD ,&nbsp;Dianna M. Milewicz MD, PhD ,&nbsp;Alan C. Braverman MD","doi":"10.1016/j.jacc.2025.04.020","DOIUrl":"10.1016/j.jacc.2025.04.020","url":null,"abstract":"<div><h3>Background</h3><div>The presence of extra-aortic arterial aneurysms (AAs) is notable in Loeys-Dietz syndrome (LDS) compared with other heritable thoracic aortic diseases (HTADs). However, the characteristics of AAs in LDS are poorly characterized to date.</div></div><div><h3>Objectives</h3><div>We sought to determine the prevalence, characteristics, and clinical outcomes of AAs in LDS.</div></div><div><h3>Methods</h3><div>A retrospective cohort study of LDS patients evaluated at Washington University in St Louis School of Medicine/Barnes-Jewish Hospital between 1998 and 2023 was performed. Clinical information, imaging data, and outcomes related to AAs were compiled.</div></div><div><h3>Results</h3><div>A total of 103 patients (53% female) from 60 families with LDS 1 through 5 caused by pathogenic/likely pathogenic variants in <em>TGFBR1</em>, <em>TGFBR2</em>, <em>SMAD3</em>, <em>TGFB2</em>, and <em>TGFB3</em> were included. The median age was 44 years, and median follow-up was 6 years. In total, 77 AAs were identified in 43 patients: 17 AAs in 9 patients with <em>TGFBR1</em> variants, 33 AAs in 15 patients with <em>TGFBR2</em>, 15 AAs in 8 patients with <em>SMAD3</em>, 9 AAs in 8 patients with <em>TGFB2</em>, and 3 AAs in 3 patients with <em>TGFB3</em>. The median age at AA diagnosis was 40 years; 75% of AAs were in the arch vessels or cerebral circulation. On univariate analysis, aortic event (type A/B dissection or prophylactic aortic surgery) at baseline and prophylactic aortic surgery at baseline were associated with the presence of an AA. Hypertelorism, bifid uvula, and arterial tortuosity approached statistical significance. A multivariate model to predict AA included baseline prophylactic aortic surgery and arterial tortuosity. Of those with vs without AA on initial imaging, 61% and 35%, respectively, presented with previous aortic events. Seventeen percent of AAs enlarged over time, and 38% of AAs that enlarged led to clinical events (prophylactic surgery, dissection, or rupture). Overall, AA-related events occurred in 22% of AAs and throughout the arterial tree. AAs were repaired by open surgical and endovascular techniques.</div></div><div><h3>Conclusions</h3><div>AAs commonly occur in patients with LDS and may occur throughout the arterial tree. Importantly, AAs may lead to clinical events including arterial dissection and rupture. Head to pelvis imaging at diagnosis and during follow-up is recommended in LDS to evaluate for AAs and their complications.</div></div>","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 24","pages":"Pages 2343-2352"},"PeriodicalIF":21.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining Left Ventricular Hypertrophy in HCM","authors":"Yong-Huai Wang MD, PhD ,&nbsp;Fan-Xin Kong MD ,&nbsp;Chen-Wen Wang MD ,&nbsp;Yue Du MD ,&nbsp;Chun-Yan Ma MD, PhD","doi":"10.1016/j.jacc.2025.01.037","DOIUrl":"10.1016/j.jacc.2025.01.037","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 24","pages":"Page 2435"},"PeriodicalIF":21.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the Outcomes for Hypoplastic Left Heart Syndrome","authors":"Pedro J. del Nido MD","doi":"10.1016/j.jacc.2025.04.063","DOIUrl":"10.1016/j.jacc.2025.04.063","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 24","pages":"Pages 2399-2400"},"PeriodicalIF":21.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision in Practice","authors":"Harlan M. Krumholz MD, SM (Editor-in-Chief, JACC; Harold H. Hines, Jr Professor)","doi":"10.1016/j.jacc.2025.05.029","DOIUrl":"10.1016/j.jacc.2025.05.029","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 24","pages":"Pages 2424-2425"},"PeriodicalIF":21.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Exercise-Induced Cardiac Troponin Elevations and Occult Coronary Atherosclerosis in Middle-Aged Athletes","authors":"Sylvan L.J.E. Janssen MD ,&nbsp;Wouter M. van Everdingen MD, PhD ,&nbsp;Wouter B.J. Saalmink MSc ,&nbsp;Sacha K. Lamers MSc ,&nbsp;Wim H.M. Vroemen PhD ,&nbsp;Ellen J.S. Denessen MSc ,&nbsp;Kristian Berge MD, PhD ,&nbsp;Otto Bekers PhD ,&nbsp;Maria T.E. Hopman MD, PhD ,&nbsp;Monique Brink MD, PhD ,&nbsp;Jesse Habets MD, PhD ,&nbsp;Vincent L. Aengevaeren MD, PhD ,&nbsp;Alma M.A. Mingels PhD ,&nbsp;Robin Nijveldt MD, PhD ,&nbsp;Thijs M.H. Eijsvogels PhD","doi":"10.1016/j.jacc.2025.04.047","DOIUrl":"10.1016/j.jacc.2025.04.047","url":null,"abstract":"<div><h3>Background</h3><div>Exercise increases cardiac troponin (cTn) concentrations with significant heterogeneity across individuals.</div></div><div><h3>Objectives</h3><div>This study compared the prevalence and magnitude of coronary atherosclerosis in middle-aged recreational athletes with high vs low postexercise cTn concentrations.</div></div><div><h3>Methods</h3><div>Pre- and postexercise concentrations of high-sensitivity cardiac troponin T (hs-cTnT) and hs-cTnI were assessed among 1,011 long-distance walkers, cyclists, and runners (median age 56 years [Q1-Q3: 49-62 years], 63% male). Subsequently, 68 high cTn responders (hs-cTnT: 35.4 ng/L [Q1-Q3: 20.2-54.0 ng/L]; hs-cTnI: 47.4 ng/L [Q1-Q3: 22.5-97.4 ng/L]) and 34 low responders (hs-cTnT: 8.5 ng/L [Q1-Q3: 5.4-13.3 ng/L]; hs-cTnI: 2.5 ng/L [Q1-Q3: 1.5-5.8 ng/L]), matched for age, sex, and sport type, underwent a cardiac computed tomography (CT) scan to determine the presence and characteristics of coronary atherosclerosis (Coronary Artery Disease-Reporting and Data System [CAD-RADS] 2.0 score and coronary artery calcium scores). CT-derived fractional flow reserve (CT-FFR) analyses assessed the hemodynamic relevance of stenoses ≥25% to 90%.</div></div><div><h3>Results</h3><div>The prevalence (CAD-RADS &gt;0 in 67.6% vs 50.0%; OR_adjusted: 1.55 [95% CI: 0.81-2.93]) and magnitude (coronary artery calcium score: 9 AU [Q1-Q3: 0-111 AU] vs 2 AU [Q1-Q3: 0-145 AU]; <em>P</em> = 0.58) of coronary atherosclerosis did not differ between high and low cTn responders. CT-FFR outcomes (FFR ≤0.75: 11.8% vs 5.9%; OR_adjusted: 1.03 [Q1-Q3: 0.67-1.60]) also revealed no differences between high and low cTn responders. Nevertheless, weak associations (<em>P</em> &lt; 0.05; R²: 4%-8%) were found between hs-cTnT, hs-cTnI concentrations, and CAD-RADS classifications.</div></div><div><h3>Conclusions</h3><div>The prevalence and magnitude of coronary atherosclerosis did not differ between recreational athletes with high vs low postexercise cTn concentrations. This suggests that most of the interindividual variation in exercise-induced cTn elevations is not attributable to occult coronary atherosclerosis.</div></div>","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 24","pages":"Pages 2370-2382"},"PeriodicalIF":21.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Audio Summary","authors":"","doi":"10.1016/S0735-1097(25)06560-X","DOIUrl":"10.1016/S0735-1097(25)06560-X","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 24","pages":"Page e205"},"PeriodicalIF":21.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise-Induced Troponin Elevation and Coronary Atherosclerosis","authors":"Cian P. McCarthy MB, BCh, BAO, SM ,&nbsp;Meagan M. Wasfy MD, MPH","doi":"10.1016/j.jacc.2025.05.028","DOIUrl":"10.1016/j.jacc.2025.05.028","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 24","pages":"Pages 2383-2385"},"PeriodicalIF":21.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2025 ACC Scientific Statement on the Management of Obesity in Adults With Heart Failure: A Report of the American College of Cardiology","authors":"Michelle M. Kittleson, Emelia J. Benjamin, Vanessa Blumer, Josephine Harrington, James L. Januzzi, John J.V. McMurray, Amanda R. Vest","doi":"10.1016/j.jacc.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.jacc.2025.05.008","url":null,"abstract":"Obesity confers increased risks of HF, coronary artery disease, and stroke, and weight loss can reduce cardiovascular disease risk. Given emerging evidence of the benefits of semaglutide and tirzepatide in individuals with HFpEF and obesity in concert with healthy behavioral interventions, clinicians should be aware of optimal diagnosis, risk assessment, and management of obesity in individuals with HF. Despite the early promise of anti-obesity medications in HFpEF, challenges remain, including whether BMI is the optimal metric to identify obesity and subsequent benefit from anti-obesity medications; the safety profile of anti-obesity medications for individuals with HF, particularly HFrEF; and whether the benefits of anti-obesity medications are attributed mainly to the magnitude of weight loss or due to other mechanisms of action. Motivated by this emerging evidence and ongoing challenges, this scientific statement: 1) reviews the diagnosis, evaluation, and risk assessment of obesity in HF; 2) describes HF-specific management strategies from lifestyle intervention to medications to surgery; and 3) addresses evidence gaps and future directions in obesity-related HF. With accurate evaluation of obesity as well as administration and monitoring of safe and effective interventions, clinicians may improve quality of life and functional capacity and potentially reduce HF events in individuals living with HF and obesity.","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"44 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}