Journal of the American College of Cardiology最新文献

{"title":"AS-0230 Circulating Exosomal miR-16-2-3p Is Associated With Coronary Microvascular Dysfunction in Diabetes Through Regulating the Fatty Acid Degradation of Endothelial Cells","authors":"Yihai Liu , Chongxia Zhong , Shan Chen , Yanan Xue , Zhonghai Wei , Li Dong , Lina Kang","doi":"10.1016/j.jacc.2024.10.006","DOIUrl":"10.1016/j.jacc.2024.10.006","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"84 22","pages":"Page C2"},"PeriodicalIF":21.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142697887","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 Implications of Pretest Probability of HFpEF on Outcomes in Precapillary Pulmonary Hypertension","authors":"Yogesh N.V. Reddy MBBS, MSc ,&nbsp;Robert P. Frantz MD ,&nbsp;Paul M. Hassoun MD ,&nbsp;Anna R. Hemnes MD ,&nbsp;Evelyn Horn MD ,&nbsp;Jane A. Leopold MD ,&nbsp;Franz Rischard MD ,&nbsp;Erika B. Rosenzweig MD ,&nbsp;Nicholas S. Hill MD ,&nbsp;Serpil C. Erzurum MD ,&nbsp;Gerald J. Beck PhD ,&nbsp;J. Emanuel Finet MD ,&nbsp;Christine L. Jellis MD ,&nbsp;Stephen C. Mathai MD ,&nbsp;W.H. Wilson Tang MD ,&nbsp;Barry A. Borlaug MD","doi":"10.1016/j.jacc.2024.08.061","DOIUrl":"10.1016/j.jacc.2024.08.061","url":null,"abstract":"<div><h3>Background</h3><div>Patients with group 1 pulmonary hypertension (PH) and risk factors for heart failure with preserved ejection fraction (HFpEF) demonstrate worse response to pulmonary vasodilator therapy. The mechanisms and optimal diagnostic approach to identify such patients remain unclear.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to compare exercise capacity, cardiac function, and hemodynamic responses to provocative maneuvers among patients with group 1 PH based upon pretest probability of HFpEF.</div></div><div><h3>Methods</h3><div>Pretest probability for HFpEF was determined using the validated HFpEF-ABA algorithm based on age, body mass index, and history of atrial fibrillation among group 1 PH patients recruited to the multicenter PVDOMICS (Redefining Pulmonary Hypertension through Pulmonary Vascular Disease Phenomics) study. Functional capacity, quality of life, and dynamic pulmonary capillary wedge pressure (PCWP) responses were compared between those with low (&lt;25%), intermediate (25%-74%), and high (≥75%) ABA score-based HFpEF probability.</div></div><div><h3>Results</h3><div>Among 424 patients with group 1 PH, 54% (n = 228) had intermediate HFpEF probability and 15% (n = 64) had high HFpEF probability. Resting PCWP increased progressively with higher HFpEF probability (<em>P &lt;</em> 0.0001), and patients with group 1 PH and high HFpEF probability had the greatest increases in PCWP with nitric oxide, fluid challenge, and exercise (<em>P &lt;</em> 0.001 for all), changes that were comparable to patients with HFpEF with no pulmonary vascular disease (n = 194), but lower than those with HFpEF and combined precapillary and postcapillary PH. Left ventricular/atrial size, diastolic function, quality of life, 6-minute walk distance, and peak VO₂ were most abnormal in patients with group 1 PH and high HFpEF probability compared with those with low or intermediate HFpEF probability (<em>P &lt;</em> 0.0001 for all). Increasing HFpEF probability in group 1 PH was associated with greater risk of death (HR per decile of HFpEF probability 1.09; 95% CI: 1.05-1.13; <em>P</em> &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>Quantifying pretest probability for HFpEF in patients with group 1 PH identifies a subset of patients with worse dynamic PCWP response indicative of subclinical left heart disease, with poorer functional status, quality of life, and survival. Further study in this group 1 PH subgroup is indicated to determine whether PH therapies are effective and safe, and also whether HFpEF-specific therapies can improve functional status and outcomes.</div></div>","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"84 22","pages":"Pages 2196-2210"},"PeriodicalIF":21.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142487567","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":"AS-0192 The Role of Remaining Distal Tears After Proximal Repair of Stanford Type B Aortic Dissection","authors":"Simeng Zhang ,&nbsp;Caiyi Wei ,&nbsp;Dongchen Shi ,&nbsp;Fengbo Pei ,&nbsp;Yongxue Zhang ,&nbsp;Zaiping Jing ,&nbsp;Jie Liu ,&nbsp;Qingsheng Lu ,&nbsp;Yi Shi","doi":"10.1016/j.jacc.2024.10.049","DOIUrl":"10.1016/j.jacc.2024.10.049","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"84 22","pages":"Pages C16-C17"},"PeriodicalIF":21.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142697965","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":"AS-0143 Deep Learning–Based Analysis of CCTA Images for the Assessment of Plaque Characteristics and Risk in Coronary Artery Disease","authors":"Tingquan Zhou ,&nbsp;Chengxing Shen ,&nbsp;Christos Bourantas","doi":"10.1016/j.jacc.2024.10.057","DOIUrl":"10.1016/j.jacc.2024.10.057","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"84 22","pages":"Page C20"},"PeriodicalIF":21.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142697480","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":"AS-0273 Sympathetic Nerve-Induced VSMC Phenotypic Transformation Promotes Aortic Dissection Through the NET-MAM Pathway","authors":"Cheng Wei ,&nbsp;Yu Sanjiu","doi":"10.1016/j.jacc.2024.10.003","DOIUrl":"10.1016/j.jacc.2024.10.003","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"84 22","pages":"Page C1"},"PeriodicalIF":21.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142697145","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":"AS-0275 Organ Protection Effect of In Situ Fenestration Within the Stent in Aortic Arch Surgery","authors":"Yu Sanjiu ,&nbsp;Cheng Wei","doi":"10.1016/j.jacc.2024.10.046","DOIUrl":"10.1016/j.jacc.2024.10.046","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"84 22","pages":"Pages C15-C16"},"PeriodicalIF":21.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142697923","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":"Why Have We Not Been Able to Demonstrate Reduced Mortality in Patients With HFmrEF/HFpEF?","authors":"Toru Kondo MD, PhD ,&nbsp;Alasdair D. Henderson PhD ,&nbsp;Kieran F. Docherty MBChB, PhD ,&nbsp;Pardeep S. Jhund MBChB, MSc, PhD ,&nbsp;Muthiah Vaduganathan MD, MPH ,&nbsp;Scott D. Solomon MD ,&nbsp;John J.V. McMurray MD","doi":"10.1016/j.jacc.2024.08.033","DOIUrl":"10.1016/j.jacc.2024.08.033","url":null,"abstract":"<div><div>No randomized controlled trial has yet demonstrated a statistically significant reduction in mortality in patients with heart failure and mildly reduced ejection (HFmrEF) or heart failure and preserved ejection fraction (HFpEF), in contrast to the benefits observed in heart failure with reduced ejection fraction (HFrEF). However, this probably reflects the statistical power of trials to date to show an effect on mortality rather than mechanistic differences between HFmEF/HFpEF and HFrEF or differences in treatment efficacy. Compared to patients with HFrEF, those with HFmrEF/HFpEF have lower mortality rates and a smaller proportion of potentially modifiable cardiovascular deaths (as opposed to unmodifiable noncardiovascular deaths). In addition, some causes of cardiovascular deaths may not be reduced by treatments for HF. Therefore, the low rate of potentially modifiable deaths in patients with HFmrEF/HFpEF, compared with HFrEF, has made it challenging to demonstrate a reduction in death (or cardiovascular death) in trials to date.</div></div>","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"84 22","pages":"Pages 2233-2240"},"PeriodicalIF":21.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108672","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":"AS-0300 Plasma Homocysteine Associates With Morning Blood Pressure in Patients With Essential Hypertension","authors":"Danni Wang ,&nbsp;Pengjie Gao ,&nbsp;Xuan Wang ,&nbsp;Tingting Zheng ,&nbsp;Xiyang Li ,&nbsp;Suining Xu ,&nbsp;Kamila Kamili ,&nbsp;Gang Tian","doi":"10.1016/j.jacc.2024.10.032","DOIUrl":"10.1016/j.jacc.2024.10.032","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"84 22","pages":"Page C10"},"PeriodicalIF":21.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142697158","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":"Hemodynamic Insights From Provocative Testing in Pulmonary Hypertension and Heart Failure With Preserved Ejection Fraction","authors":"Isabela Landsteiner MD ,&nbsp;Ashvita Ramesh MD ,&nbsp;Bin Q. Yang MD ,&nbsp;Gregory D. Lewis MD","doi":"10.1016/j.jacc.2024.09.1226","DOIUrl":"10.1016/j.jacc.2024.09.1226","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"84 22","pages":"Pages 2211-2214"},"PeriodicalIF":21.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142487287","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":"Consequences of Discontinuing Long-Term Drug Treatment in Patients With Heart Failure and Reduced Ejection Fraction","authors":"Khawaja M. Talha MBBS ,&nbsp;Javed Butler MD, MPH, MBA ,&nbsp;Milton Packer MD","doi":"10.1016/j.jacc.2024.09.005","DOIUrl":"10.1016/j.jacc.2024.09.005","url":null,"abstract":"<div><div>There is uncertainty regarding the clinical effects of discontinuation of drugs for heart failure after long-term use. The withdrawal of long-term treatment can follow 1 of 4 distinct patterns: 1) loss of on-treatment effect with no observed changes following discontinuation (eg, prazosin); 2) attenuation or loss of on-treatment effect with rebound clinical worsening following discontinuation (eg, nitroprusside); 3) persistence of deleterious on-treatment effect followed by clinical worsening after discontinuation (eg, milrinone and flosequinan); and 4) persistence of favorable on-treatment effect followed by clinical worsening after discontinuation (eg, digoxin and sodium-glucose cotransporter 2 inhibitors). Persuasive evidence for persistence of efficacy has been demonstrated for the use of digoxin, diuretic agents, sodium-glucose cotransporter 2 inhibitors, and (to a limited extent) for angiotensin-converting enzyme inhibitors. Available evidence for worsening of clinical status following the withdrawal of neurohormonal antagonists largely consists of observational studies. However, their findings are difficult to interpret because of considerable confounding related to the fact that drugs were withdrawn for clinical reasons, which represented a more important contributor to the poor outcome of these patients than the withdrawal of an effective drug. Nevertheless, the totality of available evidence points to a meaningful clinical deterioration within a few weeks following the withdrawal for most drugs that have been evaluated for the treatment of heart failure. These findings suggests that that our current emphasis on the implementation of foundational drugs needs to include an equally important emphasis to avoid even short-term gaps in treatment.</div></div>","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"84 22","pages":"Pages 2215-2232"},"PeriodicalIF":21.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142487566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}