Journal of the American College of Cardiology最新文献

{"title":"What Is the Diagnostic and Prognostic Value of the Electrocardiographic QRS Attenuation in Myocarditis?","authors":"John E. Madias","doi":"10.1016/j.jacc.2024.10.123","DOIUrl":"https://doi.org/10.1016/j.jacc.2024.10.123","url":null,"abstract":"No Abstract","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"58 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143044335","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(24)10730-9","DOIUrl":"https://doi.org/10.1016/s0735-1097(24)10730-9","url":null,"abstract":"No Abstract","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"15 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143044698","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":"Recurrent Ischemic Stroke After PFO Closure: Unconsidered Low RoPE Score and Thrombophilia","authors":"Anastasios Apostolos, Maria Drakopoulou, Konstantinos Tsioufis, Konstantinos Toutouzas","doi":"10.1016/j.jacc.2024.10.122","DOIUrl":"https://doi.org/10.1016/j.jacc.2024.10.122","url":null,"abstract":"No Abstract","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"35 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143044192","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":"Bioprosthetic vs Mechanical Aortic Valve Replacement in Patients 40-75 Years","authors":"Michael E. Bowdish, J. Hunter Mehaffey, Shu-Ching Chang, Patrick O’Gara, Michael J. Mack, Andrew Goldstone, Joanna Chikwe, A. Marc Gillinov, Changfu Wu, Greg Fontana, Joseph Bavaria, Chris Malaisrie, Tsuyoshi Kaneko, Ibrahim Sultan, Moritz W. von Ballmoos, Kathrine Harrington, Jeffrey Jacobs, Vinod Thourani, Wilson Szeto, Joseph Sabik, Vinay Badhwar","doi":"10.1016/j.jacc.2025.01.013","DOIUrl":"https://doi.org/10.1016/j.jacc.2025.01.013","url":null,"abstract":"<h3>Background</h3>The choice of bioprosthetic or mechanical surgical aortic valve replacement (AVR) should balance individual valve durability with the potential liabilities of oral anticoagulation.<h3>Objective</h3>To inform clinical practice, this study sought to evaluate contemporary, real-world, long-term AVR outcomes from the Society of Thoracic Surgeons Adult Cardiac Surgery Database (STS-ACSD).<h3>Methods</h3>All patients undergoing primary isolated bioprosthetic or mechanical AVR were identified. Patients aged &lt;40 and &gt;75 years with endocarditis, emergency/salvage status, shock, ejection fraction ≤25%, and any prior cardiac surgery were excluded. Validated methodology was applied for linkage to the National Death Index to define longitudinal all-cause mortality (2008-2019). Robust risk adjustment was performed using age-specific inverse probability weighting and restricted cubic splines to model non-linear age relationships. Sensitivity analyses excluded pure aortic insufficiency, intermediate/high risk (STS &gt;4%), and discontinued valve types.<h3>Results</h3>A total of 109,842 patients underwent bioprosthetic (n=94,125) or mechanical (n=15,717) AVR during the study period. After risk adjustment, freedom from all-cause mortality favored mechanical valves to age 60. Age group-specific analyses demonstrated mechanical valves to be associated with lower all-cause mortality in all age groups ≤ 60 years. These results remained consistent across all sensitivity analyses.<h3>Conclusions</h3>In patients 60 years of age or younger, mechanical AVR was associated with an independent risk-adjusted survival benefit compared to bioprosthetic AVR. These contemporary 12-year survival data further inform patient and provider shared clinical decision-making regarding prosthetic aortic valves.","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"14 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034973","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":"The Pathogenetic Link Between Ozone Pollution and Cardiovascular Disease","authors":"Alexandra Schneider, Kai Chen, Susanne Breitner","doi":"10.1016/j.jacc.2024.12.011","DOIUrl":"https://doi.org/10.1016/j.jacc.2024.12.011","url":null,"abstract":"<h2>Section snippets</h2><section><section><h2>Funding Support and Author Disclosures</h2>The authors have reported that they have no relationships relevant to the contents of this paper to disclose.</section></section>","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"57 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142992577","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":"Associations of Short-Term Ozone Exposure With Hypoxia and Arterial Stiffness","authors":"Qiaoyi Hua, Xin Meng, Wu Chen, Yifan Xu, Ruiwei Xu, Yunxiu Shi, Jiajianghui Li, Xueling Meng, Ailin Li, Qianqian Chai, Mengshuang Sheng, Yuan Yao, Yunfei Fan, Ruohong Qiao, Yi Zhang, Teng Wang, Yidan Zhang, Xiaoyu Cui, Yaqi Yu, Haonan Li, Tong Zhu","doi":"10.1016/j.jacc.2024.11.044","DOIUrl":"https://doi.org/10.1016/j.jacc.2024.11.044","url":null,"abstract":"<h3>Background</h3>Epidemiological studies reported associations between ozone (O₃) exposure and cardiovascular diseases, yet the biological mechanisms remain underexplored. Hypoxia is a shared pathogenesis of O₃-associated diseases; therefore, we hypothesized that O₃ exposure may induce changes in hypoxia-related markers, leading to adverse cardiovascular effects.<h3>Objectives</h3>This study aimed to investigate associations of short-term O₃ exposure with hypoxic biomarkers and arterial stiffness.<h3>Methods</h3>We conducted a panel study involving 210 young healthy residents in 2 cities at different altitudes on the Qinghai-Tibetan Plateau in China, where O₃ concentrations are high and particulate pollution is low. Participants underwent 4 repeated visits to assess ambient O₃ exposure levels, hypoxic biomarkers, and arterial stiffness. We applied linear mixed-effects models to assess the associations of O₃ exposure (lag1 to lag1-7 days) with hypoxic biomarkers and arterial stiffness, adjusted for confounders. Mediation analyses explored the hypoxia’s role in O₃-related arterial stiffness changes. We further examined effect modification by residence altitude and the robustness of results by including PM_2.5 (particulate matter ≤2.5 μm in aerodynamic diameter) or NO₂ in 2-pollutant models.<h3>Results</h3>O₃ exposure 1 to 7 days before visits was significantly associated with changes in multiple hypoxic biomarkers. A 10-ppb increase in O₃ exposure was linked to significant decreases in oxygen saturation (SpO₂) and increases in red blood cell count (RBC), hemoglobin concentration, and hematocrit, with maximum changes by −0.42%, 0.92%, 0.97%, and 1.92%, respectively. Laboratory analysis of mRNA and protein markers consistently indicated that O₃ exposure activated the hypoxia-inducible factor 1 (HIF-1) signaling pathway. Additionally, a 10-ppb increase in O₃ corresponded to a 1.04% to 1.33% increase in carotid-femoral pulse wave velocity (cfPWV), indicating increased arterial stiffness. RBC, hemoglobin concentration, and hematocrit increases significantly mediated the O₃–cfPWV association, whereas the SpO₂ reduction had an insignificant mediating effect. Associations of O₃ with hypoxic biomarkers varied by altitude. The higher altitude group showed delayed associations with SpO₂ and HIF-1 expression but stronger associations with RBC indices. These associations remained robust after adjusting for copollutants.<h3>Conclusions</h3>O₃ exposure may reduce oxygen availability, prompting compensatory increases in red blood cells and hemoglobin, which exacerbate arterial stiffening. These findings provide new insights into the mechanisms underlying O₃-induced cardiovascular injury.","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"25 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142992058","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":"Can Outpatient Worsening Heart Failure Serve as an Endpoint in Clinical Trials of Transthyretin Amyloidosis?","authors":"Richard K. Cheng, Douglas Leedy, Frederick L. Ruberg","doi":"10.1016/j.jacc.2024.10.126","DOIUrl":"https://doi.org/10.1016/j.jacc.2024.10.126","url":null,"abstract":"<h2>Section snippets</h2><section><section><h2>Funding Support and Author Disclosures</h2>Dr Ruberg is supported by NIH grant R01HL139671; has received institutional research grant support from Akcea/Ionis Therapeutics, Anumana, Alnylam Pharmaceuticals, and Pfizer; and has received consulting fees from AstraZeneca and Attralus. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.</section></section>","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"38 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142992057","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":"Worsening of Heart Failure in Outpatients With Transthyretin Amyloidosis and Cardiomyopathy in the APOLLO-B Trial","authors":"Marianna Fontana, Mathew S. Maurer, Julian D. Gillmore, Shaun Bender, Patrick Y. Jay, Scott D. Solomon","doi":"10.1016/j.jacc.2024.10.097","DOIUrl":"https://doi.org/10.1016/j.jacc.2024.10.097","url":null,"abstract":"<h3>Background</h3>Outpatient worsening heart failure (HF), defined by initiation or intensification of diuretics, is adversely prognostic for patients with either reduced or preserved ejection fraction.<h3>Objectives</h3>This study sought to investigate the prognostic value of outpatient worsening HF in transthyretin amyloidosis with cardiomyopathy and the effect of patisiran treatment.<h3>Methods</h3>Post hoc analyses of the APOLLO-B trial (<span><span>NCT03997383</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>) evaluated the associations between outpatient worsening HF (defined by oral diuretic initiation or intensification), measures of disease progression, and a composite endpoint of all-cause mortality and cardiovascular (CV) events. We further examined the effect of patisiran on outpatient worsening HF over 24 months (ie, during the double-blind and open-label extension periods).<h3>Results</h3>In APOLLO-B, 144 (40.1%) patients had no event, 157 (43.7%) had outpatient worsening HF, 13 (3.6%) required an urgent HF visit, 118 (32.9%) had a CV hospitalization, and 47 (13.1%) died. Outpatient worsening HF was associated with an increased risk of all-cause mortality and CV events (HR: 2.21; 95% CI: 1.58-3.08), as well as a greater deterioration in 6-minute walk test distance, Kansas City Cardiomyopathy Questionnaire–Overall Summary score, and NYHA functional class and a greater increase in <em>N</em>-terminal prohormone of B-type natriuretic peptide. Addition of outpatient diuretic initiation or intensification to the composite endpoint of all-cause mortality and CV events increased the overall number of patients having an event from 141 to 215 (a 52% increase). Patisiran reduced the risk of outpatient worsening HF (HR: 0.70; 95% CI: 0.51-0.96) over 24 months.<h3>Conclusions</h3>During APOLLO-B, outpatient worsening HF in patients with transthyretin amyloidosis with cardiomyopathy was frequent, prognostic, and reduced by patisiran.","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"74 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142992059","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":"Finerenone in Patients With a Recent Worsening Heart Failure Event: The FINEARTS-HF Trial.","authors":"Akshay S Desai, Muthiah Vaduganathan, Brian L Claggett, Ian J Kulac, Pardeep S Jhund, Jonathan Cunningham, Maria Borentain, James Lay-Flurrie, Prabhakar Viswanathan, Katja Rohwedder, Flaviana Amarante, Carolyn S P Lam, Michele Senni, Sanjiv J Shah, Adriaan A Voors, Faiez Zannad, Bertram Pitt, Mikhail Kosiborod, John J V McMurray, Scott D Solomon","doi":"10.1016/j.jacc.2024.09.004","DOIUrl":"10.1016/j.jacc.2024.09.004","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients with heart failure (HF) and a recent worsening heart failure (WHF) event are known to be at high risk of recurrent hospitalization and death, regardless of ejection fraction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study examined the efficacy and safety of the nonsteroidal mineralocorticoid receptor antagonist (MRA) finerenone in relation to the recency of a WHF event.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;FINEARTS-HF (FINerenone trial to investigate Efficacy and sAfety superioR to placebo in paTientS with Heart Failure) was a randomized, double-blind, placebo-controlled trial of finerenone in patients with HF and left ventricular ejection fraction ≥40%. In this prespecified analysis, we assessed the risk of cardiovascular (CV) events and response to finerenone vs placebo in relation to the time from WHF to randomization (during or within 7 days, 7 days to 3 months, &gt;3 months, or no prior WHF). The primary outcome was a composite of total (first and recurrent) WHF events and CV death, analyzed using a proportional rates method.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 6,001 patients validly randomized to finerenone or placebo, 1,219 (20.3%) were enrolled during (749 [12.5%]) or within 7 days (470 [7.8%]), 2,028 (33.8%) between 7 days and 3 months, and 937 (15.6%) &gt;3 months from a WHF event; 1,817 (30.3%) had no prior history of WHF. Rates of the primary composite outcome varied inversely with time since WHF, with &gt;2-fold higher risk in those enrolled during or within 7 days of WHF compared with those enrolled &gt;3 months from WHF or without prior WHF (risk ratio [RR]: 2.13; 95% CI: 1.82-2.55). Compared to placebo, finerenone appeared to lower the risk of the primary composite to a greater extent in those enrolled within 7 days of WHF (RR: 0.74; 95% CI: 0.57-0.95) or between 7 days and 3 months of WHF (RR: 0.79; 95% CI: 0.64-0.97) than in those &gt;3 months from WHF or without prior WHF (RR: 0.99; 95% CI: 0.81-1.21); however, no definitive treatment-by-time interaction could be confirmed (P = 0.07). Greater absolute risk reductions with finerenone were accordingly seen in those with recent WHF (P&lt;sub&gt;trend&lt;/sub&gt; = 0.011). The risk of adverse events including hyperkalemia and worsening renal function among patients assigned to finerenone was not increased in those with recent WHF.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Compared with those without recent WHF, patients with HF and mildly reduced or preserved ejection fraction who have experienced a recent WHF event are at higher risk for recurrent HF events and CV death; a possible signal of enhanced absolute treatment benefit with finerenone in this population requires further confirmation in future studies. (Study to Evaluate the Efficacy [Effect on Disease] and Safety of Finerenone on Morbidity [Events Indicating Disease Worsening] & Mortality [Death Rate] in Participants With Heart Failure and Left Ventricular Ejection Fraction [Proportion of Blood Expelled Per Heart Stroke] ","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":" ","pages":"106-116"},"PeriodicalIF":21.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349068","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":"Wildfires, Compound Extreme Events, Climate Change, and Cardiovascular Health","authors":"Kai Chen, Yuan Lu, Harlan M. Krumholz","doi":"10.1016/j.jacc.2025.01.009","DOIUrl":"https://doi.org/10.1016/j.jacc.2025.01.009","url":null,"abstract":"No Abstract","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"107 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142990856","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}