Journal of the American College of Cardiology最新文献

{"title":"My Fantastic Voyage: Innovation, Mentorship, and the Future of Cardiovascular Medicine","authors":"Christopher M. Kramer","doi":"10.1016/j.jacc.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.jacc.2025.04.003","url":null,"abstract":"<h2>Section snippets</h2><section><section><h2>The Gift of Mentorship</h2>While innovation may be the engine of progress, mentorship is the compass that guides us. I have had many accomplishments over the course of my career, but one that stands out is being named the 2021 ACC Mentor of the Year. Why? Because it represents a legacy far beyond my individual work—it represents the success of those I have had the privilege to train and mentor.At University of Virginia Health (UVA), I am proud that 5 (soon to be 6) of my former imaging trainees are now faculty members.</section></section><section><section><h2>Looking Ahead: Where the Voyage Leads</h2>So, where do we go from here? What lies ahead for the field of cardiovascular medicine?Health equity must be a central focus. It is a key pillar of the ACC’s current 5-year Strategic Plan, and it should be a daily commitment in all of our practices. We must work to reduce disparities, improve access to care, and ensure that every patient—regardless of background—receives the best possible treatment.This also means tackling the high cost of health care, addressing the growing epidemics of</section></section>","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"7 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880705","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":"Amara Yad Image: Right Anterior Oblique View of the Heart","authors":"Kalyanam Shivkumar MD, PhD","doi":"10.1016/j.jacc.2025.03.521","DOIUrl":"10.1016/j.jacc.2025.03.521","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 17","pages":"Pages 1719-1720"},"PeriodicalIF":21.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878557","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":"Proactive Mapping and Preventive Ablation Reduce Defibrillator Implantation Rates in Tetralogy of Fallot","authors":"Yoshitaka Kimura MD, PhD ,&nbsp;Justin Wallet MD ,&nbsp;Charlotte Brouwer MD ,&nbsp;Jouke P. Bokma MD, PhD ,&nbsp;Robin A. Bertels MD ,&nbsp;Monique R.M. Jongbloed MD, PhD ,&nbsp;Mark G. Hazekamp MD, PhD ,&nbsp;Nico A. Blom MD, PhD ,&nbsp;Katja Zeppenfeld MD, PhD","doi":"10.1016/j.jacc.2025.03.523","DOIUrl":"10.1016/j.jacc.2025.03.523","url":null,"abstract":"<div><h3>Background</h3><div>In patients with repaired tetralogy of Fallot (rTOF) and spontaneous ventricular tachycardia (VT), transection of slow-conducting anatomical isthmus (SCAI) by ablation results in excellent long-term VT-free survival. In patients without prior VT, proactive electroanatomical mapping and preventive SCAI ablation may impact patient selection for primary prevention implantable cardioverter-defibrillator (ICD) implantation.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to evaluate long-term outcomes after proactive electroanatomical mapping and ablation of SCAI and its impact on patient selection for primary prevention ICD implantation, compared with current risk stratification methods in rTOF patients without prior VT.</div></div><div><h3>Methods</h3><div>Consecutive rTOF patients without prior VT who underwent electroanatomical mapping for VT substrate identification were included (2005-2020). After successful SCAI ablation, ICD implantation was offered but was subject to shared decision making. The potential eligibility for ICD implantation was retrospectively determined using the following: 1) a clinical risk score; 2) guideline-recommended risk factors (American Heart Association [AHA] 2018 guidelines without late gadolinium enhancement [LGE] on cardiac magnetic resonance [CMR] information, AHA 2018 guidelines with LGE-CMR information, European Society of Cardiology [ESC] 2022 guidelines); and 3) electroanatomical mapping and SCAI ablation results. In the latter, patients with a nontransected SCAI, VT substrates remote from anatomical isthmuses, or severe right-/left ventricular dysfunction qualified for ICDs.</div></div><div><h3>Results</h3><div>A total of 97 patients were included (age 35 ± 16 years, 57 men); 33 patients (34%) had SCAI and 19 (20%) had inducible monomorphic VT (17 of 19 SCAI-dependent VT). Successful SCAI transection was achieved in 87% (26 of 30 patients) in whom attempted, without complications. In total, 13 patients received an ICD implantation. During a median follow-up of 58 months (Q1-Q3: 30-99 months), 4 patients (4%) had VT, all after ablation failure. According to clinical risk score, AHA 2018 guidelines without LGE-CMR information, AHA 2018 guidelines with LGE-CMR information, and ESC 2022 guidelines, 49 (51%), 24 (25%), 31 (32%), and 48 patients (49%) would have qualified for ICDs, respectively. After proactive mapping and preventive ablation, 11 patients (11%) remained ICD candidates, including all 4 with a VT event during the follow-up (annual VT risk 7%/y).</div></div><div><h3>Conclusions</h3><div>Long-term outcome of rTOF patients without SCAI is excellent. Proactive electroanatomical mapping and preventive SCAI ablation may significantly reduce primary prevention ICD implantation rates compared with current risk prediction methods.</div></div>","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 17","pages":"Pages 1695-1705"},"PeriodicalIF":21.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878441","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)06083-8","DOIUrl":"10.1016/S0735-1097(25)06083-8","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 17","pages":"Page e159"},"PeriodicalIF":21.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878428","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":"Advancing Electrophysiology","authors":"Harlan M. Krumholz MD, SM (Editor-in-Chief, JACC)","doi":"10.1016/j.jacc.2025.03.527","DOIUrl":"10.1016/j.jacc.2025.03.527","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 17","pages":"Pages 1647-1648"},"PeriodicalIF":21.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878430","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":"Proactive Electrophysiological Mapping and Ablation to Prevent Ventricular Tachycardia in Repaired Tetralogy of Fallot","authors":"Christian Meyer MD, MA ,&nbsp;Kalyanam Shivkumar MD, PhD","doi":"10.1016/j.jacc.2025.03.526","DOIUrl":"10.1016/j.jacc.2025.03.526","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 17","pages":"Pages 1706-1708"},"PeriodicalIF":21.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878442","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":"Prevalence of Elevated Lipoprotein(a) and its Association With Subclinical Atherosclerosis in 2.9 Million Chinese Adults","authors":"Sailimai Man PhD ,&nbsp;Yining Zu MSc ,&nbsp;Xiaochen Yang PhD ,&nbsp;Yuhan Deng MSc ,&nbsp;Dan Shen PhD ,&nbsp;Yuan Ma PhD ,&nbsp;Jingzhu Fu PhD ,&nbsp;Jing Du PhD ,&nbsp;Canqing Yu PhD ,&nbsp;Jun Lv PhD ,&nbsp;Gang Li PhD ,&nbsp;Bo Wang PhD ,&nbsp;Liming Li MPH","doi":"10.1016/j.jacc.2025.02.032","DOIUrl":"10.1016/j.jacc.2025.02.032","url":null,"abstract":"<div><h3>Background</h3><div>Elevated lipoprotein(a) [Lp(a)] is strongly associated with an increased risk of atherosclerotic cardiovascular disease; yet, large-scale studies on the epidemiology of elevated Lp(a) as well as its association with subclinical atherosclerosis in the Chinese population are limited.</div></div><div><h3>Objectives</h3><div>This study aimed to estimate the prevalence of elevated Lp(a) in a large check-up population of China, and investigate its associations with both site-specific and multisite subclinical atherosclerosis.</div></div><div><h3>Methods</h3><div>Adults who underwent Lp(a) testing between 2017 and 2023 at Meinian health check-up centers in 30 provinces of China were included. Because the test results of Lp(a) were reported in either the mass unit (mg/dL) or the molar unit (nmol/L) and conversion between units was not recommended, separate analyses were conducted for each unit. Subclinical atherosclerosis was assessed using various imaging examinations at the carotid artery, the brain, and the coronary artery. The prevalence of elevated Lp(a) was estimated across the overall study population and various subpopulations. The logistic regression model was used to investigate the associations between elevated Lp(a) and subclinical atherosclerosis.</div></div><div><h3>Results</h3><div>A total of 2,788,206 and 167,114 participants with the mass unit and the molar unit were included. In the mass unit group, the prevalence of Lp(a) &gt;30 and &gt;50 mg/dL was 18.67% and 8.41%, respectively. Significantly higher prevalence was observed among women, elderly individuals, and individuals with various cardio-renal-metabolic risk factors (all <em>P &lt;</em> 0.05). Compared with Lp(a) ≤30 mg/dL, individuals with Lp(a) &gt;30 to ∼50 mg/dL exhibited 11%, 15%, 9%, and 11% greater odds of increased carotid intima-media thickness, carotid plaque, subclinical brain infarcts, and coronary artery calcification, respectively. The odds were even higher for those with Lp(a) &gt;50 mg/dL. Furthermore, elevated Lp(a) was significantly associated with the extent of coronary artery calcification, as well as subclinical atherosclerosis at 1, 2, and 3 sites, with the association being more pronounced in cases with severe extent and multisite involvement. These results were similar in the molar unit group.</div></div><div><h3>Conclusions</h3><div>A significant burden of elevated Lp(a) was found in China, highlighting the necessity of prioritized Lp(a) screening in high-risk groups. Elevated Lp(a) was identified as a significant risk factor for site-specific subclinical atherosclerosis, with stronger associations observed in severe extent and multisite involvement. Our findings suggest that individuals with elevated Lp(a) should undergo a comprehensive assessment of subclinical atherosclerosis at multiple sites to help prevent ASCVD.</div></div>","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 21","pages":"Pages 1979-1992"},"PeriodicalIF":21.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862193","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 Role of Geriatric Expertise on Cardiovascular Outcomes When Cardiologists Are Employed by Hospitals","authors":"Qing Su, Xiaofeng Zeng","doi":"10.1016/j.jacc.2024.11.055","DOIUrl":"https://doi.org/10.1016/j.jacc.2024.11.055","url":null,"abstract":"No Abstract","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"35 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862196","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":"Albuminuria Range as a Key Metric Linking Renal Function to Heart Failure Outcome in FINEARTS-HF","authors":"Gronda Edoardo, Arduino Arduini, Massimo Iacoviello, Stefano Carugo, Luigi Tavazzi","doi":"10.1016/j.jacc.2024.12.036","DOIUrl":"https://doi.org/10.1016/j.jacc.2024.12.036","url":null,"abstract":"No Abstract","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"2 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862258","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":"Is the Efficacy of Finerenone Related to Obesity Type or Explained by the Obesity Paradox in HFmrEF/HFpEF?","authors":"Ziyi He, Chenxi Wang, Huichuan Tian","doi":"10.1016/j.jacc.2024.12.035","DOIUrl":"https://doi.org/10.1016/j.jacc.2024.12.035","url":null,"abstract":"No Abstract","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"108 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862188","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}