Korean Circulation Journal最新文献

{"title":"New Insights on Mechanisms of Nicotine in Neointimal Hyperplasia.","authors":"Weon Kim","doi":"10.4070/kcj.2024.0326","DOIUrl":"10.4070/kcj.2024.0326","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"65-66"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pivot-Balloon: A First Step Toward a Novel Transcatheter Treatment for Severe Tricuspid Regurgitation.","authors":"Jaeoh Lee, Yong-Joon Lee","doi":"10.4070/kcj.2024.0304","DOIUrl":"10.4070/kcj.2024.0304","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"32-33"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Any ABCDE Stress Echocardiography Score Equivalent to Stress-Induced Ischaemia? Reply With a Modified 2-Stage Approach.","authors":"Nikolaos Miaris","doi":"10.4070/kcj.2024.0264","DOIUrl":"10.4070/kcj.2024.0264","url":null,"abstract":"<p><p>Stress echocardiography has evolved from the sole assessment of regional wall motion abnormalities (RWMAs) to the ABCDE protocol, as recommended by the recent clinical consensus statement from the European Association of Cardiovascular Imaging, reflecting the need for a more systematic patient assessment. Steps A, B, C, D, and E assess RWMAs, lung B-lines, left ventricular contractile reserve, coronary flow velocity reserve (CFVR) in mid-distal left anterior descending artery, and heart rate reserve, respectively. Impairment of CFVR is considered as the earliest abnormality in the ischaemic cascade. While mostly steps A and D have been studied for their relation to obstructive and non-obstructive coronary artery disease, the diagnostic accuracy of steps B, C, and E for chronic coronary syndromes (CCSs) remains unknown, particularly in the context of negative steps A and D. Additionally, while ABCDE steps have been studied for their prognostic significance, there is no evidence of patients management based on this protocol in order to change the estimated risk. These concepts could be depicted in a 2-stage approach. A negative stage 1 (no stress-induced RWMAs as assessed in step A and normal CFVR as assessed in step D) imply good prognosis and non-coronary causes of symptoms should be considered, whereas guidelines for CCSs should be followed in a positive stage 1. Stage 2 includes steps B, C, and E, for further risk stratification or symptoms assessment, but it lacks evidence-based risk-modifying management and is mainly useful when stage 1 is negative and a cardiac origin of symptoms is still suspected.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":"55 1","pages":"1-4"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Pivot-Balloon for Severe Tricuspid Regurgitation: The First-in-Man Experiences.","authors":"Eun Kyoung Kim, Min-Ku Chon, Hyun-Sook Kim, Yong-Hyun Park, Sang-Hyun Lee, Ki Seok Choo, Hyung Gon Je, Dae-Hee Kim, Tae Oh Kim, Yoon Seok Koh, Jae-Hyeong Park, Jae-Hwan Lee, Young Jin Choi, Eun Seok Shin, Hyuck-Jun Yoon, Seung-Whan Lee, Joo-Yong Hahn","doi":"10.4070/kcj.2024.0147","DOIUrl":"10.4070/kcj.2024.0147","url":null,"abstract":"<p><strong>Background and objectives: </strong>Among various emerging catheter-based treatments for severe tricuspid regurgitation (TR), the spacer device can reduce the regurgitation orifice without manipulating the valve leaflet. However, its clinical application has been hampered by traumatic anchoring to the myocardium and the coaxial alignment of the balloon resulting in insufficient TR reduction. This study aimed to evaluate the early-stage safety, technical feasibility, and preliminary efficacy of the novel atraumatic vertical spacer in patients with isolated severe TR.</p><p><strong>Methods: </strong>All procedures were guided by fluoroscopy and transthoracic echocardiography. The maximum device placement time with an inflated balloon was 24 hours. Changes in the amount of TR, right ventricular function, and patient hemodynamics were measured during balloon deployment.</p><p><strong>Results: </strong>A total of 7 patients (median age 74), underwent successful device implantation without procedure-related complications. During balloon inflation (median 25 minutes), there were no symptoms or signs indicative of TR intolerance. TR was reduced by 1 grade or greater in all patients, with 2 patients exhibiting a reduction of 3 grades, from torrential TR to a moderate degree. Mild TR after balloon inflation was achieved in 3 patients with baseline severe TR. The TR reduction observed during initial balloon deployment was sustained during the subsequent balloon maintenance period.</p><p><strong>Conclusions: </strong>The Pivot-balloon procedure was safe, technically feasible, and effective in reducing TR in patients with severe TR. No periprocedural complications or adverse cardiovascular events were reported during device placement with TR reduction observed in all patients. However, longer-term follow-up is needed to confirm safety and treatment effect.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05648838.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"20-31"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Nicotine on Re-endothelialization, Inflammation, and Neoatherosclerosis After Drug-Eluting Stent Implantation in a Porcine Model.","authors":"Seok Oh, Ju Han Kim, Saleem Ahmad, Yu Jeong Jin, Mi Hyang Na, Munki Kim, Jeong Ha Kim, Dae Sung Park, Dae Young Hyun, Kyung Hoon Cho, Min Chul Kim, Doo Sun Sim, Young Joon Hong, Seung-Won Lee, Youngkeun Ahn, Myung Ho Jeong","doi":"10.4070/kcj.2024.0171","DOIUrl":"10.4070/kcj.2024.0171","url":null,"abstract":"<p><strong>Background and objectives: </strong>Cigarette smoking is a major risk factor for atherosclerosis. Nicotine, a crucial constituent of tobacco, contributes to atherosclerosis development and progression. However, evidence of the association between nicotine and neointima formation is limited. We aimed to evaluate whether nicotine enhances neointimal hyperplasia in the native epicardial coronary arteries of pigs after percutaneous coronary intervention (PCI) with drug-eluting stents (DES).</p><p><strong>Methods: </strong>After coronary angiography (CAG) and quantitative coronary angiography (QCA), we implanted 20 DES into 20 pigs allocated to 2 groups: no-nicotine (n=10) and nicotine (n=10) groups. Post-PCI CAG and QCA were performed immediately. Follow-up CAG, QCA, optical coherence tomography (OCT), and histopathological analyses were performed 2 months post-PCI.</p><p><strong>Results: </strong>Despite intergroup similarities in the baseline QCA findings, OCT analysis showed that the nicotine group had a smaller mean stent and lumen areas, a larger mean neointimal area, greater percent area stenosis, and higher peri-strut fibrin and inflammation scores than the no-nicotine group. In immunofluorescence analysis, the nicotine group displayed higher expression of CD68 and α-smooth muscle actin but lower CD31 expression than the no-nicotine group.</p><p><strong>Conclusions: </strong>Nicotine inhibited re-endothelialization and promoted inflammation and NIH after PCI with DES in a porcine model.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"50-64"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Procedural Characteristics and Clinical Outcomes Among Patients Undergoing Bifurcation PCI.","authors":"Hyun Jin Ahn, Francesco Bruno, Jeehoon Kang, Doyeon Hwang, Han-Mo Yang, Jung-Kyu Han, Leonardo De Luca, Ovidio de Filippo, Alessio Mattesini, Kyung Woo Park, Alessandra Truffa, Wojciech Wanha, Young Bin Song, Sebastiano Gili, Woo Jung Chun, Gerard Helft, Seung-Ho Hur, Bernardo Cortese, Seung Hwan Han, Javier Escaned, Alaide Chieffo, Ki Hong Choi, Guglielmo Gallone, Joon-Hyung Doh, Gaetano De Ferrari, Soon-Jun Hong, Giorgio Quadri, Chang-Wook Nam, Hyeon-Cheol Gwon, Hyo-Soo Kim, Fabrizio D'Ascenzo, Bon-Kwon Koo","doi":"10.4070/kcj.2024.0172","DOIUrl":"10.4070/kcj.2024.0172","url":null,"abstract":"<p><strong>Background and objectives: </strong>The risk profiles, procedural characteristics, and clinical outcomes for women undergoing bifurcation percutaneous coronary intervention (PCI) are not well defined compared to those in men.</p><p><strong>Methods: </strong>COronary BIfurcation Stenting III (COBIS III) is a multicenter, real-world registry of 2,648 patients with bifurcation lesions treated with second-generation drug-eluting stents. We compared the angiographic and procedural characteristics and clinical outcomes based on sex. The primary outcome was 5-year target lesion failure (TLF), a composite of cardiac death, myocardial infarction, and target lesion revascularization.</p><p><strong>Results: </strong>Women (n=635, 24%) were older, had hypertension and diabetes more often, and had smaller main vessel and side branch reference diameters than men. The pre- and post-PCI angiographic percentage diameter stenoses of the main vessel and side branch were comparable between women and men. There were no differences in procedural characteristics between the sexes. Women and men had a similar risk of TLF (6.3% vs. 7.1%, p=0.63) as well as its individual components and sex was not an independent predictor of TLF. This finding was consistent in the left main and 2 stenting subgroups.</p><p><strong>Conclusions: </strong>In patients undergoing bifurcation PCI, sex was not an independent predictor of adverse outcome.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03068494.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"5-16"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Is Not Predictor for Clinical Outcomes in Patients Undergoing Percutaneous Coronary Intervention for Coronary Bifurcation.","authors":"Cheol Ung Choi","doi":"10.4070/kcj.2024.0333","DOIUrl":"10.4070/kcj.2024.0333","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"17-19"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of Fractional Flow Reserve Versus Intravascular Ultrasound to Guide Percutaneous Coronary Intervention: Results From the FLAVOUR Study.","authors":"Doyeon Hwang, Hea-Lim Kim, Jane Ko, HyunJin Choi, Hanna Jeong, Sun-Ae Jang, Xinyang Hu, Jeehoon Kang, Jinlong Zhang, Jun Jiang, Joo-Yong Hahn, Chang-Wook Nam, Joon-Hyung Doh, Bong-Ki Lee, Weon Kim, Jinyu Huang, Fan Jiang, Hao Zhou, Peng Chen, Lijiang Tang, Wenbing Jiang, Xiaomin Chen, Wenming He, Sung Gyun Ahn, Ung Kim, You-Jeong Ki, Eun-Seok Shin, Hyo-Soo Kim, Seung-Jea Tahk, JianAn Wang, Tae-Jin Lee, Bon-Kwon Koo","doi":"10.4070/kcj.2024.0156","DOIUrl":"10.4070/kcj.2024.0156","url":null,"abstract":"<p><strong>Background and objectives: </strong>The Fractional Flow Reserve and Intravascular Ultrasound-Guided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea.</p><p><strong>Methods: </strong>A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography). The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D.</p><p><strong>Results: </strong>From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis.</p><p><strong>Conclusions: </strong>Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT02673424.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"34-46"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness Matters! FFR Versus IVUS-Guided PCI in Modern Clinical Practice: Insights From the FLAVOUR Trial.","authors":"Sun Oh Kim, Jong-Il Park, Ung Kim","doi":"10.4070/kcj.2024.0327","DOIUrl":"10.4070/kcj.2024.0327","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"47-49"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Outcomes of Acute Myocarditis: An Analysis of Korean Multicenter Registry.","authors":"Junho Hyun, Dayoung Pack, Minjung Bak, Hyukjin Park, Hyung Yoon Kim, Seonhwa Lee, In-Cheol Kim, So Ree Kim, Mi-Na Kim, Kyung-Hee Kim, Sang Eun Lee, Jeong Hoon Yang","doi":"10.4070/kcj.2024.0229","DOIUrl":"https://doi.org/10.4070/kcj.2024.0229","url":null,"abstract":"<p><strong>Background and objectives: </strong>Data are limited on the clinical manifestations and outcomes of acute myocarditis from a large-scale registry. We investigated acute myocarditis's clinical characteristics and prognosis from a large-scale, multi-center registry in the Republic of Korea.</p><p><strong>Methods: </strong>We collected data from seven hospitals between 2001 and 2021. Clinical variables and outcomes during the index hospitalization and follow-up periods were analyzed. We also evaluated inter-center and temporal differences in diagnostic and treatment patterns.</p><p><strong>Results: </strong>Eight hundred forty-one patients diagnosed with acute myocarditis were included. Common symptoms included chest pain (60.4%), followed by fever or myalgia (46.3%), and dyspnea (45.7%). Fulminant myocarditis occurred in 421 (50.1%), with 217 requiring extracorporeal membrane oxygenation (ECMO) support. Endomyocardial biopsy (EMB) was performed in 276 (32.8%) patients, and biopsy-proven diagnosis was made in 234 (27.8%). Based on the EMB results, lymphocytic myocarditis was the predominant form (69.6%), followed by eosinophilic (13.8%) and giant cell myocarditis (1.4%). Eighty-three in-hospital (9.9%) and 16 (1.9%) additional mortality during the follow-up occurred. An increase in the use of EMB, cardiac imaging, and immunosuppressive therapy was noted over time, but in-hospital mortality remained unchanged. Remarkable variations in diagnosis and treatment were observed across different centers.</p><p><strong>Conclusions: </strong>This study unveiled clinical features of acute myocarditis in the Republic of Korea, including a high incidence of fulminant myocarditis and complex cases requiring ECMO. Given the considerable inter-center variation in diagnostic and treatment patterns and prognosis, protocolized future trials are needed to clarify diagnosis and treatment in patients with acute myocarditis.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05933902.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979076","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}