Korean Circulation Journal最新文献

{"title":"Hidden Remodeling in Hypothyroidism: Insights From AF Ablation.","authors":"Akiko Ueda","doi":"10.4070/kcj.2025.0510","DOIUrl":"10.4070/kcj.2025.0510","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"341-343"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227379","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":"Atrial Fibrillation, Brain Structure and Cognitive Function: A Mediation Analysis.","authors":"Jung-Ho Yang, Sun-Seog Kweon, Yu-Mi Kim, Mi Kyung Kim, Jinho Shin, In-Sung Chung, Sang Baek Koh, Hyeon Chang Kim, Jong-Min Lee, Yeonwook Kang, Min-Ho Shin","doi":"10.4070/kcj.2025.0246","DOIUrl":"10.4070/kcj.2025.0246","url":null,"abstract":"<p><strong>Background and objectives: </strong>Atrial fibrillation (AF) is associated with an increased risk of cerebrovascular disease and cognitive impairment. However, evidence on the mediating role of brain structural changes in this association remains limited, especially in Asian populations. This study investigated the associations among AF, magnetic resonance imaging (MRI)-measured brain structures, and cognitive function, and evaluated the mediation effect of brain structural changes in the AF-cognition link.</p><p><strong>Methods: </strong>Two thousand, six hundred sixty-two participants from the KoGES-CAVAS-C cohort were analyzed, who without a history of stroke or missing data. AF was identified with electrocardiograms and confirmed by cardiologists. Cognitive function was assessed using the Seoul Neuropsychological Screening Battery-Core. Brain volumes and white matter integrity were measured using standardized MRI protocols. Multivariable linear regression and mediation analyses were performed.</p><p><strong>Results: </strong>Among 2,662 participants, 50 (1.9%) had AF. Participants with AF showed lower total brain volume, regardless of tissue type, and reduced volumes in multiple brain regions. Overall cognitive function and specific domains (memory and executive function) were poorer in the AF group than in the normal group. AF remained significantly associated with lower total brain volume (p=0.005) and cognitive scores (p=0.037) after adjustment. Total brain volume partially mediated the AF-cognition association (p=0.007), accounting for 11% of the effect.</p><p><strong>Conclusions: </strong>AF is associated with brain atrophy and cognitive impairment, and brain structure partially mediates the association between AF and cognitive function. Our study findings suggest integrated cardiovascular and cognitive assessments in AF management.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"301-311"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010836","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":"Atrial Fibrillation and Brain Health: Bridging the Heart-Brain Connection Beyond Stroke Prevention.","authors":"Daehoon Kim","doi":"10.4070/kcj.2025.0454","DOIUrl":"10.4070/kcj.2025.0454","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"312-313"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499441","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":"Massive Pneumopericardium After Removing a Pericardial Drainage Catheter.","authors":"Jeong Tae Byoun, Hyung Ki Jeong, Jae Young Cho, Donghyeon Joo, Kyeong Ho Yun","doi":"10.4070/kcj.2025.0419","DOIUrl":"10.4070/kcj.2025.0419","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"359-361"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499396","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 Emerging Lipid Risk: Lipoprotein(a).","authors":"Sang-Hak Lee, Ki Hoon Han","doi":"10.4070/kcj.2025.0380","DOIUrl":"10.4070/kcj.2025.0380","url":null,"abstract":"<p><p>Based on epidemiological and genetic studies in recent decades, lipoprotein(a) (Lp(a)) has been accepted as a causal risk factor for atherosclerotic cardiovascular disease and aortic stenosis. Although inter-ethnic differences exist, Lp(a) level ≥50 mg/dL is commonly reported to indicate elevated cardiovascular risk. Blood Lp(a) levels are largely determined based on genetic background, and the kringle IV type 2 repeat variant is a major factor. Lp(a) is structurally similar to low-density lipoprotein (LDL) but also contains apolipoprotein(a) (apo(a)), which includes kringle domains associated with diverse effects depending on particles and individuals. The LDL-like property of Lp(a) and effect of apo(a) on vascular cells can promote atherosclerosis. Apo(a) competes with plasminogen and can inhibit the role of plasmin during fibrinolysis. Furthermore, oxidized phospholipids on apo(a) may induce oxidative stress to enhance atherosclerosis and can affect valve calcification. Trials on new therapeutics targeting Lp(a) RNA, including antisense oligonucleotide (e.g., pelacarsen), siRNAs (e.g., olpasiran, lepodisiran, and zerlasiran), and small molecules (e.g., muvalaplin), are under way. Depending on the study or dose, these agents lowered Lp(a) levels by 80-100% compared with the control; however, results of clinical outcomes have yet to be reported.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"289-300"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724267","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":"Association of Hypothyroidism With Atrial Substrate Burden and Recurrence Following Catheter Ablation of Atrial Fibrillation.","authors":"Jose Antonio L Bautista, Danica Ann D Leycano, Naomi P Ong, Ahliah E Ibrahim, Fa-Po Chung, Yu-Feng Hu, Shih-Lin Chang, Yenn-Jiang Lin, Chin-Yu Lin, Ting-Yung Chang, Ling Kuo, Chih-Min Liu, Shin-Huei Liu, Wen-Han Cheng, Ming-Jen Kuo, Guan-Yi Li, Chih-Hsien Lin, Yu-Shan Huang, Shang-Ju Wu, Yoon Kee Siow, Ngoc Ngyuen Dinh Son, Shih-Ann Chen, Li-Wei Lo","doi":"10.4070/kcj.2025.0181","DOIUrl":"10.4070/kcj.2025.0181","url":null,"abstract":"<p><strong>Background and objectives: </strong>Hypothyroidism has been linked to increased atrial fibrillation (AF) susceptibility. We aimed to identify factors associated with AF recurrence after catheter ablation and to compare arrhythmogenic substrates and recurrence rates between euthyroid and hypothyroid patients.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent AF ablation from 2015 to 2019. Baseline clinical, echocardiographic, and electrophysiologic parameters were compared between hypothyroid and euthyroid groups. Pulmonary vein (PV) and non-PV (NPV) triggers, as well as AF drivers, were analyzed. Multivariate Cox regression identified predictors of AF recurrence.</p><p><strong>Results: </strong>Among 591 patients (mean age 57.2±11.1 years; 450 male), 65 (10.9%) had hypothyroidism. These patients had more hypertension (49.2% vs. 34.0%, p=0.016), larger left atrial diameter (LAD, 41.1±6.3 mm vs. 39.1 ± 6.3 mm, p=0.015), more NPV triggers (41.5% vs. 26.4%, p=0.01), and more AF drivers (26.2% vs. 12.5%, p=0.003). AF recurrence was higher in the hypothyroid group (44.6% vs. 18.1%, p<0.001). Independent predictors of recurrence included AF drivers, NPV triggers, LAD, Peak E velocity, and E/e' ratio. Hypothyroidism was not an independent predictor, but mediation analysis showed that its effect on recurrence was predominantly indirect. Kaplan-Meier analysis showed higher recurrence in hypothyroid patients (log-rank p<0.0001).</p><p><strong>Conclusions: </strong>Hypothyroidism was associated with a higher burden of atrial triggers, drivers, and AF recurrence. Its impact on recurrence was likely an indirect effect of structural and arrhythmogenic remodeling. Comprehensive driver mapping may improve ablation outcomes in this population, warranting further prospective validation.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"329-340"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227389","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":"Role of CR6-Interacting Factor 1 (Crif1) in Cardiac Mitochondrial Structure and Stress-Induced Functional Decline.","authors":"Seon-Ah Jin, Hee Jung Seo, Byung-Kwan Lim, Jin-Ok Jeong","doi":"10.4070/kcj.2025.0155","DOIUrl":"10.4070/kcj.2025.0155","url":null,"abstract":"<p><strong>Background and objectives: </strong>CR6-interacting factor 1 (CRIF1) is essential for the synthesis and insertion of mitochondrial oxidative phosphorylation (OXPHOS) complexes. Although <i>Crif1</i> deficiency has been linked to mitochondrial dysfunction in various tissues, its role in cardiac function remains unclear. Therefore, this study aimed to investigate the role of <i>Crif1</i> in regulating mitochondrial function in the heart.</p><p><strong>Methods: </strong>To determine the role of <i>Crif1</i> and examine mitochondrial dysfunction in the heart, we generated cardiac-specific <i>Crif1</i> knock-down mice using a Myh6-Cre system. Mitochondrial function was assessed by measuring oxygen consumption rates. Histological and echocardiographic examinations were performed at baseline and 2 weeks after isoproterenol infusion.</p><p><strong>Results: </strong><i>Crif1</i> knock-down in the heart led to structural mitochondrial abnormalities and decreased maximal oxygen consumption rates in cardiomyocytes. Although cardiac-specific <i>Crif1</i> knock-down resulted in mitochondrial dysfunction, the cardiac phenotype remained normal showing preserved ejection fraction (EF) and fractional shortening (FS). However, cardiac dysfunction was aggravated under isoproterenol-induced stress, resulting in a decreased EF and FS. Cardiac hypertrophy, a typical adaptive response to isoproterenol stimulation, was attenuated.</p><p><strong>Conclusions: </strong>These findings suggest that <i>Crif1</i> is critical for maintaining the structure and function of mitochondria in cardiomyocytes. Additionally, mitochondrial abnormalities in the heart impair stress adaptation, leading to aggravated cardiac dysfunction under stress.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"314-325"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227414","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":"Mitochondrial Integrity as the Gatekeeper of Cardiac Stress Adaptation: Insights From CRIF1 Deficiency.","authors":"Yong Sook Kim","doi":"10.4070/kcj.2025.0494","DOIUrl":"10.4070/kcj.2025.0494","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"326-328"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499384","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":"Effect of Early Initiation of Evolocumab on Lipid Profiles Changes in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.","authors":"Ji Woong Roh, Oh-Hyun Lee, Yongcheol Kim, Seok-Jae Heo, Eui Im, Deok-Kyu Cho","doi":"10.4070/kcj.2025.0315","DOIUrl":"10.4070/kcj.2025.0315","url":null,"abstract":"<p><strong>Background and objectives: </strong>Rapid reduction of low-density lipoprotein cholesterol (LDL-C) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) is critical but challenging. This study evaluated the efficacy and safety of early triple lipid-lowering therapy with evolocumab, a moderate-intensity statin, and ezetimibe in statin-naïve ACS patients.</p><p><strong>Methods: </strong>The C-STAR trial (Effect of Early Initiation of Evolocumab on Lipid Profile Changes in Patients with ACS Undergoing PCI) was a single-center, randomized, open-label trial conducted from December 2022 to January 2025. A total of 108 statin-naïve ACS patients undergoing PCI were randomized to evolocumab (140 mg) plus rosuvastatin 5 mg and ezetimibe 10 mg (n=54) or rosuvastatin 5 mg and ezetimibe 10 mg alone (n=54). The primary endpoint was LDL-C level at 2 weeks; cognitive safety was assessed using the Everyday Cognition (ECog) tool.</p><p><strong>Results: </strong>Baseline LDL-C levels were similar between the 2 groups. At 2 weeks, LDL-C levels were lower in the evolocumab group compared to the non-evolocumab group (31±16 mg/dL vs. 63±17 mg/dL; p<0.001), with a greater percentage reduction (-77.5% vs. -53.3%, p<0.001). Target achievement rates were also higher in the evolocumab group (84.6% vs. 26.9%, p<0.001). Comparable cognitive functions were observed using ECog questionnaire (23.9±3.4 vs. 24.5±5.5; p=0.493).</p><p><strong>Conclusions: </strong>Early initiation of evolocumab in combination therapy achieved greater LDL-C reduction and target achievement in ACS patients undergoing PCI.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05661552.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"344-355"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010916","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":"Early Initiation of Evolocumab in Patients With Acute Coronary Syndrome.","authors":"Hack-Lyoung Kim","doi":"10.4070/kcj.2025.0465","DOIUrl":"10.4070/kcj.2025.0465","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"356-358"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227369","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}