Korean Circulation Journal最新文献

{"title":"Escalating Lipid Therapy After Achieving LDL-C <70 mg/dL With Moderate-Intensity Statins in High-Risk Patients.","authors":"Geunhee Park, Eui-Young Choi, Sang-Hak Lee","doi":"10.4070/kcj.2024.0218","DOIUrl":"10.4070/kcj.2024.0218","url":null,"abstract":"<p><strong>Background and objectives: </strong>Guidelines recommend target levels of low-density lipoprotein cholesterol (LDL-C) and intensive lipid-lowering therapy (LLT) in high-risk patients. However, the value of escalating LLT when the LDL-C targets are achieved with moderate-intensity statins is unknown. We aimed to evaluate the benefits of LLT escalation in this population.</p><p><strong>Methods: </strong>In this retrospective propensity score-matched study, we screened data from two university hospitals between 2006 and 2021. Of the 54,069 patients with atherosclerotic cardiovascular disease (ASCVD), 3,205 who achieved LDL-C levels <70 mg/dL with moderate-intensity statins were included. After 1:3 matching, 1,315 patients (339 with LLT escalation and 976 without) were ultimately examined. The primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE)1 (cardiovascular death, nonfatal myocardial infarction, and nonfatal ischemic stroke) and all-cause death.</p><p><strong>Results: </strong>During a median follow-up of 5.7 years, the MACCE1 rate was not significantly lower in the escalation group than in the non-escalation group (9.8 and 14.3/1,000 person-years, respectively; hazard ratio [HR], 0.68; 95% confidence interval [CI], 0.43-1.09; p=0.11). Kaplan-Meier curves showed similar results (log-rank p=0.11). The risk of all-cause death did not differ between the groups. MACCE2 rate, which additionally includes coronary/peripheral revascularization, was lower in the escalation group (24.5 and 35.4/1,000 person-years, respectively; HR, 0.70; 95% CI, 0.52-0.94; p=0.017).</p><p><strong>Conclusions: </strong>LLT escalation did not significantly lower hard cardiovascular outcomes and all-cause death in patients with ASCVD achieving LDL-C levels <70 mg/dL with moderate-intensity statins. However, it had benefit in reducing revascularization rates in this population.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"426-436"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902854","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":"Misguided Blood Flow Near the Atrial Septum.","authors":"Qianlei Lang, Zhuo Hou, Mei Li, Honghua Yue, Zhi Fang","doi":"10.4070/kcj.2024.0394","DOIUrl":"10.4070/kcj.2024.0394","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":"55 5","pages":"459-460"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971128","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":"Pulmonary Vasodilator Therapy in Patients With Fontan Circulation: A Meta-Analysis.","authors":"Min-Jung Cho, Soo-Jin Kim, Miyoung Choi, Joo Sung Lee, Kyung Jin Oh, Hee Jung Choi, Gwang-Jun Choi, Jae Yoon Na, Jae Hee Seol, Jin Young Song","doi":"10.4070/kcj.2024.0378","DOIUrl":"https://doi.org/10.4070/kcj.2024.0378","url":null,"abstract":"<p><strong>Background and objectives: </strong>The effect of pulmonary vasodilator therapy on patients with Fontan circulation remains unclear. This study aims to assess its impact on exercise capacity and hemodynamic parameters in this population.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and the Cochrane Library for relevant studies up to November 2023. Pooled outcomes were used to evaluate the efficacy of pulmonary vasodilators in Fontan patients.</p><p><strong>Results: </strong>A total of 18 studies with 667 patients were included. Exercise capacity was assessed in 14 studies (526 patients). Pulmonary vasodilator therapy improved oxygen consumption anaerobic threshold (VO₂AT; MD, 1.12 mL/min/kg; 95% CI, 0.35 to 1.89; p=0.004) and Ve/VCO₂ slope (MD, -1.14; 95% CI, -1.97 to -0.31; p=0.007) during exercise. No significant differences were found among drug classes regarding peak oxygen consumption, Ve/VCO₂, or VO₂AT. Invasive hemodynamics were evaluated in 6 studies (126 patients). Pulmonary vasodilators significantly reduced mean pulmonary arterial pressure (MD, -2.28 mmHg; p=0.02), pulmonary vascular resistance (MD, -0.91 WU*m²; p=0.01), and improved pulmonary flow (MD, 0.46 L/min/m²; p=0.02).</p><p><strong>Conclusions: </strong>Pulmonary vasodilator therapy appears beneficial for exercise capacity and pulmonary hemodynamics in Fontan patients. More randomized controlled trials are needed to confirm these findings.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989734","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}

{"title":"Prognostic Value of Plasma Big Endothelin-1 in Patients Hospitalized for Heart Failure.","authors":"Jinxi Wang, Jiayu Feng, Gary Tse, Mei Zhai, Yan Huang, Qiong Zhou, Xiaofeng Zhuang, Huihui Liu, Yuhui Zhang, Jian Zhang","doi":"10.4070/kcj.2024.0354","DOIUrl":"https://doi.org/10.4070/kcj.2024.0354","url":null,"abstract":"<p><strong>Background and objectives: </strong>Endothelin-1 (ET-1) is a potent vasoconstrictor and multifunctional neuroendocrine hormone that is closely associated with the pathophysiology of heart failure (HF). Currently, the evidence about the predictive value of big ET-1 in HF remains insufficient. This study aims to investigate the prognostic importance of big ET-1 in HF.</p><p><strong>Methods: </strong>We examined the incidence of cardiovascular death in a single-center retrospective cohort of HF (de novo, worsening, or chronic included).</p><p><strong>Results: </strong>The 4,368 hospitalized HF patients were enrolled. During the median follow-up of 875 (365-1,400) days, 851 (19.5%) patients had primary outcome events. Big ET-1 was independently associated with cardiovascular death as a continuous variable (hazard ratio [HR], 1.13; 95% confidence interval [CI], 1.06-1.21; p<0.001) and by tertiles (HR, 1.35; 95% CI, 1.06-1.72; p=0.017 for tertile 2 and HR, 1.70; 95% CI, 1.32-2.19; p<0.001 for tertile 3). This pattern of risk was maintained after further adjustment for NT-proBNP (HR, 1.11; 95% CI, 1.03-1.19; p=0.006 for continuous variable, HR, 1.30; 95% CI, 1.02-1.67; p=0.035 for tertile 2, and HR, 1.69; 95% CI, 1.23-2.05; p=0.034 for tertile 3). Net reclassification index (NRI) and integrated discrimination improvement (IDI) analysis showed that big ET-1 provided additional predictive power in combination with NT-proBNP (NRI, 0.11; 95% CI, 0.04-0.17; p=0.012 and IDI, 0.012; 95% CI, 0.003-0.017; p<0.001).</p><p><strong>Conclusions: </strong>Elevated big ET-1 was independently associated with cardiovascular death in patients with HF. Big ET-1 may be a promising indicator of HF prognosis. In combination with NT-proBNP, big ET-1 may provide incremental predictive information.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000842","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}

{"title":"Addressing Cardiovascular Diseases Challenges in South Korea: Strategies to Improve Outcomes.","authors":"Hyun-Jae Kang, JuMee Wang, Eun Joo Cho, Hack-Lyoung Kim, Chan Joo Lee, Jae Hyoung Park, Jeehoon Kang, Jon Suh, Ki Hong Choi, Seung-Yul Lee, Jong-Il Choi, Il-Young Oh, Ungjeong Do, Seung Young Roh, Sang-Ho Jo, Jin Wi, Dae-Hwan Bae, Mi-Hyang Jung, Chan Seok Park, Chi Young Shim, Min-Kyung Kang, Mi-Na Kim, Jang-Whan Bae","doi":"10.4070/kcj.2024.0385","DOIUrl":"https://doi.org/10.4070/kcj.2024.0385","url":null,"abstract":"<p><p>Cardiovascular diseases (CVDs) pose a significant public health challenge in South Korea. This paper attempts to assess the current status of major cardiovascular risk factors and representative CVDs, and proposes policies and strategies to improve CVDs outcomes. It addresses key issues related to hypertension, dyslipidemia, ischemic heart disease, atrial fibrillation, sudden cardiac death, heart failure and valvular heart disease. The high-priority strategies for improving CVDs outcomes include raising public awareness, emphasizing prevention, ensuring equitable access to care, increasing investment in CVDs research, enhancing healthcare provider education, and incentivizing care for high-risk patients care. To implement those strategies, this paper proposes policies for both government and academic societies.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011052","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}

{"title":"Erratum: Correction of Figure in the Article \"Simple and Practical Way of Assessing Diastolic Function: Diastolic Heart Failure Revisited\".","authors":"Dae-Won Sohn","doi":"10.4070/kcj.2025.0998","DOIUrl":"https://doi.org/10.4070/kcj.2025.0998","url":null,"abstract":"<p><p>This corrects the article on p. 67 in vol. 55, PMID: 39965893.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":"55 4","pages":"362-363"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969723","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":"Real-World Experience of Mavacamten for Patients With Obstructive Hypertrophic Cardiomyopathy in South Korea: A Prospective Multi-Center Observational Study.","authors":"Jaehyun Lim, Jae Yeong Cho, Soongu Kwak, Chan-Soon Park, Jiesuck Park, Hong-Mi Choi, Goo-Yeong Cho, Ga Hui Choi, Jihoon Kim, Jin-Oh Na, Sun Hwa Lee, Mi-Hyang Jung, Kye Hun Kim, Hae Ok Jung, Sang-Chol Lee, Hyung-Kwan Kim","doi":"10.4070/kcj.2024.0443","DOIUrl":"10.4070/kcj.2024.0443","url":null,"abstract":"<p><strong>Background and objectives: </strong>Mavacamten has shown promise in obstructive hypertrophic cardiomyopathy (oHCM); however, real-world evidence is limited in Asians. We aimed to provide the first multicenter, real-world analysis of mavacamten use in Korea.</p><p><strong>Methods: </strong>This prospective observational study included symptomatic oHCM patients treated at 7 tertiary hospitals in Korea. Changes in key parameters, including left ventricular outflow tract (LVOT) gradients, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and New York Heart Association functional class (NYHA Fc), were serially assessed. Adverse events, including death, arrhythmia, and heart failure hospitalizations were documented.</p><p><strong>Results: </strong>Forty-six patients were followed for a median of 147 days (interquartile range 56-205). There was one sudden cardiac death and one non-cardiac death. Resting and Valsalva LVOT gradients significantly decreased from 58.4±46.4 mmHg and 92.6±46.8 mmHg to 17.5±21.3 mmHg and 25.7±27.1 mmHg, respectively (both p<0.001). NT-proBNP levels also decreased significantly, strongly correlating with LVOT gradient reductions. Among the 44 survivors, 25 (58.1%) had at least one NYHA Fc improvement. Moreover, left atrial volume and maximal left ventricular (LV) wall thickness significantly decreased. However, mean reduction in LV ejection fraction (LVEF) was -3.4% with one patient experiencing LVEF <50%. We observed 2 newly-detected atrial fibrillations and 2 ischemic strokes.</p><p><strong>Conclusions: </strong>This first real-world experience of mavacamten in Korean patients with oHCM demonstrates its efficacy and safety, aligning with previous pivotal trials. With the implementation of national insurance coverage, mavacamten will be more accessible to broader oHCM population, offering a non-invasive and effective therapeutic option aside from invasive septal reduction therapies.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"339-354"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764237","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":"Feasibility of Distal Radial Access in High Bleeding Risk Patients Who Underwent Percutaneous Coronary Intervention.","authors":"In Tae Jin, Ji Woong Roh, Oh-Hyun Lee, Eui Im, Deok-Kyu Cho, Jun-Won Lee, Bong-Ki Lee, Sang-Yong Yoo, Sang Yeub Lee, Chan Joon Kim, Han-Young Jin, Jin Sup Park, Jung Ho Heo, Do Hoi Kim, Jin Bae Lee, Dong-Kie Kim, Jun Ho Bae, Sung-Yun Lee, Seung-Hwan Lee, Yongcheol Kim","doi":"10.4070/kcj.2024.0239","DOIUrl":"10.4070/kcj.2024.0239","url":null,"abstract":"<p><strong>Backgrounds and objectives: </strong>The distal radial access (DRA), a potential alternative to the trans-radial approach (TRA), may offer advantages in terms of access site complications due to its smaller vessel diameter, especially for high bleeding risk (HBR) patients. This study aims to investigate the feasibility of DRA in HBR patients.</p><p><strong>Methods: </strong>Based on data from the KODRA registry, a prospective, multicenter cohort, this study analyzed 1,586 patients who underwent successful percutaneous coronary intervention (PCI) via DRA. Patients were categorized into HBR and non-HBR groups. The primary endpoint of the study is DRA-related bleeding, and the secondary endpoints of the study are overall access site complications and each component of the access site complications. To reduce the effect of potential confounders, a multivariable adjustment analysis was performed.</p><p><strong>Results: </strong>The mean age of the total population was 71.1±10.8 years, and 40.3% of patients were female. Both DRA-related bleeding (odds ratio [OR], 1.15; 95% confidence interval [CI], 0.67-1.97; p=0.616) and overall access site complications (OR, 1.08; 95% CI, 0.67-1.72; p=0.761) were not significantly different between the HBR group and non-HBR group after multivariable adjustment. No major bleeding before discharge was observed in both groups. Furthermore, the incidence of distal and conventional radial artery occlusion was less than 1% at 1-month follow-up in both groups.</p><p><strong>Conclusions: </strong>Our study results showed the safety of DRA for both DRA-related bleeding and access site complications among HBR patients who underwent PCI.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04080700.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"291-301"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903038","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":"Robotics in Interventional Cardiology: Where Are We? And How Can We Expand?","authors":"Jeehoon Kang","doi":"10.4070/kcj.2024.0399","DOIUrl":"10.4070/kcj.2024.0399","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"336-338"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649107","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":"Cardiovascular Etiologies and Risk Factors of Survival Outcomes After Resuscitation for Out-of-Hospital Cardiac Arrest: Data From the KoCARC Registry.","authors":"Joo Hee Jeong, Kyongjin Min, Jong-Il Choi, Su Jin Kim, Seung-Young Roh, Kap Su Han, Juhyun Song, Sung Woo Lee, Young-Hoon Kim","doi":"10.4070/kcj.2024.0243","DOIUrl":"10.4070/kcj.2024.0243","url":null,"abstract":"<p><strong>Background and objectives: </strong>The outcomes and characteristics of out-of-hospital cardiac arrest (OHCA) vary across geographic regions. The etiologies and prognoses of OHCA in Asian populations remain less established. This study aimed to investigate the etiologies and clinical characteristics of patients successfully resuscitated after OHCA and to identify predictors of survival outcomes.</p><p><strong>Methods: </strong>Data were extracted from a South Korean multicenter prospective registry of OHCA that included 64 tertiary hospitals from 2015 to 2018 (n=7,577). The primary outcome was in-hospital mortality, and the secondary outcome was a Cerebral Performance Category (CPC) score of grade 1 at discharge.</p><p><strong>Results: </strong>Of the 7,577 patients, 2,066 achieved return of spontaneous circulation (ROSC) and were hospitalized. A total of 915 (44.2%) presented with ventricular arrhythmia (VA) as their initial rhythm or on admission. The leading cause was obstructive coronary artery disease (n=413; 20.0%). Sudden unexplained death syndrome (SUDS) accounted for 67.5% of survivors and was significantly less common in patients with VA (82.7% vs. 48.3%, p<0.001). VA was an independent predictor of in-hospital mortality (adjusted hazard ratio, 0.774; 95% confidence interval [CI], 0.633-0.946; p=0.012) and the grade-1 CPC score at discharge (odds ratio, 2.822; 95% CI, 1.909-4.172; p<0.001). Other predictors of in-hospital mortality included age, diabetes mellitus, witnessed cardiac arrest, ROSC on arrival, total arrest time, alertness on admission, extracorporeal membrane oxygenation use, targeted temperature management, and coronary reperfusion.</p><p><strong>Conclusions: </strong>SUDS was common in patients with ROSC after OHCA. VA was independently associated with favorable survival outcomes at discharge. Prompt clinical intervention may improve clinical outcomes in patients with OHCA, particularly those with VA.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"275-287"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903319","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}