Korean Circulation Journal最新文献

{"title":"Low Aortic Pulsatility Index and Pulmonary Artery Pulsatility Index Are Associated With Increased Mortality in Patients With Dilated Cardiomyopathy Awaiting Heart Transplantation.","authors":"Yihang Wu, Yuhui Zhang, Jian Zhang","doi":"10.4070/kcj.2024.0192","DOIUrl":"10.4070/kcj.2024.0192","url":null,"abstract":"<p><strong>Background and objectives: </strong>Patients with dilated cardiomyopathy (DCM) tend to be accompanied by biventricular impairment. We hypothesized that the combination of the aortic pulsatility index (API) and pulmonary artery pulsatility index (PAPI) could refine risk stratification in DCM.</p><p><strong>Methods: </strong>We studied 120 consecutive patients with advanced DCM who underwent right heart catheterization (RHC). The primary outcome was all-cause mortality within 1 year after RHC. We used the receiver operating characteristic curve to determine the optimal cut-off of API and PAPI to predict outcomes.</p><p><strong>Results: </strong>The optimal cut-offs of API (1.02) and PAPI (2.16) were used to classify patients into four groups. There were significant differences in left ventricular ejection fraction (LVEF) and tricuspid annular plane systolic excursion (TAPSE) among the four groups (both p<0.05). When delineating API by LVEF above or below the median (28%), the cumulative rate of survival in patients with API <1.02 was lower than that of those with API ≥1.02 in both higher and lower LVEF groups (both p<0.05). Similar trends were observed when delineating PAPI using TAPSE higher or lower than the cut-off (17 mm) (both p<0.05). The cumulative rate of survival in the API <1.02 and PAPI <2.16 group was lower than that in the API ≥1.02 and/or PAPI ≥2.16 (all p<0.05).</p><p><strong>Conclusions: </strong>API and PAPI could add additional prognostic value to LVEF and TAPSE, respectively. The combination of API and PAPI could provide a comprehensive assessment of biventricular function and refine risk stratification.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT02664818.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"134-147"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590882","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":"Bridging the Gap in Mechanical Circulatory Support Strategies Before Heart Transplantation.","authors":"Jae Yeong Cho, Kye Hun Kim","doi":"10.4070/kcj.2024.0374","DOIUrl":"10.4070/kcj.2024.0374","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":"55 2","pages":"97-99"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449385","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":"Simple and Practical Way of Assessing Diastolic Function: Diastolic Heart Failure Revisited.","authors":"Dae-Won Sohn","doi":"10.4070/kcj.2025.0005","DOIUrl":"10.4070/kcj.2025.0005","url":null,"abstract":"<p><p>Recently, usage of the term 'heart failure with preserved ejection fraction (HFpEF)' has predominated over the term 'diastolic heart failure (DHF).' The term 'preserved ejection fraction' represents only one aspect of DHF and does not provide insight into the hemodynamic mechanism of heart failure. In heart failure with reduced ejection fraction (HFrEF), depressed ejection fraction is the independent determinant of prognosis regardless of etiology. However, in HFpEF, because the prognosis is predominantly determined by etiologies of HFpEF, results of the drug on the prognosis in the clinical trial cannot be interpreted as it is. Therefore, studies on patients with HFpEF should be restricted to patients with diastolic dysfunction and, effects of drugs should be focused on symptom improvement not survival benefit. One reason for the prevalent use of HFpEF over DHF is the complexity in assessing diastolic function. Current official recommendations for the evaluation of diastolic function are too complex to be widely applied in the patient enrollment in large clinical trials as well as not easily applicable in our daily clinical practice. Therefore, there is a clinical need for a simple and practical way of assessing diastolic function.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":"55 2","pages":"67-78"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449388","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":"A Real-World, Prospective, Observational Study of Rivaroxaban on Prevention of Stroke and Non-Central Nervous Systemic Embolism in Renally Impaired Korean Patients With Non-Valvular Atrial Fibrillation: XARENAL.","authors":"Il-Young Oh, Chang Hoon Lee, Eue-Keun Choi, Hong Euy Lim, Yong-Seog Oh, Jong-Il Choi, Min-Soo Ahn, Ju Youn Kim, Nam-Ho Kim, Namsik Yoon, Martin Sandmann, Kee-Joon Choi","doi":"10.4070/kcj.2024.0154","DOIUrl":"10.4070/kcj.2024.0154","url":null,"abstract":"<p><strong>Background and objectives: </strong>Several real-world studies have been done in patients with nonvalvular atrial fibrillation (NVAF); however, information on its safety profile in patients with renal impairment is limited. XARENAL, a real-world study, aimed to prospectively investigate the safety profile of rivaroxaban in patients with NVAF with renal impairment (creatinine clearance [CrCl], 15-49 mL/min).</p><p><strong>Methods: </strong>XARENAL is an observational single-arm cohort study in renal impairment NVAF patients. Patients were followed up approximately every 3 months for 1 year or until 30 days following early discontinuation. The primary endpoint was major bleeding events. All adverse events, symptomatic thromboembolic events, treatment duration, and renal function change from baseline were the secondary endpoints.</p><p><strong>Results: </strong>XARENAL included 888 patients from 29 study sites. Overall, 713 (80.3%) had moderate renal impairment (CrCl, 30-49 mL/min), and 175 (19.7%) had severe renal impairment (CrCl, 15-29 mL/min) with a mean estimated glomerular filtration rate (eGFR) of 45.2±13.0 mL/min/1.73 m². The mean risk scores were 3.3±1.4 and 1.7±0.9 for CHA₂DS₂-VASc score and HAS-BLED score, respectively. An incidence proportion of 5.6% (6.2 events per 100 patient-years) developed major bleeding; however, fatal bleeding occurred in 0.5% (0.5 events per 100 patient-years). The mean change in the eGFR was 2.22±26.47 mL/min/1.73 m² per year.</p><p><strong>Conclusions: </strong>XARENAL observed no meaningful differences in major bleeding events from other previous findings as well as renal function changes in rivaroxaban-treated NVAF patients with renal impairment, which is considered to be acceptable in clinical practice.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03746301.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"121-131"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729787","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":"Right Heart Catheterization in Patients With Advanced Heart Failure: Novel Hemodynamic Parameters for Risk Stratification.","authors":"Minjae Yoon, Jong-Chan Youn","doi":"10.4070/kcj.2024.0379","DOIUrl":"10.4070/kcj.2024.0379","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"148-150"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903163","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 Versus Late Post Cesarean Section Warfarin Initiation and Increased Risk of Maternal Complications in Patients With Mechanical Heart Valves: A Randomized, Open-Label Pilot Study.","authors":"Ghada Youssef, Tarek El Husseiny Mohamed, Maged Ahmed Abdel Raouf, Amr Samir Fouad Tammam, Amir Araby Gabr","doi":"10.4070/kcj.2024.0002","DOIUrl":"10.4070/kcj.2024.0002","url":null,"abstract":"<p><strong>Background and objectives: </strong>The timing of the reinstitution of warfarin after cesarean section (CS) delivery was not adequately addressed in the literature. This study aims to evaluate the risks of early versus late initiation of warfarin post-CS in patients with mechanical heart valves.</p><p><strong>Methods: </strong>This randomized, open-label cohort study included 114 pregnant women with mechanical heart valves planned to be delivered by CS at or after 28 weeks of gestation. Patients were randomly divided into two groups: Day-2-group, where warfarin was started on day 2, and Day-5-group, where warfarin was started on day 5 after CS. Maternal postoperative bleeding complications, mechanical valve thrombosis, need for blood transfusion or reoperation, and maternal mortality were identified.</p><p><strong>Results: </strong>Ten women (8.8%) had 11 bleeding complications, of whom 2 patients (20%) had intraperitoneal hemorrhage (none in Day-2-group and 2 in Day-5-group), 3 patients (30%) had subcutaneous hematoma (none in Day-2-group and 3 in Day-5-group), and 6 patients (60%) had sub-rectus hematoma (3 in Day-2-group and 3 in Day-5-group). No mechanical valve thrombosis, other thromboembolic events, or in-hospital maternal mortality were reported.</p><p><strong>Conclusion: </strong>Despite the small number of events, the bleeding risk was lower in the group with early post-CS warfarin introduction than in the group with late warfarin introduction in patients with prosthetic heart valves.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04855110.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"151-160"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036225","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 Versus Late Initiation of Warfarin Post-Cesarean Section: A Step Forward in Managing Mechanical Heart Valve Patients.","authors":"You-Jung Choi","doi":"10.4070/kcj.2024.0228","DOIUrl":"10.4070/kcj.2024.0228","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"161-163"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036224","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 Rivaroxaban Safe in Patients With Renal Dysfunction?","authors":"Eun-Sun Jin","doi":"10.4070/kcj.2024.0361","DOIUrl":"10.4070/kcj.2024.0361","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"132-133"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903062","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 Shank3 a 'Friend or Foe' of the Heart? Its Role in Cardiac Calcium Homeostasis.","authors":"Hyoung Kyu Kim, Jin Han","doi":"10.4070/kcj.2024.0377","DOIUrl":"10.4070/kcj.2024.0377","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":"55 2","pages":"118-120"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449386","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 Korean Organ Transplant Registry (KOTRY): Third Official Adult Heart Transplant Report.","authors":"Hyo-In Choi, Sang Eun Lee, Junho Hyun, Darae Kim, Dong-Ju Choi, Eun-Seok Jeon, Hae-Young Lee, Hyun-Jai Cho, Hyungseop Kim, In-Cheol Kim, Jaewon Oh, Minjae Yoon, Jin Joo Park, Jin-Oh Choi, Min Ho Ju, Seok-Min Kang, Soo Yong Lee, Sung-Ho Jung, Jae-Joong Kim","doi":"10.4070/kcj.2024.0176","DOIUrl":"10.4070/kcj.2024.0176","url":null,"abstract":"<p><strong>Background and objectives: </strong>The Korean Organ Transplant Registry (KOTRY) provided data for this third official report on adult heart transplantation (HT), including information from 709 recipients.</p><p><strong>Methods: </strong>Data from HTs performed at seven major centers in Korea between March 2014 and December 2020 were analyzed, focusing on immunosuppression, acute rejection, cardiac allograft vasculopathy (CAV), post-transplant survival, and mechanical circulatory support (MCS) usage.</p><p><strong>Results: </strong>The median ages of the recipients and donors were 56.0 and 43.0 years, respectively. Cardiomyopathy and ischemic heart disease were the most common preceding conditions for HT. A significant portion of patients underwent HT at waiting list status 1 and 0. In the multivariate analysis, a predicted heart mass mismatch was associated with a higher risk of 1-year mortality. Patients over 70 years old had a significantly increased risk of 6-year mortality. The risk of CAV was higher for male donors and donors older than 45 years. Acute rejection was more likely in patients with panel reactive antibody levels above 80%, while statin use was associated with a reduced risk. The employment of left ventricular assist device as a bridge to transplantation increased from 2.17% to 22.4%. Pre-transplant extra-corporeal membrane oxygenation was associated with worse post-transplant survival.</p><p><strong>Conclusions: </strong>In this third KOTRY report, we analyzed changes in the characteristics of adult HT recipients and donors and their impact on post-transplant outcomes. The most notable discovery was the increased use of MCS before HT and their impact on post-transplant outcomes.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"79-96"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468965","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}