Korean Circulation Journal最新文献

{"title":"Choosing Right Tool for the Right Substrate: Beyond Energy Source in Atrial Fibrillation Ablation.","authors":"Euijae Lee","doi":"10.4070/kcj.2026.0252","DOIUrl":"10.4070/kcj.2026.0252","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726538","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":"Beyond Detection: Rethinking Imaging Strategies for High-Risk PFO.","authors":"Chi Young Shim","doi":"10.4070/kcj.2026.0251","DOIUrl":"https://doi.org/10.4070/kcj.2026.0251","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865575","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":"Differential Prognostic Impact of Potent P2Y₁₂ Inhibitors in Patients With Acute Myocardial Infarction by Bleeding Risk.","authors":"Hyun Sung Joh, Seung Hun Lee, Sang Yoon Lee, Hyun Kuk Kim, Woo-Hyun Lim, Hack-Lyoung Kim, Jae-Bin Seo, Woo-Young Chung, Sang-Hyun Kim, Juhan Kim, Young Joon Hong, Youngkeun Ahn, Myung Ho Jeong, Seung Ho Hur, Doo Il Kim, Kiyuk Chang, Hun Sik Park, Jang-Whan Bae, Jin-Ok Jeong, Yong Hwan Park, Kyeong Ho Yun, Chang-Hwan Yoon, Yisik Kim, Jin-Yong Hwang, Hyo-Soo Kim, Ki Hong Choi, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Joo Myung Lee","doi":"10.4070/kcj.2026.0033","DOIUrl":"10.4070/kcj.2026.0033","url":null,"abstract":"<p><strong>Background and objectives: </strong>Limited data on the comparative efficacy and safety of potent P2Y₁₂ inhibitors versus clopidogrel in patients with acute myocardial infarction (AMI) stratified by bleeding risk. This study evaluated the differential prognostic impact of potent P2Y₁₂ inhibitors in patients with AMI by bleeding risk.</p><p><strong>Methods: </strong>From the nationwide pooled registry of the Korea Acute Myocardial Infarction Registry, 1,144 propensity score-matched pairs with high bleeding risk (HBR) and 6,181 matched pairs with non-HBR were selected according to use of potent P2Y₁₂ inhibitors or clopidogrel. The primary efficacy outcome was 3-year major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, MI, repeat revascularization, stent thrombosis, or ischemic cerebrovascular accident. The primary safety outcome was Bleeding Academic Research Consortium (BARC) type 2, 3, or 5 bleeding.</p><p><strong>Results: </strong>In HBR patients, the risk of MACCE was comparable between potent P2Y₁₂ inhibitors and clopidogrel (28.1% vs. 28.9%, adjusted hazard ratio [aHR], 1.00; 95% confidence interval [CI], 0.82-1.22; p=0.996). Conversely, non-HBR patients showed significantly lower risk of MACCE with potent P2Y₁₂ inhibitors (10.3% vs. 13.3%, aHR, 0.78; 95% CI, 0.69-0.88; p<0.004; p for interaction=0.016). Potent P2Y₁₂ inhibitors were associated with higher risk of bleeding in both HBR (12.4% vs. 7.6%, aHR, 1.67; 95% CI, 1.18-2.36; p=0.004) and non-HBR patients (6.5% vs. 4.3%, aHR, 1.66; 95% CI, 1.38-1.99; p<0.001; p for interaction=0.790).</p><p><strong>Conclusions: </strong>Potent P2Y₁₂ inhibitors were associated with a lower risk of MACCE only in AMI patients with non-HBR. Regardless of underlying bleeding risk, potent P2Y₁₂ inhibitors were associated with increased bleeding risk than clopidogrel.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720987","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":"Effects of Cardiac Rehabilitation on Cognitive Function in Heart Failure: A Systematic Review and Meta-Analysis.","authors":"Hanselim Lim, Jovita Stephanie, Nerisa Natakusuma Sudharto","doi":"10.4070/kcj.2025.0551","DOIUrl":"https://doi.org/10.4070/kcj.2025.0551","url":null,"abstract":"<p><strong>Background and objectives: </strong>Cognitive impairment frequently complicates heart failure (HF) and is linked to poor self-care, reduced treatment adherence, and worse clinical outcomes. Cardiac rehabilitation (CR), centered on structured exercise training, may improve cognitive function, but current evidence is inconsistent. We systematically evaluated the effects of CR on cognitive function in patients with HF.</p><p><strong>Methods: </strong>A systematic search was conducted to identify randomized controlled trials and observational studies assessing cognitive outcomes in HF patients undergoing CR. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used and heterogeneity was assessed using the I² statistic. Prespecified and exploratory subgroup analyses were conducted to explore potential sources of heterogeneity. The primary outcome was the change in global cognitive function.</p><p><strong>Results: </strong>Eleven studies involving 1,580 participants were included in the systematic review. Ten were eligible for quantitative analyses. Two pre-post CR studies (n=66) showed improved cognitive scores following CR (SMD=0.56; 95% CI, 0.21-0.91; p=0.002). In 6 CR versus non-CR studies (n=876), CR was associated with improved cognition (SMD=0.53; 95% CI, 0.09-0.97; p=0.02), with substantial heterogeneity (I²=83%). Sensitivity analyses suggested heterogeneity was influenced by methodological quality. Exploratory analyses indicated cognitive benefit was more apparent in stable chronic HF and among patients with baseline cognitive impairment. Three studies (n=190) found no significant additional benefit from beyond adjunctive therapies beyond standard CR (SMD=-0.26, 95% CI, -1.43-0.91, p=0.67).</p><p><strong>Conclusions: </strong>CR is associated with improvements in global cognitive function in patients with HF and may contribute to both physical and cognitive health in HF management.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865662","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":"Tailored Calibration Approach for Hemodynamic Boundary Conditions in CT-FFR.","authors":"Yoon A Kim, Daebeom Park, Doyeon Hwang, Seokhun Yang, Sang-Hyeon Park, Chang-Wook Nam, Joon-Hyung Doh, Hyun Kuk Kim, Yongcheol Kim, Eun Ju Chun, Bon-Kwon Koo","doi":"10.4070/kcj.2025.0535","DOIUrl":"10.4070/kcj.2025.0535","url":null,"abstract":"<p><strong>Background and objectives: </strong>Computed tomography-derived fractional flow reserve (CT-FFR) uses standardized boundary conditions that cannot represent individual patient characteristics. We developed a calibration method to individualize boundary conditions using invasive fractional flow reserve (FFR) measurement. This study assessed the feasibility and impact on prediction of lesion-specific pressure drops (ΔFFR), post-percutaneous coronary intervention (PCI) FFR, and high-risk plaque (HRP) discrimination.</p><p><strong>Methods: </strong>This retrospective multicenter study analyzed 79 patients with single left anterior descending lesions. Lumped parameter models were used to calibrate optimal boundary conditions by iteratively minimizing differences between invasive FFR and CT-FFR. HRP was assessed using an artificial intelligence-enabled analysis system, defined as low attenuation plaque, positive remodeling, or both. Discrimination performance was evaluated using ΔCT-FFR and CT-FFR gradient.</p><p><strong>Results: </strong>In 79 patients (median age 65.5 years, 77.2% male), median angiographic percent diameter stenosis 60.0%, median invasive FFR was 0.83 and CT-FFR was 0.81 before calibration. Following calibration, FFR correlation improved from 0.590 to 0.997 (p<0.001). ΔFFR correlation increased from 0.490 to 0.823 (p<0.001). Post-PCI validation showed correlation improvement from 0.440 to 0.871 (p=0.002). HRP discrimination improved for ΔCT-FFR (area under the curve [AUC], 0.62 to 0.70; p=0.018) and CT-FFR gradient (AUC, 0.62 to 0.69; p=0.032).</p><p><strong>Conclusions: </strong>Individualized boundary condition calibration using invasive FFR enables accurate prediction of lesion-specific hemodynamics and post-intervention physiology, showing potential for enhanced procedural planning and risk stratification in patients undergoing coronary angiography.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722673","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":"Overlapping Diabetes- and CKD-Driven Vascular Phenotypes of Peripheral Artery Disease: A Limb-First Framework for Chronic Limb-Threatening Ischemia.","authors":"Ju-Yeon Lee, Ji-Yong Jang, Chang-Myung Oh","doi":"10.4070/kcj.2026.0070","DOIUrl":"10.4070/kcj.2026.0070","url":null,"abstract":"<p><p>Peripheral artery disease (PAD) and chronic limb-threatening ischemia (CLTI) impose an increasing global burden. Although procedural success exceeds 90%, 1-year amputation rates remain >20%, highlighting a disconnect between technical success and clinical benefit. PAD is commonly treated as a uniform atherosclerotic condition; however, distinct biological phenotypes drive heterogeneous outcomes and require individualized management. Diabetes mellitus and chronic kidney disease (CKD), present in >70% of patients with CLTI, promote divergent pathological mechanisms. Diabetes is characterized by intimal inflammation, endothelial dysfunction, and microangiopathy, whereas CKD is dominated by medial calcification due to disordered mineral metabolism, limiting the reliability of the ankle-brachial index. Diabetes-CKD coexistence, observed in 35-50% of cases, produces combined occlusive and rigid vascular features and carries a disproportionately high risk of poor wound healing, major amputation, and early mortality-a burden that current lesion-centric approaches consistently fail to adequately address. This review integrates mechanistic insights, diagnostic considerations, and clinical evidence supporting phenotype-based management. We propose a practical framework that aligns phenotype recognition with targeted strategies: endovascular intervention with metabolic optimization for diabetes-predominant PAD, calcium-modifying approaches or bypass surgery for CKD-predominant PAD, and early prognostic counseling with palliative integration for combined phenotypes. This limb-first paradigm reframes revascularization as a biologically informed intervention and provides evidence-based pathways to improve outcomes in contemporary CLTI care.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721117","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":"Redefining Post-Ablation Anticoagulation in Low-Risk Patients: Are Two Months Still Necessary?","authors":"Joo Hee Jeong, Jong-Il Choi","doi":"10.4070/kcj.2026.0026","DOIUrl":"10.4070/kcj.2026.0026","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"615-617"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042623","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":"Tricuspid Regurgitation Can Improve After LVAD: Right Ventricular Reserve Should Not Be Overlooked.","authors":"Soo Yong Lee","doi":"10.4070/kcj.2026.0020","DOIUrl":"10.4070/kcj.2026.0020","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"602-605"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674405","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":"Korean Society of Interventional Cardiology Expert Consensus for the Management of Chronic Coronary Syndrome: Part 2.","authors":"Seung Hun Lee, Sang Don Park, Joo Myung Lee, Yisik Kim, Sang Yoon Lee, Woochan Kwon, Doyeon Hwang, Min Ku Chon, Hyun Sung Joh, Kwan Yong Lee, Young-Hoon Seo, Seonghyeon Bu, Namkyun Kim, Jung-Sun Kim, Pil-Ki Min, Chang-Wook Nam, Cheol Whan Lee, Young Joon Hong, Hyeon-Cheol Gwon, Joo-Yong Hahn, Youngkeun Ahn","doi":"10.4070/kcj.2026.0192","DOIUrl":"10.4070/kcj.2026.0192","url":null,"abstract":"<p><p>Revascularization remains an important component of chronic coronary syndrome (CCS) management, particularly in patients with high-risk coronary anatomy, impaired left ventricular (LV) function, or persistent symptoms despite guideline-directed medical therapy. Evidence indicates that prognostic benefit is most pronounced in patients with left main disease, multivessel disease, proximal left anterior descending artery involvement, and severe LV systolic dysfunction. In other patients, revascularization primarily improves angina symptoms and quality of life. The choice between percutaneous coronary intervention (PCI) and coronary artery bypass grafting should be individualized according to coronary anatomy, clinical risk, comorbidities, and the likelihood of complete revascularization. Contemporary PCI increasingly incorporates coronary physiology and intravascular imaging to refine lesion selection and improve procedural outcomes. Long-term CCS management requires structured follow-up to detect disease progression, recurrent ischemia, revascularization failure, and cardiovascular complications. Routine surveillance testing is not recommended in asymptomatic patients after PCI. Instead, follow-up should be tailored to patient risk and clinical status. When complete revascularization fails, mechanisms such as stent thrombosis, in-stent restenosis, graft failure, and progression of untreated coronary disease should be identified; intravascular imaging has an important role in guiding repeat revascularization. Comprehensive CCS management should also address complications, including heart failure, ventricular arrhythmias, and secondary valvular disease, through a multidisciplinary, patient-centered approach.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":"56 7","pages":"562-586"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430807","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":"Epigenetic Remodeling in Myocardial Reperfusion Injury: The Emerging Role of the ARID1A/SOX9 Axis.","authors":"Han-Mo Yang","doi":"10.4070/kcj.2026.0045","DOIUrl":"10.4070/kcj.2026.0045","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"646-648"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295525","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}