Korean Circulation Journal最新文献

{"title":"Machine Learning-Based Prediction of Long-Term Outcomes in Patients With Chronic Total Occlusion of the Coronary Artery.","authors":"Tae Oh Kim, Hyeonyong Hae, Hwa Jung Kim, Seung-Whan Lee, Ho Jin Kim, Joon Bum Kim, Cheol-Hyun Chung, Soo-Jin Kang","doi":"10.4070/kcj.2025.0016","DOIUrl":"10.4070/kcj.2025.0016","url":null,"abstract":"<p><strong>Background and objectives: </strong>Precise prediction of long-term outcomes in patients with chronic total occlusion (CTO) of the coronary artery is crucial for cardiovascular care. The recent development of advanced machine learning (ML) models has opened up new possibilities in medical prognostics. This study aimed to develop ML models and validate their performance in predicting long-term clinical outcomes in patients with CTO.</p><p><strong>Methods: </strong>This study retrospectively analyzed 3,248 patients listed in the Asan Medical Center CTO Registry (2003-2018). Patients underwent coronary artery bypass grafting, percutaneous coronary intervention, or optimal medical therapy and were followed up for a median period of 5.3 years. The study population was randomly split into training (n=2,598) and test (n=650) sets. Three ML algorithms-namely, L2-penalized logistic regression, artificial neural networks, and CatBoost-were employed to develop a prognostic model for 5-year cardiac death (primary endpoint) as well as 5-year all-cause mortality and target vessel revascularization (TVR) (secondary endpoints). Model performance was assessed using area under the receiver operating characteristic curves (AUCs), and feature importance was evaluated using SHapley Additive exPlanations values.</p><p><strong>Results: </strong>The three ML algorithms exhibited comparable performance in predicting 5-year cardiac death (AUC: 0.80). Additionally, these three ML algorithms successfully predicted 5-year all-cause mortality (AUC: 0.83-0.84) and TVR (AUC: 0.65-0.74), showing good predictive performance. Patient demographics and comorbidities, rather than treatment modality, were the leading predictors of outcomes.</p><p><strong>Conclusions: </strong>The ML models are reliable in predicting 5-year clinical outcomes in patients with CTO, demonstrating their potential for clinical application.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333359","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":"Non-culprit Lesion Location and FFR-guided Revascularization in Acute Myocardial Infarction With Multivessel Disease: FRAME-AMI Substudy.","authors":"Ho Sung Jeon, Jung-Hee Lee, Jun-Won Lee, Young Jin Youn, Joo Myung Lee, Hyun Kuk Kim, Keun Ho Park, Eun Ho Choo, Chan Joon Kim, Seung Hun Lee, Min Chul Kim, Young Joon Hong, Joon-Hyung Doh, Sang Yeub Lee, Sang Don Park, Hyun-Jong Lee, Min Gyu Kang, Jin-Sin Koh, Yun-Kyeong Cho, Chang-Wook Nam, Bon-Kwon Koo, Bong-Ki Lee, Kyeong Ho Yun, Joo-Yong Hahn, Sung Gyun Ahn","doi":"10.4070/kcj.2024.0430","DOIUrl":"https://doi.org/10.4070/kcj.2024.0430","url":null,"abstract":"<p><strong>Background and objectives: </strong>The prognosis of unrevascularized non-culprit lesions (NCLs) and the benefits of non-culprit percutaneous coronary intervention (PCI) may depend on their functional significance and location in patients with acute myocardial infarction (AMI) and multivessel coronary disease (MVD). We investigated the differential outcomes of fractional flow reserve (FFR) versus angiography-guided PCI for NCL between the left anterior descending artery (LAD) and non-LAD arteries.</p><p><strong>Methods: </strong>This was a prespecified post hoc analysis of the FRAME-AMI trial. The primary endpoint, a composite of time to death, myocardial infarction, or repeat revascularization, was matched between the two strategies according to the NCL location.</p><p><strong>Results: </strong>Among 562 patients, the proportions of NCL in the LAD and non-LAD groups were 55.0% and 45.0%, respectively. PCI rates (82.2% vs. 78.3%; p=0.242) and the primary outcome (9.4% vs. 11.5%; p=0.421) were comparable between the two groups. In the non-culprit LAD group, FFR-guided PCI was associated with a lower rate of the primary outcome compared to angiography-guided PCI (5.7% vs. 14.3%, p=0.010). In the non-culprit non-LAD group, the outcome rate did not significantly differ between FFR- and angiography-guided PCI (7.4% vs. 14.5%, p=0.081). Nevertheless, the interaction between the non-culprit location and FFR- or angiography-guided PCI did not affect the primary outcome (p=0.667).</p><p><strong>Conclusions: </strong>The NCL location did not affect the favorable outcomes of FFR-guided PCI over angiography-guided PCI in patients with AMI and MVD.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591573","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":"Prevalence, Pathophysiology, and Prognostic Importance of Malnutrition Risk in Early-Stage Patients With Heart Failure and Preserved Ejection Fraction.","authors":"Yuta Tani, Naoki Yuasa, Tomonari Harada, Kazuki Kagami, Fumitaka Murakami, Yuki Shimoya, Yuki Saito, Ayami Naito, Tsukasa Murakami, Takahiro Okuno, Tomoaki Ishii, Toshimitsu Kato, Naoki Wada, Shigeru Usuda, Hideki Ishii, Masaru Obokata","doi":"10.4070/kcj.2024.0366","DOIUrl":"10.4070/kcj.2024.0366","url":null,"abstract":"<p><strong>Background and objectives: </strong>Malnutrition is common and is associated with poor clinical outcomes in clinically overt patients with heart failure and preserved ejection fraction (HFpEF). However, its prevalence and pathophysiologic and prognostic relevance remain unclear in early-stage HFpEF. This study sought to assess the association between malnutrition risk, exercise capacity, cardiac and peripheral reserve limitations, and clinical outcomes in patients with early HFpEF, defined as those without a history of HF hospitalization.</p><p><strong>Methods: </strong>Patients with symptomatic HFpEF without previous HF hospitalization (n=341) underwent exercise stress echocardiography. Simultaneous expired gas analysis was conducted in 296 (87%) participants to measure peak oxygen consumption (VO₂). Nutritional status was evaluated using the Geriatric Nutritional Risk Index (GNRI).</p><p><strong>Results: </strong>At least mild malnutrition risk (GNRI ≤98) was identified in 125 patients with HFpEF (36.6%). Compared to HFpEF patients without malnutrition risk (n=216), those at risk (n=125) showed reduced exercise capacity (lower peak VO₂) and lower cardiac output and arteriovenous oxygen content difference during exercise. During a median follow-up of 435 days, 52 patients experienced a composite outcome of all-cause mortality or worsening HF events. Patients with malnutrition risk had a nearly 3-fold increased risk of this outcome compared to those without risk (hazard ratio, 3.07; 95% confidence interval, 1.73-5.44; p<0.001).</p><p><strong>Conclusions: </strong>Malnutrition risk is common in early-stage HFpEF and correlates with exercise intolerance, reduced cardiac output and oxygen uptake, and worse outcomes. Further research is needed to determine management strategies.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333373","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":"Navigating the Gray Zone: Is Intensive Lipid-Lowering Always Necessary in Patients With Atherosclerotic Cardiovascular Disease?","authors":"Jaehoon Chung","doi":"10.4070/kcj.2024.0434","DOIUrl":"10.4070/kcj.2024.0434","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"437-439"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649089","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":"LncRNA uc003pxg.1 Interacts With miR-339-5p Promote Vascular Endothelial Cell Proliferation, Migration and Angiogenesis.","authors":"Ping Li, Feng Wang, Anna Yue, Yanling Xuan, Ying Huang, Jingyi Xu, Jiayi Weng, Yuan Li, Kangyun Sun","doi":"10.4070/kcj.2024.0153","DOIUrl":"10.4070/kcj.2024.0153","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study aimed to investigate the roles of lncRNA uc003pxg.1 and miR-339-5p in regulating the occurrence and development of coronary heart disease.</p><p><strong>Methods: </strong>First, the expression levels of uc003pxg.1 and miR-339-5p were verified in peripheral blood mononuclear cells of clinical samples. Then, the target gene was identified using high-throughput sequencing combined with bioinformatics. Human umbilical vein endothelial cells (HUVECs) were transfected with si-uc003pxg.1, miR-339-5p mimic and miR-339-5p inhibitor, and the expression of related genes was detected by reverse transcription-quantitative polymerase chain reaction and western blotting. EdU, CCK-8, Cell scratch and Transwell assays were used to analyze the effects of uc003pxg.1 and miR-339-5p on cell proliferation and migration.</p><p><strong>Results: </strong>The expression of uc003pxg.1 and miR-339-5p was negatively correlated in clinical samples and HUVECs. The si-uc003pxg.1 and miR-339-5p mimic decreased the proliferation and migration of HUVECs and decreased the expression of transforming growth factor (TGF)-β1 and α-smooth muscle actin (SMA). The protein expression levels of TGF-β1, α-SMA, CD31, collagen I, collagen III and endoglin were decreased, and angiogenesis was weakened. The miR-339-5p inhibitor had the opposite effect.</p><p><strong>Conclusions: </strong>Our study revealed that upregulation of uc003pxg.1 and downregulation of miR-339-5p in vitro promote cell proliferation, cell migration and angiogenesis and upregulate the expression of TGF-β1, α-SMA, CD31, collagen I, collagen III and endoglin, which may lead to the development of vascular atherosclerosis.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"440-455"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903118","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 Regulation of Endothelial-Mesenchymal Transition in Vascular Atherosclerosis Development.","authors":"JaeHyuk Jang, Hun-Jun Park","doi":"10.4070/kcj.2025.0006","DOIUrl":"10.4070/kcj.2025.0006","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":"55 5","pages":"456-458"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007571","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":"Comparison of Thick Biolimus A9-Eluting Stent and Thin Zotarolimus-Eluting Stent in Multi-Vessel Percutaneous Coronary Intervention.","authors":"Cheol Hyun Lee, Hee Jeong Lee, Tae-Wan Chung, Seonhwa Lee, Jongmin Hwang, In-Cheol Kim, Yun-Kyeong Cho, Hyuck-Jun Yoon, Seung-Ho Hur, Jin Young Kim, Yun Seok Kim, Woo Sung Jang, Jang Hoon Lee, Woong Kim, Jin Bae Lee, Young Joon Hong, Jung Ho Heo, Bong-Ryeol Lee, Joon-Hyung Doh, Eun-Seok Shin, Bon-Kwon Koo, Chang-Wook Nam","doi":"10.4070/kcj.2024.0101","DOIUrl":"10.4070/kcj.2024.0101","url":null,"abstract":"<p><strong>Background and objectives: </strong>There are limited randomized studies on patients undergoing multi-vessel percutaneous coronary intervention (PCI) comparing the outcomes between stent thickness and polymer types. To compare the clinical outcomes of thick biodegradable polymer-based biolimus A9-eluting stents (BESs) and thin durable polymer-based zotarolimus-eluting stents (ZESs) in patients undergoing multi-vessel PCI.</p><p><strong>Methods: </strong>A total of 936 patients who underwent multi-vessel coronary artery stenting were randomly assigned to the BES (n=472) or ZES (n=464) groups. The primary endpoint was 2-year major adverse cardiac events (MACEs), a composite of all-cause death, myocardial infarction (MI), and any revascularization at the 2-year follow-up.</p><p><strong>Results: </strong>Fifty-two (11.2%) of 472 patients in BES group and 50 (10.9%) of the 464 patients in ZES group met the 2-year primary endpoint of MACE (hazard ratio, 1.00; 90% confidence interval, 0.72, 1.38; p=0.994). All-cause death (BES vs. ZES: 2.8% vs. 2.7%, p=0.758), MI (2.1% vs. 2.6%, p=0.483), and repeat revascularization (6.7% vs. 6.9%, p=0.876) were not significantly different between the 2 groups. Although there was no significant outcome difference in any subgroup analysis, the technical failure rate leading to the use of other stents was higher in BES than in ZES (3.2% vs. 0.9%, p=0.023).</p><p><strong>Conclusions: </strong>In patients who underwent multi-vessel PCI, BES and ZES showed comparable 2-year clinical outcomes. However, BES was not established to demonstrate non-inferiority to ZES in terms of the incidence of the primary endpoint at the 2-year. The technical success rate of the index PCI with the assigned stent was higher for thinner ZES.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT01947439.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"396-407"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648801","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 Strain as a Predictive Tool for Poor Exercise Capacity in Patients With Indeterminate Diastolic Function: The Utility and Challenges in Clinical Practice.","authors":"Hui-Jeong Hwang","doi":"10.4070/kcj.2025.0025","DOIUrl":"10.4070/kcj.2025.0025","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":"55 5","pages":"394-395"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015944","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":"Insights and Challenges in Acute Myocarditis Management From a Korean Multicenter Registry.","authors":"Jin Joo Park","doi":"10.4070/kcj.2025.0033","DOIUrl":"10.4070/kcj.2025.0033","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":"55 5","pages":"423-425"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970766","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":"Thick or Thin, Durable or Biodegradable Polymers: Does Stent Design Still Matter?","authors":"Seung-Jun Lee","doi":"10.4070/kcj.2025.0038","DOIUrl":"10.4070/kcj.2025.0038","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":"55 5","pages":"408-409"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989372","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}