Pulse最新文献

{"title":"Physical Activity, Cardiorespiratory Fitness, and Atherosclerotic Cardiovascular Disease: Part 2.","authors":"Barry A Franklin, Sae Young Jae","doi":"10.1159/000541166","DOIUrl":"10.1159/000541166","url":null,"abstract":"<p><strong>Background: </strong>In this second section of our 2-part review on the role of physical activity (PA) and cardiorespiratory fitness (CRF) in preventing and treating atherosclerotic cardiovascular disease (CVD), we expand on topics covered in part 1, including a comparison of moderate-intensity continuous training versus high-intensity interval training, the beneficial role of PA and CRF in heart failure, potential mal-adaptations that may result from extreme endurance exercise regimens, and the incidence of cardiac arrest and sudden cardiac death during marathon running and triathlon participation. Further, we review the principles of exercise prescription for patients with known or suspected CVD, with specific reference to exercise modalities, contemporary guidelines, the minimum exercise training intensity to promote survival benefits, and long-term goal training intensities, based on age-, sex-, and fitness-adjusted targets. Finally, we provide practical \"prescription pearls\" for the clinician, including a simple rule to estimate metabolic equivalents (METs) during level and graded treadmill walking, research-based exercise training recommendations, using steps per day, MET-minutes per week, and personal activity intelligence to achieve beneficial treatment outcomes, as well as the heart rate index equation to estimate energy expenditure, expressed as METs, during recreational and leisure-time PA.</p><p><strong>Summary: </strong>This review compares moderate-intensity continuous training and high-intensity interval training, examines the role of PA and CRF in managing heart failure, and discusses the cardiovascular risks associated with extreme endurance exercise. It also provides practical guidelines for exercise prescription tailored to patients with CVD, highlighting advanced exercise prescription strategies to optimize cardiovascular health.</p><p><strong>Key messages: </strong>Physicians and healthcare providers should prioritize referring patients to home-based or medically supervised exercise programs to leverage the cardioprotective benefits of regular PA. For most inactive patients, an exercise prescription is essential for improving overall health.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Activity, Cardiorespiratory Fitness and Atherosclerotic Cardiovascular Disease: Part 1.","authors":"Barry A Franklin, Sae Young Jae","doi":"10.1159/000541165","DOIUrl":"10.1159/000541165","url":null,"abstract":"<p><strong>Background: </strong>The cardioprotective benefits and prognostic significance of regular moderate-to-vigorous physical activity (PA), increased cardiorespiratory fitness (CRF), or both are often underappreciated by the medical community and the patients they serve. Individuals with low CRF are two to three times more likely to die prematurely from atherosclerotic cardiovascular disease (CVD), than their fitter counterparts when matched for risk factor profile or coronary artery calcium (CAC) score. Accordingly, part 1 of this 2-part review examines these relations and the potential underlying mechanisms of benefit (e.g., exercise preconditioning) on atherosclerotic CVD, with specific reference to gait speed and mortality, CRF and PA as separate risk factors, and the relation between CRF and/or PA on attenuating the adverse impact of an elevated CAC score, as well as potentially favorably modifying CAC morphology, and on incident atrial fibrillation, all-cause and cardiovascular mortality, and on sudden cardiac death (SCD).</p><p><strong>Summary: </strong>We explore the underappreciated cardioprotective effects of regular PA and CRF. Part 1 examines how CRF and PA reduce the risk of premature death from atherosclerotic CVD by investigating their roles as separate risk factors, the potential underlying mechanisms of benefit, and their impact on gait speed, mortality, and atrial fibrillation. The review also addresses how CRF and PA may mitigate the adverse impact of an elevated CAC score, potentially modifying CAC morphology, and reduce the risk of SCD.</p><p><strong>Key messages: </strong>Regular PA and high CRF are essential for reducing the risk of premature death from CVD and mitigating the negative impact of elevated CAC scores. Additionally, they provide significant protection against SCD and atrial fibrillation, emphasizing their broad cardioprotective effects.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple Cerebral Infarcts and Encephalopathy as the First Clinical Manifestations of Hypereosinophilic Syndrome: A Case Report and Narrative Review.","authors":"Sonia Romano, Giulia Avola, Marco Cesare Angeli, Francesca Brazzale, Elena Giacopazzi, Paola Castellini, Antonio Genovese","doi":"10.1159/000539379","DOIUrl":"https://doi.org/10.1159/000539379","url":null,"abstract":"<p><strong>Background: </strong>Hypereosinophilic syndrome is characterized by a peripheral blood eosinophil count >1.5 × 10³/μL on two different examinations within a month of each other and/or a 20% or higher percentage of eosinophils in a bone marrow section, associated with organ damage. Rarely, neurological manifestations may occur, even in the early stages. We report a case of idiopathic hypereosinophilic syndrome with Loeffler endocarditis presenting with multiple bilateral strokes and encephalopathy as the first clinical manifestations.</p><p><strong>Summary: </strong>Hypereosinophilia and echocardiographic findings suggested a Loeffler's endocarditis. Blood hyperviscosity and small vessels inflammation induced by the hypereosinophilia itself, the embolization of intracardiac thrombus, along with the impaired clearance of microthrombi in the watershed areas, are the main mechanisms involved in the pathophysiology of stroke in the hypereosinophilic syndrome. Additionally, encephalopathy could be considered as a consequence of multiple cerebral infarcts and neurotoxicity induced by hypereosinophilia since our patient's confusion and aggressive behavior gradually remitted after steroid therapy was started.</p><p><strong>Key messages: </strong>To the best of our knowledge, our case report is a rare instance highlighting neurological involvement as the earliest manifestation of hypereosinophilia. We aimed to elucidate the central nervous system involvement in this intriguing disorder, with the goal of encouraging clinicians to consider hypereosinophilic syndrome in the diagnostic assessment of rare stroke etiologies.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Noninvasive Derivation of the Central Aortic Pressure Waveform from Fingertip Photoplethysmography Using a Novel Selective Transfer Function Method.","authors":"James R Cox, Ehad Akeila, Alberto P Avolio, Mark Butlin, Catherine Liao, Gisele J Bentley, Ahmad Qasem","doi":"10.1159/000540666","DOIUrl":"10.1159/000540666","url":null,"abstract":"<p><strong>Introduction: </strong>Central aortic pressure waveform analyses can provide clinically relevant information beyond conventional brachial blood pressure (BP) assessment. This waveform can be reproduced noninvasively through application of a generalized transfer function (GTF) on a peripheral waveform, as conventionally performed by applanation tonometry. Photoplethysmography (PPG) is an alternate approach; however, differences in measurement site and modality demand the use of a transfer function (TF) specific for those differences. This study aimed to compare central aortic waveform features generated from radial tonometry (reference) using a proprietary GTF with a central aortic waveform and its features generated from a simultaneous fingertip PPG measurement using a selective method where one of three different TFs is chosen based on the input signal harmonic profile.</p><p><strong>Methods: </strong>Brachial BP was measured in triplicate under resting conditions and was used for subsequent calibration. Multiple simultaneous radial tonometry (SphygmoCor CVMS) and fingertip PPG measurements were then performed in individual participants (<i>n</i> = 21, 10 females, age: 39 ± 16 years). Measurements were converted into central aortic waveforms with their respective TFs. Twenty central aortic pressure waveform parameters were compared through correlation analysis, Bland-Altman plots, and a repeated measure mixed-effects ANOVA model. Central aortic waveform shape was compared using the root-mean-squared error (RMSE).</p><p><strong>Results: </strong>Correlation (<i>r</i>) of PPG-derived parameters with radially tonometry-derived central aortic parameters was high ranging from 0.79 to 0.99. Mean differences of pressure-related parameters were within 1.3 mm Hg, and differences of time-related parameters ranged from -2.2 to 3.4%. While some parameters were statistically different, these differences are not physiologically meaningful. Central aortic waveform shape had an average RMSE of 1.8 ± 0.9%.</p><p><strong>Conclusion: </strong>Fingertip PPG-derived central aortic waveform parameters using a novel selective TF were comparable to central aortic waveform features derived from radial tonometry using a previously validated GTF.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Blood Pressure and Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation","authors":"Idan Goldberg, U. Landes, Genady Drozdinsky, P. Codner, T. Bental, K. Orvin, N. Schamroth Pravda, Lotem Goldberg, Omri Soudry, T. Lerman, Ran Kornowski, A. Eisen, H. Vaknin-Assa","doi":"10.1159/000540209","DOIUrl":"https://doi.org/10.1159/000540209","url":null,"abstract":"Introduction:\u0000Transcatheter Aortic Valve Implantation (TAVI) has emerged as a common and effective treatment for patients with severe aortic stenosis. Changes in systemic blood pressure after TAVI have been described, yet their prognostic value are not established. Thus, we aimed to examine the association of the peri-procedural changes in systolic blood pressure and in pulse pressure on clinical outcomes after the procedure. \u0000Methods:\u0000A retrospective study of consecutive patients who underwent TAVI procedure in our medical center. We assessed the effect of the periprocedural changes in blood pressure measurements on mortality, acute myocardial infarction, stroke and hospitalizations at 1-year and on the combined outcome of death, myocardial infarction and stroke at one year following the procedure. \u0000Results:\u0000Our cohort included 455 patients (44% males). Of them, 343 patients (75.4%) have raised the systolic blood pressure (SBP) immediately after the procedure. Patients who raised SBP had a significantly higher rate of the 1-year composite outcome, compared to patients who did not raise SBP following the procedure (43 [13%] vs 6 [5.4%], respectively, p=0.033). After adjustment for age and sex, the postprocedural increase in SBP was significantly associated with the composite outcome, with a hazard ratio of 2.42, 95% CI 1.03-5.7. \u0000Conclusion: \u0000An immediate increase in SBP after TAVI is associated with worse 1-year clinical cardiovascular outcomes. \u0000","PeriodicalId":29774,"journal":{"name":"Pulse","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141815140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of exercise in pulmonary hypertension: Evidence from bench to bedside","authors":"Ganesh Poojary, Norman Morris, Manjunath B. Joshi, Abraham Samuel Babu","doi":"10.1159/000539537","DOIUrl":"https://doi.org/10.1159/000539537","url":null,"abstract":"Background:\u0000Pulmonary hypertension (PH) is a debilitating condition characterized by elevated pulmonary arterial pressure and progressive vascular remodeling, leading to exercise intolerance. The progression of PAH is regulated at a cellular and molecular level which influences various physiological processes. Exercise plays an important role in improving function in PH. Although the signalling pathways that regulate cardio-protection through exercise have not been fully understood, the positive impact of exercise on the various physiological systems are well established. \u0000Summary:\u0000Exercise has emerged as a potential adjunctive therapy for PH, with growing evidence supporting its beneficial effects on various aspects of the disease pathophysiology. This review highlights the contributions of cellular and molecular pathways and physiological processes to exercise intolerance. Preclinical studies have provided insight into the mechanisms underlying exercise-induced improvements in PH which are modulated through improvements in endothelial function, inflammation, oxidative stress, and mitochondrial function. Along with preclinical studies, various clinical studies have demonstrated that exercise training can lead to significant improvements in exercise capacity, hemodynamics, quality of life, and functional status. Moreover, exercise interventions have been shown to improve skeletal muscle function, and enhance pulmonary vascular remodeling, contributing to overall disease management. Further research efforts aimed at better understanding the role of exercise in PH pathophysiology and refining exercise interventions are warranted to realize its full potential in the management of this complex disease.\u0000Key messages:\u0000Despite the promising benefits of exercise in PH, several challenges remain, including the optimal intensity, duration, and type of exercise training, as well as patient selection criteria and long-term adherence. Additionally, the mechanisms underlying the observed improvements require further elucidation to optimize exercise protocols and personalize treatment strategies. Nonetheless, exercise represents a promising therapeutic approach that can complement existing pharmacological therapies and improve outcomes in PH patients. \u0000","PeriodicalId":29774,"journal":{"name":"Pulse","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141268228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In situ Reprogramming as a Pro-Angiogenic Inducer to Rescue Ischemic Tissues.","authors":"Seyong Chung, Hak-Joon Sung","doi":"10.1159/000538075","DOIUrl":"10.1159/000538075","url":null,"abstract":"<p><strong>Background: </strong>Enhanced regenerative therapeutic strategies are required to treat intractable ischemic heart disease.</p><p><strong>Summary: </strong>Since the discovery of putative endothelial progenitor cells (EPCs) in 1997, many studies have focused on their extraction, ex vivo processing, and autotransplantation under ischemic conditions. Nonetheless, numerous randomized clinical trials involving thousands of patients have yielded only marginal treatment effects, highlighting the need for advances regarding insufficient dosage and complex ex vivo processing. The prevailing paradigm of cellular differentiation highlights the potential of direct cellular reprogramming, which paves the way for in situ reprogramming. In situ reprogramming holds the promise of significantly enhancing current therapeutic strategies, yet its success hinges on the precise targeting of candidate cells for reprogramming. In this context, the spleen emerges as a pivotal \"in situ reprogramming hub,\" owing to its dual function as both a principal site for nanoparticle distribution and a significant reservoir of putative EPCs. The in situ reprogramming of splenic EPCs offers a potential solution to overcome critical challenges, including the aforementioned insufficient dosage and complex ex vivo processing.</p><p><strong>Key messages: </strong>This review explores the latest advancements in EPC therapy and in situ reprogramming, spotlighting a pioneering study that integrates those two strategies with a specific focus on the spleen. Such an innovative approach will potentially herald a new era of regenerative therapy for ischemic heart disease.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contributing factors to endothelial dysfunction in individuals with spinal cord injuries","authors":"Andres Benitez-Albiter, Cody P. Anderson, Matthew Jones, Sang-Seo Park, G. Layec, Song-Young Park","doi":"10.1159/000539199","DOIUrl":"https://doi.org/10.1159/000539199","url":null,"abstract":"Background: Patients with spinal cord injuries (SCIs) are at a greater risk for the development of cardiovascular diseases (CVDs) than able-bodied individuals due to high risks of endothelial dysfunction. \u0000Summary: For instance, patients with SCIs lose autonomic control of the heart and vasculature, which results in severe fluctuations in blood pressure. These oscillations between hypotension and hypertension have been shown to damage blood vessel endothelial cells and may contribute to the development of atherosclerosis. Furthermore, the loss of skeletal muscle control results in skeletal muscle atrophy and inward remodeling of the conduit arteries. It has been shown that blood vessels in the legs are chronically exposed to high shear, while the aorta experiences chronically low shear. These alterations to shear forces may adversely impact endothelial vasodilatory capacity and promote inflammatory signaling and leukocyte adherence. Additionally, microvascular endothelial vasodilatory capacity is impaired in patients with an SCI, and this may precede changes in conduit artery endothelial function. Finally, due to immobility and a loss of skeletal muscle mass, patients with SCIs have a higher risk of metabolic disorders, inflammation, and oxidative stress.\u0000Key Messages: Collectively, these factors may impair endothelium-dependent vasodilatory capacity, promote leukocyte adhesion and infiltration, promote the peroxidation of lipids, and ultimately support the development of atherosclerosis. Therefore, future interventions to prevent CVDs in patients with SCIs should focus on the management of endothelial health to prevent endothelial dysfunction and atherosclerosis.\u0000","PeriodicalId":29774,"journal":{"name":"Pulse","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141002796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Intensive Lifestyle Education and Forest-based Exercise, for the Primary Prevention of the risk of Coronary Artery Disease","authors":"Jong-Young Lee, Kee-Chan Joo, Peter H. Brubaker, Dae-Sik Yoon, Kyung-Su Choi","doi":"10.1159/000538517","DOIUrl":"https://doi.org/10.1159/000538517","url":null,"abstract":"Introduction: Despite its efficacy, conventional center-based cardiac rehabilitation have several limitations which have led to the emergence of home-based programs and intensive cardiac rehabilitation as alternative methods for overcoming these limitations. Alternative methods for primary prevention have been recommended for similar reasons. Lifestyle modification is considered key to success in both primary and secondary prevention. Therefore, this primary prevention study aimed to investigate the efficiency of intensive lifestyle education and home-based programs involving unstructured exercise in urban forests to pervent coronary artery disease (CAD). The availability of urban forests as preventive exercise environments was also examined. \u0000Methods: Patients with risk factors for CADparticipated in primary prevention using either FBEG (forest-based exercise group (FBEG, n=11) or CBEG (center-based exercise group (CBEG, n=17) for 12 weeks. The FBEG was provided with intensive residential lifestyle education and followed a home program that included performing exercise in an urban forest. The CBEG followed a conventional supervised exercise program at a fitness facility. Changes in body composition, cardiometabolic variables, and functional capacity were tested using a 2 × 2 (Time × Group) repeated measures ANOVA. An independent t-test was used to examine the differences in weekly energy expenditure between the two groups. \u0000Results: Significant within-group differences were identified in body composition, cardiometabolic variables, and the 10-yr probability of CAD in both groups. However, the functional capacity, weekly energy expenditure, and attendance rate showed between-group differences, with superiority in the FBEG. \u0000Conclusion: Intensive lifestyle education and subsequent home-based programs with unstructured exercise in the forest were as effective as a conventional center-based program, with superiority in terms of the change of some variables. Intensive education on experiencing and habituating a healthy lifestyle seemed to play an important role in improving motivation.","PeriodicalId":29774,"journal":{"name":"Pulse","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140660634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Coronary Imaging for Predicting Future Cardiovascular Events.","authors":"Jung-Joon Cha, Soon Jun Hong, Subin Lim, Ju Hyeon Kim, Hyung Joon Joo, Jae Hyoung Park, Cheol Woong Yu, Do-Sun Lim","doi":"10.1159/000538044","DOIUrl":"https://doi.org/10.1159/000538044","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in coronary artery disease (CAD) treatment with drug-eluting stent, its morbidity and mortality remain high. In context, intravascular imaging-guided percutaneous coronary intervention (PCI) is increasingly recommended for better clinical outcomes in patient with CAD. Near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS), as one of the intravascular imaging methods, is effective in detecting lipid-rich plaques, which is crucial for identifying high-risk or vulnerable plaques employing near-infrared light. High lipid core burden, as identified by NIRS-IVUS, correlates with an increased risk of adverse cardiac events and shows varying degrees of efficacy in plaque management and event prevention.</p><p><strong>Summary: </strong>This article addresses about how NIRS-IVUS can be used to predict event of CAD. The study highlights the crucial role of NIRS-IVUS in predicting future cardiovascular events. Findings indicate that the presence of high lipid core burden is related to increased risks of periprocedural myocardial infarction and reduced coronary flow during PCI. The study also outlines the predictive value of NIRS-IVUS in non-culprit lesions, where plaques with high lipid core burden significantly increase the occurrence of major adverse cardiac events as demonstrated in the PROSPECT II trial. In terms of therapeutic strategies, the study reviews the effectiveness of high-intensity lipid-lowering strategies in stabilizing vulnerable plaques, as evidenced in trials such as the YELLOW and PACMAN AMI trials.</p><p><strong>Key messages: </strong>NIRS-IVUS emerges as a valuable diagnostic tool in treating CAD. It effectively identifies vulnerable plaques and aids in predicting and preventing future adverse cardiac events. However, to enhance its practicality and promote widespread adoption in clinical settings, further long-term outcome research of NIRS-IVUS-guided PCI is necessary. These efforts can potentially make NIRS-IVUS a more accessible and indispensable tool in cardiovascular disease management.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11001285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}