CJC Open最新文献

{"title":"Temporal Trends in Hospitalization and Interventions for Aortic Stenosis in Canada, 2012-2024","authors":"Maria Servito MD,&nbsp;Denis Qeska MD,&nbsp;Suleman Aktaa MD, PhD,&nbsp;Philippe Pibarot MD, PhD,&nbsp;Jessica Forcillo MD, PhD,&nbsp;David Messika-Zeitoun MD, PhD,&nbsp;Janine Eckstein MD,&nbsp;Ellen Ross BSc,&nbsp;Kendra MacFarlane BSc,&nbsp;Seema Nagpal PhD,&nbsp;Harindra C. Wijeysundera MD, PhD","doi":"10.1016/j.cjco.2026.06.015","DOIUrl":"10.1016/j.cjco.2026.06.015","url":null,"abstract":"<div><h3>Background</h3><div>Given the paradigm shift from surgical aortic valve replacement (SAVR) to transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS), we examined the temporal trends in AS hospitalization and treatment across Canada.</div></div><div><h3>Methods</h3><div>Data from the Canadian Institute for Health Information Discharge Abstract Database were used for a population-based cross-sectional study of inpatients between April 1, 2012, and March 31, 2024. We estimated national and provincial rates and reported the annual changes in hospitalization for AS, SAVR, and TAVI. Rates were expressed as episodes/procedures per million, and stratified by age group, sex, and urban-vs-rural residence.</div></div><div><h3>Results</h3><div>Between 2012 and 2024, hospitalizations for AS increased from 259.8 to 362.4 per million. Rates of SAVR declined from 104.4 to 66.5 per million, whereas rates of TAVI rose from 19.0 to 136.9 per million. The average annual per-million increases in AS hospitalizations were highest in Prince Edward Island (25.0), Nova Scotia (22.9), and Newfoundland and Labrador (21.3), particularly among individuals ≥ 80 years of age. The rates of SAVR declined, as the uptake of TAVI increased, with the shift mostly evident in those 60-79 years of age. Rates of TAVI were higher in men than in women, whereas AS hospitalizations were higher in rural than in urban areas.</div></div><div><h3>Conclusions</h3><div>Not unexpectedly there has been a dramatic shift from SAVR to TAVI observed, with an overall improvement in access to care. Nevertheless, sex-related and geographic disparities persist, highlighting the need for a coordinated national effort to ensure equitable access to AS management.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 10","pages":"Pages 1365-1374"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149095976","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":"Mouse Models of Aortic Pathologies: Deciphering Molecular and Cellular Mechanisms from Bench to Bedside","authors":"Alicia Baptista Vicente PhD,&nbsp;Alexis Richard PhD,&nbsp;Clara Gourhand MSc,&nbsp;Céline Fassot PhD,&nbsp;Laurent Loufrani PhD","doi":"10.1016/j.cjco.2026.06.010","DOIUrl":"10.1016/j.cjco.2026.06.010","url":null,"abstract":"<div><h3>Background</h3><div>Aortic pathologies, including abdominal aortic aneurysm, thoracic aortic aneurysm, and aortic dissection, are life-threatening conditions characterized by complex pathophysiology and a lack of simple, early, and reliable diagnostic tools.</div></div><div><h3>Methods</h3><div>This review synthesizes current knowledge on the molecular and cellular mechanisms underlying aortic pathologies, with a particular focus on vascular smooth muscle cell dysfunction, extracellular matrix degradation, and inflammatory signaling pathways. The review critically evaluates the strengths and limitations of widely used murine models, including elastase infusion, calcium chloride application, angiotensin II infusion, and β-aminopropionitrile administration, in the context of current clinical knowledge.</div></div><div><h3>Results</h3><div>Murine models provide valuable insights into the early stages of disease, which are often inaccessible in humans, and have been instrumental in elucidating key mechanisms involved in aneurysm formation and dissection. These models differ in their anatomic specificity, vascular remodelling dynamics, immune activation profiles, and translational relevance. Emerging complementary approaches, including advanced translational platforms and computational models, further improve the interpretation and translational value of preclinical findings.</div></div><div><h3>Conclusions</h3><div>By linking experimental findings to clinical perspectives, this review proposes a bench-to-bedside framework for the study of aortic disease. Integrating complementary experimental models with human-relevant systems may improve mechanistic understanding and support future diagnostic and therapeutic strategies innovation in aortic aneurysm and dissection.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 10","pages":"Pages 1431-1446"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149095970","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":"Prognostic Impact of a Simple GDMT Score on Clinical Outcomes and Cardiac Reverse Remodelling in Patients with ADHF: Insights from the JROADHF-Next Registry","authors":"Ryuichi Matsukawa MD, PhD,&nbsp;Yasushi Mukai MD, PhD,&nbsp;Yudai Fujimoto MD,&nbsp;Yuya Matsue MD, PhD,&nbsp;Takafumi Sakamoto MD, PhD,&nbsp;Nobuyuki Enzan MD, PhD,&nbsp;Takeshi Tohyama MD, PhD,&nbsp;Shouji Matsushima MD, PhD,&nbsp;Masataka Ikeda MD, PhD,&nbsp;Takeshi Kitai MD, PhD,&nbsp;Keisuke Kida MD, PhD,&nbsp;Takahiro Okumura MD, PhD,&nbsp;Tatsunori Taniguchi MD, PhD,&nbsp;Tomomi Ide MD, PhD,&nbsp;Hiroyuki Tsutsui MD, PhD,&nbsp;Kohtaro Abe MD, PhD","doi":"10.1016/j.cjco.2026.06.022","DOIUrl":"10.1016/j.cjco.2026.06.022","url":null,"abstract":"<div><h3>Background</h3><div>Reported results indicate that implementation rates of guideline-directed medical therapy (GDMT) are associated with improved prognosis and cardiac function in heart failure (HF) patients. This study aimed to investigate the relationship between what we term a “simple GDMT score” calculated at discharge and subsequent cardiac reverse remodelling and long-term outcomes in patients hospitalized for acute decompensated HF, using data from the <strong>J</strong>apanese <strong>R</strong>egistry <strong>o</strong>f <strong>A</strong>cute <strong>D</strong>ecompensated <strong>H</strong>eart <strong>F</strong>ailure (JROADHF-NEXT) prospective registry.</div></div><div><h3>Methods</h3><div>We analyzed 2313 hospitalized patients with HFrEF or HFmrEF, stratifying them into high-score (≥ 5 points) and low-score (&lt; 5 points) groups based on their discharge GDMT score.</div></div><div><h3>Results</h3><div>The high-score group demonstrated a significantly lower risk of the composite endpoint of cardiovascular death or HF rehospitalization (hazard ratio = 0.64, 95% confidence interval: 0.55-0.76), an association that remained significant following multivariable adjustment (adjusted model: hazard ratio = 0.70, 95% confidence interval: 0.56-0.88). Furthermore, the high-score group exhibited significantly greater improvements in echocardiographic indices, including absolute changes in left ventricular ejection fraction (<em>P</em> &lt; 0.001), left ventricular end-diastolic volume index (<em>P</em> &lt; 0.001), and left ventricular end-systolic volume index (<em>P</em> &lt; 0.001), and showed significant reductions in brain natriuretic peptide (<em>P</em> = 0.005) and N-terminal pro brain natriuretic peptide levels (<em>P</em> &lt; 0.001) at 1-year follow-up assessment.</div></div><div><h3>Conclusions</h3><div>A higher simple GDMT score at discharge is independently associated with better 2-year clinical outcomes and favourable cardiac reverse remodelling in this cohort of HFrEF/HFmrEF patients hospitalized for acute decompensated HF. These findings suggest that a simple assessment of GDMT at discharge may serve as a practical benchmark of discharge medical optimization in routine clinical care.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 10","pages":"Pages 1310-1323"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096066","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":"A Rare Case of Mediastinal Hematoma Causing Mass Effect Following Transradial Access for Coronary Angiography","authors":"Prudvi Tarun Betha MD,&nbsp;Siddharth Bajaj MD,&nbsp;Harshavardhan Ghadiam MD","doi":"10.1016/j.cjco.2026.06.008","DOIUrl":"10.1016/j.cjco.2026.06.008","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 10","pages":"Pages 1419-1422"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149095972","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":"Balloon-Expandable Vs Self-Expanding Valves for Transcatheter Aortic Valve Implantation in Internally Stented Surgical Valves","authors":"Daisuke Sato MD,&nbsp;Noriaki Moriyama MD,&nbsp;Yoichi Sugiyama MD,&nbsp;Hirokazu Miyashita MD,&nbsp;Tomoki Ochiai MD,&nbsp;Koki Shishido MD,&nbsp;Futoshi Yamanaka MD, PhD,&nbsp;Tommi Vähäsilta MD, PhD,&nbsp;Teemu Laakso MD,&nbsp;Sebastian Dahlbacka MD, PhD,&nbsp;Tiina Vainikka MD, PhD,&nbsp;Juho Viikilä MD,&nbsp;Shigeru Saito MD,&nbsp;Mika Laine MD, PhD,&nbsp;Mikko Jalanko MD, PhD","doi":"10.1016/j.cjco.2026.06.013","DOIUrl":"10.1016/j.cjco.2026.06.013","url":null,"abstract":"<div><h3>Background</h3><div>Internally stented (IS) surgical valves, such as Mitroflow (Sorin Group, Arvada, CO) and Trifecta (St. Jude Medical), are known to carry an elevated risk for coronary artery obstruction during valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) procedures. The data from comparison between balloon-expandable valves (BEVs) and supra-annular self-expanding valves (SEVs) for ViV-TAVI within the IS valve remains unclear. This study aimed to evaluate clinical and hemodynamic outcomes of using BEVs and SEVs for TAVI within an IS valve.</div></div><div><h3>Methods</h3><div>Between January 2016 and February 2024, propensity score–matching was performed between BEV and SEV groups in patients undergoing ViV-TAVI within an IS valve. The data of baseline characteristics, hemodynamic parameters, and clinical outcomes were retrospectively collected. Primary endpoints were 30-day and 2-year clinical outcomes, including all-cause death, hospitalization for heart failure, and coronary obstruction.</div></div><div><h3>Results</h3><div>In total, 113 patients were included in this analysis. A total of 63 patients (55.8%) underwent BEV implantation, and 50 patients (44.2%) underwent SEV implantation. Overall, 37 pairs were identified after propensity-score matching. At day 30, the clinical and hemodynamic outcomes were similar between the groups. Patients with an SEV had better post-procedural mean gradient at 1 year compared with those with a BEV (11.7 ± 4.3 mm Hg vs 22.7 ± 8.4 mm Hg; <em>P</em> &lt; 0.001). No significant difference was observed between SEVs and BEVs in the cumulative 2-year composite endpoint (log-rank <em>P</em> = 0.489).</div></div><div><h3>Conclusions</h3><div>In patients who underwent ViV within an IS valve, the early- and midterm clinical outcomes were comparable between BEVs and SEVs. However, use of an SEV was associated with superior hemodynamics at 1-year follow-up, vs a BEV.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 10","pages":"Pages 1355-1364"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096064","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":"Prognostic Models to Trigger Palliative Care Referrals in Heart Failure: A Scoping Review","authors":"Klara Whalen BSc.,&nbsp;Hilary Bews MD, BSc. FRCPC (Cardiology),&nbsp;James W. Tam MD, FRCPC (Cardiology), FACC, PGCert (Palliative Care),&nbsp;Samuel Quan BHSc, MD, FRCPC (Geriatric Medicine), MSc,&nbsp;Jana Pilkey MD, FRCPC (Internal Medicine, Palliative Medicine), DRCPSC (Clinician Educator)","doi":"10.1016/j.cjco.2026.06.011","DOIUrl":"10.1016/j.cjco.2026.06.011","url":null,"abstract":"<div><div>Accurate prognostication in heart failure (HF) is challenging, due to its nonlinear course. This course impacts the timing of goals of care conversations and referrals to palliative care. Consequently, prognostication may contribute to misunderstandings that can lead to poor end-of-life experiences for patients. As many hospice and palliative care programs have prognostic referral criteria of 6 months or less, we aimed to identify, compare, and synthesize prognostication models that would inform decision-making for palliative consultation and referrals. A scoping review was undertaken to map and characterize prognostic models that predict 6-month mortality in HF patients. An iterative literature search was conducted using PubMed, Embase, Emcare, Google Scholar, and Ovid MEDLINE, supplemented by hand searching, to identify applicable articles. Twenty studies from cardiology, palliative care, and geriatric medicine disciplines were given priority for inclusion in data charting and synthesis. Most models demonstrated moderate-to-high risk of bias and applicability concerns. The models were developed in diverse clinical settings with mortality timeframes ranging from in-hospital death to 6 months. Four common themes for prognostic indicators emerged across the disciplines: age, functional status, comorbidities/organ involvement, and prognostic awareness. Over time, discipline-specific scores have evolved to become more alike, to better address the unique needs of the advanced HF population. Papers differed widely in patient population, goals of prognostication, and applicability for informing palliative or hospice referrals. Developing more unified, multidisciplinary prognostic approaches could have value in supporting timely goals of care conversations, and palliative care involvement, for HF patients.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 10","pages":"Pages 1324-1342"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096067","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":"In Memoriam: Dominique Vervoort, MD, MPH, MBA (1994-2026)","authors":"Maral Ouzounian MD, PhD,&nbsp;Anna Dare MBChB, PhD,&nbsp;Terrence M. Yau MD, MSc,&nbsp;Stephen E. Fremes MD, MSc","doi":"10.1016/j.cjco.2026.04.007","DOIUrl":"10.1016/j.cjco.2026.04.007","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 10","pages":"Pages 1285-1287"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096069","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":"Giant Aneurysm Involving the Sinus of Valsalva and the Right Coronary Artery with a Massive Intramural Thrombus","authors":"Jie Liu MD, PhD,&nbsp;Yuji Xie MD, PhD,&nbsp;Yifan Liu MD,&nbsp;Ying Zhong MD,&nbsp;Yuman Li MD, PhD,&nbsp;He Li MD, PhD,&nbsp;Mingxing Xie MD, PhD","doi":"10.1016/j.cjco.2026.06.019","DOIUrl":"10.1016/j.cjco.2026.06.019","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 10","pages":"Pages 1455-1457"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096076","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":"Pacemaker Dependency in Patients Undergoing Implantation of Dual-chamber Devices After Alcohol Septum Ablation: A Retrospective Analysis","authors":"Sophia Schulze Lammers MD,&nbsp;Dennis Lawin MD,&nbsp;Annika Hoyer PhD,&nbsp;Christoph Stellbrink MD,&nbsp;Thorsten Lawrenz MD","doi":"10.1016/j.cjco.2026.06.021","DOIUrl":"10.1016/j.cjco.2026.06.021","url":null,"abstract":"<div><h3>Background</h3><div>Patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing alcohol septal ablation (ASA) are at risk for high-degree atrioventricular (AV) block, often requiring permanent pacemaker (PPM) implantation. However, long-term pacemaker dependency in this population remains unclear.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed HOCM patients who underwent ASA and subsequent implantation of a cardiac implantable electronic device (CIED) due to procedure-related AV block between 2016 and 2023. CIED interrogation at ≥ 6 weeks postimplantation was used to assess ventricular pacing (VP). Pacemaker dependency was defined as &gt; 1% VP. Associations with baseline characteristics were examined using logistic regression.</div></div><div><h3>Results</h3><div>Of 464 patients undergoing ASA, 95 (20.5%) received a CIED, and 67 were available for follow-up. Only 30 patients (44.8%) showed &gt; 1% VP; 9 (13.4%) were completely dependent (100% VP). In contrast, 31 patients (46.3%) had ≤ 0.1% VP. Persistent AV block was more common in patients with preinterventional left bundle branch block. Intraprocedural AV block showed a trend toward persistent pacemaker dependency.</div></div><div><h3>Conclusions</h3><div>In this cohort, long-term pacemaker dependency after ASA was unexpectedly low. These findings suggest that AV conduction may recover in a significant proportion of patients, raising the question of whether some may safely avoid PPM implantation. Larger prospective studies are needed to guide device therapy decisions in this population. Our findings challenge the assumption of permanent AV block after ASA and suggest reconsidering routine early device implantation in selected patients.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 10","pages":"Pages 1447-1454"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149095969","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":"Real-World Yield of the RAISE Score for Cardiac Amyloidosis Screening in Patients Undergoing Transcatheter Aortic Valve Replacement","authors":"Michele Bertelli MD,&nbsp;Robert J.H. Miller MD,&nbsp;Anna Bizios MD,&nbsp;Debra Bosley RN,&nbsp;Annette Gourlay RN,&nbsp;Lyndsay Litwin RN,&nbsp;Ayaaz Sachedina MD,&nbsp;Daniel Holloway MD,&nbsp;Nishant Sharma MD,&nbsp;Nowell M. Fine MD, SM","doi":"10.1016/j.cjco.2026.06.017","DOIUrl":"10.1016/j.cjco.2026.06.017","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 10","pages":"Pages 1386-1388"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149095975","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}