IJC Heart and Vasculature最新文献

{"title":"Lactate-to-albumin ratio index correlates with the occurrence and prognosis of acute kidney injury complicated by cardiac surgery","authors":"Congying Wang ,&nbsp;Xin Sun ,&nbsp;Kun Chen ,&nbsp;Yaqing Shi ,&nbsp;Lili Wang ,&nbsp;Shuxia Chen ,&nbsp;Dehua Li ,&nbsp;Jian Gu","doi":"10.1016/j.ijcha.2025.101734","DOIUrl":"10.1016/j.ijcha.2025.101734","url":null,"abstract":"<div><h3>Background</h3><div>The lactate-to-albumin ratio (LAR) is a novel biomarker associated with poor prognosis in critical illnesses. However, its relationship with cardiac surgery associated acute kidney injury (AKI) and prognosis remains unclear. This study aimed to investigate this relationship using data from the MIMIC database.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on 11,624 adult cardiac surgery patients admitted to the ICU. Logistic regression, restricted cubic spline (RCS) analysis, and subgroup analysis were used to assess the predictive value of LAR for AKI occurrence and adverse outcomes.</div></div><div><h3>Results</h3><div>Of the 11,624 patients, 5,965 developed AKI. While LAR concentrations were higher in AKI patients, this association did not persist after multivariate adjustment for potential confounder. Logistic regression showed that LAR was independently associated with in-hospital and ICU mortality, even after adjusting for potential confounders. RCS analysis revealed a non-linear relationship between elevated LAR and increased mortality risk in AKI patients. Correlation analyses demonstrated that LAR was associated with longer hospital and ICU stays and higher SOFA scores. Subgroup analyses consistently showed that elevated LAR was associated with increased mortality risk in older adults, females, and patients with or without hypertension, chronic kidney disease, diabetes, or chronic heart failure.</div></div><div><h3>Conclusions</h3><div>Among patients with acute kidney injury related to cardiac surgery, especially in those undergoing valve surgery, elevated LAR levels are associated with an increased risk of death, but not with the occurrence of acute kidney injury. Further validation is needed to confirm its predictive role.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101734"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517489","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":"Angiographically-derived fractional flow reserve and optical coherence tomography findings after coronary stenting","authors":"Fernando Alfonso,&nbsp;Javier Cuesta,&nbsp;Fernando Rivero","doi":"10.1016/j.ijcha.2025.101733","DOIUrl":"10.1016/j.ijcha.2025.101733","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101733"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517484","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":"Long-term left ventricular ejection function in fulminant and non-fulminant myocarditis: A multicenter study in China","authors":"Guangling Li ,&nbsp;Jing Zhang ,&nbsp;Zheng Xu ,&nbsp;Yaogui Ning ,&nbsp;Li Zhang ,&nbsp;Jing Yang ,&nbsp;Gang Chen ,&nbsp;Fan Li ,&nbsp;Jiangang Jiang","doi":"10.1016/j.ijcha.2025.101738","DOIUrl":"10.1016/j.ijcha.2025.101738","url":null,"abstract":"<div><h3>Background</h3><div>There is a gap regarding comparisons of left ventricular ejection fraction (LVEF) changes between fulminant myocarditis (FM) and non-FM (NFM) patients at different follow-up intervals.</div></div><div><h3>Methods</h3><div>This multicenter retrospective study included 324 patients (163 FM and 161 NFM) with confirmed acute myocarditis through endomyocardial biopsy (EMB) or cardiac magnetic resonance imaging. We used multi-model adjustment approach and a mixed-effects model to comprehensively evaluate changes in LVEF in FM relative to NFM, considering both dichotomous outcome (primary outcome) and repeated measurements outcome (secondary outcome). Sensitivity analysis was conducted for patients aged 15 years and older.</div></div><div><h3>Results</h3><div>FM patients exhibited a higher risk of the primary outcome (LVEF &lt; 55 % at the last two follow-up visits) compared to NFM patients, with an odds ratio (OR) of 8.517 (95 % CI, 4.666–16.552; P &lt; 0.001). Following comprehensive adjustment for confounders, the OR for FM versus NFM was 7.438 (95 % CI, 3.967–14.763; P &lt; 0.001). Analysis of repeated measurements (secondary outcome) revealed that LVEF in the NFM group surpassed that in the FM group at different follow-up time points. Consistent findings were observed in the sensitivity analysis population. Additionally, after adjusting for potential confounders, intra-aortic ballon pump (IABP) and extracorporeal membrane oxygenation (ECMO) demonstrated OR values of 0.030 (95 % CI: 0.002–0.197; P = 0.001) and 0.339 (95 % CI: 0.124–0.880; P = 0.030) in patients with FM, respectively.</div></div><div><h3>Conclusion</h3><div>FM patients face a lower LVEF compared to NFM patients across various follow-up intervals. Additionally, early application of IABP and ECMO can enhance long-term LVEF in patients with FM.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101738"},"PeriodicalIF":2.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513720","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":"Association between prehospital adrenaline administration and short-term outcomes in patients with shockable out-of-hospital cardiac arrest undergoing extracorporeal cardiopulmonary resuscitation: a propensity-score matched analysis","authors":"Shoji Kawakami ,&nbsp;Hidenobu Koga ,&nbsp;Tetsuhisa Yamada ,&nbsp;Jun-Ichiro Nishi","doi":"10.1016/j.ijcha.2025.101735","DOIUrl":"10.1016/j.ijcha.2025.101735","url":null,"abstract":"<div><h3>Background</h3><div>In patients with out-of-hospital cardiac arrest (OHCA) and an initial shockable rhythm undergoing extracorporeal resuscitation (ECPR), the effect of adrenaline on neurological outcomes remains uncertain. This study aimed to investigate the association between prehospital adrenaline and clinical outcomes in this patient population.</div></div><div><h3>Methods</h3><div>This multicentre, prospective study (JAAM-OHCA registry) enrolled 81,234 patients with OHCA between 2014 and 2021. Patients with an initial shockable rhythm who underwent ECPR for a cardiac cause were eligible for this study. The primary outcome was a favourable neurological outcome at 30 days. The secondary outcome was prehospital return of spontaneous circulation (ROSC) or 30-day survival. A propensity score-matched analysis was performed to adjust for confounding and evaluate the independent association between prehospital adrenaline and study outcomes.</div></div><div><h3>Results</h3><div>Among 1,061 patients, 442 (41.7 %) received prehospital adrenaline and 619 (58.3 %) did not. In 329 matched pairs, the prehospital ROSC rate was significantly higher in the adrenaline group (30 [9 %] vs 16 [5 %]; adjusted odds ratio [OR] 1.96, 95 % confidence interval [CI] 1.05–3.67, <em>P</em> = 0.03). However, 30-day survival (70 [21 %] vs 77 [23 %]; adjusted OR 0.88, 95 % CI 0.61–1.28, <em>P</em> = 0.51) and a favourable neurological outcome at 30 days (24 [7 %] vs 30 [9 %]; adjusted OR 0.78, 95 % CI 0.45–1.37, <em>P</em> = 0.39) were not significantly different.</div></div><div><h3>Conclusions</h3><div>In patients with OHCA and an initial shockable rhythm who underwent ECPR, prehospital adrenaline was significantly associated with increased prehospital ROSC, but not with increased in survival and a favourable neurological outcome at 30 days.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101735"},"PeriodicalIF":2.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513719","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":"Mortality trends related to cardiogenic shock in heart failure patients aged 25 and older across the United States: A study utilizing the CDC WONDER database from 1999 to 2023","authors":"Abdullah Naveed Muhammad ,&nbsp;Sivaram Neppala ,&nbsp;Himaja Dutt Chigurupati ,&nbsp;Muhammad Omer Rehan ,&nbsp;Hamza Naveed ,&nbsp;Rabia Iqbal ,&nbsp;Bazil Azeem ,&nbsp;Ahila Ali ,&nbsp;Mushood Ahmed ,&nbsp;Prakash Upreti ,&nbsp;Mobeen Zaka Haider ,&nbsp;Yasar Sattar ,&nbsp;Jamal S. Rana ,&nbsp;Gregg C. Fonarow","doi":"10.1016/j.ijcha.2025.101732","DOIUrl":"10.1016/j.ijcha.2025.101732","url":null,"abstract":"<div><h3>Background</h3><div>Cardiogenic shock (CS) remains crucial in mortality rates for heart failure (HF) patients. However, contemporary data on long-term mortality trends related to CS are limited. This study investigates demographic patterns and trends in CS mortality among HF patients over 25 years.</div></div><div><h3>Methods</h3><div>Data from the Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database (1999–2023) included adults aged ≥25 diagnosed with HF and CS. Age-adjusted mortality rates (AAMRs) per 100,000 population and trends were analyzed using Joinpoint regression to find the average annual percent change (AAPC) and annual percent change (APC).</div></div><div><h3>Results</h3><div>Between 1999 and 2023, there were 108,514 deaths linked to cardiogenic shock among heart failure patients, with AAMRs increasing from 1.2 to 4.6 per 100,000 (AAPC: 5.90). The most significant increases occurred from 2009 to 2021 (APC: 14.17), followed by a sustained rise from 2021 to 2023 (APC: 7.83). Men consistently exhibited higher AAMRs than women (2.4 vs. 1.3), and Black individuals had the highest mortality rates across all racial and ethnic groups. Furthermore, mortality rates were notably higher in rural areas compared to urban settings (1.7 vs. 1.5).</div></div><div><h3>Conclusion</h3><div>In the past 25 years, CS-related mortality in HF patients has increased nearly fourfold. This trend highlights the need to investigate its causes, including potential deteriorating health outcomes or improved healthcare access. Special focus should be on high-risk groups like men, Black individuals, and rural residents, as targeted interventions could mitigate disparities and enhance outcomes.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101732"},"PeriodicalIF":2.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480198","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":"Sex-related disparities in incidence and in-hospital outcomes of Atrial fibrillation complicated by non-ST-elevation myocardial infarction from the national in-sample database (2016–2022)","authors":"Farah Yasmin ,&nbsp;Afsana Ansari Shaik ,&nbsp;Muhammad Sohaib Asghar ,&nbsp;Afia Salman ,&nbsp;Abdul Moeed ,&nbsp;Maryam Shaharyar ,&nbsp;Rohan Ochani ,&nbsp;M.Chadi Alraies","doi":"10.1016/j.ijcha.2025.101728","DOIUrl":"10.1016/j.ijcha.2025.101728","url":null,"abstract":"<div><h3>Introduction</h3><div>Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia, and if complicated by NSTEMI has a significant association with a higher all-cause and cardiovascular mortality. Previous studies show that patients with AF complicated by NSTEMI have a comparatively worse prognosis than AF patients without NSTEMI.</div></div><div><h3>Methods</h3><div>In this study, we aimed to assess the trends and gender-based disparities in the incidence and in-hospital outcomes of AF complicated by NSTEMI in the U.S. adult population, using data from the Nationwide Inpatient Sample (NIS) dataset. The NIS database was searched from 2016 to 2022 to identify patients with ICD-10 Codes. Baseline demographic characteristics along with hospital-level variables were analyzed subsequently using the odds ratio.</div></div><div><h3>Results</h3><div>The demographic, clinical, and hospital-related characteristics of the study population were stratified by gender including 125,340 males and 88,554 females. The average age of patients was 75.14 years, with males being younger (73.58 years) compared to females (77.35 years) (p &lt; 0.001). Overall, 10.8 % of the patients died; females had a significantly higher mortality rate (11.3 %) than males (10.5 %) (p &lt; 0.001). The trends in age-adjusted mortality rate (AAMR) was 19996.9 per 100,000 hospitalizations in males who demonstrated higher AAMRs than females (18156.5). The mean length of hospital stay was consistently longer for the males compared to the females. The trend analysis for inflation-adjusted hospital costs demonstrated an upward trend in both males (p &lt; 0.001) and females (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>These findings underscore the importance of addressing gender-specific differences in the management of AF patients with NSTEMI to optimize patient resource allocation.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101728"},"PeriodicalIF":2.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480141","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":"Association between post-PCI vessel fractional flow reserve (vFFR) and optical coherence tomography (OCT) findings: Results from the FAST OCT study","authors":"Annemieke C. Ziedses des Plantes ,&nbsp;Alessandra Scoccia ,&nbsp;Frederik T.W. Groenland ,&nbsp;Maria N. Tovar Forero ,&nbsp;Mariusz Tomaniak ,&nbsp;Janusz Kochman ,&nbsp;Wojciech Wojakowski ,&nbsp;Pawel Gąsior ,&nbsp;Koen Ameloot ,&nbsp;Tom Adriaenssens ,&nbsp;Wijnand K. den Dekker ,&nbsp;Rutger-Jan Nuis ,&nbsp;Isabella Kardys ,&nbsp;Nicolas M. Van Mieghem ,&nbsp;Ernest Spitzer ,&nbsp;Joost Daemen","doi":"10.1016/j.ijcha.2025.101706","DOIUrl":"10.1016/j.ijcha.2025.101706","url":null,"abstract":"<div><h3>Aims</h3><div>Reduced post-PCI fractional flow reserve (FFR) and suboptimal optical coherence tomography (OCT) findings are associated with impaired outcomes. Angiography-derived vessel FFR (vFFR) has emerged as an accurate alternative to pressure-wire based FFR. This study sought to define the association between post-PCI vFFR and OCT findings.</div></div><div><h3>Methods and results</h3><div>The FAST OCT study included 200 patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and intermediate to severe coronary artery stenosis. Patients with post-PCI OCT and vFFR evaluation of at least one study vessel were included in this post-PCI sub-analysis. Complete post PCI OCT and vFFR data were available for 109 vessels (100 patients). Median post-PCI vFFR was 0.93 [25th–75th percentile 0.90–0.96], median vessel minimal lumen area (MLA) was 3.48 mm² [25th–75th percentile 2.42–4.89] and median in-stent MLA was 5.37 [25th–75th percentile 4.14–6.82]. In multivariable analysis, post-PCI vFFR was significantly associated with vessel MLA (average decrease of 20.6 % per 0.10 decrease in vFFR (95 % CI −34.6 % to −3.7 %), p = 0.021). The optimal cutoff value of post-PCI vFFR to detect an MLA ≤ 4.5 mm² was 0.92 (sensitivity 60.5 %, specificity 87.9 %). The proximal vFFR gradient showed a good diagnostic performance to detect proximal residual disease (AUC 0.80), whereas the diagnostic performance of the in-stent gradient to detect stent underexpansion was poor (AUC 0.52).</div></div><div><h3>Conclusions</h3><div>vFFR was significantly associated with MLA and a vFFR ≤ 0.92 had a good specificity to detect an MLA ≤ 4.5 mm². Post-PCI vFFR and segmental gradients may be of interest to identify suboptimal MLA’s and proximal disease, but could not identify stent underexpansion.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101706"},"PeriodicalIF":2.5,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335932","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":"Dynamic evaluation of atrial fibrillation risk factors using multiple sensors of implantable cardioverter defibrillators","authors":"Carmelo La Greca ,&nbsp;Andrea Dell’Aquila ,&nbsp;Amedeo Prezioso ,&nbsp;Matteo Bertini ,&nbsp;Valter Bianchi ,&nbsp;Gennaro Vitulano ,&nbsp;Leonardo Calò ,&nbsp;Gianluca Savarese ,&nbsp;Vincenzo Ezio Santobuono ,&nbsp;Antonio Dello Russo ,&nbsp;Miguel Viscusi ,&nbsp;Amato Santoro ,&nbsp;Raimondo Calvanese ,&nbsp;Antonio Pangallo ,&nbsp;Claudia Amellone ,&nbsp;Giuseppe Arena ,&nbsp;Monica Campari ,&nbsp;Sergio Valsecchi ,&nbsp;Giuseppe Boriani ,&nbsp;Domenico Pecora","doi":"10.1016/j.ijcha.2025.101731","DOIUrl":"10.1016/j.ijcha.2025.101731","url":null,"abstract":"<div><h3>Aims</h3><div>The HEAD2TOES schema was introduced to identify modifiable risk factors (RF) for atrial fibrillation (AF), including heart failure (HF), physical inactivity (PA), and sleep apnea (SA). Modern implantable cardioverter-defibrillators (ICDs) can detect SA, assess HF status, and measure daily PA. This study investigates the relationship between atrial high-rate episodes (AHREs) and ICD-detected surrogates for these RF in HF patients.</div></div><div><h3>Methods and results</h3><div>Data were collected from 411 HF patients with ICDs. The HeartLogic Index measured HF status, Respiratory Disturbance Index (RDI) severe SA (≥30episodes/hour), and accelerometer detected reduced PA (≥1 h/day). Endpoints were daily AHRE burdens ≥ 5 min and ≥ 23 h. Over 26 months of median follow-up, IN-alert-HF state was 13 % of the total observation time, RDI ≥ 30 episodes/h occurred 58 % of time, and 2 % of weekly activity values were ≥ 1 h lower than usual. AHRE burden ≥ 5 min/day occurred in 139 (34 %) patients and ≥ 23 h/day in 68 (17 %). Both IN-alert-state and reduced activity were independently associated with AHRE burden (≥5 min/day and ≥ 23 h/day), while RDI ≥ 30episodes/hour was associated only with AHRE ≥ 5 min/day. We defined a score predicting AHRE burden ≥ 5 min (2*HeartLogic_IN-alert + 1*RDI ≥ 30episodes/hour + 4*Reduction_in_activity ≥ 1 h), and a score predicting AHRE burden ≥ 23 h (1*HeartLogic_IN-alert + 2*Reduction_in_activity ≥ 1 h). Lower score levels (AHRE-5 min &lt; 4 and AHRE-23 h &lt; 2) comprised the largest proportion of follow-up duration (98 %), with higher scores linked to higher incidence rate ratios for AHRE (6.75 [95 %CI:1.88–20.16] and 11.46 [95 %CI:3.34–31.72], respectively).</div></div><div><h3>Conclusions</h3><div>In HF patients, AHRE occurrence is independently associated with ICD-detected HF status, severe SA, and decreased PA. These ICD-indexes might serve as surrogates for HEAD2TOES RF, aiding in continuous AF risk assessment.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101731"},"PeriodicalIF":2.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329519","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":"Arrhythmic risk in acute myocarditis: Early threats, late events, and clinical uncertainty","authors":"Massimo Imazio","doi":"10.1016/j.ijcha.2025.101724","DOIUrl":"10.1016/j.ijcha.2025.101724","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101724"},"PeriodicalIF":2.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329518","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":"Procedural simplification in mitral valve transcatheter edge-to-edge repair: full echocardiographic guidance and outcomes","authors":"Jianrui Ma ,&nbsp;Peijian Wei ,&nbsp;Fengwen Zhang ,&nbsp;Junke Chang ,&nbsp;Manchen Gao ,&nbsp;Chuangshi Wang ,&nbsp;Xiaofang Yan ,&nbsp;Cheng Wang ,&nbsp;Shouzheng Wang ,&nbsp;Yongquan Xie ,&nbsp;Fang Fang ,&nbsp;Xiangbin Pan","doi":"10.1016/j.ijcha.2025.101730","DOIUrl":"10.1016/j.ijcha.2025.101730","url":null,"abstract":"<div><h3>Background</h3><div>Our group pioneered attempts to simplify the mitral valve transcatheter edge-to-edge repair (M-TEER) procedure under full echocardiographic guidance; however, its safety and effectiveness remain unclear. This study aimed to compare its outcome with the traditional procedure under echocardiographic and fluoroscopic co-guidance.</div></div><div><h3>Methods</h3><div>From Jan 2021 to May 2024, 194 mitral regurgitation (MR) patients undergoing the simplified procedure (Echo guidance group, n = 113) and the traditional procedure (Co-guidance group, n = 81) were retrospectively reviewed. The propensity score matching (PSM) method was performed as a sensitivity analysis.</div></div><div><h3>Results</h3><div>As defined by Mitral Valve Academic Research Consortium, the 30-day major adverse events, technical success, device success, and procedural success in the Echo guidance group were 5.31 %, 97.3 %, 89.4 %, and 88.5 %, similar to 8.64 %, 96.3 %, 85.2 %, and 84.0 % in the Co-guidance group, respectively (<em>p</em> &gt; 0.05). Significant MR reduction and improvements in New York Heart Association functional class were observed in both groups (<em>p</em> &lt; 0.05). The 1-year freedom from all-cause mortality and a composite of all-cause mortality and heart failure hospitalization were 94.5 % (95 % confidence interval (CI), 89.8 %–99.4 %) and 90.1 % (95 % CI, 83.6 %–97.2 %) in the Echo guidance group, similar to 92.1 % (95 % CI, 86.3 %–98.4 %) and 88.4 % (95 % CI, 81.6 %–95.9 %) in the Co-guidance group, respectively (<em>p</em> &gt; 0.05). PSM-cohort analysis confirmed these findings.</div></div><div><h3>Conclusions</h3><div>The simplified M-TEER procedure under full echocardiographic guidance showed comparable outcomes to the traditional procedure under echocardiographic and fluoroscopic co-guidance.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"59 ","pages":"Article 101730"},"PeriodicalIF":2.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329999","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}