Jacc: Cardiooncology最新文献

{"title":"Expanding Perspectives on Physical Activity and Cardiovascular Risk in Cancer Survivors","authors":"Fan Zhang MD, Wenlong Yu MD, Mengchen Yin PhD","doi":"10.1016/j.jaccao.2025.01.013","DOIUrl":"10.1016/j.jaccao.2025.01.013","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Page 320"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality-of-Care Measures for Cardio-Oncology","authors":"Vijay U. Rao MD, PhD ,&nbsp;Anita Deswal MD, MPH ,&nbsp;Daniel Lenihan MD ,&nbsp;Susan Dent MD ,&nbsp;Teresa Lopez-Fernandez MD ,&nbsp;Alexander R. Lyon MD ,&nbsp;Ana Barac MD, PhD ,&nbsp;Nicolas Palaskas MD ,&nbsp;Ming Hui Chen MD, MMSc ,&nbsp;Hector R. Villarraga MD ,&nbsp;Diego Sadler MD ,&nbsp;Courtney M. Campbell MD, PhD ,&nbsp;Kerry Skurka RN, BSN ,&nbsp;Matt J. Wagner ,&nbsp;Matthias Totzeck MD, PhD ,&nbsp;Kathryn J. Ruddy MD, MPH ,&nbsp;Paul Heidenreich MD ,&nbsp;Randal Thomas MD ,&nbsp;Daniel Addison MD ,&nbsp;Sarju Ganatra MD ,&nbsp;Joerg Herrmann MD","doi":"10.1016/j.jaccao.2024.11.003","DOIUrl":"10.1016/j.jaccao.2024.11.003","url":null,"abstract":"<div><div>This document serves as a perspective on quality assessments in the discipline of cardio-oncology. We aim to define the current landscape, identify needs for quality and outcome improvements, and propose a roadmap for establishing viable metrics to improve patient care. Specifically, this document: 1) addresses the current lack of measurable high-quality metrics in cardio-oncology and their implications; 2) highlights needs and topic-specific barriers; 3) illustrates the process and application of a measurable quality metric; and 4) provides a framework to demonstrate measurable value for the growing population of patients with cancer and cardiovascular diseases.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 191-202"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intermuscular Fat and Physical Activity Levels Relative to Exercise Capacity Change During Breast Cancer Treatment","authors":"Lauren Daniel BS ,&nbsp;Moriah P. Bellissimo PhD ,&nbsp;Ralph B. D’Agostino Jr. PhD ,&nbsp;Kristine C. Olson PhD ,&nbsp;Amy C. Ladd PhD ,&nbsp;Kerryn W. Reding PhD ,&nbsp;Kathryn E. Weaver PhD ,&nbsp;Glenn J. Lesser MD ,&nbsp;Bonnie Ky MD, MSCE ,&nbsp;W. Gregory Hundley MD ,&nbsp;UPBEAT Study Team","doi":"10.1016/j.jaccao.2025.01.009","DOIUrl":"10.1016/j.jaccao.2025.01.009","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 297-299"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reassessing CAC Risk Post-RRSO","authors":"Binglin Li MD,&nbsp;Yan Wang MD,&nbsp;Ruijuan Chen MD","doi":"10.1016/j.jaccao.2024.12.008","DOIUrl":"10.1016/j.jaccao.2024.12.008","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Page 312"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing Promise and Evidence","authors":"Paschalis Karakasis MD, PhD(c) ,&nbsp;Dimitrios Patoulias MD, PhD ,&nbsp;Nikolaos Fragakis MD, PhD","doi":"10.1016/j.jaccao.2025.01.017","DOIUrl":"10.1016/j.jaccao.2025.01.017","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 314-315"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and Predictors of Severity of Immunotherapy-Related Myocarditis","authors":"Dame Idossa MD ,&nbsp;Joerg Herrmann MD ,&nbsp;Kathryn J. Ruddy MD, MPH","doi":"10.1016/j.jaccao.2025.03.001","DOIUrl":"10.1016/j.jaccao.2025.03.001","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 249-251"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Phenotype and Prognostic Significance of Frailty in Transthyretin Cardiac Amyloidosis","authors":"Carlo Fumagalli MD ,&nbsp;Adam Ioannou MBBS, BSc ,&nbsp;Francesco Cappelli MD ,&nbsp;Mathew S. Maurer MD ,&nbsp;Yousuf Razvi MBChB ,&nbsp;Aldostefano Porcari MD ,&nbsp;Mattia Zampieri MD ,&nbsp;Federico Perfetto MD, PhD ,&nbsp;Muhammad U. Rauf MBBS ,&nbsp;Ana Martinez-Naharro MD, PhD ,&nbsp;Lucia Venneri MD, PhD ,&nbsp;Aviva Petrie MSc ,&nbsp;Carol Whelan MD ,&nbsp;Ashutosh Wechalekar MD ,&nbsp;Helen Lachmann MD ,&nbsp;Philip N. Hawkins MD, PhD ,&nbsp;Iacopo Olivotto MD ,&nbsp;Raffaele Marfella MD, PhD ,&nbsp;Andrea Ungar MD, PhD ,&nbsp;Niccolò Marchionni MD ,&nbsp;Marianna Fontana MD, PhD","doi":"10.1016/j.jaccao.2025.01.018","DOIUrl":"10.1016/j.jaccao.2025.01.018","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence and clinical impact of frailty in transthyretin cardiac amyloidosis (ATTR-CA) remains poorly characterized.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the prevalence, clinical determinants, and prognostic significance of frailty in a large cohort of patients with ATTR-CA.</div></div><div><h3>Methods</h3><div>Frailty was assessed in 880 patients with ATTR-CA (median age 80 years [Q1-Q3: 75-84 years], 719 [81.7%] male) using the Clinical Frailty Scale (CFS). Frailty was analyzed as a continuous variable and categorized as CFS 1 to 3, CFS 4 or 5, CFS 6 or 7, and CFS 8 or 9.</div></div><div><h3>Results</h3><div>Frailty was observed in 502 (57.1%) patients (CFS 4 or 5: 364 [41.4%]; CFS 6 or 7: 129 [14.7%]; CFS 8 or 9: 9 [1.0%]). Independent predictors of worsening frailty included older age, female sex, non-p.(V142I) hereditary ATTR-CA variants, and National Amyloidosis Centre stage 3 disease. Mortality rates increased incrementally with frailty severity (deaths per 100 person-years: 2.9 vs 11.0 vs 21.1 vs 40.9; log-rank <em>P</em> &lt; 0.001). Frailty was independently associated with higher mortality risk across all age groups, genotypes, and disease stages.</div></div><div><h3>Conclusions</h3><div>Frailty is common in ATTR-CA and is independently linked to increased mortality risk. Incorporating frailty assessment alongside traditional markers enhances prognostication across genotypes and disease severities, particularly for short-term risk estimation.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 268-278"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Long-Term Outcomes in ATTR-CM","authors":"Nowell M. Fine MD, SM","doi":"10.1016/j.jaccao.2025.01.007","DOIUrl":"10.1016/j.jaccao.2025.01.007","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 294-296"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multicenter Study of Contemporary Long-Term Tafamidis Outcomes in Transthyretin Amyloid Cardiomyopathy","authors":"Ahmad Masri MD, MS ,&nbsp;Priyanka Bhattacharya MD ,&nbsp;Brent Medoff MD ,&nbsp;Ain U. Ejaz MD ,&nbsp;Miriam R. Elman MS, MPH ,&nbsp;Pranav Chandrashekar MD ,&nbsp;Lauren Ives MPH ,&nbsp;Alfonsina Mirabal Santos MD ,&nbsp;Sergio L. Teruya MD ,&nbsp;Yuanzi Zhao MD, PhD ,&nbsp;Shuaiqi Huang PhD ,&nbsp;Xiaofeng Wang PhD ,&nbsp;Brett W. Sperry MD ,&nbsp;Mathew S. Maurer MD ,&nbsp;Prem Soman MD, PhD ,&nbsp;Mazen Hanna MD","doi":"10.1016/j.jaccao.2024.12.005","DOIUrl":"10.1016/j.jaccao.2024.12.005","url":null,"abstract":"<div><h3>Background</h3><div>Tafamidis improved survival and decreased cardiovascular hospitalizations in the ATTR-ACT trial. Due to improved recognition and earlier diagnosis, the epidemiology of transthyretin amyloid cardiomyopathy (ATTR-CM) is rapidly evolving.</div></div><div><h3>Objectives</h3><div>The authors sought to evaluate the contemporary long-term outcomes of patients with ATTR-CM treated with tafamidis.</div></div><div><h3>Methods</h3><div>Patients with ATTR-CM who received at least 1 dose of tafamidis between 2018 and 2021 at 5 amyloidosis centers in the United States were enrolled. Primary outcome was all-cause mortality.</div></div><div><h3>Results</h3><div>Among 624 patients, mean age was 76.9 ± 8.4 years, 12.5% were female, 17.5% were Black, and 17.5% had variant ATTR-CM. At the time of tafamidis start, 52% had NYHA functional class II, 34% had NYHA functional class III, 40% were in National Amyloidosis Center (NAC) Stage ≥II, 38% were in Columbia Stage ≥II, and the median NT-proBNP level was 1,914 (Q1-Q3: 957-3914) pg/mL. Over a median follow-up of 43.2 months (Q1-Q3: 25.2-52.8 months), 241 patients (38.6%) died. The probability of freedom from death at 65 months was 54.1% (95% CI: 47.4%-60.4%). Similarly, restricting the cohort to patients who received tafamidis within 6 months of their ATTR-CM diagnosis (n = 397, 63.6%) showed similar results, with a survival probability of 49.6% (95% CI: 37.6%-60.5%) at 65 months.</div></div><div><h3>Conclusions</h3><div>In a contemporary cohort of tafamidis-treated patients with ATTR-CM, 39% of patients died over a median of 43 months. Further work is needed to improve our understanding of ATTR-CM, its natural history, and how to further improve survival and prevent progression of heart failure.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 282-293"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Effects of Modern Breast Radiation Therapy in Patients Receiving Systemic Cancer Therapy","authors":"Eva Berlin MD ,&nbsp;Kyunga Ko MS ,&nbsp;Lin Ma PhD ,&nbsp;Ian Messing MD ,&nbsp;Casey Hollawell MD ,&nbsp;Amanda M. Smith BA, MA ,&nbsp;Neil K. Taunk MD, MSCTS ,&nbsp;Vivek Narayan MD, MSCE ,&nbsp;Jenica N. Upshaw MD, MS ,&nbsp;Amy S. Clark MD ,&nbsp;Payal D. Shah MD ,&nbsp;Hayley Knollman MD ,&nbsp;Saveri Bhattacharya DO ,&nbsp;Daniel Koropeckyj-Cox BA ,&nbsp;Jessica Wang BA ,&nbsp;Nikhil Yegya-Raman MD ,&nbsp;Ivy S. Han BS ,&nbsp;Benedicte Lefebvre MD ,&nbsp;Tang Li MS ,&nbsp;Nicholas S. Wilcox MD ,&nbsp;Bonnie Ky MD, MSCE","doi":"10.1016/j.jaccao.2025.01.012","DOIUrl":"10.1016/j.jaccao.2025.01.012","url":null,"abstract":"<div><h3>Background</h3><div>Radiation therapy (RT) improves breast cancer outcomes, but cardiac morbidity remains a concern.</div></div><div><h3>Objectives</h3><div>This study sought to evaluate changes in cardiac function after RT and the relationship between cardiac dose metrics and echocardiography-derived measures of function.</div></div><div><h3>Methods</h3><div>In a longitudinal cohort study of women with breast cancer, radiation cardiac dose metrics and core lab quantitated echocardiographic measures of cardiac function were evaluated. Dose metrics included the whole heart, left ventricle, right ventricle, and left anterior descending artery (LAD). Echocardiographic measures included left ventricular ejection fraction (LVEF), longitudinal strain, circumferential strain, E/e’ (ratio of early diastolic mitral inflow velocity to early diastolic mitral annular tissue velocity), Ea/Es (ventricular arterial coupling; ratio of effective arterial elastance to end systolic elastance), and right ventricular fractional area change. The mean change in echocardiographic measures over time and the association between cardiac dose metrics and echocardiographic measures were estimated by repeated-measures multivariable linear regression via generalized estimating equations.</div></div><div><h3>Results</h3><div>The cohort included 303 participants (median age 52 years, 33.3% African American) who received adjuvant RT (2010-2019) with a median mean heart dose of 1.19 Gy (Q1-Q3: 0.75-2.61 Gy), were followed over a median of 5.1 years (Q1-Q3: 3.2-7.1 years). Across all participants, there was a modest increase in LVEF (52.1% pre-RT to 54.3% at 5 years; <em>P &lt;</em> 0.001) but a worsening in sensitive measures of function, such as circumferential strain (−23.7% pre-RT to −21.0% at 5 years; <em>P =</em> 0.003). Among left-sided/bilateral breast cancer participants, changes in cardiac function were observed across all parameters (<em>P &lt;</em> 0.05). The maximum LAD dose was associated with a modest worsening in LVEF, longitudinal strain, circumferential strain, and E/e′.</div></div><div><h3>Conclusions</h3><div>Over a median of 5.1 years, modest changes in cardiac function were observed with RT. Maximum LAD dose was associated with a worsening in systolic and diastolic function parameters.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 219-230"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}