Jacc: Cardiooncology最新文献

{"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}

{"title":"Risk Stratification for Trastuzumab-Induced Cardiac Dysfunction and Potential Implications for Surveillance","authors":"Abdelrahman Ali MD ,&nbsp;Efstratios Koutroumpakis MD ,&nbsp;Juhee Song PhD ,&nbsp;Daniel Booser MD ,&nbsp;Carlos H. Barcenas MD, MSc ,&nbsp;Debu Tripathy MD ,&nbsp;Ana Barac MD, PhD ,&nbsp;Nicolas L. Palaskas MD, MPH ,&nbsp;Anita Deswal MD, MPH","doi":"10.1016/j.jaccao.2024.12.007","DOIUrl":"10.1016/j.jaccao.2024.12.007","url":null,"abstract":"<div><h3>Background</h3><div>Although patient factors and sequential anthracycline use contribute to risk for cancer therapy–related cardiac dysfunction (CTRCD) with HER2-directed cancer therapy, frequent (every 3 months) left ventricular ejection fraction (LVEF) surveillance is recommended irrespective of baseline risk.</div></div><div><h3>Objectives</h3><div>The aim of this study was to examine the incidence of trastuzumab-associated CTRCD in a contemporary cohort with HER2-positive breast cancer and assess the performance of a risk assessment tool to identify patients at low risk for CTRCD to guide risk-based surveillance strategies.</div></div><div><h3>Methods</h3><div>A retrospective cohort of patients with HER2-positive breast cancer treated with trastuzumab at a tertiary cancer center was examined. Patients were categorized as low, medium, and high or very high risk for CTRCD by Heart Failure Association/International Cardio-Oncology Society risk assessment.</div></div><div><h3>Results</h3><div>Of 496 patients treated with trastuzumab, 29.8% also received anthracyclines. Over a median follow-up period of 51 months, 8.7% developed CTRCD, but only 1.6% had associated heart failure (HF). CTRCD rates were 3.6%, 12.8%, and 32.1% in low-risk, medium-risk, and high or very high risk groups, respectively. HF incidence was 0.4% in the low-risk group and 2.1% in the medium-risk group, with no HF in patients at low- or medium-risk who received trastuzumab without anthracyclines. HF was observed in 11% of high-risk patients. The risk assessment had a negative predictive value for CTRCD in low vs moderate- or high-risk patients of 96.4% (95% CI: 93.5%-98.3%).</div></div><div><h3>Conclusions</h3><div>The findings support the exploration of a prospective personalized risk-based approach to cardiac LVEF surveillance during trastuzumab therapy. Less frequent LVEF monitoring in low-risk patients may optimize resource use and reduce patient burden without compromising safety.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 203-215"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834993","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":"Rechallenge After Severe Immune Checkpoint Inhibitor Myocarditis","authors":"Guillaume Bailly MD ,&nbsp;Maxime Robert-Halabi MD ,&nbsp;Pierre-Adrien Vion MD ,&nbsp;Yves Allenbach MD, PhD ,&nbsp;Baptiste Abbar MD, PhD ,&nbsp;Marie Bretagne MD ,&nbsp;Joe-Elie Salem MD, PhD","doi":"10.1016/j.jaccao.2025.02.004","DOIUrl":"10.1016/j.jaccao.2025.02.004","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 300-304"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835004","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":"Severe Aortic Stenosis and Chronic Myeloid Leukemia","authors":"Rebecca Cunningham MD, PhD ,&nbsp;Sang Gune K. Yoo MD ,&nbsp;Alexander A. Brescia MD, MSc ,&nbsp;Karolyn A. Oetjen MD, PhD ,&nbsp;Iskra Pusic MD, MSCI ,&nbsp;Joshua D. Mitchell MD, MSCI","doi":"10.1016/j.jaccao.2025.01.010","DOIUrl":"10.1016/j.jaccao.2025.01.010","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 305-308"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835005","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":"Long-Term Care of Childhood Cancer Survivors at Risk for Cardiac Late Effects","authors":"Aaron Ackerman MD ,&nbsp;Daniel Ly MD ,&nbsp;Monica Hall MD ,&nbsp;Mohamed S. Dabour MS ,&nbsp;Nathan Rodgers MD, MHA ,&nbsp;Shanti Narasimhan MBBS ,&nbsp;Mahmoud Elsherif BSc ,&nbsp;Beshay N. Zordoky BSc, MSc, PhD ,&nbsp;Karim T. Sadak MD, MPH, MSE","doi":"10.1016/j.jaccao.2025.01.008","DOIUrl":"10.1016/j.jaccao.2025.01.008","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 309-311"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834985","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":"Strengthening the Appreciation of Frailty in Patients With Transthyretin Cardiac Amyloidosis","authors":"Justin L. Grodin MD, MPH ,&nbsp;Parag Goyal MD, MSc","doi":"10.1016/j.jaccao.2025.03.003","DOIUrl":"10.1016/j.jaccao.2025.03.003","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 279-281"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835000","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":"Articulating the JACC Journals’ Direction in Times of Global Change","authors":"Harlan M. Krumholz MD, SM (Editor-in-Chief, JACC),&nbsp;Biykem Bozkurt MD, PhD (Editor-in-Chief, JACC: Heart Failure),&nbsp;Y. Chandrashekhar MD (Editor-in-Chief, JACC: Cardiovascular Imaging),&nbsp;Bonnie Ky MD, MSCE (Editor-in-Chief, JACC: CardioOncology),&nbsp;Douglas L. Mann MD (Editor-in-Chief, JACC: Basic to Translational Science),&nbsp;David J. Moliterno MD (Editor-in-Chief, JACC: Cardiovascular Interventions),&nbsp;Kalyanam Shivkumar MD, PhD (Editor-in-Chief, JACC: Clinical Electrophysiology),&nbsp;Candice K. Silversides MD (Editor-in-Chief, JACC: Advances),&nbsp;Gilbert H.L. Tang MD, MSc, MBA (Editor-in-Chief, JACC: Case Reports),&nbsp;Jian’an Wang MD, PhD (Editor-in-Chief, JACC: Asia)","doi":"10.1016/j.jaccao.2025.02.001","DOIUrl":"10.1016/j.jaccao.2025.02.001","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 322-323"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834868","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":"Enalapril for Preventing Cardiotoxicity After High-Dose Anthracycline Therapy in Breast Cancer and Lymphoma Patients","authors":"Daniela Cardinale MD, PhD ,&nbsp;Giancarlo Marenzi MD","doi":"10.1016/j.jaccao.2025.01.014","DOIUrl":"10.1016/j.jaccao.2025.01.014","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 317-318"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834988","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}