Journal of Asian Pacific Society of Cardiology最新文献

{"title":"Hypertension and Abnormal Renal Function and the Risk of Ischaemic Stroke in Anticoagulated Type 1 Evaluated Heart Valves, Rheumatic or Artificial Valvular AF","authors":"R. Winanti, S. Raharjo, R. Ariani, D. Hanafy, C. A. Atmadikoesoemah, P. Almazini, Armalya Pritazahra, Y. Yuniadi","doi":"10.15420/japsc.2023.44","DOIUrl":"https://doi.org/10.15420/japsc.2023.44","url":null,"abstract":"Background: AF substantially increases the risk of stroke. The most widely used risk prediction score for AF is CHA2DS2-VASC. Previous studies have mainly focused on its efficacy among patients with non-valvular AF. The few studies that have considered patients with valvular AF highlight the tool’s poor scoring accuracy. Objective: This study was conducted to evaluate the clinical factors and echocardiographic parameters related to the incidence of ischaemic stroke in anticoagulated evaluated heart valves, rheumatic or artificial (EHRA) type 1 valvular AF patients. Methods: We conducted a retrospective cohort study using data from the Indonesian Registry on Atrial Fibrillation (OneAF). Patients with EHRA type 1 valvular AF recorded in the registry from January 2015 to December 2019 were included in the study. Results: The incidence of ischaemic stroke was 17 (5.2%) out of 329 AF patients with mitral stenosis or mechanical prosthetic valves. A multivariate analysis showed that two clinical factors: hypertension (OR 5.59; 95% CI [1.93–16.15]; p=0.001) and estimated glomerular filtration rate (eGFR) ≤59 ml/min/m2 (OR 3.62; 95% CI [1.30–10.02]; p=0.013), were independently associated with the incidence of ischaemic stroke. No echocardiographic parameters were associated with the incidence of ischaemic stroke in this population. Conclusion: Hypertension and impaired renal function elevated the risk of ischaemic stroke in the patient population. Further research is necessary to determine the proper scoring system for predicting ischaemic stroke in this subgroup.","PeriodicalId":499798,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"124 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141656840","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":"Giant Eustachian Valve Mimicking an Inter-atrial Septal Defect","authors":"Nisa Nadhira Mohd Nazi, R. Shariff, Mohd Rahal Yusoff, Khairul Shafiq Ibrahim, S. Kasim","doi":"10.15420/japsc.2023.53","DOIUrl":"https://doi.org/10.15420/japsc.2023.53","url":null,"abstract":"A 68-year-old woman presented with dyspnoea attributed to acute pulmonary oedema. Due to an audible diastolic murmur, a transthoracic and transoesophageal echocardiogram (TEE) was performed revealing severe rheumatic mitral stenosis and regurgitation. Although initial assessment of the interatrial septum did not reveal any atrial septal defects, upon TEE evaluation using a 112° window, an interatrial defect was seen, with turbulent flow seen through this. However, using multiplanar imaging, a separate elongated Eustachian valve was shown to be mimicking an ‘arm’ of the interatrial septum and giving rise to the illusion of a defect. The Eustachian valve is a congenital remnant which often regresses at birth but can exist as an elongated structure originating from the inferior portion of the right atrium and may appear as an atrial septal defect. By employing multiplanar imaging on TEE, we were able to systematically discern the reason behind the apparent defect and avoid further delays to the patient’s care.","PeriodicalId":499798,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"80 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141655324","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":"Erratum: Inhaled Nitric Oxide in Patients with Cardiogenic Shock Treated with Veno-arterial Extracorporeal Membrane Oxygenation and Impella","authors":"Y. Ikeda, K. Maemura, Yuki Takigami, Y. Eda, T. Oki, Mayu Yazaki, Teppei Fujita, Yuichiro Iida, Nobuhiro Sato, Shunsuke Ishii","doi":"10.15420/japsc.2024.co1","DOIUrl":"https://doi.org/10.15420/japsc.2024.co1","url":null,"abstract":"","PeriodicalId":499798,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"41 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141663600","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":"Lambda-like ST-elevation in Acute MI: A Risk Predictor of Fatal Ventricular Arrhythmia","authors":"Heng Shee Kim, Hou Tee Lu","doi":"10.15420/japsc.2023.66","DOIUrl":"https://doi.org/10.15420/japsc.2023.66","url":null,"abstract":"Despite the increasing use of reperfusion strategies and guideline-directed medical therapy, acute MI remains a leading cause of mortality. Certain ECG abnormalities are associated with lethal ventricular arrhythmia and significant in-hospital mortality during acute MI. This report presents a case of fatal ventricular arrhythmia in a patient with acute MI, highlighting a specific ECG finding – lambda-like ST-elevation. Lambda-like ST-elevation on the ECG in acute MI may serve as a critical indicator for clinicians, predicting the risk of fatal ventricular arrhythmias, cardiogenic shock and sudden cardiac death. Early recognition and aggressive intervention strategies could significantly reduce morbidity and mortality.","PeriodicalId":499798,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"182 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141681773","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 Feasibility, Safety and Middle Term Clinical Outcome Study of Chronic Total Occlusion Percutaneous Coronary Intervention among Elderly Aged <75 Years versus ≥75 Years in a High Intravascular Imaging Usage Centre","authors":"Heng Shee Kim, Shinji Imura, Motosu Ando, M. Tsukiji, Yasuhiro Tarutani, Yuuki Nakanishi, F. Hosaka","doi":"10.15420/japsc.2023.65","DOIUrl":"https://doi.org/10.15420/japsc.2023.65","url":null,"abstract":"Background: Chronic total occlusion (CTO) is common among elderly patients, yet data on their outcomes with CTO percutaneous coronary intervention (PCI) remain limited. Understanding the feasibility, safety and clinical outcomes of CTO-PCI in this population is crucial for optimal care. The present study aimed to evaluate these aspects in elderly patients aged <75 versus ≥75 years. Methods: Two hundred and fifty-eight patients who underwent CTO-PCI at a single Japanese centre, categorised into two groups: <75 and ≥75 years old, were retrospectively analysed. Demographics, clinical factors, angiography and procedure data were collected. Follow-up data were obtained from electronic health records. The primary outcome measure was target lesion failure (TLF) at 1-year follow-up. Kaplan-Meier curve analysis and multivariable Cox-regression analysis were performed to identify predictors of TLF. Results: 68.6% were <75 years old and 31.4% were ≥75 years old. Similar procedural success rates were observed. There were no significant differences in 1-year TLF, death, non-fatal MI or target-lesion revascularisation. The older group had a higher rate of intraprocedural complications. Mechanical circulatory support and emergency PCI negatively impacted target-lesion revascularisation-free survival in older patients, while hypertension appeared protective. Conclusion: The present study demonstrates the feasibility, safety and good mid-term outcomes of CTO-PCI in elderly patients. These findings suggest its potential as a treatment option for appropriate elderly patients. Additionally, possible risk factors for adverse events were identified, potentially guiding future management strategies. Therefore, elderly patients with CTO should not be deprived of invasive PCI strategies when appropriate.","PeriodicalId":499798,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":" 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141681214","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":"Cracking the Code of Coronary Calcium: One-year Clinical Outcomes of Intravascular Lithotripsy in All-comers and Two Complex Cohorts","authors":"Jie Jun Wong, Y. S. Keh, Y. Lau, P. Tern, Abigail CC. Chng, Simon Jung Hyun Kang, N. Wong, J. Yap, T. Yong, J. Fam, Chee Tang Chin, Y. S. Goh, Soo Teik Lim, Aaron Sung Lung Wong, K. Yeo","doi":"10.15420/japsc.2023.43","DOIUrl":"https://doi.org/10.15420/japsc.2023.43","url":null,"abstract":"Background: Severe coronary calcifications are commonly encountered in real-world populations and in left main (LM) disease, heightening complication risks including stent underexpansion. Although intravascular lithotripsy (IVL) appears safe, longer-term data in high-risk populations are lacking. The aim of this study was therefore to examine 1-year IVL outcomes for severely calcified lesions in two complex cohorts: LM stenosis and underexpanded stents (UES) during stent implantation. Methods: A registry study was carried out to examine major adverse cardiovascular events (MACEs) (MI, target vessel revascularisation [TVR], cardiac mortality). The LM and UES subgroups were compared with their counterparts in the non-LM and de novo lesion subgroups, respectively. Results: The study involved 102 participants (median age, 70 years, 68% male), and the cardiovascular burden was high (diabetes, 72%; dialysis, 18%; prior MI, 43%, median left ventricular ejection fraction, 45%). Many participants presented acutely (acute coronary syndrome, 36%; decompensated heart failure, 13%) and had complex anatomies (triple-vessel disease, 77%). The cardiovascular burden was higher in the LM and UES subgroups than in the non-LM and de novo lesion subgroups, but the rates of procedural complications and 30-day MACEs were low and were not significantly different. The 1-year MACE rate was higher in the LM group than in non-LM (29% versus 10%, p=0.042), but was non-significant after adjusting for baseline variables (OR 3.08; 95% CI [0.87–10.9]); the rates of 1-year MI, TVR and mortality did not differ from non-LM. In the UES group, 1-year MACE rate (17% versus 13%, p=0.500) was similar to that for de novo lesions. Conclusion: The preliminary data suggest that the use of IVL is reasonable when encountering stent underexpansion due to severe coronary calcifications during stent implantation. The 1-year MACE rate was higher in calcific LM stenosis, probably due to greater comorbidity burden and acute presentations.","PeriodicalId":499798,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"25 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141683416","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 Future of Digital Healthcare in Cardiac Prevention Programme in Indonesia: From Bedside to Boardroom","authors":"B. Dwiputra, A. M. Ambari, D. R. Desandri, Serlie Fatrin, Naufal Zuhdi, B. Radi","doi":"10.15420/japsc.2023.46","DOIUrl":"https://doi.org/10.15420/japsc.2023.46","url":null,"abstract":"Digital technology has become integral to the practice of medicine, especially in response to the COVID-19 pandemic and its associated lockdowns and social distancing measures. It has allowed patients, including those undergoing cardiac rehabilitation, to access healthcare services regardless of their geographical location. However, the widespread integration of digital healthcare on a national scale presents numerous challenges. These obstacles encompass various aspects, including patient–physician relationships, legal policies, health information system quality, data privacy, cost–benefit analysis and the potential loss of essential human interaction. To address these hurdles, Indonesia has developed a framework and strategy for implementing digital healthcare. This review examines the experiences of digital healthcare leaders in different countries, considering their unique healthcare systems, cultural contexts and approaches to tackling these issues. Additionally, an analysis of Indonesia’s current healthcare system implementation is provided. By showcasing successful examples and considering critical factors, we hope to facilitate a successful implementation of digital healthcare in cardiac prevention while gathering valuable insights from these endeavours.","PeriodicalId":499798,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"103 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141708861","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":"Cancer Screening in Patients with Heart Failure with Mildly Reduced and Reduced Ejection Fraction","authors":"Sean Tan, Grace JX Chung, J. Chan, S. Lockwood, R. Muthalaly, A. J. Nelson, N. Nerlekar, Eva Segelov, Stephen J. Nicholls, Esther Davis","doi":"10.15420/japsc.2023.57","DOIUrl":"https://doi.org/10.15420/japsc.2023.57","url":null,"abstract":"Background: Heart failure with mildly reduced and reduced ejection fraction are associated with incident cancer. However, cancer screening is not routinely discussed in this population. This study aimed to describe the uptake and perception of cancer screening among patients with heart failure attending a specialised heart failure clinic in Australia. Methods: A prospective survey of consecutive ambulatory patients attending the clinic from 2022–2023 was performed. Included patients were eligible for recommended breast, cervical and/or bowel cancer screening according to Australian guidelines, had an ejection fraction of <50% and no prior history of cancer. The primary endpoint was adherence to recommended cancer screening according to Australian guidelines. Perceptions towards cancer screening were also assessed and cancer screening rates were compared with those of the general Australian population. Results: Among the 200 included patients, there was low uptake of recommended breast, bowel and cervical cancer screening despite the availability of free national cancer screening programmes. Cancer screening rates among heart failure patients were lower than observed in the general Australian population. Patients were unaware of the association between cancer and heart failure and expressed interest in cancer screening participation. Conclusion: Future efforts should be targeted at improving education on cancer screening among patients and cardiovascular healthcare providers to improve overall health outcomes in heart failure.","PeriodicalId":499798,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"4 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698293","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":"Molecular Mechanisms of the Failing Heart: A Fatal Regression?","authors":"Manami Katoh, Jin Komuro, Shunsuke Inoue, Yukiteru Nakayama, I. Komuro","doi":"10.15420/japsc.2024.07","DOIUrl":"https://doi.org/10.15420/japsc.2024.07","url":null,"abstract":"Heart failure (HF) is one of the most common causes of death, and the number of HF patients is increasing worldwide due to population ageing. The pathogenesis of HF has been extensively studied by many researchers with a focus on cardiomyocytes, but its complex pathophysiology has yet to be elucidated. Non-cardiomyocytes account for >70% of the cells that comprise the heart, and there is close communication between non-cardiomyocytes and cardiomyocytes, suggesting that non-cardiomyocytes might play a pivotal role in the development of HF. Neurohumoral factors, such as the autonomic nerves and hormones, regulate the heart’s function. Conversely, the heart affects many other organs through blood perfusion, underscoring the importance of interorgan communication. This review discusses the role of non-cardiomyocytes and interorgan communication between the heart and other organs in the development of HF, a topic that has not been extensively explored.","PeriodicalId":499798,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"39 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141347209","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":"Detection and Stabilisation of Vulnerable Plaques in the Coronary Arteries","authors":"G. Bikbaeva, Anna Kovalskaya, Alexander Rodin, T. Pavlova, D. Duplyakov","doi":"10.15420/japsc.2023.35","DOIUrl":"https://doi.org/10.15420/japsc.2023.35","url":null,"abstract":"Vulnerable atherosclerotic plaques (AP) can be assessed by coronary artery imaging techniques. Intravascular ultrasound allows real-time assessment of the longitudinal and transverse dimensions of the vessel, the severity of its remodelling, and the size and structure of the AP. The resolution of optical coherent tomography makes it possible to accurately identify vulnerable APs according to the following characteristic parameters: a large necrotic nucleus, a thin fibrous capsule, neoangiogenesis and inflammatory changes in the AP cap. Percent atheroma volume, total atheroma volume, maximum lipid core burden index within 4 mm, minimal fibrous cap thickness, maximum lipid arc, lipid length and macrophage grade are the main characteristics of vulnerable AP. Lipid-lowering therapy (LLT) has a stabilising effect on AP. Databases searched were PubMed and Web of Science up to April 2023. In total, eight relevant articles (original clinical studies) were selected. In the ODISSEY J-IVUS study, there was a decrease of total AP volume by 3.1% in the monotherapy group and 4.8% in the combined LLT group (p=0.23). In the GLAGOV trial, atheroma volume decreased by 0.9 mm3 in the placebo group and 5.8 mm3 in the evolocumab group (p<0.001). Plaque regression was observed in 64.3% of patients in the evolocumab group and 47.3% in the placebo group. The dynamics of the minimum thickness of the fibrous cap varied within 18.0–62.67 µm on combined LLT and 13.2–33.19 µm on monotherapy (PACMAN-AMI). Regression of the lipid arc was also observed in the HUYGENS study. The development of cardiovascular imaging has made it possible to expand understanding of the morphology of vulnerable AP.","PeriodicalId":499798,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"43 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141381918","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}