Circulation Journal最新文献_第7页

Long-Term Outcomes in Patients With Chronic Total Occlusion and Left Ventricular Systolic Dysfunction　- A Single-Center Inverse Probability of Treatment Weighting Analysis. 慢性全闭塞和左心室收缩功能障碍患者的长期预后——单中心治疗加权逆概率分析。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-12-05 DOI: 10.1253/circj.CJ-24-0655

Yuchao Zhang, Zheng Wu, Ze Zheng, Shaoping Wang, Hongyu Peng, Jinghua Liu

{"title":"Long-Term Outcomes in Patients With Chronic Total Occlusion and Left Ventricular Systolic Dysfunction　- A Single-Center Inverse Probability of Treatment Weighting Analysis.","authors":"Yuchao Zhang, Zheng Wu, Ze Zheng, Shaoping Wang, Hongyu Peng, Jinghua Liu","doi":"10.1253/circj.CJ-24-0655","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0655","url":null,"abstract":"Background: The optimal treatment strategy for patients with coronary chronic total occlusion (CTO) and left ventricular systolic dysfunction (LVSD) remains unclear. This study investigated the long-term outcomes of percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), and medical therapy (MT) in this specific patient cohort.Methods and results: This retrospective cohort study included 987 consecutive patients with CTO and LVSD who met the inclusion criteria and underwent either CTO-PCI (n=277), CTO-CABG (n=222), or CTO-MT (n=488) between 2014 and 2020. The primary outcome was all-cause mortality during follow-up. Secondary endpoints were major adverse cardiac and cerebrovascular events (MACCE) and their components, including cardiovascular mortality, myocardial infarction (MI), stroke, unplanned revascularization, and hospitalization for heart failure. During a median follow-up of 5.3 years, 232 (23.51%) patients died from any cause. In the unadjusted analysis, CTO-MT was associated with worse long-term survival prospects. After inverse probability of treatment weighting and variable adjustment, CTO-PCI and CTO-CABG demonstrated significant reductions in the long-term risks of all-cause and cardiovascular mortality. Notably, CTO-CABG was associated with the lowest long-term risks of MACCE, MI, unplanned revascularization, and hospitalization for heart failure.Conclusions: For patients with CTO and LVSD, successful CTO revascularization significantly improved long-term survival compared with CTO-MT. CTO-CABG can be regarded as the optimal treatment modality for better long-term prognosis.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Towards Metaclinical Medicine　- The Non-Human Physician as Our Destiny. 走向元临床医学——非人类医生是我们的命运。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-12-04 DOI: 10.1253/circj.CJ-24-0760

Panagiotis E Vardas, Anastasia Xintarakou, Emmanouil P Vardas, Stylianos Tzeis

{"title":"Towards Metaclinical Medicine　- The Non-Human Physician as Our Destiny.","authors":"Panagiotis E Vardas, Anastasia Xintarakou, Emmanouil P Vardas, Stylianos Tzeis","doi":"10.1253/circj.CJ-24-0760","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0760","url":null,"abstract":"Medicine, and human healing more generally, have been constantly evolving for millennia as part of humanity's persistent efforts to heal its injuries and diseases, to maintain wellbeing, and to delay the inevitable: death. The philosophy underlying medicine has always been closely intertwined with the prevailing ideas in each historical period. Prejudices, religious beliefs, even magical herbs, as well as rational thought and advanced sciences, make up the fabric of over 2,000 years of western medicine. Hippocrates (460-377 BC), a physician from ancient Greece, is considered the father of western medicine. Almost 2,000 years later, Andreas Vesalius (1514-1564), by being the first to explore anatomical dissections of humans, significantly challenged the views of Galen, thus ushering in modern medicine, which, by the mid-19th century, had evolved into clinical medicine, a holistic approach that remains relevant today. The rapid advances in artificial intelligence, and more broadly in digital health, are shifting clinical medicine towards a new perspective, that of metaclinical medicine, where human doctors will need to work closely with non-human physicians, delegating a significant part of their traditional role in diagnosis and treatment. This article outlines the existing realities regarding the role of artificial intelligence in diagnosing various diseases, and speculates on the collaboration between human and non-human physicians in the metaclinical era.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnostic Performance of Artificial Intelligence-Based Angiography-Derived Non-Hyperemic Pressure Ratio Using Pressure Wire as Reference. 以压力丝为参考的人工智能血管造影非充血压比诊断性能

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-12-04 DOI: 10.1253/circj.CJ-24-0593

Hiroyuki Omori, Yoshiaki Kawase, Takuya Mizukami, Toru Tanigaki, Tetsuo Hirata, Munenori Okubo, Hiroki Kamiya, Masanori Kawasaki, Takeshi Kondo, Takahiko Suzuki, Hitoshi Matsuo

{"title":"Diagnostic Performance of Artificial Intelligence-Based Angiography-Derived Non-Hyperemic Pressure Ratio Using Pressure Wire as Reference.","authors":"Hiroyuki Omori, Yoshiaki Kawase, Takuya Mizukami, Toru Tanigaki, Tetsuo Hirata, Munenori Okubo, Hiroki Kamiya, Masanori Kawasaki, Takeshi Kondo, Takahiko Suzuki, Hitoshi Matsuo","doi":"10.1253/circj.CJ-24-0593","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0593","url":null,"abstract":"Background: The angiography-derived non-hyperemic pressure ratio (angioNHPR) is a novel index of NHPR based on artificial intelligence (AI) that does not require pressure wires. We investigated the diagnostic accuracy of angioNHPR for detecting hemodynamically relevant coronary artery disease.Methods and results: In this retrospective single-center study, angioNHPR was assessed using the invasive NHPR as the reference standard. An angioNHPR ≤0.89 was defined as indicative of physiologically significant stenosis. Two angiographic projections ≥30° difference in angulation were selected. The lumen and centerline were automatically segmented by the prototype software, allowing for the calculation of the angioNHPR. We assessed 222 vessels from 178 patients. The accuracy of angioNHPR was 76.6% (95% confidence interval [CI] 70.4-82.0), with sensitivity 66.2% (95% CI 54.0-77.0), specificity 81.5% (95% CI 74.3-87.3), positive predictive value 62.7% (95% CI 53.6-70.9), and negative predictive value 83.7% (95% CI 78.6-87.7). The angioNHPR showed good correlation with invasive NHPR (r=0.72; 95% CI 0.64-0.77; P<0.001), and the agreement between angioNHPR and invasive NHPR was -0.01 (limits of agreement: -0.13, 0.11). The area under the curve (AUC) of angioNHPR was 0.81 (95% CI 0.75-0.86), which was significantly higher than that of 2-dimensional quantitative coronary angiography (AUC 0.69; 95% CI 0.62-0.75; P=0.007).Conclusions: AI-based angioNHPR demonstrates good diagnostic performance using invasive NHPR as the reference standard.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predicting Short-Term Mortality in Patients With Acute Pulmonary Embolism With Deep Learning. 用深度学习预测急性肺栓塞患者的短期死亡率。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-11-30 DOI: 10.1253/circj.CJ-24-0630

Vedat Cicek, Ahmet Lutfullah Orhan, Faysal Saylik, Vanshali Sharma, Yalcin Tur, Almina Erdem, Mert Babaoglu, Omer Ayten, Solen Taslicukur, Ahmet Oz, Mehmet Uzun, Nurgul Keser, Mert Ilker Hayiroglu, Tufan Cinar, Ulas Bagci

{"title":"Predicting Short-Term Mortality in Patients With Acute Pulmonary Embolism With Deep Learning.","authors":"Vedat Cicek, Ahmet Lutfullah Orhan, Faysal Saylik, Vanshali Sharma, Yalcin Tur, Almina Erdem, Mert Babaoglu, Omer Ayten, Solen Taslicukur, Ahmet Oz, Mehmet Uzun, Nurgul Keser, Mert Ilker Hayiroglu, Tufan Cinar, Ulas Bagci","doi":"10.1253/circj.CJ-24-0630","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0630","url":null,"abstract":"Background: Accurate prediction of short-term mortality in patients with acute pulmonary embolism (PE) is critical for optimizing treatment strategies and improving patient outcomes. The Pulmonary Embolism Severity Index (PESI) is the current reference score used for this purpose, but it has limitations regarding predictive accuracy. Our aim was to develop a new short-term mortality prediction model for PE patients based on deep learning (DL) with multimodal data, including imaging and clinical/demographic data.Methods and results: We developed a novel multimodal deep learning (mmDL) model using contrast-enhanced multidetector computed tomography scans combined with clinical and demographic data to predict short-term mortality in patients with acute PE. We benchmarked various machine learning architectures, including XGBoost, convolutional neural networks (CNNs), and Transformers. Our cohort included 207 acute PE patients, of whom 53 died during their hospital stay. The mmDL model achieved an area under the receiver operating characteristic curve (AUC) of 0.98 (P<0.001), significantly outperforming the PESI score, which had an AUC of 0.86 (P<0.001). Statistical analysis confirmed that the mmDL model was superior to PESI in predicting short-term mortality (P<0.001).Conclusions: Our proposed mmDL model predicts short-term mortality in patients with acute PE with high accuracy and significantly outperforms the current standard PESI score.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early Outcomes Following Transcatheter Closure With the Amplatzer Vascular Plug and Duct Occluder for Mitral Paravalvular Leak in Japanese Patients. 日本患者使用 Amplatzer 血管堵塞器和管道闭塞器经导管封堵二尖瓣口腔旁漏后的早期疗效。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-11-28 DOI: 10.1253/circj.CJ-24-0544

Hiroki Niikura, Kenji Makino, Norihiro Kogame, Go Hashimoto, Yoshiyuki Yazaki, Hidehiko Hara

{"title":"Early Outcomes Following Transcatheter Closure With the Amplatzer Vascular Plug and Duct Occluder for Mitral Paravalvular Leak in Japanese Patients.","authors":"Hiroki Niikura, Kenji Makino, Norihiro Kogame, Go Hashimoto, Yoshiyuki Yazaki, Hidehiko Hara","doi":"10.1253/circj.CJ-24-0544","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0544","url":null,"abstract":"Background: Transcatheter closure of paravalvular leak (PVL) has become an established treatment for patients at prohibitive surgical risk. However, few studies have examined the feasibility of transcatheter closure using Amplatzer occluders in Japanese patients with mitral PVL.Methods and results: Twelve patients (mean [±SD] age 78±7 years) with heart failure, hemolytic anemia, or both after surgical mitral prosthetic valve replacement (mechanical valve, 75%) underwent transcatheter PVL closure with Amplatzer Vascular Plug II (AVP-II)/Amplatzer Duct Occluder II (ADO-II) between 2014 and 2021 at Toho University Ohashi Medical Center. We examined procedural, in-hospital, 30-day, and 1-year outcomes. All procedures were performed under general anesthesia using an antegrade transseptal approach, and the procedures were successful in all cases. The mean (±SD) number of Amplatzer occluders deployment per patient was 2.9±1.1, and in 2 patients the combined use of ADO-II was required. The mitral PVL grade decreased notably from 3+ to 1+, with residual PVL being mild or absent in 9 patients. There were no all-cause mortalities, major adverse events, or device-related complications at the 30-day follow-up. At 1 year, all-cause mortality was 16.7% and 3 (25%) patients required reintervention because of the recurrence of clinical symptoms.Conclusions: Our findings suggest that transcatheter PVL closure with AVP-II/ADO-II can be feasible and safe in Japanese patients with mitral PVL, leading to satisfactory early clinical outcomes.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prognostic Value of Endogenous-Type Coronary Microvascular Dysfunction After Elective Percutaneous Coronary Intervention. 择期经皮冠状动脉介入治疗后内源性冠状动脉微血管功能障碍的预后价值

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-11-27 DOI: 10.1253/circj.CJ-24-0482

Kai Nogami, Yoshihisa Kanaji, Eisuke Usui, Masahiro Hada, Tatsuhiro Nagamine, Hiroki Ueno, Mirei Setoguchi, Kodai Sayama, Tomohiro Tahara, Takashi Mineo, Tsunekazu Kakuta

{"title":"Prognostic Value of Endogenous-Type Coronary Microvascular Dysfunction After Elective Percutaneous Coronary Intervention.","authors":"Kai Nogami, Yoshihisa Kanaji, Eisuke Usui, Masahiro Hada, Tatsuhiro Nagamine, Hiroki Ueno, Mirei Setoguchi, Kodai Sayama, Tomohiro Tahara, Takashi Mineo, Tsunekazu Kakuta","doi":"10.1253/circj.CJ-24-0482","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0482","url":null,"abstract":"Background: Global coronary flow reserve (G-CFR) impairment represents coronary microvascular dysfunction (CMD) and correlates with poor prognosis. Hyperemic coronary flow is reduced in conventional CMD, but normal or mildly reduced with elevated resting flow in endogenous-type CMD (E-CMD). This retrospective study assessed the prognostic value of post-percutaneous coronary intervention (PCI) CMD, focusing on E-CMD.Methods and results: We included 320 chronic coronary syndrome (CCS) patients undergoing PCI and post-PCI phase contrast cine-cardiac magnetic resonance imaging (CMR). Major adverse cardiac and cerebrovascular events (MACCE) were evaluated, considering the presence of post-PCI CMD and E-CMD based on G-CFR and resting myocardial flow assessed by coronary sinus flow using CMR. CMD was defined as G-CFR <2.0 and classified as E-CMD or non-E-CMD. Post-PCI CMD was observed in 43.4% of patients, 63.3% exhibiting E-CMD. During a median 2.5-year follow-up, MACCE occurred in 26 (8.1%) patients, more often in those with CMD (11.5% vs. 5.5%; P=0.063). MACCE incidence was higher in E-CMD than non-E-CMD and non-CMD (14.8% vs. 5.9% and 5.5%, respectively; P=0.027). Kaplan-Meier analysis revealed worse prognosis in E-CMD (P=0.025). Cox proportional hazards modeling revealed that E-CMD independently predicted MACCE (hazard ratio 3.24; 95% confidence interval 1.47-7.14; P=0.004).Conclusions: Post-PCI CMD, particularly E-CMD, was significantly associated with worse outcomes in CCS patients. Post-PCI CMD evaluation could guide therapeutic strategies for CCS patients.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Importance of Left Ventricular End-Systolic Diameter for Aortic Valve Replacement in Japanese Asymptomatic Patients With Chronic Severe Aortic Regurgitation. 日本慢性严重主动脉瓣反流无症状患者左心室收缩末期直径对主动脉瓣置换术的重要性

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-11-25 Epub Date: 2024-05-31 DOI: 10.1253/circj.CJ-24-0342

Kazuki Hisatomi, Takashi Miura

引用次数: 0

Sex-Specific Left Ventricular and Aorta Size Cut-Off Values for Hemodynamically Significant Chronic Aortic Regurgitation　- Implications for Treatment in Asian Populations. 有血流动力学意义的慢性主动脉瓣反流的左心室和主动脉大小的性别特异性临界值--对亚洲人群治疗的意义。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-11-25 Epub Date: 2024-05-30 DOI: 10.1253/circj.CJ-24-0095

Kuan-Yu Lai, Masashi Amano, Yosuke Nabeshima, Chien-Chang Lee, Chin-Hua Su, Kang Liu, Tetsuji Kitano, Chih-Hsien Wang, Hsien-Li Kao, Yi-Lwun Ho, Maurice Enriquez-Sarano, Masaaki Takeuchi, Chisato Izumi, Li-Tan Yang

{"title":"Sex-Specific Left Ventricular and Aorta Size Cut-Off Values for Hemodynamically Significant Chronic Aortic Regurgitation　- Implications for Treatment in Asian Populations.","authors":"Kuan-Yu Lai, Masashi Amano, Yosuke Nabeshima, Chien-Chang Lee, Chin-Hua Su, Kang Liu, Tetsuji Kitano, Chih-Hsien Wang, Hsien-Li Kao, Yi-Lwun Ho, Maurice Enriquez-Sarano, Masaaki Takeuchi, Chisato Izumi, Li-Tan Yang","doi":"10.1253/circj.CJ-24-0095","DOIUrl":"10.1253/circj.CJ-24-0095","url":null,"abstract":"Background: There are no sex-specific guidelines for chronic aortic regurgitation (AR). This retrospective study examined sex-specific differences and propose treatment criteria from an Asian AR cohort.Methods and results: Consecutive 1,305 patients with moderate-severe AR or greater at 3 tertiary centers in Taiwan and Japan (2008-2022) were identified. Study endpoints were aortic valve surgery (AVS), all-cause death (ACD), and cardiovascular death (CVD). The median follow up was 3.9 years (interquartile range 1.3-7.1 years). Compared with men (n=968), women (n=337) were older, had more advanced symptoms, more comorbidities, larger indexed aorta size (iAortamax) and indexed left ventricular (LV) end-systolic dimension (LVESDi; P<0.001 for all). Symptomatic status was poorly correlated with the degree of LV remodeling in women (P≥0.18). Women received fewer AVS (P≤0.001) and men had better overall 10-year survival (P<0.01). Ten-year post-AVS survival (P=0.9) and the progression of LV remodeling were similar between sexes (P≥0.16). Multivariable determinants of ACD and CVD were age, advanced symptoms, iAortamax, LV ejection fraction (LVEF), LVESDi, LV end-systolic volume index (LVESVi), and Taiwanese ethnicity (all P<0.05), but not female sex (P≥0.05). AVS was associated with better survival (P<0.01). Adjusted LVEF, LVESDi, LVESVi, and iAortamaxcut-off values for ACD were 53%, 24.8 mm/m2, 44 mL/m2, and 25.5 mm/m2, respectively, in women and 52%, 23.4 mm/m2, 52 mL/m2, and 23.2 mm/m2, respectively, in men.Conclusions: Early detection and intervention using sex-specific cut-off values may improve survival in women with AR.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"2010-2020"},"PeriodicalIF":3.1,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment Strategy for Severe Aortic Stenosis With Moderate/Severe Mitral Regurgitation. 重度主动脉瓣狭窄伴中度/重度二尖瓣反流的治疗策略。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-11-25 Epub Date: 2024-07-05 DOI: 10.1253/circj.CJ-24-0413

Kazuo Shimamura, Shigeru Miyagawa

引用次数: 0

Mitral Valve Repair for Mitral Regurgitation in Patients With Marfan Syndrome. 二尖瓣修复术治疗马凡氏综合征患者的二尖瓣反流。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-11-25 Epub Date: 2024-08-24 DOI: 10.1253/circj.CJ-24-0291

Shun Tanaka, Shogo Shimada, Yangsin Lee, Hyoe Komae, Masahiko Ando, Haruo Yamauchi, Minoru Ono

{"title":"Mitral Valve Repair for Mitral Regurgitation in Patients With Marfan Syndrome.","authors":"Shun Tanaka, Shogo Shimada, Yangsin Lee, Hyoe Komae, Masahiko Ando, Haruo Yamauchi, Minoru Ono","doi":"10.1253/circj.CJ-24-0291","DOIUrl":"10.1253/circj.CJ-24-0291","url":null,"abstract":"Background: There is concern about the durability of mitral valve repair (MVr) for mitral regurgitation (MR) in Marfan patients due to limited long-term data. Furthermore, a detailed time course of changes in cardiac function after MVr in Marfan patients has not been reported. We examined repair techniques, postoperative cardiac function, and outcomes of MVr in Marfan patients.Methods and results: We retrospectively reviewed 29 Marfan patients (mean [±SD] age 27.4±14.8 years) who underwent MVr at The University of Tokyo Hospital from 2010 to 2022. The mean follow-up period was 5.2±3.2 years. The causes of MR were isolated anterior leaflet prolapse in 25% of patients, isolated posterior leaflet prolapse in 11%, and bileaflet prolapse in 64%. Echocardiographic findings showed significant decreases in left ventricular (LV) diastolic and left atrial diameters 1 week after MVr. LV systolic diameter was significantly decreased 3 years after MVr, and LV ejection fraction initially declined before subsequently increasing. The in-hospital and 30-day mortality rates were 0%. At 5 years, the overall survival rate was 94% and the rate of freedom from MR was 84%.Conclusions: The mid- to long-term outcomes after MVr in Marfan patients were satisfactory, supporting the durability of MVr in these patients. Postoperative cardiac reverse remodeling occurred in a phased manner in Marfan patients, similar to that in patients with degenerative MR.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1980-1985"},"PeriodicalIF":3.1,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0