Eurointervention最新文献

{"title":"Severe aortic regurgitation: the limits of TAVI.","authors":"Victoria Delgado, Elena Díaz Peláez","doi":"10.4244/EIJ-E-24-00045","DOIUrl":"10.4244/EIJ-E-24-00045","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 17","pages":"e1051-e1052"},"PeriodicalIF":7.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11352525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous transvalvular microaxial flow pump is underused in infarct-related cardiogenic shock: pros and cons.","authors":"Thomas Engstrøm, Jasmine Melissa Madsen, Holger Thiele, Uwe Zeymer","doi":"10.4244/EIJ-E-24-00033","DOIUrl":"10.4244/EIJ-E-24-00033","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 17","pages":"e1059-e1061"},"PeriodicalIF":7.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11352518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic regurgitation: from mechanisms to management.","authors":"Andreas Baumbach, Kush P Patel, Tanja K Rudolph, Victoria Delgado, Hendrik Treede, Alexander R Tamm","doi":"10.4244/EIJ-D-23-00840","DOIUrl":"10.4244/EIJ-D-23-00840","url":null,"abstract":"<p><p>Aortic regurgitation (AR) is a common clinical disease associated with significant morbidity and mortality. Investigations based largely on non-invasive imaging are pivotal in discerning the severity of disease and its impact on the heart. Advances in technology have contributed to improved risk stratification and to our understanding of the pathophysiology of AR. Surgical aortic valve replacement is the predominant treatment. However, its use is limited to patients with an acceptable surgical risk profile. Transcatheter aortic valve implantation is an alternative treatment. However, this therapy remains in its infancy, and further data and experience are required. This review article on AR describes its prevalence, mechanisms, diagnosis and treatment.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 17","pages":"e1062-e1075"},"PeriodicalIF":7.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11352546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of transcatheter aortic valve implantation for native aortic valve regurgitation.","authors":"Robin Le Ruz, Lionel Leroux, Thibault Lhermusier, Thomas Cuisset, Eric Van Belle, Alain Dibie, Vincenzo Palermo, Didier Champagnac, Jean-François Obadia, Emmanuel Teiger, Patrick Ohlman, Didier Tchétché, Hervé Le Breton, Christophe Saint-Etienne, Pierre-Guillaume Piriou, Julien Plessis, Sylvain Beurtheret, Florence Du Chayla, Manon Leclère, Thierry Lefèvre, Jean-Philippe Collet, Hélène Eltchaninoff, Martine Gilard, Bernard Iung, Thibaut Manigold, Vincent Letocart, On Behalf Of Stop-As And France-Tavi Investigators","doi":"10.4244/EIJ-D-24-00339","DOIUrl":"10.4244/EIJ-D-24-00339","url":null,"abstract":"<p><strong>Background: </strong>Large datasets of transcatheter aortic valve implantation (TAVI) for pure aortic valve regurgitation (PAVR) are scarce.</p><p><strong>Aims: </strong>We aimed to report procedural safety and long-term clinical events (CE) in a contemporary cohort of PAVR patients treated with new-generation devices (NGD).</p><p><strong>Methods: </strong>Patients with grade III/IV PAVR enrolled in the FRANCE-TAVI Registry were selected. The primary safety endpoint was technical success (TS) according to Valve Academic Research Consortium 3 criteria. The co-primary endpoint was defined as a composite of mortality, heart failure hospitalisation and valve reintervention at last follow-up.</p><p><strong>Results: </strong>From 2015 to 2021, 227 individuals (64.3% males, median age 81.0 [interquartile range {IQR} 73.5-85.0] years, with EuroSCORE II 6.0% [IQR 4.0-10.9]) from 41 centres underwent TAVI with NGD, using either self-expanding (55.1%) or balloon-expandable valves (44.9%; p=0.50). TS was 85.5%, with a non-significant trend towards increased TS in high-volume activity centres. A second valve implantation (SVI) was needed in 8.8% of patients, independent of valve type (p=0.82). Device size was ≥29 mm in 73.0% of patients, post-procedure grade ≥III residual aortic regurgitation was rare (1.2%), and the permanent pacemaker implantation (PPI) rate was 36.0%. At 30 days, the incidences of mortality and reintervention were 8.4% and 3.5%, respectively. The co-primary endpoint reached 41.6% (IQR 34.4-49.6) at 1 year, increased up to 61.8% (IQR 52.4-71.2) at 4 years, and was independently predicted by TS, with a hazard ratio of 0.45 (95% confidence interval: 0.27-0.76); p=0.003.</p><p><strong>Conclusions: </strong>TAVI with NGD in PAVR patients is efficient and reasonably safe. Preventing the need for an SVI embodies the major technical challenge. Larger implanted valves may have limited this complication, outweighing the increased risk of PPI. Despite successful TAVI, PAVR patients experience frequent CE at long-term follow-up.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 17","pages":"e1076-e1085"},"PeriodicalIF":7.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optical frequency domain imaging-guided versus intravascular ultrasound-guided percutaneous coronary intervention for acute coronary syndromes: the OPINION ACS randomised trial.","authors":"Hiromasa Otake, Takashi Kubo, Kiyoshi Hibi, Makoto Natsumeda, Masaru Ishida, Toru Kataoka, Tomofumi Takaya, Masamichi Iwasaki, Shinjo Sonoda, Toshiro Shinke, Gaku Nakazawa, Yu Takahashi, Tetsuya Ioji, Takashi Akasaka, Opinion Acs Investigators","doi":"10.4244/EIJ-D-24-00314","DOIUrl":"10.4244/EIJ-D-24-00314","url":null,"abstract":"<p><strong>Background: </strong>The clinical benefits of optical frequency domain imaging (OFDI)-guided percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) remain unclear.</p><p><strong>Aims: </strong>We sought to compare intravascular ultrasound (IVUS)- and OFDI-guided PCI in patients with ACS.</p><p><strong>Methods: </strong>OPINION ACS is a multicentre, prospective, randomised, non-inferiority trial that compared OFDI-guided PCI with IVUS-guided PCI using current-generation drug-eluting stents in ACS patients (n=158). The primary endpoint was in-stent minimum lumen area (MLA), assessed using 8-month follow-up OFDI.</p><p><strong>Results: </strong>Patients presented with ST-segment elevation myocardial infarction (55%), non-ST-segment elevation myocardial infarction (29%), or unstable angina pectoris (16%). PCI procedural success was achieved in all patients, with comparably low periprocedural complications rates in both groups. Immediately after PCI, the minimum stent area (p=0.096) tended to be smaller for OFDI versus IVUS guidance. Proximal stent edge dissection (p=0.012) and irregular protrusion (p=0.03) were significantly less frequent in OFDI-guided procedures than in IVUS-guided procedures. Post-PCI coronary flow, assessed using corrected Thrombolysis in Myocardial Infarction frame counts, was significantly better in the OFDI-guided group than in the IVUS-guided group (p<0.001). The least squares mean (95% confidence interval [CI]) in-stent MLA at 8 months was 4.91 (95% CI: 4.53-5.30) mm² and 4.76 (95% CI: 4.35-5.17) mm² in the OFDI- and IVUS-guided groups, respectively, demonstrating the non-inferiority of OFDI guidance (pnon-inferiority<0.001). The average neointima area tended to be smaller in the OFDI-guided group. The frequency of major adverse cardiac events was similar.</p><p><strong>Conclusions: </strong>Among ACS patients, OFDI-guided PCI and IVUS-guided PCI were equally safe and feasible, with comparable in-stent MLA at 8 months. OFDI guidance may be a potential option in ACS patients. This study was registered in the Japan Registry of Clinical Trials (jrct.niph.go.jp: jRCTs052190093).</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 17","pages":"e1086-e1097"},"PeriodicalIF":7.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11352543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new resorbable magnesium scaffold (DREAMS 3G): 12-month vasomotion results from the BIOMAG-I first-in-human study.","authors":"Michael Haude, Juan F Iglesias, Hector M Garcia-Garcia, Dimitrios Barlagiannis, Sophie Degrauwe, Gebremedhin Melaku, Solomon Beyene, Ron Waksman","doi":"10.4244/EIJ-D-24-00355","DOIUrl":"10.4244/EIJ-D-24-00355","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 17","pages":"e1118-e1120"},"PeriodicalIF":7.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11352512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stent sizing in imaging-guided percutaneous coronary intervention: potential benefits of a more cautious approach.","authors":"Tom Adriaenssens, Peter Sinnaeve","doi":"10.4244/EIJ-E-24-00049","DOIUrl":"10.4244/EIJ-E-24-00049","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 17","pages":"e1053-e1055"},"PeriodicalIF":7.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11352536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal trends and outcomes of acute ischaemic strokes in patients hospitalised for percutaneous coronary intervention.","authors":"Benjamin Bay, Alina Goßling, Marko Remmel, Peter M Becher, Benedikt Schrage, David L Rimmele, Götz Thomalla, Stefan Blankenberg, Peter Clemmensen, Fabian J Brunner, Christoph Waldeyer","doi":"10.4244/EIJ-D-24-00189","DOIUrl":"10.4244/EIJ-D-24-00189","url":null,"abstract":"<p><strong>Background: </strong>Acute ischaemic stroke (AIS) after percutaneous coronary intervention (PCI) is a rare, but debilitating, complication. However, contemporary data from real-world unselected patients are scarce.</p><p><strong>Aims: </strong>We aimed to explore the temporal trends, outcomes and variables associated with AIS as well as in-hospital all-cause mortality in a nationwide cohort.</p><p><strong>Methods: </strong>A retrospective analysis of healthcare records from 2006-2021 was implemented. Patients were stratified according to the occurrence of AIS in the setting of PCI. The temporal trends of AIS were analysed. A stepwise regression model was used to identify variables associated with AIS and in-hospital all-cause mortality.</p><p><strong>Results: </strong>A total of 4,910,430 PCIs were included for the current analysis. AIS occurred in 4,098 cases (0.08%). An incremental increase in the incidence of AIS after PCI from 0.03% to 0.14% per year was observed from 2006-2021. The strongest associations with AIS after PCI included carotid artery disease, medical history of stroke, atrial fibrillation, presentation with an ST-segment elevation myocardial infarction (STEMI) or non-STEMI and coronary thrombectomy. For patients with AIS, a higher in-hospital all-cause mortality (18.11% vs 3.29%; p<0.001) was documented. With regard to all-cause mortality, the strongest correlations in the stroke cohort were found for cardiogenic shock, dialysis and clinical presentation with a STEMI.</p><p><strong>Conclusions: </strong>In an unselected nationwide cohort of patients hospitalised for PCI, a gradual increase in AIS incidence was noted. We identified several variables associated with AIS as well as with in-hospital mortality. Hereby, clinicians might identify the patient population at risk for a peri-interventional AIS as well as those at risk for an adverse in-hospital outcome after PCI.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 17","pages":"e1098-e1106"},"PeriodicalIF":7.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11352535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterisation and distribution of human coronary artery innervation.","authors":"Mert Tokcan, Jan Federspiel, Lucas Lauder, Mathias Hohl, Hussam Al Ghorani, Saarraaken Kulenthiran, Stephanie Bettink, Michael Böhm, Bruno Scheller, Thomas Tschernig, Felix Mahfoud","doi":"10.4244/EIJ-D-24-00167","DOIUrl":"10.4244/EIJ-D-24-00167","url":null,"abstract":"<p><strong>Background: </strong>A detailed understanding of the sympathetic innervation of coronary arteries is relevant to facilitate the development of novel treatment approaches.</p><p><strong>Aims: </strong>This study aimed to quantitatively examine periarterial innervation in human epicardial coronary arteries.</p><p><strong>Methods: </strong>Coronary arteries with adjacent epicardial adipose tissue were excised along the left main coronary artery (LMCA), left anterior descending artery (LAD), left circumflex artery (LCx), and right coronary artery (RCA) from 28 body donors and examined histologically. Immunofluorescence staining was performed to characterise sympathetic nerve fibres.</p><p><strong>Results: </strong>A total of 42,573 nerve fibres surrounding 100 coronary arteries (LMCA: n=21, LAD: n=27, LCx: n=26, RCA: n=26) were analysed. The nerve fibre diameter decreased along the vessel course (median [interquartile range]): (proximal 46 μm [31-73], middle 38 μm [26-58], distal 31 μm [22-46]; p<0.001), with the largest nerve fibre diameter along the LMCA (50 μm [31-81]), followed by the LAD (42 μm [27-72]; p<0.001). The total nerve fibre density was highest along the RCA (123 nerves/cm² [82-194]). Circumferentially, nerve density was higher in the myocardial tissue area of the coronary arteries (132 nerves/cm² [76-225]) than in the epicardial tissue area (101 nerves/cm² [61-173]; p<0.001). The median lumen-nerve distance was smallest around the LMCA (2.2 mm [1.2-4.1]), followed by the LAD (2.5 mm [1.1-4.5]; p=0.005).</p><p><strong>Conclusions: </strong>Human coronary arteries are highly innervated with sympathetic nerve fibres, with significant variation in the distribution and density. Understanding these patterns informs pathophysiological understanding and, potentially, the development of catheter-based approaches for cardiac autonomic modulation.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 17","pages":"e1107-e1117"},"PeriodicalIF":7.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11352544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the heart - insights into human coronary artery innervation.","authors":"Michael Joner, Alicia Beele","doi":"10.4244/EIJ-E-24-00048","DOIUrl":"10.4244/EIJ-E-24-00048","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 17","pages":"e1056-e1058"},"PeriodicalIF":7.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11352538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}