American heart journal plus : cardiology research and practice最新文献

{"title":"Supersaturated oxygen therapy using radial artery access to prevent left ventricular remodeling after anterior ST-segment elevation myocardial infarction: a randomized, controlled trial","authors":"Francis R. Joshi ,&nbsp;Maria Petty ,&nbsp;Yen Wing Ng ,&nbsp;Hamish Elliott ,&nbsp;Ross Anderson ,&nbsp;Douglas Gordon ,&nbsp;Rebecca Hanna ,&nbsp;Robert Sykes ,&nbsp;Shaun Leonard ,&nbsp;Andrew Morrow ,&nbsp;Dylan Tan ,&nbsp;Anna Kamdar ,&nbsp;Ramu Perumal ,&nbsp;Jeffrey L. Creech ,&nbsp;Peter Kellman ,&nbsp;Paul Welsh ,&nbsp;Alex McConnachie ,&nbsp;Colin Berry","doi":"10.1016/j.ahjo.2025.100556","DOIUrl":"10.1016/j.ahjo.2025.100556","url":null,"abstract":"<div><h3>Background</h3><div>Novel strategies to limit the size of infarction and prevent adverse remodeling and heart failure in patients following acute ST-segment elevation myocardial infarction (STEMI) are lacking. Supersaturated oxygen (SSO₂) therapy is approved for patients presenting within 6 h of onset of anterior STEMI using femoral artery access. The feasibility of SSO₂ therapy via radial access is unknown. A more detailed understanding of the effect of therapy is needed.</div></div><div><h3>Objectives</h3><div>To assess the primary outcome, defined as the within-participant change in the plasma concentration of NT-proBNP measured at baseline, 24 h, 2–5 days and 3-months post-MI.</div></div><div><h3>Design</h3><div>Prospective, randomized, controlled, blinded, endpoint (mechanistic, PROBE) clinical trial.</div></div><div><h3>Randomized, controlled trial</h3><div>After primary PCI, eligible participants will be blinded and randomized 2:1 to either 1 h of SSO₂ therapy using radial artery access and intravenous glycoprotein IIbIIIa inhibitor therapy or a control (sham) procedure involving wrist manipulation in addition to standard care. The primary outcome is the within-participant change in the plasma concentration of NT-proBNP as detailed above. Secondary outcome assessments include coronary microcirculatory function, infarct size, microvascular obstruction, myocardial hemorrhage, left ventricular remodeling, myocardial blood flow, quality of life (EQ-5D-5L), Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Duke Activity Status Index. Patient reported experience measures (PREMS) are an exploratory outcome. Health and economic outcomes will be assessed using electronic healthcare records.</div></div><div><h3>Value</h3><div>The study will test the feasibility of radial artery access, provide mechanistic data and inform a larger multicenter trial powered to detect treatment effects on clinical endpoints.</div><div><span><span>Clinicaltrials.gov</span><svg><path></path></svg></span>: <span><span>NCT06662890</span><svg><path></path></svg></span></div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"55 ","pages":"Article 100556"},"PeriodicalIF":1.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178326","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":"Lactation safety of cardiovascular medications","authors":"Cristina Nunez-Pellot ,&nbsp;Allison Akers ,&nbsp;Sarah Običan ,&nbsp;Mary Ashley Cain ,&nbsp;Daniela R. Crousillat","doi":"10.1016/j.ahjo.2025.100552","DOIUrl":"10.1016/j.ahjo.2025.100552","url":null,"abstract":"<div><div>Breastfeeding is the gold standard for infant feeding with well-established maternal, neonatal, and pediatric benefits. Patients with preexisting cardiovascular disease have lower breastfeeding rates than the general population. While little evidence exists regarding specific barriers to lactation in patients with preexisting cardiovascular disease, concerns regarding lactation safety and medication exposure in mothers with cardiovascular disease may be a cause for early breastfeeding cessation despite known health benefits. This literature review highlights the lactation safety of common cardiac medications. While some common cardiac medications may have limited safety data available, general pharmacokinetic principles of drug secretion in lactation can help to guide shared decision making in discussion with the patient. Enhancing provider knowledge regarding cardiac medication safety during breastfeeding may improve lactation outcomes in this population.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"55 ","pages":"Article 100552"},"PeriodicalIF":1.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089255","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 multidisciplinary management of pulmonary arterial hypertension patients in pregnancy and postpartum: A case series","authors":"Jasmine N. Edghill ,&nbsp;Evan Wasserman ,&nbsp;Mary Ashley Cain ,&nbsp;Daniela R. Crousillat ,&nbsp;Ricardo Restrepo-Jaramillo","doi":"10.1016/j.ahjo.2025.100551","DOIUrl":"10.1016/j.ahjo.2025.100551","url":null,"abstract":"<div><h3>Study objective</h3><div>Pregnancy has been contraindicated in the setting of pulmonary arterial hypertension (PAH) due to elevated maternal and fetal risk. We review our center's successful experience with pregnant PAH patients in this case series.</div></div><div><h3>Study design</h3><div>This is a retrospective case series.</div></div><div><h3>Participants</h3><div>Six patients with PAH with seven pregnancies delivered at Tampa General Hospital from 2014 to 2024.</div></div><div><h3>Interventions</h3><div>All cases involved a multidisciplinary team to optimize antenatal and intrapartum management. The REVEAL 2.0 risk assessment tool also guided treatment planning by determining risk status.</div></div><div><h3>Results</h3><div>Almost all of the patients in our study were diagnosed with PAH by right heart catheterization at our institution pre- or during pregnancy. All patients were either on a phosphodiesterase inhibitor or prostacyclin during their pregnancies. One mother was admitted at 34 weeks 1 day for decompensated heart failure without prior PAH treatment. All patients with outpatient follow-up had serial 6 min walk distances, brain natriuretic peptide levels, echocardiograms, and right heart catheterizations, and were able to achieve a low risk REVEAL 2.0 score during the pregnancy. All patient cases delivered via cesarean section with shared decision making and 5/7 cases were preterm. There was a 100 % maternal and fetal survival rate in our case series within the 1 year postpartum period.</div></div><div><h3>Conclusion</h3><div>Although pregnancy is a relative contraindication in patients with PAH, our case series demonstrates that a multidisciplinary approach to care at a specialized center for pulmonary vascular disease with close, personalized ante- and postnatal management can result in successful outcomes.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"55 ","pages":"Article 100551"},"PeriodicalIF":1.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947288","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":"Cardiovascular resource utilization in patients with diastolic dysfunction: A retrospective cohort analysis","authors":"Ato Howard ,&nbsp;Paulomi Gohel ,&nbsp;Virginia Singla,&nbsp;Aditi Naniwadekar,&nbsp;Floyd Thoma,&nbsp;Suresh Mulukutla,&nbsp;Aditya Bhonsale,&nbsp;Krishna Kancharla,&nbsp;Andrew Voigt,&nbsp;Alaa Shalaby,&nbsp;N.A. Mark Estes III,&nbsp;Sandeep Jain,&nbsp;Samir Saba","doi":"10.1016/j.ahjo.2025.100550","DOIUrl":"10.1016/j.ahjo.2025.100550","url":null,"abstract":"<div><h3>Introduction</h3><div>Diastolic dysfunction (DD) is often linked to the development and persistence of atrial fibrillation (AF), but its impact on healthcare resource utilization (HCRU) in patients with or without AF is unclear.</div></div><div><h3>Methods</h3><div>Patients who received a transthoracic echocardiogram at our institution between 2010 and 2022 were included. DD was derived from the echocardiogram reports. HCRU included cardiac interventional, structural, surgical, and electrophysiology procedures, as well as diagnostic monitoring and imaging tests.</div></div><div><h3>Results</h3><div>A cohort of 157,043 patients (mean age 58 ± 18 years, 55 % women, 88 % White, 9 % with AF, 23 % with DD, LVEF 56 ± 8 %, BMI 30 ± 8 kg/m²) was retrospectively analyzed. The presence and severity of DD is associated with a proportional increase in HCRU, calculated as the mean annual number of cardiac procedures per year. For patients with no AF, the HRCU was 0.60 ± 1.02 in patients with no DD versus 0.93 ± 1.39 in those with any grade of DD (<em>p</em> &lt; 0.001). Similar findings were seen in patients with AF (HCRU 1.08 ± 1.40 vs. 1.27 ± 1.64, in patients without versus with DD, <em>p</em> &lt; 0.001). At lower grades of DD, the presence of AF is associated with higher HCRU, but this difference dissipates in patients with grade III DD (1.77 ± 2.37 vs. 1.67 ± 2.15, <em>p</em> = 0.42).</div></div><div><h3>Discussion</h3><div>DD is associated with higher HCRU in patients with or without AF.</div></div><div><h3>Conclusion</h3><div>DD significantly increases HCRU which is higher in the presence of AF. These data emphasize the real-world impact of DD on HCRU and highlight the need to prioritize DD diagnosis and treatment to improve patients' health and reduce cost.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"54 ","pages":"Article 100550"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894936","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":"Management of non-Cardiac Organ Failure in cardiogenic shock","authors":"Chirag Mehta ,&nbsp;Abraham Shin ,&nbsp;Brian Osorio ,&nbsp;Daniel DePolo ,&nbsp;Irene Vargas ,&nbsp;Emily Hao ,&nbsp;Ali Khan ,&nbsp;Sahas Chandragiri ,&nbsp;Sandipan Shringi ,&nbsp;Paige O. McLean Diaz ,&nbsp;Nicholas S. Potter ,&nbsp;Mark Godding ,&nbsp;Athena Poppas ,&nbsp;Rachna Kataria ,&nbsp;Marwan Saad ,&nbsp;Omar Hyder ,&nbsp;Neel R. Sodha ,&nbsp;J. Dawn Abbott ,&nbsp;Saraschandra Vallabhajosyula","doi":"10.1016/j.ahjo.2025.100549","DOIUrl":"10.1016/j.ahjo.2025.100549","url":null,"abstract":"<div><div>Cardiogenic shock (CS) is a syndrome of low cardiac output leading to systemic hypoperfusion. The mainstay of management involves optimizing preload, afterload, and contractility to restore central hemodynamics. However, CS is frequently complicated by non-cardiac organ failure, for which there is limited guidance. Herein, we review the pathophysiology, assessment, and management of respiratory, renal, hepatic, and neurological failure in the context of CS. This review is intended to provide an evidence-based framework for the management of extracardiac sequelae for the patients in the cardiac and medical intensive care unit.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"55 ","pages":"Article 100549"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906873","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":"Refractory angina in women with ischemia and no obstructive coronary artery disease — A report from the Women’s Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) study","authors":"Judy M. Luu ,&nbsp;Janet Wei ,&nbsp;Chrisandra Shufelt ,&nbsp;Anum Asif ,&nbsp;Benita Tjoe ,&nbsp;Galen Cook-Wiens ,&nbsp;Eileen M. Handberg ,&nbsp;Puja K. Mehta ,&nbsp;Jenna Maughan ,&nbsp;Daniel S. Berman ,&nbsp;Louise E.J. Thomson ,&nbsp;Carl J. Pepine ,&nbsp;C. Noel Bairey Merz","doi":"10.1016/j.ahjo.2025.100547","DOIUrl":"10.1016/j.ahjo.2025.100547","url":null,"abstract":"<div><h3>Background</h3><div>Women with suspected ischemia and no obstructive coronary artery disease (INOCA) are often challenging to manage. We aimed to understand mechanisms and treatable pathways of refractory angina.</div></div><div><h3>Methods</h3><div>The Women's Ischemia Syndrome Evaluation – Coronary Vascular Dysfunction (<span><span>NCT00832702</span><svg><path></path></svg></span>) recruited women between 2008 and 2015. In a pre-defined subgroup (<em>n</em> = 198) with repeat cardiac magnetic resonance imaging (CMRI) at 1-year, we investigated severity of angina (Seattle Angina Questionnaire-7) in relation to risk factors, baseline invasive coronary function testing, and CMRI parameters. Refractory angina was defined as SAQ-7 score &lt; 75 at baseline and &lt; 10-point improvement at 1-year.</div></div><div><h3>Results</h3><div>Women with refractory angina (<em>n</em> = 60, 30 %), compared to those without, had lower incomes, and higher proportion of hypertension and nitrate use at 1-year (<em>p</em> &lt; 0.05). They also had significantly lower baseline coronary blood flow (CBF) response to acetylcholine (<em>p</em> &lt; 0.01). Myocardial perfusion reserve index was not different at baseline or follow-up. At 1-year, changes in SAQ domain scores significantly differed between groups, with persistent lack of improvement in physical limitation, disease perception, angina stability, and angina frequency (<em>p</em> &lt; 0.05) in the refractory group. In an age-adjusted regression model, hypertension (OR 4.48; 95 % CI 1.23–16.25; <em>p</em> = 0.02) and abnormal CBF (OR 3.34; 95 % CI 1.04–10.72; <em>p</em> = 0.04) were associated with refractory angina.</div></div><div><h3>Conclusions</h3><div>Refractory angina is common in women with INOCA. Hypertension and endothelial-dependent microvascular dysfunction are independently associated with a 4- and 3-fold increase in refractory angina at 1-year, respectively. These findings may identify potential treatment targets to reduce angina burden in INOCA.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"54 ","pages":"Article 100547"},"PeriodicalIF":1.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886518","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":"Epicardial adipose tissue in patients with and without COVID-19 infection","authors":"Alexander J. Küng ,&nbsp;Iryna Dykun ,&nbsp;Matthias Totzeck ,&nbsp;Raluca Mincu ,&nbsp;Lars Michel ,&nbsp;Clemens Kill ,&nbsp;Oliver Witzke ,&nbsp;Jan Buer ,&nbsp;Tienush Rassaf ,&nbsp;Amir A. Mahabadi","doi":"10.1016/j.ahjo.2025.100548","DOIUrl":"10.1016/j.ahjo.2025.100548","url":null,"abstract":"<div><h3>Background</h3><div>Acute COVID-19 infection frequently affects the cardiovascular system and causes acute myocardial injury. Epicardial Adipose Tissue (EAT), a visceral adipose tissue surrounding the myocardium and coronary arteries, has unique paracrine and endocrine effects, modulating the heart's inflammatory environment. Systemic inflammation stimulates TNF-α and Interleukin-6 secretion from EAT, contributing to cytokine storms and intensifying systemic responses. We aimed to determine whether EAT amount differs in patients with and without acute COVID-19 infection and myocardial injury.</div></div><div><h3>Methods</h3><div>This study analyzed the CoV-COR registry cohort, conducted at the University Hospital Essen, including patients with symptoms suggestive of COVID-19 infection. The infection was confirmed by PCR. EAT thickness was measured by two-dimensional TTE.</div></div><div><h3>Results</h3><div>A total of 296 patients (mean age 63.6 ± 17.26 years, 55.4 % male) were included. Patients with confirmed COVID-19 infection were younger, more frequently treated with antihypertensive medication, and had higher BMI and systolic blood pressures. Univariate logistic regression showed no association between EAT and myocardial injury 0.97 (0.74; 1.28, <em>p</em> = 0.82). A trend towards an association was observed between increasing EAT thickness and COVID-19 infection 1.25 (0.99; 1.59, <em>p</em> = 0.060). Adjusting for age and gender strengthened the association, with a 48 % (1.14; 1.93, <em>p</em> = 0.004) increased odds of COVID-19 infection per increase in EAT thickness. Multivariable regression yielded consistent effect sizes 1.47 (1.01; 2.16, <em>p</em> = 0.047).</div></div><div><h3>Conclusion</h3><div>EAT thickness is associated with the presence of an acute COVID-19 infection but not with a myocardial injury. Further research is needed to assess if systemic viral infection induces dynamic changes in EAT.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"54 ","pages":"Article 100548"},"PeriodicalIF":1.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143858730","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":"Air pollution and cardiovascular disease: a systematic review of the effects of air pollution, including bushfire smoke, on cardiovascular disease","authors":"Fariha Islam,&nbsp;Sai Keerthana Nukala,&nbsp;Pallavi Shrestha,&nbsp;Tim Badgery-Parker,&nbsp;Fiona Foo","doi":"10.1016/j.ahjo.2025.100546","DOIUrl":"10.1016/j.ahjo.2025.100546","url":null,"abstract":"<div><h3>Objective</h3><div>Particulate matter (PM) with diameter ≤ 2.5 μm (PM_2.5) and ≤ 10 μm (PM₁₀), including from bushfire smoke, is associated with cardiovascular disease (CVD) morbidity and mortality. This systematic review assesses how CVD morbidity and mortality is affected by type, duration, and level of air pollution exposure.</div></div><div><h3>Data sources</h3><div>A search was conducted on Ovid Medline, Embase and Scopus, spanning across 1 January 2012 to 30 July 2022. Primary quantitative studies exploring the effect of PM_2.5, PM₁₀ or bushfire smoke on CVD were included. Studies without adjustment for confounding factors were excluded. The Newcastle-Ottawa Scale was used to assess the risk of bias (ROB) in the studies, and meta-analysis was conducted on relevant outcomes.</div></div><div><h3>Findings</h3><div>A total 275 studies were obtained, and 80 studies were analysed with diseases ranging from ICD-10 I00-I99. For CVD morbidity, increased PM_2.5 and PM₁₀ was associated with 1.92 (95 % CI: 0.58,3.26) years of life lost per 10 μg/m³ increase in exposure. Increased PM_2.5 and PM₁₀ was associated with a 0.52 % (95 % CI: 0.37,0.68) increase in mortality per 10 μg/m³ increase in exposure. Bushfire smoke also presented similar trends. Two studies had high ROB, 42 had medium ROB, and 36 had low ROB. There was high heterogeneity between the studies, with I² values ranging between 88.09 % and 94.25 %.</div></div><div><h3>Conclusion</h3><div>Air pollution including bushfire smoke is associated with increased CVD morbidity and mortality. This effect ranges across different types, durations, and levels of air pollution exposure, making stringent climate change and air pollution mitigation strategies imperative.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"54 ","pages":"Article 100546"},"PeriodicalIF":1.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143858731","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":"Trends and outcomes of different mechanical circulatory support modalities for refractory cardiogenic shock in Takotsubo cardiomyopathy","authors":"Shafaqat Ali ,&nbsp;Manoj Kumar ,&nbsp;Yehya Khlidj ,&nbsp;Faryal Farooq ,&nbsp;Thannon Alsaeed ,&nbsp;Muhammad Sultan ,&nbsp;Pramod Kumar Ponna ,&nbsp;Laxman Byreddi ,&nbsp;Pratik Agrawal ,&nbsp;Vijaywant Brar ,&nbsp;Tarek Helmy ,&nbsp;Taher Tayeb","doi":"10.1016/j.ahjo.2025.100545","DOIUrl":"10.1016/j.ahjo.2025.100545","url":null,"abstract":"<div><h3>Background</h3><div>The use of mechanical circulatory support (MCS) devices in cardiogenic shock is growing. We aim to study trends and compare different MCS modalities in this population.</div></div><div><h3>Methods</h3><div>The National Readmission Database (2016-2020) was queried to identify TTC-CS requiring MCS. Cohorts were stratified as ECMO (extracorporeal membrane oxygenation) compared to other short-term percutaneous left ventricular assist devices (Impella). The propensity score matching (PSM) was used to remove confounders. Pearson’s x2 test was applied to PSM-matched cohorts to compare outcomes. Additionally, we used multivariate regression and reported predictive margins for adjusted trend analysis.</div></div><div><h3>Results</h3><div>Among 2,025 TTC-CS hospitalizations requiring MCS, 1,790 required Impella vs. 235 on ECMO. ECMO was more common in metropolitan teaching hospitals (72.2 % vs 56.1 %, p &lt; 0.05). On PSM cohorts (N = 131), ECMO had higher in-hospital mortality (38.9 % vs. 20.6 %, p &lt; 0.001), major bleeding (15.3 % vs. 2.3 %, p &lt; 0.001), acute blood loss anemia (48.9 % vs. 19.1 %, p &lt; 0.001) among others. Our subgroup analysis comparing ECMO when Left ventricular (LV) unloading was provided by either IABP or Impella, and Impella alone showed no difference in the short-term mortality (42.2 % vs. 33.3 %, p: 0.384). However, the rates of major bleeding (17.8 % vs. 0.0 %, p: 0.003) and acute blood loss anemia (55.6 % vs. 22.2 %, p: 0.001) were higher for ECMO cohort.</div></div><div><h3>Conclusion</h3><div>In the absence of LV unloading, the ECMO utilization in TTC-CS had higher mortality and adverse events than Impella. The mortality difference was nonsignificant when concomitant LV unloading was provided with Impella or IABP in these patients.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"54 ","pages":"Article 100545"},"PeriodicalIF":1.3,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855694","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":"A comparison of magnetocardiography with noninvasive cardiac testing in the evaluation of patients with chest pain","authors":"Sharon E. Mace ,&nbsp;Christopher Baugh ,&nbsp;Margarita E. Pena ,&nbsp;Robert Takla","doi":"10.1016/j.ahjo.2025.100541","DOIUrl":"10.1016/j.ahjo.2025.100541","url":null,"abstract":"<div><h3>Objectives</h3><div>Chest pain is a common complaint of outpatients and emergency department patients. These patients are often referred for noninvasive cardiac imaging (NCI). Problems with NCI include limited availability, lengthy test delays, test duration, radiation exposure, adverse events, NPO (holding medications, caffeine/food/liquids/tobacco), exercise requirement, limitations for certain populations, inability to assess for ischemia with no obstructive coronary artery disease (INOCA), contrast/medication/needlestick-intravenous (IV) line needed.</div><div>Magnetocardiography (MCG) advantages include faster, easier test administration, radiation avoidance, less resource utilization, safer, no needlestick/IV requirement, no NPO for caffeine/food/liquids/tobacco, and no holding medications. By avoiding medications and/or exercise, MCG avoids risk of provoking myocardial injury and dangerous events (arrhythmias). No contrast or pharmacologic agents are needed with MCG, eliminating side effects/complications: tissue necrosis from extravasation, contrast-induced nephropathy, allergic reactions including life threatening anaphylaxis.</div></div><div><h3>Design</h3><div>MCG comparison with NCI: exercise stress test, stress echo, dobutamine stress echocardiogram, myocardial perfusion imaging: single photon emission computed tomography (SPECT) or positron emission tomography (PET), cardiac magnetic resonance imaging (cMRI), coronary computed tomography angiography (CCTA).</div></div><div><h3>Outcome measures</h3><div>Literature review: NCI versus MCG.</div></div><div><h3>Conclusion</h3><div>MCG is a rapid, safe, effective, painless and radiation-free test, does not require contrast/medication administration. MCG by avoiding provocative medications and/or exercise eliminates the risk of provoking myocardial injury and causing dangerous events such as arrhythmias. MCG avoids testing delays, has higher patient satisfaction, no NPO requirement, no holding medications or caffeine/food/liquids/tobacco, with similar sensitivity and specificity. Additional clinical research is needed to validate its utility. MCG may be a complementary modality alongside current NCI.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"54 ","pages":"Article 100541"},"PeriodicalIF":1.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828352","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}