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

{"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}

{"title":"Novel and established biomarkers to complement risk scores in patients with acute decompensated heart failure – a pilot study","authors":"Valentin Hähnel ,&nbsp;Victoria Meretz ,&nbsp;Christian Butter ,&nbsp;Vera Paar ,&nbsp;Christoph Edlinger ,&nbsp;Michael Lichtenauer ,&nbsp;Ronald Biemann ,&nbsp;Berend Isermann ,&nbsp;Meike Hoffmeister ,&nbsp;Michael Haase ,&nbsp;Anja Haase-Fielitz ,&nbsp;Marwin Bannehr","doi":"10.1016/j.ahjo.2025.100544","DOIUrl":"10.1016/j.ahjo.2025.100544","url":null,"abstract":"<div><h3>Study Objective</h3><div>There are several risk scores for mortality in patients with acute decompensated heart failure (ADHF) such as the European Collaboration on Acute Decompensated Heart Failure Score (ELAN-HF Score), the ADHF/NT-proBNP-Score or A2B-Score (age, anemia, BNP). The aim of this study was to evaluate the predictive value of such risk scores with and without addition of novel cardiorenal biomarkers.</div></div><div><h3>Design &amp; Setting</h3><div>Single-center, exploratory prospective cohort study at the University Hospital Heart Centre Brandenburg.</div></div><div><h3>Participants</h3><div>Forty-four adult patients hospitalized for ADHF.</div></div><div><h3>Interventions</h3><div>Measurement of established and novel biomarkers at hospital admission including N-terminal-pro brain natriuretic peptide (NT-pro-BNP), troponin T, creatinine, cystatin C, soluble suppression of tumorigenicity 2 (sST2), Neprilysin, Dickkopf-3 (DKK3), interleukin-6 (IL-6), growth differentiation factor-15 (GDF-15), Galectin-3, Progranulin and urine neutrophil gelatinase-associated lipocalin (uNGAL).</div></div><div><h3>Main Outcome Measures</h3><div>Analysis of predictive indices of ELAN-HF, ADHF/NT-proBNP and A2B-Scores for 90-day mortality with and without adding biomarkers. AUC &lt;0.8 was considered as fair, ≥0.8 as good and &gt; 0.9 as excellent predictive value.</div></div><div><h3>Results</h3><div>Median age was 78.0 (25th–75th percentiles 69.3–83.8) years, 50 % (22/44) were female. Twelve patients (27.3 %) died within 90 days after discharge. All three risk scores were higher in non-survivors and showed fair AUC for 90-day mortality (ELAN-HF: 0.792 [0.639–0.901], p = 0.003; ADHF-NT-proBNP score: 0.749 [0.559–0.938], p = 0.012; A2B score: 0.734 [0.541–0.927], p = 0.017). Adding troponin T, cystatin C-based estimated glomerular filtration rate (eGFR) or uNGAL to risk scores was associated with an area under the curve (AUC) &gt;0.80 for all models. Combination of troponin T, cystatin C-based eGFR and uNGAL increased risk scores to AUC &gt;0.91.</div></div><div><h3>Conclusion</h3><div>These findings imply that further evaluation of the addition of a panel of cardiorenal biomarkers to ADHF risk scores is warranted.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"53 ","pages":"Article 100544"},"PeriodicalIF":1.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816314","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":"Comparative effectiveness of the EggNest complete shielding system to standard shielding in the Cath lab","authors":"Robert F. Riley ,&nbsp;Jacob Kamen ,&nbsp;Ashley Tao ,&nbsp;Daniel Gomez-Cardona","doi":"10.1016/j.ahjo.2025.100543","DOIUrl":"10.1016/j.ahjo.2025.100543","url":null,"abstract":"<div><h3>Background</h3><div>This study evaluated the effectiveness of scatter radiation reduction with the EggNest Complete shielding system compared to standard catheterization laboratory shielding.</div></div><div><h3>Methods</h3><div>Vertical poles with mounted radiation survey meters were positioned at six points around a catheterization laboratory imaging table where procedural staff usually stand. Meters were mounted on vertical tracks where the sensor could be raised on the track with stops every 20 cm (up to 200 cm). Fluoroscopy (15 frames per second) was then performed on an anthropomorphic phantom with a cardiac silhouette in PA and four quadrant angulations using a Toshiba Infinx fixed C-arm X-ray system with a 12″ detector. Scatter radiation measurements were reported in μSv/h under three radiation shielding conditions: no shielding, standard catheterization laboratory lead shielding, and the EggNest Complete system.</div></div><div><h3>Results</h3><div>Average scatter radiation levels in all angulations were significantly higher below the x-ray table and at the positions near the head of the table (1862 ± 340 μSv/h at the head vs. 605 ± 316 μSv/h below the phantom waist, p &lt; 0.05). Using the EggNest Complete system compared to standard shielding, average radiation exposure in all x-ray angulations and positions was reduced by 92.5 ± 3.9 % (83 ± 103 compared to 1087 ± 898 μS/h, p &lt; 0.01). At the Operator and Assistant positions, scatter radiation averaged 9 ± 4 μSv/h using the EggNest Complete (98 ± 1 % reduction compared to no shielding, p &lt; 0.01), 147 ± 101 μSv/h using Standard Shielding (75 ± 8 % reduction compared to no shielding, p &lt; 0.01), and 605 ± 316 μSv/h without shielding.</div></div><div><h3>Conclusion</h3><div>Compared to standard shielding, the EggNest Complete system significantly reduced radiation levels at all positions around the x-ray table. At the operator and Assistant positions, EggNest complete provided 98 % reduction in scatter radiation dose.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"54 ","pages":"Article 100543"},"PeriodicalIF":1.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826301","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":"Percutaneous atrial septostomy for left ventricular unloading in patients on peripheral venoarterial extracorporeal membrane oxygenation: A systematic review and meta-analysis","authors":"Mohammed AlGhamdi ,&nbsp;Gabriel Saiydoun ,&nbsp;Guillaume Lebreton ,&nbsp;Jean-Philippe Mazzucotelli","doi":"10.1016/j.ahjo.2025.100542","DOIUrl":"10.1016/j.ahjo.2025.100542","url":null,"abstract":"<div><h3>Background</h3><div>This study systematically reviewed the safety and efficacy of atrial septostomy as a left ventricular (LV) unloading intervention in paediatric and adult patients undergoing peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO).</div></div><div><h3>Methods</h3><div>The PubMed, Cochrane, and Google Scholar online databases were searched, and studies describing patients who received VA-ECMO for refractory cardiogenic shock and underwent atrial septostomy for LV unloading were included. Laboratory experiments, animal studies, and patients who received ECMO with a method other than atrial septostomy for LV unloading were excluded.</div></div><div><h3>Results</h3><div>From the 12 studies analysed, data were collected on 197 patients, including 97 (49 %) males and 75 (38 %) females (data unavailable for 25 patients) with ages ranging from 3.65 days to 70 years. VA-ECMO duration was 1.71 to 40 days (<em>P</em> &lt; 0.001). Weaning from VA-ECMO with LV discharge was achieved successfully in 126 (64 %) patients, with 60 (30.5 %) in recovery (<em>P</em> = 0.006) and 66 (33.5 %) converted to a ventricular assistant device or transplantation. Additionally, 54 (27.4 %) patients experienced unsuccessful weaning. During atrial septostomy for LV unloading, 14 (7.1 %) patients experienced complications, whereas 180 (91.4 %) did not (<em>P</em> = 0.250). After LV unloading in patients receiving VA-ECMO, 60 (30.5 %) experienced early mortality (<em>P</em> = 0.286).</div></div><div><h3>Conclusion</h3><div>VA-ECMO-assisted percutaneous atrial septostomy is a viable, safe, and successful alternative for LV unloading in both children and adults with refractory cardiogenic shock. However, further studies with larger sample sizes are required to comprehensively assess the morbidity and mortality associated with this approach.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"54 ","pages":"Article 100542"},"PeriodicalIF":1.3,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828351","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":"Real-world interventional outcomes for cardiogenic shock complicating acute myocardial infarction","authors":"John E. Brush Jr. ,&nbsp;Ann M. Harper ,&nbsp;Luke C. Kohan ,&nbsp;Zachary Bouker ,&nbsp;Kaivalya Dandamudi ,&nbsp;Deepak R. Talreja","doi":"10.1016/j.ahjo.2025.100540","DOIUrl":"10.1016/j.ahjo.2025.100540","url":null,"abstract":"<div><div>Acute myocardial infarction with cardiogenic shock (AMICS) carries high mortality and remains a major concern. This concern drives use of interventions with marginal benefit and some evidence of harm. The configuration of hospital care and allocation of interventions for AMICS in our health system created a natural experiment to analyze interventional outcomes for patients with AMICS.</div></div><div><h3>Objective</h3><div>To compare clinical outcomes among AMICS patients treated with mechanical circulatory support (MCS) using a micro-axial left ventricular assist device and intra-aortic balloon counter-pulsation (IABP).</div></div><div><h3>Design, setting, participants, outcome measures</h3><div>In this observational study in a large health system, we used clinical registry data augmented with data from other sources to analyze 30-day and 180-day mortality as well as complications including major bleeding, and access site injury.</div></div><div><h3>Results</h3><div>Of 505 patients with AMICS, 73 were treated with MCS and 160 with IABP. Baseline characteristics were similar between treatment groups except infarct location. Multivariable logistic regression showed that MCS was associated with 1.92 (CI = 1.10–3.37) times higher 30-day mortality risk and 2.03 (CI = 1.17–3.57) times higher 180-day mortality risk. In MCS-inclined hospitals as compared with IABP-inclined hospitals, patients had significantly higher 180-day mortality (45.3 % versus 33.9 %, <em>p</em> = 0.017), and bleeding rates (15.1 % versus 1.3 %, <em>p</em> &lt; 0.001), with trends toward higher 30-day mortality (41.4 % versus 32.6 %, <em>p</em> = 0.064) and access site injury (4.7 % versus 1.3 %, <em>p</em> = 0.063).</div></div><div><h3>Conclusion</h3><div>In this real-world setting, MCS use for AMICS was associated with higher complication rates. Before using this device for AMICS, clinicians should consider tight selection criteria to minimize harm and maximize overall benefit.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"53 ","pages":"Article 100540"},"PeriodicalIF":1.3,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816313","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":"Pregnancy associated cardiomyopathy in 2 cancer survivors with history of anthracycline use","authors":"Ramy Zughul,&nbsp;Navya Akula,&nbsp;Isaac Rhea,&nbsp;Michael Zacharias,&nbsp;Heather Blume,&nbsp;Chantal ElAmm","doi":"10.1016/j.ahjo.2025.100539","DOIUrl":"10.1016/j.ahjo.2025.100539","url":null,"abstract":"<div><div>Cardiac complications in childhood cancer survivors are increasingly recognized, with radiotherapy and anthracycline exposure being major culprits. The incidence of recurrent cardiomyopathy in this population is significant, while the incidence of new-onset cardiomyopathy remains rare. This case series presents two cases of pregnancy-associated cardiomyopathy with a history of anthracycline use.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"54 ","pages":"Article 100539"},"PeriodicalIF":1.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143815657","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":"Coronary artery bypass surgery improves restricted mean survival time in patients with ischemic cardiomyopathy","authors":"Samuel W. Reinhardt,&nbsp;Haocheng Huang,&nbsp;Helen Parise,&nbsp;Tariq Ahmad,&nbsp;Eric J. Velazquez,&nbsp;Kamil F. Faridi","doi":"10.1016/j.ahjo.2025.100538","DOIUrl":"10.1016/j.ahjo.2025.100538","url":null,"abstract":"<div><h3>Introduction</h3><div>Clinical trials commonly use Cox proportional hazards models, which may be inaccurate when evaluating procedural interventions. Restricted mean survival time (RMST) is an alternative outcome measure that quantifies treatment effects without assuming proportional hazards.</div></div><div><h3>Methods</h3><div>We determined outcomes based on RMST in the Surgical Treatment for Ischemic Heart Failure (STICH) trial, an international multicenter randomized clinical trial comparing coronary artery bypass grafting (CABG) plus optimal medical therapy to optimal medical therapy alone in patients with ischemic cardiomyopathy.</div></div><div><h3>Results</h3><div>For the primary endpoint of all-cause mortality, CABG plus medical therapy was superior to medical therapy alone at 10 years of follow up when using measures of RMST. In subgroup analyses evaluating all-cause mortality, there was a greater beneficial effect of CABG for racial/ethnic minorities vs. white patients.</div></div><div><h3>Conclusions</h3><div>These findings reinforce the benefit of CABG and can be used to help quantify anticipated outcomes for patients with ischemic cardiomyopathy.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"54 ","pages":"Article 100538"},"PeriodicalIF":1.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143815659","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":"Clarification and transparency on ILR migration review","authors":"Allam Harfoush","doi":"10.1016/j.ahjo.2025.100537","DOIUrl":"10.1016/j.ahjo.2025.100537","url":null,"abstract":"","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"53 ","pages":"Article 100537"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of radiation shielding zero gravity vs lead apron in coronary angiography and percutaneous coronary intervention","authors":"Omnia Tajelsir Abdalla Osman,&nbsp;Sara Al Balushi,&nbsp;Salaheddin Omran Arafa,&nbsp;Murad Al Khani,&nbsp;Jassim Al Suwaidi,&nbsp;Fahad Alkindi","doi":"10.1016/j.ahjo.2025.100536","DOIUrl":"10.1016/j.ahjo.2025.100536","url":null,"abstract":"<div><h3>Introduction</h3><div>Ensuring safety from radiation in catheterization labs is critical due to the cumulative nature of radiation exposure. This study compares the effectiveness of Zero Gravity (ZG) and conventional Lead Apron shields in coronary angiography and percutaneous coronary intervention.</div></div><div><h3>Methods</h3><div>Over six months, radiation exposure was assessed for two operators performing angiography procedures. One operator used a Lead Apron, while the other used the Zero Gravity system. Radiation was measured using Thermoluminescent Dosimeters (TLDs). Procedural characteristics, fluoroscopy time, and contrast dose were recorded. Feedback on Lead Apron use was collected using the Oswestry Low Back Pain Disability Questionnaire.</div></div><div><h3>Results</h3><div>Each operator performed 63 procedures with similar characteristics. Zero Gravity showed no significant difference in whole-body radiation exposure (De) compared to the Lead Apron (0.349 mSv vs. 0.346 mSv). However, Zero Gravity resulted in a lower external skin dose (Ds) compared to the Lead Apron (0.314 mSv vs. 0.339 mSv). Most cardiologists reported minimal disability from using Lead Aprons.</div></div><div><h3>Discussion</h3><div>Zero Gravity and Lead Apron provide comparable whole-body radiation protection, with Zero Gravity slightly reducing skin exposure. While ZG does not significantly alter overall radiation exposure, it may reduce ergonomic issues associated with Lead Aprons.</div></div><div><h3>Conclusion</h3><div>Zero Gravity provides comparable whole-body radiation protection to Lead Aprons and reduces skin exposure. Further research is needed to address long-term impacts and enhance protective strategies in catheterization labs.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"53 ","pages":"Article 100536"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of aficamten in obstructive hypertrophic cardiomyopathy: A systematic review and meta-analysis","authors":"Muhammad Nabeel Saddique ,&nbsp;Hamza Irfan ,&nbsp;Saad Ashraf ,&nbsp;Maria Qadri ,&nbsp;Hammad Javaid ,&nbsp;Sana Iftikhar ,&nbsp;Muhammad Zain ul Haq ,&nbsp;Laveeza Fatima ,&nbsp;Qasim Mehmood ,&nbsp;Anurag Jha ,&nbsp;Saad Masood ,&nbsp;Muhammad Safiullah ,&nbsp;Muhammad Imaz Bhatti ,&nbsp;Sheena Shamoon ,&nbsp;Javed Iqbal","doi":"10.1016/j.ahjo.2025.100535","DOIUrl":"10.1016/j.ahjo.2025.100535","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive hypertrophic cardiomyopathy (oHCM), a morbid hereditary condition, is characterized by asymmetrical intraventricular septum enlargement, obstructing blood flow from the left ventricle outflow tract (LVOT) and lowering cardiac output. Aficamten, a novel selective, oral myosin inhibitor, has been suggested to reduce myocardial hypercontractility and decrease LVOT gradient in oHCM.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted through PubMed, Embase, Scopus, and Cochrane databases for relevant literature from inception up to May 2024. Six studies focusing on efficacy and safety aficamten was included. Pooled outcome estimates were reported as mean difference (MD) and 95 % CI using random effect model. Statistical heterogeneity was assessed using I² and X² statistics.</div></div><div><h3>Results</h3><div>We found a significant change of −143.23 (pg/ml) NT-proBNP [95 % CI −564.8 to 278.4, I² = 97.65 %, <em>P</em> &lt; 0.001], −50.9 mmHg Valsalva LVOT gradient [95 % CI −55.2 to −46.6, I² = 0 %, <em>P</em> = 0.44], −38.5 mmHg resting LVOT gradient [95 % CI −49.9 to −27.6, I² = 0 %, <em>P</em> = 0.64], −5.98 % mean LVEF [95 % CI −9.4 to −2.6, I² = 64.18 %, <em>P</em> = 0.06] and −2.32 (ng/dl) Hs-Troponin I [95 % CI −7.55 to −2.91, I² = 0 %, <em>P</em> = 0.97] from the baseline. We found significant 64.9 % ≥ 1 NYHA class improvement [95 % CI 45.8 %–84.1 %, I² = 90.6 %, <em>P</em> &lt; 0.001] in aficamten. There was ‘low’ overall risk of bias in included studies.</div></div><div><h3>Conclusion</h3><div>We found that aficamten significantly reduced myocardial stress surrogates and functional disability parameters. The small sample sizes, diverse study designs and single-arm analysis limit our findings. More robust trials with larger sample sizes are required to establish conclusive evidence.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"53 ","pages":"Article 100535"},"PeriodicalIF":1.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}