JACC. Asia最新文献

{"title":"Navigating the Landscape of Translational Medicine of Calcific Aortic Valve Disease","authors":"Xingyu Qian MD ,&nbsp;Li Xu MD ,&nbsp;Bingchuan Geng PhD,&nbsp;Fei Li MD,&nbsp;Nianguo Dong MD, PhD","doi":"10.1016/j.jacasi.2025.01.014","DOIUrl":"10.1016/j.jacasi.2025.01.014","url":null,"abstract":"<div><div>Calcific aortic valve disease (CAVD) is a prevalent condition characterized by pathological thickening and calcification of the aortic valve, leading to increased pressure overload and cardiac remodeling, particularly in individuals aged 65 and older. This review synthesizes recent advances in understanding the pathogenesis of CAVD, focusing on key mechanisms including hemodynamic alterations, endothelial dysfunction, lipid deposition, inflammation, and fibrotic calcification. We evaluate emerging therapeutic targets based on pivotal basic research and clinical trials, highlighting the potential for mechanism-oriented interventions. Furthermore, we explore the implications of lipid-lowering therapies, anti-inflammatory strategies, and antifibrocalcific agents, as well as novel bioprosthetic designs aimed at enhancing patient outcomes. Additionally, we discuss the inherent genetic and molecular backgrounds influencing individual susceptibility to CAVD, emphasizing the promise of personalized therapy. By bridging the gap between basic science and clinical application, this review aims to guide future research efforts toward more effective prevention and treatment strategies for CAVD.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 4","pages":"Pages 503-515"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746713","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":"1-Year Outcomes of PT-Valve for Pulmonary Regurgitation in Native Outflow Tract","authors":"ChangYu Qin MD ,&nbsp;ChangDong Zhang MD ,&nbsp;Mei Liu PhD ,&nbsp;XiaoKe Shang PhD ,&nbsp;NianGuo Dong PhD","doi":"10.1016/j.jacasi.2024.12.014","DOIUrl":"10.1016/j.jacasi.2024.12.014","url":null,"abstract":"<div><h3>Background</h3><div>Severe pulmonary regurgitation (PR) in patients with postoperative congenital heart disease is often accompanied by extensive variability of right ventricular outflow tract (RVOT) anatomy, which limited the wide application of existing transcatheter pulmonary valves device.</div></div><div><h3>Objectives</h3><div>This study sought to evaluate 1-year safety and efficacy of the PT-Valve in the treatment of PR patients presenting with native RVOT from a multicenter, single-arm clinical trial.</div></div><div><h3>Methods</h3><div>We enrolled 130 patients of moderate or greater PR. One-year clinical outcomes are reported.</div></div><div><h3>Results</h3><div>Within the cohort (mean age 30 ± 16 years; 52% men), 124 (95%) were diagnosed with tetralogy of Fallot. The procedure success rate was 98.5%. Early explants occurred to 2 device malpositions and 1 pulmonary branch obstruction. At 1 year, there were no procedure- or device-related mortality. Device-related adverse events included 2 arrhythmias, 1 pulmonary thromboembolism, 2 endocarditis, and 1 vascular access complication. Echocardiography examinations showed that 125 (99%) patients had none/trace and mild PR, and no greater than mild paravalvular leak at 1-year visit. The mean peak pulmonary gradient was 20.0 ± 17.4 mm Hg and 16.0 ± 7.8 mm Hg at baseline and 1 year after implantation, respectively. The right ventricular end-diastolic volume index was reduced from 176.3 ± 28.4 mL/m² at baseline to 121.1 ± 20.7 mL/m² at 1 year (<em>P &lt;</em> 0.001).</div></div><div><h3>Conclusions</h3><div>The PT-Valve demonstrated a high success rate of implantation and favorable safety and efficacy in the treatment of PR through 1 year. This device is anatomically suitable for more than 90% of PR patients with native RVOT. (Prospective, Single Arm, Multi-Center Clinical Study on the Safety And Efficacy of the Sterile Transcatheter Pulmonary Valve and Delivery System; <span><span>ChiCTR2100043367</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 4","pages":"Pages 568-581"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746721","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":"Articulating the JACC Journals’ Direction in Times of Global Change","authors":"Harlan M. Krumholz MD, SM (Editor-in-Chief, JACC),&nbsp;Biykem Bozkurt MD, PhD (Editor-in-Chief, JACC: Heart Failure),&nbsp;Y. Chandrashekhar MD (Editor-in-Chief, JACC: Cardiovascular Imaging),&nbsp;Bonnie Ky MD, MSCE (Editor-in-Chief, JACC: CardioOncology),&nbsp;Douglas L. Mann MD (Editor-in-Chief, JACC: Basic to Translational Science),&nbsp;David J. Moliterno MD (Editor-in-Chief, JACC: Cardiovascular Interventions),&nbsp;Kalyanam Shivkumar MD, PhD (Editor-in-Chief, JACC: Clinical Electrophysiology),&nbsp;Candice K. Silversides MD (Editor-in-Chief, JACC: Advances),&nbsp;Gilbert H.L. Tang MD, MSc, MBA (Editor-in-Chief, JACC: Case Reports),&nbsp;Jian’an Wang MD, PhD (Editor-in-Chief, JACC: Asia)","doi":"10.1016/j.jacasi.2025.02.001","DOIUrl":"10.1016/j.jacasi.2025.02.001","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 4","pages":"Pages 607-608"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746728","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":"A Novel 3-Dimensional Reinforced Ringed Graft for Valve-Sparing Aortic Root Replacement","authors":"Joon Bum Kim MD, PhD ,&nbsp;Matthew H. Park PhD ,&nbsp;Shin Yajima MD, PhD ,&nbsp;Stefan Elde MD ,&nbsp;Yuanjia Zhu MD, PhD ,&nbsp;Perry S. Choi MD ,&nbsp;Michael Paulsen MD ,&nbsp;Y. Joseph Woo MD","doi":"10.1016/j.jacasi.2024.12.015","DOIUrl":"10.1016/j.jacasi.2024.12.015","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 4","pages":"Pages 599-602"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746726","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":"Temperature-Related Ischemic Heart Disease in Asia","authors":"Ethan Katznelson MD","doi":"10.1016/j.jacasi.2025.02.011","DOIUrl":"10.1016/j.jacasi.2025.02.011","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 4","pages":"Pages 541-542"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746716","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":"Sex Differences in Outcomes After Contemporary Percutaneous Coronary Intervention","authors":"Norihiro Kogame MD, PhD ,&nbsp;Yoshihisa Nakagawa MD, PhD ,&nbsp;Ken Kozuma MD, PhD ,&nbsp;Raisuke Iijima MD, PhD ,&nbsp;Anna Tsutsui PhD ,&nbsp;Yoshitaka Murakami PhD ,&nbsp;Hideki Ichikawa BPharm ,&nbsp;Satoru Abe LLB ,&nbsp;Go Kato BEng ,&nbsp;Masato Nakamura MD, PhD","doi":"10.1016/j.jacasi.2024.09.017","DOIUrl":"10.1016/j.jacasi.2024.09.017","url":null,"abstract":"<div><h3>Background</h3><div>Sex differences in clinical outcomes remain controversial in patients treated with a drug-eluting stent (DES).</div></div><div><h3>Objectives</h3><div>The purpose of this study was to investigate whether the effects of sex differences on ischemic and bleeding outcomes vary by bleeding risk in patients undergoing contemporary percutaneous coronary intervention (PCI) with a second-generation DES and predominant use of potent P2Y₁₂ inhibitors.</div></div><div><h3>Methods</h3><div>The PENDULUM (Platelet rEactivity in patieNts with DrUg eLUting stent and balancing risk of bleeding and ischeMic event) registry was a prospective, multicenter, PCI registry in Japan. The primary endpoints were major adverse cardiac and cerebrovascular events (MACCE) and major bleeding (Bleeding Academic Research Consortium types 3 and 5) 30 months after the index PCI.</div></div><div><h3>Results</h3><div>Of the 6,266 patients included in this subgroup analysis, 1,357 patients (21.7%) were women. The incidences of MACCE and major bleeding at 30 months were similar between the sexes (MACCE: 9.4% vs 9.4%, HR: 1.00 [95% CI: 0.82-1.22]; <em>P =</em> 1.000; major bleeding: 4.2% vs 4.5%, HR: 1.07 [95% CI: 0.81-1.43]; <em>P =</em> 0.628). After adjustment, female sex was associated with lower incidences of MACCE at 30 months (adjusted HR: 0.65 [95% CI: 0.51-0.82]; <em>P</em> &lt; 0.001). There was no interaction between sex and high bleeding risk for MACCE and major bleeding at 30-month follow-up (<em>P</em> for interaction = 0.926 and 0.617, respectively).</div></div><div><h3>Conclusions</h3><div>Female sex is an independent predictor of lower ischemic outcomes but not bleeding outcomes at 30 months in patients undergoing contemporary PCI with a second-generation DES and predominant use of potent P2Y₁₂ inhibitors. There was no interaction between high bleeding risk and sex for ischemic and bleeding outcomes. (Platelet rEactivity in patieNts with DrUg eLUting stent and balancing risk of bleeding and ischeMic event; <span><span>UMIN000020332</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 4","pages":"Pages 543-551"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746717","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":"Outcomes of Time to Treatment With Reteplase for Acute Ischemic Stroke","authors":"Xuechun Wang MD ,&nbsp;Baoyu Feng PhD ,&nbsp;Hong-Qiu Gu PhD ,&nbsp;Zixiao Li MD ,&nbsp;Yilong Wang MD ,&nbsp;Xingquan Zhao MD ,&nbsp;Shuya Li MD ,&nbsp;Yongjun Wang MD","doi":"10.1016/j.jacasi.2024.12.010","DOIUrl":"10.1016/j.jacasi.2024.12.010","url":null,"abstract":"<div><h3>Background</h3><div>The efficacy of intravenous thrombolysis is time-dependent. Reteplase has been shown to be superior to alteplase in certain acute ischemic stroke patients.</div></div><div><h3>Objectives</h3><div>The authors aimed to delineate the associations of stroke onset-to-treatment time (OTT) on the therapeutic benefits and clinical risks with reteplase in comparison to alteplase.</div></div><div><h3>Methods</h3><div>This is a post hoc analysis of the RAISE (Reteplase versus Alteplase for Acute Ischemic Stroke) trial. Patients were divided into 3 groups based on their onset-to-treatment times: 0 to 90, 91 to 180, and 181 to 270 minutes. The primary efficacy outcome was the proportion of participants with a modified Rankin scale score of 0 to 1 at 90 days. The primary safety outcome was symptomatic intracranial hemorrhage within 36 hours post–thrombolytic treatment.</div></div><div><h3>Results</h3><div>A total of 1,399 patients (99.1%) with OTT (median 180 minutes; Q1-Q3: 135-222 minutes) were included. Adjusted risk ratios of primary efficacy outcome were 1.16 (95% CI: 0.70-1.91) for the 0 to 90 minutes group, 1.14 (95% CI: 0.97-1.35) for 91 to 180 minutes group, and 1.12 (95% CI: 0.93-1.18) for 181 to 270 minutes group. The primary safety outcome had no difference between reteplase and alteplase in the 3 OTT intervals.</div></div><div><h3>Conclusions</h3><div>Among patients with ischemic stroke within 4.5 hours after symptom onset, there was no significant difference in the efficacy profile between reteplase and alteplase for achieving excellent functional outcomes at 3 different OTT intervals. (A Study of r-PA Treating Patients With Acute Ischemic Stroke [RAISE]; <span><span>NCT05295173</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 4","pages":"Pages 584-592"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746723","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":"Percutaneous Coronary Intervention","authors":"Hitesh Gurjar MD, DM ,&nbsp;Amit Hooda MD ,&nbsp;Mayank Yadav MD","doi":"10.1016/j.jacasi.2024.11.016","DOIUrl":"10.1016/j.jacasi.2024.11.016","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 4","pages":"Pages 552-553"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746718","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":"Unveiling the Complexities of Peripartum Cardiomyopathy","authors":"Beatriz Fernandez-Campos MD,&nbsp;Candice K. Silversides MD","doi":"10.1016/j.jacasi.2025.03.001","DOIUrl":"10.1016/j.jacasi.2025.03.001","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 4","pages":"Pages 565-567"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746720","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":"Hemodynamic Patterns and Left Ventricular Function Recovery in Peripartum Cardiomyopathy","authors":"Valery Meledin MD, PhD ,&nbsp;Hawani Sasmaya Prameswari MD ,&nbsp;Sara Shimoni MD ,&nbsp;Roni Ramon-Gonen PhD ,&nbsp;Melawati Hasan MD ,&nbsp;Jacob George MD ,&nbsp;Sorel Goland MD","doi":"10.1016/j.jacasi.2024.11.019","DOIUrl":"10.1016/j.jacasi.2024.11.019","url":null,"abstract":"<div><h3>Background</h3><div>The influence of hemodynamic changes at presentation on the recovery of left ventricular (LV) function in peripartum cardiomyopathy (PPCM) patients remains uncertain.</div></div><div><h3>Objectives</h3><div>This study aims to identify hemodynamic patterns in individuals with PPCM.</div></div><div><h3>Methods</h3><div>This study included women with PPCM from 2 databases in Israel and Indonesia. Conventional echocardiography, 2-dimensional strain, myocardial work, and noninvasive pressure-volume loop analysis were performed with subsequent data clustering.</div></div><div><h3>Results</h3><div>Among 89 women (median age 32 years, IQR: 8.7 years; LV ejection fraction [EF] 36.0%, IQR: 11.5%), 63 (70.8%) experienced LV function recovery (LVEF ≥50%) during 6 months of follow-up. Gestation hypertension/pre-eclampsia and LVEF &gt;35% and LVDD ≤55 mm at presentation were associated with LV recovery. Significant hemodynamic variability was observed, indicating a nonuniform PPCM pattern. Cluster analysis of 43 patients identified 3 hemodynamic subtypes. In cluster 1, patients exhibited the lowest rate of LV recovery (12.5%), profound contractility impairment, severe LV remodeling, and reduced cardiac output (CO). Cluster 2 showed a high LV recovery rate of 78.6%, prevalent in Southeast Asian patients with gestational hypertension. These patients displayed decreased CO and extremely elevated afterload. Load-dependent contractility indexes, like LVEF and global longitudinal strain, were markedly reduced, while load-independent end-systolic elastance remained unaffected, indicating afterload-dependent contractility impairment. All patients in cluster 3 recovered LVEF, presenting mildly reduced contractility indexes, mild ventricular dilatation, slightly increased afterload, and preserved CO.</div></div><div><h3>Conclusions</h3><div>PPCM exhibits heterogeneous hemodynamic patterns, with 3 distinct phenotypes displaying varying rates of LV recovery. Understanding the heterogeneity in PPCM hemodynamic phenotypes can guide optimal treatment.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 4","pages":"Pages 554-564"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746719","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}