JACC. Asia最新文献

{"title":"Full Issue PDF","authors":"","doi":"10.1016/S2772-3747(25)00033-X","DOIUrl":"10.1016/S2772-3747(25)00033-X","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages I-CXVII"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150953","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":"TAVR and Strokes","authors":"Kush P. Patel PhD, Andreas Baumbach MD","doi":"10.1016/j.jacasi.2024.11.006","DOIUrl":"10.1016/j.jacasi.2024.11.006","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 270-272"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150936","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":"OUFR Versus FFR for Functional Assessment of Coronary Artery Stenosis in Patients With Unstable Angina","authors":"Jiawei Zhao MD ,&nbsp;Chao Fang MD, PhD ,&nbsp;Huai Yu MD ,&nbsp;Zhao Wang PhD ,&nbsp;Jinfeng Tan MD ,&nbsp;Yuzhu Chen MD ,&nbsp;Xueming Xu MD ,&nbsp;Chengmei Jin MD ,&nbsp;Lili Xiu MD ,&nbsp;Wei Wang MD ,&nbsp;Rui Zhao MD ,&nbsp;Lina Cui MD ,&nbsp;Xianqin Ma MD ,&nbsp;Guo Wei MD ,&nbsp;Yanchao Liu MD ,&nbsp;Lulu Li MS ,&nbsp;Jingbo Hou MD, PhD ,&nbsp;Jiannan Dai MD, PhD ,&nbsp;Bo Yu MD, PhD","doi":"10.1016/j.jacasi.2024.10.026","DOIUrl":"10.1016/j.jacasi.2024.10.026","url":null,"abstract":"<div><h3>Background</h3><div>Hybrid intravascular ultrasound-optical coherence tomography (IVUS-OCT) imaging can integrate both advantages. Optical ultrasonic flow ratio (OUFR) was recently developed for functional assessment.</div></div><div><h3>Objectives</h3><div>This study aimed to verify the diagnostic performance of OUFR using fractional flow reserve (FFR) as the reference standard.</div></div><div><h3>Methods</h3><div>From February 2023 to June 2023, 80 patients (126 vessels) with unstable angina pectoris were assessed with FFR and either hybrid IVUS-OCT or stand-alone IVUS imaging before percutaneous coronary intervention in a prospective series. OUFR based on OCT alone (OUFR_O) or based on both (OUFR_OI) were derived from hybrid IVUS-OCT imaging in 61 patients (86 vessels). OUFR based on IVUS alone (OUFR_I) was derived from single modality IVUS imaging in 58 patients (80 vessels). In all cases, wire-based FFR was measured in the same vessels for comparison.</div></div><div><h3>Results</h3><div>All 3 computed OUFR indexes achieved high agreement with FFR, with OUFR_OI and OUFR_O showing higher correlation with FFR (r = 0.88; <em>P</em> &lt; 0.001; r = 0.85; <em>P</em> &lt; 0.001, respectively) than OUFR_I (r = 0.73; <em>P</em> &lt; 0.001). Compared with OUFR_O, the integration of both IVUS and OCT (OUFR_OI) further improved the diagnostic accuracy for predicting FFR ≤0.80 with accuracy, sensitivity, and specificity being 95%, 94%, and 96%, respectively. The area under the curve of OUFR_OI to predict FFR ≤0.80 was 0.99, higher than that for OUFR_O (0.95) and OUFR_I (0.91).</div></div><div><h3>Conclusions</h3><div>OUFR_OI is feasible and accurate in the prospective study, resulting in excellent agreement with FFR, superior to single imaging modality-based physiology indexes.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 231-241"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150948","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":"Small Annulus, Big Impact on TAVR Patients?","authors":"Sinda Hannachi MD,&nbsp;Romain Didier MD, PhD","doi":"10.1016/j.jacasi.2024.11.009","DOIUrl":"10.1016/j.jacasi.2024.11.009","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 255-257"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150951","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":"Para-Hisian Ventricular Arrhythmias","authors":"Mitsunori Maruyama MD, PhD","doi":"10.1016/j.jacasi.2024.11.018","DOIUrl":"10.1016/j.jacasi.2024.11.018","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 313-314"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150942","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":"New Frontiers in Antegrade Wiring From the Asia Pacific Chronic Total Occlusion Club","authors":"Eugene B. Wu MD ,&nbsp;Shunsuke Matsuno MD ,&nbsp;Wataru Nagamatsu MD ,&nbsp;Arun Kalyanasundaram MD ,&nbsp;Scott A. Harding MD, PhD ,&nbsp;Sidney Lo MD ,&nbsp;Soo Teik Lim MD ,&nbsp;Lei Ge MD ,&nbsp;Ji-Yan Chen MD ,&nbsp;Henry J.F. Luo MD ,&nbsp;Jie Quan MD ,&nbsp;Seung-Whan Lee MD, PhD ,&nbsp;Hsien-Li Kao MD ,&nbsp;Etsuo Tsuchikane MD PhD","doi":"10.1016/j.jacasi.2024.12.009","DOIUrl":"10.1016/j.jacasi.2024.12.009","url":null,"abstract":"<div><div>Antegrade wiring (AW) is the prevailing chronic total occlusion (CTO) crossing technique. For proximal cap ambiguity, the Global CTO consensus group uses the “anatomy dictates strategy” method: 1) intravascular ultrasound; 2) move the cap; or 3) retrograde. For CTO body crossing, anatomy dictates 4 strategies: 1) CTOs with tapered stump—loose tissue tracking; 2) CTOs with clear intimal path—intentional intimal tracking with 3-dimensional (3D) wiring; 3) CTOs without a clear intimal path—intentional intimal tracking with intermediate penetration wire; and 4) the “long plus CTOs”—intentional subintimal wiring. The new angiographic 3D antegrade puncture technique from the APCTO (Asia Pacific Chronic Total Occlusion) Club is presented for distal cap puncture. angiographic 3D antegrade puncture technique can be used as a 3D wiring technique as well as an antegrade dissection and re-entry technique. Based on these new frontiers, we have updated our APCTO algorithm in this paper. This update can form a basis for research and training.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 219-230"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150946","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":"Extended Period Outcomes of Posterior Box Isolation in 4 Randomized Atrial Fibrillation Catheter Ablation Trials","authors":"Sang Jun Lee MD,&nbsp;Hee Tae Yu MD, PhD,&nbsp;Sung Hwa Choi MD,&nbsp;Daehoon Kim MD,&nbsp;Tae-Hoon Kim MD,&nbsp;Jae-Sun Uhm MD, PhD,&nbsp;Boyoung Joung MD, PhD,&nbsp;Moon-Hyoung Lee MD, PhD,&nbsp;Hui-Nam Pak MD, PhD","doi":"10.1016/j.jacasi.2024.12.002","DOIUrl":"10.1016/j.jacasi.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Catheter-based electrical posterior box isolation (POBI) and circumferential pulmonary vein isolation (CPVI) do not improve the rhythmic outcomes of atrial fibrillation catheter ablation in previous studies with 12 to 24 months of follow-up.</div></div><div><h3>Objectives</h3><div>The authors analyzed the long-term rhythm outcomes of our 4 previously conducted randomized controlled trials comparing CPVI alone vs CPVI plus additional POBI using the intention-to-treat principle.</div></div><div><h3>Methods</h3><div>The authors analyzed 575 AF patients included in our 4 previous randomized controlled trials. We compared clinical recurrence defined as recurrent atrial arrhythmia after the index procedure. In patients who underwent a repeat procedure because of recurrence after the index procedure, the mechanism of recurrence was analyzed.</div></div><div><h3>Results</h3><div>After a median follow-up of 48 months, there were no significant differences in the clinical recurrence or major adverse cardiac events between the CPVI alone and CPVI plus POBI groups. The procedure time was significantly longer, and the atrial tachycardia recurrence rate was higher in the CPVI plus POBI group. In the patients who experienced clinical recurrence, there were no significant differences in the rates of cardioversion or need for repeat procedures between the groups. In patients who underwent a repeat procedure because of recurrence after the index procedure (n = 64), the pulmonary vein reconnection rate did not differ, but re-entrant atrial tachycardia was more common in the CPVI plus POBI group, while extrapulmonary vein triggers were more common in the CPVI alone group.</div></div><div><h3>Conclusions</h3><div>The addition of POBI to CPVI did not improve the long-term rhythm outcomes in patients undergoing atrial fibrillation catheter ablation. (The Evaluation for Prognostic Factors After Catheter Ablation of Atrial Fibrillation, <span><span>NCT02138695</span><svg><path></path></svg></span>; Evaluation of Proper Radiofrequency Catheter Ablation Strategy for the Patients Who Were Changed to Paroxysmal Atrial Fibrillation From Persistent Atrial Fibrillation, <span><span>NCT02176616</span><svg><path></path></svg></span>; Comparison of Circumferential Pulmonary Vein Isolation Alone Versus Linear Ablation in Addition to Circumferential Pulmonary Vein Isolation for Catheter Ablation in Persistent Atrial Fibrillation: Prospective Randomized Controlled Trial, <span><span>NCT02721121</span><svg><path></path></svg></span>; Comparison of Circumferential Pulmonary Vein Isolation and Complex Pulmonary Vein Isolation Additional Linear Ablation for Recurred Atrial Fibrillation After Previous Catheter Ablation: Prospective Randomized Trial [RILI Trial]; <span><span>NCT02747498</span><svg><path></path></svg></span></div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 285-295"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150855","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":"Protruding and Ulcerated Aortic Atheromas as Predictors of Periprocedural Ischemic Stroke Post-Transcatheter Aortic Valve Replacement","authors":"Shinnosuke Kikuchi MD ,&nbsp;Antonin Trimaille MD ,&nbsp;Adrien Carmona MD ,&nbsp;Dinh Phi Truong MD ,&nbsp;Kensuke Matsushita MD, PhD ,&nbsp;Benjamin Marchandot MD ,&nbsp;Amandine Granier MD ,&nbsp;Antje Reydel MD ,&nbsp;Manh Cuong Vu MD ,&nbsp;Franck Zheng MD ,&nbsp;Zoe Heyberger MD ,&nbsp;Julien Tse Sik Sun MD ,&nbsp;Florian Loizon MD ,&nbsp;Paul Knellwolf MD ,&nbsp;Dorian Recht MD ,&nbsp;Baudouin Koenig MD ,&nbsp;Mickael Ohana MD, PhD ,&nbsp;Kiyoshi Hibi MD, PhD ,&nbsp;Patrick Ohlmann MD, PhD ,&nbsp;Olivier Morel MD, PhD","doi":"10.1016/j.jacasi.2024.10.020","DOIUrl":"10.1016/j.jacasi.2024.10.020","url":null,"abstract":"<div><h3>Background</h3><div>Aortic atherosclerosis can affect the strategy and outcomes of transcatheter aortic valve replacement (TAVR). Limited investigation exists into how aortic atheroma morphology influences outcomes post-TAVR.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the influence of protruding and ulcerated aortic atheromas on periprocedural ischemic stroke post-TAVR.</div></div><div><h3>Methods</h3><div>This analysis included 977 patients who underwent TAVR between February 2010 and May 2019, with available contrast-enhanced computed tomography data. Protruding aortic atheroma was defined as atheroma of ≥3 mm thickness with protruding components. Ulcerated aortic atheroma was defined as atheroma with ulcer-like intimal disruption. The primary endpoint was periprocedural ischemic stroke within 30 days post-TAVR.</div></div><div><h3>Results</h3><div>In total, 43 (4.4%) experienced periprocedural ischemic stroke. Patients with protruding or ulcerated aortic atheroma had a significantly higher incidence of periprocedural stroke compared with those without (8.0% [95% CI: 4.9%-12.2%] vs 3.2% [95% CI: 2.1%-4.8%]; <em>P =</em> 0.003). Protruding or ulcerated atheroma (adjusted OR [aOR]: 2.55 [95% CI: 1.37-4.74]), particularly in the aortic arch (aOR: 3.86 [95% CI: 1.69-8.83]), independently increased periprocedural stroke risk. Among patients undergoing transfemoral TAVR with self-expandable valves (n = 315, 32%), protruding or ulcerated atheroma in the aortic arch was independently associated with periprocedural stroke (aOR: 9.04 [95% CI: 1.59-51.4]), whereas it was not among those with balloon-expandable valves (n = 580, 59%) (aOR: 2.85 [95% CI: 0.92-8.84]).</div></div><div><h3>Conclusions</h3><div>Protruding and ulcerated aortic atheromas are associated with a higher risk of periprocedural ischemic stroke post-TAVR. Careful selection of TAVR strategy, including valve type and procedural approach, is essential for patients with such aortic lesions.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 258-269"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150952","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":"30-Day Transcatheter Aortic Valve Replacement Outcomes in Severe Symptomatic Aortic Stenosis Chinese Patients","authors":"Mao Chen MD ,&nbsp;Xianbao Liu MD, PhD ,&nbsp;Yujie Zhou MD ,&nbsp;Yundai Chen MD ,&nbsp;Yuan Feng MD ,&nbsp;Sarah Verdoliva Boatman MSc ,&nbsp;Jianan Wang MD, PhD","doi":"10.1016/j.jacasi.2024.10.011","DOIUrl":"10.1016/j.jacasi.2024.10.011","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 318-321"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150944","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":"Extremely Small 20-mm Versus Standard-Size Balloon-Expandable Transcatheter Heart Valves","authors":"Taishi Okuno MD ,&nbsp;Masaki Izumo MD ,&nbsp;Kai Takahiko MD ,&nbsp;Shingo Kuwata MD ,&nbsp;Masashi Koga MD ,&nbsp;Yoshihiro J. Akashi MD ,&nbsp;Shinichi Shirai MD ,&nbsp;Yusuke Watanabe MD ,&nbsp;Toru Naganuma MD ,&nbsp;Norio Tada MD ,&nbsp;Futoshi Yamanaka MD ,&nbsp;Masahiko Noguchi MD ,&nbsp;Hiroshi Ueno MD ,&nbsp;Yohei Ohno MD ,&nbsp;Hidetaka Nishina MD ,&nbsp;Kensuke Takagi MD ,&nbsp;Masahiko Asami MD ,&nbsp;Kazuki Mizutani MD ,&nbsp;Fumiaki Yashima MD ,&nbsp;Toshiaki Otsuka MD ,&nbsp;Kentaro Hayashida MD","doi":"10.1016/j.jacasi.2024.09.005","DOIUrl":"10.1016/j.jacasi.2024.09.005","url":null,"abstract":"<div><h3>Background</h3><div>The 20-mm balloon-expandable transcatheter heart valve (THV) represents the smallest available option for transcatheter aortic valve replacement (TAVR). Its current underutilization stems from concerns regarding prosthesis-patient mismatch, durability, and potential adverse outcomes.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to compare the long-term outcomes between the 20-mm balloon-expandable THVs and standard-size balloon-expandable THVs.</div></div><div><h3>Methods</h3><div>Patients who underwent transfemoral TAVR with SAPIEN THVs were sourced from the OCEAN-TAVI (Optimized Transcatheter Valvular Intervention) registry, an ongoing, multicenter cohort study that has enrolled over 7,000 TAVR patients in Japan. A 1:3 propensity-matched analysis, based on 24 baseline clinical and echocardiographic variables, was used to contrast the 20-mm with &gt;20-mm balloon-expandable THVs.</div></div><div><h3>Results</h3><div>Of 5,086 eligible patients, 284 (5.6%) received the 20-mm balloon-expandable THV. After propensity-matching, the 20-mm THV group (n = 276) and the &gt;20-mm THV group (n = 828) demonstrated balanced baseline characteristics, with an absolute standardized difference &lt;0.10. The average follow-up duration for patients who were alive was 955 ± 512 days, and the average time to death was 584 ± 543 days. The 20-mm group showed a higher frequency of prosthesis-patient mismatch (PPM) (moderate PPM: 29.2% vs 10.8%; severe PPM: 4.9% vs 1.5%; <em>P &lt;</em> 0.001). Over a 5-year period, all-cause mortality and heart failure rehospitalization rates were comparable between the 2 groups (all-cause mortality: 34.2% vs 38.0%; HR: 1.01; 95% CI: 0.74-1.37; <em>P =</em> 0.970; heart failure rehospitalization: 15.2% vs 16.3%; HR: 0.81; 95% CI: 0.50-1.29; <em>P =</em> 0.371).</div></div><div><h3>Conclusions</h3><div>This registry-based study suggests that the initially observed inferior forward hemodynamics associated with the 20-mm THV do not translate into heightened long-term mortality or heart failure rehospitalization risks. (The OCEAN-TAVI registry [Optimized Transcatheter Valvular Intervention-Transcatheter Aortic Valve Implantation]; <span><span>UMINID:000020423</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 245-254"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150950","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}