JACC. Asia最新文献

{"title":"Association Between Modifiable Lifestyle Factors and Incident Cardiac Conduction Disease","authors":"Jiwen Zhong MM ,&nbsp;Rui Tang MD ,&nbsp;Liuxin Li MM ,&nbsp;Wei Zheng MM ,&nbsp;Shuohua Chen MM ,&nbsp;Jun Feng ,&nbsp;Jingli Qu MD ,&nbsp;Xi Wang MD ,&nbsp;Yu Yin MM ,&nbsp;Yu Yuan MD, PhD ,&nbsp;Shouling Wu MD, PhD","doi":"10.1016/j.jacasi.2025.03.009","DOIUrl":"10.1016/j.jacasi.2025.03.009","url":null,"abstract":"<div><h3>Background</h3><div>The associations between modifiable lifestyles and cardiac conduction disease (CCD) are poorly studied.</div></div><div><h3>Objectives</h3><div>This study aimed to prospectively assess the association between modifiable lifestyle factors and incident CCD.</div></div><div><h3>Methods</h3><div>A total of 89,377 participants (aged 18-90 years) free of CCD at baseline were enrolled in the Kailuan cohort. Lifestyle factors, including smoking, alcohol consumption, physical activity, sedentary behavior, and nighttime sleep duration, were collected to test the relations of both baseline and long-term lifestyle factors with incident CCD.</div></div><div><h3>Results</h3><div>During 1,226,634.1 person-years of follow-up (median: 14.1 years; Q1-Q3: 13.8-14.2 years), 3,723 CCD cases (3.04 per 1,000 person-years; 95% CI: 2.94-3.13 person-years) were identified. Compared with the participants who had healthy lifestyles at baseline, the adjusted HRs for participants who consumed alcohol ≥5 drinks per day, had sedentary behavior ≥4 hours per day, and had night sleep <em>≥</em>9 hours per day were 1.16 (95% CI: 1.04-1.32), 1.12 (95% CI: 1.03-1.22), and 1.32 (95% CI: 1.02-1.68), respectively. Furthermore, compared with the participants adhered to long-term healthy lifestyles, the adjusted HRs for participants who chronically consumed alcohol ≥5 drinks per day, had sedentary behavior ≥4 hours per day, and had night sleep ≥9 hours per day were 2.16 (95% CI: 1.68-2.79), 1.77 (95% CI: 1.50-2.09), and 1.67 (95% CI: 1.25-2.24), respectively.</div></div><div><h3>Conclusions</h3><div>The study revealed excessive alcohol consumption, high sedentary behavior, and longer sleep duration were associated with higher risks of CCD in adults. The findings supported the beneficial impact of a low-risk lifestyle on the primary prevention of CCD.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 7","pages":"Pages 927-939"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112586","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":"Noncoronary Sinus Pivot Implantation for Transcatheter Aortic Valve Replacement With Self-Expanding Valve for Aortic Regurgitation","authors":"Lifan Yang MD ,&nbsp;Zilong Weng MB ,&nbsp;Shasha Chen MD ,&nbsp;Yuan Zhang MD ,&nbsp;Daxin Zhou MD ,&nbsp;Wenzhi Pan MD ,&nbsp;Junbo Ge MD","doi":"10.1016/j.jacasi.2025.04.004","DOIUrl":"10.1016/j.jacasi.2025.04.004","url":null,"abstract":"<div><h3>Background</h3><div>Our initial study suggested that patients undergoing transcatheter aortic valve replacement (TAVR) with a self-expanding valve for pure native aortic regurgitation (PNAR) had a lower rate of major adverse cardiac events (MACE) when the noncoronary sinus pivot implantation (NCPI) was achieved.</div></div><div><h3>Objectives</h3><div>This study enrolled patients with PNAR who underwent TAVR with self-expanding valves between January 2019 and April 2024, compared the NCPI strategy with the conventional approach, and analyzed factors associated with successful NCPI.</div></div><div><h3>Methods</h3><div>We divided 87 patients into an early (conventional) group of patients treated before February 2023 and a late (NCPI strategy) group of patients treated after February 2023. Then the patients were also categorized by successful NCPI and non-NCPI group.</div></div><div><h3>Results</h3><div>The late group had significantly higher device success rates than the early group (92.9% vs 73.3%; <em>P =</em> 0.016) and lower rates of MACE (19.5% vs 51.1%; <em>P =</em> 0.002) and valve-in-valve implantation (4.8% vs 24.4%; <em>P =</em> 0.01). Importantly, NCPI was achieved in 90.5% of patients in the late group compared with only 17.8% in the early group (<em>P &lt;</em> 0.001). The NCPI group had a higher device success rate (93.5% vs 70.7%; <em>P =</em> 0.005) and lower MACE rate (17.4%vs 56.1%; <em>P</em> &lt; 0.001) than the non-NCPI group. NCPI (OR: 6.71; <em>P =</em> 0.032) and aortic angulation (OR: 1.07; <em>P =</em> 0.035) were independent predictors of device success.</div></div><div><h3>Conclusions</h3><div>NCPI strategy could be a general method used in TAVR with a self-expanding valve for patients with PNAR, which had a higher device success rate and lower rate of complications than the conventional method.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 7","pages":"Pages 884-894"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327984","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":"Arrhythmogenic Cardiomyopathy","authors":"Natalia Olivetti MD, PhD ,&nbsp;Luciana Sacilotto MD, PhD ,&nbsp;Marcelo Luiz Campos Vieira MD, PhD","doi":"10.1016/j.jacasi.2025.05.010","DOIUrl":"10.1016/j.jacasi.2025.05.010","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 7","pages":"Pages 924-926"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524193","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":"Cardiac Conduction Disorder","authors":"Yoshihiro Miyamoto MD, PhD","doi":"10.1016/j.jacasi.2025.05.006","DOIUrl":"10.1016/j.jacasi.2025.05.006","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 7","pages":"Pages 940-941"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524194","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 Long March to Identify Patients With Coronary Artery Disease by Pretest Probability Model","authors":"Shengxian Tu PhD,&nbsp;Miao Chu PhD","doi":"10.1016/j.jacasi.2025.05.011","DOIUrl":"10.1016/j.jacasi.2025.05.011","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 7","pages":"Pages 881-883"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524199","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":"Early- Versus Newer-Generation Transcatheter Mitral Valve Edge-to-Edge Repair Systems: Insights From the OCEAN-Mitral Registry.","authors":"Taishi Okuno, Masaki Izumo, Shingo Kuwata, Yoshihiro J Akashi, Masanori Yamamoto, Shunsuke Kubo, Mike Saji, Yuki Izumi, Yusuke Enta, Shinichi Shirai, Shingo Mizuno, Yusuke Watanabe, Makoto Amaki, Kazuhisa Kodama, Junichi Yamaguchi, Toru Naganuma, Hiroki Bota, Yohei Ohno, Masahiko Asami, Daisuke Hachinohe, Masahiro Yamawaki, Hiroshi Ueno, Kazuki Mizutani, Toshiaki Otsuka, Kentaro Hayashida","doi":"10.1016/j.jacasi.2025.05.013","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.05.013","url":null,"abstract":"<p><strong>Background: </strong>Comparative data on early- (G2) vs newer-generation (G4) MitraClip transcatheter edge-to-edge repair (TEER) systems remain limited.</p><p><strong>Objectives: </strong>The authors compared procedural and clinical outcomes of both devices in patients with degenerative mitral regurgitation (DMR) or functional mitral regurgitation (FMR).</p><p><strong>Methods: </strong>Using the OCEAN (Optimized Catheter Valvular Intervention)-Mitral registry, 3,738 patients undergoing TEER with either G2 (n = 1,481) or G4 (n = 2,257) MitraClips were analyzed. Outcomes included procedural metrics, echocardiographic parameters, and clinical events.</p><p><strong>Results: </strong>Despite being older (P = 0.010) and higher-risk (EuroSCORE [European System for Cardiac Operative Risk Evaluation] II: P = 0.002), the newer-generation group achieved comparable procedural success (residual MR ≤2+) with shorter procedure time and fewer clips, resulting in significantly lower transmitral mean pressure gradients (TMPG) (DMR: median: 3.0 [Q1-Q3: 2.0-4.0] mm Hg vs 2.7 [Q1-Q3: 2.0-3.8] mm Hg; P = 0.009; FMR: median 3.0 [Q1-Q3: 2.0-4.0] mm Hg vs 2.5 [Q1-Q3: 1.9-3.5] mm Hg; P < 0.001) in both DMR and FMR cohorts. Rates of mechanical complications, such as single leaflet device attachment and leaflet tear, were rare across both device generations but were further reduced in the newer-generation device. The newer-generation device was associated with reduced heart failure (HF) rehospitalization in DMR (adjusted HR: 0.51; 95% CI: 0.33-0.77; P = 0.001) and FMR (adjusted HR: 0.76; 95% CI: 0.61-0.93; P = 0.009), with a greater risk reduction in DMR (P_interaction < 0.001). A causal mediation analysis revealed that postprocedural TMPG modestly mediated the association between device generation and HF rehospitalization risk (proportion mediated = 1.8% [Q1-Q3: 0.3%-4.0%]; P = 0.016).</p><p><strong>Conclusions: </strong>The newer-generation TEER system offers a safer and more efficient procedure, with shorter procedural time, fewer mechanical complications, fewer clips, and a lower postprocedural TMPG, contributing to reduced HF rehospitalization risk, particularly in DMR.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644308","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":"Discordance of Small Dense LDL Cholesterol Beyond LDL Cholesterol or Non-HDL Cholesterol and Carotid Plaque.","authors":"Jinqi Wang, Xiaoyu Zhao, Yanchen Zhao, Rui Jin, Yunfei Li, Jiahe Wang, Yueruijing Liu, Zhiyuan Wu, Xiuhua Guo, Lixin Tao","doi":"10.1016/j.jacasi.2025.04.015","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.04.015","url":null,"abstract":"<p><strong>Background: </strong>Different low-density lipoprotein (LDL) particles exhibit distinct proatherogenic properties.</p><p><strong>Objectives: </strong>This study sought to evaluate associations of small dense low-density lipoprotein cholesterol (sdLDL-C), large buoyant low-density lipoprotein cholesterol (lbLDL-C), sdLDL-C/LDL-C ratio, and sdLDL-C/lbLDL-C ratio with carotid plaque (CP) risk in the general population, and to perform discordance analyses to determine which biomarker better reflects CP risk beyond low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C).</p><p><strong>Methods: </strong>This study enrolled 20,369 participants from Beijing Health Management Cohort. Discordant sdLDL-C, lbLDL-C, or ratio metrics (sdLDL-C/LDL-C and sdLDL-C/lbLDL-C) relative to LDL-C or non-HDL-C, and discordant ratio metrics relative to sdLDL-C, were defined by residual differences and median values. Logistic regression models were used to estimate ORs and 95% CIs.</p><p><strong>Results: </strong>In this study, higher levels of sdLDL-C (OR: 1.354; 95% CI: 1.299-1.410), sdLDL-C/LDL-C ratio (OR: 1.196; 95% CI: 1.148-1.247), and sdLDL-C/lbLDL-C ratio (OR: 1.153; 95% CI: 1.110-1.197) were more strongly associated with increased odds of CP than lbLDL-C (OR: 1.110; 95% CI: 1.070-1.151). Additionally, discordantly high sdLDL-C or low lbLDL-C relative to LDL-C or non-HDL-C were associated with increased odds of CP, whereas discordantly low sdLDL-C or high lbLDL-C were associated with reduced odds. Finally, discordantly high sdLDL-C/LDL-C and sdLDL-C/lbLDL-C ratios relative to LDL-C, non-HDL-C, or sdLDL-C were linked to increased odds of CP.</p><p><strong>Conclusions: </strong>The sdLDL-C, sdLDL-C/LDL-C, and sdLDL-C/lbLDL-C, but not lbLDL-C, are superior to LDL-C and non-HDL-C in identifying individuals at increased risk of CP. The sdLDL-C/LDL-C and sdLDL-C/lbLDL-C ratios may capture additional risk information beyond sdLDL-C.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593068","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 Effect of Lipid-Lowering Therapy on Coronary Artery Plaque in East Asia Population.","authors":"Tomohiro Fujisaki, Yuichiro Shirahama, Feng Sheng, Ken Ikeda, Nobuhiro Osada, Satoru Tanaka, Yang Zhang, Kenichi Tsujita","doi":"10.1016/j.jacasi.2025.05.016","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.05.016","url":null,"abstract":"<p><strong>Background: </strong>Lipid-lowering therapy (LLT) is important to control atherosclerosis and prevent atherosclerotic cardiovascular disease (ASCVD) events.</p><p><strong>Objectives: </strong>This study aimed to summarize the effects of LLT on coronary atherosclerotic plaque stability and progression in East Asian individuals.</p><p><strong>Methods: </strong>A systematic literature search was performed from respective inception dates to November 21, 2023. Studies carried out on East Asian participants who received LLT were included. Meta-analysis and meta-regression analysis were used to investigate the effects of LLT on plaque regression indicators and plaque stabilization indicators (PROSPERO registration number CRD42024504184).</p><p><strong>Results: </strong>Forty-eight studies with a total of 4,147 patients were included in the final analysis. In East Asian patients, low-density lipoprotein cholesterol (LDL-C) levels ≤130 mg/dL resulted in a pooled percent atheroma volume decrease of -1.09% (95% CI: -1.38% to -0.79%; I² = 91%), and the lowest levels of LDL-C (≤55 mg/dL) were associated with the greatest decrease (-1.56%, 95% CI: -2.20% to -0.92%; I² = 0%) of percent atheroma volume when compared with levels in the range of 55 to 70, 70 to 100, and 100 to 130 mg/dL. LLT resulted in a pooled fibrous cap thickness gain of 66.90 μm (95% CI: 50.06-83.75 μm) at the end of the follow-up. There was a trend that decreasing follow-up LDL-C levels were associated with larger increases of fibrous cap thickness, especially when LCL-C was less than 70 mg/dL.</p><p><strong>Conclusions: </strong>LLT is beneficial for East Asian patients with established ASCVD or with higher risks of ASCVD. Intensive LLT with a lower target LDL-C, especially to less than 55 mg/dL, would be beneficial for atherosclerosis treatment.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644310","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":"Dynamic Changes of 3D Bending Angle Through the Cardiac Cycle: Implications With Bioresorbable Scaffold Performance.","authors":"Simone Fezzi, Jiayue Huang, Paolo Alberto Del Sole, Daixin Ding, Alessandro Sarai, Domenico Tavella, Gabriele Pesarini, Roberto Scarsini, William Wijns, Shengxian Tu, Flavio Luciano Ribichini","doi":"10.1016/j.jacasi.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.05.012","url":null,"abstract":"<p><strong>Background: </strong>Several predictors of adverse events following bioresorbable scaffold (BRS) percutaneous coronary intervention (PCI) have been identified. The role of vessel biomechanical properties remains underexplored.</p><p><strong>Objectives: </strong>This study aimed to describe the biomechanical properties of coronary arteries after BRS implantation by assessing the maximum bending angle (BAmax) changes through the cardiac cycle and their interaction with long-term incidence of target-vessel failure (TVF).</p><p><strong>Methods: </strong>Three-dimensional BAmax was computed at end-diastole and end-systole, before and after BRS implantation. Cardiac motion-induced angulation change (ΔcBAmax) was calculated as the absolute difference between end-systole and end-diastole, and scaffold-induced angulation changes as the absolute difference between pre- and postimplantation.</p><p><strong>Results: </strong>BAmax computation was available in 164 coronary vessels at baseline and in 88 at long-term follow-up (57 [42-66] months). Following BRS implantation, BAmax decreased both in diastole (-6.2°) and in systole (-9.0°). TVF-related vessels showed higher pre-PCI BAmax at end-diastole, at end-systole, and higher ΔcBAmax (11.4° [6.0°-22.9°] vs 5.8° [2.7°-12.4°]; P = 0.002), whereas no significant difference in post-PCI BAmax was present. Scaffold-induced BAmax change was significantly higher in vessels with TVF compared with TVF-free ones, both at end-diastole, end-systole, and in the ΔcBAmax group (10.1° [4.4°-20.6°] vs 5.7° [2.3°-10.9°]; P = 0.001). Multivariate analysis identified scaffold-induced change in ΔcBAmax as an independent predictor of TVF (for 10° increase: aHR 1.65; 95% CI: 1.11-2.45; P = 0.01). After BRS resorption, coronary artery BAmax increased, restoring baseline biomechanics.</p><p><strong>Conclusions: </strong>BA changes through the cardiac cycle decrease after PCI with BRS; the greater the decrease, the higher the risk of target vessel failure at follow-up.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644307","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":"Effects of Mavacamten on Cardiac Magnetic Resonance Features in Chinese Patients With Obstructive Hypertrophic Cardiomyopathy.","authors":"Zhuang Tian, Liwen Li, Xiaoyan Li, Qing Zhang, Daoquan Peng, Wei Ma, Ping Yang, Fang Wang, Xiang Cheng, Yiqun Fu, Jing Sun, Jian'an Wang, Shuyang Zhang","doi":"10.1016/j.jacasi.2025.05.015","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.05.015","url":null,"abstract":"<p><strong>Background: </strong>Mavacamten, a first-in-class cardiac myosin inhibitor and the only approved cardiac myosin inhibitor worldwide, improved clinical symptoms and health status in patients with symptomatic obstructive hypertrophic cardiomyopathy (HCM) in phase 3 EXPLORER-HCM (Clinical Study to Evaluate Mavacamten [MYK-461] in Adults With Symptomatic Obstructive Hypertrophic Cardiomyopathy) (NCT03470545) and EXPLORER-CN (A Study to Evaluate the Efficacy and Safety of Mavacamten in Chinese Adults With Symptomatic Obstructive HCM) (NCT05174416).</p><p><strong>Objectives: </strong>The purpose of this work was to study the effect of mavacamten on cardiac structure and function by cardiac magnetic resonance (CMR) imaging in Chinese participants in EXPLORER-CN.</p><p><strong>Methods: </strong>Eligible patients with obstructive HCM underwent CMR imaging at screening and week 30. Change from baseline to week 30 in left ventricular (LV) mass index was analyzed as a prespecified secondary outcome. Prespecified exploratory outcomes included changes in cellular hypertrophy, cardiac structure and function, and myocardial fibrosis by CMR.</p><p><strong>Results: </strong>Among 81 patients randomized, 58 patients (mean age 51.2 years, 74.1% men) with CMR data available were analyzed (mavacamten, n = 39; placebo, n = 19). After 30 weeks, greater reductions from baseline were observed (mean between-group difference) with mavacamten vs placebo in LV mass index (-30.8 g/m² [95% CI: -41.5 to -20.1 g/m²]), maximal LV wall thickness (-3.5 mm [95% CI: -4.7 to -2.4 mm]), and maximal left atrial volume index (-18.3 mL/m² [95% CI: -26.7 to -9.8 mL/m²]); all nominal P < 0.001. Reduction from baseline to week 30 in global mass of late gadolinium enhancement by 6 SDs was also observed with mavacamten vs placebo (mean between-group difference, -2.0 g [95% CI: -11.9 to 8.0 g]; nominal P = 0.007).</p><p><strong>Conclusions: </strong>At 30 weeks, improvements were observed in measures of cardiac structure and function, with reductions in indicators of myocardial fibrosis, in the mavacamten vs the placebo group. (A Study to Evaluate the Efficacy and Safety of Mavacamten in Chinese Adults With Symptomatic Obstructive HCM; NCT05174416).</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593069","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}