JACC. Asia最新文献

{"title":"Interpretable Independent Recurrent Networks for Forecasting Stroke in Atrial Fibrillation.","authors":"Jung-Chi Hsu, Yi-Hsien Hsieh, Yen-Yun Yang, Shu-Lin Chuang, Che Lin, Lian-Yu Lin","doi":"10.1016/j.jacasi.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.04.003","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a major risk factor for transient ischemic attack (TIA)/ischemic stroke (IS).</p><p><strong>Objectives: </strong>Given the dynamic nature of IS risk, this study aimed to predict IS risk in AF patients using a high-dimensional time-series model.</p><p><strong>Methods: </strong>We conducted a cohort study at the National Taiwan University Hospital from 2014 to 2019, including 7,710 AF patients, with external validation in 6,822 patients from the National Taiwan University Hospital Yunlin Branch. The Forecasting Strokes via Interpretable Independent Networks (ForeSIIN) model, based on gated recurrent units, was proposed. Kaplan-Meier analysis with log-rank test evaluated risk group differences.</p><p><strong>Results: </strong>The annual TIA/IS incidence rate ranged from 181.96 (95% CI: 164.42-200.93) to 15.81 (95% CI: 12.38-20.18) per 1,000 person-years, with an overall incidence of 42.40 (95% CI: 39.60-45.39). The ForeSIIN model achieved the best prediction with an area under the receiver-operating characteristics curve of 0.764 (95% CI: 0.722-0.810), compared with the CHA₂DS₂-VASc score (AUC: 0.650; 95% CI: 0.596-0.699) and other nonsequential models: extreme gradient boosting AUC: 0.722 (95% CI: 0.676-0.769), support vector machine AUC 0.691 (95% CI: 0.637-0.741), random forest AUC: 0.689 (95% CI: 0.637-0.742). External validation showed area under the receiver-operating characteristics curve of 0.646 (95% CI: 0.618-0.671) and area under the precision-recall curve of 0.222 (95% CI: 0.184-0.259). Feature impact analysis identified the top 5 factors: history of TIA/IS, estimated glomerular filtration rate, C-reactive protein, hematocrit, and plasma fasting glucose. Kaplan-Meier analysis showed significant risk differences between ForeSIIN groups (log-rank P < 0.001).</p><p><strong>Conclusions: </strong>The innovative ForeSIIN model demonstrated accurate stroke prediction in AF patients and enhanced the interpretation of dynamic risk factors over time.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268043","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":"Nationwide Epidemiology and Management Time Trends for Atrial Fibrillation: Insights From the Korean AF Factsheet.","authors":"So-Ryoung Lee, Daehoon Kim, Yun Gi Kim, Pil-Sung Yang, Ki Hong Lee, Jaemin Shim, Bong-Seong Kim, Kyung-Do Han, Eue-Keun Choi","doi":"10.1016/j.jacasi.2025.03.012","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.03.012","url":null,"abstract":"<p><p>Atrial fibrillation (AF) represents the most prevalent cardiac arrhythmia in clinical practice, with its incidence rising globally. Korea's comprehensive national health insurance system facilitates the meticulous collection and management of health care utilization data for its entire population. This robust data infrastructure has enabled numerous recent studies on AF in Korea, encompassing its prevalence, incidence, anticoagulation treatment rates, health care burden, and associated complications. A comprehensive understanding of AF epidemiology and patient characteristics is essential for enhancing both primary and secondary prevention strategies and improving clinical outcomes. This review presents an up-to-date analysis of AF epidemiology, patient demographics, and treatment modalities in Korea, drawing from the extensive Korea National Health Insurance Service database.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164044","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":"Implication of the Dose of Mineralocorticoid Receptor Antagonist Following Transcatheter Edge-To-Edge Mitral Valve Repair.","authors":"Teruhiko Imamura, Shuhei Tanaka, Nobuyuki Fukuda, Hiroshi Ueno, Koichiro Kinugawa, Shunsuke Kubo, Masanori Yamamoto, Yuki Izumi, Mike Saji, Masahiko Asami, Yusuke Enta, Shinichi Shirai, Masaki Izumo, Shingo Mizuno, Yusuke Watanabe, Makoto Amaki, Kazuhisa Kodama, Junichi Yamaguchi, Toru Naganuma, Hiroki Bota, Yohei Ohno, Daisuke Hachinohe, Masahiro Yamawaki, Kazuki Mizutani, Toshiaki Otsuka, Kentaro Hayashida","doi":"10.1016/j.jacasi.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.03.014","url":null,"abstract":"<p><strong>Background: </strong>Mineralocorticoid receptor antagonists (MRAs) are integral components of medical therapy for patients with heart failure with reduced ejection fraction. However, implication of MRA dosing in older patients undergoing transcatheter edge-to-edge mitral valve repair (TEER) for secondary mitral regurgitation remains uncertain.</p><p><strong>Objectives: </strong>The authors aimed to investigate the prognostic impacts of MRA dosing in older patients receiving TEER for secondary mitral regurgitation.</p><p><strong>Methods: </strong>This study included patients who underwent TEER and were enrolled in the OCEAN (Optimized CathEter vAlvular iNtervention)-Mitral registry. Patients with a left ventricular ejection fraction <50% and secondary mitral regurgitation were selected. The dose-dependent effects of MRA, administered at discharge, on the 2-year composite outcome of all-cause mortality and heart failure hospitalization were evaluated.</p><p><strong>Results: </strong>A total of 2,026 patients (median age 77 years; 1,287 men) were included and followed for a median 416 days (Q1-Q3: 294-730 days). Post-TEER, the administration of MRA at a dose of ≥12.5 mg/d (ie, any doses of MRA) was independently associated with a lower 2-year cumulative incidence of the primary composite outcome, with an adjusted HR of 0.83 (95% CI: 0.69-0.99; P = 0.046). In contrast, higher doses of MRA were not significantly associated with a further reduction in the risk of the primary outcome (P = 0.97).</p><p><strong>Conclusions: </strong>In older patients who underwent TEER for secondary mitral regurgitation caused by systolic heart failure, even a low-dose MRA was associated with improved clinical outcomes compared with no MRA administration. However, further up-titration of the MRA dose did not result in additional improvements in clinical outcomes. (OCEAN-Mitral registry; UMIN000023653).</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164100","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":"Long-Term and Time-Dependent Association of Predictors on Mortality in Patients With Iliofemoral Artery Disease.","authors":"Yoshimitsu Soga, Mitsuyoshi Takahara, Osamu Iida, Kenji Suzuki, Shinsuke Mori, Daizo Kawasaki, Kazuki Haraguchi, Terutoshi Yamaoka, Kenji Ando","doi":"10.1016/j.jacasi.2025.03.013","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.03.013","url":null,"abstract":"<p><strong>Background: </strong>Although several predictors affect long-term mortality in patients with lower extremity artery disease, long-term association of predictors on mortality over time remain unclear.</p><p><strong>Objectives: </strong>The aim of this study was to explore the long-term and time-dependent association of baseline characteristics with mortality in patients with iliofemoral arterial disease.</p><p><strong>Methods: </strong>This study is a multicenter retrospective analysis of 4,086 consecutive patients (mean age 72 ± 9 years, 74% men) who underwent endovascular therapy for symptomatic de novo iliofemoral arterial disease between January 2004 and December 2011 at 16 cardiovascular centers in Japan.</p><p><strong>Results: </strong>During the median follow-up of 3.8 years (Q1-Q3: 1.4-7.4 years), 1,100 deaths, and 637 major adverse cardiovascular events (MACE) (defined as death, myocardial infarction, and stroke) were observed. Overall survival and MACE-free rates were estimated to be 56.1% and 50.6% at 10 years. Old age, chronic kidney disease stage, heart failure, the lack of renin-angiotensin-system inhibitor use, chronic limb threatening ischemia (CLTI), decreased ankle-brachial index, femoropopliteal lesion were significantly associated with an increased risk of mortality. while the prognostic impact of CLTI was significantly attenuated afterwards. Old age, chronic kidney disease stage, cerebrovascular disease, coronary artery disease, heart failure, warfarin use, the lack of statin use, and CLTI were significantly associated with an increased risk of MACE, while the prognostic impact of cerebrovascular disease and CLTI was significantly attenuated afterwards.</p><p><strong>Conclusions: </strong>This study demonstrated long-term and time-dependent association of predictors on mortality and MACE following endovascular therapy. It highlights the need for continuous management of cardiovascular risk factors in this high-risk population.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164102","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":"Prognostic Significance of Time Between Balloon and Peak CK-MB in AMI Patients Undergoing Primary PCI","authors":"Eiji Shibahashi MD, PhD ,&nbsp;Ryoko Kawakami PhD ,&nbsp;Noritoshi Fukushima MD, PhD ,&nbsp;Issei Ishida MD ,&nbsp;Hisao Otsuki MD, PhD ,&nbsp;Takehiro Hata MD ,&nbsp;Kazuho Kamishima MD, PhD ,&nbsp;Kensuke Shimazaki MD ,&nbsp;Takahiro Yamada MD ,&nbsp;Natsuko Shiozaki MD ,&nbsp;Shohei Kataoka MD, PhD ,&nbsp;Yuta Morioka MD ,&nbsp;Toshiaki Oka MD, PhD ,&nbsp;Yutaka Terajima MD, PhD ,&nbsp;Yoshimi Ota MD ,&nbsp;Katsumi Saito MD, PhD ,&nbsp;Atsushi Honda MD, PhD ,&nbsp;Hiroyuki Tanaka MD, PhD ,&nbsp;Junichi Yamaguchi MD, PhD ,&nbsp;Kentaro Jujo MD, PhD","doi":"10.1016/j.jacasi.2024.12.013","DOIUrl":"10.1016/j.jacasi.2024.12.013","url":null,"abstract":"<div><h3>Background</h3><div>Peak creatine kinase-MB (CK-MB) level is an established predictor of clinical outcomes following acute myocardial infarction (AMI). However, the significance of the duration between balloon inflation and peak CK-MB level (BP time) after primary percutaneous coronary intervention (PCI) remains underexplored in terms of prognostic impact.</div></div><div><h3>Objectives</h3><div>This study aimed to elucidate the relationship between BP time and prognostic outcomes in patients with AMI.</div></div><div><h3>Methods</h3><div>In this multicenter observational study, 935 AMI patients who underwent primary PCI and achieved TIMI flow grade 3 on final angiography were included. CK-MB levels were measured systematically at admission and at 3-hour intervals post-PCI. Based on a BP time threshold of 553 minutes, patients were categorized into 2 groups: the long BP-time group (n = 183) and the short BP-time group (n = 752).</div></div><div><h3>Results</h3><div>The mean age of the patients was 67 years, with a median BP time of 334 minutes (Q1-Q3: 248-491 minutes). The long BP-time group exhibited a higher prevalence of male patients and a history of prior PCI. Cardiovascular mortality was significantly greater in the long BP-time group (log-rank test: <em>P =</em> 0.002). Multivariable Cox regression analysis indicated that a prolonged BP time was independently associated with increased cardiovascular mortality (HR: 2.63; 95% CI: 1.19-5.78).</div></div><div><h3>Conclusions</h3><div>Our findings reveal a significant association between BP time and 1-year cardiovascular mortality in patients with AMI. As a readily assessable parameter, BP time can be a valuable tool for early mortality risk stratification in patients post-primary PCI. (Prognostic Implications of Time between Balloon to Peak Creatinine Kinase-MB in patients with Acute Myocardial Infarction Undergoing Primary PCI: Multicenter Cohort Study; <span><span>UMIN000049942</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 5","pages":"Pages 650-659"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912878","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":"CK-MB Kinetics as a Superior Prognostic Indicator in Primary PCI","authors":"Abhishek Goyal MBBS, MD, DM","doi":"10.1016/j.jacasi.2025.02.004","DOIUrl":"10.1016/j.jacasi.2025.02.004","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 5","pages":"Pages 660-662"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912879","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":"Resolution of Thrombi in Left Atrial Appendage With Edoxaban","authors":"Jongmin Hwang MD ,&nbsp;Seongwook Han MD ,&nbsp;Hyoung-Seob Park MD ,&nbsp;Tae-Wan Chung MD ,&nbsp;Min-Su Jung MD ,&nbsp;Seung Yong Shin MD ,&nbsp;Eue-Keun Choi MD ,&nbsp;Young Keun On MD ,&nbsp;Gi-Byoung Nam MD ,&nbsp;Young Soo Lee MD ,&nbsp;Dong Gu Shin MD ,&nbsp;Ki Hong Lee MD ,&nbsp;Jong-Il Choi MD ,&nbsp;Ji Hyun Lee MD","doi":"10.1016/j.jacasi.2025.01.011","DOIUrl":"10.1016/j.jacasi.2025.01.011","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 5","pages":"Pages 695-698"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912768","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":"Head-Neck-Aorta CT Angiography in Patients With Acute Type A Aortic Dissection","authors":"Yunpeng Zhu MD ,&nbsp;Fuhua Yan MD","doi":"10.1016/j.jacasi.2025.02.013","DOIUrl":"10.1016/j.jacasi.2025.02.013","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 5","pages":"Pages 689-690"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912766","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":"Using a Cardiogenic Shock Classification System for Predicting Postcardiotomy Shock Mortality","authors":"Yiwen Wang MD ,&nbsp;Chenglong Li MD ,&nbsp;Liangshan Wang MD,&nbsp;Xing Hao MD,&nbsp;Xiaomeng Wang MD,&nbsp;Tingting Wu MD,&nbsp;Dengbang Hou MD,&nbsp;Ming Jia MD,&nbsp;Feng Yang MD,&nbsp;Zhongtao Du MD,&nbsp;Hong Wang MD, PhD,&nbsp;Xiaotong Hou MD, PhD","doi":"10.1016/j.jacasi.2025.01.007","DOIUrl":"10.1016/j.jacasi.2025.01.007","url":null,"abstract":"<div><h3>Background</h3><div>Cardiogenic shock (CS) is a life-threatening hemodynamic state. Patients with differing shock severity show varying responsiveness to clinical interventions. CS also occurs in patients who have undergone cardiac surgery. A few evaluation systems have been developed for postcardiotomy patients. The Society for Cardiovascular Angiography and Intervention (SCAI) has developed a new classification scheme for CS.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the parameters that define the stages of CS and the diagnostic utility of an SCAI-based CS classification system for patients undergoing cardiac surgery to inform the prediction of outcomes.</div></div><div><h3>Methods</h3><div>This single-center, retrospective, observational study included 8,335 consecutive adult patients undergoing cardiac surgery from January to December 2022. This cohort was divided into 5 groups based on lactate and types of intervention received, including vasopressors and mechanical circulatory support systems. The primary outcome was in-hospital mortality.</div></div><div><h3>Results</h3><div>CS occurred in 970 (11.1%) patients of this cohort. The frequencies of distribution of various postcardiotomy shock stages differed significantly: stage A = 4,747 (57.0%), stage B = 2,658 (31.9%), stage C = 779 (9.3%), stage D = 64 (0.8%), and stage E = 87 (1.0%) (<em>P &lt;</em> 0.001) patients. In-hospital mortality was 1.1% (94 of 8,335). A progressive increase in the stage of the disease led to a clear stepwise increase in in-hospital mortality: Stage A = 0.4% (19 of 4747), Stage B = 0.8% (21 of 2658), Stage C = 2.8% (22 of 779), Stage D = 7.8% (5 of 64), and Stage E = 31.0% (27 of 87) (<em>P &lt;</em> 0.001). The area under the receiver-operating curve of this classification for postcardiotomy CS was 0.781 (95% CI: 0.746-0.815).</div></div><div><h3>Conclusions</h3><div>In this single-center postcardiotomy population, CS occurred in 11.1% of patients. Postcardiotomy SCAI-derived criteria for CS severity suggested a good correlation with in-hospital mortality.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 5","pages":"Pages 663-676"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912880","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 Guidance of Head-Neck-Aorta CT Angiography in Acute Type A Aortic Dissection Patients","authors":"Hongliang Zhao MD ,&nbsp;Chengxiang Li MD ,&nbsp;Jian Xu MD ,&nbsp;Chao Xue MD ,&nbsp;Yingjuan Chang MD ,&nbsp;Mengqi Wei MD ,&nbsp;Lei Shang MD ,&nbsp;Shushen Lin MD ,&nbsp;Weixun Duan MD ,&nbsp;Minwen Zheng MD","doi":"10.1016/j.jacasi.2024.12.011","DOIUrl":"10.1016/j.jacasi.2024.12.011","url":null,"abstract":"<div><h3>Background</h3><div>The benefit of preoperative craniocervical artery imaging has not been elucidated for decision-making during the surgical repair of acute type A aortic dissection (ATAAD).</div></div><div><h3>Objectives</h3><div>The purpose of this study was to explore the clinical implication of a preoperative extended head-neck-aorta computed tomography angiography (CTA) among ATAAD patients.</div></div><div><h3>Methods</h3><div>ATAAD patients undergoing surgical repair were retrospectively enrolled. Preoperatively, 215 patients underwent aortic CTA (conventional group) and 220 underwent extended CTA (extended group). In the extended group, the surgical team was informed of assessment of craniocervical arteries before the operation. The primary endpoint was postoperative transient neurological deficit and permanent neurological deficit. A 1:1 propensity score matching analysis was performed to account for baseline differences between groups, resulting in 154 pairs.</div></div><div><h3>Results</h3><div>In the extended group, 135 patients were free of preoperative neurological symptoms, but 35 (25.9%) presented with severely stenosed or occluded common carotid artery. Common carotid artery reconstruction and cannulation combined with femoral artery cannulation (24.1% vs 5.1%; <em>P &lt;</em> 0.001) and bilateral antegrade selective cerebral perfusion during hypothermic circulatory arrest (56.4% vs 19.1%; <em>P &lt;</em> 0.001) were more adopted in the extended group. In the matched cohort, the extended CTA was significantly associated with fewer postoperative permanent neurological deficit (adjusted OR: 0.186; 95% CI: 0.059-0.587; <em>P =</em> 0.004) after adjustment with logistic regression.</div></div><div><h3>Conclusions</h3><div>The extended head-neck-aorta CTA protocol provided additional anatomical clarity preoperatively for modified surgical strategies and may subsequently improved the neurological outcomes of ATAAD.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 5","pages":"Pages 679-688"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912765","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}