JACC. Asia最新文献

{"title":"Full Issue PDF","authors":"","doi":"10.1016/S2772-3747(25)00072-9","DOIUrl":"10.1016/S2772-3747(25)00072-9","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 3","pages":"Pages I-LXXII"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548443","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":"Impact of Tricuspid Valve Repair on Less Than Moderate Tricuspid Regurgitation After Degenerative Mitral Repair","authors":"Jinren Du MD ,&nbsp;Yichen Zhao MD ,&nbsp;Kemin Liu MD,&nbsp;Qing Ye MD,&nbsp;Cheng Zhao MD,&nbsp;Jie Han MD,&nbsp;Xu Meng MD,&nbsp;Fei Meng MD,&nbsp;Tiange Luo MD,&nbsp;Baiyu Tian MD,&nbsp;Jiangang Wang MD","doi":"10.1016/j.jacasi.2025.01.012","DOIUrl":"10.1016/j.jacasi.2025.01.012","url":null,"abstract":"<div><h3>Background</h3><div>Whether tricuspid valve (TV) repair should be performed during degenerative mitral valve repair in patients with less than moderate regurgitation remains controversial.</div></div><div><h3>Objectives</h3><div>This study aimed to explore the clinical outcomes of degenerative mitral valve repair for less than moderate tricuspid regurgitation (TR).</div></div><div><h3>Methods</h3><div>Between 2010 and 2019, 541 patients with less than moderate TR underwent mitral valve repair for degenerative mitral disease at the Beijing Anzhen Hospital. Among these patients, 255 underwent concomitant TV repair. The median follow-up was 8 years (Q1-Q3: 6-11 years). The primary endpoint was the development of moderate TR. The secondary endpoint was death, recurrent mitral regurgitation (MR), reoperation for MR or TR, new-onset atrial fibrillation, and permanent pacemaker implantation. Propensity score matching was performed to reduce selection bias.</div></div><div><h3>Results</h3><div>After baseline adjustment, propensity score matching analysis identified 207 pairs. There were no significant differences in the primary endpoints between the patients who underwent simultaneous TV repair and those who did not. Mortality, recurrent MR, permanent pacemaker implantation, and reoperation for MR or TR did not differ significantly between groups. Concomitant TV repair only contributed to new-onset atrial fibrillation, with 24 (11.6%) in the TV-repair group and 7 (3.4%) in the no-repair group (<em>P =</em> 0.001).</div></div><div><h3>Conclusions</h3><div>Considering its minimal effects on the development of TR and potential contributions to postoperative new-onset atrial fibrillation during follow-up among these patients, more aggressive TV repair is not encouraged among patients with less than moderate TR during MV surgery.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 3","pages":"Pages 467-475"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698080","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":"Transcatheter Tricuspid Annuloplasty in Tricuspid Regurgitation Patients With Right Ventricular-Pulmonary Arterial Uncoupling","authors":"Dawei Lin MD ,&nbsp;Qinchun Jin MD ,&nbsp;Jiaxin Miao MD,&nbsp;Zhenzhen Li MB,&nbsp;Jianing Fan MB,&nbsp;Wanjiao Chen MD,&nbsp;Wenzhi Pan MD,&nbsp;Daxin Zhou MD,&nbsp;Xiaochun Zhang MD,&nbsp;Junbo Ge MD","doi":"10.1016/j.jacasi.2025.01.004","DOIUrl":"10.1016/j.jacasi.2025.01.004","url":null,"abstract":"<div><h3>Background</h3><div>There is limited evidence regarding evidence of transcatheter tricuspid annuloplasty using K-Clip (Huihe Medical Technology) in tricuspid regurgitation (TR) patients with right ventricular-pulmonary arterial (RV-PA) uncoupling.</div></div><div><h3>Objectives</h3><div>This study sought to explore the role of transcatheter tricuspid annuloplasty in patients with RV-PA uncoupling.</div></div><div><h3>Methods</h3><div>This was a retrospective observational study, including patients who underwent transcatheter annular repair successfully using the K-Clip device with RV-PA uncoupling at 9 centers in China. RV-PA uncoupling was characterized by a tricuspid annular plane systolic excursion/pulmonary artery systolic pressure (PASP) ratio &lt;0.55. Baseline information, imaging results, and their subsequent follow-up data were collected.</div></div><div><h3>Results</h3><div>All 81 patients (29 men, 72.6 ± 6.9 years of age) underwent successful intervention were enrolled in this study. During 30 days and 6 months follow-up, patients showed significant improvement in tricuspid annular plane systolic excursion/PASP rate (baseline vs 30 days: 0.40 ± 0.07 vs 0.50 ± 0.18; <em>P</em> &lt; 0.001; baseline vs 6 months: 0.40 ± 0.07 vs 0.44 ± 0.11; <em>P =</em> 0.007) and decline in PASP comparing to those at baseline; patients with RV-PA uncoupling showed sustained improvement in TR status with significant improvement in life quality (NYHA functional class, Kansas City Cardiomyopathy Questionnaire scores); 3 noncardiovascular deaths were documented, and the rate of adverse events during follow-up was acceptable.</div></div><div><h3>Conclusions</h3><div>Transcatheter tricuspid annuloplasty showed a significant and durable improvement in TR in patients with RV-PA uncoupling. Significant improvement and decline are observed in RV-PA ratio and PASP, respectively. All-cause mortality and adverse event rates were acceptable, with sustained improvements in quality of life.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 3","pages":"Pages 424-433"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698086","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":"Impact of Height Exponents on the Diagnosis and Prognosis of LVH","authors":"Clement Lee MBBS ,&nbsp;Ryan Chan MBBS ,&nbsp;Desiree-Faye Toh MSc ,&nbsp;Michelle Kui MBBS ,&nbsp;Vivian Lee MSc ,&nbsp;Jennifer A. Bryant PhD ,&nbsp;Redha Boubertakh PhD ,&nbsp;Chi-Hang Lee MBBS, MD ,&nbsp;Thu-Thao Le PhD ,&nbsp;Calvin W.L. Chin MD, PhD","doi":"10.1016/j.jacasi.2024.12.006","DOIUrl":"10.1016/j.jacasi.2024.12.006","url":null,"abstract":"<div><h3>Background</h3><div>Left ventricular hypertrophy (LVH) is a strong predictor of adverse outcomes. Although normalizing LV mass (LVM) to height exponents reduced variability from body size, specific recommendations for height exponents are lacking due to a scarcity of normal cohorts to define appropriate height exponents.</div></div><div><h3>Objectives</h3><div>The authors aimed to show the diagnostic and prognostic implications of establishing height exponents specific to sex, ethnicity, and imaging modality.</div></div><div><h3>Methods</h3><div>Nonoverweight/nonobese Asian healthy volunteers (n = 416) were used to establish appropriate height exponents. The impact of these height exponents was examined in a separate cohort of Asian subjects with hypertension (n = 878). All individuals underwent standardized cardiovascular magnetic resonance imaging. The primary outcome was a composite of acute coronary syndrome, heart failure hospitalization, stroke, and cardiovascular mortality.</div></div><div><h3>Results</h3><div>The height exponents for healthy female subjects and male subjects were 1.57 and 2.33, respectively. LVH was present in 27% of individuals with hypertension when indexed to body surface area and 47% when indexed to sex-specific height exponents. Most individuals reclassified to LVH with height exponents were overweight or obese. There were 37 adverse events over 60 months (37-73 months) of follow-up. Regardless of indexing method, LVH was independently associated with increased adverse events (height exponent HR: 2.80 [95% CI: 1.25-6.29; <em>P</em> = 0.013]; body surface area HR: 5.43 [95% CI: 2.49-11.8; <em>P</em> &lt; 0.001]).</div></div><div><h3>Conclusions</h3><div>Reference ranges specific to ethnicity, sex, and imaging modality are necessary to establish appropriate height exponents. Although using height exponents resulted in more LVH reclassification, this did not translate to a notable improvement in event prediction.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 3","pages":"Pages 350-357"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548437","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":"Prevalence of Cardiovascular-Kidney-Metabolic Syndrome Stages Among Middle-Aged and Older Adults in China","authors":"Hui Zhang PhD ,&nbsp;Zixin Hu PhD ,&nbsp;Jingyi Wu BA ,&nbsp;Yi Li PhD ,&nbsp;Shuai Jiang PhD ,&nbsp;Li Jin PhD ,&nbsp;Xiaofeng Wang MD ,&nbsp;Meng Hao PhD","doi":"10.1016/j.jacasi.2024.12.003","DOIUrl":"10.1016/j.jacasi.2024.12.003","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 3","pages":"Pages 393-395"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548441","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":"Impacts of Tricuspid Regurgitation and Concomitant Tricuspid Surgery in Aortic Valve Replacement","authors":"Kitae Kim MD ,&nbsp;Tae Hyun Park MD ,&nbsp;Sungsil Yoon MD,&nbsp;Soojin Park MD, PhD,&nbsp;Hong Rae Kim MD, PhD,&nbsp;Ho Jin Kim MD, PhD,&nbsp;Jae Suk Yoo MD, PhD,&nbsp;Sung-Ho Jung MD, PhD,&nbsp;Cheol Hyun Chung MD, PhD,&nbsp;Joon Bum Kim MD, PhD","doi":"10.1016/j.jacasi.2024.10.014","DOIUrl":"10.1016/j.jacasi.2024.10.014","url":null,"abstract":"<div><h3>Background</h3><div>Recent studies on the effects of preoperative tricuspid regurgitation (TR) severity and concomitant tricuspid valve (TV) surgery in patients undergoing aortic valve replacement (AVR) have yielded conflicting results, complicating the decision making on concomitant TV surgery in AVR.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to investigate the impact of preoperative TR severity on outcomes of AVR and to assess the impact of concomitant TV surgery.</div></div><div><h3>Methods</h3><div>Patients who underwent AVR from 2000 to 2022 were included. The primary outcome was all-cause mortality, and the secondary outcome was a composite of mortality, TV-related reoperation, stroke, and heart failure. For patients with moderate TR, the impact of TV surgery was analyzed using the inverse probability of treatment weighting to address for selection bias.</div></div><div><h3>Results</h3><div>A total of 2,679 consecutive patients (median 7.22 years, Q1-Q3: 4.21-11.83 years) constituted the study cohort. At baseline, TR severity was none-to-trivial, mild, moderate, and severe in 1,688 (63.0%), 731 (27.3%), 215 (8.0%), and 45 (1.7%) patients, respectively. Clinical outcomes demonstrated significant disparities depending on baseline TR severity (<em>P</em> for trend &lt; 0.001). After adjusting for potential covariates, TV surgery did not affect overall survival among patients with moderate TR (HR: 0.57; 95% CI: 0.21-1.50). However, the TV surgery group exhibited a favorable composite outcome and lower TV-related reoperation rate (HR: 0.37; 95% CI: 0.15-0.92, and subdistribution HR: 0.07; 95% CI: 0.01-0.63, respectively).</div></div><div><h3>Conclusions</h3><div>In patients who underwent AVR, baseline TR severity correlated with unfavorable clinical outcomes. Concomitant TV surgery reduced the rate of TV-related reoperations, but not mortality, among patients with moderate TR.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 3","pages":"Pages 455-464"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698078","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":"Optimal Mechanical Circulatory Support Timing in Patients With Acute Myocardial Infarction With Cardiogenic Shock","authors":"Dong-Gil Kim MD ,&nbsp;Cheol Woong Yu MD, PhD ,&nbsp;Ik Hyun Park MD, PhD ,&nbsp;Woo Jin Jang MD, PhD ,&nbsp;Hyun-Joong Kim MD, PhD ,&nbsp;Sang-Don Park MD, PhD ,&nbsp;Ki Hong Choi MD, PhD ,&nbsp;Jeong Hoon Yang MD, PhD ,&nbsp;Hyeon-Cheol Gwon MD, PhD ,&nbsp;Sung Uk Kwon MD, PhD","doi":"10.1016/j.jacasi.2024.11.003","DOIUrl":"10.1016/j.jacasi.2024.11.003","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 3","pages":"Pages 390-392"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548440","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":"Transcatheter Tricuspid Valve Intervention in Right Heart Failure","authors":"Chenxu Zhao MPhil ,&nbsp;Kevin Ka-Ho Kam MBChB ,&nbsp;Alex Pui-Wai Lee MD","doi":"10.1016/j.jacasi.2025.01.002","DOIUrl":"10.1016/j.jacasi.2025.01.002","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 3","pages":"Pages 434-435"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697860","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":"Clinical Characteristics, Outcomes, and Risk Stratification of Combined Mitral and Tricuspid Regurgitation","authors":"Junxing Lv MD ,&nbsp;Qianhong Lu MD ,&nbsp;Weiwei Wang MD ,&nbsp;Yunqing Ye MD ,&nbsp;Zhe Li MD ,&nbsp;Bin Zhang MD, PhD ,&nbsp;Qinghao Zhao MD ,&nbsp;Haitong Zhang MD ,&nbsp;Qingrong Liu MD ,&nbsp;Zhenyan Zhao MD ,&nbsp;Bincheng Wang MD ,&nbsp;Zikai Yu MD ,&nbsp;Shuai Guo MD ,&nbsp;Zhenya Duan MD ,&nbsp;Yanyan Zhao PhD ,&nbsp;Runlin Gao MD, PhD ,&nbsp;Haiyan Xu MD, PhD ,&nbsp;Junbo Ge MD, PhD ,&nbsp;Yongjian Wu MD, PhD ,&nbsp;CHINA-VHD Collaborators","doi":"10.1016/j.jacasi.2024.07.009","DOIUrl":"10.1016/j.jacasi.2024.07.009","url":null,"abstract":"<div><h3>Background</h3><div>Combined mitral regurgitation (MR) and tricuspid regurgitation (TR) is related to more complicated hemodynamic burdens than isolated atrioventricular valve regurgitation.</div></div><div><h3>Objectives</h3><div>This study aimed to investigate clinical characteristics and outcomes of combined MR and TR, as well as developing dedicated prognostic instruments.</div></div><div><h3>Methods</h3><div>A total of 6,704 patients with ≥ moderate MR or TR from the China Valvular Heart Disease study were included in this analysis. The study outcomes included all-cause mortality, death or hospitalization for heart failure, and worsening functional status or death within 2 years.</div></div><div><h3>Results</h3><div>Compared with those with isolated valvular regurgitation, patients with combined MR and TR more often experienced atrial fibrillation or flutter and pulmonary hypertension. During a median follow-up of 733 days (Q1, Q3: 706, 749 days), 624 (9.3%) deaths occurred. Combined MR and TR was related to poorer 2-year outcomes than isolated MR, and was independently associated with worse prognosis in symptomatic patients (all-cause mortality: MR vs MR+TR, HR: 0.776 [95% CI: 0.616-0.978]; <em>P =</em> 0.031) and those with normal left ventricular systolic function (composite endpoint: HR: 0.629 [95% CI: 0.400-0.990]; <em>P =</em> 0.045). Based on carefully evaluated predictors of mortality, a prognostic nomogram and a risk score were developed and externally validated for patients with combined MR and TR, with superior predictive performance than the MitraScore and comparable discrimination compared with artificial intelligence-derived models.</div></div><div><h3>Conclusions</h3><div>Patients with combined MR and TR displayed worse clinical profiles and poorer outcomes compared with those with isolated MR. The novel prognostic tools may improve personalized risk assessment of combined MR and TR.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 3","pages":"Pages 436-452"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697861","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":"Navigating the Dual Challenge","authors":"Alex Pui Wai Lee MBChB, MD","doi":"10.1016/j.jacasi.2024.10.007","DOIUrl":"10.1016/j.jacasi.2024.10.007","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 3","pages":"Pages 453-454"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697862","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}