JACC. Asia最新文献

{"title":"Causal Associations Between Socioeconomic Status, Intelligence, Cognition and Atrial Fibrillation","authors":"Wulamiding Kaisaier MD ,&nbsp;Min Ye MD ,&nbsp;Zexuan Wu MD ,&nbsp;Chen Liu MD ,&nbsp;Jiangui He MD ,&nbsp;Gregory Y.H. Lip MD ,&nbsp;Yili Chen MD ,&nbsp;Wengen Zhu MD","doi":"10.1016/j.jacasi.2025.04.008","DOIUrl":"10.1016/j.jacasi.2025.04.008","url":null,"abstract":"<div><h3>Background</h3><div>Lower socioeconomic status, intelligence, and cognition are linked to a higher likelihood of atrial fibrillation (AF). However, whether these factors directly cause AF or whether others mediate this relationship is unclear.</div></div><div><h3>Objectives</h3><div>Our study aimed to determine the causal link between lower socioeconomic status, intelligence, cognition, and AF, and identify mediators.</div></div><div><h3>Methods</h3><div>We conducted a 2-sample Mendelian randomization analysis with data from European ancestry genome-wide association studies. Genetic instruments for education, intelligence, cognition, income, and occupation (n = 248,847-1,131,881) evaluated their relationship with AF (FinnGen study: 50,743 cases and 210,652 control subjects; 6 European studies: 60,620 and 970,216).</div></div><div><h3>Results</h3><div>The pooled results from meta-analysis combining data from 2 studies indicated that education, intelligence, and cognition were causally associated with AF (<em>P</em> &lt; 0.05). Genetically predicted, each 1-SD increase in educational attainment was associated with a 19% decreased risk of AF (OR: 0.81; 95% CI: 0.71–0.92), independent of intelligence and cognition. Among 44 candidate mediators, 8 factors were identified to mediate the education-AF association, including heart failure (mediation proportion: 95.35%), body fat mass (44.05%), waist circumference (42.93%), coronary heart disease (30.1%), body mass index (29.0%), myocardial infarction (28.8%), diastolic blood pressure (21.7%), and waist-to-hip ratio (14.3%).</div></div><div><h3>Conclusions</h3><div>Our study suggests that education exerts a causal and protective effect against AF, independent of intelligence and cognition. Heart failure, obesity, and ischemic heart disease serve as mediating factors in the pathway from education to AF, underscoring the importance of considering these conditions in preventing AF associated with education inequality.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 983-996"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487379","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":"Assessment of Right Atrial Strain by Echocardiography for Predicting Prognosis in Hypertrophic Cardiomyopathy","authors":"Yu Zhang MD ,&nbsp;Haiming Zhuang MD ,&nbsp;Kejia Lou MD ,&nbsp;Channa Zhang MD ,&nbsp;Lianjun Xu MD ,&nbsp;Lianming Kang MD ,&nbsp;Kunjing Pang MD ,&nbsp;Lei Song MD, PhD","doi":"10.1016/j.jacasi.2025.05.003","DOIUrl":"10.1016/j.jacasi.2025.05.003","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 1078-1081"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487378","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":"Epidemiology of Atrial Fibrillation in East Asia","authors":"Shin-Huei Liu MD, PhD ,&nbsp;Tze-Fan Chao MD, PhD","doi":"10.1016/j.jacasi.2025.05.009","DOIUrl":"10.1016/j.jacasi.2025.05.009","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 963-965"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593070","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 MD, PhD ,&nbsp;Yuichiro Shirahama MD, PhD ,&nbsp;Feng Sheng MD ,&nbsp;Ken Ikeda PhD ,&nbsp;Nobuhiro Osada PhD ,&nbsp;Satoru Tanaka MS ,&nbsp;Yang Zhang Master ,&nbsp;Kenichi Tsujita MD, PhD","doi":"10.1016/j.jacasi.2025.05.016","DOIUrl":"10.1016/j.jacasi.2025.05.016","url":null,"abstract":"<div><h3>Background</h3><div>Lipid-lowering therapy (LLT) is important to control atherosclerosis and prevent atherosclerotic cardiovascular disease (ASCVD) events.</div></div><div><h3>Objectives</h3><div>This study aimed to summarize the effects of LLT on coronary atherosclerotic plaque stability and progression in East Asian individuals.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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%; <em>I</em>² = 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%; <em>I</em>² = 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 &lt;70 mg/dL.</div></div><div><h3>Conclusions</h3><div>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 &lt;55 mg/dL, would be beneficial for atherosclerosis treatment.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 1032-1047"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","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":"Systolic Dyssynchrony Index in Hypertrophic Cardiomyopathy","authors":"Rong Wang MD ,&nbsp;Haiming Zhuang MD ,&nbsp;Nan Xu MD ,&nbsp;Li Zhang MD, PhD ,&nbsp;Jiayi Xing MD, PhD ,&nbsp;Tingting Zhang MD ,&nbsp;Lianming Kang MD ,&nbsp;Lei Song MD, PhD ,&nbsp;Kunjing Pang MD","doi":"10.1016/j.jacasi.2025.05.002","DOIUrl":"10.1016/j.jacasi.2025.05.002","url":null,"abstract":"<div><h3>Background</h3><div>Mechanical dispersion (MD) has been demonstrated to be associated with nonsustained ventricular tachycardia (NSVT) and could potentially predict sudden cardiac death in hypertrophic cardiomyopathy (HCM) patients.</div></div><div><h3>Objectives</h3><div>The authors sought to evaluate the systolic dyssynchrony index (SDI) measured with 3-dimensional echocardiography and explore its predictive value for risk assessment in HCM patients.</div></div><div><h3>Methods</h3><div>A total of 610 HCM patients were prospectively enrolled, and we measured the MD and SDI. Their associations with NSVT and guideline-based implantable cardioverter-defibrillator class of recommendation (ICD-COR) were analyzed.</div></div><div><h3>Results</h3><div>A total of 81 (13.28%) patients were diagnosed with NSVT by the 24-hour Holter monitoring. The SDI of HCM patients with NSVT was significantly higher than that of HCM patients without NSVT (8.60% (7.00%–10.80%) vs. 6.00% (4.70%–7.15%). <em>P</em> = 0.000). The SDI was independently associated with the presence of NSVT (OR: 1.57; <em>P</em> = 0.000). The SDI identified NSVT in HCM patients with an area under the curve of 0.79 at a cutoff value of 7.58%, which was significantly higher than MD, with an area under the curve of 0.70 (<em>P</em> = 0.025). The percentages for Class IIa ICD-COR in HCM patients with SDI ≥7.58% were significantly higher than those in HCM patients with SDI &lt;7.58% according the current guidelines.</div></div><div><h3>Conclusions</h3><div>The SDI was more capable of assessing mechanical dyssynchrony and detecting NSVT in HCM patients compared with MD. The SDI might serve to identify HCM patients eligible for Class IIa ICD-COR according to current guidelines.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 1050-1061"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487380","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":"Triple Assessments of Atherosclerosis in Patients With Heterozygous Familial Hypercholesterolemia","authors":"Hayato Tada MD ,&nbsp;Nobuko Kojima MD ,&nbsp;Kan Yamagami MD ,&nbsp;Akihiro Nomura MD ,&nbsp;Atsushi Nohara MD ,&nbsp;Soichiro Usui MD ,&nbsp;Kenji Sakata MD ,&nbsp;Masa-aki Kawashiri MD ,&nbsp;Masayuki Takamura MD","doi":"10.1016/j.jacasi.2025.04.011","DOIUrl":"10.1016/j.jacasi.2025.04.011","url":null,"abstract":"<div><h3>Background</h3><div>Data on the appropriate timing and impact of atherosclerosis assessment in patients with heterozygous familial hypercholesterolemia (HeFH) are limited.</div></div><div><h3>Objectives</h3><div>The authors aimed to determine when atherosclerotic changes occur and the utility of triple assessments of carotid plaque, coronary plaque, and coronary artery calcium (CAC) in patients with HeFH.</div></div><div><h3>Methods</h3><div>Data from patients with HeFH in the primary prevention setting admitted to Kanazawa University Hospital between 2000 and 2020 who underwent triple atherosclerosis assessment and were followed up were retrospectively reviewed (n = 622, male = 306, mean age = 54 ± 13 years). Risk factors for coronary heart disease events were determined using the Cox proportional hazard model. Carotid plaque, coronary plaque, and CAC scores were plotted against age.</div></div><div><h3>Results</h3><div>We found that the age was independently associated with coronary heart disease events. Regression equations of carotid plaque, coronary plaque, and CAC scores against age were Y = 0.12X – 2.07 (β coefficient = 0.12 [95% CI: 0.09-0.15]; r² = 0.12), Y = 0.36X – 9.30 (β coefficient = 0.36 [95% CI: 0.26-0.46]; r² = 0.14), and Y = 2.48X – 77.23 (β coefficient = 0.07 [95% CI: 0.04-0.10]; r² = 0.23) in men and Y = 0.12X – 3.60 (β coefficient = 0.12 [95% CI: 0.08-0.16]; r² = 0.18), Y = 0.33X – 11.75 (β coefficient = 0.33 [95% CI: 0.29-0.37]; r² = 0.17), and Y = 2.23X – 89.47 (β coefficient = 0.09 [95% CI: 0.06-0.12]; r² = 0.34) in women, respectively. Significant differences of cardiovascular events were observed among the groups according to atherosclerotic burden.</div></div><div><h3>Conclusions</h3><div>On average, carotid plaque, coronary plaque, and CAC may develop at ages 17, 26, and 31 years in male patients and 30, 36, and 40 years in female patients with HeFH, respectively, based on regression equations. Furthermore, triple assessments help in risk stratification.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 999-1007"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593071","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":"Carotid Plaque, Coronary Calcium, and Coronary Plaque","authors":"Reed Mszar MPH, MS ,&nbsp;Jamal S. Rana MD, PhD","doi":"10.1016/j.jacasi.2025.06.004","DOIUrl":"10.1016/j.jacasi.2025.06.004","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 1008-1011"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692625","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":"Residual Risk for Carotid Atherosclerosis Within Normal LDL-C Levels","authors":"Tsutomu Hirano MD, PhD","doi":"10.1016/j.jacasi.2025.07.001","DOIUrl":"10.1016/j.jacasi.2025.07.001","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 1029-1031"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781103","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":"Educational Attainment as a Causal and Modifiable Risk Factor for Atrial Fibrillation","authors":"Naoto Otsuka MD, PhD,&nbsp;Yasuo Okumura MD, PhD","doi":"10.1016/j.jacasi.2025.05.018","DOIUrl":"10.1016/j.jacasi.2025.05.018","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 997-998"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692626","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 MD ,&nbsp;Liwen Li MD ,&nbsp;Xiaoyan Li MD ,&nbsp;Qing Zhang MD ,&nbsp;Daoquan Peng MD ,&nbsp;Wei Ma MD ,&nbsp;Ping Yang MD ,&nbsp;Fang Wang MD ,&nbsp;Xiang Cheng MD ,&nbsp;Yiqun Fu MD ,&nbsp;Jing Sun MD ,&nbsp;Jian’an Wang MD ,&nbsp;Shuyang Zhang MD","doi":"10.1016/j.jacasi.2025.05.015","DOIUrl":"10.1016/j.jacasi.2025.05.015","url":null,"abstract":"<div><h3>Background</h3><div>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; <span><span>NCT03470545</span><svg><path></path></svg></span>) and EXPLORER-CN (A Study to Evaluate the Efficacy and Safety of Mavacamten in Chinese Adults With Symptomatic Obstructive HCM; <span><span>NCT05174416</span><svg><path></path></svg></span>).</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 <em>P &lt;</em> 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 <em>P =</em> 0.007).</div></div><div><h3>Conclusions</h3><div>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; <span><span>NCT05174416</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 1064-1074"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","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}