JACC. Asia最新文献

{"title":"Prevalence of Cardiovascular-Kidney-Metabolic Syndrome Stages Among Middle-Aged and Older Adults in China","authors":"Hui Zhang PhD , Zixin Hu PhD , Jingyi Wu BA , Yi Li PhD , Shuai Jiang PhD , Li Jin PhD , Xiaofeng Wang MD , 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}

{"title":"Single-Cell Transcriptomics Identified Fibrosis-Activated Valve Interstitial Cells Involved in Functional Tricuspid Regurgitation","authors":"Ruojin Zhao MD ,&nbsp;Mengxia Fu MD, PhD ,&nbsp;Songren Shu MD ,&nbsp;Xiao Chen MD ,&nbsp;Xiaohu Wang MD ,&nbsp;Ningning Zhang BS ,&nbsp;Keming Yang MD ,&nbsp;Xiumeng Hua MD, PhD ,&nbsp;Xin Wang MD, PhD ,&nbsp;Jiangping Song MD, PhD","doi":"10.1016/j.jacasi.2025.01.013","DOIUrl":"10.1016/j.jacasi.2025.01.013","url":null,"abstract":"<div><h3>Background</h3><div>The treatment of functional tricuspid regurgitation (TR) is still controversial. Characterizing the cellular composition of the tricuspid valve and identifying the molecular alterations of each cell type in valves with TR will advance our understanding of the mechanisms of TR and guide improvements in treatment.</div></div><div><h3>Objectives</h3><div>The authors aimed to investigate the changes in cellular composition and gene expression patterns of cells in regurgitant tricuspid valves and shed light on the mechanisms of functional TR.</div></div><div><h3>Methods</h3><div>To improve our understanding of the pathogenesis of functional TR, we performed single-cell RNA sequencing of tricuspid valve from 10 patients, including 5 patients with moderate-to-severe functional TR and 5 nondiseased control subjects. Multiplexed fluorescence was used to detect the spatial distributions of valvular cell states and validated the cell-cell interaction.</div></div><div><h3>Results</h3><div>We assessed the transcriptional profiles of 84,102 cells and identified 6 major cell clusters, along with 25 cell subtypes, in the specimens. Valve interstitial cells (VICs) were the largest population. VICs and lymphoid cells exhibited more heterogeneity in TR patients. VICs exhibited higher transcriptional activity toward matrifibrocyte-like cells and myofibroblast-like cell differentiation, myeloid cells activated immune response, and lymphoid cells promoted fibrosis. In TR, the alternation of COMP-CD47 and FGF2-FGFR1 interaction may occur in TR specimens, which may serve as promising therapeutic targets for TR.</div></div><div><h3>Conclusions</h3><div>Our single-cell atlas highlights the transcriptomic heterogeneity underlying the cell functions and interactions in human tricuspid valves and defines molecular and cellular perturbations in functional TR. We identified VIC clusters with fibrosis activation accumulated in TR valves.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 3","pages":"Pages 478-495"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698082","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":"Balancing Risks and Timing","authors":"So-Ryoung Lee MD, PhD","doi":"10.1016/j.jacasi.2024.12.007","DOIUrl":"10.1016/j.jacasi.2024.12.007","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 3","pages":"Pages 371-373"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143547848","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":"A Membrane Modification Technique for Left Atrial Appendage Occlusion","authors":"Youqi Fan MD ,&nbsp;Dongxing Ma MD ,&nbsp;Changqian Wang MD ,&nbsp;Jun Luo MD ,&nbsp;Zhiyu Ling MD ,&nbsp;Shuyan Li MD ,&nbsp;Xiaoping Peng MD ,&nbsp;Zheng Zhang MD ,&nbsp;Huimin Chu MD ,&nbsp;Jianan Wang MD ,&nbsp;investigators in the present study","doi":"10.1016/j.jacasi.2024.12.008","DOIUrl":"10.1016/j.jacasi.2024.12.008","url":null,"abstract":"<div><h3>Background</h3><div>We previously pioneered a negatively ionized polyethylene terephthalate membrane method (the SMART technique) with the LAMax (test) occluder to reduce platelet adhesion and promote endothelialization.</div></div><div><h3>Objectives</h3><div>This study aimed to compare the safety and efficacy of the test occluder with the Watchman 2.5 device (control) in patients with nonvalvular atrial fibrillation to reduce stroke risk.</div></div><div><h3>Methods</h3><div>Overall, 236 patients were randomly assigned (1:1) (open-label) to the test or control device for left atrial appendage occlusion (LAAO). The effectiveness endpoints included 12-month successful left atrial appendage (LAA) sealing with residual flow ≤5 mm and clinical success (composite of ischemic stroke, transient ischemic attack, and systemic embolism). Safety endpoints were also studied. A noninferiority margin of –7% was set between the devices.</div></div><div><h3>Results</h3><div>The test device was noninferior to the control device for the effectiveness endpoints of successful LAA sealing (test 93.2% vs control 89.8%; <em>P</em> &lt; 0.05) and clinical success (test 93.2% vs control 89.8%; <em>P</em> &lt; 0.05). The 12-month safety endpoints were similar between the 2 devices. The device-related thrombus rates for the control device at the 3- and 12-month visits were 5.7% and 4.6%, respectively; no cases of device-related thrombus occurred with the test device.</div></div><div><h3>Conclusions</h3><div>This study suggests that transcatheter LAAO using the SMART technique may effectively and safely prevent stroke in patients with nonvalvular atrial fibrillation. Although further studies with larger sample sizes are needed, this novel technique may prevent device-related thrombus formation and has high potential for application in interventional therapies. (LAMax Vs. Watchman LAAC Device for Subjects With Non-valvular AF to Reduce the Risk of Stroke; <span><span>NCT04429646</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 3","pages":"Pages 374-387"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548435","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","authors":"Xinqiao Lian PhD ,&nbsp;Minjie Lu PhD","doi":"10.1016/j.jacasi.2025.01.003","DOIUrl":"10.1016/j.jacasi.2025.01.003","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 3","pages":"Pages 358-360"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548438","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}