American Journal of Cardiology最新文献

Invasive coronary angiography has limited diagnostic accuracy for detecting reduction of myocardial perfusion assessed by cardiac magnetic resonance.

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-03-29 DOI: 10.1016/j.amjcard.2025.03.027

Anna E Székely, Shahnaz Akil, Fredrik Hedeer, Peter Kellman, Marcus Carlsson, David Erlinge, Moman A Mohammad, Håkan Arheden, Henrik Engblom

{"title":"Invasive coronary angiography has limited diagnostic accuracy for detecting reduction of myocardial perfusion assessed by cardiac magnetic resonance.","authors":"Anna E Székely, Shahnaz Akil, Fredrik Hedeer, Peter Kellman, Marcus Carlsson, David Erlinge, Moman A Mohammad, Håkan Arheden, Henrik Engblom","doi":"10.1016/j.amjcard.2025.03.027","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.03.027","url":null,"abstract":"The relationship between degree of coronary artery stenosis and its effect on myocardial perfusion is complex and constitutes a clinical challenge. The aim of this study was to assess diagnostic accuracy of visual assessment of invasive coronary angiography (ICA) for detecting reduced myocardial perfusion determined by quantitative first-pass perfusion (qFPP) cardiac magnetic resonance (CMR) in patients with suspected or established chronic coronary syndrome (CCS). Forty-nine patients with suspected or established CCS were included from the elective ICA list in this prospective, observational study and underwent qFPP CMR prior to ICA. Myocardial perfusion at stress and myocardial perfusion reserve (MPR) were assessed for each vessel territory. Myocardial perfusion at stress <2.0 ml/min/g and MPR <2.4 were considered abnormal. Visually assessed coronary artery stenoses from ICA were considered significant if ≥70%. Sensitivity and specificity of visual assessment of ICA for detecting significant reduction of myocardial perfusion ranged between 32-41% and 70-76% on a per vessel level depending on myocardial perfusion measure used as reference. Accuracy ranged between 0.48-0.64. In 59-68% of vessel territories with reduced stress perfusion or MPR, no significant stenosis was found. Thus, visual assessment of invasive coronary angiography has limited diagnostic accuracy for detecting significant reduction of myocardial perfusion assessed by qFPP CMR in patients with suspected or established CCS. Hence, quantitative myocardial perfusion is required when evaluating the cause of angina to distinguish between coronary stenosis, microvascular dysfunction and non-cardiac causes of chest pain.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Right Ventricular Dysfunction in Heart Failure Patients: Does Sex Matter?

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-03-29 DOI: 10.1016/j.amjcard.2025.03.029

Carolina Guimaraes, Rita Gouveia, Helena Hipólito-Reis, Rui Ribeiro, Francisca Correia, Sérgio Madureira, Catarina Elias, Ana Margarida Fonseca, Helena Rocha, Mariana Matos, Ana Ribeiro, Jorge Almeida, Patrícia Lourenço

{"title":"Right Ventricular Dysfunction in Heart Failure Patients: Does Sex Matter?","authors":"Carolina Guimaraes, Rita Gouveia, Helena Hipólito-Reis, Rui Ribeiro, Francisca Correia, Sérgio Madureira, Catarina Elias, Ana Margarida Fonseca, Helena Rocha, Mariana Matos, Ana Ribeiro, Jorge Almeida, Patrícia Lourenço","doi":"10.1016/j.amjcard.2025.03.029","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.03.029","url":null,"abstract":"Right ventricular dysfunction (RVD) predicts poor survival in chronic heart failure (HF). Sex differences in RVD have been suggested but are still unraveled. We studied the influence of sex in the prognostic impact of RVD in chronic HF. We retrospectively analyzed adult ambulatory chronic HF with left ventricular systolic dysfunction (LVSD) followed from January/2012 to December/2020. Patients with no data on right ventricular function were excluded. Primary outcome: all-cause mortality; follow-up: January 2023. A Cox-regression analysis was used to determine the prognostic impact of RVD, adjustment for confounders was performed. Interaction between sex and RVD was tested. The analysis was stratified according to sex. We studied 1152 patients, 65% male, mean age 71 years. RVD coexisted in 192 (17%). Patients with RVD were younger, more often presented atrial fibrillation and non-ischemic HF, they had more severe LVSD, were more symptomatic, and presented higher BNP levels. During a median 44-month follow-up, 618 (54%) patients died. Patients with RVD presented higher all-cause mortality: multivariate-adjusted HR=1.86 (1.26-2.76). When the analysis was stratified according to sex this negative prognostic impact was only present in females: multivariate-adjusted HR=1.56 (1.02-2.39). The present of RVD was not prognostic associated in men. There was interaction between sex and RVD, p=0.03. In conclusion, RVD appears to be associated with ominous outcome only in female patients: women with systolic HF with RVD presented a 56% higher risk of dying. In male HF patients, RVD showed no prognostic implications. Sex seems to influence the prognostic impact of RDV in chronic HF.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mid-Term Outcomes of Patients with Hypoplastic Left Heart Syndrome and Left Ventricle-Coronary Artery Fistula.

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-03-27 DOI: 10.1016/j.amjcard.2025.03.023

Ryan L Kobayashi, Kaylah Brown, Kimberlee Gauvreau, Ele Valencia, Aditya K Kaza, Nicholas S Boscamp, Kathryn O Stack, T P Singh

{"title":"Mid-Term Outcomes of Patients with Hypoplastic Left Heart Syndrome and Left Ventricle-Coronary Artery Fistula.","authors":"Ryan L Kobayashi, Kaylah Brown, Kimberlee Gauvreau, Ele Valencia, Aditya K Kaza, Nicholas S Boscamp, Kathryn O Stack, T P Singh","doi":"10.1016/j.amjcard.2025.03.023","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.03.023","url":null,"abstract":"Infants with hypoplastic left heart syndrome (HLHS) with mitral stenosis/aortic atresia (MS/AA) have worse outcomes compared to other anatomic variants; this may be related to left ventricle-coronary artery (LV-CA) fistula. We reviewed patients with HLHS (MS/AA) referred to Boston Children's Hospital and managed from birth during 2008-2023 and compared those with and without LV-CA fistula defined angiographically. Among 90 patients, 58 (64%) had LV-CA fistula. In total, 66 (73%) of patients underwent surgical stage 1 palliation (S1P) and 22 (24%) underwent hybrid S1P; hybrid S1P was more common in the fistula group (36% vs 6%, p=0.002). Probability of transplant-free survival at 1 year was 63% (95% CI 49%, 74%) for those with fistula and 78% (95% CI 60%, 89%) for those without. Over a median follow up of 4.3 years [IQR 0.5,7.9], 38 (42%) patients died or underwent transplant. In univariate analysis, lower GA (HR 1.31, 95% CI 1.16, 1.48), lower BW (HR 1.68, 95% CI 1.28, 2.19), initial hybrid S1P (HR 3.50, 95% CI 1.79, 6.84), and need for perioperative ECMO (HR 4.48, 95% CI 2.23, 8.99) were associated with increased risk of death/transplant (P<0.001 for all). The association of LV-CA fistula with death or transplant did not reach statistical significance (HR 1.83, 95% 0.89, 3.76, p=0.10). Mortality remains high for children with HLHS (MS/AA) and while there was a trend toward worse transplant-free survival for children with LV-CA fistula compared to those without, factors other than LV-CA fistula may contribute.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extracorporeal Membrane Oxygenation as a Bridge to Recovery in COVID-19 Myocarditis: A Case Vignette and Evidence-Based Discussion. 体外膜氧合作为 COVID-19 心肌炎患者康复的桥梁：病例小故事与循证讨论。

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-03-26 DOI: 10.1016/j.amjcard.2025.03.026

Taylor Pickering, Rakushumimarika Harada, Jenelle Sheasby, Timothy George, Aasim Afzal

引用次数: 0

Increase in Lipoprotein (a) Screening and Utilization at an Urban Academic Medical Center.

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-03-26 DOI: 10.1016/j.amjcard.2025.03.022

Willis Wong, Cindy Kao, Ruth Schneider, Alagarraju Muthukumar, Ann Marie Navar, Anand Rohatgi, Amit Khera, Parag Joshi

引用次数: 0

Prediction Model of in Hospital Death for Stanford Type A Aortic Dissection Based on a Meta-analysis of 24 Cohorts.

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-03-26 DOI: 10.1016/j.amjcard.2025.03.017

Zhiyuan Wang, Yongbo Zhao, Shichao Guo, Jia LiuMS, Huijun Zhang

{"title":"Prediction Model of in Hospital Death for Stanford Type A Aortic Dissection Based on a Meta-analysis of 24 Cohorts.","authors":"Zhiyuan Wang, Yongbo Zhao, Shichao Guo, Jia LiuMS, Huijun Zhang","doi":"10.1016/j.amjcard.2025.03.017","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.03.017","url":null,"abstract":"Aims: Patients with Stanford type A aortic dissection (TAAD) have high postoperative mortality. This study aimed to develop a prediction model for in-hospital death after surgery in patients with TAAD .Methods: The derivation cohort came from a meta-analysis. Major risk factors were counted. The corresponding hazard ratio was reported to establish a prediction model for in-hospital death in patients with TAAD. Validation cohorts from 2 centres were used to evaluate the prediction model.Results: The meta-analysis included 24 cohort studies with a total of 11404 patients and 1554 patients died early after surgery. Risk factors for the prediction model included age, body mass index, smoking, coronary heart disease, preoperative stroke, shock, preoperative cardiopulmonary resuscitation, pericardial tamponade and malperfusion. Patients with TAAD admitted to the First and the Fourth Hospital of Hebei Medical University between January 2020 and June 2024 were retrospectively collected. Patients from the 2 hospitals constituted validation cohorts A (n = 262) and B (n = 138). Risk scores were calculated for model validation and the prediction model demonstrated better differentiation for validation cohort A, with an area under the curve of 0.886 (95% confidence interval 0.842-0.931).Conclusion: This study established a simple risk prediction model, including 13 risk factors, to predict in-hospital death in patients with TAAD. However, multi-center data is still needed to evaluate the prediction accuracy of the model.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Optimizing Coronary Imaging for Valve Surgery: Is CCTA the Future?

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-03-26 DOI: 10.1016/j.amjcard.2025.03.025

Najia Sadiq, Ashfaq Ahmad, Javed Iqbal, Brijesh Sathian, Ayesha Parvaiz Malik

引用次数: 0

Fasting Versus Nonfasting Before Cardiac Catheterization - Are we asking the right questions?

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-03-26 DOI: 10.1016/j.amjcard.2025.03.024

Anne Rüggeberg, Eike A Nickel

引用次数: 0

Intravascular Ultrasound Predictors of 12-month Patency Loss Following Drug-Coated Balloon Angioplasty for the Femoropopliteal Artery.

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-03-26 DOI: 10.1016/j.amjcard.2025.03.018

Jaeoh Lee, Ji Yong Jang, Chul-Min Ahn, Seung-Jun Lee, Sang-Hyup Lee, Yong-Joon Lee, Sung-Jin Hong, Jung-Sun Kim, Byeong-Keuk Kim, Myeong-Ki Hong, Yangsoo Jang, Tae-Hoon Kim, Ha-Wook Park, Jae-Hwan Lee, Jae-Hyeong Park, Su Hong Kim, Eui Im, Sang-Ho Park, Donghoon Choi, Young-Guk Ko

{"title":"Intravascular Ultrasound Predictors of 12-month Patency Loss Following Drug-Coated Balloon Angioplasty for the Femoropopliteal Artery.","authors":"Jaeoh Lee, Ji Yong Jang, Chul-Min Ahn, Seung-Jun Lee, Sang-Hyup Lee, Yong-Joon Lee, Sung-Jin Hong, Jung-Sun Kim, Byeong-Keuk Kim, Myeong-Ki Hong, Yangsoo Jang, Tae-Hoon Kim, Ha-Wook Park, Jae-Hwan Lee, Jae-Hyeong Park, Su Hong Kim, Eui Im, Sang-Ho Park, Donghoon Choi, Young-Guk Ko","doi":"10.1016/j.amjcard.2025.03.018","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.03.018","url":null,"abstract":"Intravascular ultrasound (IVUS) has been shown to improve outcomes of drug-coated balloon (DCB) angioplasty for treatment of femoropopliteal artery (FPA) disease. However, the optimal IVUS criteria for achieving improved outcomes of DCB angioplasty for FPA disease remain uncertain. The study aimed to identify IVUS predictors for loss of patency at 12 months after DCB angioplasty for FPA disease. After excluding one patient due to insufficient IVUS imaging data, 98 patients in the IVUS-guidance group of the IVUS-DCB trial were included in the analysis. IVUS parameters predicting loss of patency at 12 months and their optimal cut-off values were investigated. Among the 98 patients who underwent IVUS-guided FPA intervention, 16 patients (16.3%) lost primary patency within 12 months. End-stage renal disease on hemodialysis and, bailout stenting, post-procedural dissection length >50% were independent procedural predictors for 12-month patency loss. Receiver operating characteristic (ROC) curve demonstrated that post-procedural minimal lumen area (MLA) ≥11.6 mm2 (area under the ROC curve: 0.685, 95% CI: 0.513-0.857) as the optimal cut-off value for sustained primary patency. In survival analysis, patients with MLA ≥11.6 mm2 had a hazard ratio of 0.27 (95% CI: 0.09-0.80, p-value =0.019, risk difference: 19.8) for lower risk of patency loss. A post-procedural MLA ≥11.6 mm2 was an independent IVUS predictor for sustained primary patency after DCB angioplasty in patients with FPA disease. Our findings suggest that lesion optimization and achieving sufficient lumen area under IVUS guidance during DCB angioplasty are crucial for maintaining target vessel patency. TRIAL REGISTRATION: ClinicalTrial.gov, identifier NCT03517904.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Application and Performance of CT-Fractional Flow Reserve in Non-ST-Segment Elevation Myocardial Infarction.

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-03-25 DOI: 10.1016/j.amjcard.2025.03.019

Josephine Warren, Luke Dawson, Tori McCollom, Lauren Hudson, Misha Dagan, Adil Zia, Helen Kavnoudias, Philip Lew, James Shaw, Dion Stub, Andrew J Taylor

{"title":"Application and Performance of CT-Fractional Flow Reserve in Non-ST-Segment Elevation Myocardial Infarction.","authors":"Josephine Warren, Luke Dawson, Tori McCollom, Lauren Hudson, Misha Dagan, Adil Zia, Helen Kavnoudias, Philip Lew, James Shaw, Dion Stub, Andrew J Taylor","doi":"10.1016/j.amjcard.2025.03.019","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.03.019","url":null,"abstract":"Only half of patients with non-ST-segment elevation myocardial infarction (NSTEMI) have obstructive coronary artery disease (CAD) on invasive coronary angiography (ICA). A non-invasive test that can safely rule out obstructive CAD therefore warrants investigation. Computed tomography fractional flow reserve (CT-FFR) enables hemodynamic interrogation of lesions identified on coronary computed tomography angiography (CCTA) but it has not been evaluated in NSTEMI. Inpatients with NSTEMI were recruited to undergo CCTA with CT-FFR prior to ICA. Blinded CT-FFR was performed using Siemens Frontiers cFFR, version 1.4. Invasive FFR was performed on all intermediate lesions with stenoses measuring >30% to <90%. The performance of CT-FFR and CTCA was compared to the gold-standard of ICA plus FFR. Forty patients (131 vessels) were included. The mean age was 61 ± 11 years and 75% were male. CT-FFR showed good correlation with invasive FFR (r = 0.78) and exhibited excellent diagnostic accuracy for obstructive CAD (defined as FFR<0.80 or angiographic stenosis >90%) on a per-vessel analysis, with a sensitivity of 87%, specificity 99%, positive predictive value (PPV) 97%, negative predictive value (NPV) 95% and area under the receiver operating curve (AUC) 0.93, which was superior to CCTA alone (sensitivity 82%, specificity 92%, PPV 82%, NPV 92%, AUC 0.87, p-value for AUC comparison = 0.04). On a per-patient analysis, CT-FFR had a diagnostic accuracy of 100%. In conclusion, CT-FFR provides additive diagnostic accuracy to CCTA in evaluating patients with NSTEMI and exhibits good correlation with invasive FFR.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0