American Journal of Cardiology最新文献

{"title":"Disparities and Trends in Autopsy Rates Among Cardiovascular Disease Decedents in the US, 2011-2020.","authors":"Marco Zuin, Gianluca Rigatelli, Claudio Bilato, C Micheal Gibson, Thach Nguyen","doi":"10.1016/j.amjcard.2024.09.018","DOIUrl":"https://doi.org/10.1016/j.amjcard.2024.09.018","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306963","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}

{"title":"Outcomes of Acute Myocardial Infarction in Patients with Systemic Lupus Erythematosus: A Propensity-Matched Nationwide Analysis.","authors":"Ali Bin Abdul Jabbar, Mahmoud Ismayl, Anjali Mishra, Ryan W Walters, Andrew M Goldsweig, Herbert D Aronow, Abubakar Tauseef, Ahmed S Aboeata","doi":"10.1016/j.amjcard.2024.09.014","DOIUrl":"https://doi.org/10.1016/j.amjcard.2024.09.014","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306964","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}

{"title":"Diastolic Stress Echocardiography in Patients with Hypertrophy Cardiomyopathy: Association with Exercise Capacity.","authors":"Agostina M Fava, Zoran B Popovic, Alaa Alashi, Maran Thamilarasan, Bo Xu, Milind Y Desai","doi":"10.1016/j.amjcard.2024.09.017","DOIUrl":"https://doi.org/10.1016/j.amjcard.2024.09.017","url":null,"abstract":"<p><p>Diastolic dysfunction plays a major role in precipitating congestive heart failure (CHF) in hypertrophic cardiomyopathy (HCM) patients. In many such patients, symptoms are unmasked only during exercise, as left ventricular (LV) filling pressure is normal at rest but increase with exercise. We sought to establish if abnormal post-exercise diastolic parameters are associated with reduced exercise capacity in patients with HCM. We examined 590 asymptomatic/minimally symptomatic HCM patients (54±14 years, 57% men, body mass index 30±6 kg/m2, 84% on betablockers) with HCM by two-dimensional and Doppler echocardiography at rest and following maximal treadmill exercise echocardiography (TSE). A complete echocardiogram (including LV ejection fraction, LV thickness, LV outflow tract [LVOT] gradient, degree of mitral regurgitation [MR]) was recorded. Diastolic parameters (septal and lateral [e'] velocities of the mitral annulus, peak early [E] and late [A] mitral inflow velocity, E/A ratio, E/e', right ventricular systolic pressure [RVSP] and left atrial volume index [LAVI]) were recorded at rest and post-TSE. Exercise functional capacity was recorded and divided into <85% or >85% of age-gender predicted metabolic equivalents (AGP-METs). Following maximal exercise, 32% patients had at least moderate MR, mean LVOT gradient was 61±59 mmHg, E/A ratio was 1.2± 1.0, average E/e' ratio 12.9±1.0 and peak RVSP was 36±15 mm Hg. Only 42% patients achieved >85% of AGP-METs; mean Mets were 7±3. On multivariable logistic regression analysis, higher body mass index (odds ratio [OR] 1.05), betablocker use (OR 2.58), higher LAVI (OR 1.02), higher peak-stress LVOTG (OR 1.06), peak-stress E/e' (OR 1.04) and higher RVSP (OR 1.03) were independently associated with <85% AGP-METs achieved (all p<0.05). In conclusion, in asymptomatic/minimally symptomatic patients with HCM undergoing TSE, there is a significant and independent association between abnormal diastolic response to exercise and reduced exercise capacity in HCM. Incorporating diastolic parameters during stress echocardiography could provide incremental diagnostic utility in deciphering the exact etiology of dyspnea in such patients.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279133","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}

{"title":"Eight-Year Outcomes of Patients With Reduced Left Ventricular Ejection Fraction Undergoing Trans-Catheter Aortic Valve Replacement With a Self-Expanding Bioprosthesis.","authors":"Francesco De Felice, Luca Paolucci, Carmine Musto, Marco Stefano Nazzaro, Diana Chin, Rocco Stio, Mauro Pennacchi, Marianna Adamo, Giuliano Chizzola, Mauro Massussi, Cristina Giannini, Marco Angelillis, Marco De Carlo, Riccardo Gorla, Francesco Bedogni, Barbara Bellini, Matteo Montorfano, Giuseppe Bruschi, Bruno Merlanti, Erica Ferrara, Arnaldo Poli, Damiano Regazzoli, Tullio Palmerini, Alessandro Iadanza, Elisa Nicolini, Marco Toselli, Federico De Marco, Domenico Gabrielli","doi":"10.1016/j.amjcard.2024.09.015","DOIUrl":"https://doi.org/10.1016/j.amjcard.2024.09.015","url":null,"abstract":"<p><p>Conflicting results have been reported regarding the relationship between impaired left ventricular ejection fraction (LVEF) and adverse outcomes in patients undergoing transcatheter aortic valve replacement (TAVR) and long-term clinical data are lacking. The aims of this study were to investigate the long-term outcomes of patients with reduced LVEF undergoing TAVR Data deriving from patients undergoing TAVR between 2007 and 2017 in 13 Italian centers were prospectively collected. Patients were stratified in those with normal LVEF and reduced LVEF. The latter was further classified according to ischemic or non-ischemic etiology. The primary endpoint was a composite of all-cause death and re-hospitalizations, the secondary endpoints were the isolated composers of the primary one and cardiac death. Overall, 2626 patients were included in the analysis, 68.1% with NLVEF and 31.9% with reduced LVEF. At eight years, reduced LVEF was significantly associated with the primary endpoint (adj. HR 1.17 95% CI 1.06-1.29). Consistent findings were evident for the composite endpoint. No differences in these trends were found at 30 days landmark analyses. Compared to non-ischemic etiology, ischemic reduced LVEF was associated with an increased risk of cardiac death (adj. HR 1.43 95% CI 1.02-2.02). In conclusion, patients with reduced LVEF undergoing TAVR are exposed to a progressively increased risk of death and re-hospitalizations even at very long-term follow-up.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279135","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}

{"title":"Evaluating patients with chest pain using the recalibrated HEART score and a single high sensitive cardiac troponin measurement.","authors":"Vernon V S Bonarjee","doi":"10.1016/j.amjcard.2024.09.016","DOIUrl":"https://doi.org/10.1016/j.amjcard.2024.09.016","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279137","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}

{"title":"Meta-analysis of Physiology-guided Complete or Culprit lesion-only Percutaneous Coronary Interventions in Myocardial Infarction.","authors":"Sahib Singh, Udaya S Tantry, Kevin Bliden, Marwan Saad, Paul A Gurbel, J Dawn Abbott, Aakash Garg","doi":"10.1016/j.amjcard.2024.09.013","DOIUrl":"https://doi.org/10.1016/j.amjcard.2024.09.013","url":null,"abstract":"<p><p>Whether a physiology-guided complete revascularization of non-culprit lesions is superior to culprit lesion-only percutaneous coronary intervention (PCI) in patients with myocardial infarction (MI) and multivessel disease (MVD) remains debated. Online databases were searched for randomized controlled trials (RCTs) comparing physiology-guided complete revascularization and culprit lesion-only PCI in MI patients. The outcomes of interest were all-cause death, cardiovascular (CV) death, repeat revascularization, MI, stent thrombosis and contrast associated nephropathy/acute kidney injury (AKI). Pooled odds ratios (OR) along with 95% confidence intervals (CI) were calculated. A total of 4,849 patients (n = 2,288 physiology-guided complete revascularization, n = 2,561 culprit lesion-only PCI) were included. Mean age was 66 years and 76% were men. At mean follow-up of 2.5 years, physiology-guided complete revascularization was associated with significant reductions in CV death (OR 0.72, 95% CI 0.54-0.97, p = 0.03) and repeat revascularizations (0.50, 95% CI 0.38-0.66, p < 0.00001) as compared to culprit lesion-only PCI. There were no differences between the two approaches in all-cause death (0.91, 95% CI 0.69-1.19, p = 0.50), MI (0.85, 95% CI 0.59-1.21, p = 0.36), stent thrombosis (1.24, 95% CI 0.58-2.69, p = 0.58) and contrast associated nephropathy/AKI (1.07, 95% CI 0.88-1.31, p = 0.50). In conclusion, among patients with MI and MVD, physiology-guided complete revascularization was associated with significant reductions in CV death and revascularizations when compared to culprit lesion-only PCI.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279140","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}

{"title":"A Giant Left Anterior Descending Artery Aneurysm and an Updated Review on Coronary Aneurysms","authors":"","doi":"10.1016/j.amjcard.2024.09.010","DOIUrl":"10.1016/j.amjcard.2024.09.010","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279131","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}

{"title":"Diagnosis of Congenital Heart Disease in Adulthood: How Often, How Relevant?","authors":"","doi":"10.1016/j.amjcard.2024.09.004","DOIUrl":"10.1016/j.amjcard.2024.09.004","url":null,"abstract":"<div><div>Congenital heart disease (CHD) is typically detected during fetal life, infancy, or early childhood. However, there is no published data regarding the proportion of congenital heart defects that are diagnosed in adulthood or the impact of these defects. Retrospective analyses of all consecutive patients (n = 1,010) referred to an adult CHD unit between 2018 and 2023. We analyzed the proportion of cases diagnosed in adulthood, defining the type of defect, reasons for diagnosis, complications, and need for intervention. In total, 26.5% of patients were diagnosed in adulthood (mean age 47 ± 16 years). Overall, 75% were in New York Heart Association class I/IV. Most were mild complexity lesions (57.5%). The most common diagnoses were pre-tricuspid shunts, including ostium secundum atrial septal defect (ASD, 23.9%), partial anomalous pulmonary vein drainage (18.3%), and other types of ASD (5.9%). Bicuspid aortic valve (16.8%) and aortic coarctation (8.2%) were common. Other diagnoses included Ebstein's anomaly (5.6%), ventricular septal defect (4.5%), patent ductus arteriosus (2.6%), or congenitally corrected transposition of the great arteries (2.6%). The main reason for diagnostic work-up was cardiac symptoms (28.4%) such as dyspnea (19%) and palpitations (7.1%), followed by incidental findings on imaging (25.4%). A total of 47.4% had some complications, the most common being pulmonary hypertension (24.3%). Surgical repair was required in 27.2% and 25.4% underwent percutaneous intervention. About one-fourth of patients with CHD were diagnosed in adulthood, and up to 42.5% had moderate or severe complexity lesions. A significant proportion had developed complications at the time of diagnosis and half of them required intervention.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279132","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}

{"title":"Is the Advantage of DOACs Due to Better Targeting?","authors":"Christopher L Hansen","doi":"10.1016/j.amjcard.2024.09.007","DOIUrl":"https://doi.org/10.1016/j.amjcard.2024.09.007","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279139","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}

{"title":"Sub-intimal tracking and re-entry and investment procedures: current applications and future directions.","authors":"Jesse A Kane, Jasleen Tiwana, Mauro Carlino, Angelo Nascimbene, Silvia Moscardelli, Lorenzo Azzalini","doi":"10.1016/j.amjcard.2024.09.009","DOIUrl":"https://doi.org/10.1016/j.amjcard.2024.09.009","url":null,"abstract":"<p><p>In seeking to improve upon CTO percutaneous coronary intervention (PCI) success rates and minimize risk, CTO modification procedures (investment procedures) have been developed and utilized with increasing frequency. Two key techniques have emerged: subintimal tracking and re-entry (STAR) and subintimal plaque modification (SPM). Both require a staged approach with an index procedure for plaque modification and a second procedure weeks later for stenting. Both approaches require entry and wiring with a polymer jacketed wire in the extra plaque space (EPS), yet unlike SPM which exclusively requires angioplasty of the EPS throughout the CTO segment, STAR also involves re-entry into the true lumen distal to the CTO before angioplasty. STAR and SPM in many ways represent a paradigm shift in our approach to CTO PCI from a 1-step to 2-step approach in complex cases. In this review, we discuss the technical aspects of the procedures, as well as controversies and ongoing trials pointing to the future of these techniques. We also highlight non-device-based and intravascular ultrasound-based approaches to antegrade dissection and re-entry, which add to the CTO operator's toolkit for challenging cases.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279141","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}