American Journal of Cardiology最新文献

{"title":"Hiding in Plain Sight: Pulmonic Valve Involvement in Carcinoid Heart Disease.","authors":"M Kasim Malik, Alexander Whitaker, Ghadi Moubarak, Courtney Campbell, Purav Mody","doi":"10.1016/j.amjcard.2025.06.014","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.014","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367791","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":"Insights into the Benefits of Reverse Remodeling from an Echocardiographic Pressure/Volume Loop Model in Patients With Heart Failure Treated With Sacubitril/Valsartan.","authors":"Frank L Dini, Giovanni Cioffi, Erberto Carluccio, Stefano Ghio, Nicola Riccardo Pugliese, Michele Correale, Giuseppe Dattilo, Alberto Palazzuoli","doi":"10.1016/j.amjcard.2025.06.012","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.012","url":null,"abstract":"<p><p>Left ventricular (LV) reverse remodeling (RR) can occur in response to interventions that reduce the neurohormonal activation and hemodynamic overload in patients with heart failure with reduced ejection fraction (HFrEF). The aim of the study was to investigate whether the occurrence of LVRR in response to treatment with sacubitril/valsartan (S/V) is related to changes in ventricular-arterial (VA) coupling, as defined by the ratio of arterial elastance (Ea)/LV elastance (Ees), as well as to modifications of mechanoenergetic parameters. This multicenter study included 662 patients with HFrEF and LV EF ≤40% who underwent S/V therapy. The mean age of the study population was 65±11 years. Non-invasive pressure-volume (PV) loops were obtained from echocardiography with brachial artery blood pressure measurements. Ea, Ees and the ratio Ea/Ees and mechanoenergetic parameters, including stroke work (SW), potential energy (PE), PV area (PVA) and LV efficiency, were estimated. At a median interval of 7.8 months, 14% of patients exhibited LVRR, defined as an increase in LVEF >10% and a relative decrease in LV end-systolic volume >15%. In these patients, VA coupling changed from 2.90 ± 1.33 to 1.58 ± 0,53 (-45%) and LV efficiency increased from 46% to 57% (+24%), while PE decreased from 0.68 ± 0.18 joule to 0.44 ±1.0 joule (-35%). VA coupling was closely associated with LV efficiency at baseline (r = - 0.92) and after follow-up (r = - 0.74). In conclusion, LVRR that occurred in patients treated with S/V was associated with a better VA coupling and likely accounted for the beneficial effects on LV efficiency, namely SW/PVA.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367792","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":"Filling the Void: The Past, Present, and Future of Left Atrial Appendage Occlusion.","authors":"Shahbaz A Malik, Aravdeep Jhand, Muhammad Asim Shabbir, Soban Ahmad, Andrew M Goldsweig","doi":"10.1016/j.amjcard.2025.06.011","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.011","url":null,"abstract":"<p><p>Left atrial appendage occlusion (LAAO) has emerged as an alternative strategy to oral anticoagulation (OAC) to mitigate the risk of thromboembolic events in patients with atrial fibrillation (AF). Endovascular LAAO devices were first developed in the early 2000s for patients with relative and absolute contraindications to OAC. Four randomized controlled trials have demonstrated the safety and efficacy of LAAO procedures, and two LAAO devices have been approved and are commercially available in the United States. Procedural complications, especially pericardial effusion, as well as subsequent peri-device leak and device-related thrombosis have decreased over time due to improved device design and implantation techniques. Many aspects of the LAAO technology continue to evolve. Intracardiac echocardiography (ICE) is used increasingly and offers distinct advantages and disadvantages compared to transesophageal echocardiography (TEE) for procedural guidance. The role of universal post-procedure surveillance imaging remains unclear. Post-LAAO antithrombotic therapy has shifted from short-term anticoagulation to immediate dual antiplatelet therapy, with ongoing research exploring the feasibility of single antiplatelet therapy. Novel devices with improved design and technology are currently undergoing clinical trials. Additionally, the patient population eligible for LAAO may significantly increase in the coming years, as ongoing trials are evaluating the effectiveness of LAAO devices in a broader population of patients with AF. In conclusion, the history, current state, and active research related to LAAO are summarized in this review article.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339821","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":"Long-Term Outcomes After Myocardial Infarction in Young Adults: The Unseen Impact of Delays, Non-Atherosclerotic Factors, and Subgroup Vulnerabilities.","authors":"Artur Dziewierz, Beata Bobrowska, Barbara Zdzierak, Wojciech Zasada","doi":"10.1016/j.amjcard.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.010","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293215","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":"Cardiogenic shock: need to distinguish between ischemic and non-ischemic cause to define treatment networks.","authors":"Stefano Savonitto, Alice Sacco, Nuccia Morici","doi":"10.1016/j.amjcard.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.003","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293214","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":"Survival Trends of Patients after Coronary Artery Bypass Grafting and Sex-specific Differences - A Meta-analysis of Reconstructed Time-to-event Data: Survival Trends of Patients after Coronary Artery Bypass Grafting.","authors":"Hristo Kirov, Tulio Caldonazo, Sultonbek Toshmatov, Panagiotis Tasoudis, Johannes Fischer, Angelique Runkel, Aryan Dadashzadeh K, Murat Mukharyamov, Torsten Doenst","doi":"10.1016/j.amjcard.2025.06.007","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.007","url":null,"abstract":"<p><strong>Background: </strong>Randomized evidence suggest that coronary artery bypass grafting (CABG) has the potential to improve life expectancy. Women are considered to have worse outcomes after CABG, but they are generally underrepresented in randomized trials meanwhile registry data and trial sub-analyses provide controversial results. We systematically assessed the survival after CABG in both sexes by analyzing studies that assessed CABG outcomes compared to the age-matched general population.</p><p><strong>Methods: </strong>Three databases were assessed (MEDLINE, ScienceDirect and Cochrane Library). Primary and single outcome was long-term all-cause mortality. Reconstruction of time-to-event data was performed. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated.</p><p><strong>Results: </strong>A total of 1,352 studies were retrieved. Eight studies and 142,165 patients were included in the analysis. For the entire 19-year observation period, patients who underwent CABG had worse survival than the general population in both male (HR= 1.14, 95% CI, 1.05-1.23, p=0.002) and female patients (HR= 1.21, 95% CI, 1.01-1.47, p=0.045). Performing landmark analyses suggests that there is no difference in life expectancy compared with the general population in the first 10 years. The direct comparison of men versus women suggests that very long-term survival was slightly better in women (HR: 1.04, 95% CI, 1.01-1.08).</p><p><strong>Conclusions: </strong>Both men and women after CABG treatment for CAD experience similar life expectancy in the first decade compared to the general population. Beyond 10 years, life expectancy becomes worse than the general population and is the worst in men. It may be speculated that this difference is due to graft occlusions.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293216","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":"Renal Denervation: Patient Selection and When to Refer.","authors":"Raven A Voora, Michael J Bloch, Naomi Dl Fisher","doi":"10.1016/j.amjcard.2025.06.009","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.009","url":null,"abstract":"<p><p>The US FDA approved Renal Denervation for hypertension treatment in November 2023. Regardless of the methodology used to denervate, most but not all people had a clinically significant reduction in blood pressure in the months following the procedure. In this review we summarize the current data informing patient selection, and provide guidance on when to refer potential patients for consideration of this therapy in the management of uncontrolled hypertension.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274019","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":"Early Aortic Valve Replacement Versus Clinical Surveillancein Asymptomatic Patients With Severe Aortic Stenosis.","authors":"Yasuaki Takeji, Tomohiko Taniguchi, Takeshi Morimoto, Shinichi Shirai, Takeshi Kitai, Hiroyuki Tabata, Nobuhisa Ohno, Ryosuke Murai, Kohei Osakada, Koichiro Murata, Masanao Nakai, Hiroshi Tsuneyoshi, Tomohisa Tada, Masashi Amano, Shin Watanabe, Hiroki Shiomi, Hirotoshi Watanabe, Yusuke Yoshikawa, Ryusuke Nishikawa, Yuki Obayashi, Ko Yamamoto, Mamoru Toyofuku, Shojiro Tatsushima, Norio Kanamori, Makoto Miyake, Hiroyuki Nakayama, Kazuya Nagao, Masayasu Izuhara, Kenji Nakatsuma, Moriaki Inoko, Takanari Fujita, Masahiro Kimura, Mitsuru Ishii, Shunsuke Usami, Fumiko Nakazeki, Kiyonori Togi, Yasutaka Inuzuka, Kenji Ando, Tatsuhiko Komiya, Koh Ono, Kenji Minatoya, Takeshi Kimura","doi":"10.1016/j.amjcard.2025.06.004","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.004","url":null,"abstract":"<p><p>The optimal timing for aortic valve replacement (AVR) in asymptomatic patients with severe aortic stenosis (AS) remains debatable. This study aimed to compare the clinical outcomes of early AVR and clinical surveillance in asymptomatic patients with high-gradient severe AS. Among 3369 patients enrolled in the CURRENT AS Registry-2, which included consecutive patients with severe AS, we identified 596 asymptomatic patients with high-gradient severe AS (initial AVR strategy: 285 patients; clinical surveillance strategy: 311 patients). A propensity score-matched cohort was constructed, comprising 206 patients each in the initial AVR and clinical surveillance groups. The primary outcome measure was a composite of all-cause death, stroke, or hospitalization for heart failure (HF). In the propensity score-matched cohort, the mean age was 79.6 years, and the median Society of Thoracic Surgeons-predicted risk of mortality was 3.2%. In the initial AVR group, surgical and transcatheter AVR were performed in 83 and 123 patients, respectively, whereas in the clinical surveillance group, conversion to AVR occurred in 11.1%, 32.9%, and 69.0% patients at 6 months, 1 year, and 3 years. The cumulative 3-year incidence of the primary outcome was not significantly different between the initial AVR and clinical surveillance groups (26.4% vs. 28.4%; log-rank P = 0.46; hazard ratio [HR]: 0.85, 95% confidence interval [CI]: 0.56-1.29). In conclusion, in asymptomatic patients with high-gradient severe AS, the initial AVR strategy compared to clinical surveillance was not associated with a lower risk for a composite of all-cause death, stroke or hospitalization for HF. UMINID: UMIN000034169.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257140","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":"Incidence and Prognostic Impact of New-Onset Ischemic Symptoms following Elective Percutaneous Coronary Intervention in Chronic Coronary Syndromes.","authors":"Raffaele Piccolo, Fiorenzo Simonetti, Marisa Avvedimento, Domenico Angellotti, Attilio Leone, Giuliana Fortunato, Luca Bardi, Plinio Cirillo, Luigi Di Serafino, Carmen Anna Maria Spaccarotella, Anna Franzone, Giovanni Esposito","doi":"10.1016/j.amjcard.2025.06.005","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.005","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257141","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":"6 Year Follow-Up of Balloon-Expandable Versus Self-Expanding Transcatheter Aortic Valves: A Propensity-Matched Analysis.","authors":"Zade Bihag, Jay Patel, Jeff F Mather, Robert Hagberg, Jawad Haider, Talhat Azemi, Immad Sadiq, Mohiuddin Cheema, Bryan Piccirillo, Sheelagh Pousatis, Priyesh Thakurathi, David Yaffee, Sabet W Hashim, Raymond G McKay","doi":"10.1016/j.amjcard.2025.06.002","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.002","url":null,"abstract":"<p><p>Prior reports comparing long-term outcomes of balloon-expandable (BE) versus self-expanding (SE) transcatheter aortic valve implantation (TAVI) have been limited. We compared in-hospital, 1-year, and 6-year outcomes in 1,685 BE (S3, Ultra) versus 776 SE (Evolut R, PRO, PRO+) patients undergoing transfemoral TAVI at a single center. Valve-in-valve and non-transfemoral access cases were excluded. Propensity-score matched BE (n=683) and SE (n=680) cohorts did not differ with respect to age (82.2±8.0 vs 82.1±7.8 years, p=0.407), baseline demographics and comorbidities, pre-TAVI echo and cardiac catheterization results, and STS Risk Score (7.9±5.9 vs 7.9±5.5%, p=0.481). BE vs SE patients had similar in-hospital mortality (0.9 vs 0.6%, p=0.0.072), stroke (1.3 vs 1.8%, p=0.503), major vascular complications (2.8 vs 2.2%, p=0.495) and composite bleeding (4.7 vs 3.4%, p=0.178), although the BE cohort required fewer permanent pacemakers (8.3 vs 13.3%, p=0.003). At 1-year, BE and SE patients had similar all-cause mortality (10.8 vs 11.2%, p=0.825), hospital readmission (22.5 vs 19.6%, p=0.192), and KCCQ12 scores (83.7±25.5 vs 83.0±24.6, p=0.606). At a median follow-up of 77.0 (72.6-81.5) months, Kaplan-Meier survival analysis demonstrated no difference in BE vs SE all-cause mortality (33.2 vs 40.4%, p=0.586), with no differences in late valve-related outcomes including myocardial infarction, stroke, AV endocarditis, and AV re-intervention (balloon aortic valvuloplasty, percutaneous paravalvular leak closure, repeat TAVI, surgical AV replacement). However, BE patients more commonly required treatment for subclinical leaflet thrombosis, while SE patients had a higher incidence of transient ischemic attack during follow-up. In conclusion, BE and SE TAVI patients have similar in-hospital, 1-year and median 6-year adverse outcomes, other than higher subclinical leaflet thrombosis in BE patients and an increased transient ischemic attack rate in SE patients.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257139","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}