American Journal of Cardiology最新文献

Efficacy of Cardiac Myosin Inhibition in Patients Post Septal Reduction Therapy. 心肌酶抑制剂对接受室间隔缩小术治疗的患者的疗效

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2024-11-05 DOI: 10.1016/j.amjcard.2024.10.026

Aakash Bavishi, Robyn Bryde, Marybeth Soutar, Margaret Kurnides, Heather Speer, Glenda Ovarce, Karen Richards, Karen DeMarco, Matthew W Martinez

引用次数: 0

Right Ventricular-Pulmonary Arterial Uncoupling as a Predictor of Invasive Hemodynamics and Normotensive Shock in Acute Pulmonary Embolism. 右心室-肺动脉不偶联作为急性肺栓塞时侵入性血流动力学和正常血压休克的预测因子

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2024-11-04 DOI: 10.1016/j.amjcard.2024.10.036

Eugene Yuriditsky, Robert S Zhang, Peter Zhang, Radu Postelnicu, Allison A Greco, James M Horowitz, Samuel Bernard, Orly Leiva, Vikramjit Mukherjee, Kerry Hena, Lindsay Elbaum, Carlos L Alviar, Norma M Keller, Sripal Bangalore

{"title":"Right Ventricular-Pulmonary Arterial Uncoupling as a Predictor of Invasive Hemodynamics and Normotensive Shock in Acute Pulmonary Embolism.","authors":"Eugene Yuriditsky, Robert S Zhang, Peter Zhang, Radu Postelnicu, Allison A Greco, James M Horowitz, Samuel Bernard, Orly Leiva, Vikramjit Mukherjee, Kerry Hena, Lindsay Elbaum, Carlos L Alviar, Norma M Keller, Sripal Bangalore","doi":"10.1016/j.amjcard.2024.10.036","DOIUrl":"https://doi.org/10.1016/j.amjcard.2024.10.036","url":null,"abstract":"Right ventricular-pulmonary arterial (RV-PA) coupling describes the relationship between RV contractility and its afterload and is estimated as the ratio of the tricuspid annular plane systolic excursion (TAPSE) to pulmonary arterial systolic pressure (PASP) via echocardiography. Whether TAPSE/PASP is reflective of invasive hemodynamics or occult shock in acute pulmonary embolism (PE) is unknown. This was a single-center retrospective study over a 3-year period of consecutive patients with PE undergoing mechanical thrombectomy and simultaneous pulmonary artery catheterization with echocardiograms performed within 24 hours prior to the procedure. Seventy patients (81% intermediate-risk) had complete invasive hemodynamic profiles and echocardiograms with TAPSE/PASP calculated. The optimal cutoff for TAPSE/PASP as a predictor of a reduced cardiac index (CI≤ 2.2 L/min/m2) was 0.34 mm/mmHg with an AUC of 0.97 and sensitivity, specificity, positive predictive value, and negative predictive value of 97.3%, 90.9%, 92.3% and 96.8%, respectively. Every 0.1 mm/mmHg decrease in TAPSE/PASP was associated with a 0.24 L/min/m2 decrease in the CI. This relationship was similar when restricted to intermediate-risk PE. The TAPSE/PASP ratio was predictive of normotensive shock with an OR 2.63 (95% CI: 1.42, 4.76, p=0.002) per unit decrease in the ratio. In conclusion, patients with acute PE undergoing mechanical thrombectomy, TAPSE/PASP was a strong predictor of a reduced CI and normotensive shock. This means of non-invasive point-of-care assessment of hemodynamics may have added value in PE risk stratification.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589961","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

Surgical Ablation for Atrial Fibrillation: A Lasting Impact on Outcomes after Cardiac Surgery. 心房颤动的手术消融：对心脏手术后疗效的持久影响。

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2024-11-04 DOI: 10.1016/j.amjcard.2024.10.037

Irsa Hasan, Danny Chu

引用次数: 0

Echocardiographic Assessment of Cardiac Remodeling According to Obesity Class. 根据肥胖程度对心脏重塑进行超声心动图评估

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2024-11-04 DOI: 10.1016/j.amjcard.2024.10.035

Rahil Prajapati, Tingting Qin, Kim A Connelly, Anas Merdad, Chi-Ming Chow, Howard Leong-Poi, Geraldine Ong

{"title":"Echocardiographic Assessment of Cardiac Remodeling According to Obesity Class.","authors":"Rahil Prajapati, Tingting Qin, Kim A Connelly, Anas Merdad, Chi-Ming Chow, Howard Leong-Poi, Geraldine Ong","doi":"10.1016/j.amjcard.2024.10.035","DOIUrl":"https://doi.org/10.1016/j.amjcard.2024.10.035","url":null,"abstract":"Evidence supports the existence of cardiac remodeling in obesity, but no standard diagnostic criteria has been proposed or validated.The objective of this study was to identify echocardiographic features of cardiac remodeling according to obesity class and assess the effect of non-surgical weight loss on cardiac structure and function.A total of 120 patients were divided according to their obesity class (Group 1: BMI 18.5-24.9; Group 2: 25-29.9; Group 3: 30-39.9; Group 4: >40) and underwent cross-sectional transthoracic echocardiography. Echocardiographic parameters of cardiac chamber quantification and function were compared between the 4 groups. Echocardiographic parameters were compared pre- and post-non-surgical weight loss in a subgroup of patients. Overall, there was an incremental increase in left ventricular (LV), left atrial (LA), and right ventricular dimensions, LV mass and LV stroke volume (all p<0.0001) across obesity classes. There was no significant difference in LV ejection fraction or right ventricular systolic function as assessed by tricuspid annular plane systolic excursion (TAPSE) but a significant decrease in global longitudinal strain (BMI 18.5-24.9: 22.8%±1.7%; BMI 25-29.9: 22.0%±1.4%; BMI 30-39.9: 20.8%±1.1%; BMI >40: 20.6%±1.3%, p<0.0001) and left atrial strain (BMI 18.5-24.9: 37.7%±2.3%; BMI 25-29.9: 32.8%±2.1%; BMI 30-39.9: 31.5%±1.8%; BMI >40: 29.0%±2.8%, p<0.0001). Allometric height-indexed LV and LA dimensions increased with increasing BMI class (p<0.0001). Echocardiographic parameters did not change significantly after non-surgical weight loss.In conclusion, echocardiographic features can be described according to obesity class. Allometric height indexation may better reflect cardiac remodeling in obesity in comparison to BSA indexation. Non-surgical weight loss was not associated with significant changes in cardiac chamber dimensions and function.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589958","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

Tailored Therapy in Cardiogenic Shock: Case-Based Management Choices. 心源性休克的定制疗法：基于病例的管理选择。

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2024-11-01 DOI: 10.1016/j.amjcard.2024.10.022

S Shiva Patlolla, Amit H Alam, Jason N Katz, Shelley A Hall

{"title":"Tailored Therapy in Cardiogenic Shock: Case-Based Management Choices.","authors":"S Shiva Patlolla, Amit H Alam, Jason N Katz, Shelley A Hall","doi":"10.1016/j.amjcard.2024.10.022","DOIUrl":"10.1016/j.amjcard.2024.10.022","url":null,"abstract":"Cardiogenic shock (CS) is a complex, multisystem disorder precipitated by hypoperfusion from cardiac dysfunction. Our current approach to defining and treating CS encompasses all patients under 1 umbrella regardless of phenotype. This has created challenges for clinical trials and patient care owing to the heterogeneity of the patient population with CS. The Society of Coronary Angiography and Interventions shock classification has created a universal language for CS that has been rapidly adopted by researchers and clinicians. Its latest iteration established the 3-axis model incorporating shock severity, risk modifiers, and phenotypes. Phenotypes of CS have unique hemodynamic profiles that require nuanced adjustment approaches. In this study, we discuss representative cases including acute myocardial infarction, acute-on-chronic heart failure, fulminant myocarditis, and right ventricular failure. For each phenotype, specific hemodynamic parameters may help confirm appropriate diagnosis and direct to therapeutic targets signaling stability and recovery. The underlying pathophysiology of each phenotype can also help predict the extent of stabilization with pharmacologic interventions or the need to escalate to mechanical circulatory support. In conclusion, this tailored approach to CS, rather than a 1-size-fits-all approach, could help improve outcomes.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567691","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

Important Findings for Patients With Previous Coronary Intervention for De Novo and In-Stent Restenosis Indications: A Novel Use of Randomized Trial Data. 针对既往冠状动脉介入治疗新发和支架内再狭窄适应症患者的重要发现：随机试验数据的新用途。

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2024-11-01 DOI: 10.1016/j.amjcard.2024.10.028

Charles Maynard

引用次数: 0

Prognostic Value of Incidental Coronary Artery Calcifications in Computed Tomography Pulmonary Angiography for Suspected Pulmonary Embolism. 计算机断层扫描肺血管造影中疑似肺栓塞的偶然冠状动脉钙化的预后价值

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2024-10-31 DOI: 10.1016/j.amjcard.2024.10.020

Marouane Boukhris, Thomas Madelrieux, Guillaume Signoret, Cyrille Boulogne, Paul Gendrin, Aymeric Rouchaud, Victor Aboyans

{"title":"Prognostic Value of Incidental Coronary Artery Calcifications in Computed Tomography Pulmonary Angiography for Suspected Pulmonary Embolism.","authors":"Marouane Boukhris, Thomas Madelrieux, Guillaume Signoret, Cyrille Boulogne, Paul Gendrin, Aymeric Rouchaud, Victor Aboyans","doi":"10.1016/j.amjcard.2024.10.020","DOIUrl":"10.1016/j.amjcard.2024.10.020","url":null,"abstract":"Computed tomography (CT) has emerged as a noninvasive method to identify coronary artery calcifications (CAC). We sought to investigate the association between opportunistic visual CAC evaluation in patients without known coronary artery disease who underwent CT pulmonary angiography (CTPA) for pulmonary embolism (PE) suspicion, and cardiovascular prognosis. We analyzed data of patients who underwent CTPA for suspected PE in 2017 at CHU Dupuytren, Limoges, France. Patients were categorized into 4 groups according to a simple visual ordinal score to assess the extent and severity of CAC on a whole-patient basis: none (grade 0), mild (grade 1), moderate (grade 2), and severe (grade 3). The primary outcome was a composite of cardiovascular mortality, myocardial infarction (MI), or coronary revascularization. The secondary outcomes were all-cause mortality, and an extended composite outcome including cardiovascular mortality, MI, coronary revascularization, ischemic stroke, ischemic peripheral events, and hospitalization for heart failure. A total of 414 patients (mean age 69.7 ± 14.3 years, 42% men, 18.1% PE) were included in the analysis and subdivided according to CAC categories as follows: grade 0 (n = 123; 29.7%), grade 1 (n = 133; 32.1%), grade 2 (n = 79; 19.1%) and grade 3 (n = 79; 19.1%). The mean follow-up was 3.5 ± 2.4 years. After adjustment, the presence of CAC grade 2 to 3 CAC independently predicted the primary outcome (hazard ratio [HR] = 5.30, 95% CI 2.56 to 10.98, p <0.001). CAC grade 2 to 3 were also independent predictors for all-cause mortality (HR = 1.52, 95% CI 1.10 to 2.11, p = 0.011); and the extended composite event (HR = 1.82, 95% CI 1.13 to 2.95, p = 0.014). In conclusion, the opportunistic assessment of CAC in CTPA for suspected PE could provide important mid-term prognostic information, independently from the PE findings.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563664","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

Determination of Inoue Balloon Size by Analysis of Mitral Valve Geometry Using Three-Dimensional Transesophageal Echocardiography in Patients With Mitral Stenosis. 通过使用三维经食道超声心动图分析二尖瓣狭窄患者的二尖瓣几何形状确定井上球囊大小

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2024-10-30 DOI: 10.1016/j.amjcard.2024.10.031

Mi-Jin Kim, Yoo-Jin Jung, Sun-Hack Lee, Byung Joo Sun, Sahmin Lee, Jung-Min Ahn, Duk-Woo Park, Dae-Hee Kim, Duk-Hyun Kang, Jong-Min Song

{"title":"Determination of Inoue Balloon Size by Analysis of Mitral Valve Geometry Using Three-Dimensional Transesophageal Echocardiography in Patients With Mitral Stenosis.","authors":"Mi-Jin Kim, Yoo-Jin Jung, Sun-Hack Lee, Byung Joo Sun, Sahmin Lee, Jung-Min Ahn, Duk-Woo Park, Dae-Hee Kim, Duk-Hyun Kang, Jong-Min Song","doi":"10.1016/j.amjcard.2024.10.031","DOIUrl":"10.1016/j.amjcard.2024.10.031","url":null,"abstract":"In percutaneous mitral balloon commissurotomy (PMBC) for patients with mitral stenosis (MS), the size of the balloon has traditionally been determined using a crude method based on the patient's height or body surface area. We aimed to evaluate the clinical value of balloon size selection by quantitatively analyzing mitral valve geometry using 3-dimensional (3D) transesophageal echocardiography. In 184 consecutive patients who underwent PMBC, the geometry of the mitral valve annulus was analyzed during mid-diastole, including the measurement of lateral-medial diameters obtained from dedicated 3D software or from analysis using multiplanar reconstruction images. Patients were categorized into 3 groups: those with successful results after PMBC (SU group), those with residual mitral stenosis (MS group), and those with significant MR (MR group). The SU, MS, and MR groups included 110, 50, and 17 patients, respectively. We compared 3 conventional formulas (formulas 1, 2, and 3) based on the patient's height or body surface area, with 2 new formulas derived from data in the SU group: balloon size = 0.0684 × lateral-medial diameters obtained from dedicated 3D software + 24.309 (formula 4) and 0.061 × lateral-medial diameters obtained from dedicated 3D software or from analysis using multiplanar reconstruction images + 24.573 (formula 5). Compared with the calculated balloon sizes using formula 4, the inflated balloon sizes were significantly smaller (-0.78 ± 1.02, p <0.001) in the MS group, whereas they were significantly larger (0.56 ± 1.05, p = 0.04) in the MR group. This pattern was also consistent in formula 5. In conclusion, selecting the Inoue balloon inflation size based on the mitral annulus diameter determined by 3D transesophageal echocardiography might be a reasonable approach.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563762","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

The Current State of Physician-Modified Endovascular Grafts in Complex Abdominal Aortic Aneurysms. 医生改良型血管内移植物在复杂腹主动脉瘤中的应用现状。

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2024-10-29 DOI: 10.1016/j.amjcard.2024.10.025

Pedro J F Neves, John J Kanitra, Rafael D Malgor, Mazin I Foteh

引用次数: 0

Comparative Influences of Beta blockers and Verapamil on Cardiac Outcomes in Hypertrophic Cardiomyopathy. 倍他受体阻滞剂和维拉帕米对肥厚型心肌病患者心脏预后影响的比较

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2024-10-29 DOI: 10.1016/j.amjcard.2024.10.029

Giuseppe Pinto, Mauro Chiarito, Tania Puscas, Anne Bacher, Erwan Donal, Patricia Reant, Gianluigi Condorelli, Albert Hagège

{"title":"Comparative Influences of Beta blockers and Verapamil on Cardiac Outcomes in Hypertrophic Cardiomyopathy.","authors":"Giuseppe Pinto, Mauro Chiarito, Tania Puscas, Anne Bacher, Erwan Donal, Patricia Reant, Gianluigi Condorelli, Albert Hagège","doi":"10.1016/j.amjcard.2024.10.029","DOIUrl":"10.1016/j.amjcard.2024.10.029","url":null,"abstract":"Guidelines recommend β blockers (BBs) as first-line therapy in symptomatic patients with hypertrophic cardiomyopathy (HCM) and nondihydropyridine calcium channel blockers, particularly, verapamil, as the second-line therapy, despite the absence of comparison trials between those 2 drugs. Because deleterious effects of verapamil have been reported in this setting, the present analysis aimed to evaluate the prognostic impact of BBs and verapamil in a cohort of patients with HCM. From a nationwide cohort of 1,434 patients with a diagnosis of HCM included in the French prospective observational REgistry of hypertrophic cardioMYopathy (REMY), we retrospectively analyzed patients with sarcomeric HCM included in the 3 largest centers and treated either with BBs or verapamil. Patients with a cardiac defibrillator or a pacemaker or who underwent a procedure of atrial fibrillation or septal ablation were excluded. The primary end point was the composite of cardiovascular death, hospitalization for heart failure, and hospitalization for atrial fibrillation. Of 600 patients with HCM, 544 (91%) were treated with BBs and 56 (9%) with verapamil. At inclusion, the 2 groups were comparable concerning the presence/amplitude of obstruction and sudden cardiac death risk factors. At up to 8 years of follow-up (median 3.9 years, interquartile range 2.1 to 5.8), no significant differences were observed in the primary end point (132 [24%] vs 10 [18%] under BBs or verapamil, respectively, hazard ratio 1.84, 95% confidence interval 0.94 to 3.63). In conclusion, in a real-world cohort of low-risk patients with HCM, verapamil therapy was not associated with a higher incidence of adverse events than β-blocker therapy.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543139","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