American Journal of Cardiology最新文献

{"title":"Incidence of Clinically Significant Ventricular Arrhythmias in Patients on Home Inotrope Infusion in the Contemporary Era","authors":"Seth Fakess DO ,&nbsp;Gregory A. Panza PhD ,&nbsp;Ayesha Shaik MBBS ,&nbsp;Ina Lico DO ,&nbsp;Aneesh Tolat MD","doi":"10.1016/j.amjcard.2025.03.042","DOIUrl":"10.1016/j.amjcard.2025.03.042","url":null,"abstract":"<div><div>Approximately 6.2 million Americans live with heart failure (HF). Inotropic support is often used as bridge therapy and palliation. The incidence of events attributed to hemodynamically significant ventricular arrhythmias (VA) on current medical therapy is not well established. Establish incidence rates of clinically meaningful VA events (syncope, defibrillator therapy, sustained VA's or cardiac arrest) in the contemporary era. Consecutive charts were reviewed of patients with end-stage HF who received home inotrope therapy. ICD interrogations and history of presentation with an event in the electronic medical record were also reviewed. About 438 consecutive patients aged 68.0 ± 13.7yr (72.4% Male) were included in the analysis. Patients were on milrinone (<em>n</em> = 353) or dobutamine (<em>n</em> = 85) over 9.3 ± 11.6 months. Incidence of VA events for the overall sample was 5.66 events per 100 person-months (95% CI = 4.97 to 6.44). Patients on Milrinone (<em>n</em> = 353) had a VA event rate of 6.04 events per 100 person-months, while on Dobutamine (<em>n</em> = 85) the VA event rate was 3.79 events per 100 person-months. Incidence rate for patients with nonischemic cardiomyopathy was significantly greater than those with ischemic cardiomyopathy [difference = 2.54 events per 100-person months (95% CI = −1.09 to 3.99; p <em>&lt;</em>0.001)]. Incidence rate for patients on antiarrhythmics was significantly greater than those not on antiarrhythmics [difference=5.65 events per 100-person months (95% CI = 3.71 to 7.59; p &lt;0.001)]. In this contemporary evaluation of significant VA events in patients receiving home inotropes, overall event rates were low (∼6 per 100 person-months) in the current era. Event rates were higher in patients on Milrinone, with nonischemic cardiomyopathy or taking antiarrhythmic medications</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 50-54"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770982","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":"Novel Right Ventricular Function Parameters can Identify Short-Term Nonresponders to Transcatheter Edge-to-Edge Repair for Mitral Regurgitation","authors":"Raffaella Mistrulli ,&nbsp;Tatyana Storozhenko ,&nbsp;Arthur Iturriagagoitia ,&nbsp;Sara Corradetti ,&nbsp;Michele Mattia Viscusi ,&nbsp;Dimitri Buytaert ,&nbsp;Thabo Mahendiran ,&nbsp;Elayne Kelen de Oliveira ,&nbsp;Lucio Addeo ,&nbsp;Emanuele Barbato ,&nbsp;Jerrold Spapen ,&nbsp;Jozef Bartunek ,&nbsp;Marc Vanderheyden ,&nbsp;Guy Van Camp ,&nbsp;Martin Penicka","doi":"10.1016/j.amjcard.2025.03.034","DOIUrl":"10.1016/j.amjcard.2025.03.034","url":null,"abstract":"<div><div>Mitral regurgitation (MR) is a common valvular disease associated with poor prognosis. Percutaneous mitral valve repair (PMVR) combined with guideline-directed medical therapy has shown prognostic benefits, yet a substantial proportion of patients experience major adverse cardiovascular events (MACE), including death and heart failure hospitalization, within the first year. Identifying short-term nonresponders remains a clinical priority. This study evaluated the prognostic value of advanced right ventricular (RV) function parameters in predicting MACE following PMVR using the MitraClip system. A total of 60 consecutive patients with symptomatic severe MR undergoing PMVR were analyzed. Echocardiographic assessments were performed at baseline, postprocedure before discharge, and at 6-month follow-up. Parameters included tricuspid annular plane systolic excursion (TAPSE) normalized to pulmonary artery systolic pressure (TAPSE/PASP), right ventricular end-diastolic area (TAPSE/RVAD), and end-systolic area (TAPSE/RVAS), along with RV myocardial work indices. During the first year, 35% of patients experienced MACE. At baseline, those who developed MACE had significantly higher creatinine, troponin T, NT-proBNP levels, larger right heart dimensions, and lower TAPSE (all p &lt;0.05), while other clinical, imaging, and procedural characteristics were similar. In multivariate analysis, TAPSE/PASP, TAPSE/RVAS, and TAPSE/RVAD were independent predictors of MACE (all p &lt;0.05), with AUC values ranging from 0.80 to 0.85, indicating strong predictive capacity. Throughout follow-up, these indices remained significantly lower in patients with MACE, while RV myocardial work parameters had lower predictive accuracy (AUC&lt;0.60). In conclusion, a comprehensive RV assessment, particularly TAPSE-based indices, can help identify patients at higher risk of adverse outcomes after PMVR, whereas RV myocardial work indices appear less reliable.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 13-20"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770985","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":"Anticoagulation Versus No Anticoagulation for Post-Operative Atrial Fibrillation After Isolated Coronary Artery Bypass Graft: A Meta-Analysis.","authors":"Mariam Shariff, Ashish Kumar, Gabor Bagameri, Narayan G Kowlgi, Abhishekh Deshmukh, John Stulak","doi":"10.1016/j.amjcard.2025.03.036","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.03.036","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778754","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 in Patients with Asymptomatic Severe Aortic Stenosis with Preserved Left Ventricular Systolic Function: A Systematic Review and Meta-Analysis.","authors":"Vinicius Bittar de Pontes, Mariana R C Clemente, Thierry Trevisan, Sebastian Jaramillo, Mauricio Ferreira Boneli, Nicole Felix, Laura G S Gameiro, Philippe Garot, Wilton F Gomes","doi":"10.1016/j.amjcard.2025.03.039","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.03.039","url":null,"abstract":"<p><p>Current guidelines recommend routine clinical surveillance for patients with asymptomatic severe aortic stenosis (AS) and preserved left ventricular ejection fraction (LVEF). However, the role of early aortic valve replacement (AVR) as compared with conservative treatment in these patients remains unclear. We systematically searched PubMed, Embase and Cochrane databases to identify studies comparing early AVR versus conservative treatment in asymptomatic patients with severe AS and preserved LVEF. All statistical analyses were performed using R software version 4.3.1 with a random-effects model. Seven studies comprising 2,531 patients with asymptomatic severe AS and preserved LVEF were included, of whom 1,234 (49%) underwent AVR. Median follow-up time was 49.3 months. Early AVR was associated with significantly lower incidence of all-cause (HR 0.51; 95% CI 0.31-0.83) and cardiac mortality (RR 0.51; 95% CI 0.30-0.89). There were no significant differences between early AVR and conservative treatment in terms of sudden death, hospitalization for cardiovascular (CV) causes, stroke, or myocardial infarction (MI). However, upon a subanalysis of randomized controlled trials (RCTs) only, patients undergoing early AVR had lower rates of hospitalization for CV causes (RR 0.41; 95% CI 0.27-0.63) and stroke (RR 0.62; 95% CI 0.40-0.95), with no difference in terms of all-cause mortality, sudden death, MI, or cardiac death. In this meta-analysis, early AVR was associated with reduced rates of all-cause and cardiac mortality, while yielding similar rates of stroke, hospitalization for CV causes, MI, or sudden death in the overall cohort analysis as compared with conservative treatment.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778781","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 Combined Electrocardiographic and Imaging Predictive Risk Model for new Permanent Pacemaker after Transcatheter Aortic Valve Implantation: the RITMO Score.","authors":"Giulia Costa, Marco Angelillis, Cristina Giannini, Matteo Mazzola, Chiara Primerano, Giulia Brandi, Paolo Spontoni, Laura Stazzoni, Anna Sonia Petronio, Marco De Carlo","doi":"10.1016/j.amjcard.2025.03.028","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.03.028","url":null,"abstract":"<p><strong>Aims: </strong>Currently, permanent pacemaker implantation (PPMI) is the most common complication of transcatheter aortic valve implantation (TAVI). The aim of this analysis is to develop a simple and effective risk prediction model for PPMI within 30 days of TAVI.</p><p><strong>Methods: </strong>Data from 370 patients who underwent TAVI with the self-expanding valve between February 2015 and June 2022 at our center were collected in the development cohort (DC). A risk score was developed based on baseline anatomical and electrocardiographic characteristics, including the estimation of aortic calcium load (ACL) using both the Agatston score and calcium volume. A validation cohort (VC) of 234 patients was used to test the score.</p><p><strong>Results: </strong>Seventy-two patients (19.5%) underwent PPMI in DC. Pre-procedural right bundle branch block (RBBB), membranous septum length (MSL) <5 mm, and severe ACL were significant predictors of PPMI. The Agatston score showed higher agreement with PPMI compared to calcium volume (K=0.89; 95% CI: 0.84 - 0.93 vs. K=0.71; 95% CI: 0.64 - 0.79, respectively). Pre-existing RBBB, MSL, and Agatston score have been combined into a simple score, called RITMO (theoretical range from -1 to 4 points). We applied the score to the VC and find that a high score (>1) had an OR>6 to predict PPMI after TAVI.</p><p><strong>Conclusion: </strong>In patients undergoing TAVI with a self-expanding valve, baseline RBBB, shorter MSL, and higher ACL evaluated using the Agatston method were predictive of 30-day PPMI. In conclusion, the RITMO score represents a simple tool for risk stratification, with implications for procedural planning and patient counselling.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771053","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":"Transcatheter Aortic Valve Replacement With a Fully Retrievable Self-Expanding Dry-Tissue Valve: First-in-Man Study","authors":"Zhengang Zhao MD ,&nbsp;Yong Peng MD ,&nbsp;Fei Chen MD ,&nbsp;Esteban Villegas MD ,&nbsp;Adolfo Lopez Campanher MD ,&nbsp;Zhongkai Zhu MD ,&nbsp;Xi Li MD ,&nbsp;Xin Wei MD ,&nbsp;Jiafu Wei MD ,&nbsp;Scott Lim MD ,&nbsp;Jorge Baccaro MD ,&nbsp;Yuan Feng MD ,&nbsp;Mao Chen MD, PhD","doi":"10.1016/j.amjcard.2025.03.032","DOIUrl":"10.1016/j.amjcard.2025.03.032","url":null,"abstract":"<div><div>Contemporary self-expanding transcatheter aortic valve replacement (TAVR) devices are retrievable and repositionable at partial release, however, valve migration may occur during final release. The Venus-PowerX Valve is a novel self-expanding dry-tissue TAVR device which is retrievable at 100% full deployment. This first-in-man study sought to evaluate the feasibility and safety of the new TAVR device. The clinical outcomes and adverse events were assessed and reported according to the Valve Academic Research Consortium-3 criteria. A total of 25 patients with severe aortic stenosis (75.3 ± 5.3 years, 48.0% male, 52.0% bicuspid aortic valve) were enrolled. Acute technical success was achieved in 25 (100%) patients. Valve recapture at 100% full deployment was attempted in 2 patients due to suboptimal position or inappropriate valve size, and was successful in both. No patient required a second valve. At 30 days, device success was achieved in 88.0%. The reasons for unachieved device success included residual gradient (4.0%), moderate paravalvular leak (PVL, 4.0%) and VARC type 2 bleeding (4.0%). New permanent pacemaker was required in 5 (20.0%) patients. At 1-year follow-up, overall survival rate was 96.0%, there was no stroke, myocardial infarction, or cardiovascular rehospitalization. Mean aortic valve gradient improved significantly from 56.0 ± 17.9 mmHg to 11.6 ± 6.0 mmHg, and effective orifice area improved from 0.6 ± 0.2 cm² to 1.8 ± 0.4 cm²; 79.1% had none or trivial PVL. In conclusion, the novel fully retrievable Venus-PowerX Valve could enable highly predictable TAVR device positioning and produce satisfactory hemodynamic and clinical outcomes in both bicuspid and tricuspid aortic valve stenosis.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 29-34"},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770986","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":"Major Intraprocedural Complications During Transcatheter Aortic Valve Implantation Requiring Emergent Cardiac Surgery: An Updated Systematic Review","authors":"Giuseppe Verolino MD ,&nbsp;Michele Di Mauro MD, PhD ,&nbsp;Dario Calderone MD ,&nbsp;Roberto Lorusso MD, PhD","doi":"10.1016/j.amjcard.2025.03.031","DOIUrl":"10.1016/j.amjcard.2025.03.031","url":null,"abstract":"<div><div>Transcatheter aortic valve implantation (TAVI) is an established treatment for patients &gt;75 years old with severe aortic stenosis. From the technique's beginnings in the early 2000s, over 20 years of experience in the TAVI procedure have allowed its wide diffusion with optimal procedural results. Intraprocedural complications during TAVI are yet a fearful scenario, sometimes requiring emergent open-heart surgery (EOHS) that is burdened by high intraoperative mortality (50% at 30 days). Furthermore, also when a surgical treatment is not needed, intraprocedural complications have a challenging management and a critical impact on patients’ prognosis. The volume of procedures in the last 10 years has been observed to increase substantially, with an incidence of major intraprocedural complications of around 1%. However, the features and specific incidence for each complication have not been revised recently. This work aims to update the knowledge about major intraprocedural complications during TAVI, considering the increased operators' experience and recent device developments. An updated point of view on major intraprocedural complications could suggest a need for change in the TAVI paradigm, promoting TAVI programs even in centers without on-site cardiac surgery.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 21-28"},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770983","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 Intracoronary Brachytherapy for In-Stent Restenosis","authors":"Thomas R. Basala BS ,&nbsp;Muhmmad S. Khalid ,&nbsp;Ozgur Selim Ser MD ,&nbsp;Michael Megaly MD, MS ,&nbsp;Matthew Glogoza MD ,&nbsp;Dimitrios Strepkos MD ,&nbsp;Athanasios Rempakos MD ,&nbsp;Michaella Alexandrou MD ,&nbsp;Deniz Mutlu MD ,&nbsp;Pedro Carvalho MD ,&nbsp;Sydney Peng ,&nbsp;Olga Mastrodemos BS ,&nbsp;Sandeep Jalli DO ,&nbsp;Judit Karacsonyi MD ,&nbsp;Yader Sandoval MD ,&nbsp;Yale Wang MD ,&nbsp;Patsa Sullivan MD ,&nbsp;David J. Monyak MD ,&nbsp;Konstantinos Voudris MD, PhD ,&nbsp;Ahmed Al-Ogaili MD ,&nbsp;Emmanouil S. Brilakis MD, PhD","doi":"10.1016/j.amjcard.2025.02.024","DOIUrl":"10.1016/j.amjcard.2025.02.024","url":null,"abstract":"<div><div>Because of limited alternative options, intracoronary brachytherapy (ICBT) continues to be used for treating in-stent restenosis (ISR). We examined the indications, characteristics, and outcomes of ICBT in consecutive patients who underwent ICBT for ISR between January 2014 and December 2023 at a tertiary care center. During the study period 343 patients underwent ICBT of 502 lesions. The median patient age was 67 [60, 74] years, 73.4% of the patients were men, 77.3% had prior myocardial infarction, and 49.4% had prior coronary artery bypass graft surgery. The most common target vessel was the right coronary artery (38.7%) and 7.37% of lesions were in bypass grafts (33 saphenous vein grafts, 4 arterial grafts). A diffuse ISR pattern was found in 76.2% of lesions. Among the study lesions, 58.0% had 2 stent layers and 20.6% had 3 or more stent layers. Technical success was achieved in 96.1% of lesions. Follow-up was available for all patients with a mean follow-up of 701.5 days. The 3-year incidence of target lesion failure (TLF), target vessel myocardial infarction, and major adverse cardiac events were 36.4%, 17.2%, and 45.6%, respectively. In multivariable analysis, higher brachytherapy radiation dose was associated with a lower risk for TLF (aHR per 10 Gy: 0.73; 95% CI 0.54<strong>–</strong>0.93; p = 0.048). Repeat ICBT procedures had a higher incidence of TLF over 3 years compared with lesions treated with ICBT for the first time (log-rank test: p = 0.008). In conclusion, the 3-year incidence of TLF after ICBT is 36.4% and was lower with higher radiation dose and higher in lesions retreated with ICBT.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"244 ","pages":"Pages 89-98"},"PeriodicalIF":2.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741968","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":"Invasive Coronary Angiography has Limited Diagnostic Accuracy for Detecting Reduction of Myocardial Perfusion Assessed by Cardiac Magnetic Resonance","authors":"Anna E. Székely MD ,&nbsp;Shahnaz Akil Engblom PhD ,&nbsp;Fredrik Hedeer MD, PhD ,&nbsp;Peter Kellman PhD ,&nbsp;Marcus Carlsson MD, PhD ,&nbsp;David Erlinge MD, PhD ,&nbsp;Moman A. Mohammad MD, PhD ,&nbsp;Håkan Arheden MD, PhD ,&nbsp;Henrik Engblom MD, PhD","doi":"10.1016/j.amjcard.2025.03.027","DOIUrl":"10.1016/j.amjcard.2025.03.027","url":null,"abstract":"<div><div>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 &lt;2.0 ml/min/g and MPR &lt;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 ICA 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.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 68-75"},"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}

{"title":"Right Ventricular Dysfunction in Heart Failure Patients: Does Sex Matter?","authors":"Carolina Guimaraes MD ,&nbsp;Rita Gouveia MD ,&nbsp;Helena Hipólito-Reis MD ,&nbsp;Rui Ribeiro MD ,&nbsp;Francisca Correia MD ,&nbsp;Sérgio Madureira MD ,&nbsp;Catarina Elias MD ,&nbsp;Ana Margarida Fonseca MD ,&nbsp;Helena Rocha MD ,&nbsp;Mariana Matos MD ,&nbsp;Ana Ribeiro MD ,&nbsp;Jorge Almeida MD ,&nbsp;Patrícia Lourenço PhD","doi":"10.1016/j.amjcard.2025.03.029","DOIUrl":"10.1016/j.amjcard.2025.03.029","url":null,"abstract":"<div><div>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 patients 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 1,152 patients, 65% male, mean age 71 years. RVD coexisted in 192 (17%). Patients with RVD were younger, more often presented atrial fibrillation and nonischemic 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 to 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 to 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.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 35-40"},"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}