American Journal of Cardiology最新文献

{"title":"The current state of the board-certified adult congenital heart disease workforce 10 years after initial certification.","authors":"Georges Ephrem","doi":"10.1016/j.amjcard.2025.06.034","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.034","url":null,"abstract":"<p><strong>Introduction: </strong>There is growing concern about a workforce shortage in Adult Congenital Heart Disease (ACHD) cardiologists to care for the ever-increasing population of ACHD patients. Providing an accurate representation of the ACHD field and its board-certified workforce is crucial.</p><p><strong>Methods: </strong>This retrospective analysis examined a cohort of all American Board of Internal Medicine's (ABIM) ACHD board-certified physicians since 2015. The variables of interest include year of certification, eligibility pathway, additional ABIM certifications, age group, sex, medical school type, and geographic location.</p><p><strong>Results: </strong>The all-time cohort included 509 diplomates by ABIM, 89% of whom were certified before the sundowning of the practice pathway. The cohort is predominantly male, older, and has a background in pediatric cardiology and USMG MD training. Most are in highly populated states and major urban centers. Compared to those certified before the practice pathway ended, the more recent diplomates are younger, with fewer males and more from adult cardiology training programs.</p><p><strong>Conclusion: </strong>There is a workforce shortage of ACHD cardiologists, and current ACHD fellowship training is insufficient to offset the attrition of the ACHD physician workforce or to support its growth to the desired size. This constitutes a call for action to survey the ACHD workforce, explore potential advancements in the ACHD training model, dissemination of a certain level of ACHD knowledge, and advocate further for the value of ACHD and its providers in the healthcare system.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564297","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":"Impact of Orbital Atherectomy on Side Branch Patency in Severely Calcified Coronary Artery Lesions: A Retrospective Single-Center Experience.","authors":"Hassan Saleh, Hesham Affify, Kush Patel, Muhammad Umer, Nicholas Pavlatos, Zachary Meili, Thomas Beyerle, Emily Converse, John Dillon, Nicholas Stone, Suneil Bhaskara, Ravi Sharma, Marcel Letorneau, Sohail Ikram, Naresh Solankhi","doi":"10.1016/j.amjcard.2025.06.032","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.032","url":null,"abstract":"<p><strong>Background: </strong>Severe coronary artery calcification is associated with reduced procedural success and increased long-term adverse events. Orbital atherectomy (OA) is a commonly used plaque-modification strategy in this setting. However, the impact on side branch (SB) patency remains undefined.</p><p><strong>Aim: </strong>To evaluate side branch patency and associated clinical outcomes in patients with severely calcified coronary lesions undergoing OA.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective analysis of 272 patients who underwent orbital atherectomy between January 1, 2021, and December 1, 2024. We identified and included lesions with a SB ≥ 2.0 mm in diameter within the main branch (MB) stented area. A total of 142 SB vessels were identified. Pre and post-procedural SB TIMI flow grade was assessed, procedural complications and major adverse cardiovascular events (MACE) were recorded at discharge, 30 days and 1 year.</p><p><strong>Results: </strong>Mean age was 70.7 with 70.7% of patients being male. 50.7% of patients had diabetes, 41.5% had chronic kidney disease, 33.8% had heart failure, 12.0% had prior coronary artery bypass grafting and 17.6% had been referred for surgery and deemed ineligibile. Adjunctive device use was low. The mean number of burr passes was 11.5±5.9. The most common SB vessels were diagonal (60.5%), SB ballooning was performed in 16.2% and stenting in 10.6% of cases. SBs had pre-procedure TIMI 3 flow in 93.7% of cases and final TIMI 3 flow in 93.7%. Procedural complications and MACE events at discharge, 30-days and 1-year were low.</p><p><strong>Conclusion: </strong>In this single-center, retrospective analysis, the use of orbital atherectomy in heavily calcified MB vessels with an adjacent SB ≥ 2.0 mm in diameter resulted in high rates of SB TIMI 3 flow with low rates of complications. These findings highlight the need for further prospective, multicenter studies to define the impact of OA on SB preservation.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564296","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":"Legends in Cardiology: Giant Sense of Humor.","authors":"Mori J Krantz","doi":"10.1016/j.amjcard.2025.06.029","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.029","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558827","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":"Oxylipins are Associated with Poor Right Ventricular to Pulmonary Artery Coupling and Adverse Outcomes in Heart Failure with Preserved Ejection Fraction.","authors":"Alex Kloster, Alborz Sherafati, Kevin Wunderly, Vaishnavi Aradhyula, Sareeta Manandhar, Anas Fares, Prabhatchandra Dube, Pamela Brewster, Steven Haller, David Kennedy, Rajesh Gupta, Samer Khouri","doi":"10.1016/j.amjcard.2025.06.030","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.030","url":null,"abstract":"<p><p>Right ventricular (RV) coupling to pulmonary artery (PA) pressure is a key parameter in heart failure with preserved ejection fraction (HFpEF). Oxylipins, a class of fatty acid signaling molecules that regulate inflammation, may be associated with RV-PA uncoupling. We sought to determine the association of RV-PA uncoupling with clinical outcomes in HFpEF and to discover oxylipins associated with RV-PA uncoupling. A prospective HFpEF cohort study was established. Echocardiogram and right heart catheterization were performed and venous and arterial blood samples were collected. 234 oxylipins were measured in all participants. Kaplan Meier curves were used to assess the relationship between the tricuspid annular plane systolic excursion (TAPSE) to RV systolic pressure (RVSP) ratio and mortality or heart failure (HF) hospitalizations. Volcano plots were used to determine the relationship between oxylipins and RV-PA uncoupling. The primary endpoint was a composite of all-cause mortality and HF hospitalizations. 83 patients (mean age 68.69 ± 10.7 years, 67.5% female) in our cohort study had TAPSE/RVSP data and entered the analysis. Receiver operating characteristic (ROC) analysis determined an optimal cutpoint of TAPSE/RVSP of 0.31. TAPSE/RVSP<0.31 was associated with higher risk of the primary endpoint (HR=2.61, 95% CI=1.28-5.33, p=0.008). Arterial oxylipins 19(R)-OH PGF2a and 20-OH PGF2a, and venous oxylipin 7(8)-EpDPE were associated with an increased odds of TAPSE/RVSP<0.31, while arterial oxylipin 20-HETE was associated with decreased odds of TAPSE/RVSP<0.31. In conclusion, RV-PA uncoupling is associated with higher risk of all-cause mortality or HF hospitalizations in patients with HFpEF. Specific oxylipins were associated with RV-PA uncoupling.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558828","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":"Critical Appraisal of \"Association of Mechanical Circulatory Support and Cardiac Catheterization Laboratory Procedural Volumes with Outcomes of Cardiogenic Shock\".","authors":"Nabiah Shakeel, Noor Un Nisa Irshad, Mazhar Hussain, Aleesha Jannat","doi":"10.1016/j.amjcard.2025.06.020","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.020","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551737","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":"First-in-Human Ringer™ Balloon-Assisted Coil Embolization of Large Saphenous Vein Graft Aneurysm Using the Ping-Pong Technique.","authors":"Hafez Golzarian, Lojayne Osman, Jamie Saum, Dylan Pitts, Constance Dahill, Benjamin Wischmeyer, Jennifer Music, Lisa Racer, Ali Ahmad, Nicole Nelson, Sandeep M Patel","doi":"10.1016/j.amjcard.2025.06.013","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.013","url":null,"abstract":"<p><p>Saphenous vein graft aneurysms in patients who are at high risk for surgery can present a challenging management dilemma, particularly when large and symptomatic. We report the first-in-human use of a Ringer™ perfusion balloon catheter to facilitate percutaneous coiling of a coronary saphenous vein graft aneurysm. This technique enabled temporary occlusion of the aneurysm neck during coil embolization while maintaining distal coronary perfusion. This case highlights a novel approach to treating complex and large vein graft aneurysms, avoiding the need for covered stents or vascular plugging.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537784","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":"Atrial Fibrillation Burden, Risk Factors, and Prognosis in Wild-type Transthyretin Amyloidosis Cardiomyopathy.","authors":"Jens Kaestel Skov, Bertil Ladefoged, Anders Lehmann Dahl Pedersen, Tor Skibsted Clemmensen, Jens Cosedis Nielsen, Steen Hvitfeldt Poulsen","doi":"10.1016/j.amjcard.2025.06.015","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.015","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is common in patients with wild-type transthyretin amyloidosis (ATTRwt), yet data on incident AF following diagnosis, associated risk factors, and its prognostic impact remain limited. In this single-centre cohort study conducted at Aarhus University Hospital, we examined the incidence of new-onset AF, identified clinical predictors, and explored the association between AF and all-cause mortality in patients with ATTRwt diagnosed between 2016 and 2022. Among 208 patients, AF was present at diagnosis in 56%, and the cumulative incidence of new-onset AF in the remaining patients reached 45% (95% CI: 32-56) within three years. Multivariable Cox regression identified body mass index (HR 1.13, 95% CI: 1.04-1.23), higher National Amyloidosis Centre stage (HR 1.93, 95% CI: 1.14-3.27), and left ventricular mass index per 10-unit increase (HR 1.06, 95% CI: 1.01-1.12) as significant risk factors of new-onset AF. A clinical history of AF at the time of ATTRwt diagnosis seemed to be associated with increased all-cause mortality, but did not reach statistical significance (HR 1.74, 95% CI: 0.96-3.16, p = 0.07). In conclusion, AF is highly prevalent at diagnosis and frequently develops after diagnosis in patients with ATTRwt, with body mass index, National Amyloidosis Centre stage, and increasing left ventricular mass index emerging as risk factors for new-onset AF. Having AF is likely associated with adverse prognostic implications warranting further investigation.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526059","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":"Impact of Lipid-Lowering Medications on Cardiovascular Outcomes and Lipid Profiles in NAFLD/NASH Patients: A 5-Year Retrospective Cohort Study.","authors":"Osman Yousafzai, Frank Annie, Kainat Kanwal, Sarah Rinehart","doi":"10.1016/j.amjcard.2025.06.018","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.018","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526061","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":"Atrial Fibrillation Catheter Ablation in Patients With Hypertrophic Cardiomyopathy: A Systematic Review and Meta-analysis.","authors":"Francesco Stabile, Sebastian Jaramillo, Bezalel Hakkeem, Giang Son Arrighini, Stefano Cangemi, Daniela Di Lisi, Egle Corrado, Alfredo Ruggero Galassi, Giuseppina Novo","doi":"10.1016/j.amjcard.2025.06.026","DOIUrl":"10.1016/j.amjcard.2025.06.026","url":null,"abstract":"<p><p>Atrial fibrillation (AF) frequently complicates hypertrophic cardiomyopathy (HCM) and is associated with significant morbidity and mortality. Catheter ablation (CA) has emerged as an effective treatment modality; however, its efficacy compared to medical therapy in HCM patients remains unclear. We conducted a systematic review and meta-analysis to assess the impact of CA compared with medical therapy on hard prognostic outcomes in patients with HCM and AF. PubMed, Scopus, and Cochrane databases were systematically searched for randomized controlled trials and observational studies comparing CA with medical therapy alone in HCM patients with documented AF. We Included studies that reported at least 1 clinical outcome of interest over a minimum 5-year follow-up period: all-cause mortality, cardiovascular death, heart failure hospitalizations and stroke. A random-effects model was applied, and heterogeneity was assessed by I² statistics. We analyzed 4 studies comprising a total of 570 patients, 316 (55%) of whom underwent CA. CA significantly reduced heart failure hospitalizations compared to medical therapy alone (RR 0.37; 95% CI 0.16 to 0.87; p = 0.02). However, CA showed no statistically significant effect on all-cause mortality (RR 0.68; 95% CI 0.41 to 1.11; p = 0.12), cardiovascular death (RR 0.66; 95% CI 0.35 to 1.25; p = 0.20), or stroke incidence (RR 0.29; 95% CI 0.03 to 2.61; p = 0.27). In conclusion, in patients with HCM and AF, CA is associated with a significant reduction in heart failure hospitalizations compared to medical therapy alone, without a significant impact on all-cause mortality, cardiovascular death, or stroke.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526060","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":"Reader's Comments: Clinical Outcomes of Intravenous Iron Therapy in Systolic Heart Failure Patients Receiving Sodium-Glucose Cotransporter-2 Inhibitors.","authors":"Tugce Colluoglu, Yesim Akın","doi":"10.1016/j.amjcard.2025.06.027","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.06.027","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526063","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}