American Journal of Cardiology最新文献

{"title":"Mid-Term Outcomes of Patients With Hypoplastic Left Heart Syndrome and Left Ventricle-Coronary Artery Fistula","authors":"Ryan L. Kobayashi ,&nbsp;Kaylah Brown ,&nbsp;Kimberlee Gauvreau ,&nbsp;Ele Valencia ,&nbsp;Aditya K. Kaza ,&nbsp;Nicholas S. Boscamp ,&nbsp;Kathryn O. Stack ,&nbsp;Tajinder P. Singh","doi":"10.1016/j.amjcard.2025.03.023","DOIUrl":"10.1016/j.amjcard.2025.03.023","url":null,"abstract":"<div><div>Infants with hypoplastic left heart syndrome (HLHS) with mitral stenosis/aortic atresia (MS/AA) have worse outcomes compared to other anatomic variants; this may be related to left ventricle-coronary artery (LV-CA) fistula. We reviewed patients with HLHS (MS/AA) referred to Boston Children's Hospital and managed from birth during 2008 to 2023 and compared those with and without LV-CA fistula defined angiographically. Among 90 patients, 58 (64%) had LV-CA fistula. In total, 66 (73%) of patients underwent surgical stage 1 palliation (S1P) and 22 (24%) underwent hybrid S1P; hybrid S1P was more common in the fistula group (36% vs 6%, p = 0.002). Probability of transplant-free survival at 1 year was 63% (95% CI 49%, 74%) for those with fistula and 78% (95% CI 60%, 89%) for those without. Over a median follow up of 4.3 years [IQR 0.5,7.9], 38 (42%) patients died or underwent transplant. In univariate analysis, lower GA (HR 1.31, 95% CI 1.16, 1.48), lower BW (HR 1.68, 95% CI 1.28, 2.19), initial hybrid S1P (HR 3.50, 95% CI 1.79, 6.84), and need for perioperative ECMO (HR 4.48, 95% CI 2.23, 8.99) were associated with increased risk of death/transplant (p &lt;0.001 for all). The association of LV-CA fistula with death or transplant did not reach statistical significance (HR 1.83, 95% 0.89, 3.76, p = 0.10). Mortality remains high for children with HLHS (MS/AA) and while there was a trend toward worse transplant-free survival for children with LV-CA fistula compared to those without, factors other than LV-CA fistula may contribute.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 44-49"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741955","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":"Extracorporeal Membrane Oxygenation as a Bridge to Recovery in COVID-19 Myocarditis: A Case Vignette and Evidence-Based Discussion","authors":"Taylor Pickering DO ,&nbsp;Rakushumimarika Harada MD ,&nbsp;Jenelle Sheasby MSN ,&nbsp;Timothy J. George MD ,&nbsp;Aasim Afzal MD","doi":"10.1016/j.amjcard.2025.03.026","DOIUrl":"10.1016/j.amjcard.2025.03.026","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 64-67"},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741950","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":"Increase in Lipoprotein(a) Screening and Utilization at an Urban Academic Medical Center","authors":"Willis Wong MD, MBA,&nbsp;Cindy Kao MS,&nbsp;Ruth Schneider MSN, APRN, ANP-BC,&nbsp;Alagarraju Muthukumar PhD,&nbsp;Ann Marie Navar MD, PhD,&nbsp;Anand Rohatgi MD,&nbsp;Amit Khera MD,&nbsp;Parag H. Joshi MD, MHS","doi":"10.1016/j.amjcard.2025.03.022","DOIUrl":"10.1016/j.amjcard.2025.03.022","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"246 ","pages":"Pages 47-49"},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741952","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":"Prediction Model of in Hospital Death for Stanford Type A Aortic Dissection Based on a Meta-Analysis of 24 Cohorts","authors":"Zhiyuan Wang MS ,&nbsp;Yongbo Zhao MD ,&nbsp;Shichao Guo MS ,&nbsp;Jia Liu MS ,&nbsp;Huijun Zhang MD","doi":"10.1016/j.amjcard.2025.03.017","DOIUrl":"10.1016/j.amjcard.2025.03.017","url":null,"abstract":"<div><div>Patients with Stanford type A aortic dissection (TAAD) have high postoperative mortality. This study aimed to develop a prediction model for in-hospital death after surgery in patients with TAAD. The derivation cohort came from a meta-analysis. Major risk factors were counted. The corresponding hazard ratio was reported to establish a prediction model for in-hospital death in patients with TAAD. Validation cohorts from 2 centres were used to evaluate the prediction model. The meta-analysis included 24 cohort studies with a total of 11,404 patients and 1,554 patients died early after surgery. Risk factors for the prediction model included age, body mass index, smoking, coronary heart disease, preoperative stroke, shock, preoperative cardiopulmonary resuscitation, pericardial tamponade and malperfusion. Patients with TAAD admitted to the First and the Fourth Hospital of Hebei Medical University between January 2020 and June 2024 were retrospectively collected. Patients from the 2 hospitals constituted validation cohorts A (<em>n</em> = 262) and B (<em>n</em> = 138). Risk scores were calculated for model validation and the prediction model demonstrated better differentiation for validation cohort A, with an area under the curve of 0.886 (95% confidence interval 0.842 to 0.931). This study established a simple risk prediction model, including 13 risk factors, to predict in-hospital death in patients with TAAD. However, multicenter data is still needed to evaluate the prediction accuracy of the model.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"246 ","pages":"Pages 50-57"},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741969","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":"Optimizing Coronary Imaging for Valve Surgery: Is CCTA the Future?","authors":"Najia Sadiq, Ashfaq Ahmad, Javed Iqbal, Brijesh Sathian, Ayesha Parvaiz Malik","doi":"10.1016/j.amjcard.2025.03.025","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.03.025","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741956","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":"Fasting Versus Nonfasting Before Cardiac Catheterization—Are We Asking the Right Questions?","authors":"Anne Rüggeberg,&nbsp;Eike A. Nickel","doi":"10.1016/j.amjcard.2025.03.024","DOIUrl":"10.1016/j.amjcard.2025.03.024","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 1-2"},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741951","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":"Intravascular Ultrasound Predictors of 12-Month Patency Loss Following Drug-Coated Balloon Angioplasty for the Femoropopliteal Artery","authors":"Jaeoh Lee MD ,&nbsp;Ji Yong Jang MD ,&nbsp;Chul-Min Ahn MD ,&nbsp;Seung-Jun Lee MD ,&nbsp;Sang-Hyup Lee MD ,&nbsp;Yong-Joon Lee MD ,&nbsp;Sung-Jin Hong MD ,&nbsp;Jung-Sun Kim MD ,&nbsp;Byeong-Keuk Kim MD ,&nbsp;Myeong-Ki Hong MD ,&nbsp;Yangsoo Jang MD ,&nbsp;Tae-Hoon Kim MD ,&nbsp;Ha-Wook Park MD ,&nbsp;Jae-Hwan Lee MD ,&nbsp;Jae-Hyeong Park MD ,&nbsp;Su Hong Kim MD ,&nbsp;Eui Im MD ,&nbsp;Sang-ho Park MD ,&nbsp;Donghoon Choi MD ,&nbsp;Young-Guk Ko MD","doi":"10.1016/j.amjcard.2025.03.018","DOIUrl":"10.1016/j.amjcard.2025.03.018","url":null,"abstract":"<div><div>Intravascular ultrasound (IVUS) has been shown to improve outcomes of drug-coated balloon (DCB) angioplasty for treatment of femoropopliteal artery (FPA) disease. However, the optimal IVUS criteria for achieving improved outcomes of DCB angioplasty for FPA disease remain uncertain. The study aimed to identify IVUS predictors for loss of patency at 12 months after DCB angioplasty for FPA disease. After excluding one patient due to insufficient IVUS imaging data, 98 patients in the IVUS-guidance group of the IVUS-DCB trial were included in the analysis. IVUS parameters predicting loss of patency at 12 months and their optimal cut-off values were investigated. Among the 98 patients who underwent IVUS-guided FPA intervention, 16 patients (16.3%) lost primary patency within 12 months. End-stage renal disease on hemodialysis and, bailout stenting, postprocedural dissection length &gt;50% were independent procedural predictors for 12-month patency loss. Receiver operating characteristic (ROC) curve demonstrated that postprocedural minimal lumen area (MLA) ≥ 11.6 mm² (area under the ROC curve: 0.685, 95% CI: 0.513 to 0.857) as the optimal cut-off value for sustained primary patency. In survival analysis, patients with MLA ≥ 11.6 mm² had a hazard ratio of 0.27 (95% CI: 0.09 to 0.80, p-value = 0.019, risk difference: 19.8) for lower risk of patency loss. A postprocedural MLA ≥11.6 mm² was an independent IVUS predictor for sustained primary patency after DCB angioplasty in patients with FPA disease. Our findings suggest that lesion optimization and achieving sufficient lumen area under IVUS guidance during DCB angioplasty are crucial for maintaining target vessel patency.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"246 ","pages":"Pages 58-64"},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741953","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":"Application and Performance of CT-Fractional Flow Reserve in Non-ST-Segment Elevation Myocardial Infarction","authors":"Josephine Warren BMedSc, MBBS ,&nbsp;Luke Dawson MBBS, PhD ,&nbsp;Tori McCollom BSc, MSc ,&nbsp;Lauren Hudson BRadMedImag ,&nbsp;Misha Dagan MEpi, MD ,&nbsp;Adil Zia MSci, BSci ,&nbsp;Helen Kavnoudias MBBS, PhD ,&nbsp;Philip Lew MBBS ,&nbsp;James Shaw MBBS, PhD ,&nbsp;Dion Stub MBBS, PhD ,&nbsp;Andrew J. Taylor MBBS, PhD","doi":"10.1016/j.amjcard.2025.03.019","DOIUrl":"10.1016/j.amjcard.2025.03.019","url":null,"abstract":"<div><div>Only half of patients with non-ST-segment elevation myocardial infarction (NSTEMI) have obstructive coronary artery disease (CAD) on invasive coronary angiography (ICA). A non-invasive test that can safely rule out obstructive CAD therefore warrants investigation. Computed tomography fractional flow reserve (CT-FFR) enables hemodynamic interrogation of lesions identified on coronary computed tomography angiography (CCTA) but it has not been evaluated in NSTEMI. Inpatients with NSTEMI were recruited to undergo CCTA with CT-FFR prior to ICA. Blinded CT-FFR was performed using Siemens Frontiers cFFR, version 1.4. Invasive FFR was performed on all intermediate lesions with stenoses measuring &gt;30% to &lt;90%. The performance of CT-FFR and CTCA was compared to the gold-standard of ICA plus FFR. Forty patients (131 vessels) were included. The mean age was 61 ± 11 years and 75% were male. CT-FFR showed good correlation with invasive FFR (<em>r</em> = 0.78) and exhibited excellent diagnostic accuracy for obstructive CAD (defined as FFR&lt;0.80 or angiographic stenosis &gt;90%) on a per-vessel analysis, with a sensitivity of 87%, specificity 99%, positive predictive value (PPV) 97%, negative predictive value (NPV) 95% and area under the receiver operating curve (AUC) 0.93, which was superior to CCTA alone (sensitivity 82%, specificity 92%, PPV 82%, NPV 92%, AUC 0.87, p-value for AUC comparison = 0.04). On a per-patient analysis, CT-FFR had a diagnostic accuracy of 100%. In conclusion, CT-FFR provides additive diagnostic accuracy to CCTA in evaluating patients with NSTEMI and exhibits good correlation with invasive FFR.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 6-12"},"PeriodicalIF":2.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727525","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":"Risk of Coronary Artery Calcification Based on Degree of Obesity and Age Group in Korean Adults: Analysis of Kangbuk Samsung Health Study Data","authors":"Da-Eun Sung MD ,&nbsp;Da-Youn Lee MD ,&nbsp;Eun-Jung Rhee MD, PhD","doi":"10.1016/j.amjcard.2025.03.020","DOIUrl":"10.1016/j.amjcard.2025.03.020","url":null,"abstract":"<div><div>This study examined the relationship between body mass index (BMI) and coronary artery calcification (CAC) in a large cohort of adults undergoing routine health evaluations, focusing particularly on the modifying role of age. We analyzed health data from 182,008 male employees and their family members in South Korea between 2010 and 2019, categorizing participants by BMI and age. CAC, a validated marker of subclinical atherosclerosis and a predictor of cardiovascular events, was measured via multidetector computed tomography. In unadjusted analyses, overweight and obese individuals exhibited a significantly higher risk of CAC compared to those with underweight BMI. After adjusting for potential confounding factors, obesity remained independently associated with an increased risk of CAC, while the association with overweight was no longer significant. Age strongly influenced this relationship; individuals aged 70 years or older demonstrated a markedly higher CAC risk, but obesity's association with CAC was significant only in those aged 60 years or younger. These findings indicate that obesity, even in the absence of metabolic abnormalities, contributes to an increased risk of atherosclerosis in younger individuals, challenging the concept of \"metabolically healthy obesity.\" In conclusion, our results underscore the importance of targeted cardiovascular risk assessments that consider both BMI and age, highlighting the need for early intervention in younger adults with elevated BMI to prevent atherosclerosis and suggesting a distinct risk profile in older adults.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"246 ","pages":"Pages 80-83"},"PeriodicalIF":2.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727528","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":"The Safety and Effectiveness of Slow Pathway Region Visualization Strategy in Radiofrequency Ablation for Adults With Atrioventricular Nodal Reentry Tachycardia: A Multicenter Retrospective Study","authors":"Wenchi Guan MD, PhD ,&nbsp;Jun Liu MD, PhD ,&nbsp;Yanbing Gu MD ,&nbsp;Jianjun Li MD ,&nbsp;Keping Chen MD, PhD ,&nbsp;Yan Yao MD, PhD","doi":"10.1016/j.amjcard.2025.03.016","DOIUrl":"10.1016/j.amjcard.2025.03.016","url":null,"abstract":"<div><div>Targeting the atrioventricular nodal slow pathway (AVNsp) is the standard treatment in catheter ablation procedures for atrioventricular nodal reentrant tachycardia (AVNRT). However, significant anatomical variability in Koch's triangle poses challenges for precise ablation and increases the risk of atrioventricular block (AVB). Previous studies have reported that the AVNsp visualization strategy reduces the incidence of AVB, however, these studies were conducted in pediatric patients or with the energy of cryoablation. However, the safety and effectiveness of this strategy in adults undergoing radiofrequency ablation (RFA) remains unclear. This study aimed to evaluate the safety and effectiveness of high-density mapping (HDM)-guided AVNsp visualization strategy for AVNRT ablation compared to the conventional approach. We retrospectively analyzed data from 149 AVNRT patients across 3 hospitals in China. Patients were divided into 2 groups: experimental group (i.e. treated with the HDM-guided AVNsp visualization strategy, <em>n</em> = 88) and control group (i.e. treated with the traditional mapping and ablation strategy, <em>n</em> = 61). Procedural parameters, complication rates, and long-term outcomes were compared. The experimental group required fewer ablation points (4.8 ± 3.6 vs 8.5 ± 7.7, p = 0.003), shorter total ablation time (284 ± 178 s vs 408 ± 345 s, p = 0.028), and reduced procedure time (41.4 ± 14.2 min vs 51.5 ± 27.2 min, p = 0.009) compared with the control group. No cases of AVB occurred in the experimental group, while the control group reported 5 (8.2%) transient AVB and 1 (1.6%) persistent first-degree AVB after procedure. After a mean follow-up of 488 ± 246 days, no recurrences of AVNRT were observed in either group. In conclusion, for adult patients with AVNRT, the AVNsp visualization strategy enhances the safety and effectiveness of RFA by reducing procedure time and minimizing the risk of AVB.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"246 ","pages":"Pages 25-29"},"PeriodicalIF":2.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690453","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}