American Journal of Cardiology最新文献_第5页

Reflections on Sheath Type and Closure Approaches in Contemporary TF-TAVI Practice 当代TF-TAVI实践中鞘式与闭合方式的思考。

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-05-24 DOI: 10.1016/j.amjcard.2025.05.028

Ritesh Kanyal MBBS, Mahmood Ahmad MBBS

引用次数: 0

Inflammation-Still an Underestimated Player in Coronary Artery Disease. 炎症——在冠状动脉疾病中仍然是一个被低估的角色。

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-05-23 DOI: 10.1016/j.amjcard.2025.05.023

Tomasz Podolecki, Zbigniew Kalarus, Jacek Kowalczyk

引用次数: 0

Noninvasive Right Ventricular Myocardial Work by Pressure-Strain Loop: A New Perspective on Right Ventricular Function and Cardiac Resynchronization Therapy 压力-应变循环无创右室心肌工作：右室功能和心脏再同步化治疗的新视角。

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-05-23 DOI: 10.1016/j.amjcard.2025.05.024

Fangyan Tian , Chunqiang Hu , Wen Liu , Bei Zhang , Haiyan Chen , Xianhong Shu

{"title":"Noninvasive Right Ventricular Myocardial Work by Pressure-Strain Loop: A New Perspective on Right Ventricular Function and Cardiac Resynchronization Therapy","authors":"Fangyan Tian , Chunqiang Hu , Wen Liu , Bei Zhang , Haiyan Chen , Xianhong Shu","doi":"10.1016/j.amjcard.2025.05.024","DOIUrl":"10.1016/j.amjcard.2025.05.024","url":null,"abstract":"<div><div>Myocardial work (MW) by noninvasive pressure-strain loop (PSL) is a novel echocardiographic tool that provides a more precise estimation of right ventricular (RV) performance by accounting for the RV loading conditions. The study sought to investigate the impact of cardiac resynchronization therapy (CRT) on RV function and explore the role of RV MW indices in predicting CRT response. Ninety-one CRT-candidates were prospectively enrolled. Left ventricular (LV) MW parameters, RV global longitudinal strain (RV GLS) and RV free wall strain (RV FWS) were obtained. RV MW indices, including RV global work index (RV GWI), RV global constructive work (RV GCW), RV global wasted work (RV GWW), and RV global work efficiency (RV GWE), were measured by PSL analysis. Response to CRT was defined as a reduction in left ventricular end-systolic volume of ≥15% at follow-up. RV GWI significantly increased in responders. CRT caused significant improvements in RV GWI, RV GCW, and RV GWE (p <0.05). In multivariate analysis, RV GWI (adjusted odds ratio (OR): 1.010; 95% CI: 1.003 to 1.017; p <0.05), and LV GCW (adjusted OR: 1.002; 95% CI: 1.000 to 1.003; p <0.05) were associated with CRT response. Adding RV GWI to the basal model yielded a significant improvement in continuous net reclassification improvement at 0.284 (p = 0.032), while other function parameters failed to improve reclassification. RV MW indices provide a new reference for the quantitative evaluation of RV myocardial performance before and after CRT. Although both RV GWI and LV GCW have prognostic value, RV GWI may better predict the response to CRT.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"252 ","pages":"Pages 8-15"},"PeriodicalIF":2.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141129","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

Five Years After ARCHBR’s Global Introduction: A Prospective Validation Study in Egypt ARC-HBR全球引入五年后：埃及的前瞻性验证研究。

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-05-23 DOI: 10.1016/j.amjcard.2025.05.022

Nehad El-Amrawy MD, Salah El-Tahan PhD, Mohamed Sadaka PhD, Amr Kamal PhD

{"title":"Five Years After ARCHBR’s Global Introduction: A Prospective Validation Study in Egypt","authors":"Nehad El-Amrawy MD, Salah El-Tahan PhD, Mohamed Sadaka PhD, Amr Kamal PhD","doi":"10.1016/j.amjcard.2025.05.022","DOIUrl":"10.1016/j.amjcard.2025.05.022","url":null,"abstract":"<div><div>Five years after the global introduction of the ARC<img>HBR criteria, prospective validation in real-world clinical settings has remained globally lacking. This study aims to prospectively assess the predictive utility of ARC<img>HBR criteria in an Egyptian percutaneous coronary intervention (PCI) population, describe contemporary bleeding patterns, and establish a regional reference for post-PCI major bleeding outcomes. This single-center study included 1,018 PCI patients treated at Alexandria Main University Hospital between March 2022 and August 2023. High bleeding risk (HBR) was defined as ≥1 major or ≥2 minor ARC<img>HBR criteria. The primary endpoint was major bleeding (BARC type 3 or 5), including in-hospital, postdischarge, and cumulative events. Secondary endpoints included ARC<img>HBR prevalence, individual criterion associations with bleeding, and overall predictive performance. HBR patients (44.6%) experienced significantly higher cumulative major bleeding rates (8.4% vs 3.2%; HR = 2.8, p <0.001). In-hospital bleeding was low (1.2%) with no significant group difference, while postdischarge bleeding was markedly higher in HBR patients (7.6% vs 2.4%, p <0.001). Mild anemia and chronic kidney disease (CKD) were the most common ARC<img>HBR criteria. Severe CKD, nondeferrable surgery on dual antiplatelet therapy (DAPT), and oral anticoagulation (OAC) were the strongest predictors of bleeding. ARC<img>HBR demonstrated moderate predictive performance (C-statistic = 0.682). In conclusion, this study provides the first prospective validation of ARC<img>HBR in Egypt. While ARC<img>HBR criteria effectively identify HBR patients, persistently high postdischarge and cumulative bleeding rates highlight the need for improved mitigation strategies in real-world, resource-limited healthcare systems.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"252 ","pages":"Pages 16-26"},"PeriodicalIF":2.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141043","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

Prognostic Implications of High-Sensitivity Cardiac Troponins in Patients With Acute Kidney Injury Without Myocardial Infarction 高敏感性心肌肌钙蛋白对急性肾损伤无心肌梗死患者的预后影响。

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-05-22 DOI: 10.1016/j.amjcard.2025.05.020

Love Cyon MD , Erik Kadesjö MD, PhD , Andreas Roos MD, PhD

{"title":"Prognostic Implications of High-Sensitivity Cardiac Troponins in Patients With Acute Kidney Injury Without Myocardial Infarction","authors":"Love Cyon MD , Erik Kadesjö MD, PhD , Andreas Roos MD, PhD","doi":"10.1016/j.amjcard.2025.05.020","DOIUrl":"10.1016/j.amjcard.2025.05.020","url":null,"abstract":"<div><div>Elevated and dynamic high-sensitivity cardiac troponin T (hs-cTnT) concentrations are often observed in patients with acute kidney injury (AKI) without myocardial infarction (MI), yet their prognostic implications are unknown. This study investigated associations between hs-cTnT measurements and prognosis in patients with AKI in the emergency department (ED). All first visits to 7 EDs during 2010 to 2017 by patients without MI fulfilling AKI criteria and ≥1 hs-cTnT measured were included. Logistic and Cox regression analyses were applied to estimate short- and long-term risks of mortality and major adverse cardiovascular events (MACE) according to peak hs-cTnT and relative hs-cTnT change (Δhs-cTnT). A total of 12,136 patients were included. In-hospital- and long-term mortality was 15% and 49% (median follow-up: 3.8 years, IQR: 1.3 to 6.0). Adjusted in-hospital mortality risk increased with higher peak hs-cTnT, being >8-fold (aOR 8.68, 95% CI: 6.85 to 11.0) in the highest quintile of hs-cTnT, in whom long-term risk of cardiovascular mortality and MACE was 3-fold (HR: 3.01, 95% CI: 2.74 to 3.31) and 2-fold (HR: 2.12, 95% CI: 2.00 to 2.24). Associated risks were elevated already at intermediately elevated hs-cTnT and evident in patients with transient AKI and with normalized eGFR at discharge. Patients with the highest Δhs-cTnT experienced an increased short-term mortality risk, but Δhs-cTnT was not associated with long-term mortality and only weakly associated with the risk of MACE. In conclusion, in patients with AKI but without acute MI, peak hs-cTnT are associated with a worse prognosis in both the short and long term, whereas dynamic hs-cTnT changes may have less prognostic significance.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"251 ","pages":"Pages 70-78"},"PeriodicalIF":2.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141113","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

Diagnosis and Management of Phrenic Paralysis Associated Hypoxemia 膈瘫痪伴低氧血症的诊断与治疗。

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-05-21 DOI: 10.1016/j.amjcard.2025.05.019

Antoine Premachandra MD , Matthieu Perier MD , Amandine Richard MD , Guillaume Tachon MD , Florent Huang MD , Benjamin Zuber MD

{"title":"Diagnosis and Management of Phrenic Paralysis Associated Hypoxemia","authors":"Antoine Premachandra MD , Matthieu Perier MD , Amandine Richard MD , Guillaume Tachon MD , Florent Huang MD , Benjamin Zuber MD","doi":"10.1016/j.amjcard.2025.05.019","DOIUrl":"10.1016/j.amjcard.2025.05.019","url":null,"abstract":"<div><div>Phrenic nerve paralysis caused by herpes zoster infection is an exceptionally rare condition associated with severe respiratory complications. An even rarer phenomenon is the development of hypoxemia due to a right-to-left shunt through a patent foramen ovale (PFO), triggered by mediastinal shift and redirection of venous flow caused by right diaphragmatic elevation. We report the case of a 74-year-old woman admitted to the intensive care unit with severe hypoxemia refractory to oxygen therapy, requiring mechanical ventilation, following a recent herpes zoster infection affecting the C4 dermatome. Imaging revealed right hemidiaphragm elevation due to phrenic nerve paralysis, leading to mediastinal shift and a right-to-left shunt through a PFO without an interatrial pressure gradient. Transesophageal echocardiography confirmed a massive shunt. Emergency percutaneous PFO closure was performed, resulting in immediate improvement in oxygenation. In this article, the authors provide a framework for navigating the diagnostic reasoning and management of this rare condition. In conclusion, this case emphasizes the importance of considering phrenic nerve paralysis and PFO-related shunting in the differential diagnosis of unexplained hypoxemia, particularly in patients with recent cervical herpes zoster infections. Early screening for diaphragmatic dysfunction and transesophageal echocardiography are essential diagnostic tools, and percutaneous PFO closure offers a safe and effective solution for severe shunt-related hypoxemia.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"252 ","pages":"Pages 3-7"},"PeriodicalIF":2.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132108","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

Vigorous But Not Moderate Physical Activity Is Associated With Reduced Cardiovascular Disease Risk In Young Hispanic Men 西班牙裔年轻男性剧烈而非适度的体育活动与心血管疾病风险降低相关

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-05-21 DOI: 10.1016/j.amjcard.2025.05.021

Chiara Gattoni PhD , Katelin Bebe BS , Rachelle Bross PhD , Christina Wang MD , Ronald S. Swerdloff MD , Ronald J. Oudiz MD , William E. Kraus MD , Harry B. Rossiter PhD

{"title":"Vigorous But Not Moderate Physical Activity Is Associated With Reduced Cardiovascular Disease Risk In Young Hispanic Men","authors":"Chiara Gattoni PhD , Katelin Bebe BS , Rachelle Bross PhD , Christina Wang MD , Ronald S. Swerdloff MD , Ronald J. Oudiz MD , William E. Kraus MD , Harry B. Rossiter PhD","doi":"10.1016/j.amjcard.2025.05.021","DOIUrl":"10.1016/j.amjcard.2025.05.021","url":null,"abstract":"<div><div>Physical Activity Guidelines for Americans recommend at least 150 min/week of moderate (MPA) to vigorous (VPA) physical activity to maintain health, regardless of cardiovascular disease (CVD) risk. This study assessed whether physical activity (PA) intensity distinguishes between low and high CVD risk in 196 lean and obese Hispanic men aged 18-40 from the Study of Male Reproductive Epigenomics. PA was measured for 7 days using triaxial accelerometry. The 30-year “full” Framingham Risk Score (FRS) was calculated. Diet quality was assessed using the Healthy Eating Index (HEI-2020). Mean age was 30 ± 5 years with a median FRS of 14% (range: 3% to 85%). The high-risk group (n = 89) had a mean full FRS of 20.3% ± 11.1%, compared to 7.0% ± 3.6% in the low-risk group (n = 107; p <0.001). Both groups met guideline-recommended PA levels. However, the low-risk group performed more VPA (25 ± 20 vs 12 ± 12 min/day; p <0.001). Logistic regressions showed that each additional 1 min/day of VPA reduced the odds of high CVD risk by 4.4% (p = 0.007), adjusted for smoking, diet, age and Body Mass Index (BMI), while MPA did not significantly predict CVD risk (p = 0.823). Stepwise regressions showed that smoking status, BMI, VPA, and diet explained 47.8% of FRS variance (p <0.001), while MPA was excluded. In conclusion, VPA, but not MPA, significantly distinguished low from high CVD risk in young Hispanic men, highlighting the potential role of higher-intensity exercise to reduce CVD risk in this population.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"251 ","pages":"Pages 79-84"},"PeriodicalIF":2.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132109","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

Rethinking Coronary Dissections in Drug-Coated Balloon Angioplasty-A Paradigm Shift. 重新思考药物包被球囊血管成形术中的冠状动脉剥离——一个范式转变。

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-05-20 DOI: 10.1016/j.amjcard.2025.05.017

Abdulla Shehab, Hussien Heshmat Kassem, Rajeev Gupta

引用次数: 0

Erratum to 'Lipid Management in United States Commercial and Medicare Enrollees With Atherosclerotic Cardiovascular Disease: Treatment Patterns and Low-Density Lipoprotein Cholesterol Control' [The American Journal of Cardiology 242 (2025) 1-9]. 对“美国商业和医疗保险登记的动脉粥样硬化性心血管疾病患者的脂质管理：治疗模式和低密度脂蛋白胆固醇控制”的勘误[美国心脏病学杂志242(2025)1-9]。

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-05-17 DOI: 10.1016/j.amjcard.2025.05.010

Ann Marie Navar, Batul Electricwala, Jasjit K Multani, Zifan Zhou, Chi-Chang Chen, Barnabie C Agatep, Allison A Petrilla, Taylor T Schwartz, Laetitia N'dri, Joaquim Cristino, Fatima Rodriguez

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Cancer Patients With Atrial Fibrillation Need More Aggressive Treatment to Prevent Stroke. 癌症心房颤动患者需要更积极的治疗来预防中风。

IF 2.3 3区医学

American Journal of Cardiology Pub Date : 2025-05-15 DOI: 10.1016/j.amjcard.2025.05.014

Gerald V Naccarelli

引用次数: 0