American Journal of Cardiology最新文献

{"title":"Eight-Year Outcomes of Patients With Reduced Left Ventricular Ejection Fraction Who Underwent Transcatheter Aortic Valve Replacement With a Self-Expanding Bioprosthesis","authors":"Francesco De Felice MD ,&nbsp;Luca Paolucci MD ,&nbsp;Carmine Musto PhD ,&nbsp;Marco Stefano Nazzaro PhD ,&nbsp;Diana Chin PhD ,&nbsp;Rocco Stio PhD ,&nbsp;Mauro Pennacchi PhD ,&nbsp;Marianna Adamo PhD ,&nbsp;Giuliano Chizzola MD ,&nbsp;Mauro Massussi MD ,&nbsp;Cristina Giannini PhD ,&nbsp;Marco Angelillis PhD ,&nbsp;Marco De Carlo PhD ,&nbsp;Riccardo Gorla PhD ,&nbsp;Francesco Bedogni MD ,&nbsp;Barbara Bellini MD ,&nbsp;Matteo Montorfano MD ,&nbsp;Giuseppe Bruschi PhD ,&nbsp;Bruno Merlanti MD ,&nbsp;Erica Ferrara MD ,&nbsp;Domenico Gabrielli MD","doi":"10.1016/j.amjcard.2024.09.015","DOIUrl":"10.1016/j.amjcard.2024.09.015","url":null,"abstract":"<div><div>Data deriving from patients who underwent TAVR between 2007 and 2017 in 13 Italian centers were prospectively collected. Patients were stratified in those with normal LVEF and reduced LVEF. The latter was further classified according to ischemic or nonischemic etiology. The primary end point was a composite of all-cause death and rehospitalizations; the secondary end points were the isolated composers of the primary end point and cardiac death. Overall, 2,626 patients were included in the analysis: 68.1% with normal LVEF and 31.9% with reduced LVEF. At 8 years, reduced LVEF was significantly associated with the primary end point (adjusted hazard ratio 1.17, 95% confidence interval 1.06 to 1.29). Consistent findings were evident for the composite end point. No differences in these trends were found at the 30-day landmark analyses. Compared with nonischemic etiology, ischemic reduced LVEF was associated with an increased risk of cardiac death (adjusted hazard ratio 1.43, 95% confidence interval 1.02 to 2.02). In conclusion, patients with reduced LVEF who underwent TAVR are exposed to a progressively increased risk of death and rehospitalizations, even at very long-term follow-up.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279135","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":"Disparities and Trends in Autopsy Rates Among Cardiovascular Disease Decedents in the United States, 2011 to 2020","authors":"Marco Zuin MD, MS ,&nbsp;Gianluca Rigatelli MD, PhD ,&nbsp;Claudio Bilato MD, PhD ,&nbsp;Charles Micheal Gibson MD ,&nbsp;Thach Nguyen MD","doi":"10.1016/j.amjcard.2024.09.018","DOIUrl":"10.1016/j.amjcard.2024.09.018","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306963","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 Acute Myocardial Infarction in Patients With Systemic Lupus Erythematosus: A Propensity-Matched Nationwide Analysis","authors":"Ali Bin Abdul Jabbar MD ,&nbsp;Mahmoud Ismayl MD ,&nbsp;Anjali Mishra BS ,&nbsp;Ryan W. Walters PhD ,&nbsp;Andrew M. Goldsweig MD, MS ,&nbsp;Herbert D. Aronow MD, MPH ,&nbsp;Abubakar Tauseef MD ,&nbsp;Ahmed S. Aboeata MD","doi":"10.1016/j.amjcard.2024.09.014","DOIUrl":"10.1016/j.amjcard.2024.09.014","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diastolic Stress Echocardiography in Patients With Hypertrophy Cardiomyopathy: Association With Exercise Capacity","authors":"Agostina M. Fava MD,&nbsp;Zoran B. Popovic MD, PhD,&nbsp;Alaa Alashi MD,&nbsp;Maran Thamilarasan MD,&nbsp;Bo Xu MD,&nbsp;Milind Y. Desai MD, MBA","doi":"10.1016/j.amjcard.2024.09.017","DOIUrl":"10.1016/j.amjcard.2024.09.017","url":null,"abstract":"<div><div>Diastolic dysfunction plays a major role in precipitating congestive heart failure in patients with hypertrophic cardiomyopathy (HCM). In many such patients, symptoms are unmasked only during exercise because left ventricular (LV) filling pressure is normal at rest but increase with exercise. We sought to establish whether abnormal postexercise diastolic parameters are associated with reduced exercise capacity in patients with HCM. We examined 590 patients with asymptomatic/minimally symptomatic HCM (age 54 ± 14 years, 57% men, body mass index 30 ± 6 kg/m², 84% on β blockers) with HCM by 2-dimensional and Doppler echocardiography at rest and after maximal treadmill exercise echocardiography (TSE). A complete echocardiogram (including LV ejection fraction, LV thickness, LV outflow tract [LVOT] gradient, degree of mitral regurgitation) was recorded. Diastolic parameters (septal and lateral [e’] velocities of the mitral annulus, peak early [E] and late [A] mitral inflow velocity, E/A ratio, E/e’, right ventricular systolic pressure [RVSP], and left atrial volume index) were recorded at rest and after TSE. Exercise functional capacity was recorded and divided into &lt;85% or &gt;85% of age-gender predicted metabolic equivalents (AGP-METs). After maximal exercise, 32% patients had at least moderate mitral regurgitation, mean LVOT gradient was 61 ± 59 mm Hg, E/A ratio was 1.2 ± 1.0, average E/e’ ratio 12.9 ± 1.0, and peak RVSP was 36 ± 15 mm Hg. Only 42% of patients achieved &gt;85% of AGP-METs; the mean METs was 7 ± 3. On multivariable logistic regression analysis, higher body mass index (odds ratio [OR] 1.05), β-blocker use (OR 2.58), higher left atrial volume index (OR 1.02), higher peak stress LVOT gradient (LVOTG) (OR 1.06), peak stress E/e’ (OR 1.04), and higher RVSP (OR 1.03) were independently associated with &lt;85% AGP-METs achieved (all p &lt;0.05). In conclusion, in patients with asymptomatic/minimally symptomatic HCM who underwent TSE, there is a significant and independent association between abnormal diastolic response to exercise and reduced exercise capacity in HCM. Incorporating diastolic parameters during stress echocardiography could provide incremental diagnostic utility in deciphering the exact etiology of dyspnea in such patients.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-Analysis of Physiology-Guided Complete or Culprit Lesion-Only Percutaneous Coronary Interventions in Myocardial Infarction","authors":"Sahib Singh MD ,&nbsp;Udaya S. Tantry PhD ,&nbsp;Kevin Bliden MBA ,&nbsp;Marwan Saad MD ,&nbsp;Paul A. Gurbel MD ,&nbsp;J. Dawn Abbott MD ,&nbsp;Aakash Garg MD","doi":"10.1016/j.amjcard.2024.09.013","DOIUrl":"10.1016/j.amjcard.2024.09.013","url":null,"abstract":"<div><div>Whether physiology-guided complete revascularization of nonculprit lesions is superior to culprit lesion-only percutaneous coronary intervention (PCI) in patients with myocardial infarction (MI) and multivessel disease remains debated. Online databases were searched for randomized controlled trials comparing physiology-guided complete revascularization and culprit lesion-only PCI in patients with MI. The outcomes of interest were all-cause death, cardiovascular (CV) death, repeat revascularization, MI, stent thrombosis, and contrast-associated nephropathy/acute kidney injury. Pooled odds ratios, along with 95% confidence intervals (CI) were calculated. A total of 4,849 patients (n = 2,288 physiology-guided complete revascularization, n = 2,561 culprit lesion-only PCI) were included. The mean age was 66 years and 76% were men. At a mean follow-up of 2.5 years, physiology-guided complete revascularization was associated with significant reductions in CV death (odds ratio 0.72, 95% CI 0.54 to 0.97, p = 0.03) and repeat revascularizations (0.50, 95% CI 0.38 to 0.66, p &lt;0.00001) compared with culprit lesion-only PCI. There were no differences between the 2 approaches in all-cause death (0.91, 95% CI 0.69 to 1.19, p = 0.50), MI (0.85, 95% CI 0.59 to 1.21, p = 0.36), stent thrombosis (1.24, 95% CI 0.58 to 2.69, p = 0.58), and contrast-associated nephropathy/acute kidney injury (1.07, 95% CI 0.88 to 1.31, p = 0.50). In conclusion, among patients with MI and multivessel disease, physiology-guided complete revascularization was associated with significant reductions in CV death and revascularizations compared with culprit lesion-only PCI.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279140","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":"Evaluating Patients With Chest Pain Using the Recalibrated HEART Score and a Single High Sensitive Cardiac Troponin Measurement.","authors":"Vernon V S Bonarjee","doi":"10.1016/j.amjcard.2024.09.016","DOIUrl":"10.1016/j.amjcard.2024.09.016","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279137","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":"Is the Advantage of DOACs Due to Better Targeting?","authors":"Christopher L. Hansen MD","doi":"10.1016/j.amjcard.2024.09.007","DOIUrl":"10.1016/j.amjcard.2024.09.007","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279139","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 Giant Left Anterior Descending Artery Aneurysm and an Updated Review on Coronary Aneurysms","authors":"Aldo E. Rafael-Yarihuaman MD ,&nbsp;Jerry Wang BBA ,&nbsp;Cristhian Guevara MD ,&nbsp;Avantika Banerjee MD ,&nbsp;Robert C. Stoler MD ,&nbsp;Julio E. Peralta MD ,&nbsp;Subhash Banerjee MD","doi":"10.1016/j.amjcard.2024.09.010","DOIUrl":"10.1016/j.amjcard.2024.09.010","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279131","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":"Diagnosis of Congenital Heart Disease in Adulthood: How Often, How Relevant?","authors":"Elisabet Viera MD ,&nbsp;Pablo Meras MD ,&nbsp;Carlos Merino MD ,&nbsp;Eliu Perez MD ,&nbsp;Jose Ruiz MD ,&nbsp;Enrique Balbacid MD ,&nbsp;Cesar Abelleira MD ,&nbsp;Angel Aroca PhD ,&nbsp;Raul Moreno PhD","doi":"10.1016/j.amjcard.2024.09.004","DOIUrl":"10.1016/j.amjcard.2024.09.004","url":null,"abstract":"<div><div>Congenital heart disease (CHD) is typically detected during fetal life, infancy, or early childhood. However, there is no published data regarding the proportion of congenital heart defects that are diagnosed in adulthood or the impact of these defects. Retrospective analyses of all consecutive patients (n = 1,010) referred to an adult CHD unit between 2018 and 2023. We analyzed the proportion of cases diagnosed in adulthood, defining the type of defect, reasons for diagnosis, complications, and need for intervention. In total, 26.5% of patients were diagnosed in adulthood (mean age 47 ± 16 years). Overall, 75% were in New York Heart Association class I/IV. Most were mild complexity lesions (57.5%). The most common diagnoses were pre-tricuspid shunts, including ostium secundum atrial septal defect (ASD, 23.9%), partial anomalous pulmonary vein drainage (18.3%), and other types of ASD (5.9%). Bicuspid aortic valve (16.8%) and aortic coarctation (8.2%) were common. Other diagnoses included Ebstein's anomaly (5.6%), ventricular septal defect (4.5%), patent ductus arteriosus (2.6%), or congenitally corrected transposition of the great arteries (2.6%). The main reason for diagnostic work-up was cardiac symptoms (28.4%) such as dyspnea (19%) and palpitations (7.1%), followed by incidental findings on imaging (25.4%). A total of 47.4% had some complications, the most common being pulmonary hypertension (24.3%). Surgical repair was required in 27.2% and 25.4% underwent percutaneous intervention. About one-fourth of patients with CHD were diagnosed in adulthood, and up to 42.5% had moderate or severe complexity lesions. A significant proportion had developed complications at the time of diagnosis and half of them required intervention.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279132","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":"Sub-Intimal Tracking and Re-Entry and Investment Procedures: Current Applications and Future Directions","authors":"Jesse A. Kane MD ,&nbsp;Jasleen Tiwana MD ,&nbsp;Mauro Carlino MD ,&nbsp;Angelo Nascimbene MD ,&nbsp;Silvia Moscardelli MD ,&nbsp;Lorenzo Azzalini MD, PhD, MSc","doi":"10.1016/j.amjcard.2024.09.009","DOIUrl":"10.1016/j.amjcard.2024.09.009","url":null,"abstract":"<div><div>In seeking to improve upon chronic total occlusion (CTO) percutaneous coronary intervention success rates and minimize risk, CTO modification procedures (investment procedures) have been developed and utilized with increasing frequency. Two key techniques have emerged: subintimal tracking and re-entry (STAR) and subintimal plaque modification (SPM). Both require a staged approach with an index procedure for plaque modification and a second procedure weeks later for stenting. Both approaches require entry and wiring with a polymer-jacketed wire in the extra-plaque space, yet unlike SPM, which exclusively requires angioplasty of the extra-plaque space throughout the CTO segment, STAR also involves re-entry into the true luminal distal to the CTO before angioplasty. STAR and SPM, in many ways, represent a paradigm shift in our approach to CTO percutaneous coronary intervention from a 1-step to a 2-step approach in complex cases. In this review, we discuss the technical aspects of the procedures, and controversies and ongoing trials pointing to the future of these techniques. We also highlight non-device-based and intravascular ultrasound-based approaches to anterograde dissection and re-entry, which add to the CTO operator's toolkit for challenging cases.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279141","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}