American Journal of Cardiology最新文献

{"title":"Comparative Safety of Ultrasound Enhancing Agents: A Systematic Review and Bayesian Network Meta-Analysis.","authors":"Ricardo De La Fuente Gonzalez, Arturo Cabra, Daphne Liu, Myra Gueco, Emi Naslazi, Shuai Fu, Zuzanna Maliszewska, Noemi Hummel, Dustin M Dunham","doi":"10.1016/j.amjcard.2024.11.009","DOIUrl":"10.1016/j.amjcard.2024.11.009","url":null,"abstract":"<p><p>Ultrasound enhancing agents (UEAs), including Optison, DEFINITY, and LUMASON, enhance the diagnostic performance of echocardiography, particularly, in patients with suboptimal acoustic windows. However, there remains a paucity of comparative safety assessments among the Food and Drug Administration-approved UEAs. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic literature review performed in August 2023 searched Medline, Embase, Cochrane Library, and gray literature. Randomized and nonrandomized comparative evidence on safety of contrast-enhanced procedures were included. A feasibility assessment ensured homogeneity across studies by comparing patient characteristics and outcomes. Bayesian hierarchical network meta-regression was used to indirectly compare published safety outcomes across different UEAs. In addition, adverse events (AEs) between 2019 and 2023 for each UEA were retrieved from the Food and Drug Administration Adverse Events Reporting System (FAERS), and comparative safety outcomes were derived using annual UEA administration in the United States. The screening of 4,146 records rendered 19 studies for inclusion in the indirect comparison analysis after feasibility assessment. Optison demonstrated favorable safety in direct comparisons with DEFINITY and LUMASON across the majority of investigated AEs. Network meta-regression results on serious AEs within 30 minutes revealed odds ratios (ORs) of 0.59 (95% confidence interval 0.27 to 1.23) and 0.63 (0.29 to 1.33) for Optison versus LUMASON and DEFINITY, respectively, indicating a decreased risk of serious AEs for Optison versus LUMASON and DEFINITY, further supported by statistically significant ORs within FAERS: 0.01 (0 to 0.02), p <0.001 and 0.15 (0.05 to 0.48), p = 0.001 for Optison versus LUMASON and DEFINITY, respectively. In conclusion, our results restate the favorable comparative safety profile of Optison, providing new evidence to inform clinical decision-making.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643245","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 Associated With Novel Oral Anticoagulants and Warfarin in Patients With Cardiac Thrombus Following ST-Segment Elevation Myocardial Infarction","authors":"Aiham Albaeni MD,&nbsp;Shuang Li PhD,&nbsp;Yong Shan PhD,&nbsp;Ravi Thakker MD,&nbsp;Diann E. Gaalema PhD,&nbsp;Ritika Saxena MPH,&nbsp;Yong-fang Kuo PhD,&nbsp;Hani Jneid MD,&nbsp;James Goodwin MD","doi":"10.1016/j.amjcard.2024.11.006","DOIUrl":"10.1016/j.amjcard.2024.11.006","url":null,"abstract":"<div><div>The treatment of cardiac thrombus after ST-segment elevation myocardial infarction (STEMI) is anticoagulation. There are conflicting data on the effectiveness and safety of novel oral anticoagulants (NOACs) versus warfarin. Using the national Medicare data, we identified patients with an admission diagnosis of STEMI and cardiac thrombus within 6 months after STEMI. Patients were divided into 2 groups based on initial type of anticoagulation medication (NOACs vs warfarin). The 2 main outcomes were ischemic stroke/transient ischemic attack and bleeding. Follow-up was performed through the end of 2023. Kaplan–Meier curves and Cox proportional hazard models were used. Of 881 patients prescribed anticoagulation after STEMI with subsequent cardiac thrombus, 496 patients were prescribed NOACs (56.3%) and 385 patients (43.7%) were prescribed warfarin. For ischemic stroke, the median follow-up time was 177 days (95% confidence interval [CI] 148 to 193) for warfarin and 266 days (95% CI 204 to 326) for NOACs. There was a significantly lower risk of ischemic stroke or transient ischemic attack in patients with cardiac thrombus treated with NOACs than those treated with warfarin [hazard ratio 0.73 (0.57 to 0.93)]. For bleeding, the median follow-up time was 192 days (95% CI 175 to 232) for warfarin and 277 days (95% CI 212 to 332) for NOACs. There was also a lower risk of bleeding in patients treated with NOACs than those treated with warfarin (hazard ratio 0.78, CI 0.66 to 0.92). In conclusion, patients with STEMI with cardiac thrombus had a lower risk of ischemic stroke and bleeding when treated with NOACs than when treated with warfarin. Prospective randomized studies are needed to confirm these findings and further examine the comparative effectiveness of different anticoagulant strategies.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"236 ","pages":"Pages 72-78"},"PeriodicalIF":2.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638553","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":"Hemodynamic Effects and Clinical Outcomes of Left Atrial Veno-Arterial Extracorporeal Membrane Oxygenation (LAVA-ECMO) in Cardiogenic Shock","authors":"Pedro Arturo Villablanca MD ,&nbsp;Raef Ali Fadel DO ,&nbsp;Gennaro Giustino MD ,&nbsp;Ahmad Jabri MD ,&nbsp;Mir Babar Basir Do ,&nbsp;Jennifer Cowger MD ,&nbsp;Khaldoon Alaswad MD ,&nbsp;Brian O'Neill MD ,&nbsp;Pedro Engel Gonzalez MD ,&nbsp;Gillian Grafton Gyzm Do ,&nbsp;Tiberio Frisoli MD ,&nbsp;James Lee MD ,&nbsp;Lindsey Aurora MD ,&nbsp;Sarah Gorgis MD ,&nbsp;Hassan Nemeh MD ,&nbsp;Dimitrios Apostolou MD ,&nbsp;Mohammad Alqarqaz MD ,&nbsp;Gerald C. Koenig MD, PhD ,&nbsp;Herbert D. Aronow MD ,&nbsp;Brittany Fuller MD ,&nbsp;William O'Neill MD","doi":"10.1016/j.amjcard.2024.11.005","DOIUrl":"10.1016/j.amjcard.2024.11.005","url":null,"abstract":"<div><div>Left atrial veno-arterial extracorporeal membrane oxygenation (LAVA-ECMO) in cardiogenic shock (CS) is a novel mechanical cardiocirculatory support strategy that provides robust cardiocirculatory support and simultaneous left and right atrial venting by way of a multifenestrated transeptal catheter. We performed a single-center retrospective analysis of all patients aged ≥18 years with CS who underwent LAVA-ECMO at a quaternary care institution from 2018 to 2023. Clinical outcomes and prehemodynamics and posthemodynamics were evaluated. A total of 68 patients were analyzed (75% were men, 72% were white, median age of 63 years). The indications for LAVA-ECMO were CS because of myocardial infarction (29.4%), biventricular failure (26.5%), and/or valvular heart disease (26.5%). Trans-septal puncture was guided by intracardiac echocardiography (86.8%) or transesophageal echocardiography (13.2%). Arterial cannulation was performed by way of transcaval access in 25% of the cases. Post-LAVA-ECMO cannulation was associated with substantial improvement in the hemodynamics within 24 hours after cannulation, including reduction in right atrial pressure (absolute mean difference: −5.0 mm Hg, p &lt;0.001), mean pulmonary artery pressure (−9.0 mm Hg, p &lt;0.001), pulmonary capillary wedge pressure (−10.0 mm Hg, p &lt;0.001), and left ventricular end-diastolic pressure (−14.0 mm Hg, p &lt;0.001). Survival to decannulation occurred in 69.1%, whereas the 30-day survival from cannulation was 51.5%. The in-hospital all-cause mortality was 51.5%. Only 5 patients (7.4%) required additional mechanical circulatory support (MCS) (4 Impella, 1 veno-arterio-venous extracorporeal membrane oxygenation). There were no complications related to transeptal placement of the venous ECMO cannula. In conclusion, LAVA-ECMO, an MCS strategy providing biatrial drainage, appears to also provide simultaneous left ventricular venting, as demonstrated by improved invasive hemodynamics. Although the procedure appears safe, with no direct complications to interatrial septal cannulation, postcannulation complications remain high, and further studies are needed to evaluate the full safety profile of LAVA-ECMO compared with alternative MCS strategies.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"236 ","pages":"Pages 79-85"},"PeriodicalIF":2.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638552","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":"Sex Differences in a Real-World Registry Examining Coronary Lithotripsy for Calcified Lesions","authors":"Martijn J.H. van Oort MSc ,&nbsp;Federico Oliveri MD ,&nbsp;Al Amri Ibtihal MD, PhD ,&nbsp;Brian O. Bingen MD, PhD ,&nbsp;Bimmer E.P.M. Claessen MD, PhD ,&nbsp;Aukelien C. Dimitriu-Leen MD, PhD ,&nbsp;Tessel N. Vossenberg MD ,&nbsp;Joelle Kefer MD, PhD ,&nbsp;Hany Girgis MD ,&nbsp;Franka van der Kley MD, PhD ,&nbsp;J. Wouter Jukema MD, PhD ,&nbsp;Jose M. Montero-Cabezas MD, PhD","doi":"10.1016/j.amjcard.2024.11.002","DOIUrl":"10.1016/j.amjcard.2024.11.002","url":null,"abstract":"<div><div>Intravascular lithotripsy (IVL) has been established as a safe and effective treatment for coronary artery calcification (CAC). This study aimed to evaluate sex-related differences in the treatment with IVL in a real-world, all-comers international registry. Patients who underwent IVL between May 2019 and February 2024 were enrolled from the BENELUX-IVL registry. Patients were divided into men and women groups. Efficacy end points included device success (delivery of the IVL balloon across the target lesion and administration of therapy without related complications), technical success (thrombolysis in myocardial infarction 3 flow and residual stenosis &lt;30% by quantitative coronary analysis and/or fluoroscopically) and procedural success (composite of technical success with absence of in-hospital major adverse cardiovascular events (MACE: cardiac death, myocardial infarction or target vessel revascularization). Safety end points were IVL-related complications and MACE at 1-year follow-up. 454 patients (73 ± 9.0 years) were treated with IVL, comprising 342 men (75%) and 112 women (25%). More women presented with acute coronary syndrome (41% in men vs 54% in women; p = 0.014) and aorto-ostial lesions (17% in men vs 29% in women; p = 0.009), whereas the SYNTAX score (23.5 ± 14.2 in men vs 17.1 ± 1.0 in women; p &lt;0.001) was higher in men. Rates of device success (97% vs 98%; p = 1.000), technical success (90% vs 91%; p = 0.821) procedural success (90% vs 88%; p = 0.749), IVL-related complications (1% vs 2%; p = 0.362) and 1-year MACE rates (12% vs 17%; p = 0.456) were comparable. In conclusion, despite differences in clinical presentation and lesion types, IVL seems to be safe and effective for both sexes across various clinical and anatomical scenarios.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"236 ","pages":"Pages 49-55"},"PeriodicalIF":2.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612541","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":"Breaking Down Cardiogenic Shock: An Analytical Reflection on the DanGer-SHOCK and ECLS-SHOCK Trials","authors":"Giuseppe Tarantini MD, PhD ,&nbsp;Andrea Panza MD ,&nbsp;Giulia Lorenzoni PhD ,&nbsp;Dario Gregori PhD ,&nbsp;Giulia Masiero MD","doi":"10.1016/j.amjcard.2024.10.032","DOIUrl":"10.1016/j.amjcard.2024.10.032","url":null,"abstract":"<div><div>Mechanical circulatory support devices, particularly the microaxial flow pump (mAFP), have gained traction in managing cardiogenic shock in patients with acute myocardial infarction. However, trials like DanGer-SHOCK (Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock) and ECLS-SHOCK (Extracorporeal Life Support in Infarct Related Cardiogenic Shock) have reported differing outcomes, making it challenging to draw definitive conclusions. To explore this further, we conducted a comparative analysis of the 30-day and 6-month mortality rates from the DanGer-SHOCK and ECLS-SHOCK trials, examining differences in patient populations and risk profiles. The goal was to determine whether these differences could explain the conflicting outcomes or if the benefits observed in the DanGer-SHOCK trial were directly attributable to the mAFP strategy. One key finding is that, despite similar control group mortality rates, the intervention group in DanGer-SHOCK demonstrated a notably lower mortality rate at both 30 days and 6 months compared with the ECLS trial, with an absolute difference of approximately 8%. This benefit is not due to inherent risk differences but is instead attributed to the Impella-based strategy. Compared with standard care, mAFP data revealed a 7% mortality reduction at 30 days, which grew to 12.7% at 180 days, highlighting the long-term effectiveness of the mAFP strategy in maintaining hemodynamic stability and improving survival. These results suggest that, in cardiogenic shock management, the DanGer unloading strategy, when combined with percutaneous coronary intervention, plays a significant role in improving long-term survival through early intervention and ventricular unloading, independent of control group factors. Further research is needed to confirm the broader applicability of this approach in different patient populations.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"236 ","pages":"Pages 30-33"},"PeriodicalIF":2.3,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612527","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":"Meta-Analysis of Renal Denervation Therapy During Pulmonary Vein Isolation in Atrial Fibrillation","authors":"Husam M. Salah MD ,&nbsp;Karl-Philipp Rommel MD ,&nbsp;Karl-Patrik Kresoja MD ,&nbsp;Felix Mahfoud MD ,&nbsp;Philipp Lurz MD, PhD ,&nbsp;Jonathan P. Piccini MD, MHS ,&nbsp;Marat Fudim MD, MHS","doi":"10.1016/j.amjcard.2024.11.001","DOIUrl":"10.1016/j.amjcard.2024.11.001","url":null,"abstract":"<div><div>Pulmonary vein isolation (PVI) has been established as a first-line therapy for symptomatic atrial fibrillation (AF) in selected patients with symptomatic AF and in those whose antiarrhythmic drug treatment failed. However, AF recurrence rates after PVI remain high, prompting the exploration of adjunct therapies, such as renal denervation (RDN), to improve outcomes. This meta-analysis aimed to assess the efficacy of RDN as an adjunct to PVI in reducing AF recurrence. A comprehensive search of randomized controlled trials comparing RDN plus PVI with PVI alone was conducted, yielding 9 studies with 955 patients. The primary end point was freedom from AF at 12 months. The results showed that 61.7% of patients in the RDN+PVI group were free from AF compared with 52.6% in the PVI alone group (risk ratio 1.32, 95% confidence interval 1.07 to 1.61, I² = 48%). These findings support the potential of RDN to enhance PVI efficacy; however, further large-scale randomized controlled trials with standardized methods and longer follow-up periods are necessary to confirm these results and establish the role of RDN in the treatment of AF.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"236 ","pages":"Pages 20-22"},"PeriodicalIF":2.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612518","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 Baseline Left Ventricular Ejection Fraction on Midterm Outcomes in Women Undergoing Transcatheter Aortic Valve Implantation: Insight from the WIN-TAVI Registry","authors":"Francesca Maria Di Muro MD ,&nbsp;Birgit Vogel MD ,&nbsp;Samantha Sartori PhD ,&nbsp;Didier Tchetche MD ,&nbsp;Yihan Feng MS ,&nbsp;Anna Sonia Petronio MD ,&nbsp;Julinda Mehilli MD ,&nbsp;Benjamin Bay MD ,&nbsp;Mauro Gitto MD ,&nbsp;Thierry Lefevre MD ,&nbsp;Patrizia Presbitero MD ,&nbsp;Piera Capranzano MD ,&nbsp;Angelo Oliva MD ,&nbsp;Alessandro Iadanza MD ,&nbsp;Gennaro Sardella MD ,&nbsp;Nicolas Van Mieghem MD, PhD ,&nbsp;Emanuele Meliga MD ,&nbsp;Pier Pasquale Leone MD ,&nbsp;Nicolas Dumonteil MD ,&nbsp;Chiara Fraccaro MD, PhD ,&nbsp;Roxana Mehran MD","doi":"10.1016/j.amjcard.2024.11.004","DOIUrl":"10.1016/j.amjcard.2024.11.004","url":null,"abstract":"<div><div>Limited evidence exists concerning the prognostic impact of baseline left ventricular ejection fraction (LVEF) on outcomes among women undergoing transcatheter aortic valve implantation (TAVI), which we aimed to investigate in the present analysis. Patients from the Women's International Transcatheter Aortic Valve Implantation (WIN-TAVI) registry were categorized according to baseline LVEF into 3 groups: reduced (LVEF ≤40%), mildly reduced (LVEF between 41% and 49%), and preserved (LVEF ≥50%) LVEF. The primary (Valve Academic Research Consortium 2 [VARC-2]) efficacy point was defined as a composite of mortality, stroke, myocardial infarction, hospitalization for valve-related symptoms or heart failure, or valve-related dysfunction at 1 year. The primary (VARC-2) safety end point included all-cause mortality, stroke, major vascular complication, life-threatening bleeding, stage 2 to 3 acute kidney injury, coronary artery obstruction requiring intervention, or valve-related dysfunction requiring repeated procedures. A Cox regression model was performed using the preserved LVEF group as the reference. Among the 944 patients included, 764 (80.9%) exhibited preserved, 80 (8.5%) had mildly reduced, and 100 (10.6%) had reduced LVEF. The 1-year incidence of VARC-2 efficacy end point was numerically higher in patients with reduced LVEF, albeit not resulting in a significant risk difference. Notably, reduced LVEF was associated with a higher risk of the 1-year VARC-2 safety end point, still significant after adjustment (28.0% vs 19.6%, Hazard Ratio 1.78, 95% Confidence Interval 1.12- 2.82, p = 0.014). These differences were primarily driven by trends toward increased rates of all-cause mortality, cardiovascular mortality, and major vascular complications. Clinical outcomes were similar between patients with mildly reduced and preserved LVEF. In conclusion, when performed in women with reduced LVEF, TAVI was associated with a worse (VARC-2) safety profile at 1-year follow-up. In contrast, patients with mildly reduced LVEF appeared to align more closely with outcomes observed in the preserved LVEF group than with the reduced LVEF group.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"236 ","pages":"Pages 56-63"},"PeriodicalIF":2.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612489","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":"Are There Racial and Ethnic Differences in Outcomes Following Left Main Percutaneous Coronary Intervention?","authors":"Zachary Tugaoen, Brian P Kelley, Kevin A Friede, George A Stouffer","doi":"10.1016/j.amjcard.2024.11.003","DOIUrl":"10.1016/j.amjcard.2024.11.003","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612502","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":"Long-Term Mortality and Impact of Implantation-Associated Factors on the Incidence of Patient-Prosthesis Mismatch After Transcatheter Aortic Valve Implantation in Patients With Small Annuli","authors":"Lisa Voigtländer-Buschmann MD ,&nbsp;Ina von der Heide ,&nbsp;Alina Goßling ,&nbsp;Lara Waldschmidt MD ,&nbsp;Laura Hannen MD ,&nbsp;David Grundmann MD ,&nbsp;Sebastian Ludwig MD ,&nbsp;Till Demal MD ,&nbsp;Oliver D. Bhadra MD ,&nbsp;Niklas Schofer MD ,&nbsp;Hermann Reichenspurner MD ,&nbsp;Stefan Blankenberg MD ,&nbsp;Lenard Conradi MD ,&nbsp;Andreas Schaefer MD ,&nbsp;Moritz Seiffert MD","doi":"10.1016/j.amjcard.2024.10.033","DOIUrl":"10.1016/j.amjcard.2024.10.033","url":null,"abstract":"<div><div>Prosthesis-patient mismatch (PPM) is a common phenomenon after transcatheter aortic valve implantation (TAVI), especially in patients with small aortic annuli. Whether factors during implantation, such as the implantation depth, have an impact on the occurrence of PPM is currently unclear. The objectives of our study were to (1) investigate the influence of procedure planning- and implantation-related factors on the occurrence of PPM and (2) evaluate the impact of PPM on long-term mortality after TAVI. Data from 315 patients with small aortic annuli, defined as multidetector computed tomography-derived annulus area &lt;400 mm², treated with transfemoral TAVI between 2014 and 2021 were retrospectively analyzed. TAVI was performed with ballon-expandable valves (BEVs) in 113 and self-expanding valves (SEVs) in 202 cases. PPM was defined according to Valve Academic Research Consortium 3 and follow-up was obtained within 5 years after TAVI. Overall, PPM occurred in 121 patients (38.4%) and was significantly more frequent in patients treated with BEVs (54.9%) than with SEVs (29.2%, p &lt;0.001). Evaluation of planning- and implantation-related factors found that deeper implantation of BEVs significantly increased the risk of PPM (p = 0.014), whereas no association was observed in SEVs. The overall mortality rates at 3 and 5 years were 25.5% and 43.1%, respectively, without significant differences between patients with and without PPM. In conclusion, PPM occurred frequently, especially after BEV implantation. In these patients, implantation depth was identified as a predictor of PPM, whereas no association was found for SEV implantation. In addition, there was no difference in longer-term mortality between patients with and without PPM.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"236 ","pages":"Pages 23-29"},"PeriodicalIF":2.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612493","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":"Efficacy of Cardiac Myosin Inhibition in Patients After Septal Reduction Therapy","authors":"Aakash Bavishi MD, MSCI ,&nbsp;Robyn Bryde MD ,&nbsp;Marybeth Soutar MS ,&nbsp;Margaret Kurnides RDCS ,&nbsp;Heather Speer RDCS ,&nbsp;Glenda Oyarce RCS ,&nbsp;Karen Richards RN ,&nbsp;Karen DeMarco RN ,&nbsp;Matthew W. Martinez MD","doi":"10.1016/j.amjcard.2024.10.026","DOIUrl":"10.1016/j.amjcard.2024.10.026","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"235 ","pages":"Pages 85-87"},"PeriodicalIF":2.3,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602861","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}