American Journal of Cardiology最新文献

{"title":"The Influence of Height on Occupational Radiation Exposure of Interventional Cardiologists During Selective Coronary Angiography Using a Radial Artery Approach","authors":"Richard Casazza MAS ,&nbsp;Bilal Malik MD ,&nbsp;Arsalan Hashmi ,&nbsp;Joshua Fogel Phd ,&nbsp;Enrico Montagna RT ,&nbsp;Darren Gibson RT ,&nbsp;Andres Palacio RT ,&nbsp;Habiba Beginyazova RT ,&nbsp;Robert Frankel MD ,&nbsp;Jacob Shani MD","doi":"10.1016/j.amjcard.2025.04.027","DOIUrl":"10.1016/j.amjcard.2025.04.027","url":null,"abstract":"<div><div>Radiation exposure is one of the most adverse occupational hazards faced by interventional cardiologists. Operator height can influence operator radiation exposure. This single-center retrospective study (<em>n</em> = 534) assessed the cumulative radiation (CR) exposure in μSv and normalized radiation exposure (CR/DAP) using three different ranges of height (short, regular, and tall) of the primary operator at four anatomical locations when using a radial artery approach. A multivariate linear regression analyses for cumulative operator radiation dose found that tall operator height had significantly lesser values than regular operator height for the thorax (p &lt;0.001), abdomen (p = 0.01), left eye (p &lt;0.001), and right eye (p &lt;0.001). Short operator height did not significantly differ from regular operator height. Multivariate linear regression analyses for normalized operator radiation dose found that tall operator height had significantly lesser values than regular operator height for the thorax (p &lt;0.001), abdomen (p = 0.01), left eye (p &lt;0.001), and right eye (p = 0.002). Short operator height did not significantly differ from regular operator height. In conclusion, there was an association of lower operator radiation dose in the thorax, abdomen, left eye, and right eye for tall operators as compared to regular height operators. We recommend regular height operators be exceedingly vigilant with their personal radiation protection techniques. Furthermore, these same protection techniques should be considered with patients that have a higher likelihood of generating greater dose-area-products.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"251 ","pages":"Pages 1-8"},"PeriodicalIF":2.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961354","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":"Factors Associated with the Uncoupling of Perceived and Achieved Exercise Capacity in Patients Undergoing Cardiopulmonary Exercise Testing","authors":"Kaivalya Dandamudi MD ,&nbsp;Adarsh Mallepally BS ,&nbsp;Teymur Zavar BS ,&nbsp;Justin M. Canada PhD ,&nbsp;Ross Arena PhD ,&nbsp;Inna Tchoukina MD ,&nbsp;Cory R. Trankle MD","doi":"10.1016/j.amjcard.2025.04.029","DOIUrl":"10.1016/j.amjcard.2025.04.029","url":null,"abstract":"<div><div>An objective of the Duke Activity Status Index (DASI) is to standardize assessments of exertional intolerance. However, patient factors associated with inaccurate assessments of exercise capacity with this tool are not well described. Patients who completed the DASI in preparation for a treadmill cardiopulmonary exercise test (CPET) at our institution from 2022 to 2023 were analyzed. Metabolic equivalents of task (METs) were calculated from the DASI score and measured from CPET. Clinical characteristics were compared using Chi square or Mann-Whitney U tests between those who overestimated versus underestimated exercise capacity via the DASI. Correlations were assessed with a Spearman test, and a binary logistic regression model was fit to the clinical characteristics to identify patient characteristics associated with overestimating METs with the DASI. Overall, 512 patients were included in the current study, and the majority (419 [82%]) overestimated exercise capacity via the DASI. DASI-predicted METs had moderate correlation with CPET-achieved METs (Spearman’s rho = +0.620, p &lt;0.001). Patients who overestimated exercise capacity by DASI were more likely to be older, female sex, Black race, on beta blockers, of higher body mass index, and with cardiac comorbidities. The regression model (Χ² = 87.6, p &lt;0.001, Nagelkerke R² = 0.259) found older age, female sex, diagnosis of heart failure, and congenital heart disease most strongly associated with overestimating exercise capacity (all p ≤0.002). In conclusion, a majority of patients referred for CPET overestimate exercise capacity by DASI score, particularly those with older age, female sex, heart failure, and congenital heart disease.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"250 ","pages":"Pages 48-53"},"PeriodicalIF":2.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957750","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":"Safety and Effectiveness of the High-Sensitivity HEART Pathway Safely Across Age Groups in Patients With Suspected Acute Coronary Syndrome","authors":"Michael Supples MD, MPH ,&nbsp;Simon Smits BS ,&nbsp;Akalya Villenthi MS ,&nbsp;Anna C. Snavely PhD ,&nbsp;Nicklaus P. Ashburn MD, MS ,&nbsp;Simon A. Mahler MD, MS","doi":"10.1016/j.amjcard.2025.04.022","DOIUrl":"10.1016/j.amjcard.2025.04.022","url":null,"abstract":"<div><div>The high-sensitivity HEART Pathway (hs-HP) is a risk stratification algorithm for Emergency Department (ED) patients with chest pain. However, its diagnostic performance across age subgroups is unknown. We conducted a subgroup analysis of the 5-site hs-HP implementation study. Pre-implementation (1/2019-4/2020) the traditional HEART Pathway was used with contemporary troponins. Postimplementation (11/2020-2/2022) the hs-HP was used with high-sensitivity troponins to risk-stratify patients into rule-out, observation, and rule-in groups. Patients were classified as young (aged: 18 to 45), middle-aged (46 to 64), or older (≥65). Effectiveness and safety outcomes included 30-day hospitalizations and 30-day all-cause mortality or myocardial infarction (MI), respectively. Multivariable logistic regression was used to compare outcomes pre- vs. postimplementation within age subgroups. The 26,126 patients accrued (12,317 pre- and 13,809 postimplementation) were 35.3% non-White and 52.7% female. Postimplementation, hospitalizations decreased 18.1% among the older patients (70.6% vs. 52.5%; aOR 0.47, 95% CI, 0.42 to 0.52), 18.2% in middle-aged (50.0% vs. 31.8%; aOR 0.48, 95% CI, 0.44 to 0.52), and 7.5% among young patients (20.1% vs. 7.6%; aOR 0.69, 95% CI, 0.59 to 0.76). In older patients, 30-day death or MI occurred in 12.9% (497/3,861) postimplementation vs. 13.5% (482/3,571) preimplementation (aOR 1.02; 95% CI, 0.89 to 1.18). In middle-aged patients, 7.0% (382/5,495) had 30-day death or MI postimplementation vs. 7.5% (395/5,257) preimplementation (aOR 1.01; 95% CI, 0.87-1.18). Finally, 30-day death or MI occurred in 1.5% (66/4,453) of young patients postimplementation vs. 2.0% (71/3,489) preimplementation (aOR 1.01; 95% CI 0.69 to 1.48). In conclusion, the hs-HP significantly reduced hospitalizations across all age groups of patients with chest pain, without increasing 30-day adverse events.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"250 ","pages":"Pages 38-47"},"PeriodicalIF":2.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952284","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":"Unmasking Nonresponders: Right Ventricular Function as the Missing Link in Transcatheter Mitral Valve Repair Outcomes.","authors":"Rahul Chaudhary, George Chalhoub, Matthew E Harinstein","doi":"10.1016/j.amjcard.2025.04.019","DOIUrl":"10.1016/j.amjcard.2025.04.019","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957549","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":"Renal Denervation for Hypertension: From Innovation to Indication","authors":"Raymond R. Townsend MD ,&nbsp;Michael A. Weber MD","doi":"10.1016/j.amjcard.2025.04.011","DOIUrl":"10.1016/j.amjcard.2025.04.011","url":null,"abstract":"<div><div>High blood pressure is a common problem around the world. Although many trials attest to the value of reducing blood pressure with medication and lifestyle changes, current prevalence studies of high blood pressure show a substantial portion of the adult population with uncontrolled high blood pressure. Treatment nonadherence is part of the challenge to achieving blood pressure control and newer approaches to high blood pressure treatment, whether device based, or using agents such as silencing ribonucleic acids, have shown high levels of treatment efficacy and since they are administered in the health care setting, adherence is less of an issue. In this introduction to a special issue of the American Journal of Cardiology we will review the history of hypertension treatment and some current epidemiology highlighting the public health importance of improving blood pressure control to reap the well described benefits of lower blood pressure upon the target organs of hypertension. Subsequent sections of this special issue will focus on aspects of renal denervation, including patient selection, efficacy in blood pressure lowering, measuring success of denervation and procedural guidance for this emerging therapy in the management of uncontrolled hypertension.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"249 ","pages":"Pages 65-67"},"PeriodicalIF":2.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942675","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":"Predictive Value of V̇O2peak in Adult Congenital Heart Disease in Comparison With Heart Failure With Reduced Ejection Fraction","authors":"Andrea Soares MD ,&nbsp;Lauren K. Park PhD ,&nbsp;Emily Mansour MS, MD ,&nbsp;Elena Deych MS ,&nbsp;Alyssa Puritz DPT ,&nbsp;Min Zhao MS ,&nbsp;Chao Cao MPH ,&nbsp;Andrew R. Coggan PhD ,&nbsp;Phillip M. Barger MD ,&nbsp;Randi Foraker PhD, MA, FAHA ,&nbsp;Susan B. Racette PhD ,&nbsp;Linda R. Peterson MD, FACC, FAHA, FASE","doi":"10.1016/j.amjcard.2025.04.020","DOIUrl":"10.1016/j.amjcard.2025.04.020","url":null,"abstract":"<div><div>Peak oxygen consumption (V̇O_2peak) is used to predict outcomes and time to transplantation in patients with heart failure with reduced ejection fraction (HFrEF); V̇O_2peak also has predictive utility in patients with adult congenital heart disease (ACHD). However, the predictive value of a given V̇O_2peak on cardiac events in patients with ACHD compared to HFrEF, especially after adjustment for age and sex, is unclear. Therefore, we performed a longitudinal cohort study comparing patients with ACHD to patients with HFrEF. The cohorts were sex and age matched (±10 years). V̇O_2peak tests were conducted from 1993 to 2012. Cardiac events included death, cardiac transplantation, and LVAD placement. Events were obtained via electronic medical record, SSDI, and phone interview. Cox proportional-hazard regression analyses were used to evaluate relationships of event-free survival with predictor variables. Patients with ACHD (N = 137) and HFrEF (N = 137) had median follow-up times of 19.0 years (14.8 to 21.1) and 14.5 years (13.4 to 15.6), respectively. In multivariable models, Higher V̇O_2peak was associated with lower risk for a cardiac event, independent of age and sex, in both ACHD (HR 0.89, 95% CI 0.83 to 0.96, p = 0.002) and HFrEF (HR 0.86, 95% CI 0.82 to 0.91, p &lt;0.001). Male sex was associated with greater risk of a cardiac event HFrEF (HR 1.90, 95% CI 1.24 to 2.90, p = 0.003) but not in ACHD group. After multivariable adjustment (Beta-blockers, sex, and V̇O_2peak), having ACHD conferred a 71% lower risk of cardiac events compared to a HFrEF diagnosis (HR 0.29, 95% CI 0.18 to 0.47, p &lt;0.001). V̇O_2peak independently predicts event-free survival among adults with ACHD or HFrEF and has clinical utility in outpatient settings. Patients with ACHD have a better prognosis after multivariable adjustment including V̇O_2peak compared to HFrEF.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"249 ","pages":"Pages 29-35"},"PeriodicalIF":2.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935919","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":"Mechanisms of Cardiac Implantable Electronic Device Interference With the Tricuspid Valve Apparatus","authors":"Karima Addetia MD ,&nbsp;Michael Henry MD ,&nbsp;Heather Smith MD ,&nbsp;Megan Yamat RDCS ,&nbsp;Gene Kim MD ,&nbsp;Renuka Jain MD ,&nbsp;Eisha Wali MD ,&nbsp;Linda Lee MD ,&nbsp;Nathan Marzlin MD ,&nbsp;AbdulRahman Abutaleb MD ,&nbsp;Jonathan Crouch MD ,&nbsp;Eric S. Weiss MD ,&nbsp;Takeyoshi Ota MD ,&nbsp;Christopher Salerno MD ,&nbsp;Huihua Li MD ,&nbsp;Aliya A. Husain MD ,&nbsp;Valluvan Jeevanandam MD ,&nbsp;Roberto M. Lang MD","doi":"10.1016/j.amjcard.2025.04.016","DOIUrl":"10.1016/j.amjcard.2025.04.016","url":null,"abstract":"<div><div>Cardiac implantable electronic devices (CIEDs) have been implicated in the development of tricuspid valve (TV) dysfunction. However, the mechanisms of dysfunction are not well characterized. We sought to define the prevalence, location and mechanisms of CIED-TV interference based on direct inspection of gross pathologic specimens from consecutive patients with CIEDs who had undergone orthotopic heart transplantation (OHT). CIED-interference was classified by location (septal, posterior or anterior trigone of the RV), portion of TV apparatus involved (leaflet(s) only, sub-tricuspid apparatus (STA) only or a combination of both leaflet and STA) and type of interference (adherence, trapping or both). Sixty-two cases of CIED-TV interference were identified (5 leaflet, 30 STA and 27 leaflet and STA). The majority of patients had nonischemic cardiomyopathy (81%) and leads in situ for &lt;10 years (77%). Most CIED-TV interference involved either the posterior (<em>n</em> = 23, 37%), septal (<em>n</em> = 15, 24%) or posteroseptal regions of the RV (<em>n</em> = 16, 26%). Interference with the anterior leaflet or anterior STA was rare. STA interference consisted of lead trapping behind the papillary muscles or chordae alone (<em>n</em> = 6), lead adherence with trapping (<em>n</em> = 21) and lead adherence alone (<em>n</em> = 3). Combination STA and leaflet interference consisted of adherence and trapping (<em>n</em> = 20) and adherence without trapping (<em>n</em> = 7). In conclusion, CIED-TV interference occurs most frequently with the STA in the posterior and septal regions of the RV. These findings have the potential to instruct imagers on how to evaluate for CIED-TV interference in an era where, elucidating the mechanism of TV dysfunction and considering options for repair is gaining momentum.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"250 ","pages":"Pages 30-37"},"PeriodicalIF":2.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965352","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":"CHA2DS2-VASc Score in Patients With Atrial Fibrillation and Cancer: A U.S. Nationwide Study","authors":"Mohammad AL Mouslmani MD, MPH ,&nbsp;Mohamad Alhoda Alahmad MD ,&nbsp;Zafer Akman MD ,&nbsp;Raiza Rossi MD ,&nbsp;Mufti Rahman MD, MSc, MPH ,&nbsp;Michael G. Nanna MD, MHS","doi":"10.1016/j.amjcard.2025.04.025","DOIUrl":"10.1016/j.amjcard.2025.04.025","url":null,"abstract":"<div><div>The CHA₂DS₂-VASc score is widely accepted as the most reliable tool for risk stratification to guide the initiation of anticoagulation in patients with atrial fibrillation/flutter. However, it has not been validated for use in patients with malignancy, and lacks cancer-related parameters. We aimed to evaluate the CHA₂DS₂-VASc score’s association with acute cerebrovascular accident (CVA) in cancer patients during hospitalization for atrial fibrillation/flutter in the United States. We conducted a cross-sectional analysis of the Nationwide Readmissions Database (NRD) from 2016 to 2019, extracting all cases with a primary diagnosis of atrial fibrillation/flutter. We then divided all patients based on the presence or absence of malignancy and calculated CHA₂DS₂-VASc scores. We identified 1,769,603 weighted admissions with atrial fibrillation/flutter, of those, 96,982 had malignancy. The cohort with malignancy had a mean age of 74 years (SD, 13.4) vs 70.4 years (SD, 17.8). In both cohorts, each additional point in the CHA₂DS₂-VASc score was associated with higher odds of acute CVA during index hospitalization. For the cohort with malignancy, a score of 2 (compared to 0) was associated with an odds ratio (OR) of 4.73 (1.71 to 13.10) compared with 2.61 (2.08 to 3.27) for the cohort without malignancy. In conclusion, the CHA₂DS₂-VASc score was linearly associated with acute CVA in patients with atrial fibrillation/flutter with and without cancer. However, the odds ratios were higher in the cohort with malignancy, emphasizing the importance of anticoagulation initiation in patients with cancer.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"249 ","pages":"Pages 59-64"},"PeriodicalIF":2.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946708","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":"Predictors and Mechanisms of Nonculprit Plaque Progression in Patients With Acute Coronary Syndromes: An In-Vivo Serial Optical Coherence Tomography Study","authors":"Yishuo Xu MD ,&nbsp;Jianlin Ma MD ,&nbsp;Luping He MD, PHD ,&nbsp;Dirui Zhang MD ,&nbsp;Boling Yi MD ,&nbsp;Yan Zuo MD ,&nbsp;Yuhan Qin MD, PHD ,&nbsp;Chen Zhao MD ,&nbsp;Ziqian Weng MD, PHD ,&nbsp;Yanli Sun MD, PHD ,&nbsp;Ming Zeng MD ,&nbsp;Xi Chen MD ,&nbsp;Ning Wang MD ,&nbsp;Xue Feng MD, PHD ,&nbsp;Yue Zhu MD ,&nbsp;Wei Hao MD ,&nbsp;Lulu Li MS ,&nbsp;Huai Yu MD, PHD ,&nbsp;Yini Wang MD, PHD ,&nbsp;Sining Hu MD, PHD ,&nbsp;Bo Yu MD, PHD","doi":"10.1016/j.amjcard.2025.04.023","DOIUrl":"10.1016/j.amjcard.2025.04.023","url":null,"abstract":"<div><div>Plaque progression is vital in the relationship between baseline phenotypes and future adverse events. Serial optical coherence tomography (OCT) has enabled the comprehensive assessment of plaque progression in vivo. This study aimed to explore the predictors of nonculprit plaque progression in patients with acute coronary syndrome (ACS) and assess the underlying mechanisms of progression using serial OCT. Patients diagnosed with ACS who underwent baseline and 12 ± 3 months of follow-up OCT scans between September 2013 and August 2022 were retrospectively enrolled. OCT defined plaque progression as a reduction in minimal lumen area of ≥0.84 mm² at follow-up. A total of 406 patients with ACS and 1,054 nonculprit plaques met the inclusion criteria, with a median follow-up duration of 369 days. Lesion location, luminal severity and the prevalence of vulnerable features significantly differed between the progression and nonprogression groups. In the multivariate analysis, thin-cap fibroatheroma (TCFA) (OR: 2.028, 95% CI: 1.287 to 3.196), macrophages (OR: 1.919, 95% CI: 1.212 to 3.040), microchannels (OR: 1.941, 95% CI: 1.353-2.782), and layered plaques (OR: 1.660, 95% CI: 1.178 to 2.339) were independent predictors of plaque progression. Two mechanisms of lesion progression were observed: Type I (54.6%): lesion progression without silent event(s). Type II (45.4%): lesion progression accompanied by silent event(s), including new layer formation and/or new intra-plaque hemorrhage. In conclusion, TCFA, macrophages, microchannels, and layered plaques independently predict nonculprit plaque progression in patients with ACS. Serial OCT examinations can identify distinct mechanisms of plaque progression that vary dramatically among different plaque phenotypes.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"249 ","pages":"Pages 19-28"},"PeriodicalIF":2.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935618","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":"Relationship Between Pressure-Derived Physiologic Indices and Inducible Myocardial Ischemia During the Adenosine Stress Test","authors":"Do-Yoon Kang MD ,&nbsp;Ji Sung Lee PhD ,&nbsp;Cheol Whan Lee MD","doi":"10.1016/j.amjcard.2025.04.024","DOIUrl":"10.1016/j.amjcard.2025.04.024","url":null,"abstract":"<div><div>We evaluated the relationship between pressure-derived physiologic indices and inducible myocardial ischemia (IMI), defined by significant ST-segment changes during adenosine stress testing, in 227 patients with left main or left anterior descending coronary artery disease. Associations with symptomatic improvement, assessed by the 7-item Seattle Angina Questionnaire at 1 month post-PCI, were also analyzed. Optimal cut-off values for IMI were lower than current thresholds, with the instantaneous wavefree ratio (iFR) showing superior diagnostic accuracy (higher AUC) compared to other indices. PCI provided the greatest symptomatic relief in patients with moderate-to-severe angina and concomitant IMI. In conclusion, iFR more accurately identifies IMI, and PCI benefits are most pronounced in patients with IMI-related chest pain.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"250 ","pages":"Pages 17-19"},"PeriodicalIF":2.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953938","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}