American Journal of Cardiology最新文献

{"title":"The Magnesium Bioresorbable Stent May Yet Prevail.","authors":"Harris Majeed, James Blankenship","doi":"10.1016/j.amjcard.2025.08.058","DOIUrl":"10.1016/j.amjcard.2025.08.058","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013701","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":"Drug Coated Balloons vs Drug Eluting Stents in Elderly Patients: What Matters Most, the Question or the Answer?","authors":"Carlo Briguori, Luca Paolucci","doi":"10.1016/j.amjcard.2025.08.056","DOIUrl":"10.1016/j.amjcard.2025.08.056","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013674","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":"Principles of Coronary Sinus Narrowing to Relieve Myocardial Ischemia and Improve Angina","authors":"Megha Prasad MD, MS ,&nbsp;Maayan Konigstein MD, MHA ,&nbsp;Ranil de-Silva MBBS, PhD ,&nbsp;Amir Lerman MD ,&nbsp;Shmuel Banai MD","doi":"10.1016/j.amjcard.2025.08.066","DOIUrl":"10.1016/j.amjcard.2025.08.066","url":null,"abstract":"<div><div>Effective therapy for patients suffering from refractory angina remains a major unmet need. Chronic angina, which is refractory to medical and interventional therapies, affects patients who are not suitable for revascularization, patients following successful revascularization, and patients with coronary microvascular dysfunction.</div><div>Coronary sinus (CS) narrowing has been studied as a potential therapy for patients with angina. Pre-clinical and clinical data, including 2 randomized sham-controlled clinical trials and 2 large prospective multi-center registries, have confirmed the safety and effectiveness of CS narrowing in patients with refractory angina due to obstructive coronary artery disease (CAD). Preliminary pathophysiologic studies suggest that CS narrowing may also improve coronary microvascular function and alleviate microvascular angina. Here, we review the historical perspective, mechanism of action, and clinical applications of CS narrowing.</div><div>In Conclusion: With the accumulation of new data, the time is ripe to revisit the therapeutic benefits seen in historical CS interventions and demonstrated in recent clinical research to reduce angina and ischemia and improve quality of life of patients with disabling refractory angina.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"258 ","pages":"Pages 128-133"},"PeriodicalIF":2.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013734","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 Myocardial Bridge–Related Ischemia by Quantitative Flow Ratio Functional Evaluation","authors":"Francesco Cardaioli MD,&nbsp;Tommaso Sciarretta MD,&nbsp;Federico Arturi MD,&nbsp;Tommaso Fabris MD,&nbsp;Giulia Masiero MD,&nbsp;Massimo Napodano MD, PhD,&nbsp;Chiara Fraccaro MD, PhD,&nbsp;Andrea Panza MD,&nbsp;Luca Nai Fovino MD, PhD,&nbsp;Giuseppe Tarantini MD, PhD","doi":"10.1016/j.amjcard.2025.08.062","DOIUrl":"10.1016/j.amjcard.2025.08.062","url":null,"abstract":"<div><div>A myocardial bridge (MB) is a condition where a segment of an epicardial coronary artery passes through the myocardial muscle. While traditionally regarded as benign, MBs have been associated with various cardiovascular conditions. Therefore, assessing their hemodynamic impact is crucial for informed treatment decisions. Intracoronary functional assessments, such as fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR), have proven useful, especially under inotropic stimulation. However, their invasive nature limits their widespread clinical application. The Quantitative Flow Ratio (QFR) has emerged as a minimally invasive alternative for functional evaluation of MBs, though data on its use are still limited. This study aims to compare the diagnostic efficacy of FFR, iFR, and QFR for evaluating MBs both at rest and under stress conditions. Patients with confirmed MB on the LAD and typical angina (or abnormal noninvasive tests indicating myocardial ischemia) were included. According to a prespecified protocol, all patients underwent functional intracoronary evaluation with FFR and iFR at rest and after dobutamine and atropine intravenous infusion. QFR was also calculated for all cases both at rest and during dobutamine infusion. FFR values ≤0.80, iFR values ≤0.89 and QFR values ≤0.84 were considered indicative of significant myocardial ischemia. A total of 21 patients were included. Median FFR remained unchanged from rest (0.85) to stress (0.85), with only 1 patient showing a positive stress-FFR. In contrast, median iFR significantly decreased from 0.91 to 0.79 (p &lt;0.001), with stress-iFR ≤0.89 in 18 patients. Resting QFR did not indicate significant hemodynamic impact of the MB (median 0.90), but under inotropic stimulation, ischemia was detected in 18 patients (median 0.79, p &lt;0.001). QFR and iFR were concordant during stress in 19 patients, showing a significant positive correlation (Spearman’s ρ = 0.702, p = 0.037) and comparable sensitivity (0.86). QFR, computed during inotropic infusion, shows high sensitivity for detecting MB-related ischemia, comparable to stress-iFR and superior to stress-FFR. The correlation between stress-induced iFR and QFR suggests QFR as a reliable, minimally invasive alternative for functional lesion-specific evaluation in MB patients. Larger studies are necessary to confirm these preliminary findings and standardize QFR use in dynamic coronary stenosis assessments.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"258 ","pages":"Pages 112-118"},"PeriodicalIF":2.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008088","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":"Treatment of Ostial Left Anterior Descending Coronary Artery Lesions: to Cross or not to Cross.","authors":"Fernando Alfonso, Manuel Pan, Héctor M García-García","doi":"10.1016/j.amjcard.2025.08.057","DOIUrl":"10.1016/j.amjcard.2025.08.057","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008038","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":"Interaction of Risk of Death and Improvement in Functional Capacity After Cardiac Rehabilitation on Heart Failure Prognosis","authors":"Domenico Scrutinio ,&nbsp;Pietro Guida ,&nbsp;Andrea Passantino","doi":"10.1016/j.amjcard.2025.08.054","DOIUrl":"10.1016/j.amjcard.2025.08.054","url":null,"abstract":"<div><div>Whether risk of death interacts with change in 6-minute walking test (6MWT) distance after cardiac rehabilitation (CR) on heart failure (HF) prognosis is unknown. We studied 1,569 patients with HF admitted to 6 inpatient CR units. A 6MWT was performed at admission to and at discharge from CR. The primary outcome was 3-year mortality. The interaction of baseline risk and 50-meter increase in 6MWT distance on the primary outcome was tested using a Cox regression model with an interaction term between baseline risk and 50-meter increase. To further illustrate the interaction between baseline risk and change in 6MWT distance, participants were stratified into low- and high-risk subgroups. The p value for the interaction was 0.588. Three-year mortality was 16.1% in the low-risk and 53.7% in the high-risk subgroup. 43.0% of the low-risk and 43.4% of the high-risk patients achieved an increase ≥50 meters in 6MWT distance. The adjusted hazard ratio of 3-year mortality for the patients who achieved a 50-meter increase in 6MWT distance was 0.67 (0.47–0.96; p = 0.030) in the low-risk and 0.75 (0.61–0.91; p = 0.005) in the high-risk subgroup. These findings suggest that improvement in functional capacity after CR is associated with improved survival regardless of baseline risk of death.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"258 ","pages":"Pages 41-48"},"PeriodicalIF":2.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005740","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":"Editorial Comments.","authors":"Kaoru Dohi","doi":"10.1016/j.amjcard.2025.08.059","DOIUrl":"10.1016/j.amjcard.2025.08.059","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005756","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":"Extracoronary Arterial Pathologies in Patients With Spontaneous Coronary Artery Dissection","authors":"Hend Bcharah DO ,&nbsp;George Bcharah BS ,&nbsp;Hussein Abdul Nabi MD ,&nbsp;Luke Dreher MD ,&nbsp;Ramzi Ibrahim MD ,&nbsp;Mahmoud Abdelnabi MBBCh, MSc ,&nbsp;Hoang Nhat Pham MD ,&nbsp;Chirstopher Kanaan MD ,&nbsp;Sant Kumar MD ,&nbsp;Linnea M. Baudhuin PhD ,&nbsp;Yuxiang Wang MD ,&nbsp;Mayowa A. Osundiji MBBS, PhD ,&nbsp;Fadi E. Shamoun MD","doi":"10.1016/j.amjcard.2025.08.042","DOIUrl":"10.1016/j.amjcard.2025.08.042","url":null,"abstract":"<div><div>Spontaneous coronary artery dissection (SCAD) is increasingly recognized as a cause of acute coronary syndrome and has been associated with extracoronary arteriopathies, such as fibromuscular dysplasia (FMD), aneurysms, and dissections across other vascular beds. However, these associations remain understudied in the literature. This study aims to characterize the prevalence and distribution of extracoronary arteriopathies in a large cohort of SCAD patients. Patients diagnosed with SCAD were extracted from 2018 to 2024. Baseline characteristics and comorbidities were collected. Available vascular imaging, including echocardiograms, computed tomography, and magnetic resonance, were used to assess for extracoronary arteriopathies. The prevalence and location of FMD, aneurysms, and dissections in extracoronary vascular beds were documented. Among 1,380 SCAD patients, 564 (40.9%) were found to have FMD, 166 (12.0%) had extra-coronary arterial dissections, and 228 (16.5%) had aneurysms in at least 1 extracoronary vascular bed. The most common sites of FMD were renal, carotid, vertebral, and iliac/femoral arteries. Aneurysms were most frequently located in cerebral, carotid, renal, and splenic arteries. Dissections were most prevalent in the carotid, vertebral, extremity, and celiac arteries. Thoracic aortic aneurysms were rare, with only 4 patients showing thoracic aortic dissection. Extracoronary arteriopathies are prevalent in patients with SCAD, affecting more than 47% of the cohort described here. These findings underscore the importance of comprehensive vascular imaging in patients with SCAD to detect extracoronary vascular abnormalities, which may have implications for surveillance and management strategies.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"258 ","pages":"Pages 151-157"},"PeriodicalIF":2.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005746","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":"Chagas Cardiomyopathy: Lessons Learned and Future Directions From Bolivia.","authors":"Carolina Duque, Monica R Mugnier, Luigi Adamo, Amit Alam","doi":"10.1016/j.amjcard.2025.08.055","DOIUrl":"10.1016/j.amjcard.2025.08.055","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005714","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":"Two Approaches, One Clearer Picture.","authors":"David T Linker","doi":"10.1016/j.amjcard.2025.08.050","DOIUrl":"10.1016/j.amjcard.2025.08.050","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005751","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}