American heart journal最新文献

{"title":"Information for Readers","authors":"","doi":"10.1016/S0002-8703(25)00079-1","DOIUrl":"10.1016/S0002-8703(25)00079-1","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"284 ","pages":"Page iv"},"PeriodicalIF":3.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular health, lifestyle factors, and social determinants among Hispanic or Latino adults in the United States","authors":"Frans Serpa MD ,&nbsp;Sudheesha Perera MD, MPH ,&nbsp;Daniel E. Cruz MD ,&nbsp;Jose F. Figueroa MD, MPH ,&nbsp;Fatima Rodriguez MD, MPH ,&nbsp;Daniel B. Kramer MD, MPH ,&nbsp;Rishi K. Wadhera MD, MPP, MPhil","doi":"10.1016/j.ahj.2025.03.002","DOIUrl":"10.1016/j.ahj.2025.03.002","url":null,"abstract":"<div><h3>Background</h3><div>Among Hispanic/Latino subgroups residing in the US, disparities in cardiovascular health status remain largely uncharacterized.</div></div><div><h3>Methods</h3><div>This national study used the National Health Interview Survey to assess the burden of cardiometabolic risk factors (hypertension, hyperlipidemia, obesity, diabetes) and cardiovascular diseases (history of heart attack, coronary heart disease, angina, stroke) across Hispanic/Latino subgroups (Mexican, Cuban, Puerto Rican, Central/South American), and the extent to which differences are related to lifestyle factors (physical inactivity, smoking, and alcohol consumption) and/or social determinants of health (income, education, food security, and health insurance status).</div></div><div><h3>Results</h3><div>The weighted study population included 35,549,841 Hispanic/Latino adults (26,008 respondents). In age- and sex-adjusted models, hypertension was more common among Puerto Rican adults (OR 1.34, 95% CI: 1.12-1.60) but less common among Central/South American adults (OR 0.71, 95% CI: 0.61-0.82) compared to Mexican adults (reference group). Central/South Americans were also less likely to have obesity (OR 0.63, 95% CI: 0.57-0.70) and diabetes (OR 0.50, 95% CI: 0.42-0.61). For cardiovascular diseases, Puerto Rican adults were more likely to have angina (OR 1.69, 95% CI: 1.06-2.71), whereas Central/South Americans were less likely to have angina (OR 0.50, 95% CI: 0.30-0.84), coronary heart disease (OR 0.70, 95% CI: 0.51-0.96), and heart attack (OR 0.49, 95% CI: 0.33–0.72). Moreover, Cuban adults were less likely to have hyperlipidemia (OR 0.73, 95% CI: 0.61–0.88), obesity (OR 0.58, 95% CI: 0.49-0.70), diabetes (OR 0.44. 95% CI: 0.34-0.57) and stroke (OR 0.54, 95% CI: 0.32-0.92) Differences persisted after sequentially adjusting for lifestyle factors and social determinants of health.</div></div><div><h3>Conclusion</h3><div>This study used disaggregated data to demonstrate the complex landscape of cardiovascular health among Hispanic/Latino adults in the US, emphasizing the need for targeted interventions and policy efforts to reduce health inequities in this rapidly growing population.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"285 ","pages":"Pages 133-144"},"PeriodicalIF":3.7,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rationale and design of the ILIAS ANOCA clinical trial: A blinded-arm controlled trial for routine ad-hoc coronary function testing","authors":"Coen K.M. Boerhout MD ,&nbsp;Hanae F. Namba MD ,&nbsp;Tommy Liu MD ,&nbsp;Marcel A.M. Beijk MD, PhD ,&nbsp;Peter Damman MD, PhD ,&nbsp;Martijn Meuwissen MD, PhD ,&nbsp;Peter Ong MD ,&nbsp;Udo Sechtem MD, PhD ,&nbsp;Yolande Appelman MD, PhD ,&nbsp;Colin Berry MD, PhD ,&nbsp;Javier Escaned MD, PhD ,&nbsp;Amir Lerman MD, PhD ,&nbsp;Timothy D. Henry MD, PhD ,&nbsp;Pim van der Harst MD, PhD ,&nbsp;Ronak Delewi MD, PhD ,&nbsp;Jan J. Piek MD, PhD ,&nbsp;Tim P. van de Hoef MD, PhD","doi":"10.1016/j.ahj.2025.03.004","DOIUrl":"10.1016/j.ahj.2025.03.004","url":null,"abstract":"<div><h3>Background:</h3><div>Angina with nonobstructive coronary arteries (ANOCA) is a major cause of chronic coronary syndromes, affecting nearly half of patients with anginal symptoms who undergo invasive coronary angiography. ANOCA may lead to substantial symptom burden, increased risk of adverse cardiac events, increased healthcare utilization due to ongoing symptoms, repeat hospitalizations, and invasive testing. The pathophysiology of ANOCA often involves a variety of coronary disorders, such as coronary microvascular dysfunction, epicardial or microvascular vasospasm and endothelial dysfunction. While coronary function testing (CFT) can identify each of these specific endotypes, in current practice it is used as a second- or third-line diagnostic tool, delaying diagnosis which contributes to persistent symptoms and diminished quality of life. The ILIAS ANOCA clinical trial aims to enhance understanding and management of ANOCA through early routine CFT-guided management.</div></div><div><h3>Methods:</h3><div>After exclusion of obstructive coronary artery disease, eligible patients undergo comprehensive CFT, and will be randomized to blinding of the CFT results (control group) or disclosure of the CFT results combined with a tailored medical therapy escalation plan (intervention group). The control group will be unblinded after 1 year. The primary outcome is the mean difference in the within-subject change in Seattle Angina Questionnaire (SAQ) summary score between the groups at 6 months from baseline. Secondary outcomes include differences in SAQ-summary score and additional health-status and quality of life questionnaires at 12 and 24 months from baseline.</div></div><div><h3>Clinical trial registration:</h3><div>International Clinical Trials Registry Platform identifier NL-OMON20739.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"286 ","pages":"Pages 1-13"},"PeriodicalIF":3.7,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and Rationale of the CORE -TIMI 72a and CORE2 -TIMI 72b Trials of Olezarsen in Patients with Severe Hypertriglyceridemia.","authors":"Nicholas A Marston, Brian A Bergmark, Veronica J Alexander, Ewa Karwatowska-Prokopczuk, Yu Mi Kang, Filipe A Moura, Thomas A Prohaska, Andre Zimerman, Shuanglu Zhang, Sabina A Murphy, Sotirios Tsimikas, Robert P Giugliano, Marc S Sabatine","doi":"10.1016/j.ahj.2025.03.003","DOIUrl":"10.1016/j.ahj.2025.03.003","url":null,"abstract":"<p><p>Severe hypertriglyceridemia (HTG), defined as a serum triglyceride (TG) concentration ≥500 mg/dl, is present in approximately 1 in every 500 individuals and carries direct clinical consequences, including pancreatitis, which can be life-threatening. Olezarsen is an investigational antisense oligonucleotide targeted to the mRNA for apolipoprotein C-III (apoC-III), a protein known to impair TG clearance by inhibiting lipoprotein lipase and the hepatic uptake of triglycerides and triglyceride-rich remnants. Olezarsen has been evaluated in patients with predominantly moderate HTG (150-499 mg/dl) and a rare genetic condition known as Familial Chylomicronemia Syndrome (FCS), with TG lowering effects of 53% and 44%, respectively, and reductions in pancreatitis among the FCS population. However, no dedicated trial has tested olezarsen in patients with severe HTG. In these two pivotal phase 3 trials, CORE -TIMI 72a (NCT05079919) and CORE2 -TIMI 72b (NCT05552326), over 1,000 patients with severe HTG will be randomized in a 2:1 fashion to either olezarsen (80 mg or 50 mg dose) or matching placebo. Patients will be treated for a total of 53 weeks and evaluated for the primary endpoint of percent change in TGs from baseline to 6 months compared to placebo. Pooled analyses of CORE and CORE2 will also assess olezarsen's effect on acute pancreatitis events and change in hepatic steatosis. Together, CORE -TIMI 72a (NCT05079919) and CORE2 -TIMI 72b (NCT05552326) are designed to establish the efficacy and safety of olezarsen in patients with severe HTG.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S0002-8703(25)00064-X","DOIUrl":"10.1016/S0002-8703(25)00064-X","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"283 ","pages":"Page iii"},"PeriodicalIF":3.7,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency department visits and hospitalizations after a diagnosis of angina with no obstructive coronary artery disease (ANOCA)","authors":"Shubh Patel ,&nbsp;Marinda Fung BLT ,&nbsp;Shuvam Prasai BHSc ,&nbsp;Sonia Butalia MD, FRCPC, MSc ,&nbsp;Todd J. Anderson MD","doi":"10.1016/j.ahj.2025.02.021","DOIUrl":"10.1016/j.ahj.2025.02.021","url":null,"abstract":"<div><h3>Background</h3><div>Angina with no obstructive coronary artery disease (ANOCA) presents diagnostic and treatment challenges, significantly burdening healthcare resources. This study assessed emergency department (ED) visits and hospitalizations and factors associated with these outcomes following ANOCA and stable angina (SA) with obstructive coronary artery disease (CAD) diagnoses.</div></div><div><h3>Methods</h3><div>A retrospective cohort of individuals who had their first invasive cardiac catheterization for chest pain in Alberta from 2002 to 2017 was extracted retrospectively from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) database. Incidence rates (IRs) were calculated for ED visits and hospitalizations, while factors associated with these outcomes were analyzed using Cox models.</div></div><div><h3>Results</h3><div>Our analysis included 28,881 individuals (ANOCA, 36%). Two-year postcatheterization IRs of ED visits were 100.3-119.3 per 1,000 person-years for ANOCA and increased over time (unstandardized beta coefficient [b] = 2.19 per biennium [95% CI 0.83-3.55]; <em>P</em> = .008); for SA with obstructive CAD the IRs were 209.3-240.2 per 1,000 person-years and remained stable (b = −1.83 per biennium [95% CI −5.73 to 1.70]; <em>P</em> = .25). IRs of hospitalizations were 12.4-25.8 per 1,000 person-years and stable for ANOCA (b = −0.93 per biennium [95% CI −2.49 to 0.64]; <em>P</em> = .20); for SA with obstructive CAD, they were 106.4-171.4 per 1,000 person-years and decreased over time (b = −9.02 per biennium [95% CI −13.27 to −4.77; <em>P</em> = .002). A previous history of heart failure was most associated with ED visits (HR = 1.74 [95% CI 1.41-2.14]; <em>P</em> &lt; .001) and hospitalizations (HR = 2.40 [95% CI 1.82-3.18]; <em>P</em> &lt; .001) for ANOCA.</div></div><div><h3>Conclusions</h3><div>ED visits for ANOCA have risen over time while hospitalizations remain stable, indicating a growing burden despite generally lower rates than SA with obstructive CAD. These findings underscore the need for more effective management strategies to address the significant morbidity and resource utilization in ANOCA.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"285 ","pages":"Pages 82-92"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of direct oral anticoagulant versus warfarin after transcatheter aortic valve replacement: From the STS/ACC TVT registry","authors":"Tomo Ando MD ,&nbsp;Tamim Nazif MD ,&nbsp;Alexandros Briasoulis MD, PhD ,&nbsp;Luis Afonso MD ,&nbsp;Amanda Stebbins PhD ,&nbsp;Guillaume Marquis-Gravel MD ,&nbsp;Andrzei S. Kosinski PhD ,&nbsp;Martin Leon MD ,&nbsp;Sreekanth Vemulapalli MD","doi":"10.1016/j.ahj.2025.02.019","DOIUrl":"10.1016/j.ahj.2025.02.019","url":null,"abstract":"<div><h3>Background</h3><div>Transcatheter aortic valve replacement (TAVR) recipients frequently have an indication for long-term oral anticoagulation, including atrial fibrillation or systemic thromboembolic disease. It remains unclear if there are differences in safety and effectiveness between direct oral anticoagulants (DOAC) and warfarin in this patient population.</div></div><div><h3>Methods</h3><div>Clinical outcomes were compared between TAVR recipients receiving DOACs or warfarin using data from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (TVT) registry linked with Centers for Medicare &amp; Medicaid Services claims data. The analysis included patients from the TVT registry who underwent successful TAVR and were discharged on either a DOAC or warfarin between January 2013 and May 2018. The primary outcome was any bleeding requiring hospitalization from discharge to 1 year. Secondary outcomes included all-cause mortality and stroke from discharge to 1 year. Multivariable Cox proportional hazards regression models were used to compare these outcomes between the 2 groups.</div></div><div><h3>Results</h3><div>A total of 29,142 patients underwent TAVR and were discharged on oral anticoagulation, among whom 10,973 (37.7%) were discharged on a DOAC. The use of DOACs increased throughout the study period and exceed the use of warfarin by the final year (2018). The cumulative incidence of bleeding requiring hospitalization at 1 year (11.8% vs 15.2%, <em>P</em> &lt; <em>.</em>001) and all-cause mortality (15.5% vs 17.5%, <em>P</em> &lt; <em>.</em>001) was significantly lower in DOAC group while stroke (2.47% vs 2.39%, <em>P</em> = <em>.</em>64) was not statistically different between groups. In an adjusted model, the use of a DOAC as opposed to warfarin was associated with a significantly lower risk of bleeding requiring hospitalization (adjusted hazard ratio 0.49, 95% confidence interval 0.43-0.56), all-cause mortality (adjusted hazard ratio 0.61, 95% confidence interval 0.57-0.66), and stroke (adjusted hazard ratio 0.86, 95% confidence interval 0.81-0.92) (all <em>P</em> &lt; <em>.</em>001).</div></div><div><h3>Conclusions</h3><div>In this analysis of TAVR recipients discharged on oral anticoagulation in a large U.S. registry, the use of a DOAC rather than warfarin was associated with a lower risk of bleeding requiring hospitalization, all-cause mortality, and stroke from discharge to 1 year. Future randomized studies will be necessary to establish the optimal choice of anticoagulant in TAVR patients.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"285 ","pages":"Pages 66-73"},"PeriodicalIF":3.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-risk features and probability of ischemic and bleeding events after percutaneous coronary intervention.","authors":"Johann Auer, Gudrun Lamm","doi":"10.1016/j.ahj.2025.02.018","DOIUrl":"10.1016/j.ahj.2025.02.018","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genotype-guided de-escalation and abbreviation of dual antiplatelet therapy in patients with myocardial infarction and high bleeding risk: Design and rationale of the investigator-initiated, multicenter, randomized, controlled trial, DAN-DAPT","authors":"Mia Ravn Jacobsen MD ,&nbsp;Reza Jabbari MD, PhD ,&nbsp;Erik Lerkevang Grove MD, PhD ,&nbsp;Michael Mæng MD, PhD, DMSC ,&nbsp;Karsten Veien MD ,&nbsp;Mikkel Hougaard MD, PhD ,&nbsp;Philip Freeman MB, BS, PhD ,&nbsp;Henning Kelbæk MD, DMSC ,&nbsp;Mette Gitz Charlot MD, PhD ,&nbsp;Thomas Engstrøm MD, PhD, DMSC ,&nbsp;Rikke Sørensen MD, PhD","doi":"10.1016/j.ahj.2025.02.020","DOIUrl":"10.1016/j.ahj.2025.02.020","url":null,"abstract":"<div><h3>Rationale</h3><div>Approximately one-third of patients with myocardial infarction (MI) treated with percutaneous coronary intervention (PCI) are at high risk of bleeding side-effects when on dual antiplatelet therapy (DAPT). High bleeding risk is often accompanied by high ischemic risk, thus challenging the choice of P2Y₁₂ inhibitor and duration of DAPT. The optimal DAPT strategy for these patients remains debated, and it is unknown whether genotype-guided DAPT de-escalation to clopidogrel and aspirin, with or without abbreviation of DAPT to 3 months, is noninferior in terms of net adverse clinical events (NACE) and superior in reducing bleeding side-effects compared with standard DAPT for 6 months.</div></div><div><h3>Design</h3><div>The DAN-DAPT trial is an investigator-initiated, open-label, multicenter, multiarm, randomized controlled trial conducted at all Danish hospitals performing PCI. From 2022 to 2029, we planned to randomize 2,700 patients with MI and high bleeding risk in a 1:1:1 ratio to 1 of 3 groups: CYP2C19-genotyping and 6 months DAPT (experimental group 1), CYP2C19-genotyping and 3 months DAPT (experimental group 2), and 6 months DAPT with prasugrel (or ticagrelor) and aspirin (control group). The coprimary outcomes are NACE defined as the composite of all-cause mortality, recurrent MI, definite stent thrombosis, stroke, and BARC type 3-5 bleeding (Bleeding Academic Research Consortium), and major and minor bleedings defined as the composite of BARC type 2-5 bleedings at 1 year.</div></div><div><h3>Conclusion</h3><div>DAN-DAPT trial is an open-label, multicenter, randomized controlled trial comparing genotype-guided DAPT de-escalation to clopidogrel - with or without DAPT abbreviation to 3 months - and standard DAPT for 6 months after PCI in high bleeding risk patients with MI. As of March 2025, 36% of the planned 2,700 patients have been enrolled in the study.</div></div><div><h3>Trial Registration</h3><div><span><span>ClincialTrials.gov</span><svg><path></path></svg></span> (NCT05262803) and EU number (2022-500125-32-00).</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"285 ","pages":"Pages 74-81"},"PeriodicalIF":3.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rationale and design of the women's ischemia syndrome evaluation mechanisms of coronary microvascular dysfunction leading to preheart failure with preserved ejection fraction (WISE Pre-HFPEF)","authors":"Tatsunori Takahashi MD ,&nbsp;Janet Wei MD ,&nbsp;Ana C. Iribarren MD ,&nbsp;Martha Gulati MD MS ,&nbsp;Galen Cook-Wiens MS ,&nbsp;Michael D. Nelson PhD ,&nbsp;Behzad Sharif PhD ,&nbsp;Eileen M. Handberg PhD ,&nbsp;R. David Anderson MD ,&nbsp;John Petersen MD ,&nbsp;Daniel S. Berman MD ,&nbsp;Carl J. Pepine MD ,&nbsp;C. Noel Bairey Merz MD","doi":"10.1016/j.ahj.2025.02.017","DOIUrl":"10.1016/j.ahj.2025.02.017","url":null,"abstract":"<div><h3>Background</h3><div>There is increasing recognition that the pathophysiology of coronary microvascular dysfunction (CMD) plays a pivotal role in the development of heart failure with preserved ejection fraction (HFpEF). However, the mechanisms underlying this role are not known.</div></div><div><h3>Study design and methods</h3><div>The Women's Ischemia Syndrome Evaluation Mechanisms of Coronary Microvascular Dysfunction Leading to Pre-Heart Failure With Preserved Ejection Fraction (WISE Pre-HFpEF) is a prospective cohort study enrolling 180 women and men undergoing clinically indicated invasive coronary angiography for suspected ischemia with no obstructive coronary artery disease. The study aims to investigate (1) CMD-related ischemia contribution to myocellular damage and impaired left ventricular (LV) relaxation as determined invasively by ultra-high sensitivity cardiac troponin I (u-hs-cTnI) measurements in the coronary sinus/great cardiac vein and LV pressure-volume loops, respectively, during provocative stress testing with isometric handgrip, and (2) CMD-related ischemic myocellular damage contribution to LV diastolic dysfunction progression as assessed using cardiac magnetic resonance imaging obtained at enrollment and 1-2 years later, along with prospectively repeated ambulatory u-hs-cTnI measurements.</div></div><div><h3>Conclusions</h3><div>The WISE pre-HFpEF study is designed to investigate whether ischemic myocardial damage secondary to CMD contributes to the progression of LV diastolic dysfunction. The findings from this study will provide new understanding of the role of CMD in HFpEF development as well as the potential benefits of CMD-directed therapies for the prevention and treatment of HFpEF.</div></div><div><h3>Trial registration</h3><div><span><span>ClilicalTrial.gov</span><svg><path></path></svg></span>, NCT03876223</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"284 ","pages":"Pages 47-56"},"PeriodicalIF":3.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}