Canadian Journal of Cardiology最新文献

{"title":"Comparison of Percutaneous Endocardial Septal Radiofrequency Ablation with Alcohol Septal Ablation in Treating Hypertrophic Obstructive Cardiomyopathy.","authors":"Aiju Tian, Shubin Qiao, Jiansong Yuan, Weixian Yang, Yan Yao, Yuhe Jia, Chengzhi Yang","doi":"10.1016/j.cjca.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.05.005","url":null,"abstract":"<p><strong>Background: </strong>Alcohol septal ablation (ASA) and percutaneous endocardial septal radiofrequency ablation (PESA) are two mini-invasive interventions for treatment of hypertrophic obstructive cardiomyopathy (HOCM). Studies comparing the PESA and ASA remain scant.</p><p><strong>Methods: </strong>We analyzed patients with HOCM who underwent PESA or ASA at our hospital between January 2008 and December 2023. A total of 145 patients were enrolled, with 37 receiving PESA and 108 receiving ASA.</p><p><strong>Results: </strong>Compared to the ASA group, patients in the PESA group were older (p = 0.001), but suffered from less severer heart failure (p < 0.001). Patients in the ASA group were more likely to develop new bundle branch block (BBB), and stayed much longer at intensive care unit, but took less medical care cost. During the follow-up, there were no significant differences in rates of repeat septal reduction therapy (SRT) and the composite endpoint of repeat SRT and re-hospitalization between the two groups. Both PESA and ASA significantly alleviated heart failure, septal hypertrophy, and left ventricular outflow tract (LVOT) obstruction. However, ASA led to greater reduction in NYHA functional class (-1.4 ± 0.9 vs -0.7 ± 0.8, p < 0.001) , septal thickness (-4.5 ± 4.1mm vs -2.1 ± 4.1mm, p = 0.012), and the LVOTG (-51.1 ± 43.7 vs -23.0 ± 35.1 mmHg, p = 0.004) compare to PESA.</p><p><strong>Conclusions: </strong>Both ASA and PESA are viable strategies for septal reduction in HOCM. ASA seems to be more effective in achieving significant anatomical and functional improvements, while PESA is excellent in avoiding BBB.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086117","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":"Advancing Risk Prediction in Takayasu Arteritis - A Step Toward Precision Medicine and Improved Outcomes?","authors":"Gitanjali Mansukhani, Marisha McClean","doi":"10.1016/j.cjca.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.05.006","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076144","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":"Systems-Level Insights to Improve Prenatal Detection of Congenital Heart Disease: Emotional Intelligence Today, Artificial Intelligence Tomorrow.","authors":"Koyelle Papneja, Lindsay R Freud","doi":"10.1016/j.cjca.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.05.004","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076150","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":"Reassessing Cardiovascular Risk in Patients with Peripheral Artery Disease undergoing Myocardial Perfusion Imaging.","authors":"Kaiming Wang, Tali Sharir, M Timothy Hauser, Sharmila Dorbala, Marcelo Di Carli, Mathews B Fish, Terrence D Ruddy, Timothy Bateman, Andrew J Einstein, Philipp A Kaufmann, Edward J Miller, Albert J Sinusas, Wanda Acampa, Julian Halcox, Monica Martins, Joanna X Liang, Valerie Builoff, Damini Dey, Daniel S Berman, Robert J H Miller, Piotr J Slomka","doi":"10.1016/j.cjca.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.05.002","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease(CAD) and peripheral artery disease(PAD) are often regarded as analogous risk factors for major adverse cardiovascular events(MACE) given their shared pathophysiology. We aimed to investigate whether the elevated MACE risk in PAD is driven by myocardial perfusion abnormalities or through other PAD-specific mediators.</p><p><strong>Methods: </strong>We analyzed 45252 patients from an international, multicenter registry who underwent SPECT myocardial perfusion imaging, excluding those with early coronary revascularization (<90 days). Myocardial perfusion abnormalities were quantified using total perfusion deficit (TPD). MACE was defined as all-cause mortality, unstable angina admission, myocardial infarction or late coronary revascularization. PAD was defined using questionnaires or review of electronic medical records. Propensity score matching was used to select balanced groups of patients with and without PAD.</p><p><strong>Results: </strong>During a median follow-up of 3.6 years (IQR: 2.6 - 4.8 years), 5932 patients (13.7%) experienced at least one MACE. Compared to patients with neither disease, isolated history of CAD (aHR: 1.92, 95% CI: 1.80-2.05) conferred a similar MACE risk as concomitant history of CAD and PAD (aHR: 1.57, 95%CI: 1.44-1.71) and greater risk than isolated history of PAD (aHR: 1.20, 95%CI: 1.09-1.32, p<0.001). After propensity-score matching, history of PAD alone was not independently associated with increased MACE risk (p=0.064).</p><p><strong>Conclusions: </strong>Although patients with PAD often have concomitant CAD and greater myocardial perfusion abnormalities, PAD itself was not linked to higher MACE risk after adjusting for these factors. These findings highlight the importance of assessing myocardial ischemic burden in PAD for risk-stratification and prompt initiation of disease-modifying therapies.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076148","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":"Changes in Left Ventricular Hemodynamic Forces in Breast Cancer Patients Under Anthracycline Therapy: The CMR Study.","authors":"Tomas Lapinskas, Skaiste Astasauskaite, Lina Padervinskiene, Paulius Bucius, Laura Velickiene, Lina Gatelyte, Gianni Pedrizzetti, Remigijus Zaliunas","doi":"10.1016/j.cjca.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.05.003","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954905","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":"Prognostic Value of Angiography-derived Index of Microcirculatory Resistance in Patients with diabetes and ST-Segment Elevation Myocardial Infarction.","authors":"Yixuan Wu, Jiahua Liu, Xinjia Du, Maochen Li, Yanfei Ren, Lei Chen, Yuan Lu","doi":"10.1016/j.cjca.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.05.001","url":null,"abstract":"<p><strong>Background: </strong>The occurrence of coronary microvascular dysfunction (CMD) after primary PCI in DM patients with STEMI and its impact on prognosis remains elusive.</p><p><strong>Methods: </strong>This single-center retrospective observational study included 293 patients diagnosed with DM and STEMI. The caIMR was calculated using the measurement software FlashAngio, while cardiac magnetic resonance parameters were quantified using the post-processing software Cvi42. CMD was defined as caIMR ≥ 25 U. The primary endpoint was MACE, defined as all-cause mortality, non-fatal myocardial infarction, ischemia-driven revascularization, and heart failure.</p><p><strong>Results: </strong>MACE occurred in 86 patients (29.4%) during a median follow-up of 31 months. A significant correlation was identified between caIMR and both microvascular obstruction (MVO) (R = 0.61, P < 0.001) and infarct size (IS) (R = 0.39, P < 0.001). Furthermore, caIMR ≥ 25 was identified as an independent risk factor for MACE (HR, 2.99; 95% CI, 1.78-5.03; P < 0.001). Additionally, the integration of caIMR into risk modeling significantly improved MACE prediction (Net reclassification improvement 0.264, P<0.001; Integrated discrimination improvement 0.060, P<0.001). Lastly, the Kaplan-Meier survival curves displayed that patients with caIMR ≥ 25 were at a higher risk of MACE (log-rank P < 0.001).</p><p><strong>Conclusion: </strong>The caIMR demonstrated a satisfactory correlation with CMR-determined MVO and IS in DM patients with STEMI. Elevated caIMR was independently linked to a higher risk of MACE in diabetic STEMI patients post-PCI, serving as an effective predictor for MACE.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985673","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":"Reply: Dual antiplatelet therapy in cancer patients undergoing revascularization - which second agent to use?","authors":"Roxana Mehran, Mauro Gitto","doi":"10.1016/j.cjca.2025.04.028","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.04.028","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983450","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":"Supra-annular prosthesis anchoring in bicuspid aortic valve: evidence in large annuli exceeding the device sizing chart range.","authors":"Barbara Bellini, Vittorio Romano, Gianmarco Iannopollo, Greca Zanda, Ciro Vella, Luca Angelo Ferri, Filippo Russo, Marco Bruno Ancona, Antonio Esposito, Matteo Montorfano","doi":"10.1016/j.cjca.2025.04.027","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.04.027","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976659","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":"Balloon-Expandable versus Self-Expanding Valves in Patients With Prior Surgical Mitral Valve Replacement Undergoing Transcatheter Aortic Valve Replacement.","authors":"Lluis Asmarats, Pilar Jiménez-Quevedo, Ignacio J Amat-Santos, María-Cruz Ferrer-Gracia, Fernando Sarnago, Juan H Alonso-Briales, Juan Francisco Oteo, Vicenç Serra, Guillem Muntané-Carol, Victoria Vilalta, David Del Val, Manuel Pan, José M De la Torre Hernández, Sergio García-Blas, José Luis Díez, Alberto Berenguer, Raquel Del Valle, Felipe Navarro Del Amo, Miguel Artaiz, Ander Regueiro, Manuel López-Pérez, Albert Massó van-Roessel, José G Paredes-Vázquez, Clara Fernández-Cordón, José Antonio Diarte de Miguel, Nicolás Maneiro, Alberto Piserra-López, Jorge de la Fuente, Juan Muñoz, Rafael Romaguera, Xavier Carrillo, Fernando Alfonso, Marco Alvarado, Gabriela Veiga, Xavier Millán, Luis Nombela-Franco, Dabit Arzamendi","doi":"10.1016/j.cjca.2025.04.026","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.04.026","url":null,"abstract":"<p><strong>Background: </strong>Preexisting mitral prosthesis raises technical challenges for transcatheter aortic valve replacement (TAVR) but has been scarcely studied. This study sought to compare outcomes of patients with previous surgical mitral valve prostheses undergoing TAVR with balloon-expandable (BEV) or self-expanding valve (SEV) systems.</p><p><strong>Methods: </strong>Patients from the Spanish TAVR registry with preexisting surgical mitral prostheses were included. The primary endpoints were Valve Academic Research Consortium-3 technical and device success and were analyzed according to valve type. The rates of transcatheter heart valve (THV) embolization, mitral valve impingement, THV performance and pacemaker were also assessed.</p><p><strong>Results: </strong>A total of 243 patients were included (BEV: 37%; SEV: 63%). Overall technical success was 95.9%. 30-day device success was higher in BEV patients (94.4% vs 85.0%, p=0.036), mainly driven by lower incidences of moderate residual aortic regurgitation (0% vs 5.9%, p=0.028) and THV embolization (0% vs 3.9%, p=0.087). BEV recipients exhibited higher mean transvalvular gradients (10.5 vs 8.1 mmHg, p=0.002) and lower rates of permanent pacemaker implantation (5.6% vs 15.7%, p=0.023). There were no differences in mortality, bleeding or readmission at 30 days. In multivariate analysis, a mitroaortic distance ≤7 mm and lack of transesophageal echocardiography guidance were associated with increased device failure.</p><p><strong>Conclusions: </strong>In patients with preexisting MV prostheses, TAVR was safe and effective regardless of the THV type. Nevertheless, the use of BEVs resulted in a greater rate of device success driven by lesser THV embolization and residual aortic regurgitation.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981229","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":"Strategies to identify echocardiogram complexity to support learning echocardiogram interpretation.","authors":"Thomas C Raissi, Thivya Sivarajan, Aws Almufleh, Annabel Chen-Tournoux, Robin Ducas, Parvathy Nair, Matthew Sibbald, Graham C Wong, Samuel C B Siu, Sarah Blissett","doi":"10.1016/j.cjca.2025.04.025","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.04.025","url":null,"abstract":"<p><p>Cardiology residents need to identify appropriately complex transthoracic echocardiograms (TTE) to maximize learning and to meet current training standards. Residents currently use TTE indication to identify complexity, however this is time consuming and may not accurately identify TTE complexity. Alternative strategies, such as sonographer ratings of complexity or using TTE characteristics could aid trainees in identifying the complexity. In this multicentre study, we found resident and sonographer ratings had fair agreement with experts. Sonographers with teaching experience had greater agreement with experts than junior residents. The number of images correlated with expert ratings of complexity.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970714","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}