Canadian Journal of Cardiology最新文献

{"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":"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":"10.1016/j.cjca.2025.04.026","url":null,"abstract":"<p><strong>Background: </strong>Pre-existing mitral prosthesis raises technical challenges for transcatheter aortic valve replacement (TAVR) but has been scarcely studied. In this work we sought to compare outcomes of patients with previous surgical mitral valve prostheses undergoing TAVR with balloon-expandable valve (BEV) or self-expanding valve (SEV) systems.</p><p><strong>Methods: </strong>Patients from the Spanish TAVR registry with pre-existing surgical mitral prostheses were included this investigation. The primary endpoints were Valve Academic Research Consortium-3 technical and device success, with analysis according to valve type. Transcatheter heart valve (THV) embolization, mitral valve impingement, THV performance, and pacemaker findings were also assessed.</p><p><strong>Results: </strong>A total of 243 patients were included (37% BEVs, 63% SEVs). Overall technical success was 95.9%. Thirty-day device success was higher in BEV patients (94.4% vs 85.0%, P = 0.036), mainly driven by fewer 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 mm Hg, 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 the multivariate analysis, a mitroaortic distance of ≤ 7 mm and lack of transesophageal echocardiography guidance were associated with increased device failure.</p><p><strong>Conclusions: </strong>In patients with pre-existing MV prostheses, TAVR was safe and effective regardless of the THV type. Nevertheless, the use of BEVs resulted in an increased 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":"10.1016/j.cjca.2025.04.025","url":null,"abstract":"","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}

{"title":"Assessing Coronary Microvascular Dysfunction Using Angiographic Frame Count in Patients With Angina and Nonobstructive Coronary Arteries.","authors":"Zhaoxue Sheng, Wuqiang Che, Shuoyan An, Zhen Zhang, Xuecheng Zhao, Qiang Chen, Yakun Mu, Xuexi Li, Hu Zhang, Xiaofei Liu, Dongliang Fu, Yanxiang Gao, Zhu Xiao, Jingang Zheng","doi":"10.1016/j.cjca.2025.04.024","DOIUrl":"10.1016/j.cjca.2025.04.024","url":null,"abstract":"<p><strong>Background: </strong>Coronary microvascular dysfunction (CMD) is underdiagnosed, mainly because of the low clinical adoption of wire-based invasive coronary function testing. Angiography-based, wireless methods might facilitate widespread assessment of CMD. To our knowledge, the diagnostic utility of angiographic Thrombolysis In Myocardial Infarction (TIMI) frame count and frame count reserve (FCR) in identifying CMD in patients with angina and nonobstructive coronary arteries (ANOCA) has never been explored.</p><p><strong>Methods: </strong>A total of 140 ANOCA patients underwent coronary angiography and invasive coronary function testing with thermodilution-derived index of microcirculatory resistance (IMR) and coronary flow reserve (CFR). CMD was defined as CFR < 2.5 or IMR ≥ 25. TIMI frame count was measured from resting (TFC_rest) and hyperemic (TFC_hyp) angiography, with FCR calculated as TFC_rest/TFC_hyp.</p><p><strong>Results: </strong>Among the 140 patients enrolled, the mean age was 63.3 years and 50.7% were women. TFC_hyp correlated more strongly with IMR than TFC_rest (r = 0.557 [P < 0.001] and r = 0.394 [P < 0.001], respectively) and had superior diagnostic performance for CMD with abnormal IMR (area under the curve, 0.810 vs 0.711; P = 0.015). FCR showed a good correlation with CFR (r = 0.686; P < 0.001) and high diagnostic accuracy (area under the curve, 0.871; P < 0.001) for CMD with abnormal CFR. TFC_hyp ≥ 19 independently predicted CMD with abnormal IMR (odds ratio, 13.11; 95% confidence interval, 5.39-35.59), whereas FCR < 2 independently predicted CMD with abnormal CFR (odds ratio, 24.21; 95% confidence interval, 9.93-65.97).</p><p><strong>Conclusions: </strong>TFC_hyp combined with FCR offers a comprehensive, accurate, wireless alternative for CMD diagnosis, facilitating a broader assessment of CMD in ANOCA patients.</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":"143960239","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":"Pump, Valves, Wiring, and \"Code\": Integrating the Multiple Components of the Right Heart.","authors":"Lawrence G Rudski, Christine D'Arsigny, Susanna Mak, Luc Mertens, Lisa Mielniczuk, Duncan Stewart","doi":"10.1016/j.cjca.2025.04.023","DOIUrl":"10.1016/j.cjca.2025.04.023","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977409","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":"Editorial Commentary to Apelin Analog Reduces the Burden of Post–Myocardial Infarction Adverse Remodelling: A New Therapeutic Approach for Ischemic Heart Disease","authors":"Huachen Chen PhD ,&nbsp;Amanda Adam BSc ,&nbsp;Gavin Y. Oudit MD, PhD, FRCPC","doi":"10.1016/j.cjca.2025.01.001","DOIUrl":"10.1016/j.cjca.2025.01.001","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 5","pages":"Pages 925-927"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945150","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}