Canadian Journal of Cardiology最新文献

{"title":"The RV Puzzle: How Electromechanical Dyssynchrony Shapes Outcomes in Patients With Tetralogy of Fallot.","authors":"Paul Khairy, Jan Janoušek","doi":"10.1016/j.cjca.2025.02.008","DOIUrl":"10.1016/j.cjca.2025.02.008","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413194","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":"Mitral Valve Surgery After Failed Transcatheter Edge-to-Edge Repair: A Meta-Analysis.","authors":"Francesco Cabrucci, Massimo Baudo, Dimitrios E Magouliotis, Yoshiyuki Yamashita, Stephanie Kjelstrom, Beatrice Bacchi, Massimo Bonacchi, Aleksander Dokollari, Serge Sicouri, Basel Ramlawi","doi":"10.1016/j.cjca.2025.02.010","DOIUrl":"10.1016/j.cjca.2025.02.010","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter edge-to-edge repair (TEER) is increasingly used for mitral regurgitation (MR), particularly in high-risk patients. However, when TEER fails, patients often require mitral valve surgery, which remains challenging because of patients' compromised condition. This study aims to evaluate short- and long-term surgical outcomes following failed TEER.</p><p><strong>Methods: </strong>This meta-analysis included observational studies with reported outcomes of mitral valve surgery after failed TEER published until September 2024. Multivariable meta-regressions were performed to predict short- and long-term mortality. Kaplan-Meier function was reconstructed from individual studies.</p><p><strong>Results: </strong>Sixteen studies were included with a total sample of 892 patients. The mean age was 74.8 years (55% males), with most patients (87.8%) in New York Heart Association class III or IV before surgery. Pooled mean Society of Thoracic Surgeons (STS) predicted risk of mortality score before index TEER was 6.3%. Surgical indications were recurrent MR ≥3+ (93%), mitral stenosis (17%), and endocarditis (2.7%). The average time between TEER and surgery was 6.4 months. Mitral valve replacement was performed in 83.8% of cases. Thirty-day all-cause mortality was 12.2% but significantly lower for elective cases (2.5%). At a mean follow-up of 14.7 months, mortality was 28.3%. Preoperative incidence of coronary artery disease, lower left ventricle ejection fraction (LVEF), rate of concomitant procedures, and functional mitral regurgitation were predictors of short- and long-term outcomes.</p><p><strong>Conclusion: </strong>Mitral valve surgery after failed TEER presents significant challenges, yet acceptable outcomes are achievable, particularly in elective cases. Complete treatment of concomitant lesions may improve outcomes in patients with preserved LVEF. Future research should stratify outcomes based on emergent vs elective surgery and MR etiology to guide tailored surgical strategies.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412957","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":"Transcatheter Edge-to-Edge Repair in Intermediate Risk Patients With Degenerative Mitral Regurgitation: A Word of Caution.","authors":"Harold L Lazar","doi":"10.1016/j.cjca.2025.01.020","DOIUrl":"10.1016/j.cjca.2025.01.020","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482348","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":"Giant Coronary Artery Aneurysm Originated From the Vieussens Arterial Ring Associated With Coronary-Pulmonary Artery Fistula.","authors":"Hao Niu, Xiangfeng Gong, Yingqiang Guo, Zhenghua Xiao","doi":"10.1016/j.cjca.2025.02.013","DOIUrl":"10.1016/j.cjca.2025.02.013","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412947","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":"Recanalisation of a Chronic Total Occlusion in a Coronary Artery With Previous Coil Embolisation.","authors":"Primero Ng, William L Lombardi, Lorenzo Azzalini","doi":"10.1016/j.cjca.2025.02.014","DOIUrl":"10.1016/j.cjca.2025.02.014","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413005","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":"Clinical Prediction Score for Successful Liberation from Temporary Mechanical Circulatory Support in Cardiogenic Shock Patients.","authors":"Stefania Sacchi, Angela Venuti, Francesca Maria Gobbi, Alessia Gambaro, Luca Baldetti, Francesco Calvo, Mario Gramegna, Vittorio Pazzanese, Beatrice Peveri, Lorenzo Cianfanelli, Giovanni Lino Cardillo, Flavio Luciano Ribichini, Silvia Ajello, Anna Mara Scandroglio","doi":"10.1016/j.cjca.2025.02.009","DOIUrl":"10.1016/j.cjca.2025.02.009","url":null,"abstract":"<p><strong>Background: </strong>In cardiogenic shock (CS) patients requiring temporary mechanical circulatory support (tMCS), assessing cardiac recovery vs the need for heart replacement therapy is critical. We developed and validated a new clinical score aimed at predicting successful tMCS liberation.</p><p><strong>Methods: </strong>A cohort of 80 CS patients treated with Impella support between January 2018 and December 2020 was analyzed. Hemodynamic, echocardiographic, and laboratory data were collected at baseline, 24 hours, 48 hours, and 96 hours after device insertion. Patients were classified as successfully or unsuccessfully liberated from tMCS, based on recovery vs progression to death, left ventricular assist device implantation, or heart transplant. The W score, derived using independent predictors of successful liberation, was validated in 2 cohorts: 86 CS patients at our center and 23 patients from an external center.</p><p><strong>Results: </strong>Among the 80 patients (mean age 62.5 ± 11.8 years, 63.7% acute myocardial infarction CS), 47.5% achieved successful tMCS liberation. Independent predictors included left ventricular ejection fraction, N-terminal pro-brain natriuretic peptide, and inotropic score at 24 hours, along with creatinine and lactate at 96 hours (area under the curve [AUC] ≥ 0.7, P < 0.05). The W score, using a cutoff of ≥7, demonstrated good diagnostic accuracy (AUC 0.92, sensitivity 80%, specificity 85%, P < 0.001). In validation cohorts, a score ≥7 predicted successful liberation with AUCs of 0.80 (P < 0.001) and 0.72 (P < 0.015) at the internal and external centers, respectively.</p><p><strong>Conclusions: </strong>The W score, based on key parameters at 24 and 96 hours post-tMCS, effectively supports clinicians in identifying CS patients likely to achieve successful tMCS liberation.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412842","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":"Recurrent Atrioventricular Block and Pacemaker Implant in a Properly Treated Lyme Carditis Patient.","authors":"Agustina Vasvari, Laura V López-Gutiérrez, Alejandro Narváez-Orozco, Daniela Hincapie, Adrian Baranchuk, Andres F Miranda-Arboleda","doi":"10.1016/j.cjca.2025.02.011","DOIUrl":"10.1016/j.cjca.2025.02.011","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413011","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":"Sex Differences of Pulmonary Arterial Hypertension Patients With and Without Cardiopulmonary Comorbidities.","authors":"Shyla Gupta, Jiaming Calvin Liang, Christina J Qian, Jason Zelt, George Chandy, Vladamir Contreras-Dominguez, Duncan J Stewart, Julia Foxall, Rosemary Dunne, Lisa Mielniczuk","doi":"10.1016/j.cjca.2025.02.007","DOIUrl":"10.1016/j.cjca.2025.02.007","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405767","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":"The Etiology and Management of Critical Acute Right Heart Failure.","authors":"Adriana Luk, Ricardo Teijeiro-Paradis, Andrew Kochan, Filio Billia, Ghislaine Douflé, Sheldon Magder, Asher A Mendelson, Caroline McGuinty, John Granton","doi":"10.1016/j.cjca.2025.02.006","DOIUrl":"10.1016/j.cjca.2025.02.006","url":null,"abstract":"<p><p>Right ventricular failure contributes to the morbidity and mortality of acute myocardial function, massive pulmonary embolism, and chronic pulmonary hypertension. Understanding how the normal physiology of the right ventricle (RV) is disrupted is integral to managing patients who present with RV decompensation. Therapeutic advances in mechanical circulatory support, pharmacotherapies to reduce afterload, mechanical and chemical lytic therapies for acute pulmonary embolism have improved outcomes of patients by offloading the RV. In this report we provide an overview of the physiology of the RV, medical management (volume optimization, hemodynamic targets, rhythm management), along with critical care-specific topics (induction with mechanical ventilation, sedation strategies, and mechanical circulatory support) and provide a framework for managing patients who present with leveraging principles of preload, contractility, and afterload. Last, because of the complexity of right ventricular failure management, and the complexity of presentation, we also discuss the role of team-based approach (cardiogenic shock and pulmonary embolism response teams), and highlight its benefits at improving outcomes.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405768","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":"On the Consistency Assumption for Causal Inference in Cardiovascular Epidemiology: Reply.","authors":"Nicholas Grubic, Cristian Carmeli, Brice Batomen","doi":"10.1016/j.cjca.2025.02.012","DOIUrl":"10.1016/j.cjca.2025.02.012","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398219","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}