Catheterization and Cardiovascular Interventions最新文献

{"title":"Exercise Mildly Increases Transaortic Gradients in Aortic Stenosis With Preserved Ejection Fraction: An Invasive Hemodynamic Study.","authors":"Abdullah Al-Abcha, C Charles Jain, Rick A Nishimura, Trevor J Simard, Mackram F Eleid, Benjamin Hibbert, Jae K Oh, Blase A Carabello, William R Miranda","doi":"10.1002/ccd.31511","DOIUrl":"https://doi.org/10.1002/ccd.31511","url":null,"abstract":"<p><strong>Background: </strong>The assessment of aortic stenosis (AS) severity remains a challenge in some patients, and hemodynamic exercise testing has been proposed as a diagnostic tool in this population. However, the current understanding of exercise hemodynamics in AS is limited.</p><p><strong>Methods: </strong>Retrospective review of 34 adults (aged ≥ 18 years) with ≥ moderate AS and preserved left ventricular ejection fraction (LVEF) undergoing exercise invasive hemodynamics (supine cycle protocol) with simultaneous measurement of aortic and left ventricular pressures.</p><p><strong>Results: </strong>Age was 77.1 (IQR 68.6; 84.1) years, and 50% were female. LVEF was 62.1 ± 6.6%. All patients were symptomatic. Resting aortic valve area (AVA) was 1.0 ± 0.2 cm² and aortic valve (AV) systolic mean gradient 22.0 ± 7.3 mmHg. At peak exercise (40 [IQR 30; 60] W), AV systolic mean gradient (Δ3 [0.6; 7] mmHg, p < 0.001) and AVA (Δ0.2 [0; 0.6] cm², p = 0.002) significantly increased, while stroke volume (SV) did not (Δ6.8 ± 19.4 ml; p = 0.07). Exercise-induced changes in AV systolic mean gradient were directly related to changes in cardiac output (r = 0.53, p = 0.003), being inversely related to exercise systemic vascular resistance (r = -0.60, p = 0.002). Elevated pulmonary artery wedge pressure was present in 41.2% at rest (≥ 15 mmHg) and 69.7% during exercise (≥ 25 mmHg).</p><p><strong>Conclusions: </strong>Symptomatic patients with ≥ moderate AS and preserved LVEF experience small increases in AV mean gradient with exercise, and unlike the normal physiological response to exercise, there was no significant increase in SV. In most patients, AVA rose during exercise. Exercise-induced elevation in filling pressures was highly prevalent.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810061","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":"Dual Antiplatelet Therapy Prior to Percutaneous Coronary Intervention for Acute Coronary Syndrome: Prevalence and Outcomes in Contemporary Practice.","authors":"Shi Hui Goh, Riley Batchelor, Diem Dinh, Angela Brennan, Stacey Peters, Dion Stub, Christopher Reid, William Chan, Danny Liew, William Wilson, Jeffrey Lefkovits","doi":"10.1002/ccd.31520","DOIUrl":"https://doi.org/10.1002/ccd.31520","url":null,"abstract":"<p><strong>Background: </strong>Dual antiplatelet therapy (DAPT) is standard following percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Preloading is the practice of administering both aspirin and a P2Y₁₂ inhibitor before PCI. DAPT preloading is common practice, however clinical trial evidence demonstrating benefit is lacking.</p><p><strong>Aims: </strong>This study aimed to examine the prevalence and associated clinical outcomes of DAPT before PCI for ACS in a contemporary population of Australian patients.</p><p><strong>Methods: </strong>Data on consecutive PCI procedures from patients included in the Victorian Cardiac Outcomes Registry (VCOR) from 2014 to 2021 was collected and stratified by administration of DAPT before PCI versus single, or no, antiplatelet therapy.</p><p><strong>Results: </strong>In total, 42,453 consecutive PCI procedures for ACS were included. Of these, 33,520 (79%) patients were either preloaded or already on DAPT before PCI. Patients on DAPT were younger (63.9 vs. 65.1, p < 0.001) and generally had fewer comorbidities. Unadjusted outcomes were more favorable with pre-loading with lower in-hospital mortality with DAPT (2.6% vs. 5.6%, p < 0.001), and 30-day cardiovascular mortality (0.3% vs. 0.4%, p = 0.039). 30-day major adverse cardiovascular events (MACE) (5.5% vs. 8.8%, p < 0.001) was similarly lower in the preloaded group. Major bleeding in hospital was less common in patients on DAPT (1.0% vs. 1.7%, p < 0.001). However, following adjustment for covariates, there was no difference in in-hospital or 30-day all-cause mortality, MACE or stent thrombosis between groups.</p><p><strong>Conclusions: </strong>DAPT before PCI is common in ACS but not independently associated with improvements in in-hospital mortality, MACE, or stent thrombosis.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802548","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":"Assessing Serum Apolipoproteins A-I and b100 and the Apo A-I/Apo b100 Ratio in Relation to Premature Coronary Artery Disease and Its Severity.","authors":"Zahra Zarepour, Mohammad Parsa Mahjoob, Niloufar Taherpour, Mohammad Haji Aghajani","doi":"10.1002/ccd.31497","DOIUrl":"https://doi.org/10.1002/ccd.31497","url":null,"abstract":"<p><strong>Background: </strong>Apolipoproteins are proposed to predict the status of CAD and its occurrence. The aim of this study was to assess the association between serum levels of apolipoproteins A-I, b100 and the ratio of Apo A-I/Apo b100 with the development and severity of premature coronary artery disease (PCAD).</p><p><strong>Methods: </strong>In this registry-based case-control study, patients under the age of 50 years with at least one coronary artery disease with stenosis ≥ 50% (PCAD group) were assessed and compared with patients without coronary artery involvement (normal group). The Gensini score considered to assess the CAD severity.</p><p><strong>Results: </strong>The mean Apo A-I and Apo A-I/Apo b100 levels were higher in the control group, but Apo b100 was higher in the patient group (p < 0.05). Apo A-I and Apo A-I/Apo b100 ratio had a negative correlations (rho = -0.57, rho = -0.71, respectively) with the severity of PCAD based on the Gensini score. Apo b100 also had a positive correlation (rho = 0.67) with the severity of PCAD (p < 0.05). Apo A-I and Apo b100 were significantly associated with the occurrence of PCAD. Based on the results of multivariable analysis, with a 1 mg/dL increase in Apo A-I levels and Apo b100, the odds of PCAD decreased by 13% and increased by 31%, respectively. With a 1 mg/dL increase in apolipoprotein A-I and apolipoprotein b100 levels, the odds of high Gensini score decreased by 7% and increased by 8%, respectively (p = 0.001).</p><p><strong>Conclusion: </strong>The use of serum apolipoproteins in patients with suspected PCAD can predict the occurrence of CAD and its severity.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810601","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":"Concerns Regarding \"Mechanical Circulatory Support With Impella in High-Risk Patients With Chronic Total Occlusion and Complex Multivessel Disease\".","authors":"Muhammad Nouman Javed, Umna Ahmed, Noor Ul Eman","doi":"10.1002/ccd.31536","DOIUrl":"https://doi.org/10.1002/ccd.31536","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810604","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":"Minimal Microvascular Resistance: Agreement Between Continuous and Bolus Thermodilution.","authors":"Thabo Mahendiran, Daniëlle Keulards, Nico H J Pijls, Michele Viscusi, Emanuele Gallinoro, Dario Bertolone, Peter Damman, Niels van Royen, Jeroen Sonck, Carlos Collet, Adriaan Wilgenhof, Paul Knaapen, Bernard De Bruyne","doi":"10.1002/ccd.31515","DOIUrl":"https://doi.org/10.1002/ccd.31515","url":null,"abstract":"<p><strong>Background: </strong>Continuous thermodilution quantifies absolute microvascular resistance (R_μ, Wood units), a key metric of microvascular function. R_μ is minimal during hyperemia (R_μ,hyper) with increased R_μ,hyper suggestive of microvascular dysfunction. Bolus thermodilution measures the index of microcirculatory resistance (IMR), a dimensionless surrogate of R_μ,hyper.</p><p><strong>Aims: </strong>We compared R_μ,hyper measured by continuous thermodilution (invasive R_μ,hyper) with the gold standard [¹⁵O]H₂O positron emission tomography (PET R_μ,hyper), and assessed the correlation between invasive R_μ,hyper and IMR.</p><p><strong>Methods: </strong>First, the accuracy of invasive R_μ,hyper was assessed in a cohort of 24 patients in which both invasive R_μ,hyper and PET R_μ,hyper were measured in the left anterior descending (LAD) and circumflex (LCX) arteries, corresponding to 46 measurements of R_μ,hyper in total (LAD = 24, LCX = 22). Next, agreement between invasive R_μ,hyper and IMR was evaluated in the LAD in a cohort of 250 patients with angina and non-obstructive coronary arteries.</p><p><strong>Results: </strong>Invasive R_μ,hyper exhibited a strong correlation with PET R_μ,hyper (r = 0.86 [95% CI 0.76-0.92], p < 0.001), with good absolute agreement (ICC 0.82 [95% CI 0.70-0.90], p < 0.001). Passing-Bablok regression analysis found no significant systematic (intercept A: 54.53 [95% CI -18.95 to 120.96]) or proportional (slope B: 0.90 [95% CI 0.71-1.15]) bias between invasive R_μ,hyper and PET R_μ,hyper. However, invasive R_μ,hyper exhibited no significant correlation with IMR (r = 0.11 [95% CI -0.01 to 0.23], p = 0.08).</p><p><strong>Conclusion: </strong>Invasive R_μ,hyper derived from continuous thermodilution exhibited excellent agreement with noninvasive R_μ,hyper measured by [¹⁵O]H₂O PET, the current non-invasive standard of reference. In contrast, IMR exhibited no significant correlation with invasive R_μ,hyper in patients with angina and non-obstructive coronary arteries.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802554","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":"Emergent Cardiac Surgery After Transcatheter Structural Heart Procedures: Narrative Review.","authors":"Miriam Compagnone, Gianni Dall'Ara, Simone Grotti, Daniela Spartà, Giuseppe Guerrieri, Carmine Pizzi, Fabio Felice Tarantino, Marcello Galvani","doi":"10.1002/ccd.31519","DOIUrl":"https://doi.org/10.1002/ccd.31519","url":null,"abstract":"<p><p>Transcatheter structural heart procedures have become standard therapy for elderly patients with high surgical risk. Over time, these procedures have significantly increased worldwide, accompanied by a concomitant reduction of major complications, including those requiring emergent cardiac surgery (ECS). This marked decline in ECS is due to technological advancements, improved patient selection and procedural techniques, and increased institutional and operators expertize. Moreover, most major structural complications after transcatheter structural heart procedures are now managed percutaneously, with only a small proportion requiring ECS. It is important to note that outcomes for patients requiring ECS remain unfavorable, even in the optimal setting. Currently, ECS after percutaneous structural interventions is very rare, less than 0.5%, as reported in multicenter available studies. However, fragmented data exist in the literature on the need of ECS. Indeed, low incidence, different definitions, and lack of recent reports make it difficult to have a precise and up-to-date overview of bailout surgery for treatment of procedural complications. This is the first comprehensive analysis focusing on ECS following the major frequent percutaneous structural procedures, that is, transcatheter aortic valve replacement, mitral valve repair/replacement, and left atrial appendage occlusion. More in general, a collaborative approach among Heart Team members, along with thorough procedural planning guided by advanced imaging techniques, is essential for ensuring high-quality interventions thus minimizing the risk of adverse events.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802550","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":"Impact of D-Dimer on the Prognostic Value of PARIS Thrombosis Risk Score in Acute Coronary Syndrome Patients Undergoing PCI: From a Large Prospective Cohort Study.","authors":"Sida Jia, Deshan Yuan, Ying Song, Jingjing Xu, Peizhi Wang, Yan Chen, Ce Zhang, Runlin Gao, Xueyan Zhao, Jinqing Yuan","doi":"10.1002/ccd.31526","DOIUrl":"https://doi.org/10.1002/ccd.31526","url":null,"abstract":"<p><strong>Background: </strong>Guideline-recommended PARIS thrombotic risk score predicts coronary thrombosis events (CTE) in Acute Coronary Syndrome (ACS) patients undergoing Percutaneous Coronary Intervention. We aim to evaluate whether D-dimer, a thrombotic biomarker, can predict long-term adverse events and improve the prognostic value of PARIS score.</p><p><strong>Methods and results: </strong>This is a post-hoc analysis on a prospective cohort of 10,724 Chinese patients undergoing PCI. Patients who presented as ACS were included and stratified according to baseline D-dimer level (cutoff 0.28 µg/mL). The primary endpoint is all-cause death. Secondary endpoints are cardiac death and CTE. A total of 5139 ACS patients with PCI were analyzed, 2735 patients had D-dimer ≥ 0.28 µg/mL, while 2404 patients had D-dimer < 0.28 µg/mL. After adjusting for confounders, patients with higher D-dimer had significantly higher risk of 5-year all-cause death (HR = 1.951, 95% CI: 1.366-2.787) and cardiac death (HR = 2.513, 95% CI: 1.574-4.012), whilst a trend toward higher risk of 5-year CTE (HR = 1.285, 95% CI: 0.956-1.729) was observed. Compared with PARIS score alone, adding D-dimer to the model increased the area under the receiver operating characteristic curve on 5-year all-cause death (0.663-0.701, p = 0.006) and cardiac death (0.652-0.699, p = 0.015), both with significant net reclassification improvement (p < 0.001).</p><p><strong>Conclusion: </strong>In our cohort of ACS patients undergoing PCI, D-dimer independently predicts long-term all-cause death and cardiac death, and improves the predictive value of PARIS score over 5-year all-cause death and cardiac death.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802552","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":"A Unique Method for Successful Primary Percutaneous Coronary Intervention of an Anomalous Origin of the Culprit Coronary Artery.","authors":"Masataka Yoshinaga, Takashi Muramatsu, Hiroki Higami, Kenya Nasu","doi":"10.1002/ccd.31513","DOIUrl":"https://doi.org/10.1002/ccd.31513","url":null,"abstract":"<p><p>We present a novel, simple, and low-cost \"side-hole\" technique for a patient with ST-segment elevation myocardial infarction (STEMI) caused by an occlusion of an anomalous origin of the culprit coronary artery (AOCCA). In a case where standard guiding catheters failed to engage the anomalous left coronary artery (LCA), we created an approximately 3 mm side-hole near the tip of a 5 Fr diagnostic catheter and then introduced a guidewire and microcatheter directly into the anomalous left main trunk (LMT). Subsequently, we withdrew this diagnostic catheter and exchanged it for a guiding catheter over the guide wire, enabling rapid primary PCI. This approach facilitated rapid wire passage, minimized additional device use, and helped reduce overall reperfusion time. It may be especially useful in urgent STEMI cases where a suitable guiding catheter for AOCCA lesions cannot be readily identified.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763012","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":"Association Between Medial Calcification and Chronic Thrombus: An Optical Frequency Domain Imaging Study.","authors":"Hiroyuki Jinnouchi, Kenichi Sakakura, Masashi Hatori, Takunori Tsukui, Yusuke Watanabe, Masaru Seguchi, Shun Ishibashi, Taku Kasahara, Kei Yamamoto, Yousuke Taniguchi, Hideo Fujita","doi":"10.1002/ccd.31524","DOIUrl":"https://doi.org/10.1002/ccd.31524","url":null,"abstract":"<p><strong>Background: </strong>The below the knee (BTK) arteries of legs with peripheral artery disease (PAD) frequently exhibit medial calcification and chronic thrombus. However, the relationship between chronic thrombus and medial calcification remains poorly understood.</p><p><strong>Aims: </strong>This study aimed to evaluate the association between chronic thrombus and medial calcification in the BTK arteries of patients with PAD using optical frequency domain imaging (OFDI).</p><p><strong>Methods: </strong>OFDI frames were analyzed in legs with PAD undergoing OFDI-guided endovascular therapy. Data regarding thrombus, medial calcification, and the type and extent of calcification were collected. The multivariate logistic regression analysis was used to find the OFDI factors significantly associated with chronic thrombus. The causes of chronic thrombus were examined.</p><p><strong>Results: </strong>A total of 5293 frames from 21 legs in 19 patients were analyzed. Among all frames, medial calcification and chronic thrombus were observed in 51% and 23%, respectively. The multivariate logistic regression analysis showed that medial calcification and the degree of arc-quadrant of medial calcification were significantly associated with chronic thrombus. Medial calcification-related thrombus was the most common cause of chronic thrombus (57%), followed by lipidic atherosclerosis (35%), calcified nodule (3%) and distal emboli (3%). The prevalence of chronic thrombus related to medial calcification increased as the degree of arc-quadrant of medial calcification increased.</p><p><strong>Conclusions: </strong>Chronic thrombus was significantly associated with medial calcification in the BTK arteries. The major cause of chronic thrombus was medial calcification-related thrombus. This study proposed a potential mechanism by which medial calcification can induce chronic thrombus in the BTK lesions.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763017","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":"Mitral Transcatheter Edge-to-Edge Repair (MTEER) in Heart Failure Patients Refractory to Cardiac Resynchronization Therapy.","authors":"Farah Yasmin, Asim Shaikh, Eman Ali, Hala Najeeb, Zunera Huda, Unaiza Naeem, Safi Khan, Sachin S Goel","doi":"10.1002/ccd.31518","DOIUrl":"https://doi.org/10.1002/ccd.31518","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751359","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}