Pub Date : 2025-02-01DOI: 10.1016/j.ijcha.2025.101609
Xiaowei Zhou , Qinghua Hu , Meihong Yu , Kaixuan Li
This article has been retracted at the request of the Authors and the Editor-in-Chief: please see Elsevier policy on article withdrawal (https://www.elsevier.com/about/policies-and-standards/article-withdrawal).
Post-publication, the authors identified significant errors in the experimental data and statistical analysis methods presented in the study. Upon thorough review, it was discovered that these inaccuracies compromise the integrity of the findings, and therefore, the authors believe it is in the best interest of the scientific community to retract the paper. The authors apologise for any inconvenience this may cause.
{"title":"RETRACTED: Overexpression of Neural Precursor Cell Expressed Developmentally Downregulated 9 (NEDD9) reduces ox-LDL-induced Anoikis in atherosclerotic vascular endothelial cells","authors":"Xiaowei Zhou , Qinghua Hu , Meihong Yu , Kaixuan Li","doi":"10.1016/j.ijcha.2025.101609","DOIUrl":"10.1016/j.ijcha.2025.101609","url":null,"abstract":"<div><div>This article has been retracted at the request of the Authors and the Editor-in-Chief: please see Elsevier policy on article withdrawal (<span><span>https://www.elsevier.com/about/policies-and-standards/article-withdrawal</span><svg><path></path></svg></span>).</div><div>Post-publication, the authors identified significant errors in the experimental data and statistical analysis methods presented in the study. Upon thorough review, it was discovered that these inaccuracies compromise the integrity of the findings, and therefore, the authors believe it is in the best interest of the scientific community to retract the paper. The authors apologise for any inconvenience this may cause.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101609"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.ijcha.2025.101598
Mustafa Yildirim , Hauke Hund , Matthias Mueller-Hennessen , Hugo A Katus , Norbert Frey , Evangelos Giannitsis , Christian Salbach
Background
A significant number of patients with atrial fibrillation (AF) on direct oral anticoagulants (DOACs) receives off-label or inappropriate doses. This study examines the prevalence, dosages, and clinical outcomes in AF-patients on DOAC therapy admitted to an emergency department (ED).
Methods
This retrospective single-center observational study utilized data from the Heidelberg Registry of Atrial Fibrillation (HERA-FIB), consecutively including patients with AF presenting to the ED of the University Hospital of Heidelberg from June 2009 to March 2020. Rates of DOAC dosages at discharge from the ED were correlated with outcomes, focusing on a composite endpoint that included all-cause mortality, stroke, major bleeding, and myocardial infarction (MI).
Resultsand Conclusions
Among 10,222 patients included in the HERA-FIB registry, 4,239 (41.5 %) were prescribed DOACs, and 3,031were eligible for the analysis. Of these, 2,199 (72.6 %) received appropriate dosages, 627 (20.7 %) were under-dosed, and 205 (6.8 %) were over-dosed. Under-dosed AF-patients demonstrated a significantly increased risk of the composite endpoint compared to those receiving appropriate dosages (HR 1.84, 95 %CI:1.55–2.18, p < 0.0001). Over-dosage had no significant effect on the HR for the composite endpoint, all-cause mortality, stroke, MI, or major bleeding compared to correct dosing but was associated with higher risks of the composite endpoint (HR 1.43, 95 %CI:1.04–1.96, p = 0.029) relative to under-dosage. This study underscores the critical importance of accurate DOAC dosing in patients with AF presenting to an ED. Both under-dosing and over-dosing are linked to significant clinical risks, highlighting the urgent need for improved dosing protocols and careful monitoring to enhance patient outcomes.
{"title":"Clinical impact of inappropriate DOAC dosing in atrial fibrillation: Insights from a real-world registry","authors":"Mustafa Yildirim , Hauke Hund , Matthias Mueller-Hennessen , Hugo A Katus , Norbert Frey , Evangelos Giannitsis , Christian Salbach","doi":"10.1016/j.ijcha.2025.101598","DOIUrl":"10.1016/j.ijcha.2025.101598","url":null,"abstract":"<div><h3>Background</h3><div>A significant number of patients with atrial fibrillation (AF) on direct oral anticoagulants (DOACs) receives off-label or inappropriate doses. This study examines the prevalence, dosages, and clinical outcomes in AF-patients on DOAC therapy admitted to an emergency department (ED).</div></div><div><h3>Methods</h3><div>This retrospective single-center observational study utilized data from the Heidelberg Registry of Atrial Fibrillation (HERA-FIB), consecutively including patients with AF presenting to the ED of the University Hospital of Heidelberg from June 2009 to March 2020. Rates of DOAC dosages at discharge from the ED were correlated with outcomes, focusing on a composite endpoint that included all-cause mortality, stroke, major bleeding, and myocardial infarction (MI).</div></div><div><h3>Resultsand Conclusions</h3><div>Among 10,222 patients included in the HERA-FIB registry, 4,239 (41.5 %) were prescribed DOACs, and 3,031were eligible for the analysis. Of these, 2,199 (72.6 %) received appropriate dosages, 627 (20.7 %) were under-dosed, and 205 (6.8 %) were over-dosed. Under-dosed AF-patients demonstrated a significantly increased risk of the composite endpoint compared to those receiving appropriate dosages (HR 1.84, 95 %CI:1.55–2.18, p < 0.0001). Over-dosage had no significant effect on the HR for the composite endpoint, all-cause mortality, stroke, MI, or major bleeding compared to correct dosing but was associated with higher risks of the composite endpoint (HR 1.43, 95 %CI:1.04–1.96, p = 0.029) relative to under-dosage. This study underscores the critical importance of accurate DOAC dosing in patients with AF presenting to an ED. Both under-dosing and over-dosing are linked to significant clinical risks, highlighting the urgent need for improved dosing protocols and careful monitoring to enhance patient outcomes.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101598"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.ijcha.2024.101595
Helen S. Anwar , Pilar Lopez Santi , Magdy Algowhary , Mohamed Aboel-Kassem F. Abdelmegid , Hatem A. Helmy , J. Wouter Jukema , Nina Ajmone Marsan , Frank Van Der Kley
Background
Epicardial fat tissue (EFT) is an active organ that can affect cardiac function and structure through endocrine, paracrine, and proinflammatory mechanisms. We hypothesized that greater thickness of EFT may harm the recovery of left ventricular (LV) systolic function in patients with severe aortic stenosis (AS) and reduced LV ejection fraction (EF ≤ 50 %) undergoing transcatheter aortic valve implantation (TAVI).
Methods
A sixty six patients with severe AS and 20 % ≥ LVEF ≤ 50 % who underwent TAVI were included. Patients were categorized into two groups based on LV systolic function recovery 30 days after TAVI defined by ≥ 20 % relative increase in LV Global longitudinal strain (GLS) from baseline. EFT was determined by ECG-gated contrast-enhanced multidetector computed tomography (MDCT).
Results
Forty-five patients (68.0 %) showed LV systolic function recovery. EFT showed no significant correlation with the baseline LV-GLS but was associated with less likelihood of LV systolic function recovery (OR 0.7, 95 % CI 0.50 – 0.98, P = 0.04). In the multivariate analysis, higher LVMI (OR 1.05, 95 % CI 1.00–1.10, P = 0.02), lower LV-GLS (OR 0.55, 95 % CI 0.40–0.82, P = 0.002), and thinner EFT (OR 0.38, 95 % CI 0.20–0.73, P = 0.003) were independently associated with LV systolic function recovery after TAVI.
Conclusion
EFT extent is associated with LV systolic function recovery in AS patients with impaired LVEF undergoing TAVI and therefore may help in risk stratification and management of these patients.
{"title":"Epicardial fat tissue, a hidden enemy against the early recovery of left ventricular systolic function after transcatheter aortic valve implantation","authors":"Helen S. Anwar , Pilar Lopez Santi , Magdy Algowhary , Mohamed Aboel-Kassem F. Abdelmegid , Hatem A. Helmy , J. Wouter Jukema , Nina Ajmone Marsan , Frank Van Der Kley","doi":"10.1016/j.ijcha.2024.101595","DOIUrl":"10.1016/j.ijcha.2024.101595","url":null,"abstract":"<div><h3>Background</h3><div>Epicardial fat tissue (EFT) is an active organ that can affect cardiac function and structure through endocrine, paracrine, and proinflammatory mechanisms. We hypothesized that greater thickness of EFT may harm the recovery of left ventricular (LV) systolic function in patients with severe aortic stenosis (AS) and reduced LV ejection fraction (EF ≤ 50 %) undergoing transcatheter aortic valve implantation (TAVI).</div></div><div><h3>Methods</h3><div>A sixty six patients with severe AS and 20 % ≥ LVEF ≤ 50 % who underwent TAVI were included. Patients were categorized into two groups based on LV systolic function recovery 30 days after TAVI defined by ≥ 20 % relative increase in LV Global longitudinal strain (GLS) from baseline. EFT was determined by ECG-gated contrast-enhanced multidetector computed tomography (MDCT).</div></div><div><h3>Results</h3><div>Forty-five patients (68.0 %) showed LV systolic function recovery. EFT showed no significant correlation with the baseline LV-GLS but was associated with less likelihood of LV systolic function recovery (OR 0.7, 95 % CI 0.50 – 0.98, P = 0.04). In the multivariate analysis, higher LVMI (OR 1.05, 95 % CI 1.00–1.10, P = 0.02), lower LV-GLS (OR 0.55, 95 % CI 0.40–0.82, P = 0.002), and thinner EFT (OR 0.38, 95 % CI 0.20–0.73, P = 0.003) were independently associated with LV systolic function recovery after TAVI.</div></div><div><h3>Conclusion</h3><div>EFT extent is associated with LV systolic function recovery in AS patients with impaired LVEF undergoing TAVI and therefore may help in risk stratification and management of these patients.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101595"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.ijcha.2024.101581
Tobias Lerchner , Raluca I. Mincu , Florian Bühning , Julia Vogel , Karin Klingel , Mathias Meetschen , Thomas Schlosser , Johannes Haubold , Lale Umutlu , Dobromir Dobrev , Matthias Totzeck , Tienush Rassaf , Lars Michel
Background and aims
Cardiotoxicity from immune checkpoint inhibitor (ICI) therapy is a challenge in clinical practice, and the assessment of ICI-related myocarditis (ICI-M) is often complicated by a variable phenotype. Cardiac magnetic resonance imaging (CMR) is used frequently, but evidence is poor. Here, we aim to assess the role of CMR in the assessment of suspected ICI-M in a real-world clinical setting.
Methods
All patients receiving CMR at our centre for suspected ICI-M between September 2019 and January 2024 were included and retrospectively analysed. CMR parameters were correlated with clinical, laboratory and echocardiographic parameters and stratified for presence of myocarditis as per final diagnosis.
Results
A total of 55 patients who received CMR for suspected ICI-M were analysed, including 25 patients with ICI-M and 30 patients with non-myocarditis cardiotoxicity (non-M). The mean age (ICI-M versus (vs.) non-M) was 65.7 ± 13.6 vs. 67.3 ± 9.9 (p = 0.61) years, 32.0 % vs. 26.7 % (p = 0.67) were female, and 40.0 % vs. 26.7 % (p = 0.29) had pre-existing coronary heart disease. Cardiac biomarkers and echocardiographic data did not differ between the groups. In CMR analysis, presence of LGE was associated with ICI-M (56.0 % in ICI-M vs. 26.7 % in non-M, p = 0.03). Myocardial oedema was generally rare and not associated with ICI-M.
Conclusion
In this real-life assessment of routine clinical practice, the diagnostic assessment of ICI-M is challenged by low sensitivity of common diagnostic measures, often requiring a multimodal approach. Presence of LGE in CMR is associated with ICI-M, but sensitivity and specificity are low. Prospective data to improve diagnostic criteria is needed.
{"title":"Cardiac magnetic resonance imaging in patients with suspected myocarditis from immune checkpoint inhibitor therapy – A real-world observational study","authors":"Tobias Lerchner , Raluca I. Mincu , Florian Bühning , Julia Vogel , Karin Klingel , Mathias Meetschen , Thomas Schlosser , Johannes Haubold , Lale Umutlu , Dobromir Dobrev , Matthias Totzeck , Tienush Rassaf , Lars Michel","doi":"10.1016/j.ijcha.2024.101581","DOIUrl":"10.1016/j.ijcha.2024.101581","url":null,"abstract":"<div><h3>Background and aims</h3><div>Cardiotoxicity from immune checkpoint inhibitor (ICI) therapy is a challenge in clinical practice, and the assessment of ICI-related myocarditis (ICI-M) is often complicated by a variable phenotype. Cardiac magnetic resonance imaging (CMR) is used frequently, but evidence is poor. Here, we aim to assess the role of CMR in the assessment of suspected ICI-M in a real-world clinical setting.</div></div><div><h3>Methods</h3><div>All patients receiving CMR at our centre for suspected ICI-M between September 2019 and January 2024 were included and retrospectively analysed. CMR parameters were correlated with clinical, laboratory and echocardiographic parameters and stratified for presence of myocarditis as per final diagnosis.</div></div><div><h3>Results</h3><div>A total of 55 patients who received CMR for suspected ICI-M were analysed, including 25 patients with ICI-M and 30 patients with non-myocarditis cardiotoxicity (non-M). The mean age (ICI-M versus (vs.) non-M) was 65.7 ± 13.6 vs. 67.3 ± 9.9 (p = 0.61) years, 32.0 % vs. 26.7 % (p = 0.67) were female, and 40.0 % vs. 26.7 % (p = 0.29) had pre-existing coronary heart disease. Cardiac biomarkers and echocardiographic data did not differ between the groups. In CMR analysis, presence of LGE was associated with ICI-M (56.0 % in ICI-M vs. 26.7 % in non-M, p = 0.03). Myocardial oedema was generally rare and not associated with ICI-M.</div></div><div><h3>Conclusion</h3><div>In this real-life assessment of routine clinical practice, the diagnostic assessment of ICI-M is challenged by low sensitivity of common diagnostic measures, often requiring a multimodal approach. Presence of LGE in CMR is associated with ICI-M, but sensitivity and specificity are low. Prospective data to improve diagnostic criteria is needed.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101581"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.ijcha.2024.101576
Pietro G. Lacaita , Sven Bleckwenn , Fabian Barbieri , Yannick Scharll , Johannes Deeg , Nikolaos Bonaros , Gerlig Widmann , Gudrun M. Feuchtner
Background
Stroke is a feared complication after TAVI. The objective was to assess whether left atrial appendage (LAA) filling-defect (FD) patterns from early and late-phase computed tomography (CT), predict stroke/TIA in patients with severe aortic stenosis.
Methods
124 patients with severe aortic stenosis (79.5y, 46.8% females) who underwent CT-Angiography for TAVI-planning were included (66.1% underwent TAVI, 18.6% surgical, 15.3% conservative treatment).CT-image-analysis included: CT-density (HU) from LAA tip-to-base and HU-gradients (I-III), the HU-ratio LAA/aorta, left-atrial-wall-thickness (LAWT) and the periatrial fat attenuation index (FAI).
Results
Stroke/TIA rate was 9.6 %. LAA-HU-gradient was slightly higher in non-stroke patients (p = 0.087). Persisting FDs during the late-phase were associated with stroke (p = 0.047) but not early-phase FDs. Early-phase FDs with HU < 245 (n = 15) were correlated with stroke (p = 0.05). A LAA-HU-gradient > 10HU had 91 % sensitivity and 68 % specificity for prediction of stroke. LAA-HU gradient I had a moderate accuracy (c = 0.592; 95 %CI:0.472–0.711; p = 0.317) for discrimination of stroke during the early phase, which enhanced during the late phase (c = 0.686;95 %CI:0.503–0.868; p = 0.046). Patients with stroke had a higher rate of FDs with HU-progression from early to late phase (>10HU)(p = 0.013), while the ratios LAA/aorta, LAWT, and periatrial-FAI were not different. Among clinical parameters, only age predicted stroke but not CHA2DS2-VASc-score. In multivariate analysis, late-phase FDs (p = 0.059)(OR 5.66: 95 %CI:0.936–34.28) but not early-phase FD were associated with stroke, and none of the major conventional risk factors.
Conclusion
Persisting LAA-filling defects on CT during the late-phase, and early-phase FD with <245HU predict stroke, and a CT-density progression >10HU from early-to-late phase. LAA-FD may improve stroke risk stratification.
{"title":"Prediction of stroke in patients with severe aortic stenosis by left atrial appendage filling defect patterns on early and late-phase computed tomography","authors":"Pietro G. Lacaita , Sven Bleckwenn , Fabian Barbieri , Yannick Scharll , Johannes Deeg , Nikolaos Bonaros , Gerlig Widmann , Gudrun M. Feuchtner","doi":"10.1016/j.ijcha.2024.101576","DOIUrl":"10.1016/j.ijcha.2024.101576","url":null,"abstract":"<div><h3>Background</h3><div>Stroke is a feared complication after TAVI. The objective was to assess whether left atrial appendage (LAA) filling-defect (FD) patterns from early and late-phase computed tomography (CT), predict stroke/TIA in patients with severe aortic stenosis.</div></div><div><h3>Methods</h3><div>124 patients with severe aortic stenosis (79.5y, 46.8% females) who underwent CT-Angiography for TAVI-planning were included (66.1% underwent TAVI, 18.6% surgical, 15.3% conservative treatment).CT-image-analysis included: CT-density (HU) from LAA tip-to-base and HU-gradients (I-III), the HU-ratio LAA/aorta, left-atrial-wall-thickness (LAWT) and the periatrial fat attenuation index (FAI).</div></div><div><h3>Results</h3><div>Stroke/TIA rate was 9.6 %. LAA-HU-gradient was slightly higher in non-stroke patients (p = 0.087). Persisting FDs during the late-phase were associated with stroke (p = 0.047) but not early-phase FDs. Early-phase FDs with HU < 245 (n = 15) were correlated with stroke (p = 0.05). A LAA-HU-gradient > 10HU had 91 % sensitivity and 68 % specificity for prediction of stroke. LAA-HU gradient I had a moderate accuracy (<em>c = 0.592;</em> 95 %CI:0.472–0.711; p = 0.317) for discrimination of stroke during the early phase, which enhanced during the late phase (<em>c = 0.686</em>;95 %CI:0.503–0.868; p = 0.046). Patients with stroke had a higher rate of FDs with HU-progression from early to late phase (>10HU)(p = 0.013), while the ratios LAA/aorta, LAWT, and periatrial-FAI were not different. Among clinical parameters, only age predicted stroke but not CHA2DS2-VASc-score. In multivariate analysis, late-phase FDs (p = 0.059)(OR 5.66: 95 %CI:0.936–34.28) but not early-phase FD were associated with stroke, and none of the major conventional risk factors.</div></div><div><h3>Conclusion</h3><div>Persisting LAA-filling defects on CT during the late-phase, and early-phase FD with <245HU predict stroke, and a CT-density progression >10HU from early-to-late phase. LAA-FD may improve stroke risk stratification.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101576"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The optimal imaging modality for selecting the device size in patients with atrial fibrillation undergoing one-stop left atrial appendage occlusion (LAAO) with concomitant pulmonary vein isolation (PVi) remains undefined. We compared preprocedural 3-dimensional computed tomography (3D CT) with intra-procedural transesophageal echocardiography (TEE) and left atrial appendage (LAA) angiography in guiding one-stage PVi and LAAO.
Methods
We measured the LAA ostium diameter using an interactive 3D CT system with a central line-based approach and compared these measurements with those from intra-procedural TEE and angiography, and the actual device size. The optimal compression ratio was used to assess the attainment rates of the three imaging modalities.
Results
Twenty-two patients (median age: 68.5 years, 21.8 % female) underwent the one-stage procedure. The median LAA ostium diameter measured by 3D CT (24.3 mm, interquartile range [IQR] = 22.0–27.0 mm) was closer to the Watchman device size (27.0 mm, IQR = 24.0–31.0 mm, P = 0.127) compared to TEE (21.2 mm, IQR = 18.4–22.7 mm, P < 0.001) and angiography (22.5 mm, IQR = 17.9–25.1 mm, P < 0.001). 3D CT had a better attainment rate for the optimal compression ratio than TEE (10.8 %, IQR = 7.4–16.5 % vs. 22.7 %, IQR = 19.2–29.3 %, P < 0.001) and angiography (19.7 %, IQR = 15.1–24.1 %, P = 0.001). All patients underwent successful device implantation without peri-device leak or complications during the periprocedural period and follow-up.
Conclusions
In this pilot study, a preprocedural central line-based 3D CT planning system appeared to be more effective than intraoperative TEE and angiography in measuring the LAA ostium diameter to guide device size selection in patients with atrial fibrillation undergoing one-stop LAAO with concomitant PVi.
背景：心房颤动患者行一站式左房耳闭塞术（LAAO）合并肺静脉隔离术（PVi）时，选择装置尺寸的最佳成像方式尚不明确。我们比较了术前三维计算机断层扫描（3D CT）与术中经食管超声心动图（TEE）和左心耳血管造影（LAA）对一期PVi和LAAO的指导作用。方法：我们使用基于中心线的交互式3D CT系统测量LAA口直径，并将这些测量结果与术中TEE和血管造影的测量结果以及实际设备尺寸进行比较。使用最佳压缩比来评估三种成像方式的成功率。结果：22例患者（中位年龄：68.5岁，21.8%为女性）接受了一期手术。与TEE （21.2 mm, IQR = 18.4 ~ 22.7 mm, P < 0.001）和血管造影（22.5 mm, IQR = 17.9 ~ 25.1 mm, P < 0.001）相比，3D CT测量LAA中位口直径（24.3 mm，四分位间距[IQR] = 22.0 ~ 27.0 mm）更接近Watchman装置尺寸（27.0 mm, IQR = 24.0 ~ 31.0 mm, P = 0.127）。3D CT对最佳压缩比的满意率高于TEE （10.8%, IQR = 7.4 ~ 16.5% vs. 22.7%, IQR = 19.2 ~ 29.3%, P < 0.001）和血管造影（19.7%,IQR = 15.1 ~ 24.1%, P = 0.001）。所有患者在围手术期和随访期间均成功植入器械，无器械外漏或并发症。结论：在这项初步研究中，术前基于中心线的3D CT规划系统比术中TEE和血管造影更有效地测量LAA口直径，以指导房颤患者进行一站式LAAO合并PVi的设备尺寸选择。
{"title":"Usefulness of preprocedural 3-dimensional computed tomography planning in assisting one-stage pulmonary veins isolation with concomitant left atrial appendage occlusion procedure: A pilot study","authors":"Ke-Wei Chen , Yen-Nien Lin , Mei-Yao Wu , Yi-Hsiu Wu , Wen-Sheng Feng , Ping-Han Lo , Wei-Hsin Chung , Cheng-Chang Tung , Kuan-Cheng Chang","doi":"10.1016/j.ijcha.2024.101594","DOIUrl":"10.1016/j.ijcha.2024.101594","url":null,"abstract":"<div><h3>Background</h3><div>The optimal imaging modality for selecting the device size in patients with atrial fibrillation undergoing one-stop left atrial appendage occlusion (LAAO) with concomitant pulmonary vein isolation (PVi) remains undefined. We compared preprocedural 3-dimensional computed tomography (3D CT) with intra-procedural transesophageal echocardiography (TEE) and left atrial appendage (LAA) angiography in guiding one-stage PVi and LAAO.</div></div><div><h3>Methods</h3><div>We measured the LAA ostium diameter using an interactive 3D CT system with a central line-based approach and compared these measurements with those from intra-procedural TEE and angiography, and the actual device size. The optimal compression ratio was used to assess the attainment rates of the three imaging modalities.</div></div><div><h3>Results</h3><div>Twenty-two patients (median age: 68.5 years, 21.8 % female) underwent the one-stage procedure. The median LAA ostium diameter measured by 3D CT (24.3 mm, interquartile range [IQR] = 22.0–27.0 mm) was closer to the Watchman device size (27.0 mm, IQR = 24.0–31.0 mm, P = 0.127) compared to TEE (21.2 mm, IQR = 18.4–22.7 mm, P < 0.001) and angiography (22.5 mm, IQR = 17.9–25.1 mm, P < 0.001). 3D CT had a better attainment rate for the optimal compression ratio than TEE (10.8 %, IQR = 7.4–16.5 % vs. 22.7 %, IQR = 19.2–29.3 %, P < 0.001) and angiography (19.7 %, IQR = 15.1–24.1 %, P = 0.001). All patients underwent successful device implantation without peri-device leak or complications during the periprocedural period and follow-up.</div></div><div><h3>Conclusions</h3><div>In this pilot study, a preprocedural central line-based 3D CT planning system appeared to be more effective than intraoperative TEE and angiography in measuring the LAA ostium diameter to guide device size selection in patients with atrial fibrillation undergoing one-stop LAAO with concomitant PVi.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101594"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.ijcha.2024.101589
Qian-ji Che , Jun-hao Qiu , Jian Sun , Mu Chen , Wei Li , Qun-Shan Wang , Peng-Pai Zhang , Yu-li Yang , Rui Zhang , Yi-Gang Li
Background
Acute decompensated heart failure (ADHF) is often accompanied by persistent atrial fibrillation (AF). However, the optimal timing for RFCA in patients with persistent AF and ADHF is still uncertain.
Objectives
The aim of this observational cohort study is to investigate the safety and efficacy of early RFCA in patients with persistent AF after ADHF attack.
Methods
Patients with persistent AF and ADHF who underwent early RFCA as soon as the ADHF symptoms were initially controlled (Early group, n = 63) and those who received elective procedures after a transitional period (Elective group, n = 67) were investigated. After 1:1 propensity score matching, 50 matched pairs were analyzed.
Results
The overall procedural complication rates were similar (Early group: 6.0 %, n = 3; Elective group: 6.0 %, n = 3; P = 1.000). Patients in the early group had significantly less HF rehospitalization than the elective group during the 1-year post-procedure follow-up period (Mantel-Cox test: P = 0.036; HR: 0.369; 95 %CI: 0.145–0.938), though AF recurrence showed no difference (Mantel-Cox test: P = 0.645; HR: 1.204; 95 %CI: 0.547–2.648). A 90-day rehospitalization rate was significantly higher in the transitional period in the elective group, compared with patients who already received early RFCA (Elective group: 13, 26.0 %; Early group: 2, 4.0 %; P = 0.002).
Conclusions
Early RFCA therapy for persistent AF after ADHF attack was safe and effective. Patients who received early RFCA therapy had significantly less HF rehospitalization in the 1-year post-procedure follow-up period. On the other hand, the elective procedure was accompanied by a higher risk of HF rehospitalization during the waiting period.
{"title":"Catheter ablation for persistent atrial fibrillation after acute decompensated heart failure Attack: Earlier is Better?","authors":"Qian-ji Che , Jun-hao Qiu , Jian Sun , Mu Chen , Wei Li , Qun-Shan Wang , Peng-Pai Zhang , Yu-li Yang , Rui Zhang , Yi-Gang Li","doi":"10.1016/j.ijcha.2024.101589","DOIUrl":"10.1016/j.ijcha.2024.101589","url":null,"abstract":"<div><h3>Background</h3><div>Acute decompensated heart failure (ADHF) is often accompanied by persistent atrial fibrillation (AF). However, the optimal timing for RFCA in patients with persistent AF and ADHF is still uncertain.</div></div><div><h3>Objectives</h3><div>The aim of this observational cohort study is to investigate the safety and efficacy of early RFCA in patients with persistent AF after ADHF attack.</div></div><div><h3>Methods</h3><div>Patients with persistent AF and ADHF who underwent early RFCA as soon as the ADHF symptoms were initially controlled (Early group, n = 63) and those who received elective procedures after a transitional period (Elective group, n = 67) were investigated. After 1:1 propensity score matching, 50 matched pairs were analyzed.</div></div><div><h3>Results</h3><div>The overall procedural complication rates were similar (Early group: 6.0 %, n = 3; Elective group: 6.0 %, n = 3; P = 1.000). Patients in the early group had significantly less HF rehospitalization than the elective group during the 1-year post-procedure follow-up period (Mantel-Cox test: P = 0.036; HR: 0.369; 95 %CI: 0.145–0.938), though AF recurrence showed no difference (Mantel-Cox test: P = 0.645; HR: 1.204; 95 %CI: 0.547–2.648). A 90-day rehospitalization rate was significantly higher in the transitional period in the elective group, compared with patients who already received early RFCA (Elective group: 13, 26.0 %; Early group: 2, 4.0 %; P = 0.002).</div></div><div><h3>Conclusions</h3><div>Early RFCA therapy for persistent AF after ADHF attack was safe and effective. Patients who received early RFCA therapy had significantly less HF rehospitalization in the 1-year post-procedure follow-up period. On the other hand, the elective procedure was accompanied by a higher risk of HF rehospitalization during the waiting period.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101589"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.ijcha.2025.101601
Volker H. Schmitt , Martin Geyer , Sonja Born , Kevin Bachmann , Katharina Schnitzler , Michaela Hell , Alexander R. Tamm , Tobias Friedrich Ruf , Theresa Ann Maria Gößler , Marc A. Rogmann , Omar Hahad , Lukas Hobohm , Johannes Herzog , Johannes Windschmitt , Sören Schwuchow-Thonke , Recha Blessing , Eberhard Schulz , Philipp Lurz , Thomas Münzel , Karsten Keller , Ralph Stephan von Bardeleben
Aim
Diabetes mellitus (DM) represents a notable risk factor within surgical and interventional procedures. Data on its influence on survival after Transcatheter Edge-to-Edge Repair (TEER) of Mitral valve Regurgitation (MR) are sparse.
Methods
In a retrospective monocentric assessment after successful treatment of MR using TEER from 06/2010 to 03/2018 patients were stratified for DM. Mortality was analyzed during follow-up using Cox regression analyses.
Results
Of 627 patients (47.0 % females, 88.2 % aged ≥ 70 years, median follow-up 486 days) consecutively included, subjects with DM (N = 174, 27.8 %) had a higher prevalence of comorbidities like obesity (27.3 % vs. 9.2 %, p < 0.001), arterial hypertension (91.4 % vs. 83.7 %, p = 0.013), renal insufficiency (63.8 % vs. 43.9 %, p < 0.001), coronary artery disease (77.0 % vs. 59.8 %, p < 0.001) and peripheral artery disease (14.4 % vs. 8.4 %, p = 0.026). Patients with DM presented with higher median logistic Euroscore I (29.4 % [20.0/43.0] vs. 25.0 % [16.7/36.6], p = 0.001) and more severely reduced systolic function (LVEF 35 % [30/50] vs. 45 % [30/55], p < 0.001). No difference in short- and long-term survival was detected between patients with and without DM (in-hospital mortality 1.7 vs. 2.6 %, p = 0.771; at 30-days 5.0 vs. 6.0 %, p = 0.842, 1-year 28.7 vs. 25.0 %, p = 0.419, 3-years 49.2 vs. 44.1 %, p = 0.554, 5-years 69.0 vs. 68.3 %, p = 0.497). The presence of DM was not attributed as an individual risk factor for elevated mortality (HR 1-year 1.17 [95 % CI 0.80–1.71], p = 0.419; HR long-term 1.13 [95 %CI 0.86–1.49], p = 0.373).
Conclusion
Although linked to a more vulnerable clinical profile and despite being factored in common risk factor models, DM was not associated with an elevated short- and long-term mortality after TEER of MR.
{"title":"Impact of diabetes mellitus on long-term survival after transcatheter mitral valve edge-to-edge repair","authors":"Volker H. Schmitt , Martin Geyer , Sonja Born , Kevin Bachmann , Katharina Schnitzler , Michaela Hell , Alexander R. Tamm , Tobias Friedrich Ruf , Theresa Ann Maria Gößler , Marc A. Rogmann , Omar Hahad , Lukas Hobohm , Johannes Herzog , Johannes Windschmitt , Sören Schwuchow-Thonke , Recha Blessing , Eberhard Schulz , Philipp Lurz , Thomas Münzel , Karsten Keller , Ralph Stephan von Bardeleben","doi":"10.1016/j.ijcha.2025.101601","DOIUrl":"10.1016/j.ijcha.2025.101601","url":null,"abstract":"<div><h3>Aim</h3><div>Diabetes mellitus (DM) represents a notable risk factor within surgical and interventional procedures. Data on its influence on survival after Transcatheter Edge-to-Edge Repair (TEER) of Mitral valve Regurgitation (MR) are sparse.</div></div><div><h3>Methods</h3><div>In a retrospective monocentric assessment after successful treatment of MR using TEER from 06/2010 to 03/2018 patients were stratified for DM. Mortality was analyzed during follow-up using Cox regression analyses.</div></div><div><h3>Results</h3><div>Of 627 patients (47.0 % females, 88.2 % aged ≥ 70 years, median follow-up 486 days) consecutively included, subjects with DM (N = 174, 27.8 %) had a higher prevalence of comorbidities like obesity (27.3 % vs. 9.2 %, p < 0.001), arterial hypertension (91.4 % vs. 83.7 %, p = 0.013), renal insufficiency (63.8 % vs. 43.9 %, p < 0.001), coronary artery disease (77.0 % vs. 59.8 %, p < 0.001) and peripheral artery disease (14.4 % vs. 8.4 %, p = 0.026). Patients with DM presented with higher median logistic Euroscore I (29.4 % [20.0/43.0] vs. 25.0 % [16.7/36.6], p = 0.001) and more severely reduced systolic function (LVEF 35 % [30/50] vs. 45 % [30/55], p < 0.001). No difference in short- and long-term survival was detected between patients with and without DM (in-hospital mortality 1.7 vs. 2.6 %, p = 0.771; at 30-days 5.0 vs. 6.0 %, p = 0.842, 1-year 28.7 vs. 25.0 %, p = 0.419, 3-years 49.2 vs. 44.1 %, p = 0.554, 5-years 69.0 vs. 68.3 %, p = 0.497). The presence of DM was not attributed as an individual risk factor for elevated mortality (HR 1-year 1.17 [95 % CI 0.80–1.71], p = 0.419; HR long-term 1.13 [95 %CI 0.86–1.49], p = 0.373).</div></div><div><h3>Conclusion</h3><div>Although linked to a more vulnerable clinical profile and despite being factored in common risk factor models, DM was not associated with an elevated short- and long-term mortality after TEER of MR.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101601"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.ijcha.2024.101497
Mingxiu Wen , Jinzhang Li , Songhao Jia , Shipan Wang , Shuanglei Zhao , Pixiong Su , Dong Xu , Ming Gong
Objective
The objective was to evaluate the relationship between carotid stenting and off-pump coronary artery grafting (CAS-OPCABG) and OPCABG only in patients with asymptomatic severe carotid stenosis.
Methods
This study retrospectively included 669 patients with asymptomatic severe carotid artery stenosis who underwent OPCABG at multiple centers. After propensity score matching for baseline characteristics, the study compared two groups of patients with clinical data, early and midterm death, stroke, and myocardial infarction (MI).
Results
After matching, there was no significant difference between two groups at baseline. The rates of early stroke, midterm stroke, and intensive care unit (ICU) stay were significantly lower in the CAS OPCABG group, yet the use of the internal mammary artery (IMA) was comparatively lower. Kaplan–Meier analysis revealed that there was no significant difference in midterm mortality between two groups. In the bilateral asymptomatic carotid stenosis subgroup, the early stroke rate was significantly lower after CAS-OPCABG, but there was no significant difference in the unilateral carotid stenosis subgroup. Multivariate logistic regression analysis identified previous atrial fibrillation, previous stroke, aortic atherosclerosis, bilateral carotid stenosis and the use of an intra-aortic balloon pump (IABP) as significant risk factors for early postoperative stroke, CAS emerged as a protective factor. Use of IMA was found to be a protective factor against postoperative mortality.
Conclusions
CAS-OPCABG is an efficacious and safe approach for the treatment of asymptomatic severe carotid artery stenosis, effectively decreasing the incidence of postoperative stroke.
{"title":"CAS-OPCABG vs OPCABG-alone in patients with asymptomatic carotid Stenosis: Multi-center experience","authors":"Mingxiu Wen , Jinzhang Li , Songhao Jia , Shipan Wang , Shuanglei Zhao , Pixiong Su , Dong Xu , Ming Gong","doi":"10.1016/j.ijcha.2024.101497","DOIUrl":"10.1016/j.ijcha.2024.101497","url":null,"abstract":"<div><h3>Objective</h3><div>The objective was to evaluate the relationship between carotid stenting and off-pump coronary artery grafting (CAS-OPCABG) and OPCABG only in patients with asymptomatic severe carotid stenosis.</div></div><div><h3>Methods</h3><div>This study retrospectively included 669 patients with asymptomatic severe carotid artery stenosis who underwent OPCABG at multiple centers. After propensity score matching for baseline characteristics, the study compared two groups of patients with clinical data, early and midterm death, stroke, and myocardial infarction (MI).</div></div><div><h3>Results</h3><div>After matching, there was no significant difference between two groups at baseline. The rates of early stroke, midterm stroke, and intensive care unit (ICU) stay were significantly lower in the CAS OPCABG group, yet the use of the internal mammary artery (IMA) was comparatively lower. Kaplan–Meier analysis revealed that there was no significant difference in midterm mortality between two groups. In the bilateral asymptomatic carotid stenosis subgroup, the early stroke rate was significantly lower after CAS-OPCABG, but there was no significant difference in the unilateral carotid stenosis subgroup. Multivariate logistic regression analysis identified previous atrial fibrillation, previous stroke, aortic atherosclerosis, bilateral carotid stenosis and the use of an intra-aortic balloon pump (IABP) as significant risk factors for early postoperative stroke, CAS emerged as a protective factor. Use of IMA was found to be a protective factor against postoperative mortality.</div></div><div><h3>Conclusions</h3><div>CAS-OPCABG is an efficacious and safe approach for the treatment of asymptomatic severe carotid artery stenosis, effectively decreasing the incidence of postoperative stroke.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101497"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11714374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Early catheter ablation: A promising and effective approach for atrial fibrillation and post-heart failure recovery—Timing matters","authors":"Satoshi Yanagisawa, Yasuya Inden, Toyoaki Murohara","doi":"10.1016/j.ijcha.2025.101604","DOIUrl":"10.1016/j.ijcha.2025.101604","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101604"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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