Acta cardiologica最新文献

Danon disease is a rare X-linked multi-system lysosomal storage disorder. It may manifest as severe cardiomyopathy in affected individuals, with different clinical courses observed for men and women. Women may experience a hypertrophic or a dilated/hypokinetic phenotype irrespective of their disease stage. Men typically present earlier with progressive hypertrophy, and rapid regression of their hypertrophy with dilation and hypokinesis with onset of heart failure outcomes. In this case we demonstrate echocardiographic images of a young male taken just 2 years apart.

Objective: In patients with chronic total occlusion (CTO) and coronary artery disease (CAD), the J-CTO score reflects the difficulty of revascularization, while the triglyceride-glucose (TyG) index is an indicator of insulin resistance and atherosclerosis. The aim of this study is to explore the relationship between the J-CTO score and the TyG index in patients with chronic total occlusion.

Methods: This is a single-centre, retrospective study conducted with approval from the local ethics committee. A total of 243 patients who underwent coronary angiography and percutaneous coronary intervention (PCI) due to stable CAD between 1 October 2022, and 1 October 2024, and were found to have chronic total occlusion, were included. The relationship between the J-CTO score and the TyG index, evaluated through blood tests, was assessed.

Results: Of the 243 patients, 102 were classified into the low difficulty group (J-CTO score 0-1), and 141 were in the high difficulty group (J-CTO score 2-3). The high difficulty group had significantly higher levels of age, uric acid, hs-CRP, LDL-C, and TyG index compared to the low difficulty group. Univariate and multivariate regression analyses identified age, LDL-C, hs-CRP, uric acid, and the TyG index as independent risk factors in the high difficulty group.

Conclusion: This study is the first to demonstrate that a high TyG index is an independent risk factor for an elevated J-CTO score. It suggests that the TyG index may serve as a significant biomarker for predicting the need for revascularization and for long-term prognostic evaluation.

Background: Right heart haemodynamics, including right ventricular function and pulmonary arterial capacitance (PAC), are important prognostic determinants in cardiovascular disease. However, their combined role in patients undergoing transcatheter aortic valve implantation (TAVI) remains unclear. This study aimed to determine whether the combined assessment using pulmonary artery pulsatility index (PAPi) and PAC can stratify clinical outcomes in patients with aortic stenosis (AS) undergoing TAVI.

Methods: This retrospective single-centre study included 77 patients with severe AS who underwent right heart catheterisation within 3 months before TAVI. Patients were stratified into four groups based on the median values of PAPi and PAC. The primary endpoint was a composite of all-cause death or heart failure-related hospitalisation.

Results: During a median follow-up of 3.60 years (interquartile range: 1.89-4.62), 15 patients experienced the primary endpoint. Kaplan-Meier's analysis showed significant stratification by PAPi-PAC groups (log-rank p = 0.040). In Cox regression models, the low PAPi/low PAC group was independently associated with adverse outcomes compared with the other groups (hazard ratio (HR): 3.65, 95% confidence interval (CI): 1.28-10.40, p = 0.015 adjusted for age and sex; HR: 3.61, 95% CI: 1.27-10.26, p = 0.016 adjusted for natriuretic peptide levels; HR: 3.07, 95% CI: 1.07-8.81, p = 0.038 adjusted for the Meta-analysis Global Group in Chronic Heart Failure score).

Conclusions: Combined PAPi-PAC assessment identified distinct haemodynamic phenotypes with prognostic significance following TAVI. This approach offers a simple, physiologically grounded framework for postprocedural risk stratification and individualised management.