Pub Date : 2025-12-04DOI: 10.1016/j.jacasi.2025.10.017
Xiaoyuan Bai, Yiyuan Zhang, Jing Qu, Guang-Hui Liu
Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide, with their prevalence rising with advancing age. Progressive remodeling of the cardiovascular system during aging underlies increased vulnerability to cardiovascular pathologies. This review summarizes current insights into the structural, functional, and molecular hallmarks of both cardiovascular aging (CVA) and CVDs, highlighting their mechanistic convergence. By further discussing diagnostic biomarkers and intervention strategies that bridge these processes, we delineated the translational continuum linking CVA and CVDs. The understanding of their interconnections underscores the potential of targeting CVA as a strategy for CVD prevention, early diagnosis, and treatment.
{"title":"Interconnected Pathways and Therapeutic Implications for Cardiovascular Aging and Diseases.","authors":"Xiaoyuan Bai, Yiyuan Zhang, Jing Qu, Guang-Hui Liu","doi":"10.1016/j.jacasi.2025.10.017","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.10.017","url":null,"abstract":"<p><p>Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide, with their prevalence rising with advancing age. Progressive remodeling of the cardiovascular system during aging underlies increased vulnerability to cardiovascular pathologies. This review summarizes current insights into the structural, functional, and molecular hallmarks of both cardiovascular aging (CVA) and CVDs, highlighting their mechanistic convergence. By further discussing diagnostic biomarkers and intervention strategies that bridge these processes, we delineated the translational continuum linking CVA and CVDs. The understanding of their interconnections underscores the potential of targeting CVA as a strategy for CVD prevention, early diagnosis, and treatment.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jacasi.2025.07.011
Yunhe Wang MD , Deyong Long MD , Fangyi Xiao MD , Minglong Chen MD , Xingpeng Liu MD , Jidong Zhang MD , Yumei Xue MD , Jie Fan MD , Haixiong Wang MD , Mengzuo Wu MD , Rui Wang MD , Jia Li MD , Tao He MD , Weili Ge MD , Xiaobo Huang MD , Ruhong Jiang MD , Qiang Liu MD , Zuwen Zhang BS , Guosheng Fu MD , Chenyang Jiang MD
Background
Intracardiac echocardiography (ICE)-guided non/minimized-fluoroscopy catheter ablation for atrial fibrillation (AF) has been reported, but its effectiveness and safety still lack multicenter evidence.
Objectives
The authors sought to evaluate the effectiveness and safety of ICE-guided non/minimized-fluoroscopy catheter ablation compared with the traditional fluoroscopy-guided approach in patients with paroxysmal AF.
Methods
A total of 448 patients with paroxysmal AF, from 15 centers in China, were randomly assigned in a 1:1 ratio to a non/minimized-fluoroscopy group (n = 223) and a traditional approach group (n = 225). The primary efficacy endpoint was freedom from AF recurrence after a single ablation procedure. The primary safety endpoint was a composite of death from any cause, stroke or transient ischemic attack, and other serious adverse events.
Results
Pulmonary vein isolation was achieved in all patients. After a median follow-up of 12.2 (Q1-Q3: 8.8-17.7) months, 184 of 223 patients (82.5%) in the non/minimized-fluoroscopy group and 189 of 225 (84.0%) in the traditional approach group remained free from arrhythmia. Cox analysis showed a HR of 0.949 (95% CI: 0.774 to 1.164); P = 0.858, demonstrating the noninferiority of the non/minimized-fluoroscopy approach. The primary safety endpoint did not differ significantly in the 2 groups (P = 0.975). This protocol enabled near zero–radiation procedures (mean <1 mGy) in 7 of 15 centers (46.7%), and radiation-free AF ablation in 125 of 223 patients (56.1%), significantly reducing x-ray exposure and operator radiation protection equipment usage.
Conclusions
ICE-combined non/minimized-fluoroscopy AF ablation was noninferior in effectiveness compared to traditional AF ablation, with no significant difference in safety endpoints, indicating its potential of widespread adoption.
{"title":"Multicenter Practice of Non/Minimized Fluoroscopy Ablation for Paroxysmal AF in China","authors":"Yunhe Wang MD , Deyong Long MD , Fangyi Xiao MD , Minglong Chen MD , Xingpeng Liu MD , Jidong Zhang MD , Yumei Xue MD , Jie Fan MD , Haixiong Wang MD , Mengzuo Wu MD , Rui Wang MD , Jia Li MD , Tao He MD , Weili Ge MD , Xiaobo Huang MD , Ruhong Jiang MD , Qiang Liu MD , Zuwen Zhang BS , Guosheng Fu MD , Chenyang Jiang MD","doi":"10.1016/j.jacasi.2025.07.011","DOIUrl":"10.1016/j.jacasi.2025.07.011","url":null,"abstract":"<div><h3>Background</h3><div>Intracardiac echocardiography (ICE)-guided non/minimized-fluoroscopy catheter ablation for atrial fibrillation (AF) has been reported, but its effectiveness and safety still lack multicenter evidence.</div></div><div><h3>Objectives</h3><div>The authors sought to evaluate the effectiveness and safety of ICE-guided non/minimized-fluoroscopy catheter ablation compared with the traditional fluoroscopy-guided approach in patients with paroxysmal AF.</div></div><div><h3>Methods</h3><div>A total of 448 patients with paroxysmal AF, from 15 centers in China, were randomly assigned in a 1:1 ratio to a non/minimized-fluoroscopy group (n = 223) and a traditional approach group (n = 225). The primary efficacy endpoint was freedom from AF recurrence after a single ablation procedure. The primary safety endpoint was a composite of death from any cause, stroke or transient ischemic attack, and other serious adverse events.</div></div><div><h3>Results</h3><div>Pulmonary vein isolation was achieved in all patients. After a median follow-up of 12.2 (Q1-Q3: 8.8-17.7) months, 184 of 223 patients (82.5%) in the non/minimized-fluoroscopy group and 189 of 225 (84.0%) in the traditional approach group remained free from arrhythmia. Cox analysis showed a HR of 0.949 (95% CI: 0.774 to 1.164); <em>P</em> = 0.858, demonstrating the noninferiority of the non/minimized-fluoroscopy approach. The primary safety endpoint did not differ significantly in the 2 groups (<em>P</em> = 0.975). This protocol enabled near zero–radiation procedures (mean <1 mGy) in 7 of 15 centers (46.7%), and radiation-free AF ablation in 125 of 223 patients (56.1%), significantly reducing x-ray exposure and operator radiation protection equipment usage.</div></div><div><h3>Conclusions</h3><div>ICE-combined non/minimized-fluoroscopy AF ablation was noninferior in effectiveness compared to traditional AF ablation, with no significant difference in safety endpoints, indicating its potential of widespread adoption.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 12","pages":"Pages 1540-1548"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jacasi.2025.10.003
Xin Du MD
{"title":"Subanalyses in HFmrEF Patients of Asian Ethnicity","authors":"Xin Du MD","doi":"10.1016/j.jacasi.2025.10.003","DOIUrl":"10.1016/j.jacasi.2025.10.003","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 12","pages":"Pages 6-7"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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