American Journal of Cardiology最新文献_第8页

Impact of Updated Invasive Right Ventricular and Pulmonary Hemodynamics on Long-Term Outcomes in Patients With Mitral Valve Transcatheter Edge-to-Edge Repair 二尖瓣经导管边对边修补术患者的最新侵入性右心室和肺血流动力学对长期疗效的影响。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-01-01 DOI: 10.1016/j.amjcard.2024.11.010

Giulia Masiero MD , Federico Arturi MD , Elisa Boscolo Soramio MD , Luca Nai Fovino MD, PhD , Tommaso Fabris MD , Francesco Cardaioli MD , Andrea Panza MD , Giulia Lorenzoni MD, PhD , Massimo Napodano MD, PhD , Chiara Fraccaro MD, PhD , Giuseppe Tarantini MD, PhD

Right-sided cardiac catheterization (RHC) is selectively recommended in mitral valve transcatheter edge-to-edge (M-TEER) workup because right ventricle (RV) hemodynamic parameters predict adverse outcomes. This study examines the impact of RV hemodynamics and the prognostic value of the 2022 European Society of Cardiology (ESC) pulmonary hypertension definitions on outcomes after M-TEER. Of 152 patients treated with M-TEER for symptomatic severe mitral regurgitation (MR) between December 2014 and February 2024 at our tertiary center, 71 underwent elective RHC before the procedure. The primary outcomes assessed were all-cause mortality and a composite of heart failure hospitalization and death at the longest available follow-up. In a cohort of 152 mostly male patients (64%) with a median age of 79 years who were treated for symptomatic severe MR, 71 underwent elective RHC. The causes were categorized as degenerative (47%), functional ventricular (41%), and atrial (12%). Pulmonary hypertension (PH) was common, with 74% showing mean pulmonary artery pressure (mPAP) >20 mm Hg and 39% with pulmonary vascular resistance (PVR) >2 Wood Units. Success rates were high, with technical, device, and procedural success at 97%, 88%, and 84%, respectively. At a median follow-up of 681 days, all-cause mortality was 50%, and the composite outcome (death or heart failure hospitalizations) occurred in 61%. Key hemodynamic parameters, including mPAP, PVR, and the tricuspid annular plane systolic excursion/systolic pulmonary artery pressure ratio, were independently linked to mortality risk. Kaplan-Meier analysis found significant associations with mPAP >20 mm Hg and pulmonary capillary wedge pressure >15 mm Hg for long-term mortality, whereas the 2022 ESC PH thresholds showed greater sensitivity, correlating with increased mortality risk. In patients with severe MR who undergo M-TEER, most RV invasive hemodynamic parameters are linked to adverse long-term outcomes, with mPAP, PVR, and the tricuspid annular plane systolic excursion/systolic pulmonary artery pressure ratio identified as independent predictors of mortality. Despite the study's limited sample size, the updated ESC PH definitions enhance prognostic assessment.

由于右心室（RV）血流动力学参数可预测不良预后，因此在二尖瓣经导管边对边（M-TEER）检查中选择性推荐右侧心导管检查（RHC）。本研究探讨了右心室血流动力学和 2022 年欧洲心脏病学会（ESC）肺动脉高压定义对 M-TEER 术后预后的影响。2014年12月至2024年2月期间，在我们的三级中心接受M-TEER治疗的152例症状性重度二尖瓣反流（MR）患者中，71例在术前接受了选择性RHC治疗。评估的主要结果是全因死亡率以及最长随访时间内心衰住院和死亡的复合死亡率。在一个由152名男性患者（64%）组成的队列中，中位年龄为79岁，他们都曾接受过无症状重度MR治疗，其中71人接受了选择性RHC手术。病因分为退行性（47%）、功能性室性（41%）和房性（12%）。肺动脉高压（PH）很常见，74%的患者平均肺动脉压（mPAP）大于20毫米汞柱，39%的患者肺血管阻力（PVR）大于2伍德单位。成功率很高，技术、设备和手术成功率分别为 97%、88% 和 84%。中位随访时间为 681 天，全因死亡率为 50%，综合结果（死亡或心衰住院）发生率为 61%。包括 mPAP、PVR 和三尖瓣环面收缩期偏移/收缩期肺动脉压力比值在内的主要血液动力学参数与死亡风险有独立联系。Kaplan-Meier 分析发现，mPAP >20 mm Hg 和肺毛细血管楔压 >15 mm Hg 与长期死亡率有显著相关性，而 2022 ESC PH 临界值显示出更高的敏感性，与死亡率风险增加相关。在接受 M-TEER 的重度 MR 患者中，大多数 RV 有创血流动力学参数与不良的长期预后有关，其中 mPAP、PVR 和三尖瓣环平面收缩期偏移/收缩期肺动脉压力比值被认为是死亡率的独立预测因素。尽管该研究的样本量有限，但更新后的ESC PH定义加强了预后评估。

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引用次数: 0

Cardiovascular Prognosis in Limb Ischemia Patients With Heart Failure and Systolic Dysfunction Following Major Amputation 肢体缺血合并心力衰竭和收缩功能障碍患者的心血管预后。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2024-12-31 DOI: 10.1016/j.amjcard.2024.12.031

Takuma Takada MD, PhD , Eiji Shibahashi MD, PhD , Shun Hasegawa MD , Ayano Yoshida MD, PhD , Makoto Kishihara MD , Shonosuke Watanabe MD , Shota Shirotani MD, PhD , Takuro Abe MD , Masashi Nakao MD, PhD , Junichi Yamaguchi MD, PhD , Kentaro Jujo MD, PhD

Chronic limb-threatening ischemia (CLTI), the severest stage of peripheral artery disease, frequently necessitates amputation. In CLTI patients, heart failure with reduced ejection fraction (HFrEF) markedly raises mortality risk, with increased peripheral vascular resistance contributing to this exacerbation. This investigation aimed to assess the impact of major amputation (MA) on the cardiovascular (CV) prognosis in CLTI patients with HFrEF by lowering peripheral vascular resistance. Conducting a retrospective, observational analysis at a single center, a total of 60 patients with CLTI and HFrEF (EF < 50%) who underwent endovascular therapy (EVT) at our institution were assessed. We compared CV outcomes in CLTI patients with HFrEF who received MA (n = 17) to those who did not (n = 43) after undergoing EVT. During the follow-up period, which median 641 (IQR: 245 to 1,734) days post-EVT, a composite primary endpoint of CV death or hospitalization for HF was observed. During the study period, 19 patients (32%) were admitted for HF or died as a consequence of CV events. Kaplan-Meier analysis revealed a significantly reduced incidence of the primary endpoint in the MA cohort (log-rank test: p = 0.035). Adjustments for age and sex showed MA was significantly linked to improved CV prognosis (HR: 0.19; 95% confidence interval: 0.04 to 0.87). A nonsignificant trend toward decreased overall mortality was noted in the MA group, with infections being the predominant cause of death across both groups. In conclusion, in CLTI patients with HFrEF, MA might be linked to reduced CV events, proposing it as a potential definitive strategy for improving CV outcomes in this high-risk population.

慢性肢体威胁缺血（CLTI）是外周动脉疾病最严重的阶段，经常需要截肢。在CLTI患者中，心力衰竭伴射血分数降低（HFrEF）显著增加死亡风险，外周血管阻力增加导致这种恶化。本研究旨在通过降低周围血管阻力来评估大截肢（MA）对CLTI HFrEF患者心血管（CV）预后的影响。在单个中心对60例CLTI和HFrEF患者进行回顾性观察分析

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引用次数: 0

Hospital-Level Disparities in the Management and Outcomes of Pulmonary Embolism 肺栓塞治疗和预后的医院水平差异

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2024-12-31 DOI: 10.1016/j.amjcard.2024.12.030

Aryan Mehta MD , Mridul Bansal MD , Abhishek Singh MD , Ritika Kompella MD , Anindita Chanda DO , Chirag Mehta MD , Christopher J. Mullin MD , J. Dawn Abbott MD , Saraschandra Vallabhajosyula MD, MSc

引用次数: 0

Clinical Outcomes for Postinfarct Ventricular Septal Defect Repair in a Large State-Wide Surgical Registry 梗死后室间隔缺损修复的临床结果在全国范围内的大型外科登记。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2024-12-30 DOI: 10.1016/j.amjcard.2024.12.028

Mohamad B. Moumneh MD , Mohammed A. Quader MD , Nicholas R. Teman MD , Daniel Tang MD , Liam Ryan MD , Raymond J. Strobel MD, MSc , Mark Joseph MD , Michael Mazzeffi MD , Zachary M. Gertz MD , Michael C. Kontos MD , Ramesh Singh MD , Alan Spier MD , Eric Sarin MD , Abdulla A. Damluji MD, PhD, MBA

Ventricular septal defect (VSD) is a life-threatening complication occurring after delayed presentation of acute myocardial infarction (AMI). We assessed clinical characteristics based on mortality following surgical repair of post-AMI VSD and evaluated trends of mortality, mechanical circulatory support (MCS) device use, and surgical approach. We included all patients who had surgical VSD repair following AMI who were included in a regional quality collaborative from May 2008 through January 2020. The primary outcome was in-hospital mortality. A univariate logistic regression model was utilized for each clinical variable on in-hospital mortality, while a multivariable model was used on age and variables that showed significant association (p <0.05) in the univariable model. Of the 79 patients who received repair, 32 (41%) were ≥70 years, 49 (62%) were male, and 28 (35%) died. The preoperative mean ejection fraction was 35%. Cardiogenic shock (CS) was observed in 53% (alive vs dead: 39% vs 79%, p = 0.001), while 6% required cardiopulmonary resuscitation (alive vs dead: 2% vs 14%, p = 0.05). MCS devices including extracorporeal membrane oxygenation were used in 22% (alive vs dead: 4% vs 54%, p <0.001). Emergent surgery was performed in 37% (alive vs dead: 18% vs 71%, p <0.001), concomitant aortic valve replacement in 10% (alive vs dead: 11% vs 9%, p = 0.029), and delayed intervention (beyond 7 days) in 44% (alive vs dead: 57% vs 21%, p = 0.002). Intraoperatively, blood products were used in 49% (alive vs dead: 45% vs 57%, p = 0.005). Following repair, 22% suffered from renal failure (alive vs dead: 19% vs 48%, p = 0.021). Patients who experienced delayed intervention had higher survival rates probably related to survival bias. Patients who suffered in-hospital mortality were more likely to have CS and to require MCS. Improvement in patient selection by a “Heart Team” approach and new therapeutic options are needed as part of advanced care for mechanical complications of AMI.

室间隔缺损（VSD）是急性心肌梗死（AMI）延迟表现后发生的危及生命的并发症。我们根据ami后室间隔缺损手术修复后的死亡率评估临床特征，并评估死亡率、机械循环支持（MCS）装置使用和手术入路的趋势。我们纳入了2008年5月至2020年1月区域质量协作的所有AMI术后VSD手术修复患者。主要终点是住院死亡率。对住院死亡率的每个临床变量使用单变量logistic回归模型，而对年龄和显示显着相关性的变量使用多变量模型(p

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引用次数: 0

The Integrated Multidisciplinary Pathway for Large-Scale Management of Dyslipidemia in High-Risk Patients (ENNA) Project: Rationale and Project Design 综合多学科途径大规模管理高危患者血脂异常（ENNA）项目：理论基础和项目设计。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2024-12-26 DOI: 10.1016/j.amjcard.2024.12.027

Federica Agnello MD , Calogero Russo PharmD , Giulia Laterra MD , Salvatore Ingala MD , Stefania Saragoni BSc , Mario Giuffrida PharmD , Paola Maria Greca PharmD , Francesco La Tona MD , Noemi Rinaldi MD , Ilaria Gagliano MD , Carmela Nappi MSc , Alessandro Ghigi MSc , Maria Cappuccilli BSc, PhD , Luca Degli Esposti PhD , Lorenzo Scalia MD , Emanuele Cassarà MD , Marco Barbanti MD

Atherosclerotic cardiovascular disease is a leading cause of morbidity and mortality globally, significantly influenced by modifiable risk factors, particularly hypercholesterolemia. Despite the availability of effective lipid-reducing drugs, achieving the low-density lipoprotein cholesterol (LDL-C) target levels remains a significant challenge in clinical practice, contributing to persistently high rates of cardiovascular events. The intEgrated multidiscipliNary pathway for large-scale maNagement of dyslipidemiA in high-risk patients (ENNA) Project was designed to address the alarming rates of suboptimal lipid management in patients at high and very-high risk in the province of Enna, Sicily. This program aims to optimize LDL-C control through an integrated care model that fosters collaboration among pharmacists, general practitioners, and cardiologists, ultimately promoting a patient-centered approach to therapy. The patients who are eligible are identified using data-driven methods through prescription claims, laboratory results, and hospital discharge data, facilitated by local pharmacies. General practitioners play a crucial role as the primary care providers for initiating or optimizing lipid-reducing therapy, whereas cardiologists are involved in managing more complex cases requiring specialized intervention. The primary objective of the ENNA Project is to increase the percentage of patients at great risk in whom LDL-C targets are achieved, improving overall lipid management and therapeutic adherence.

动脉粥样硬化性心血管疾病（ASCVD）是全球发病率和死亡率的主要原因，受可改变的危险因素，特别是高胆固醇血症的显著影响。尽管有有效的降脂药物，但在临床实践中，实现低密度脂蛋白胆固醇（LDL-C）的目标水平仍然是一个重大挑战，导致心血管事件的持续高发。高风险患者血脂异常大规模管理综合多学科途径（ENNA）项目旨在解决西西里岛ENNA省高风险和极高风险患者中不理想脂质管理的惊人比率。该项目旨在通过促进药剂师、全科医生（gp）和心脏病专家之间合作的综合护理模式，优化LDL-C控制，最终促进以患者为中心的治疗方法。在当地药房的协助下，通过处方索赔、实验室结果和出院数据，使用数据驱动的方法确定符合条件的患者。全科医生作为初级保健提供者在启动或优化降脂治疗方面发挥着至关重要的作用，而心脏病专家则参与管理更复杂的病例，需要专门的干预。ENNA项目的主要目标是提高高危患者达到LDL-C目标的百分比，改善整体脂质管理和治疗依从性。

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引用次数: 0

Gender Differences in Acute Type A Aortic Dissection: A Comprehensive Review and Meta-Analysis 急性A型主动脉夹层的性别差异：综合综述和荟萃分析。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2024-12-24 DOI: 10.1016/j.amjcard.2024.12.023

He Jiao MM , Xiankun Liu MD , Yiming Bai MD , Lin Cong MM , Yunpeng Bai MD , Zhigang Guo MD

We aimed to undertake a meta-analysis of cohort studies to evaluate gender-based differences for patients with acute type A aortic dissection. A systematic search was performed across PubMed, Embase, and Cochrane Library (2000 to 2023) for studies reporting gender-related discrepancies in clinical presentation, in-hospital management, and/or outcomes. Study effects were assessed using mean difference or risk ratio (RR) as aggregated estimates. Besides, individual patient-level data on survival were reestablished to form gender-related Kaplan–Meier curves to evaluate long-term survival outcome. The study protocol was registered in PROSPERO (ID: CRD42024524125). The 21 studies were analyzed, comprising 6,728 women and 12,839 men. Women had lower risks of postoperative acute kidney injury (RR 0.85; 95% confidence interval [CI] 0.72 to 1.00, p = 0.049) and reoperation (RR 0.89; 95% CI 0.81 to 0.99, p = 0.024) but a higher perioperative mortality (RR 1.11; 95% CI 1.03 to 1.18, p = 0.005) than men. In addition, the overall survival was poorer in women (p <0.001), with 10-year survival rates of 66.5% for men and 60.0% for women. In conclusion, acute type A aortic dissection presents gender differences, with women facing higher perioperative and long-term mortality despite lower acute kidney injury and reoperation risks, suggesting a need for tailored management and prevention strategies.

目的：对队列研究进行荟萃分析，以评估急性a型主动脉夹层（ATAAD）患者的性别差异。方法：在PubMed、Embase和Cochrane图书馆（2000-2023）中进行系统检索，以报告临床表现、和/或院内管理和/或结果中与性别相关的差异。利用平均差异或风险比（RR）作为汇总估计来评估研究效果。此外，重新建立个体患者水平的生存数据，形成与性别相关的Kaplan-Meier曲线，以评估长期生存结果。该研究方案已在PROSPERO注册（ID: CRD42024524125）。结果：对21项研究进行分析，包括6728名女性和12839名男性。女性术后AKI风险较低(RR, 0.85；95% CI, 0.72-1.00, P = 0.049)和再手术(RR, 0.89；95% CI, 0.81-0.99, P = 0.024)，但围手术期死亡率较高(RR, 1.11；95% CI, 1.03-1.18, P = 0.005)高于男性。此外，女性的总生存率较低（P < 0.001），男性的10年生存率为66.5%，女性为60.0%。结论：ATAAD存在性别差异，女性患者围手术期和远期死亡率较高，但AKI和再手术风险较低，提示需要有针对性的管理和预防策略。

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引用次数: 0

Long-Term Outcomes of True Versus Nontrue Coronary Bifurcation Lesions Treated With Bioresorbable Polymer Sirolimus-Eluting Ultimaster Stent Under Intravascular Imaging Guidance 血管内成像指导下生物可吸收聚合物西罗莫司洗脱Ultimaster支架治疗真与非真冠状动脉分叉病变的长期疗效

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2024-12-24 DOI: 10.1016/j.amjcard.2024.12.025

Nobuki Matsuna MD, Shoichi Kuramitsu MD, PhD, Yutaka Tadano MD, Takuro Sugie MD, Umihiko Kaneko MD, Hisanori Yui MD, PhD, Takuya Shimizu MD, PhD, Shigeyoshi Miura MD, Ken Kobayashi MD, Daitaro Kanno MD, Yoshifumi Kashima MD, Tsutomu Fujita MD

Limited evidence exists regarding the long-term outcomes of true versus nontrue coronary bifurcation lesions (CBLs) treated with current-generation drug-eluting stents and intravascular imaging guidance. The Sapporo Cardiovascular Clinic (SCVC) registry was a prospective, single-center, all-comers registry enrolling 1,727 consecutive patients treated with bioresorbable polymer sirolimus-eluting stent under complete imaging guidance. From this registry, 440 patients with CBLs (25.5%) were analyzed. Patients were categorized into the true and nontrue CBL groups according to the Medina classification (n = 234 and 206, respectively). The primary end point was the cumulative incidence of target vessel failure (TVF) (a composite of cardiac death, target vessel-related myocardial infarction, and clinically driven target vessel revascularization). The 1-stent strategy was predominantly chosen for the true and nontrue CBL groups (93.9% and 96.2%, respectively). During the median follow-up of 5.4 years, the cumulative incidence of TVF did not differ between true and nontrue CBL groups after adjustment for baseline differences (5-year incidence 22.0% vs 17.7%, adjusted hazard ratio 1.27, 95% confidence interval 0.79 to 2.05, p = 0.32). Although the Medina 0.0.1 lesions were very rare (1.1%), they had the highest rate of TVF among the Medina subtypes. Final kissing balloon inflation technique was associated with a lower incidence of TVF (p = 0.036). In conclusion, imaging-guided percutaneous coronary intervention with bioresorbable polymer sirolimus-eluting stent resulted in comparable long-term clinical outcomes between true and nontrue CBLs, primarily using the 1-stent technique.

关于当前一代药物洗脱支架和血管内成像引导治疗真与非真冠状动脉分叉病变（CBLs）的长期结果，证据有限。SCVC（札幌心血管诊所）登记是一项前瞻性、单中心、全患者登记，纳入1,727例连续患者，在完全成像指导下接受生物可吸收聚合物西罗莫司洗脱支架（BP-SES）治疗。从该注册表中，分析了440例CBLs患者（25.5%）。根据Medina分类将患者分为真CBL组和非真CBL组（n=234和206）。主要终点是靶血管衰竭的累积发生率(TVF；心源性死亡、靶血管相关性心肌梗死和临床驱动靶血管重建术的复合。真实和非真实CBL组均主要选择单支架策略（分别为93.9%和96.2%）。在中位随访5.4年期间，在基线差异调整后，真CBL组和非真CBL组之间TVF的累积发病率没有差异(5年发病率；22.0% vs. 17.7%，校正风险比1.27[95%可信区间：0.79-2.05]；P = 0.32)。虽然Medina 0.0.1病变非常罕见（1.1%），但在Medina亚型中TVF发生率最高。最后接吻气球充气技术与较低的TVF发生率相关（P=0.036）。总之，成像引导下的BP-SES PCI在真性和非真性CBLs之间的长期临床结果可比较，主要使用单支架技术。

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引用次数: 0

Intervening on Partial Anomalous Pulmonary Venous Return Without Leaving a Trace Ready for a Minimally Invasive Future? 介入部分异常肺静脉回流而不留下痕迹准备好微创的未来了吗？

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2024-12-24 DOI: 10.1016/j.amjcard.2024.12.026

Georges Ephrem

引用次数: 0

Comparison of Alcohol Septal Ablation With Mavacamten in Obstructive Hypertrophic Cardiomyopathy 酒精室间隔消融术与马伐卡坦治疗梗阻性肥厚性心肌病的比较。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2024-12-24 DOI: 10.1016/j.amjcard.2024.12.024

Ashraf Samhan MD , Danish Saleh MD, PhD , Ellis Y. Kim MD, PhD , Mo Hu MS , Kayla Mueller BSN, RN , Abigail Garza BSN, RN , Elizabeth Schormann MPH , Parmeen Bindra MS, MBA , Baljash Cheema MD, MSCI, MSAI , Dominic E. Fullenkamp MD, PhD , Abigail S. Baldridge DrPH , Jyothy J. Puthumana MD , James D. Flaherty MD , Lubna Choudhury MD, MRCPI

Obstructive hypertrophic cardiomyopathy (HCM) is associated with significant morbidity attributed to left ventricular outflow tract (LVOT) obstruction. Although alcohol septal ablation (ASA) is an established interventional treatment, mavacamten, a novel cardiac myosin inhibitor, has emerged as a noninvasive pharmacologic alternative. Understanding the comparative efficacy of these 2 treatments is important for optimizing patient care. This single-center retrospective study assessed the hemodynamic and functional changes in adult patients with obstructive HCM treated with ASA (n = 58) or mavacamten (n = 36) from July 2012 to May 2024. Outcomes, including changes in LVOT gradient, left ventricular ejection fraction, mitral regurgitation (MR) severity, and New York Heart Association (NYHA) class, were collected at baseline, 16 weeks, and after 32 weeks of treatment. ASA and mavacamten were associated with over 70% reductions in Valsalva-induced LVOT gradient and MR after 32 weeks. The maximal effect of ASA on LVOT gradient was observed at 16 weeks, whereas mavacamten's peak effect was noted after 32 weeks. MR severity improved similarly in both cohorts (p <0.01). Patients who underwent ASA had a poorer baseline NYHA functional class than their counterparts; however, each treatment significantly improved LVOT gradients (p <0.001) and average NYHA class after 32 weeks (p <0.001). The average left ventricular ejection fraction was comparable at baseline and after 32 weeks between the 2 groups. Patients treated with ASA were older than those treated with mavacamten (68.5 vs 60.8 years, p <0.001). In patients with obstructive HCM, ASA and mavacamten yield significant and comparable improvements in hemodynamics and functional status after 32 weeks.

背景：梗阻性肥厚性心肌病（HCM）与左心室流出道（LVOT）梗阻相关。虽然酒精室间隔消融术（ASA）是一种成熟的介入治疗方法，但马伐卡坦，一种新型心肌肌球蛋白抑制剂，已成为一种非侵入性药物替代方法。了解这两种治疗方法的比较疗效对于优化患者护理非常重要。方法：本单中心回顾性研究评估了2012年7月至2024年5月接受ASA （n=58）或马伐卡坦（n=36）治疗的成人阻塞性HCM患者的血流动力学和功能变化。结果，包括LVOT梯度、左室射血分数（LVEF）、二尖瓣反流（MR）严重程度和纽约心脏协会（NYHA）等级的变化，在治疗后基线、16周和32周收集。结果：ASA和马伐camten在32周后缬沙瓦诱导的LVOT梯度和MR降低超过70%。ASA对LVOT梯度的影响在16周时达到最大，而马伐卡坦的影响在32周后达到峰值。两组患者的MR严重程度改善相似（p < 0.01）。ASA患者的基线NYHA功能等级较差，但每次治疗均显著改善LVOT梯度（p < 0.001）和32周后的平均NYHA等级（p < 0.001）。两组在基线和32周后的平均LVEF具有可比性。接受asa治疗的患者比接受mavacamten治疗的患者年龄大（68.5岁vs 60.8岁，p < 0.001）。结论：在阻塞性HCM患者中，ASA和马伐卡坦在32周后可显著改善血液动力学和功能状态。

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引用次数: 0

The Importance of Time from Event in Assessing Mortality in Patients With ST-Segment Elevation Myocardial Infarction and Non-ST-Segment Elevation Myocardial Infarction. 事件间隔时间在评估STEMI和NSTEMI患者死亡率中的重要性。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2024-12-22 DOI: 10.1016/j.amjcard.2024.12.022

Sahib Singh, Udaya S Tantry, Young-Hoon Jeong, Paul A Gurbel

引用次数: 0