American Journal of Cardiology最新文献

{"title":"Echocardiographic Predictors of Mortality in Cardiac Intensive Care Unit Patients With Pulmonary Hypertension","authors":"Meir Tabi MD ,&nbsp;Mitchell Padkins MD ,&nbsp;Limor Ilan Bushari MD ,&nbsp;Jeremy Thaden MD ,&nbsp;Michael A Solomon MD, MBA ,&nbsp;Garvan C Kane MD, PhD ,&nbsp;Jacob C. Jentzer MD","doi":"10.1016/j.amjcard.2025.09.060","DOIUrl":"10.1016/j.amjcard.2025.09.060","url":null,"abstract":"<div><div>Pulmonary Hypertension (PH) is associated with high mortality in Cardiac Intensive Care Unit (CICU) patients. We sought to determine the association of Transthoracic Echocardiography (TTE) parameters with in-hospital mortality in patients admitted to the CICU, and found to have PH. We included Mayo Clinic CICU admissions from 2007 to 2018, with a TTE within 1 day of CICU admission demonstrating PH, defined as estimated right ventricular systolic pressure (RVSP) ≥36 mmHg. Logistic regression was used to identify predictors of in-hospital mortality. We included 3085 unique CICU patients with PH by TTE; median age was 73.7 (63.8, 82.4) years, and 1343 (43.5%) were females. Heart failure (65.6%) and respiratory failure (34.0%) were the most common admission diagnoses. The median RVSP was 47 (41, 56) mmHg, and 1314 (42.6%) had RVSP ≥50 mmHg. A total of 337 (10.9%) patients died during hospitalization. The RVSP was higher among in-hospital deaths (51 vs 47 mmHg, p &lt; 0.001), reflecting higher right atrial (RA) pressure (14 versus 10 mmHg, p &lt; 0.001). In-hospital mortality increased with higher RA pressure and worse Right Ventricle-Pulmonary Artery (RV-PA) coupling, such as a lower tricuspid S’ velocity to RVSP ratio (AUC 0.72) or higher pulmonary artery elastance (AUC 0.72). In conclusion, in CICU patients found to have elevated pulmonary pressures, several 2D and Doppler TTE parameters predict in-hospital mortality. Specifically, RA pressure and parameters of RV-PA coupling, had highest association with worse outcomes. Early identification of high-risk hemodynamic parameters may facilitate improved investigation, management, and prognostication.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"257 ","pages":"Pages 245-252"},"PeriodicalIF":2.1,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285421","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":"Comparative Outcomes and Cardiac Imaging Features in Light Chain Versus Transthyretin Cardiac Amyloidosis: A Multicenter Retrospective Cohort Study","authors":"Hassan Mahmood MD ,&nbsp;Julius Albert Kato DO","doi":"10.1016/j.amjcard.2025.09.063","DOIUrl":"10.1016/j.amjcard.2025.09.063","url":null,"abstract":"<div><div>Cardiac amyloidosis, most commonly presenting as immunoglobulin light-chain (AL) and wild-type transthyretin (ATTR-wt) subtypes, has distinct pathophysiological features and prognoses. Accurate differentiation between these forms is critical for patient management. We conducted a multicenter retrospective cohort study of 200 patients (100 AL, 100 ATTR-wt) diagnosed between 2015 and 2022 within the Baptist Health System in the Southern United States. Clinical, biochemical, echocardiographic, and cardiac magnetic resonance imaging data were systematically reviewed. Patients with light-chain amyloidosis were younger, exhibited higher serum proBNP, lower left ventricular ejection fraction, and greater impairment in global longitudinal strain compared with those with transthyretin amyloidosis. Imaging patterns also differed, with subendocardial late gadolinium enhancement predominating in AL and transmural enhancement more frequent in ATTR-wt. Clinically, AL patients experienced substantially higher heart failure hospitalization rates and worse 2-year survival. In conclusion, significant demographic, imaging, and outcome differences exist between light-chain and transthyretin cardiac amyloidosis, highlighting the importance of multimodal assessment to guide timely and targeted management strategies.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"257 ","pages":"Pages 240-244"},"PeriodicalIF":2.1,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285471","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 High-Density Lipoprotein Cholesterol and the Risk of Cardiovascular Disorders: A Cohort Study of Healthy Adults","authors":"Bo Eun Park MD ,&nbsp;Kang-Un Choi MD, PhD ,&nbsp;Ji-Yong Choi MD, PhD ,&nbsp;Hyungseop Kim MD, PhD ,&nbsp;Sojeong Park MPH ,&nbsp;Hasung Kim MPH","doi":"10.1016/j.amjcard.2025.10.004","DOIUrl":"10.1016/j.amjcard.2025.10.004","url":null,"abstract":"<div><div>High-density lipoprotein cholesterol (HDL-C) has been considered protective against cardiovascular (CV) disease, but its correlation with reduced CV risk was inconsistent. This retrospective study analyzed the relationship between HDL-C levels and CV outcomes from South Korea’s National Health Insurance Service on healthy adults, focusing on conditions such as ischemic heart disease (IHD), stroke, heart failure (HF), and mortality. Cox proportional hazards regression and Kaplan-Meier curves were used for primary (CV death, IHD, stroke) and secondary (plus all-cause mortality and HF) composite endpoints. Covariates included age, sex, body mass index, blood pressure, lipid levels, glucose levels, and medication use. From 2009 to 2022, a total of 810,848 subjects were enrolled and divided into three groups based on HDL-C levels: HDL-<em>C</em> ≤ 40 mg/dL, 40 &lt; HDL-<em>C</em> &lt; 60 mg/dL, and HDL-<em>C</em> ≥ 60 mg/dL. Compared with the reference group (HDL-C, 40-60 mg/dL), individuals with HDL-<em>C</em> ≤ 40 mg/dL had increased risks of all-cause mortality (HR 1.05, 95% CI 1.02-1.08), CV death (HR 1.12, 95% CI 1.05-1.20), ischemic stroke (HR 1.11, 95% CI 1.07-1.15), IHD (HR 1.08, 95% CI 1.06-1.09), and HF (HR 1.09, 95% CI 1.05-1.13). HDL-<em>C</em> ≥ 60 mg/dL was associated with a lower risk of IHD (HR 0.95, 95% CI 0.94-0.96) but a higher risk of hemorrhagic stroke (HR 1.13, 95% CI 1.08-1.19). A U-shaped association was observed for all-cause mortality. In conclusion, higher HDL-C was associated with lower CVD risk but increased hemorrhagic stroke and all-cause mortality, suggesting the need for nuanced HDL-C interpretation.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"257 ","pages":"Pages 200-206"},"PeriodicalIF":2.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273322","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":"The Efficacy of Hemostatic Agents on Radial Artery Compression Methods Following Transradial Procedures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Carlos De Melo Neto MS ,&nbsp;Mariana Kondo Obara MS ,&nbsp;Denise Filippini MS ,&nbsp;Miguel Godeiro Fernandez MD ,&nbsp;Dilson Pimentel-Junior MS ,&nbsp;Milena Monteiro Mastra MS ,&nbsp;Enrico Prajiante Bertolino MD ,&nbsp;Grace Carvajal Mulatti MD, PhD","doi":"10.1016/j.amjcard.2025.09.058","DOIUrl":"10.1016/j.amjcard.2025.09.058","url":null,"abstract":"<div><div>Radial artery hemostasis in patients undergoing transradial procedures can be achieved through various compression methods, including manual or mechanical devices, with or without the use of hemostatic agents, and may involve patent hemostasis or concomitant ulnar compression. Previous findings suggest that radial artery compression should be maintained for 120 minutes postprocedure. However, the optimal compression method and the efficiency of hemostatic agents remain uncertain. Therefore, we decided to perform a systematic review and meta-analysis evaluating the efficacy of radial artery compression with adjunctive hemostatic agents versus compression without hemostatic agents on patients following transradial procedures. The systematic search was conducted using PubMed, Embase, and Cochrane Central databases. The outcomes evaluated were: time to achieve hemostasis (TAH), failure to achieve hemostasis (FAH), 24-hour radial artery occlusion (24-RAO), and hematoma occurrence. We performed subgroup analyses separating manual and mechanical compression with hemostatic agents. 13 randomized controlled trials were included, comprising 6,588 patients. 2,924 (44.4%) patients underwent compression with hemostatic agents, and 3,664 (55.6%) underwent compression without hemostatic agents. The statistical analysis indicated that hemostatic agents were associated with a significantly reduced TAH (MD -86.59 min; 95% CI -106.88 to -66.30; p &lt; 0.01) compared to compressions without hemostatic agents. No statistical difference was found between the methods regarding 24-RAO, FAH, and hematoma occurrence. However, subgroup analyses revealed that, in the manual compression with hemostatic agents subgroup, 24-RAO was also significantly reduced (RR 0.46; 95% CI 0.27–0.78). In conclusion, this meta-analysis of randomized controlled trials reveals that compression with hemostatic agents, compared to compressions without hemostatic agents, can reduce TAH without compromising the occurrence of hematomas for patients following transradial procedures. 24-RAO was also less frequent in patients who underwent manual compression with hemostatic agents.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"258 ","pages":"Pages 210-217"},"PeriodicalIF":2.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273551","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 Pulmonary Disease on Clinical Outcomes in Patients Undergoing Mitral Valve Edge-to-Edge Repair","authors":"Juri Iwata MD ,&nbsp;Masanori Yamamoto MD ,&nbsp;Toshinobu Ryuzaki MD ,&nbsp;Hikaru Tsuruta MD ,&nbsp;Takashige Yamada MD ,&nbsp;Hideyuki Shimizu MD ,&nbsp;Shunsuke Kubo MD ,&nbsp;Yuki Izumi MD ,&nbsp;Mike Saji MD ,&nbsp;Masahiko Asami MD ,&nbsp;Yusuke Enta MD ,&nbsp;Shinichi Shirai MD ,&nbsp;Masaki Izumo MD ,&nbsp;Shingo Mizuno MD ,&nbsp;Yusuke Watanabe MD ,&nbsp;Makoto Amaki MD ,&nbsp;Kazuhisa Kodama MD ,&nbsp;Hisao Otsuki MD ,&nbsp;Toru Naganuma MD ,&nbsp;Hiroki Bota MD ,&nbsp;Kentaro Hayashida MD","doi":"10.1016/j.amjcard.2025.10.005","DOIUrl":"10.1016/j.amjcard.2025.10.005","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary diseases (PD) are frequently associated with impaired cardiac function and the presence of mitral and tricuspid regurgitation (MR and TR).</div></div><div><h3>Objectives</h3><div>The study aimed to clarify the impact of PD on clinical outcomes following mitral transcatheter edge-to-edge repair (M-TEER).</div></div><div><h3>Methods</h3><div>Of the 3,764 patients who underwent M-TEER, 3,666 were included in the analysis and stratified according to the absence or presence of PD before the procedure. The primary endpoint was all-cause mortality, evaluated using Kaplan-Meier analysis. Cardiovascular and non-cardiovascular mortality and HFH (HFH) were also assessed during a 4-year follow-up. Moreover, the prognostic impact of TR improvement after M-TEER was evaluated in patients with and without PD.</div></div><div><h3>Results</h3><div>Of the 3,666 patients, 580 (15.8%) had PD, included fewer women, and exhibited greater frailty compared with those without PD. Within a median follow-up of 432 [314–826] days, all-cause mortality did not differ significantly between patients with PD and those without (150 [25.9%] vs. 682 [22.1%], Log rank P = 0.331). No significant differences were observed in the incidence of cardiovascular mortality, non-cardiovascular mortality, and HFH between the two groups. When stratified by PD status, residual significant TR after M-TEER was significantly associated with HFH both in patients with PD and without PD.</div></div><div><h3>Conclusions</h3><div>The intermediate-term prognosis after M-TEER was comparable between patients with and without PD. In patients with PD, MR was effectively reduced through minimally invasive M-TEER. However, appropriate management of TR after MTEER may be required to improve outcomes in this population.</div></div><div><h3>Clinical trials</h3><div>OCEAN-Mitral registry (UMIN-ID: UMIN000023653).</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"257 ","pages":"Pages 263-274"},"PeriodicalIF":2.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273462","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":"Aortic Arch Morphology and Cerebrovascular Accidents After Transfemoral Transcatheter Aortic Valve Implantation","authors":"Laura Baltruskeviciute MD ,&nbsp;Federico Moccetti MD ,&nbsp;Mathias Wolfrum MD ,&nbsp;Lucca Loretz MD ,&nbsp;Stephanie Brunner MD ,&nbsp;Maani Hakimi MD ,&nbsp;Peter Matt MD ,&nbsp;Stefan Toggweiler MD","doi":"10.1016/j.amjcard.2025.09.066","DOIUrl":"10.1016/j.amjcard.2025.09.066","url":null,"abstract":"<div><div>Cerebrovascular accidents (CVA) after transcatheter aortic valve implantation (TAVI) remain a major concern. However, the impact of aortic arch morphology has not been investigated in this context. To address this gap, consecutive patients undergoing transfemoral TAVI between March 2009 and January 2025 were analysed. Aortic arch morphology was assessed on preprocedural computed tomography scans, including measurements of arch angle, presence of calcification and soft plaques. Patients were classified as having an acutely angled (gothic, angle ≤ 138°) aortic arch or a round (romanesque, angle &gt; 138°) arch. The primary endpoint was the occurrence of CVA within 30 days following TAVI. A total of 1248 patients with a mean age of 81 ± 6 years (44% female) were studied. CVA occurred in 38 patients (3.0%) within 30 days. Notably, patients who experienced CVA had a significantly higher prevalence of a round arch (89% versus 72%, p = 0.021) and soft plaques along the outer curvature (45% versus 26%, p = 0.010). Other predictors of CVA included peripheral arterial disease (29% versus 12%, p = 0.002) and implantation of more than 1 transcatheter heart valve (11% versus 2%, p &lt; 0.001). Interestingly, use of cerebral protection devices did not reduce stroke rates. In conclusion, an acutely angled (gothic) arch was not associated with increased risk for CVA within 30 days after TAVI. Instead, a round arch and soft plaques along the outer curvature were associated with more strokes. Such patients may benefit from careful advancement of the valve catheter when crossing the aortic arch or an alternative (transapical, direct aortic) access route.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"258 ","pages":"Pages 229-233"},"PeriodicalIF":2.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278892","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":"Angiographically-Derived Physiological Assessment of Myocardial Bridging. An Elegant Rationale in Search of Clinical Application","authors":"Fernando Alfonso MD,&nbsp;Javier Cuesta MD,&nbsp;Fernando Rivero MD","doi":"10.1016/j.amjcard.2025.10.003","DOIUrl":"10.1016/j.amjcard.2025.10.003","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"258 ","pages":"Pages 361-363"},"PeriodicalIF":2.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273328","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":"Comparative outcomes of interventions for femoropopliteal occlusive disease in patients with chronic renal insufficiency from the multicenter XLPAD registry","authors":"Holly Haley DO ,&nbsp;Shirling Tsai MD ,&nbsp;Yulun Liu PhD ,&nbsp;David Fernandez Vazquez MD ,&nbsp;Bala Ramanan MD ,&nbsp;John F. Eidt MD ,&nbsp;Sameh Sayfo MD ,&nbsp;Zachary Rosol MD ,&nbsp;Dennis Gable MD ,&nbsp;Blake Bruneman BS ,&nbsp;Harsh Chauhan BDS, MPH ,&nbsp;Minseob Jeong MD ,&nbsp;Subhash Banerjee MD","doi":"10.1016/j.amjcard.2025.09.065","DOIUrl":"10.1016/j.amjcard.2025.09.065","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"258 ","pages":"Pages 276-279"},"PeriodicalIF":2.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273325","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":"Risk Reduction by IMPELLA Support in High-Risk Percutaneous Coronary Intervention","authors":"Takashi Ishimatsu MD, PhD,&nbsp;Yoshihiro Fukumoto MD, PhD","doi":"10.1016/j.amjcard.2025.10.001","DOIUrl":"10.1016/j.amjcard.2025.10.001","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"260 ","pages":"Pages 91-93"},"PeriodicalIF":2.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273532","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":"Reply to Letter to the Editor: ‘‘Interpreting the Outcomes of Crossover versus Ostial Stenting in the CROSS-ANATOLIA Registry’’","authors":"Ezgi Gültekin Güner MD ,&nbsp;Ahmet Güner MD ,&nbsp;Veysel Ozan Tanık MD ,&nbsp;Bülent Özlek MD ,&nbsp;Fatih Uzun MD","doi":"10.1016/j.amjcard.2025.09.056","DOIUrl":"10.1016/j.amjcard.2025.09.056","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"257 ","pages":"Pages 207-208"},"PeriodicalIF":2.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273548","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}