American heart journal最新文献

{"title":"Information for Readers","authors":"","doi":"10.1016/S0002-8703(24)00213-8","DOIUrl":"10.1016/S0002-8703(24)00213-8","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"276 ","pages":"Page v"},"PeriodicalIF":3.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BASELINE trial: update in study design","authors":"Rutger-Jan Nuis MD, PhD, Nicolas M. Van Mieghem MD, PhD, BASELINE Investigators","doi":"10.1016/j.ahj.2024.08.013","DOIUrl":"10.1016/j.ahj.2024.08.013","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Pages 1-4"},"PeriodicalIF":3.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart failure and nocturnal hypoxemic burden, the connection is getting closer and closer.","authors":"Henrik Fox","doi":"10.1016/j.ahj.2024.08.012","DOIUrl":"10.1016/j.ahj.2024.08.012","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antihypertensive medication prescription dispensation among pregnant women in the United States: A cohort study","authors":"Melanie T. Chen MD, MPH ,&nbsp;Brandi L. Vollmer MPH, PhD ,&nbsp;C. Adair Blyler PharmD ,&nbsp;Natalie A. Cameron MD, MPH ,&nbsp;Eliza C. Miller MD, MS ,&nbsp;Yongmei Huang MD, DrPH ,&nbsp;Alexander M. Friedman MD ,&nbsp;Jason D. Wright MD ,&nbsp;Amelia K. Boehme MSPH, PhD ,&nbsp;Natalie A. Bello MD, MPH","doi":"10.1016/j.ahj.2024.08.010","DOIUrl":"10.1016/j.ahj.2024.08.010","url":null,"abstract":"<div><h3>Importance</h3><p>Hypertension is increasingly common in pregnancy capable individuals, yet there is limited data on antihypertensive medication dispensation in peripartum individuals.</p></div><div><h3>Objective</h3><p>To describe antihypertensive medication dispensation from preconception through the first year postpartum.</p></div><div><h3>Design, Setting, and Participants</h3><p>This retrospective cohort study used the Truven Health Market Scan administrative data from 2008 to 2014 to identify women in the United States with commercial or government health insurance, aged 15-54, free from heart disease, who experienced a pregnancy and filled at least 1 prescription for an antihypertensive medication between 3 months prior to conception and 12 months after the end of the pregnancy.</p></div><div><h3>Main Outcomes and Measures</h3><p>We describe antihypertensive dispensation patterns (continuation, initiation, and discontinuation) by medication class during 5 time periods: preconception, first, second, and third trimesters, and the first year postpartum.</p></div><div><h3>Results</h3><p>Of 1,058,521 pregnancies, 108,614 (10.3%) were exposed to at least 1 antihypertensive medication dispensation. The most commonly dispensed medications across all periods combined were adrenergic blockers, calcium channel blockers (CCBs), and diuretics. Renin-angiotensin-aldosterone system (RAAS) inhibitors were the third most dispensed medication class in the preconception period (26.4%), and fills decreased to 5.7% and 1.7% in the second and third trimesters, respectively. Of the women with chronic hypertension who filled at least 1 prescription prior to conception, 8.4% were not dispensed an antihypertensive medication during the first year after delivery.</p></div><div><h3>Conclusions and Relevance</h3><p>Antihypertensive prescription dispensation of both preferred and potentially harmful agents is common in pregnancy capable individuals. Patterns of dispensation suggest room for improvement in the treatment of chronic hypertension after a pregnancy.</p></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Pages 5-13"},"PeriodicalIF":3.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel markers of nocturnal hypoxemia in sleep apnea and heart failure with reduced ejection fraction (HFrEF).","authors":"Gonzalo Labarca","doi":"10.1016/j.ahj.2024.08.006","DOIUrl":"10.1016/j.ahj.2024.08.006","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholesterol lowering therapy is highly efficacious in reducing atherosclerotic cardiovascular disease risk but grossly underutilized: How do we move the needle?","authors":"Todd M Brown","doi":"10.1016/j.ahj.2024.08.007","DOIUrl":"10.1016/j.ahj.2024.08.007","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S0002-8703(24)00191-1","DOIUrl":"10.1016/S0002-8703(24)00191-1","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"275 ","pages":"Page v"},"PeriodicalIF":3.7,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141993688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and feasibility of triage and rapid discharge of patients with chest pain from emergency room: A pragmatic, randomized noninferiority control trial of the European Society of Cardiology (ESC) 0 to 1 hour pathway vs conventional 0 to 3 hour accelerated diagnostic protocol","authors":"Aleem Khand MD ,&nbsp;James Hatherley MBChB ,&nbsp;Ahmed Dakshi MBBCh ,&nbsp;Guy Miller BMBS ,&nbsp;Lisa Bailey PhD ,&nbsp;Michael Fisher MD, PhD ,&nbsp;Christopher Goulden MBBS ,&nbsp;Zaid Noori MBCHB ,&nbsp;Anju Rawat MSc ,&nbsp;Rachel Hornby BSC (hons) ,&nbsp;Hannah Fearon MSC ,&nbsp;Nirmol Meah MBBS ,&nbsp;Sarah Davies MChem ,&nbsp;Katarzyna Sekulska BAN ,&nbsp;Awtad Hassan BSC ,&nbsp;Angela Lambert BSC ,&nbsp;Suzannah Phillips PhD ,&nbsp;Ray Raj MRSEd ,&nbsp;Tom Wiles MBChB ,&nbsp;Paul Collinson MD","doi":"10.1016/j.ahj.2024.08.005","DOIUrl":"10.1016/j.ahj.2024.08.005","url":null,"abstract":"<div><div>Patients presenting with chest pain represent a significant proportion of Emergency Department (ED) attendances but only a minority, typically 10%, have a final diagnosis of myocardial infarction (MI). Prompt discharge of patients without MI will alleviate ED overcrowding as well as improve patient satisfaction and reduce exposure to risk of hospital acquired infections such as Covid 19.</div><div>The measurement of cardiac troponin (cTn) by a high sensitivity method is recommended by the National Institute for health and Care Excellence (NICE) for rapid categorization of patients presenting with chest pain. Strategies proposed include measurement on admission and 1 hour from admission (ESC <strong>0-1-hour pathway</strong>, the recent guideline approved pathway which has not been implemented widely), and measurement on admission and 3 hours from admission (<strong>0-3-hour pathway</strong>, which is conventional and widely adopted).</div><div>The <strong>primary objective</strong> of this study is twofold: firstly, to assess the safety, feasibility, and impact of implementing the ESC (European Society of Cardiology) 0 to 1-hour pathway in clinical practice by reference to the more established ESC 0 to 3-hour protocol. The principal outcome measure will be the safety of the ESC 0 to 1-hour protocol. However, there are concerns that the time from sample draw to result availability (typically around 60 minutes) will impact on the feasibility of the ESC 0 to 1-hour pathway. Secondly, therefore, our goal is to evaluate whether measurement of high sensitivity troponin by a bedside analyzer (point of care testing, POCT), which will produce results in 15 minutes is a feasible alternative to laboratory testing. We will compare the results produced by POCT with the laboratory results in the context of the ESC 0 to 1 hour and 0 to 3-hour pathway, as a nested controlled study in the context of a randomized controlled trial. (clinicaltrials.gov: <strong>NCT05322395).</strong></div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Pages 235-247"},"PeriodicalIF":3.7,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences and long-term clinical outcomes after transcatheter aortic valve replacement: A SWEDEHEART study","authors":"Michael Dismorr MD, PhD ,&nbsp;Malin Granbom-Koski MD ,&nbsp;Emma Ellfors MD ,&nbsp;Andreas Rück MD, PhD ,&nbsp;Magnus Settergren MD, PhD ,&nbsp;Ulrik Sartipy MD, PhD ,&nbsp;Natalie Glaser MD, PhD","doi":"10.1016/j.ahj.2024.07.018","DOIUrl":"10.1016/j.ahj.2024.07.018","url":null,"abstract":"<div><h3>Background</h3><p>Previous studies on the impact of sex differences after transcatheter aortic valve replacement (TAVR) have shown conflicting results. The aim was to analyze the risk of long-term mortality, heart failure hospitalization, myocardial infarction, stroke, bleeding and aortic valve reintervention in females versus males after TAVR.</p></div><div><h3>Methods</h3><p>This nationwide, population-based cohort study included all patients who underwent TAVR in Sweden between 2008 and 2022 from the SWEDEHEART register. Additional baseline and outcome data were gathered from other national health data registers. Regression standardization was used to adjust for differences between the sexes.</p></div><div><h3>Results</h3><p>Of 10,475 patients, 4,886 (47%) were female and 5,589 (53%) were male. The mean age was 81 years. The cumulative incidence of mortality at 1, 5, and 10 years was 8% vs. 10%, 38% vs. 45%, and 75% vs. 82% for females and males, respectively. After regression standardization, the risk of all-cause mortality was lower for females (absolute difference at 10 years of 6.4%, 95% confidence interval [CI] 4.4%-8.4%). The mean follow up was 3.1 years (maximum 14.1 years). Females also had a lower risk of major bleeding than males (absolute survival difference at 10 years of 4.0%, 95% CI 1.9%-6.2%), but there was no difference in the risk of heart failure, myocardial infarction, stroke, or reintervention between the sexes.</p></div><div><h3>Conclusions</h3><p>Females had a higher survival rate and a lower bleeding risk than males after TAVR. Sex-specific factors are important to consider in the management of patients after TAVR.</p></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"277 ","pages":"Pages 27-38"},"PeriodicalIF":3.7,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0002870324001856/pdfft?md5=5b1302f1172c5ee7cd700a4f3bab2c86&pid=1-s2.0-S0002870324001856-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of artificial intelligence‐guided echocardiography to detect cardiac dysfunction and heart valve disease in rural and remote areas: Rationale and design of the AGILE‐echo trial","authors":"Cheng Hwee Soh PhD ,&nbsp;Leah Wright PhD ,&nbsp;Angus Baumann MBBS ,&nbsp;Bastian Seidel PhD ,&nbsp;Christopher Yu MBBS ,&nbsp;Mark Nolan PhD ,&nbsp;Tony Mylius MBBS ,&nbsp;Thomas H. Marwick PhD, MPH, MBBS ,&nbsp;AGILE-Echo investigators in Tasmania, Western New South Wales, Northern Victoria, Western Australia, Western Queensland and Northern Territory, Australia","doi":"10.1016/j.ahj.2024.08.004","DOIUrl":"10.1016/j.ahj.2024.08.004","url":null,"abstract":"<div><h3>Background</h3><p>Transthoracic echocardiography (TTE) is essential in the diagnosis of cardiovascular diseases (CVD), including but not limited to heart failure (HF) and heart valve disease (HVD). However, its dependence on expert acquisition means that its accessibility in rural areas may be limited, leading to delayed management decisions and potential missed diagnoses. Artificial intelligence-guided (AI)-TTE offers a solution by permitting non-expert image acquisition. The impact of AI-TTE on the timing of diagnosis and early initiation of cardioprotection is undefined.</p></div><div><h3>Methods</h3><p>AGILE-Echo (use of Artificial intelligence-Guided echocardiography to assIst cardiovascuLar patient managEment) is a randomized-controlled trial conducted in 5 rural and remote areas around Australia. Adults with CV risk factors and exercise intolerance, or concerns regarding HVD are randomized into AI-TTE or usual care (UC). AI-TTE participants may have a cardiovascular problem excluded, identified (leading to AI-guided interventions) or unresolved (leading to conventional TTE). UC participants undergo usual management, including referral for standard TTE. The primary endpoint is a composite of HVD or HF diagnosis at 12-months. Subgroup analysis, stratified based on age range and sex, will be conducted. All statistical analyses will be conducted using R.</p></div><div><h3>Results</h3><p>Of the first 157 participants, 78 have been randomized into AI-TTE (median age 68 [IQR 17]) and 79 to UC (median age 65 [IQR 17], <em>P</em> = .034). HVD was the primary concern in 37 participants (23.6%) while 84.7% (n = 133) experienced exercise intolerance. The overall 10-year HF incidence risk was 13.4% and 20.0% (<em>P</em> = .089) for UC and AI-TTE arm respectively. Atrial remodeling, left ventricular remodeling and valvular regurgitation were the most common findings. Thirty-three patients (42.3%) showed no abnormalities.</p></div><div><h3>Conclusions</h3><p>This randomized-controlled trial of AI-TTE will provide proof-of-concept for the role of AI-TTE in identifying pre-symptomatic HF or HVD when access to TTE is limited. Additionally, this could promote the usage of AI-TTE in rural or remote areas, ultimately improving health and quality of life of community dwelling adults with risks, signs or symptoms of cardiac dysfunction.</p></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"277 ","pages":"Pages 11-19"},"PeriodicalIF":3.7,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0002870324001984/pdfft?md5=acf4880d1aa01bfb21665e274da1a066&pid=1-s2.0-S0002870324001984-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}