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Pacing for better visualization of the left atrial appendage prior to transcatheter left atrial appendage closure. 在经导管左心耳关闭前,起搏以更好地观察左心耳。
IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-01 Epub Date: 2023-11-23 DOI: 10.1007/s12928-023-00969-0
Keisuke Hosono, Mike Saji, Ryo Wada, Hiroshi Ohara, Tadashi Fujino, Takanori Ikeda
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引用次数: 0
Volume-outcome relationships for extracorporeal membrane oxygenation in acute myocardial infarction. 急性心肌梗死体外膜氧合的容量-结果关系。
IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-01 Epub Date: 2023-12-26 DOI: 10.1007/s12928-023-00976-1
Yuichi Saito, Kazuya Tateishi, Masato Kanda, Yuki Shiko, Yohei Kawasaki, Yoshio Kobayashi, Takahiro Inoue

Acute myocardial infarction (MI) is one of the major scenarios of extracorporeal membrane oxygenation (ECMO) use. The utilization of mechanical circulatory support systems including ECMO varies widely at the hospital level, while whether ECMO volume per hospital is associated with outcomes in acute MI is unclear. Using a Japanese nationwide administrative database, a total of 26,913 patients with acute MI undergoing percutaneous coronary intervention from 154 hospitals were included. The relations among PCI volume for acute MI, observed and predicted in-hospital mortality, and observed and predicted rates of ECMO use were evaluated at the hospital level. Of 26,913 patients, 423 (1.6%) were treated with ECMO, and 1561 (5.8%) died during the hospitalization. Median ECMO use per hospital per year was 0.5. An observed rate of ECMO use was linearly correlated with the predicted probability of ECMO use and was not associated with the observed/predicted in-hospital mortality ratio. The observed/predicted mortality ratio was lowest in hospitals with the observed/predicted ECMO use ratio of around one. In conclusion, ECMO was infrequently used in a setting of acute MI at each hospital annually. An observed rate of ECMO use was not associated with observed/predicted in-hospital mortality ratio, while the observed/predicted in-hospital mortality ratio was lowest when ECMO was used as predicted, suggesting that standardized ECMO use may be an institutional quality indicator in acute MI.

急性心肌梗死(MI)是使用体外膜肺氧合(ECMO)的主要情况之一。包括 ECMO 在内的机械循环支持系统的使用情况在医院层面差异很大,而每家医院的 ECMO 使用量是否与急性心肌梗死的预后相关尚不清楚。本研究利用日本全国性行政数据库,纳入了 154 家医院的 26,913 名接受经皮冠状动脉介入治疗的急性心肌梗死患者。在医院层面评估了急性心肌梗死的 PCI 容量、观察到的和预测的院内死亡率、观察到的和预测的 ECMO 使用率之间的关系。在 26913 名患者中,423 人(1.6%)接受了 ECMO 治疗,1561 人(5.8%)在住院期间死亡。每家医院每年使用 ECMO 的中位数为 0.5。观察到的 ECMO 使用率与预测的 ECMO 使用概率呈线性相关,与观察到的/预测的院内死亡率比值无关。在观察到的/预测的 ECMO 使用率约为 1 的医院中,观察到的/预测的死亡率最低。总之,各医院每年在急性心肌梗死的情况下很少使用 ECMO。观察到的 ECMO 使用率与观察到的/预测的院内死亡率无关,而观察到的/预测的院内死亡率在 ECMO 使用率与预测值一致时最低,这表明标准化 ECMO 的使用可能是急性心肌梗死的一项机构质量指标。
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引用次数: 0
Diagnosis and treatment of cardiovascular disease in patients with heritable connective tissue disorders or heritable thoracic aortic diseases. 诊断和治疗遗传性结缔组织疾病或遗传性胸主动脉疾病患者的心血管疾病。
IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-01 Epub Date: 2024-01-05 DOI: 10.1007/s12928-023-00977-0
Takeshi Yagyu, Teruo Noguchi

Patients with heritable connective tissue disorders (HCTDs), represented by Marfan syndrome, can develop fatal aortic and/or arterial complications before age 50. Therefore, accurate diagnosis, appropriate medical treatment, and early prophylactic surgical treatment of aortic and arterial lesions are essential to improve prognosis. Patients with HCTDs generally present with specific physical features due to connective tissue abnormalities, while some patients with heritable thoracic aortic diseases (HTADs) have few distinctive physical characteristics. The development of genetic testing has made it possible to provide accurate diagnoses for patients with HCTDs/HTADs. This review provides an overview of the diagnosis and treatment of HCTDs/HTADs, including current evidence on cardiovascular interventions for this population.

以马凡综合征为代表的遗传性结缔组织病(HCTD)患者可能在 50 岁之前就出现致命的主动脉和/或动脉并发症。因此,准确的诊断、适当的药物治疗以及对主动脉和动脉病变的早期预防性手术治疗对于改善预后至关重要。HCTD 患者通常因结缔组织异常而表现出特定的体征,而一些遗传性胸主动脉疾病(HTAD)患者则几乎没有明显的体征。基因检测的发展使得为 HCTDs/HTADs 患者提供准确诊断成为可能。本综述概述了遗传性胸主动脉疾病/遗传性胸主动脉疾病的诊断和治疗,包括针对这一人群的心血管干预措施的现有证据。
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引用次数: 0
Sinus of Valsalva and leaflet thrombosis after surgical aortic valve replacement. 手术主动脉瓣置换术后的瓦尔萨尔瓦窦和瓣叶血栓形成。
IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-01 Epub Date: 2023-12-12 DOI: 10.1007/s12928-023-00974-3
Riku Kato, Soh Hosoba, Kentaro Adachi, Shogo Maeda, Toshiaki Ito
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引用次数: 0
Bailout stenting for delayed coronary obstruction after self-expandable transcatheter aortic valve implantation. 自体可扩张经导管主动脉瓣植入术后延迟性冠状动脉阻塞的救助支架植入术。
IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-01 Epub Date: 2024-01-08 DOI: 10.1007/s12928-023-00978-z
Hiroyuki Tabata, Kenichi Ishizu, Naoto Murakami, Masaomi Hayashi, Shinichi Shirai, Kenji Ando
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引用次数: 0
IMPELLA® mechanical circulatory support delivery using a VIABAHN VBX-covered stent. IMPELLA®机械循环支持输送使用VIABAHN VBX覆盖支架。
IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-01 Epub Date: 2023-10-19 DOI: 10.1007/s12928-023-00964-5
Yusuke Tomoi, Kenji Kanenawa, Akira Otani, Taichi Hirano, Kenji Ando
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引用次数: 0
Coronary events in elderly patients with non-valvular atrial fibrillation: a prespecified sub-analysis of the ANAFIE registry. 非瓣膜性心房颤动老年患者的冠心病事件:ANAFIE 登记的预设子分析。
IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-01 Epub Date: 2024-02-13 DOI: 10.1007/s12928-024-00984-9
Masato Nakamura, Hiroshi Inoue, Takeshi Yamashita, Masaharu Akao, Hirotsugu Atarashi, Takanori Ikeda, Yukihiro Koretsune, Ken Okumura, Wataru Shimizu, Shinya Suzuki, Hiroyuki Tsutsui, Kazunori Toyoda, Masahiro Yasaka, Takenori Yamaguchi, Satoshi Teramukai, Yoshiyuki Morishima, Masayuki Fukuzawa, Atsushi Takita, Atsushi Hirayama

Real-world data on coronary events (CE) in elderly patients with atrial fibrillation (AF) are lacking in the direct oral anticoagulant era. This prespecified sub-analysis of the ANAFIE Registry, a prospective observational study in > 30,000 Japanese patients aged ≥ 75 years with non-valvular AF (NVAF), investigated CE incidence and risk factors. The incidence and risk factors for new-onset CE (a composite of myocardial infarction [MI] and cardiac intervention for coronary heart diseases other than MI), MI, and cardiac intervention for coronary heart diseases other than MI during the 2-year follow-up were assessed. Bleeding events in CE patients were also examined. Among 32,275 patients, the incidence rate per 100 patient-years was 0.48 (95% confidence interval (CI): 0.42-0.53) for CE during the 2-year follow-up, 0.20 (0.16-0.23) for MI, and 0.29 (0.25-0.33) for cardiac intervention for coronary heart diseases other than MI; that of stroke/systemic embolism was 1.62 (1.52-1.73). Patients with CE (n = 287) likely had lower creatinine clearance (CrCL) and higher CHADS2 and HAS-BLED scores than patients without CE (n = 31,988). Significant risk factors associated with new-onset CE were male sex, systolic blood pressure of ≥ 130 mmHg, diabetes mellitus (glycated hemoglobin ≥ 6.0%), CE history, antiplatelet agent use, and CrCL < 50 mL/min. Major bleeding incidence was significantly higher in patients with new-onset CE vs without CE (odds ratio [95% CI], 3.35 [2.06-5.43]). In elderly patients with NVAF, CE incidence was lower than stroke/systemic embolism incidence. New-onset CE (vs no CE) was associated with a higher incidence of major bleeding.Trial registration: UMIN000024006.

在直接口服抗凝剂的时代,缺乏有关老年房颤患者冠心病事件(CE)的真实数据。ANAFIE 登记是一项前瞻性观察研究,研究对象是年龄大于 75 岁的 30,000 名日本非瓣膜性房颤(NVAF)患者,本预设子分析调查了 CE 的发生率和风险因素。该研究评估了随访 2 年期间新发 CE(心肌梗死 [MI] 和心肌梗死以外的冠心病心脏介入治疗的综合)、心肌梗死和心肌梗死以外的冠心病心脏介入治疗的发病率和风险因素。此外,还对 CE 患者的出血事件进行了研究。在 32,275 名患者中,随访 2 年期间每 100 患者年的 CE 发生率为 0.48(95% 置信区间 (CI):0.42-0.53),MI 为 0.20(0.16-0.23),MI 以外的冠心病心脏介入治疗为 0.29(0.25-0.33);中风/系统性栓塞的发生率为 1.62(1.52-1.73)。与无 CE 的患者(n = 31,988)相比,有 CE 的患者(n = 287)肌酐清除率 (CrCL) 可能较低,CHADS2 和 HAS-BLED 评分可能较高。与新发 CE 相关的重要风险因素包括:男性、收缩压≥ 130 mmHg、糖尿病(糖化血红蛋白≥ 6.0%)、CE 病史、使用抗血小板药物和 CrCL
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引用次数: 0
Atrial septal defect closure via left subclavian vein: a novel technique using a steerable sheath. 左锁骨下静脉封闭房间隔缺损:一种使用可操纵鞘的新技术。
IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-01 Epub Date: 2023-12-03 DOI: 10.1007/s12928-023-00970-7
Yusuke Akazawa, Takashi Higaki, Hidemi Takata, Hiroshi Sakamoto, Shunji Uchita, Osamu Yamaguchi
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引用次数: 0
Consensus document on the clinical application of invasive functional coronary angiography from the Japanese Association of Cardiovascular Intervention and Therapeutics. 日本心血管介入和治疗协会关于有创功能性冠状动脉造影临床应用的共识文件。
IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-01 Epub Date: 2024-02-17 DOI: 10.1007/s12928-024-00988-5
Taku Asano, Toru Tanigaki, Kazumasa Ikeda, Masafumi Ono, Hiroyoshi Yokoi, Yoshio Kobayashi, Ken Kozuma, Nobuhiro Tanaka, Yoshiaki Kawase, Hitoshi Matsuo

Invasive functional coronary angiography (FCA), an angiography-derived physiological index of the functional significance of coronary obstruction, is a novel physiological assessment tool for coronary obstruction that does not require the utilization of a pressure wire. This technology enables operators to rapidly evaluate the functional relevance of coronary stenoses during and even after angiography while reducing the burden of cost and complication risks related to the pressure wire. FCA can be used for treatment decision-making for revascularization, strategy planning for percutaneous coronary intervention, and procedure optimization. Currently, various software-computing FCAs are available worldwide, with unique features in their computation algorithms and functions. With the emerging application of this novel technology in various clinical scenarios, the Japanese Association of Cardiovascular Intervention and Therapeutics task force was created to outline expert consensus on the clinical use of FCA. This consensus document advocates optimal clinical applications of FCA according to currently available evidence while summarizing the concept, history, limitations, and future perspectives of FCA along with globally available software.

有创功能性冠状动脉造影(FCA)是通过血管造影获得的冠状动脉阻塞功能性生理指标,是一种无需使用压力导线的新型冠状动脉阻塞生理评估工具。这项技术使操作人员能够在血管造影过程中甚至造影后快速评估冠状动脉狭窄的功能相关性,同时降低与压力导线相关的成本负担和并发症风险。FCA 可用于血管再通的治疗决策、经皮冠状动脉介入治疗的策略规划和手术优化。目前,世界上有各种软件计算的 FCA,其计算算法和功能各具特色。随着这项新技术在各种临床场景中的应用不断涌现,日本心血管介入和治疗协会成立了专门小组,就 FCA 的临床应用达成专家共识。这份共识文件提倡根据现有证据优化 FCA 的临床应用,同时总结了 FCA 的概念、历史、局限性和未来前景以及全球可用的软件。
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引用次数: 0
Diagnostic performance of pressure-bounded coronary flow reserve. 压力约束冠状动脉血流储备的诊断性能。
IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-01 Epub Date: 2024-02-08 DOI: 10.1007/s12928-024-00983-w
Kazumasa Ikeda, Takashi Kubo, Takahide Murasawa, Haruyuki Deguchi, Kazuya Takihara, Masato Nukariya, Asuka Kuwahara, Tomoaki Nakayama, Miki Kitamura, Taiyo Tezuka, Ryu Takagi, Ryosuke Ito, Shuichiro Kazawa, Yoichi Iwasaki, Satoshi Yamada, Kazuhiro Satomi, Nobuhiro Tanaka

Fluid dynamics studies have proposed that coronary flow reserve can be calculated from coronary artery pressure instead of coronary blood flow. We sought to investigate the diagnostic performance of pressure-bounded coronary flow reserve (pb-CFR) compared with CFR measured by conventional thermodilution method (CFRthermo) in the clinical setting. Pressure guidewire was used to measure CFRthermo and fractional flow reserve (FFR) in left anterior descending coronary artery in 62 patients with stable coronary artery disease. Pb-CFR was calculated only with resting distal coronary artery pressure (Pd), resting aortic pressure (Pa) and FFR. Pb-CFR was moderately correlated with CFRthermo (r = 0.54, P < 0.001). Pb-CFR showed a poor agreement with CFRthermo, presenting large values of mean difference and root mean square deviation (1.5 ± 1.4). Pb-CFR < 2.0 predicted CFRthermo < 2.0 with an accuracy of 79%, sensitivity of 83%, specificity of 78%, positive predictive value of 48%, negative predictive value of 95%. The discordance presenting CFRthermo < 2.0 and pb-CFR ≥ 2.0 was associated with diffuse disease (P < 0.001). The discordance presenting CFRthermo ≥ 2 and pb-CFR < 2 was associated with a high FFR (P = 0.002). Pb-CFR showed moderate correlation and poor agreement with CFRthermo. Pb-CFR might be reliable in excluding epicardial coronary artery disease and microcirculatory disorders.

流体动力学研究提出,冠状动脉血流储备可以通过冠状动脉压力而不是冠状动脉血流量来计算。我们试图研究在临床环境中,压力约束冠状动脉血流储备(pb-CFR)与传统热稀释法(CFRthermo)相比的诊断性能。我们使用压力导丝测量了 62 名冠状动脉疾病稳定期患者左前降支冠状动脉的 CFRthermo 和分数血流储备(FFR)。Pb-CFR仅与静息远端冠状动脉压力(Pd)、静息主动脉压力(Pa)和FFR一起计算。Pb-CFR 与 CFRthermo 呈中度相关(r = 0.54,P thermo),平均差和均方根偏差值较大(1.5 ± 1.4)。Pb-CFR thermo thermo ≥ 2,pb-CFR thermo ≥ 2。Pb-CFR 在排除心外膜冠状动脉疾病和微循环障碍方面可能是可靠的。
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引用次数: 0
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Cardiovascular Intervention and Therapeutics
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