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“Temporal Changes in Transvalvular Pressure Gradients in Balloon-Expandable and Self-Expanding Transcatheter Aortic Valves” 球囊扩张和自扩张经导管主动脉瓣经瓣压力梯度的时间变化。
IF 1.9 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-11-06 DOI: 10.1002/ccd.70322
Sanhia Maheshwari
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引用次数: 0
Predictors of Variability in Coronary Flow Reserve and Microvascular Resistance Measurement Using the Bolus Thermodilution Technique 冠状动脉血流储备变异性的预测因素和微血管阻力测量使用大剂量热稀释技术。
IF 1.9 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-11-06 DOI: 10.1002/ccd.70301
Jason Galo, Aziz Maksoud, Samit Shah, Olga Toleva, Yuhei Kobayashi, Akl C. Fahed, Evan Shlofmitz, Alok Sharma, Jorn op den Buijs, Joia Spinelli, Richard Rapoza, Brian Bergmark, Hayder Hashim

Background

Bolus thermodilution is the most commonly used invasive assessment for coronary microvascular dysfunction (CMD). However, variability in thermodilution transit time measurements (TTM) affects calculated Coronary Flow Reserve (CFR) and Index of Microvascular Resistance (IMR) values. This study determined variables associated with transit time variability and quantified confidence intervals for the range of measured CFR and IMR values.

Methods

The CoroFlow Cardiovascular System (Coroventis, Sweden) and PressureWire™ X Guidewire (Abbott) were used to collect 2541 TTM from 259 vessels at 14 US sites included in the FlowLab Study. Correlations with baseline patient and procedural variables were determined by both linear and mixed linear models. Mixed linear models with the physician or vessel as the random effect were computed. Monte Carlo simulations of CFR and IMR were performed to determine 95% confidence intervals for thresholds of 2.5 for CFR and 25 for IMR.

Results

Mixed linear analysis with vessel as the random effect provided the best model fit (R2 = 0.948). In this model, RCA vessel location (p < 0.001) and pressure sensor distance < 5 cm (p < 0.005) were significantly associated with transit time. Monte Carlo simulations identified a “gray zone” range of 2.1–3.1 for CFR and 19–31 for IMR.

Conclusions

Minimizing variability in invasive CMD assessment is essential for improving diagnostic accuracy and guiding clinical decision-making as testing becomes more widespread. In this study, target vessel choice (RCA) and pressure sensor placement were identified as key modifiable sources of transit time variability. Clinically applicable confidence intervals around CFR and IMR values were defined.

背景:大剂量热稀释是冠状动脉微血管功能障碍(CMD)最常用的侵入性评估方法。然而,热稀释传递时间测量值(TTM)的变异性影响计算的冠状动脉血流储备(CFR)和微血管阻力指数(IMR)值。本研究确定了与传输时间变异性相关的变量,并量化了测量CFR和IMR值范围的置信区间。方法:使用CoroFlow心血管系统(Coroventis,瑞典)和PressureWire™X Guidewire (Abbott)从FlowLab研究中包括的14个美国地点的259个血管中收集2541个TTM。通过线性和混合线性模型确定与基线患者和程序变量的相关性。以医师或血管为随机效应计算混合线性模型。对CFR和IMR进行蒙特卡罗模拟,以确定CFR阈值为2.5和IMR阈值为25的95%置信区间。结果:以血管为随机效应的混合线性分析模型拟合最佳(R2 = 0.948)。结论:随着有创性CMD评估的普及,将可变性最小化对于提高诊断准确性和指导临床决策至关重要。在这项研究中,目标容器选择(RCA)和压力传感器的放置被确定为传输时间可变性的关键可修改源。在CFR和IMR值周围定义临床适用的置信区间。
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引用次数: 0
Letter to the Editor: Femoral Access-Assisted Balloon Trapping: A Novel Approach to Managing Kinked Catheter During Transradial Coronary Intervention—A Case Report 致编辑的信:经桡动脉冠状动脉介入治疗中,股骨通道辅助球囊捕获:一种处理导管扭结的新方法——一例报告。
IF 1.9 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-11-05 DOI: 10.1002/ccd.70308
Mohsin Tariq, Suleman Arshad, Taha Yahya, Syed Ali Raza Zaidi
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引用次数: 0
A Streamline Strategy for Indication and Length of Telemetry Monitoring After TAVR TAVR术后遥测监测指示和时间的简化策略。
IF 1.9 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-11-05 DOI: 10.1002/ccd.70299
Antonin Fournier, Pierre Robert, Benoit Lattuca, Claire Duflos, Maël-Morvan Duroyon, Jean-Christophe Macia, Laurent Schmutz, Matthieu Steinecker, Jean-Michel Berdeu, Thomas Gandet, Jean Luc Pasquie, François Roubille, Guillaume Cayla, Florence Leclercq

Background

Both indication and length of ECG telemetry monitoring (TM) after transcatheter aortic valve replacement (TAVR) are not well defined.

Aims

We hypothesize that a targeted strategy for monitoring conductive disorders (CD) post-TAVR can reduce the need and duration of in-hospital TM without compromising safety.

Methods

We prospectively evaluated consecutive patients undergoing transfemoral TAVR between February 2023 and September 2024. Intensive care unit (ICU) transfer for TM was considered when previous right bundle branch block or when new or worsening CD. TM duration was standardized, from 24 to 48 h. The primary endpoint was incidence of severe CD, defined as symptomatic or requiring medical intervention, occurring outside the ICU, at 1-month follow-up.

Results

Among 250 patients included (mean age: 80.53 ± 6.86 years), 138 (55.20%) required TM, mainly due to new left bundle branch block (n = 64, 44.80%). By respecting the protocol, the primary endpoint was achieved for three patients (1.20%, 95% CI: 0.31; 3.77), all related to post-discharge CD occurring after Day 6 and requiring permanent pacemaker implantation (PPI). There were no deaths and no severe in-hospital CD outside the ICU. The PPI rate was 16.80%. The mean ICU length of stay was 1.34 days. Absence of TM was associated with shorter mean global hospitalization duration (1.43 vs. 2.93 days, p < 0.001).

Conclusion

Selective indication and length of TM after TAVR is possible with no in-hospital events, no deaths, and a low rate of rhythmic events after hospital discharge, confirming the safety of this in-hospital strategy. Nearly half of the patients did not require TM, and very short global and ICU lengths were observed.

背景:经导管主动脉瓣置换术(TAVR)后心电图遥测监测(TM)的适应症和持续时间尚不明确。目的:我们假设有针对性地监测tavr后传导障碍(CD)的策略可以在不影响安全性的情况下减少住院TM的需求和持续时间。方法:我们前瞻性评估了2023年2月至2024年9月期间连续接受经股TAVR的患者。当先前的右束分支阻滞或新的或恶化的CD时,考虑转移到TM的重症监护病房(ICU)。TM持续时间标准化,从24到48小时。主要终点是在1个月的随访中重症CD的发生率,定义为有症状或需要医疗干预,发生在ICU以外。结果:纳入的250例患者(平均年龄:80.53±6.86岁)中,138例(55.20%)需要TM,主要原因是新发左束支阻滞(n = 64, 44.80%)。通过遵守该方案,3例患者(1.20%,95% CI: 0.31; 3.77)达到了主要终点,所有患者都与出院后第6天发生的CD有关,需要永久性起搏器植入(PPI)。无死亡病例,ICU外无严重的院内CD。PPI为16.80%。ICU平均住院时间1.34天。结论:TAVR术后选择性TM的适应证和时间长度是可能的,无院内事件,无死亡,出院后节律性事件发生率低,证实了这种院内策略的安全性。近一半的患者不需要TM,观察到的总长度和ICU长度都很短。
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引用次数: 0
Letter to the Editor: Critique of ‘Transcatheter Aortic Valve Replacement in the Catheterization Laboratory: Moving From Exceptional to Everyday’ 致编辑的信:对“导管实验室经导管主动脉瓣置换术:从特殊到日常”的批评。
IF 1.9 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-11-05 DOI: 10.1002/ccd.70307
Mohsin Tariq, Muhammad Ahmad, Taha Yahya, Mian Zain Hayat
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引用次数: 0
Nutrition Status May be Related to Discordance of the Resting Full-Cycle Ratio and Fractional Flow Reserve 营养状况可能与静息全周期比和部分血流储备的不一致有关。
IF 1.9 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-11-05 DOI: 10.1002/ccd.70297
Tomohiro Honda, Hiroaki Kawano, Ryohei Akashi, Seiji Koga, Takahiro Muroya, Satoshi Ikeda, Koji Maemura

Background

Clinical guidelines recommend using both hyperemic (fractional flow reserve [FFR]) and non-hyperemic (instantaneous wave-free ratio or resting full-cycle ratio [RFR]) methods to evaluate coronary artery stenoses in patients with coronary artery disease (CAD). However, discordant results have been reported between RFR and FFR. Previous studies have demonstrated that malnutrition is associated with adverse cardiovascular events in patients with CAD. This study aimed to assess the relationship between nutritional status and discordance between RFR and FFR measurements.

Methods

A total of 168 coronary arteries in 168 patients with CAD were analyzed. Ischemia was defined as FFR ≤ 0.80 and RFR ≤ 0.89. The vessels (n = 168) were categorized into four groups based on FFR and RFR results, including high FFR/high RFR, high FFR/low RFR, low FFR/high RFR, and low FFR/low RFR groups.

Results

Univariate analysis revealed that low levels of hemoglobin, albumin, and estimated glomerular filtration rate, as well as low prognostic nutritional index (PNI) and Geriatric Nutritional Risk Index scores, were associated with discordance in the high FFR/low RFR group. Multivariate analysis identified albumin and PNI as independent predictors of high FFR/low RFR discordance among vessels with discordant FFR and RFR results.

Conclusion

Nutritional status may influence the pattern of discordance between FFR and RFR measurements, particularly distinguishing high FFR/low RFR from low FFR/high RFR cases.

背景:临床指南推荐使用充血(分数血流储备[FFR])和非充血(瞬时无波比或静息全周期比[RFR])方法来评估冠状动脉疾病(CAD)患者的冠状动脉狭窄。然而,在RFR和FFR之间报道了不一致的结果。先前的研究表明,营养不良与冠心病患者的不良心血管事件有关。本研究旨在评估营养状况与RFR和FFR测量值不一致之间的关系。方法:对168例冠心病患者的168条冠状动脉进行分析。以FFR≤0.80、RFR≤0.89定义缺血。根据FFR和RFR结果将168只血管分为高FFR/高RFR组、高FFR/低RFR组、低FFR/高RFR组和低FFR/低RFR组。结果:单因素分析显示,低水平的血红蛋白、白蛋白和肾小球滤过率,以及低预后营养指数(PNI)和老年营养风险指数评分,与高FFR/低RFR组的不一致性有关。多因素分析发现,在FFR和RFR结果不一致的血管中,白蛋白和PNI是高FFR/低RFR不一致的独立预测因子。结论:营养状况可能影响FFR和RFR测量之间的不一致模式,特别是区分高FFR/低RFR与低FFR/高RFR病例。
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引用次数: 0
A Novel Index for Intravascular Imaging to Identify Functionally Significant Left Main Coronary Stenosis 一种新的血管内成像指标识别功能显著的左主干冠状动脉狭窄。
IF 1.9 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-11-05 DOI: 10.1002/ccd.70315
Aybüke Şimşek Bedir, Fatih Furkan Bedir, Ezgi Gültekin Güner, Kaan Gökçe, Koray Çiloğlu, Berkay Serter, Ahmet Güner
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引用次数: 0
Lower-Limb Peripheral Artery Disease: An Insight Into Trends Across Different Income-Stratified Regions 下肢外周动脉疾病:对不同收入阶层地区趋势的洞察。
IF 1.9 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-11-05 DOI: 10.1002/ccd.70318
Shree Rath
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引用次数: 0
Critique on “Paclitaxel-Coated Balloon for the Management of In-Stent Coronary Restenosis: An Updated Meta-Analysis and Trial Sequential Analysis” 评论“紫杉醇包被球囊治疗支架内冠状动脉再狭窄:一项更新的荟萃分析和试验序列分析”。
IF 1.9 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-11-05 DOI: 10.1002/ccd.70311
Emaan Sadiq
{"title":"Critique on “Paclitaxel-Coated Balloon for the Management of In-Stent Coronary Restenosis: An Updated Meta-Analysis and Trial Sequential Analysis”","authors":"Emaan Sadiq","doi":"10.1002/ccd.70311","DOIUrl":"10.1002/ccd.70311","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"112-113"},"PeriodicalIF":1.9,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145447079","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}
引用次数: 0
Letter to the Editor: “Clinical Impact of Concordant and Discordant Physiology Parameters Post-Percutaneous Coronary Intervention in the EASY-PREDICT Study” 致编辑的信:“在EASY-PREDICT研究中经皮冠状动脉介入治疗后生理参数一致和不一致的临床影响”。
IF 1.9 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-11-04 DOI: 10.1002/ccd.70310
Shyam Sundar Sah, Abhishek Kumbhalwar
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引用次数: 0
期刊
Catheterization and Cardiovascular Interventions
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