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J Cardiovasc Magn ResonDec 01, 2019: 21 (1)今日发布01篇（共计26篇）

BMC Cardiovasc DisordDec 01, 2019: 19 (1)今日发布03篇（共计102篇）

CirculationEarly Recent, May 02, 201901篇

Heart and VesselsEarly Recent, May 02, 201902篇

High Blood Press Cardiovasc PrevEarly Recent, May 03, 201901篇

CirculationEarly Recent, May 03, 201901篇

01

2剂达比加群对房颤中风和严重出血的个体治疗效果评价：来自RE-LY试验的结果

Circulationresearch-article

Manon C. Stam-Slob, Stuart J. Connolly, etc.

2小时前

Background:We aimed to estimate absolute benefit and harm from treatment with dabigatran in individual patients with atrial fibrillation, and to select the optimal dose for each individual.

我们旨在评估达比加群治疗个体房颤患者的绝对益处和危害，并为每个个体选择最佳剂量。

Methods:We derived and validated a prediction model for ischemic stroke/ systemic embolism (SE) and major bleeding in patients with atrial fibrillation from the 3 treatment arms of the randomized evaluation of long-term anticoagulation therapy (RE-LY) trial (n=11,955 in derivation cohort, n=6,158 in validation cohort). Readily available patient characteristics were included in Fine & Gray competing risk models (sex, age, smoking, antiplatelet drugs, prior vascular disease, diabetes, blood pressure, eGFR, and hemoglobin). Five-year risks for ischemic stroke/SE and major bleeding were estimated without anticoagulation therapy, and compared with high and low dose dabigatran.

我们从长期抗凝治疗（RE-LY）试验的随机评价的3个治疗组（衍生组n=11955，验证组n=6158）中推导并验证了房颤患者缺血性卒中/全身栓塞（SE）和大出血的预测模型。现有的患者特征包括在精细和灰色竞争风险模型中（性别、年龄、吸烟、抗血小板药物、既往血管疾病、糖尿病、血压、eGFR和血红蛋白）。在没有抗凝治疗的情况下，估计缺血性卒中/SE和严重出血的5年风险，并与高剂量和低剂量达比加群进行比较。

Results:Model calibration was good, and discrimination was adequate with a c-statistic of 0.65 (95%CI 0.62-0.70) for ischemic stroke/SE and 0.69 (95%CI 0.66-0.71) for major bleeding. The 5-year absolute risk reduction (ARR) for ischemic stroke/SE with dabigatran 150 mg twice daily ranged from <10% in 20% of patients to >25% in 7% of patients, and the 5-year absolute risk increase (ARI) for major bleeding ranged from <5% in 53% of patients to 15-20% in 1% of patients. Comparing high-dose to low-dose dabigatran, the net benefit (ARR - ARI) was positive for 46% of patients.

模型校正良好，缺血性卒中/SE的C统计量为0.65（95%可信区间0.62-0.70），大出血的C统计量为0.69（95%可信区间0.66-0.71），可充分区分。达比加群150 mg组缺血性卒中/SE的5年绝对风险降低（ARR）从20%的患者<10%到7%的患者>25%，大出血的5年绝对风险增加（ARI）从53%的患者<5%到1%的患者15-20%。与低剂量达比加群相比，46%的患者的净获益（ARR-ARI）为阳性。

Conclusions:The absolute treatment benefits and harms of dabigatran in atrial fibrillation can be estimated based on readily available patient characteristics. Such treatment effect estimations can be used for shared decision-making before starting dabigatran treatment, and to determine the optimal dose.

达比加群治疗房颤的绝对疗效和危害可根据现有的患者特征进行评估。这种治疗效果估计可用于达比加群治疗开始前的共同决策，并确定最佳剂量。

Early Recent, May 03, 2019

10.1161/CIRCULATIONAHA.118.035266

02

血管老化和大血管疾病：炎症的作用

High Blood Press Cardiovasc PrevReview Article

Alessandro Maloberti, Paola Vallerio, etc.

6小时前

Structural and functional arterial properties commonly impair with aging process. These effects on vasculature could act at many levels from microcirculation to large vessels. Above normal aging process classic cardio-vascular risk factors (hypertension, diabetes mellitus, dyslipidemia, etc.) accelerate the physiological process leading to premature structural and functional alterations that has also been termed early vascular aging. Target organ damage evaluation could be clinically important since these alterations precede by many years’ cardiovascular events and so their assessment can predict the onset of more serious and costly events giving the opportunity to prevent CV events by earlier therapeutic intervention. This review will focus on large artery functional properties and particularly on the role of inflammation on the aortic stiffening process.

结构和功能性动脉的特性通常会随着老化过程而受损。从微循环到大血管，这些对血管系统的影响可以在很多层面上发挥作用。高于正常的老化过程经典的心血管危险因素（高血压、糖尿病、血脂异常等）加速生理过程，导致过早的结构和功能改变，也被称为早期血管老化。靶器官损伤评估可能在临床上很重要，因为这些改变先于多年的心血管事件，因此他们的评估可以预测更严重和昂贵的事件的发生，从而有机会通过早期的治疗干预来预防心血管事件。这篇综述将集中于大动脉的功能特性，特别是炎症对主动脉硬化过程的作用。

Early Recent, May 03, 2019

10.1007/s40292-019-00318-4

03

首次心肌梗死的正常血压患者血糖异常和左心室质量增加：随访14年血糖异常的预后意义

BMC Cardiovasc DisordResearch article

Gokulan Pararajasingam, Brian Bridal Løgstrup, etc.

昨天 23:32

BackgroundLeft ventricle mass (LVM) can be influenced by various conditions including hypertension and/or inherent cardiomyopathies. Dysglycemia is also thought to exert an anabolic effect on heart tissue by hyperinsulinemia and thereby promoting increased LVM. The primary aim of this study was to assess the influence of dysglycemia on LVM evaluated by an oral glucose tolerance test (OGTT) in patients admitted with a first myocardial infarction (MI) without hypertension. The secondary aim was to assess the impact of dysglycemia on major adverse cardiovascular events (MACE) and all-cause mortality during long-term follow-up.

左心室质量（LVM）可能受到各种条件的影响，包括高血压和/或固有的心肌病。血糖异常也被认为通过高胰岛素血症对心脏组织产生合成代谢作用，从而促进左室肥厚的增加。本研究的主要目的是通过口服葡萄糖耐量试验（OGTT）评估首次无高血压心肌梗死（MI）患者血糖异常对左室肥厚的影响。第二个目的是评估长期随访中血糖异常对主要不良心血管事件（MACE）和全因死亡率的影响。

MethodsPatients admitted with a first MI without known history of hypertension were included. All patients without previously known type 2 diabetes mellitus (T2DM) had a standardized 2-hour OGTT performed and were categorized as: normal glucose tolerance (NGT), impaired fasting glucose (IFG)/impaired glucose tolerance (IGT) and newly detected T2DM (new T2DM). LVM was measured by echocardiography using Devereaux formula and indexed by body surface area. Multivariate linear regression analysis was used to assess the impact of confounders (dysglycemia by OGTT, known T2DM, age, sex and type of MI) on LVM. Cox proportional hazard model was used to assess the impact of dysglycemia on all-cause mortality and a composite endpoint of MACE (all-cause mortality, MI, revascularisation due to stable angina, coronary artery bypass graft, ischemic stroke or hemorrhagic stroke).

包括无高血压病史的首次心肌梗死患者。所有既往未发现2型糖尿病（T2DM）的患者均进行了标准化的2小时OGTT检查，分类为：正常葡萄糖耐受性（NGT）、空腹血糖受损（IFG）、葡萄糖耐受性受损（IGT）和新检测的T2DM（新的T2DM）。采用Devereaux公式通过超声心动图测量左室肥厚，并根据体表面积进行指数化。多变量线性回归分析用于评估混杂因素（OGTT导致的血糖异常、已知的T2DM、年龄、性别和心肌梗死类型）对左室肥厚的影响。采用Cox比例风险模型评估血糖异常对全因死亡率和MACE复合终点（全因死亡率、心肌梗死、稳定型心绞痛所致的血运重建、冠状动脉旁路移植、缺血性卒中或出血性卒中）的影响。

ResultsTwo-hundred-and-five patients were included and followed up to 14 years. In multivariate regression analysis, LVM was only significantly increased in patients categorized as new T2DM (β = 25.3; 95% CI [7.5–43.0]) and known T2DM (β = 37.3; 95% CI [10.0-64.5]) compared to patients with NGT. Patients with new T2DM showed higher rates of MACE and all-cause mortality compared to patients with IFG/IGT and NGT; however no significantly increased hazard ratio was detected.

包括250名患者，随访至14年。在多变量回归分析中，与NGT患者相比，新的t2dm（β=25.3；95%可信区间[7.5–43.0]）和已知的t2dm（β=37.3；95%可信区间[10.0-64.5]）患者的左室肥厚显著增加。与IFG/IGT和NGT患者相比，新的t2dm患者的MACE和全因死亡率更高，但没有发现显著增加的危险比。

ConclusionsDysglycemia is associated with increasing LVM in normotensive patients with a first acute myocardial infarction and the strongest association was observed in patients with new T2DM and patients with known T2DM. Dysglycemia in normotensive patients with a first MI is not an independent predictor of neither MACE nor all-cause mortality during long-term follow-up compared to normotensive patients without dysglycemia.

低血糖障碍与首次急性心肌梗死的正常血压患者的左室肥厚增加相关，在新的t2dm患者和已知的t2dm患者中观察到最强的相关性。与无血糖异常的正常血压患者相比，首次心肌梗死的正常血压患者的血糖异常不是长期随访中MACE或全因死亡率的独立预测因素。

Dec 01, 2019: 19 (1), 103

10.1186/s12872-019-1084-5

04

AHA/ACCF定义的危险因素在肝移植患者心脏病评估中的诊断和预后价值

BMC Cardiovasc DisordResearch article

Sarah Alexander, Meron Teshome, etc.

昨天 23:32

BackgroundThe diagnostic and prognostic utility of risk factors proposed by the 2012 American Heart Association and American College of Cardiology Foundation (AHA/ACCF) Scientific Statement on the cardiac assessment of asymptomatic liver transplantation candidates have not been validated. We investigated whether the sum of risk factors proposed by the AHA/ACCF can identify liver transplant candidates at increased cardiac risk.

2012美国心脏协会和美国心脏病基金会（AHA/ACCF）科学声明对无症状肝移植候选人心脏评估提出的危险因素的诊断和预后效用尚未得到证实。我们研究了由AHA/ACCF提出的风险因素之和是否能够识别心脏风险增加的肝移植候选者。

MethodsIn a retrospective cohort of consecutive liver transplantation recipients, we calculated, for each subject, the pre-transplantation sum of AHA/ACCF risk factors (age > 60 years, prior cardiovascular disease, hypertension, dyslipidemia, diabetes mellitus, smoking, and left ventricular hypertrophy). The primary outcome was the presence of severe coronary artery disease (CAD), defined as ≥70% stenosis or ≥ 50% left main stenosis on pre-transplantation angiography. The secondary outcomes were the composite of cardiac death or myocardial infarction (MI) and the composite of cardiac death, MI, or coronary revascularization.

在一个连续肝移植受者的回顾性队列中，我们计算了每名受试者移植前AHA/ACCF危险因素的总和（年龄>60岁、既往心血管疾病、高血压、血脂异常、糖尿病、吸烟和左心室肥大）。主要结果是严重冠状动脉疾病（CAD）的存在，在移植前血管造影中定义为≥70%狭窄或≥50%左主干狭窄。次要结局是心源性死亡或心肌梗死（MI）和心源性死亡、心肌梗死或冠状动脉血运重建的复合结果。

ResultsAmong 220 liver transplant recipients, the sum of AHA/ACCF risk factors had good discriminatory capacity for severe CAD [area under the curve, 0.77; 95% confidence interval (CI), 0.62–0.92; P = 0.007]; having ≥3 risk factors provided 75% sensitivity and 77% specificity for severe CAD. During mean post-transplantation follow-up of 48 ± 31 months, having ≥3 risk factors was associated with increased risk of the secondary composite outcomes of cardiac death or MI [hazard ratio, 2.39; P = 0.044] and cardiac death, MI, or coronary revascularization [hazard ratio, 2.39; P = 0.044].

在220例肝移植受者中，AHA/ACCF危险因素之和对严重CAD具有良好的鉴别能力[曲线下面积，0.77；95%置信区间（CI），0.62-0.92；P=0.007]；具有3个以上危险因素对严重CAD具有75%的敏感性和77%的特异性。在平均移植后随访48个月时，有3个以上的危险因素与心脏死亡或心肌梗死（危险比2.39；P 0.044）和心脏死亡、心肌梗死或冠状动脉血运重建（危险比2.39；P 0.044）二次复合结局的风险增加相关。

ConclusionsIn patients undergoing cardiac assessment prior to liver transplantation, the sum of risk factors proposed by the AHA/ACCF provides significant diagnostic and prognostic utility. Having ≥3 AHA/ACCF risk factors is a reasonable threshold to prompt non-invasive stress testing in asymptomatic liver transplantation candidates.

在肝移植前接受心脏评估的患者中，AHA/ACCF提出的危险因素总和提供了重要的诊断和预后效用。对于无症状的肝移植候选者来说，具有≥3个AHA/ACCF危险因素是一个促使进行无创应激测试的合理阈值。

Dec 01, 2019: 19 (1), 102

10.1186/s12872-019-1088-1

05

急性肺血栓栓塞患者的残余肺动脉高压与临床结局相关

Heart and VesselsOriginal Article

Tatsuro Ibe, Hiroshi Wada, etc.

昨天 23:16

In patients with acute pulmonary thromboembolism (PTE), the influence of residual pulmonary hypertension (PH) has not been well investigated. The aim of this study was to compare clinical characteristics between patients with and without residual PH, and to investigate the association between residual PH and clinical outcomes after acute phase in acute PTE. We included acute PTE patients who underwent echocardiogram after acute phase between January 2009 and December 2016. These patients were divided into residual PH and non-residual PH groups according to the value of estimated right ventricular systolic pressure (eRVSP) by echocardiogram after acute phase (the residual PH group: eRVSP ≥ 40 mmHg, the non-residual PH group: eRVSP < 40 mmHg). Kaplan–Meier survival curves were applied to investigate whether the residual PH were associated with PTE-related death or recurrent PTE in patients with acute PTE. A total of 49 patients with acute PTE were allocated into the residual PH group (n = 10) and non-residual PH group (n = 39). Median follow-up period for 49 patients was 7 months. The event-free survival rate was significantly lower in the residual PH group as compared with the non-residual PH group (p = 0.003), whereas there was no statistical significance between two groups stratified by initial PH or not (p = 0.97). Residual PH after acute phase was significantly associated with mid-term PTE-related death or recurrent PTE in patients with acute PTE.

在急性肺血栓栓塞（PTE）患者中，残余肺动脉高压（ph）的影响尚未得到很好的研究。本研究的目的是比较有或无残余ph的患者的临床特征，并调查急性PTE急性期后残余ph与临床结局之间的关系。我们包括2009年1月至2016年12月接受急性期后超声心动图检查的急性PTE患者。根据急性期后超声心动图估计的右室收缩压（ERVSP）≥40 mmHg，非残余ph组：ERVSP<40 mmHg），将患者分为残余ph组和非残余ph组。应用Kaplan–Meier生存曲线研究急性PTE患者的残余ph值是否与PTE相关死亡或复发性PTE相关。49例急性PTE患者被分配到残余ph组（n=10）和非残余ph组（n=39）。49名患者的中位随访期为7个月。与非残余ph组相比，残余ph组的无事件生存率显著降低（p=0.003），而按初始ph分层的两组之间没有统计学意义（p=0.97）。急性期后残余酸碱度与急性期PTE患者的中期PTE相关死亡或复发PTE显著相关。

Early Recent, May 02, 2019

10.1007/s00380-019-01420-2

CONTENTS

今日发文一览

J Cardiovasc Magn ResonDec 01, 2019: 21 (1)今日发布1篇文章

ResearchNo.01 P.26Myocardial fibrosis by late gadolinium enhancement cardiovascular magnetic resonance in myotonic muscular dystrophy type 1: highly prevalent but not associated with surface conduction abnormality肌强直性肌营养不良1型患者晚期钆强化心血管磁共振心肌纤维化：高发病率，但与表面传导异常无关05-03 07:01 | 10.1186/s12968-019-0535-6

BMC Cardiovasc DisordDec 01, 2019: 19 (1)今日发布3篇文章

ReviewNo.01 P.104Predictors of cardiac arrhythmic events in non coronary artery disease patients非冠状动脉疾病患者心律失常事件的预测因子05-02 23:32 | 10.1186/s12872-019-1083-6

Research articleNo.02 P.103Dysglycemia and increased left ventricle mass in normotensive patients admitted with a first myocardial infarction: prognostic implications of dysglycemia during 14 years of follow-up首次心肌梗死的正常血压患者血糖异常和左心室质量增加：随访14年血糖异常的预后意义05-02 23:32 | 10.1186/s12872-019-1084-5

Research articleNo.03 P.102The diagnostic and prognostic utility of risk factors defined by the AHA/ACCF on the evaluation of cardiac disease in liver transplantation candidatesAHA/ACCF定义的危险因素在肝移植患者心脏病评估中的诊断和预后价值05-02 23:32 | 10.1186/s12872-019-1088-1

CirculationEarly Recent, May 02, 2019今日发布1篇文章

research-articleNo.01Effects of Arteriovenous Fistula Ligation on Cardiac Structure and Function in Kidney Transplant Recipients动静脉瘘结扎对肾移植受者心脏结构和功能的影响05-02 21:25 | 10.1161/CIRCULATIONAHA.118.038505

Heart and VesselsEarly Recent, May 02, 2019今日发布2篇文章

Original ArticleNo.01 P.1-8Residual pulmonary hypertension is associated with clinical outcomes in patients with acute pulmonary thromboembolism急性肺血栓栓塞患者的残余肺动脉高压与临床结局相关05-02 23:16 | 10.1007/s00380-019-01420-2

Original ArticleNo.02 P.1-9The association between left atrial stiffness and low-voltage areas of left atrium in patients with atrial fibrillation房颤患者左心房强直与左心房低压区的关系05-02 23:16 | 10.1007/s00380-019-01423-z

High Blood Press Cardiovasc PrevEarly Recent, May 03, 2019今日发布1篇文章

Review ArticleNo.01 P.1-8Vascular Aging and Disease of the Large Vessels: Role of Inflammation血管老化和大血管疾病：炎症的作用05-03 13:42 | 10.1007/s40292-019-00318-4

CirculationEarly Recent, May 03, 2019今日发布1篇文章

research-articleNo.01Individual Treatment Effect Estimation of 2 Doses of Dabigatran on Stroke and Major Bleeding in Atrial Fibrillation: Results from the RE-LY Trial2剂达比加群对房颤卒中和严重出血的个体治疗效果评价：来自RE-LY试验的结果05-03 17:21 | 10.1161/CIRCULATIONAHA.118.035266