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Featured topics and Editors' Picks from all of ACC's JACC Journals.
Chronic venous insufficiency (CVI) in adults with Fontan physiology appears to be associated with adverse outcomes, according to findings from an analysis of patients in the CALF study published in a research letter in JACC: Advances.
CVI was shown in the CALF study of patients with Fontan physiology, published in JACC in 2010, to be highly prevalent and severe venous insufficiency was three- to fourfold more frequent than in the general population. A recent population study showed an association between CVI and increased mortality.
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In a retrospective chart review of 103 patients enrolled from Boston Children's Hospital in the original CALF cohort, Tony A. Pastor, MD, and colleagues examined the time from enrollment to the first composite outcome event, defined as all-cause mortality, heart transplantation, thrombotic or thromboembolic event and infectious conditions.
Over the median follow-up of 11.3 years, 30 patients (29%) experienced a primary outcome: 28 deaths, 20 thrombotic/thromboembolic events, nine infectious complications (cellulitis [5], graft infection [2], endocarditis [2]), and two heart transplantations. The median time to the composite outcome was three years.
A significant association between baseline CVI and severe CVI and the composite outcome (hazard ratios, 9.1 and 9.5, respectively; p=0.04 for both) was found on the adjusted multivariable Cox regression analysis.
The authors write adults with Fontan physiology are among the most challenging groups followed in adult congenital clinics and have a high rate of morbidity that increases in incidence and severity with age and mortality. Their finding of the association between CVI – an easily identifiable clinical finding –and important adverse outcomes "provides the foundation for the next step in developing innovative therapies to mitigate CVI and potentially improve long-term outcomes," as well as employing therapeutic strategies earlier.
Pastor T, Landzberg MJ, Gauvreau K, et al. JACC Adv 2022;1:1-2.
A risk-prediction model incorporating age and identified clinical characteristics may help predict mortality risk in patients receiving transcatheter edge-to-edge repair (TEER) to treat severe mitral regurgitation (MR), according to a study published in the Journal of the American College of Cardiology.
A growing demand for critical care cardiology (CCC) specialists in modern cardiac intensive care unit (CICU) practices and a lack of tailored training has created a need for a contemporary CCC training model, according to a paper published in the Journal of the American College of Cardiology.
Many children and adolescents in China may have less than ideal cardiovascular health, with only about a third meeting ideal levels of physical activity and a healthy diet, according to a study published in JACC: Asia. Socioeconomic factors including sex, education, family history of cardiovascular disease and geographic location contribute to the lower overall percentage of youth engaging in positive heart healthy behaviors.
Psychological stress is recognized as a contributing factor in atrial fibrillation (AFib), both in initiation and heightening of AFib. In a review paper published in JACC: Clinical Electrophysiology, potential mechanisms linking stress and AFib and the possible use of stress reduction in AFib management are explored.
Women remain underrepresented in the leadership of cardiovascular clinical trials, which corresponds with underrepresentation and a lack of gender diversity among presenters at scientific meetings, according to a review published in the Journal of the American College of Cardiology (JACC).
Yoga added to standard therapy is more effective than standard therapy alone in reducing the symptomatic burden and improving quality of life in patients with recurrent vasovagal syncope (VVS), according to findings from the LIVE-Yoga study published in the JACC: Clinical Electrophysiology.
Assessment of frailty should be integrated into cardiovascular practice in an effort to identify patients who may benefit from frailty interventions and improve health and well-being of older patients, particularly after cardiovascular interventions, according to a state-of-the-art review published in the Journal of the American College of Cardiology.
There should be a standard baseline drug therapy against which new therapies are studied for patients with heart failure (HF), according to a review paper published in the Journal of the American College of Cardiology.
Clinical Topics: Arrhythmias and Clinical EP, Cardiac Surgery, Cardiovascular Care Team, Congenital Heart Disease and Pediatric Cardiology, Diabetes and Cardiometabolic Disease, Dyslipidemia, Geriatric Cardiology, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Prevention, Valvular Heart Disease, Atherosclerotic Disease (CAD/PAD), Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Cardiac Surgery and Arrhythmias, Cardiac Surgery and CHD and Pediatrics, Cardiac Surgery and Heart Failure, Cardiac Surgery and VHD, CHD and Pediatrics and Arrhythmias, CHD and Pediatrics and Interventions, CHD and Pediatrics and Prevention, CHD and Pediatrics and Quality Improvement, Lipid Metabolism, Nonstatins, Acute Heart Failure, Heart Transplant, Interventions and Structural Heart Disease, Interventions and Vascular Medicine, Diet, Exercise, Smoking, Stress, Mitral Regurgitation
Keywords: ACC Publications, Cardiology Magazine, Adolescent, Adult, Aged, Alcohol Drinking, Algorithms, Anemia, Anti-Anxiety Agents, Antidepressive Agents, Asia, Atrial Fibrillation, Autonomic Pathways, Benchmarking, Blood Glucose, Blood Pressure, Body Mass Index, Boston, Calibration, Canada, Cardiac Rehabilitation, Cardiac Surgical Procedures, Cardiologists, Cardiology, Cardiovascular Diseases, Cellulitis, China, Cholesterol, Clergy, Clinical Decision-Making, Cognition, Confidence Intervals, Consensus, Consensus, Control Groups, Cost-Benefit Analysis, Critical Care, Cultural Diversity, Curriculum, Data Visualization, Data Visualization, Diet, Diet, Healthy, Diuretics, Drinking, Electronic Mail, Electrophysiology, Emergencies, Emergency Service, Hospital, Emotions, Employment, Endocarditis, Exercise, Fasting, Fellowships and Scholarships, Financial Stress, Follow-Up Studies, Food Deserts, Frailty, Functional Status, Glomerular Filtration Rate, Goals, Health Behavior, Health Status, Heart Failure, Heart Transplantation, Hospitals, Incidence, India, Intensive Care Units, Leadership, Leg, Mentors, Middle Aged, Mindfulness, Mitral Valve Insufficiency, National Institutes of Health (U.S.), Obesity, Patient Readmission, Perception, Peripheral Arterial Disease, Pharmaceutical Preparations, Pharmacists, Policy, Prospective Studies, Pulmonary Disease, Chronic Obstructive, Quality Indicators, Health Care, Quality of Life, Reference Standards, Registries, Regression Analysis, Rehabilitation Nursing, Renal Replacement Therapy, Renin-Angiotensin System, Research, Research Personnel, Retrospective Studies, Risk Factors, Sedentary Behavior, Self Report, Sex Education, Sex Factors, Smoking, Social Media, Societies, Medical, Socioeconomic Factors, Stress, Psychological, Stroke Volume, Surgeons, Surveys and Questionnaires, Syncope, Vasovagal, Telephone, Therapies, Investigational, Tobacco Smoke Pollution, United States Food and Drug Administration, Venous Insufficiency, Ventilators, Mechanical, Ventricular Function, Left, Weight Gain, World Health Organization, Yoga, Young Adult
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