ESC Congress 2022 Science Published Across JACC Journals

The following science being presented during ESC Congress 2022 in Barcelona was simultaneously published online on Aug. 22 in JACC, JACC: Cardiovascular Imaging, JACC: Cardiovascular Interventions and JACC: Clinical Electrophysiology. Access all JACC Journals simultaneous publications throughout the meeting and find information on joint sessions and journal-related events on JACC.org.

JACC

MYH7 Variant Dilated Cardiomyopathy: A study by Fernando de Frutos, MD, et al., looked to determine the phenotype and prognosis of MYH7-related dilated cardiomyopathy and evaluated the influence of variant location on phenotypic expression. Overall findings found MYH7-related dilated cardiomyopathy “is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to [end-stage heart failure]. Heart failure complications predominate over ventricular arrhythmias, which are rare,” they said. Read the full study.

JACC: Cardiovascular Imaging

RV Longitudinal Contractility Mismatch: Challenges remain regarding the differential diagnosis between arrhythmogenic right ventricular cardiomyopathy (ARVC) and other potential diseases that resemble ARVC despite having a different pathophysiological and clinical substrate, according to Simone Frea, MD, et al. In their study evaluating the ratio of right ventricular (RV) free wall peak systolic velocity (S’) to RV outflow tract S’, they found Doppler velocity ratio to be a novel echocardiographic parameter for accurately diagnosing ARVC, relying on the reproducibility and ease of use of tissue Doppler imaging. Read the full study.

JACC: Cardiovascular Interventions

Supraventricular Arrhythmia Following PFO Closure: New research from Paul Guedeney, MD, et al., prospectively looks to determine “the incidence, timing, and determinants of supraventricular arrhythmia after patent foramen ovale (PFO) closure based on loop recorder monitoring found.” Results found that supraventricular arrhythmia was diagnosed in one out of five patients using ≥28-days loop recorder monitoring, with a median delay of 14 days. The findings suggest that “this post-procedural event has been so far, underestimated,” write the authors. Read the full study. In a related editorial comment, Suzanne J. Baron, MD, MSc, notes “The time is now to engage in research endeavors to answer … questions regarding the management of the post-PFO closure patient with atrial arrhythmias, once thought to be uncommon, but which clearly are not so rare after all.”

AKI Following TEER: A study by Tetsu Tanaka, MD, et al., looks at the prognostic impact of post-procedural acute kidney injury (AKI) following transcatheter edge-to-edge repair (TEER) for tricuspid regurgitation (TR). Results found that post-procedural AKI occurred in 15.7% of patients undergoing TEER for TR, despite the absence of iodinated contrast agents, which was associated with worse clinical outcomes. “Our findings highlight the clinical impact of AKI following TEER for TR and should help with identifying patients at high risk of AKI,” the authors note. Read the full study. In a related editorial comment, Bernard Chevalier, MD, FACC, and Antoinette Neylon, MD, write that a “thorough early follow-up of renal function after TEER is useful to detect AKI.” They also suggest that “post-procedural AKI may be regarded as a polyfactorial marker of poor prognosis that integrates with the appropriateness of edge-to edge repair indication, efficacy of the procedure to reduce the regurgitation and periprocedural hemodynamic conditions.”

TEER For ASMR: Another study by Tetsu Tanaka, MD, et al., investigates the effectiveness of TEER for patients with atrial secondary mitral regurgitation (ASMR). Overall findings found TEER to be “a safe and feasible therapeutic option for patients with ASMR” and Tanaka and colleagues suggest that “assessments of left atrial volume index and leaflet-to-annulus index may assist with patient selection for TEER” among this patient population. They also note that the “use of a newer generation of the MitraClip systems (NTR/XTR or G4 systems) was associated with a higher incidence of mitral regurgitation (MR) reduction.” Read the full story.

Cardiac Amyloidosis in ASMR Patients Undergoing TEER: A study by Carolina Donà, MD, et al., “for the first time describes the prevalence and associated clinical outcomes of concomitant cardiac amyloidosis in patients with severe MR undergoing TEER. Based on the findings the authors suggest future studies should evaluate the prognostic benefits of TEER and cardiac amyloidosis-specific treatment in MR-cardiac amyloidosis. Read the study. In a related editorial comment, Islam Y. Elgendy, MD, FACC, and Ayman Elbadawi, MD, write that the findings “should encourage clinicians to actively screen for cardiac amyloidosis using bone scintigraphy among patients with severe MR and other characteristic features.”

Gender Differences in 10-Year Outcomes Following STEMI: In a subanalysis from the EXAMINATION-EXTEND trial, Rami Gabani, MD, et al., assess whether very long-term outcomes following STEMI treatment are influenced by gender. “At very long-term follow-up there were no differences in the combined patient-oriented endpoint between women and men, with a trend towards a higher all-cause death in women not driven by cardiac death,” the authors write. “Our findings underline the need for focused personalized medicine in women after percutaneous revascularization aimed at both cardiovascular as well as gender-specific risk factor control and targeted treatment.” Read the study. In a related editorial comment, Stefano Savonitto, MD, and Nuccia Morici, MD, PhD, write that the “hopeful conclusions remain, so far, unsubstantiated” and they note data is still missing in terms of gender specific care after primary angioplasty.

JACC: Clinical Electrophysiology

CNA For Reflex Syncope: Cardioneuroablation (CNA) has emerged as a new therapeutic option for treating cardioinhibitory vasovagal syncope (VVS). New research from Roman Piotrowski, MD, PhD, et al., for the first time assesses the effects of CNA on syncope recurrences in patients with VVS. Researchers found quality of life significantly improved in the CNA group compared with remaining stable in controls. They suggest larger studies are needed to confirm these findings. Read more.

Clinical Topics: Arrhythmias and Clinical EP, Congenital Heart Disease and Pediatric Cardiology, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Stable Ischemic Heart Disease, Valvular Heart Disease, Implantable Devices, Genetic Arrhythmic Conditions, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Congenital Heart Disease, CHD and Pediatrics and Arrhythmias, CHD and Pediatrics and Imaging, CHD and Pediatrics and Interventions, CHD and Pediatrics and Quality Improvement, Acute Heart Failure, Interventions and Imaging, Interventions and Structural Heart Disease, Interventions and Vascular Medicine, Echocardiography/Ultrasound, Nuclear Imaging, Chronic Angina, Mitral Regurgitation

Keywords: Reflex, Phenotype, Arrhythmias, Cardiac, Recurrence, Angioplasty, Amyloidosis, Radionuclide Imaging, Hemodynamics, Heart Failure, Kidney, Heart Atria, Echocardiography, Acute Kidney Injury, Risk Factors, Electrophysiology, Tricuspid Valve Insufficiency, Syncope, Vasovagal, Sex Factors, ST Elevation Myocardial Infarction, Prognosis, Prevalence, Precision Medicine, Patient Selection, Mitral Valve Insufficiency, Incidence, Foramen Ovale, Patent, Diagnosis, Differential, Cardiomyopathy, Dilated, Arrhythmogenic Right Ventricular Dysplasia, Age of Onset, Reproducibility of Results, Quality of Life, Follow-Up Studies, Contrast Media, ESC Congress, ESC22

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