JACC-AdvancesJACC 进展
JACC-Advances(英文缩写 JACC-ADV),ISSN 2772-963X,eISSN 2772-963X,中文译名:JACC 进展 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-10-01 至 2026-09-30，按本站收录文献的发表日期统计。
期刊介绍
JACC-Advances 最新收录文献
-
1. A Knowledge Graph Framework for Longitudinal Congenital Heart Disease Modeling: Methodology Corner.
PMID:日期:2026-10-03Congenital heart disease (CHD) is characterized by evolving clinical trajectories; staged interventions; and complex relationships among diagnoses, procedures, and encounters. Conventional machine learning applied to electronic health record (EHR) data often rely on static feature representations that do not preserve the natural longitudinal disease progression or clinical context. The purpose of this study was to develop a knowledge graph-based framework for trajectory-aware representation and analysis of longitudinal CHD EHR data. We constructed a longitudinal knowledge graph that integrates patients, encounters, diagnoses, and procedures while preserving temporal ordering across the care continuum. Term frequency-inverse document frequency and Word2Vec approaches were applied to encounter contexts extracted from the graph to generate longitudinal patient representations that supported phenotyping, patient similarity analysis, and retrospective classification. Using accumulated longitudinal EHR from a cardiovascular magnetic resonance cohort, we demonstrate that the framework captured clinically meaningful patterns and supported retrospective identification of single ventricle physiology as a representative use case. This knowledge graph framework provides a scalable approach for preserving temporal and relational clinical context and enable trajectory-aware modeling of longitudinal cardiovascular EHR data in patients with CHD.
-
2. Association of Predicted Surgical Risk With 3-Year Outcomes After Isolated Tricuspid Valve Surgery: An Analysis of Medicare Beneficiaries.
PMID:日期:2026-10-03With recent approval of transcatheter tricuspid valve (TV) interventions for high/prohibitive surgical risk patients, understanding the long-term outcomes of isolated TV surgery has become increasingly relevant. The objective of the study was to evaluate longitudinal outcomes and health care costs of isolated surgical TV surgery to provide a potential benchmark for emerging transcatheter therapies. Using the U.S. fee-for-service Medicare database, we evaluated longitudinal outcomes of all beneficiaries undergoing isolated TV repair or replacement (TVR) from 2018 to 2022. Patients with endocarditis were excluded. A claims-based, frailty-inclusive multivariable logistic regression model of predicted in-hospital mortality was developed (optimism-corrected area under the receiver-operating characteristic curve = 0.870). Patients were stratified by low (<4%), intermediate (4% to 8%), or high (>8%) predicated risk of surgical mortality. Kaplan-Meier and Fine Gray methods were used for time to event analysis. A total of 3,437 patients underwent isolated TVR (n = 1,285) or TV repair (n = 2,152). In-hospital mortality was higher for TVR (8.1% vs 5.3%; P = 0.001). Most patients (71.0%) were low risk, 9.0% intermediate, and 20.0% high risk. Three-year survival was significantly higher in the low (84.9%) and intermediate (66.5%) risk groups compared to high risk (49.6%), P < 0.001. Heart failure readmission-free survival correlated with predicted risk whereas valve reintervention was low in all groups (2.5% at 3 years). Index hospitalization costs increased with predicted risk. In Medicare beneficiaries undergoing isolated TV surgery, predicted operative mortality was associated with 3-year survival, heart failure readmission, and health care costs. These contemporary real-world data may inform heart team discussions and future trial designs for emerging transcatheter therapies.
-
4. Absence of Fibrosis Influences Prognosis of Cardiac Resynchronization in Nonischemic Cardiomyopathy: Systematic Review and Meta-Analysis.
PMID:日期:2026-10-01In patients with nonischemic cardiomyopathy (NICM) undergoing cardiac resynchronization therapy (CRT), there are no clear recommendations on selecting CRT with defibrillator (CRT-D) vs pacemaker (CRT-P). Patients with high probability of response to CRT and low arrhythmic risk may be ideal candidates to CRT-P. The objectives of the study was to evaluate if the absence of late gadolinium enhancement (LGE) is associated with CRT response and ventricular arrhythmia (VA) in NICM treated with CRT. A systematic review and meta-analysis was conducted. Search of PubMed, Web of Science, and Scopus identified observational studies of NICM patients who underwent cardiac magnetic resonance before CRT implantation. Studies assessing echocardiographic response to CRT or VA stratified by LGE status were included. The VA endpoint comprised sustained ventricular tachycardia, appropriate implantable cardioverter-defibrillator therapy, resuscitated cardiac arrest, and sudden death. Ten studies were included: 9 (n = 831) for CRT response and 6 (745 patients) for arrhythmic risk. CRT response was significantly higher in patients without LGE than in patients with LGE (78.7% vs 50.7%; P < 0.001). The cumulative incidence of VA was extremely low in LGE cases, significantly lower than that of LGE+ ones (0.8% vs 21.1%, P < 0.001). The absence of LGE was strongly associated with higher CRT response (OR: 3.52; 95% CI: 2.54-4.88; P < 0.001) and much lower arrhythmic risk (OR: 0.06; 95% CI: 0.02-0.15; P < 0.001). In NICM patients undergoing CRT, the absence of LGE is strongly associated with greater echocardiographic response and very low arrhythmic risk. In this subgroup the incremental benefit of CRT with defibrillator over CRT-P may be limited.
-
5. AI-Enabled Electrocardiogram for Rule-Out of NSTEMI Across Clinically Challenging Presentations.
PMID:日期:2026-09-29该文献暂无摘要。
-
6. Life-Course Noncardiac Comorbidity Burden and Mortality in Lower-Complexity Congenital Heart Disease.
PMID:日期:2026-09-24Lower-complexity congenital heart disease (CHD) is generally perceived as a low-risk condition. However, its long-term systemic comorbidity burden and impact on survival remain poorly defined, despite increasing recognition of lifelong care needs. The authors aimed to determine whether lower-complexity CHD is a life-course condition characterized by high noncardiac comorbidity burden and mortality among adults. This population-based prospective cohort study identified 3,316 adults with lower-complexity CHD and 492,232 individuals without CHD from the UK Biobank. The primary outcome was the first occurrence of 9 system-specific noncardiac comorbidities, with relative rates estimated by multivariable Cox regression models and lifetime risk from age 40 to 90 assessed using life-table methods. The secondary outcome was all-cause mortality among individuals with lower-complexity CHD, assessed according to baseline and incident comorbidity status using time-varying Cox regression models. The median follow-up was approximately 13 years. Compared to individuals without CHD, adults with lower-complexity CHD had significantly elevated relative rates of noncardiac comorbidities across 9 organ systems, particularly for blood, endocrine, and pulmonary diseases. Comorbidity incidence diverged from midlife and accelerated with age. Absolute lifetime risks ranged from 17.1% (skin disease) to 45.8% (digestive disease), with the largest excess risks observed in endocrine (18.6%), digestive (15.7%), and pulmonary (12.5%) systems. Among individuals with CHD, incident noncardiac comorbidities were independently associated with increased subsequent all-cause mortality, with pulmonary disease conferring the strongest relative rate. Lower-complexity CHD is associated with higher lifetime noncardiac comorbidity burden and increased subsequent mortality. These findings support a shift toward integrated, life-course clinical management.
-
7. Automated Aortic Valve Calcification Scoring: Multicenter External Validation of a Deep Learning Algorithm.
PMID:日期:2026-09-23Aortic valve calcification (AVC) quantification is a guideline-recommended imaging biomarker for aortic stenosis (AS) severity and progression yet remains underreported on routine chest computed tomography (CT). With nearly 20 million nongated chest CTs performed annually in the United States, automated AVC detection offers potential for opportunistic AS screening without added radiation or cost. This study evaluated whether deep learning can accurately quantify AVC from nongated, noncontrast chest CT, with performance comparable to expert assessment. We evaluated a convolutional neural network across a multicenter consortium of 33 sites spanning 8 health systems in the United States and Brazil. The algorithm was developed using training (n = 1,446) and validation (n = 361) sets and evaluated on a separate holdout test set (n = 239) acquired from 2021 to 2024. Reference standards were manual segmentations independently verified by at least 2 board-certified radiologists. Primary outcomes were Pearson correlation and Bland-Altman analysis of algorithm-estimated vs manual Agatston scores. Secondary outcomes were sensitivity and specificity for a high calcium burden associated with moderate-to-severe AS using validated sex-specific thresholds. The algorithm showed high correlation with expert reference standards (r = 0.99; 95% CI: 0.98-0.99; P < 0.001). Bland-Altman analysis showed minimal bias (mean difference: 5.2 AU; 95% CI: -7.6 to 17.9). For moderate-to-severe AS, sensitivity was 0.92 (95% CI: 0.80-0.97) and specificity 0.98 (95% CI: 0.95-0.99). Performance remained consistent across demographic subgroups and CT technical parameters. This automated deep learning algorithm quantifies AVC from routine chest CT with expert-comparable performance, potentially enabling opportunistic AS screening. Prospective studies are needed to determine whether it improves clinical outcomes.
-
8. Temporal Trends in Transcatheter Tricuspid Valve Interventions After FDA Approval in the United States.
PMID:日期:2026-09-23Transcatheter tricuspid valve interventions (TTVIs) have recently received commercial approval; however, contemporary adoption trends in early postapproval phase are not well described. The objectives of the study were to characterize trends in utilization of transcatheter tricuspid edge-to-edge repair (T-TEER) and transcatheter tricuspid valve replacement (TTVR) and to describe baseline patient characteristics and in-hospital outcomes. We performed a retrospective cohort study using the Vizient Clinical Data Base including patients who underwent T-TEER or TTVR between October 2024 and December 2025. Monthly procedural trends, baseline characteristics, and in-hospital outcomes were evaluated. The study included 2,143 T-TEER procedures performed at 180 implanting hospitals; median annualized hospital volume 6.4 (IQR: 2.4-13.6) and 1,301 TTVR procedures performed at 113 implanting hospitals; median annualized hospital volume 6.4 (IQR: 3.2-11.2). Overall monthly volumes increased for both T-TEER (128 in October 2024 to 156 in December 2025; P for trend = 0.004) and TTVR (60 in October 2024 to 111 in December 2025; P for trend <0.001). The proportion of TTVR among all TTVI increased over time (from 31.9% to 41.6%; P for trend = 0.006). Baseline patient comorbidities of patients undergoing TTVI were similar to pivotal trial populations. In-hospital mortality was 0.5% following T-TEER and 2.0% following TTVR. The incidence of major bleeding was 6.0% and 12.4% after T-TEER and TTVR, respectively. Among TTVR patients, 11.3% required new pacemaker implantation. There is increased adoption of both T-TEER and TTVR in early commercial experience with clinical characteristics of treated patients similar to those enrolled in pivotal trials. In-hospital outcomes were overall favorable supporting the generalizability of the pivotal trial findings to contemporary practice.
-
9. Left Atrial Appendage Occlusion vs Direct Oral Anticoagulants for Atrial Fibrillation: Network Meta-Analyses.
PMID:日期:2026-09-23Left atrial appendage occlusion (LAAO) is a treatment option to prevent thromboembolic events in patients with atrial fibrillation. However, it remains unclear whether LAAO offers superior efficacy and safety compared with oral anticoagulation for these patients. This study aimed to assess the efficacy and safety of LAAO vs direct oral anticoagulants (DOACs). We reviewed randomized controlled trials comparing oral anticoagulation and LAAO, using MEDLINE and CENTRAL. The primary outcome was a composite of stroke, systemic embolism, and cardiovascular death, whereas the safety outcome was major bleeding. Two network meta-analyses were conducted to assess LAAO vs DOAC, incorporating indirect comparisons: 1 comparing LAAO, DOACs, and vitamin K antagonist (3 arms), and the other comparing Watchman, Amulet, DOACs, and vitamin K antagonist (4 arms). A total of 67,693 patients from 11 randomized controlled trials were included, of whom 5,735 underwent LAAO. In the three-arm network meta-analysis, LAAO and DOACs demonstrated statistically similar risks for both the primary efficacy outcome (HR: 1.02; 95% CI: 0.88-1.19; I = 0%) and the safety outcome (HR: 0.98; 95% CI: 0.78-1.23; I = 70.5%). In the 4-arm network meta-analysis, both Amulet and Watchman were associated with similar risks of the primary outcome, comparable to those of DOACs, as well as the risk of major bleeding. LAAO devices did not demonstrate statistical superiority over DOACs in reducing thromboembolic events and major bleeding. Further trials are warranted to define patients for whom LAAO may offer the most significant benefit, such as those with high bleeding risk (CRD420251237886).