Left anterior descending artery wrapping around the left ventricular apex predicts additional risk of future events after anterior myocardial infarction

Abstract:
Anterior ST-segment elevation myocardial infarction (STEMI) owing to an occlusion of the left anterior descending artery (LAD) is associated with the highest risk of adverse clinical outcomes because of the large amount of myocardial territory supplied by the LAD compared with other coronary arteries (1, 2). In addition, anatomical features, such as a long LAD wrapping around the left ventricular (LV) apex, can play an important role in the outcomes in patients with anterior STEMI (3-5). In this study, a wrap-around LAD was defined as an LAD wrapping more than one-fourth of the inferior wall of LV (68), and the frequency of LAD wrapping around LV apex was reported to be 26.4%–34.9%. Interestingly, even when the definition was expanded to include a minor wrap-around LAD (perfusion of the LV apex by any branch from LAD, with a prevalence of 76.0%–79.5%) (3, 4, 9, 10), wrap-around LAD has been reported to be associated with poor long-term outcomes. The following are the mechanisms of worse cardiovascular outcomes in patients with anterior STEMI and a wrap-around LAD compared with those without. (i) The infarcted myocardium territory is larger in patients with a wrap-around LAD and (ii) occlusion of a wrap-around LAD is associated with subsequent apical LV remodeling. Using cardiac magnetic resonance imaging (cMRI), we have reported that in patients who had a myocardial infarction (MI), having a wrap-around LAD was related to an apical wall infarction and a higher incidence of heart failure and stroke, regardless of the overall infarct size (3). In a subsequent larger study of patients with STEMI (4), we also showed that patients with a wrap-around LAD had a higher prevalence of stroke owing to LV mural thrombus and stent thrombosis, in addition to a higher prevalence of heart failure. In this issue of The Anatolian Journal of Cardiology, Bozbeyoğlu et al. (6) describe the electrocardiography findings of patients with anterior STEMI and a wrap-around LAD. The authors concluded that inferior ST-segment elevation could occur in the following settings (i) distal LAD occlusion with a wrap-around LAD; (ii) wrap-around LAD only; or (iii) only distal LAD occlusion because the electrical vector of inferior leads during anterior STEMI would be affected by multiple factors (balance of injury of anterior and/or inferior wall, collaterals, and others). This illustrates the importance of direct diagnoses of the occluded location of the infarct artery, injured myocardial territory, and their remodeling over time in relation to the optimal medical therapy. A recent study (11) that was conducted to detect LV thrombus within 30 days after MI showed that (i) LV thrombus remains common (8%); (ii) LV thrombi were mostly in LAD MI (94% of all LV thrombi); (iii) LV thrombus can occur even in the absence of aneurysm (76% of LV thrombus without aneurysm); and (iv) the sensitivity of echocardiography to detect LV thrombus (using cMRI as the gold standard) was limited (35% without contrast and 64% with contrast). Altogether, based on unique electrocardiography findings, detection of a wrap-around LAD by coronary angiography during primary percutaneous coronary intervention, followed by diagnoses of apical remodeling and thrombus seems to be a reasonable sequence of risk stratification in patients with LAD MI.
Author Listing： Nobuaki Kobayashi;Akiko Maehara
Volume： 21
Pages： 259 - 260
DOI： 10.14744/AnatolJCardiol.2019.79803
Language： English
Journal： Anatolian Journal of Cardiology

Anatolian Journal of Cardiology

ANATOL J CARDIOL

影响因子：1.4 是否综述期刊：否 是否OA：是 是否预警：不在预警名单内 发行时间：- ISSN：2149-2263 发刊频率：- 收录数据库：SCIE/Scopus收录/DOAJ开放期刊 出版国家/地区：TURKEY 出版社：Kare Publishing

期刊介绍

The Anatolian Journal of Cardiology is an international monthly periodical on cardiology published on independent, unbiased, double-blinded and peer-review principles. The journal’s publication language is English.The Anatolian Journal of Cardiology aims to publish qualified and original clinical, experimental and basic research on cardiology at the international level. The journal’s scope also covers editorial comments, reviews of innovations in medical education and practice, case reports, original images, scientific letters, educational articles, letters to the editor, articles on publication ethics, diagnostic puzzles, and issues in social cardiology.The target readership includes academic members, specialists, residents, and general practitioners working in the fields of adult cardiology, pediatric cardiology, cardiovascular surgery and internal medicine.

《安纳托利亚心脏病学杂志》是一份国际性的心脏病学月刊，以独立、公正、双盲和同行评议原则出版。《安纳托利亚心脏病学杂志》的出版语言为英语。《安纳托利亚心脏病学杂志》旨在发表国际水平的合格和原创的心脏病学临床、实验和基础研究。杂志的范围还包括编辑评论、医学教育和实践创新的评论、病例报告、原始图像、科学信件、教育文章、致编辑的信件、关于出版伦理的文章、诊断难题和社会心脏病学问题。目标读者包括学术成员、专家、住院医师和在成人心脏病学、儿科心脏病学、心血管外科和内科。

年发文量 83
国人发稿量 23
国人发文占比 27.71%
自引率 14.3%
平均录取率 -
平均审稿周期 12 Weeks
版面费 -
偏重研究方向 CARDIAC & CARDIOVASCULAR SYSTEMS-
期刊官网 http://www.anakarder.com/
投稿链接 http://www.anadolukardiyolderg.com/login.php?page=0

质量指标占比

研究类文章占比 OA被引用占比 撤稿占比 出版后修正文章占比
86.75% 70.92% 0.00% 0.00%

相关指数

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期刊预警不是论文评价，更不是否定预警期刊发表的每项成果。《国际期刊预警名单（试行）》旨在提醒科研人员审慎选择成果发表平台、提示出版机构强化期刊质量管理。

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具体而言，就是通过综合评判期刊载文量、作者国际化程度、拒稿率、论文处理费（APC）、期刊超越指数、自引率、撤稿信息等，找出那些具备风险特征、具有潜在质量问题的学术期刊。最后，依据各刊数据差异，将预警级别分为高、中、低三档，风险指数依次减弱。

《国际期刊预警名单（试行）》确定原则是客观、审慎、开放。期刊分区表团队期待与科研界、学术出版机构一起，夯实科学精神，打造气正风清的学术诚信环境！真诚欢迎各界就预警名单的分析维度、使用方案、值得关切的期刊等提出建议！

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JCR分区 WOS分区等级：Q3区

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WOS期刊SCI分区
WOS期刊SCI分区是指SCI官方（Web of Science）为每个学科内的期刊按照IF数值排 序，将期刊按照四等分的方法划分的Q1-Q4等级，Q1代表质量最高，即常说的1区期刊。
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分区表升级版（试行）旨在解决期刊学科体系划分与学科发展以及融合趋势的不相容问题。由于学科交叉在当代科研活动的趋势愈发显著，学科体系构建容易引发争议。为了打破学科体系给期刊评价带来的桎梏，“升级版方案”首先构建了论文层级的主题体系，然后分别计算每篇论文在所属主题的影响力，最后汇总各期刊每篇论文分值，得到“期刊超越指数”，作为分区依据。

分区表升级版（试行）的优势：一是论文层级的主题体系既能体现学科交叉特点，又可以精准揭示期刊载文的多学科性；二是采用“期刊超越指数”替代影响因子指标，解决了影响因子数学性质缺陷对评价结果的干扰。整体而言，分区表升级版（试行）突破了期刊评价中学科体系构建、评价指标选择等瓶颈问题，能够更为全面地揭示学术期刊的影响力，为科研评价“去四唯”提供解决思路。相关研究成果经过国际同行的认可，已经发表在科学计量学领域国际重要期刊。

《2019年中国科学院文献情报中心期刊分区表升级版（试行）》首次将社会科学引文数据库（SSCI）期刊纳入到分区评估中。升级版分区表（试行）设置了包括自然科学和社会科学在内的18个大类学科。基础版和升级版（试行）将过渡共存三年时间，推测在此期间各大高校和科研院所仍可能会以基础版为考核参考标准。 提示：中科院分区官方微信公众号“fenqubiao”仅提供基础版数据查询，暂无升级版数据，请注意区分。

中科院分区 查看说明

版本 大类学科 小类学科 Top期刊 综述期刊
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4区
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心脏和心血管系统
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旧的升级版
医学
4区
CARDIAC & CARDIOVASCULAR SYSTEMS
心脏和心血管系统
4区
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2022年12月
最新升级版
医学
4区
CARDIAC & CARDIOVASCULAR SYSTEMS
心脏和心血管系统
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