Clinical Cardiology最新文献

{"title":"“Investigation of the Effect of Sleep Hygiene Training on Obstructive Sleep Apnea Symptoms, Fatigue, and Sleep Quality In Patients With Atrial Fibrillation”","authors":"Besey Ören,&nbsp;Busra Zehra Buyukkilic,&nbsp;Semiha Akin Eroglu,&nbsp;Ahmet Lutfullah Orhan","doi":"10.1002/clc.70128","DOIUrl":"https://doi.org/10.1002/clc.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Sleep hygiene education is widely used as a coping strategy for sleep disorders and is known to be an effective, and side-effect-free approach. To improve sleep quality by reducing the symptoms and fatigue level experienced by patients with OSAS with sleep hygiene education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The study was a single-center, randomized controlled research. A structured training program was applied face-to-face to the intervention group. Received inpatient treatment for atrial fibrillation in the Cardiology Service of a Training and Research Hospital between June 2023 and December 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant difference was found between the MOS Sleep Scale scores of the control group and the intervention group at 1 month in terms of sleep disturbance, sleep adequacy, shortness of breath, sleepiness, snoring, and sleep duration subscales. Fatigue, concentration, motivation, and physical activity scores of the intervention group patients were lower at the end of the 1st month.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Sleep hygiene education has a positive effect on sleep duration in patients with Atrial Fibrillation, however it is ineffective in ensuring high quality sleep.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Walking and Respiratory Training on Cardiopulmonary Function and Activity Endurance in Patients With Chronic Heart Failure","authors":"Qiu-Chen Wang,&nbsp;Jiang-Ying Li,&nbsp;Xiao-Su Ni,&nbsp;Wen-Wen Zhao,&nbsp;Xiao-Cui Wang,&nbsp;Li-Chun Wang","doi":"10.1002/clc.70123","DOIUrl":"https://doi.org/10.1002/clc.70123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to examine the impact of combining walking with respiratory training in patients with chronic heart failure (CHF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eighty patients with CHF, admitted to the Department of Cardiology at the Affiliated Taizhou People's Hospital of Nanjing Medical University between January 2024 and June 2024, were selected as study participants. They were randomly assigned to either a control group or an observation group, with 40 patients in each group. The control group received standard rehabilitation care, while the observation group underwent walking combined with respiratory training along with standard rehabilitation care. Cardiac function, pulmonary function, and activity tolerance were compared between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After 3 months of intervention, the observation group exhibited lower levels of heart rate (HR), left ventricular end-diastolic diameter (LVEDD), and left ventricular end-systolic diameter (LVESD) compared to the control group, while the left ventricular ejection fraction (LVEF) was significantly higher (<i>p</i> &lt; 0.05). Additionally, the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV₁), FEV₁/FVC ratio, and 6-min walking distance were greater in the observation group compared to the control group (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with CHF, combining walking and respiratory training significantly enhances cardiopulmonary function and activity tolerance, demonstrating potential clinical use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Risk Factors for Atrial Fibrillation With a Particular Focus on Echocardiographic Parameters, in Patients With Acute Myocardial Infarction","authors":"Beata Jacuś,&nbsp;Anna Milewska,&nbsp;Paweł Miękus,&nbsp;Marcin Konarzewski,&nbsp;Ludmiła Daniłowicz-Szymanowicz,&nbsp;Andrzej Lubiński,&nbsp;Grzegorz Grześk","doi":"10.1002/clc.70114","DOIUrl":"https://doi.org/10.1002/clc.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atrial fibrillation is the most common arrhythmia worldwide, affecting between 2% and 4% of population. The projected further progression is a reason to consider AF as a global epidemic problem. The efficiency in diagnosing new cases is still unsatisfactory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The prospective study included 74 patients hospitalized for acute myocardial infarction. Echocardiography with advanced assessment of the left atrium was performed on all patients. R Statistical Software was used for statistical and graphical processing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Atrial fibrillation was first diagnosed in 13.5% of patients with acute myocardial infarction, and in 5.4% of the patients the diagnosis was made during the long-term follow-up period. Analysis of the data collected showed that patients with arrythmia were older (71.79 vs 63.5 years; <i>p</i> = 0.047), had a higher BMI (30.15 vs 26.76 kg/m²; <i>p</i> = 0.039) and had a higher CHA₂DS₂ VASc score (4.14 vs 3.02 points). Among the echocardiographic parameters, those that significantly differentiated patients with arrythmia included larger LA area (21.62 vs 18.84 cm²; <i>p</i> = 0.027), lower LAEF 4CH (43.46 vs 55.93%; <i>p</i> = 0.029), lower LAEF mean (44.08 vs 55.63%; <i>p</i> = 0.014), lower EI (1.03 vs 1.49; <i>p</i> = 0.032), lower LASr 4CH (19.08 vs 26.72%; <i>p</i> = 0.020), lower LASr mean (18.62 vs 26.73%; <i>p</i> = 0.009), higher E/e’ (12.62 vs 9.58; <i>p</i> = 0.01), higher LASI (0.95 vs 0.45; <i>p</i> = 0.016).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among the echocardiographic parameters, those that may indicate an increased risk of atrial fibrillation and could be implemented in clinical practice are LASr and LASI. Determining them in risk profiling and the implementation of individualized arrhythmia detection methods could increase diagnostic efficiency.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting In-Hospital Mortality in Patients With Acute Myocardial Infarction: A Comparison of Machine Learning Approaches","authors":"Hamidreza Soleimani,&nbsp;Soroush Najdaghi,&nbsp;Delaram Narimani Davani,&nbsp;Parham Dastjerdi,&nbsp;Parham Samimisedeh,&nbsp;Hedieh Shayesteh,&nbsp;Babak Sattartabar,&nbsp;Farzad Masoudkabir,&nbsp;Haleh Ashraf,&nbsp;Mehdi Mehrani,&nbsp;Yaser Jenab,&nbsp;Kaveh Hosseini","doi":"10.1002/clc.70124","DOIUrl":"https://doi.org/10.1002/clc.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acute myocardial infarction (AMI) remains a leading global cause of mortality. This study explores predictors of in-hospital mortality among AMI patients using advanced machine learning (ML) techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 7422 AMI patients treated with percutaneous coronary intervention (PCI) at Tehran Heart Center (2015–2021) were analyzed. Fifty-eight clinical, demographic, and laboratory variables were evaluated. Seven ML algorithms, including Random Forest (RF), logistic regression with LASSO, and XGBoost, were implemented. The data set was divided into training (70%) and testing (30%) subsets, with fivefold cross-validation. The class imbalance was addressed using the synthetic minority oversampling technique (SMOTE). Model predictions were interpreted using SHapley Additive exPlanations (SHAP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In-hospital mortality occurred in 129 patients (1.74%). RF achieved the highest predictive performance, with an area under the curve (AUC) of 0.924 (95% CI 0.893–0.954), followed by XGBoost (AUC 0.905) and logistic regression with LASSO (AUC 0.893). Sensitivity analysis in STEMI patients confirmed RF's robust performance (AUC 0.900). SHAP analysis identified key predictors, including lower left ventricular ejection fraction (LVEF; 33.24% vs. 43.46% in survivors, <i>p</i> &lt; 0.001), higher fasting blood glucose (190.38 vs. 132.29 mg/dL, <i>p</i> &lt; 0.001), elevated serum creatinine, advanced age (70.92 vs. 61.88 years, <i>p</i> &lt; 0.001), and lower LDL-C levels. Conversely, BMI showed no significant association (<i>p</i> = 0.456).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ML algorithms, particularly RF, effectively predict in-hospital mortality in AMI patients, highlighting critical predictors such as LVEF and biochemical markers. These insights offer valuable tools for enhancing clinical decision-making and improving patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Changes in Heart Rate and Adverse Events in Patients With Non-Valvular Atrial Fibrillation: A Post Hoc Analysis of the J-RHYTHM Registry","authors":"Eitaro Kodani,&nbsp;Takeshi Yamashita,&nbsp;Hiroshi Inoue,&nbsp;Hirotsugu Atarashi,&nbsp;Ken Okumura,&nbsp;Hideki Origasa,&nbsp;J-RHYTHM Registry Investigators","doi":"10.1002/clc.70122","DOIUrl":"https://doi.org/10.1002/clc.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We previously reported that the heart rate (HR) at the time closest to an event or at the last visit during the follow-up period (HR-end) was more closely associated with adverse events (AEs) than baseline HR in patients with non-valvular atrial fibrillation (NVAF). However, it remains uncertain whether changes in HR during the follow-up period or absolute HR values would be more closely associated with AEs. Thus, we performed post hoc analyses using data from the J-RHYTHM Registry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Of 7406 outpatients with NVAF from 158 institutions, 6886 (age, 69.8 ± 9.9 years; men, 70.8%), who had both baseline HR and HR-end data, were included. Patients were divided into five groups based on the changing patterns of HR quartiles from baseline (&lt; 63, 63–70, 71–79, and ≥ 80 beats per minute) to the end of follow-up (no-change, down-to-the-lowest-quartile, down-to-the-2nd or -3rd-quartile, up-to-the-2nd or -3rd-quartile, and up-to-the-highest-quartile).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Hazard ratios for AEs were significantly higher only in the up-to-highest-quartile group (2.89 [95% confidence interval, 1.71–4.90] for thromboembolism, 2.46 [1.53–3.95] for major hemorrhage, and 2.36 [1.51–3.70] for all-cause death) compared with the no-change group, after adjusting for confounding factors. Furthermore, in the no-change group, hazard ratios for AEs were significantly higher in the highest-to-highest-quartile subgroup (5.55 [1.49–20.77] for major hemorrhage and 3.60 [1.03–12.53] for all-cause death) compared with the 2nd-to-2nd-quartile subgroup.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both excessive increases in HR and consistently high HR were independently associated with AEs in patients with NVAF. By contrast, modest decrease in HR during follow-up was associated with lower mortality. Accordingly, it is important to pay attention to changes in HR during follow-up for the management of patients with AF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Trial Registration</h3>\u0000 \u0000 <p>The J-RHYTHM Registry is registered in the University Hospital Medicine Information Network (UMIN) Clinical Trials Registry (unique identifier: UMIN000001569) http://www.umin.ac.jp/ctr/.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise-Based Cardiac Rehabilitation for Patients After Heart Valve Surgery: A Systematic Review and Re-Evaluation With Evidence Mapping Study","authors":"Rongxiang Zhang,&nbsp;Chenyang Zhu,&nbsp;Shiqi Chen,&nbsp;Feng Tian,&nbsp;Yuan Chen","doi":"10.1002/clc.70117","DOIUrl":"https://doi.org/10.1002/clc.70117","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This systematic review and evidence mapping study aims to assess the effects of exercise-based cardiac rehabilitation on clinical outcomes in patients after heart valve surgery. By consolidating and visualizing existing evidence, the study seeks to identify gaps in knowledge, evaluate the quality and breadth of current research, and provide guidance for clinical practice and future research. The evidence mapping will highlight under-researched areas and inform healthcare providers on effective strategies to enhance postoperative recovery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search was performed across multiple databases, including PubMed, Embase, Cochrane CENTRAL, Web of Science, CNKI, and Wanfang, up to May 2024. Two reviewers independently screened the articles, extracted relevant data, and assessed study quality. Study characteristics and outcomes were visualized using bubble plots.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten systematic reviews/meta-analyses met the inclusion criteria. Based on AMSTAR-2, two were rated “high quality,” two “low quality,” and six “very low quality.” Using the GRADE system, of the 48 pieces of evidence across 10 outcomes, 1 was “high quality,” 8 “moderate,” 19 “low,” and 20 “very low.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Current evidence indicates that exercise-based cardiac rehabilitation can enhance physical capacity, left ventricular ejection fraction, peak oxygen uptake, and daily living activities in heart valve surgery patients. However, more large-scale, high-quality studies are needed to verify its effects on all-cause mortality, quality of life, adverse events, return to work, and emotional health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes and Prognostic Implications of TAVR in Patients With Active Cancer: A Meta-Analysis","authors":"Parsa Saberian,&nbsp;Rafael Contreras,&nbsp;Anoop Gurram,&nbsp;Amir Nasrollahizadeh,&nbsp;Narsimha Rao Keetha,&nbsp;Anthony Loc Nguyen,&nbsp;Sandeep Samethadka Nayak,&nbsp;Mohammad-Hossein Keivanlou,&nbsp;Mohammad Hashemi,&nbsp;Ehsan Amini-Salehi,&nbsp;Daniyal Ameen","doi":"10.1002/clc.70121","DOIUrl":"https://doi.org/10.1002/clc.70121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Transcatheter aortic valve replacement (TAVR) is an alternative to surgical aortic valve replacement (SAVR) for high-risk patients with severe aortic stenosis (AS). However, the clinical outcomes and prognostic implications of TAVR in patients with active cancer remain uncertain. This meta-analysis evaluates procedural success, complications, and survival outcomes of TAVR in patients with and without active cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science databases. Statistical analysis was performed using a random-effects model. Statistical analyses were conducted using STATA version 18.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results of the meta-analysis showed no significant difference in in-hospital mortality between cancer and non-cancer patients (OR = 1.17; 95% CI: 0.83, 1.65; <i>p</i> = 0.27). Similarly, 30-day mortality did not differ between the two groups (OR = 0.93; 95% CI: 0.72, 1.19; <i>p</i> = 0.49). However, 1-year mortality was significantly higher in cancer patients (OR = 1.93; 95% CI: 1.45, 2.56; <i>p</i> &lt; 0.01). Two-year mortality was also higher in cancer patients (OR = 2.65; 95% CI: 1.79, 3.93; <i>p</i> &lt; 0.01). No significant differences were observed in major bleeding, acute kidney injury, stroke, or permanent pacemaker implantation between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While TAVR offers comparable in-hospital and short-term survival outcomes for cancer and non-cancer patients, long-term mortality is significantly higher in those with active cancer. These findings suggest that TAVR is a viable option for cancer patients with severe AS but requires careful long-term prognostic considerations. Further studies are needed to optimize management strategies for this complex population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and Impact of Cardiology Evaluation Following Perioperative Myocardial Infarction","authors":"Anthony Hung,&nbsp;R. Parker Ward,&nbsp;Daniel S. Rubin","doi":"10.1002/clc.70120","DOIUrl":"10.1002/clc.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Perioperative myocardial infarction (PMI) after noncardiac surgery results in significant morbidity and mortality. While comprehensive management, including imaging and guideline-directed medical therapy (GDMT), improves outcomes, utilization of these strategies and the impact of physician evaluation on their utilization are unknown. This study evaluates the frequency of cardiology evaluation after PMI and its association with guideline-recommended care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using IBM MarketScan (2016–2021), we analyzed claims for patients ≥ 45 years old with PMI during or after major noncardiac surgery. We examined the relationship between cardiology evaluation and post-PMI care using three regression models: (1) a Poisson model for GDMT class prescriptions filled within 3 months post-discharge, and logistic models for (2) ischemic testing and (3) echocardiography during hospitalization or within 3 months post-discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 5660 patients with PMI (mean age 68, 56.9% male, 27.2% with STEMI), 19% were not evaluated by a cardiologist. Patients with cardiology evaluation were more likely to receive at least one GDMT prescription after PMI (78.8% vs 74.0%, <i>p</i> &lt; 0.001). Cardiology evaluation was also associated with an increased likelihood of ischemic testing (38.2% vs 23.0%, <i>p</i> &lt; 0.001) and echocardiography (75.9% vs 53.6%, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>One in five PMI patients lacks cardiology evaluation, and evaluation is associated with an increased likelihood of recommended management after PMI. Future studies should explore whether cardiology evaluation and management strategies impact patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrial Fibrillation and Heart Failure: Synergistic Effect on Functional Class and Quality of Life","authors":"Sofía Zapata,&nbsp;Maria F. Colorado,&nbsp;Andrés Medina,&nbsp;Jaime A. Mejía,&nbsp;Sofia Betancur,&nbsp;Johanna M. Vanegas,&nbsp;James S. Díaz","doi":"10.1002/clc.70113","DOIUrl":"10.1002/clc.70113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atrial fibrillation (AF) and heart failure (HF) are highly prevalent conditions associated with significant morbidity and symptom burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Hypothesis</h3>\u0000 \u0000 <p>This study compared the evolution over time of functional class and quality of life (QoL) in patients with HF according to the presence of AF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted at an outpatient heart failure clinic in Colombia, between 2020 and 2022. Functional class (based on the New York Heart Association classification) and QoL (measured by the Minnesota Living with Heart Failure Questionnaire), were analyzed at baseline, 3 months, 6 months, and the last visit. The simultaneous impact of AF and left ventricular ejection fraction was analyzed using a generalized estimation equation model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 440 patients (median age 74 years, 56.6% men), 41.4% with AF, and 65.2% with reduced ejection fraction (HFrEF). Over time, functional class improved in both groups, with a more significant improvement in patients without AF. Patients with AF and HFrEF were more likely to remain in worse functional classes (OR: 2.77; 95% CI: 1.37–5.62). Similar trends were observed in QoL questionnaire, with sustained improvement after 3 months. However, AF negatively affected the physical dimension in patients with HFrEF, increasing the QoL questionnaire score by up to 4%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The presence of AF and reduced ejection fraction was associated with a lesser improvement in functional class and physical dimension of QoL questionnaire, emphasizing the importance of early detection and management of AF as part of comprehensive HF care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Effects of Left Bundle Branch Area Pacing Versus Traditional Right Ventricular Pacing on Atrial Fibrillation After Dual-Chamber Pacemaker Implantation","authors":"Jieruo Chen,&nbsp;Zefeng Wang,&nbsp;Fei Hang,&nbsp;Weiping Sun,&nbsp;Haiwei Li,&nbsp;Yongquan Wu","doi":"10.1002/clc.70116","DOIUrl":"https://doi.org/10.1002/clc.70116","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Traditional right ventricular pacing (RVP) can lead to asynchronous cardiac mechanical contractions and increase the risk of atrial fibrillation (AF). This study aimed to compare the occurrence of new-onset AF and the progression of AF between novel physiological pacing—left bundle branch area pacing (LBBAP) and RVP with a long-term follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>Patients with a dual-chamber permanent pacemaker initial implantation, no history of persistent AF, and an expected high proportion of ventricular pacing (VP ≥ 20%) were included in this retrospective cohort study (LBBAP, <i>n</i> = 122; RVP, <i>n</i> = 166). The pacing QRS duration (QRSd) of the LBBAP was significantly shorter than that of the RVP (113 ± 22 vs. 140 ± 27 ms, <i>p</i> &lt; 0.001), while the intrinsic QRSd values from the two groups were comparable. During a mean follow-up of 21.9 ± 9.4 months, the composite outcome of postoperative new-onset AF or AF progression was higher in the RVP group than in the LBBAP group (RVP HR 2.62, 95%CI 1.21–5.67, <i>p</i> = 0.014). Left ventricular end-diastolic diameter (LVEDD) levels decreased in the LBBAP group at 1 year follow-up (50 ± 6 vs. baseline 48 ± 6, <i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In a mean follow-up period of 2 years, compared to RVP, LBBAP patients with VP ≥ 20% had a decreased risk of occurrence and progression of AF events.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}