Heart, Lung and Circulation最新文献

{"title":"Change in Frailty After Transcatheter and Surgical Aortic Valve Replacement for Aortic Stenosis-A Systematic Review and Meta-Analysis.","authors":"Hasan Mohiaddin, Joseph Hayes, Ravi Chotalia, Shirley Sze, Iain B Squire","doi":"10.1016/j.hlc.2025.12.022","DOIUrl":"https://doi.org/10.1016/j.hlc.2025.12.022","url":null,"abstract":"<p><strong>Background: </strong>Frailty is common among patients awaiting intervention for aortic stenosis (AS) by transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR). Although the association between pre-procedure frailty and poor outcomes is well-established, it remains unclear whether aortic valve interventions can lead to changes in frailty.</p><p><strong>Methods: </strong>Ovid MEDLINE, SCOPUS, CINAHL and Cochrane databases were searched for studies that reported frailty assessments before and after TAVI and/or SAVR. Data from these studies were used to calculate a standardised score for change in frailty following either TAVI or SAVR, as part of a pooled random effects meta-analysis, with Hedges' adjusted g value.</p><p><strong>Results: </strong>Of 4,093 records screened, nine relevant studies were identified. Among 1,598 TAVI and 200 SAVR patients, no overall changes to frailty were observed, although there was considerable heterogeneity among studies. Improvements to frailty were observed in a sensitivity analysis of lower-risk TAVI cohorts (Society of Thoracic Surgeons predicted risk of mortality [STS-PROM] ≤5%). Higher-risk TAVI and SAVR cohorts (STS-PROM >5%) did not show improvements in frailty post-aortic valve intervention.</p><p><strong>Conclusions: </strong>Overall, neither TAVI nor SAVR leads to significant changes in frailty measurements, although data are highly heterogeneous. Further research into the possible role of additional frailty interventions, particularly in higher-risk patients with AS undergoing TAVI or SAVR, should be considered.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Digitoxin the Fifth Pillar in Heart Failure With Reduced Ejection Fraction? A Response to the DIGIT-HF Trial","authors":"Rakila Kurugalage BCS, MD ,&nbsp;Alasdair Leslie MBBS ,&nbsp;Stephen Bacchi MBBS, PhD ,&nbsp;Carmine De Pasquale MBBS, PhD","doi":"10.1016/j.hlc.2025.11.010","DOIUrl":"10.1016/j.hlc.2025.11.010","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 5","pages":"Pages e76-e77"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147828121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence Deep Learning Methods in the Assessment of Cardiovascular Risk for Patients With Autoimmune Diseases: A Promising Prospect","authors":"Taylor Strube MD ,&nbsp;Alasdair Leslie MBBS, MBEE ,&nbsp;Brandon Stretton MBBS ,&nbsp;Stephen Bacchi MBBS, PhD, FRACP","doi":"10.1016/j.hlc.2025.11.011","DOIUrl":"10.1016/j.hlc.2025.11.011","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 5","pages":"Pages e78-e79"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147828122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Exposure to Sodium-Glucose Cotransporter-2 Inhibitors and Acute Kidney Injury After Cardiac Surgery: A Retrospective Single-Centre Cohort Study With Overlap Weighting Propensity Score Analysis","authors":"Martin Ruste MD, PhD ,&nbsp;Alexandre Vieira MSc ,&nbsp;Yann Le Guennec-Lux MD ,&nbsp;Christelle Berthod MD ,&nbsp;Matteo Pozzi MD, PhD ,&nbsp;Nathan Mewton MD, PhD ,&nbsp;Jean-Luc Fellahi MD, PhD ,&nbsp;Matthias Jacquet-Lagrèze MD, PhD","doi":"10.1016/j.hlc.2026.01.004","DOIUrl":"10.1016/j.hlc.2026.01.004","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>This study aims to investigate the impact of preoperative sodium-glucose cotransporter 2 inhibitor (SGLT2i) exposure on cardiac surgery-associated acute kidney injury. This is a single-centre retrospective cohort study with a propensity score weighting analysis for causal inference. The study was set in a cardiovascular and thoracic centre of a teaching hospital (France), between January 2022 and February 2024.</div></div><div><h3>Method</h3><div>Participants were adults who had undergone cardiac surgery with cardiopulmonary bypass and had ≥1 of the following indications for long-term treatment with SGLT2i: type 2 diabetes with high cardiovascular risk; heart failure with a left ventricular ejection fraction &lt;50%; chronic kidney disease with a glomerular filtration rate &lt;60 mL/min/1.73 m². Preoperative long-term SGLT2i medication versus no preoperative long-term SGLT2i medication, whether or not the treatment was discontinued during the preoperative period.</div></div><div><h3>Results</h3><div>The primary end point was cardiac-associated acute kidney injury Stage ≥1 in the 7 days after surgery as defined by the creatinine variation (Kidney Disease: Improving Global Outcomes criteria). Causal inference analysis was performed with overlap weighting propensity score analysis. A total 509 patients were included (117 with preoperative exposure to SGLT2i, 65 patients without preoperative treatment discontinuation). Preoperative exposure to SGLT2i was not associated with a significant reduction in cardiac surgery-associated acute kidney injury (35% vs 30%, relative risk 1.12; 95% confidence interval 0.80–1.55).</div></div><div><h3>Conclusions</h3><div>Preoperative exposure to SGLT2i was not associated with a reduction in cardiac surgery-associated acute kidney injury in the present study, which was underpowered to rule out a potential clinically significant effect.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 5","pages":"Pages 658-667"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and Sex Disparities in Patients With Takotsubo Cardiomyopathy With Inflammatory Bowel Disease","authors":"Ankit Agrawal MD ,&nbsp;Shrey Chopra MD ,&nbsp;Umesh Bhagat MD ,&nbsp;Akshat Banga MBBS, MD ,&nbsp;Akiva Rosenzveig MD ,&nbsp;Aro Daniela Arockiam MD ,&nbsp;Saad Ur Rahman MD ,&nbsp;Rushin Patel MD ,&nbsp;Sarju Ganatra MD ,&nbsp;Sourbha S. Dani MD","doi":"10.1016/j.hlc.2025.12.016","DOIUrl":"10.1016/j.hlc.2025.12.016","url":null,"abstract":"<div><h3>Background &amp; Aim</h3><div>Takotsubo cardiomyopathy (TCM), a stress-induced cardiomyopathy, has been increasingly recognised, but its association with patients with inflammatory bowel disease (IBD) is not well established. This study aimed to assess the sex and racial differences in cardiovascular adverse events and outcomes in patients with TCM with IBD.</div></div><div><h3>Method</h3><div>Using the National Inpatient Sample (2016–2021), we identified adult patients (aged ≥18 years) with IBD and TCM. Demographic, clinical characteristics, and adverse inpatient outcomes were compared in patients with TCM with and without IBD. Subgroup analyses were performed to assess sex and racial disparities in outcomes among patients with TCM and IBD.</div></div><div><h3>Results</h3><div>Among 1,978,434 patients admitted to hospital with IBD, 3,225 (0.16%) had a concurrent diagnosis of TCM. The mean age was 64.8±13.6 years, with women comprising 83.9% of this cohort. Patients with IBD were less likely than those without IBD to have hypertension (57.6% vs 66.7%; p&lt;0.001), diabetes (17.6% vs 24.4%; p&lt;0.001), and hyperlipidaemia (34.1% vs 43.0%; p&lt;0.001). IBD was linked to higher rates of venous thromboembolism (5.1% vs 3.4%; p=0.018), acute kidney injury (28.9% vs 23.8%; p=0.002), cardiogenic shock (8.8% vs 6.8%; p=0.042), extracorporeal membrane oxygenation (ECMO) use (0.6% vs 0.2%; p=0.03), and vasopressor support (6.2% vs 4.6%; p=0.048). Among patients with TCM-IBD, women were less likely to experience adverse events such as arrhythmias (odds ratio [OR] 0.51; 95% confidence interval [CI] 0.32–0.80; p=0.004). Black adults were more likely to require ECMO (OR 16.04; 95% CI 1.99–129.12; p=0.009).</div></div><div><h3>Conclusions</h3><div>IBD is associated with increased adverse outcomes in patients with TCM, with notable sex and racial disparities in complications.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 5","pages":"Pages 696-703"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ANZSCTS ASM advert","authors":"","doi":"10.1016/S1443-9506(26)00243-X","DOIUrl":"10.1016/S1443-9506(26)00243-X","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 5","pages":"Pages 705-706"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147828038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gap Between Machine Learning Innovation and Clinical Practice","authors":"Salvatore Pepe PhD, FAHA, FESC, FCSANZ","doi":"10.1016/j.hlc.2026.04.003","DOIUrl":"10.1016/j.hlc.2026.04.003","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 5","pages":"Pages 595-597"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147828152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Diabetes on Graft Patency and Progression of Proximal Coronary Stenosis After Coronary Bypass Surgery","authors":"Christopher Siderakis B BiomedSc ,&nbsp;Nilesh Srivastav MBBS ,&nbsp;Justin Ren PhD ,&nbsp;Colin Royse MBBS, MD ,&nbsp;Alistair Royse MBBS, MD","doi":"10.1016/j.hlc.2025.12.020","DOIUrl":"10.1016/j.hlc.2025.12.020","url":null,"abstract":"<div><h3>Background</h3><div>Patients with diabetes experience diminished survival after coronary artery bypass grafting (CABG), despite comparable long-term graft patency to patients without diabetes. Reduced survival may be related to accelerated progression of native coronary disease proximal to the graft in patients with diabetes, reducing native flow reserve in the case of progressive graft failure. This phenomenon has not been previously investigated.</div></div><div><h3>Method</h3><div>Patients referred for CABG at the Royal Melbourne Hospital were included if both their preoperative and postoperative coronary angiography reports were available. Study outcomes were patency of internal mammary artery (IMA), radial artery (RA) and saphenous vein grafts (SVG); and progression of proximal stenosis in grafted coronary arteries that were non-chronic total occlusions (non-CTO), stratified by diabetic and non-diabetic status. On postoperative angiography, a patent graft demonstrated contrast opacification, and a progressive native lesion demonstrated an absolute increase in preoperative stenosis severity of ≥20 percentage points or development of a new occlusion. Analyses were performed with an exchangeable Generalised Estimating Equations (GEE) multivariable binary logistic regression model.</div></div><div><h3>Results</h3><div>Postoperative angiography occurred mostly for symptoms between August 1997 and March 2020. Overall, 250 patients with diabetes and 497 patients without diabetes received 858 grafts (312 IMA, 461 RA, 85 SVG) and 1,433 grafts (561 IMA, 719 RA, 153 SVG), respectively. Mean follow-up was at 8.7±5.6 years after surgery. Overall graft patency was not different between patients with and without diabetes, 90.6% vs 88.5% (odds ratio [OR]=1.35, 95% confidence interval [CI]=0.89-2.04; p=0.161). Among patients with diabetes, arterial graft (IMA+RA) patency remained stable over time (OR=0.98, 95% CI=0.93-1.03; p=0.339) and was superior to SVG, 92.0% vs 77.6% (OR=2.94, 95% CI=1.41-6.11; p=0.004), for which the odds of patency declined by 17% with each postoperative year (OR=0.83, 95% CI=0.73-0.94; p=0.002). Of the grafted non-CTO coronary arteries, progression of proximal stenosis occurred more frequently in patients with diabetes compared to patients without diabetes, 62.1% vs 53.7% (OR=1.34, 95% CI=1.03-1.74; p=0.03).</div></div><div><h3>Conclusions</h3><div>Diabetes did not impact overall graft patency, but was associated with accelerated progression of proximal stenosis in grafted coronary arteries. The SVG demonstrated progressive decline in patency, which may heighten the risk of myocardial ischaemia in patients with diabetes due to reduced flow reserve from the native circulation. In contrast, arterial grafts demonstrated durable patency over time and may promote sustained myocardial protection in patients with diabetes.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 5","pages":"Pages 668-675"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"10-Year Trends in Lipoprotein(a) Testing in Queensland and Australia: A Retrospective Analysis of Ordering Patterns","authors":"Caroline A.E. Bachmeier MD ,&nbsp;Greg J. Ward MSc ,&nbsp;Ashley Arnott MAppSc(MedSc) ,&nbsp;Behzad Kiani PhD ,&nbsp;Andrew J. Kassianos PhD ,&nbsp;Michael M. Page PhD ,&nbsp;Karam M. Kostner PhD","doi":"10.1016/j.hlc.2026.01.007","DOIUrl":"10.1016/j.hlc.2026.01.007","url":null,"abstract":"<div><h3>Background</h3><div>Lipoprotein(a) [Lp(a)] is a genetically determined, highly atherogenic lipoprotein that contributes to cardiovascular disease and calcific aortic valve stenosis. Increased Lp(a) levels warrant intensified management of cardiovascular risk factors. With targeted Lp(a)-lowering therapies in clinical development, identification of individuals with increased levels has increasing therapeutic implications. Guidelines differ, recommending testing in either high-risk groups or universally once in a lifetime, yet testing rates remain low.</div></div><div><h3>Method</h3><div>We performed a retrospective analysis of laboratory data from a large tertiary referral centre in Queensland, Australia, evaluating trends in Lp(a) testing between 1 January 2015 and 31 December 2024.</div></div><div><h3>Results</h3><div>Lp(a) testing increased markedly over the 10-year study period. In Queensland, annual test volumes rose from 652 in 2015 to 4,364 in 2024. Including interstate referrals, test numbers increased from 2,686 in 2015 to 23,135 in 2024. The steepest rise occurred in the final 2 years of observation. Despite these increases, testing rates relative to the screened population remained low, and testing generally occurred late in individuals in their 50s.</div></div><div><h3>Conclusion</h3><div>Lp(a) testing has grown substantially in Queensland and Australia over the past decade, likely reflecting increased recognition of its causal role in cardiovascular disease, evolving guideline recommendations, test accessibility, and the emergence of novel therapies. However, overall testing remains limited. Broader implementation of guideline-based testing and greater clinician awareness will be critical to ensure timely identification of individuals who may benefit from available and emerging therapeutic strategies.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 5","pages":"Pages 620-626"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Society of Australia and New Zealand","authors":"","doi":"10.1016/S1443-9506(26)00244-1","DOIUrl":"10.1016/S1443-9506(26)00244-1","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 5","pages":"Pages 707-708"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147828037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}