Heart, Lung and Circulation最新文献

{"title":"Epidemiological Trends and Survival Outcomes for Thymic Epithelial Tumours: An Australian Population-Based Retrospective Cohort Study.","authors":"Joshua G Goldblatt, Lachlan P Crawford, Danica Cossio, Christopher M W Cole","doi":"10.1016/j.hlc.2024.12.011","DOIUrl":"https://doi.org/10.1016/j.hlc.2024.12.011","url":null,"abstract":"<p><strong>Background: </strong>Thymic epithelial tumours (TETs) represent a heterogenous group of relatively uncommon lesions which have varied disease behaviour. There is limited literature on the epidemiology and survival outcomes of these tumours in an Australian context.</p><p><strong>Method: </strong>We conducted a population-based retrospective cohort study of patients diagnosed with TETs in the Australian state of Queensland between 2000 and 2021, recruited via the Queensland Oncology Repository.</p><p><strong>Results: </strong>Four hundred and ninety-seven (497) patients were identified, with a significant increase in the incidence of TETs over the study period. The 5-year overall survival for the full study cohort was 80.7%, declining to 67.1% at 10 years. Disease-specific survival was higher at 87.1% by 5 years, and 79.3% at 10 years. The majority of patients underwent upfront surgical resection, with a trend towards better survival.</p><p><strong>Conclusions: </strong>Survival outcomes to 5 years and beyond are generally favourable, particularly for patients with less histologically aggressive lesions. Patients treated surgically, either with or without neoadjuvant chemotherapy/radiotherapy, had favourable survival and disease control compared to patients receiving definitive intent chemotherapy and/or radiotherapy.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086177","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":"Eligibility for Semaglutide 2.4 mg in Patients With Acute Myocardial Infarction and Overweight or Obesity Without Diabetes: A Real-World Analysis.","authors":"Rahil Ajmera, Hassan Karim, P Gerry Fegan, Girish Dwivedi, Nick S R Lan","doi":"10.1016/j.hlc.2025.01.011","DOIUrl":"https://doi.org/10.1016/j.hlc.2025.01.011","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077057","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":"Lipidomic Profiling of a Preclinical Model of Streptozotocin-Induced Diabetic Cardiomyopathy Reveals Potential Plasma Biomarkers.","authors":"Bianca C Bernardo, Alexandra N Faulkner, Tingting Wang, Kevin Huynh, Peter J Meikle, Kate L Weeks, Yow Keat Tham","doi":"10.1016/j.hlc.2024.11.036","DOIUrl":"https://doi.org/10.1016/j.hlc.2024.11.036","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077347","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":"Heart Rhythm Harmony Becomes Discordant as We Age.","authors":"Edward G Lakatta","doi":"10.1016/j.hlc.2025.04.084","DOIUrl":"https://doi.org/10.1016/j.hlc.2025.04.084","url":null,"abstract":"<p><p>Heartbeats are initiated by pacemaker cells within the sinoatrial node (SAN) that generate spontaneous impulses at intervals that resonate around a preferred mean frequency. A coupled-clock system (CCS) intrinsic to individual pacemaker cells, that is modulated by autonomic input, drives SAN normal automaticity. Subcellular and cell-wide mechanisms within the CCS are in \"dynamic equilibrium,\" and never achieve a true steady state. Nanoscale electromagnetic \"vibrations\" caused by mechanisms intrinsic to the CCS and their autonomic modulation create heartbeat rhythm, (\"heartbeat music\"). A \"Heart-Brain Grand Symphony\" (HBGS), that emerges from this \"beautiful noise\" as the heart beats, is broadcast to the body surface, and its numerous motifs within the symphony can be experienced by tuning into electrocardiogram (EKG) RR-interval variability rhythms. As age increases, one or more of the components of physiologic coupling within the neuroautonomic regulatory sinus node and atrial networks begins to deteriorate, and cacophony emerges within the HBGS, manifested by reductions in the mean rate and rhythm at which the CCS within SAN cells fires action potentials. These subclinical changes in SAN structure and function as age advances become \"partners\" with pathophysiology that defines clinical SAN and other cardiac tissue diseases, e.g., Sick Sinus Syndrome and atrial fibrillation, and as such age-associated changes in SAN structure and function are co-morbidities of these clinical cardiac diseases. In other terms as age advances, sub-clinical age-associated changes in SAN structure and function, per se, are major shareholders in SAN disease enterprises.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998250","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":"Australian Cardiac Outcomes Registry of Transcatheter Aortic Valve Implantation: Report and Update of Transcatheter Aortic Valve Implantation in Australia","authors":"Ajay Sinhal FRACP FCSANZ ,&nbsp;Jayme Bennetts FRACS FCSANZ ,&nbsp;Ravinay Bhindi FRACP FCSANZ ,&nbsp;Kara Cashman MSc ,&nbsp;Anita Deakin MSc ,&nbsp;Robert Gooley FRACP FCSANZ ,&nbsp;Emma Heath MSc ,&nbsp;Michelle Lorimer PhD ,&nbsp;David Muller FRACP FCSANZ ,&nbsp;Martin Ng FRACP FCSANZ ,&nbsp;Ross Roberts-Thomson FRACP FCSANZ ,&nbsp;Darren Walters FRACP FCSANZ ,&nbsp;Antony Walton FRACP FCSANZ ,&nbsp;Robert Whitbourn FRACP FCSANZ ,&nbsp;William Wilson FRACP FCSANZ ,&nbsp;Gerald Yong FRACP FCSANZ ,&nbsp;Anthony Camuglia FRACP FCSANZ","doi":"10.1016/j.hlc.2025.02.107","DOIUrl":"10.1016/j.hlc.2025.02.107","url":null,"abstract":"<div><h3>Background</h3><div>Transcatheter aortic valve implantation (TAVI) procedures performed in Australia are recorded in the national Australian Cardiac Outcomes Registry (ACOR) TAVI Registry. Characteristics of patients and operators are prospectively collected with reference to patient demographics, procedural factors as well as outcomes related to both efficacy and safety metrics.</div></div><div><h3>Methods</h3><div>Patient level data reported to the ACOR TAVI Registry from enrolled sites from registry inception up until 31 December 2021 were analysed. Key safety and efficacy metrics were identified and used to assess TAVI performance and outcomes in the Australian setting.</div></div><div><h3>Results</h3><div>From 10 April 2018 to 31 December 2021, 9,881 consecutive patients underwent a TAVI procedure in Australia across 42 TAVI hospitals. The mean age of patients treated was 81.8 years (± standard deviation [SD] 7.1 years), 40.6% were female and the mean STS (Society for Thoracic Surgeons) score was 5.3% (±SD 4.4%). Overall, 0.3% of the cohort identified as Australian Aboriginal or Torres Strait Islander peoples. All-cause mortality at 30 days and 12 months was 1.37% and 5.57% respectively. The 30-day rates of stroke, major vascular complications and newly implanted permanent pacemaker were 2.19%, 1.23% and 10.68% respectively. There were 181 unique primary operators who performed TAVI during this time with an annualised median number of 19 procedures per operator per year (interquartile range [IQR] 42.5) and 63% of operators performed &lt;30 cases per year.</div></div><div><h3>Conclusions</h3><div>TAVI is being performed in Australia with the encouraging outcomes described. These would appear to compare favourably with other international datasets.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages 472-484"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657030","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":"Transcatheter Aortic Valve Implantation (TAVI) in Australia","authors":"Kiran Sarathy MBBS FRACP ,&nbsp;Virag Kushwaha MBBS, PhD, FRACP ,&nbsp;Vinayak Nagaraja MBBS, MBiostat, FRACP","doi":"10.1016/j.hlc.2025.04.079","DOIUrl":"10.1016/j.hlc.2025.04.079","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages 419-421"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924712","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":"Paid MBP advert: Cardiac Society of Australia and New Zealand","authors":"","doi":"10.1016/S1443-9506(25)00316-6","DOIUrl":"10.1016/S1443-9506(25)00316-6","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages 531-532"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924905","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":"Transcatheter Aortic Valve Implantation in Patients at Intermediate and Low Risk Is Not (Yet) the Existential Threat That Surgeons Feared: A Retrospective Analysis of Medicare Claims Data","authors":"Jonathon B. Ryan MHPol, PhD, FRACS","doi":"10.1016/j.hlc.2024.11.022","DOIUrl":"10.1016/j.hlc.2024.11.022","url":null,"abstract":"<div><h3>Background</h3><div>In Australia, the role of surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) in patients who are suitable for both procedures remains controversial. In 2022, new Items were added to the Medicare Benefits Schedule (MBS) to allow patients at intermediate and low risk with appropriate private health insurance to undergo TAVI. The Cardiac Society of Australia and New Zealand supported these changes whereas the Australian and New Zealand Society of Cardiac and Thoracic Surgeons opposed them. The aim of this study was to document subsequent private TAVI activity in patients at intermediate and low risk, relative to both private TAVI activity in patients at high risk and private SAVR activity.</div></div><div><h3>Method</h3><div>A retrospective population-level descriptive study was undertaken, using Medicare claims data obtained from Services Australia.</div></div><div><h3>Results</h3><div>Among private patients who underwent TAVI, the groups at high, intermediate, and low risk all had a median age between 75 and 84 years. Only 1% were aged ≤64 years (86/6,586), and 80% of these were at high risk (69/86). Among private patients at intermediate and low risk who underwent TAVI and private patients who underwent SAVR, only 4% of patients aged 55–64 years chose private TAVI over private SAVR (8/211), and 63% of these were at intermediate risk (5/8).</div></div><div><h3>Conclusions</h3><div>The introduction of MBS Items for private TAVI in patients at intermediate and low risk without accompanying age exclusion criteria has not (yet) had a major impact on private SAVR activity. This suggests that the multidisciplinary heart team (TAVI case conference) approval process remains an effective mechanism for ensuring access to private TAVI is consistent with international guidelines.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages 467-471"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381306","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":"Psychosocial Well-Being and Healthy Eating in Cardiac Rehabilitation: A National Survey of Cardiac Rehabilitation Practitioners Self-Reported Practices","authors":"Sarah Gauci PhD ,&nbsp;Georgia K. Chaseling PhD ,&nbsp;Susie Cartledge PhD ,&nbsp;Madeline L. West PhD ,&nbsp;Ling Zhang PhD ,&nbsp;Clara Zwack PhD ,&nbsp;Matthew Hollings PhD ,&nbsp;Tom Briffa PhD ,&nbsp;Robyn Gallagher PhD ,&nbsp;Julie Redfern PhD ,&nbsp;Adrienne O’Neil PhD","doi":"10.1016/j.hlc.2024.11.027","DOIUrl":"10.1016/j.hlc.2024.11.027","url":null,"abstract":"<div><h3>Background</h3><div>Psychosocial well-being and nutritional counselling are important components of cardiac rehabilitation endorsed by national and international guidelines. However, both areas can be complex for cardiac rehabilitation practitioners to navigate. This study aimed to examine whether practitioners have implemented standardised program content for psychosocial well-being and healthy eating and explore attitudes to these components.</div></div><div><h3>Method</h3><div>Cardiac rehabilitation practitioners were recruited to complete a 32-item cross-sectional survey via convenience sampling. The survey was developed by a team of researchers and practitioners to assess practices, practitioner approaches, and any barriers to implementation. Quantitative results were explored using descriptive statistics, and qualitative responses were coded and classified.</div></div><div><h3>Results</h3><div>Participants (n=98) represented approximately 89 (22%) cardiac rehabilitation services across Australia. Results suggested that most participants were familiar with standardised program content (92.3%). However, there were inconsistencies about the implementation. For example, although 93.9% of practitioners stated that their programs routinely screen for psychosocial well-being, only 47.2% repeat screening at program completion. On healthy eating, 99% of practitioners report providing healthy dietary advice—however, just over half offered individualised consultations with an expert professional such as an Accredited Practising Dietitian. Practitioners considered psychosocial well-being and healthy eating important components of the program.</div></div><div><h3>Conclusions</h3><div>Practitioners reaffirm the importance of psychosocial well-being and nutritional counselling in cardiac rehabilitation programs. However, practitioners inconsistently assess psychosocial well-being at cardiac rehabilitation completion, and individualised dietary counselling by experts is uncommon.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages 506-514"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440731","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":"Prognostic Implications of Machine Learning Algorithm–Supported Diagnostic Classification of Myocardial Injury Using the Fourth Universal Definition of Myocardial Infarction","authors":"Kristina Lambrakis BSc ,&nbsp;Ehsan Khan MBBS, MMed ,&nbsp;Zhibin Liao PhD ,&nbsp;Joey Gerlach BN ,&nbsp;Adam J. Nelson MBBS, PhD, MBA ,&nbsp;Shaun G. Goodman MD, MSc ,&nbsp;Tom Briffa PhD ,&nbsp;Louise Cullen MBBS, PhD ,&nbsp;Johan Verjans MD, PhD ,&nbsp;Derek P. Chew MBBS, MPH, PhD","doi":"10.1016/j.hlc.2024.11.023","DOIUrl":"10.1016/j.hlc.2024.11.023","url":null,"abstract":"<div><h3>Background</h3><div>With widespread adoption of high-sensitivity troponin assays, more individuals with myocardial injury are now identified, with type 1 myocardial infarction (T1MI) being less common despite having the most well-established evidence base to inform care. This study assesses the temporal time course of cardiovascular events among various forms of myocardial injury.</div></div><div><h3>Method</h3><div>Consecutive hospital encounters were identified. Using the first episode of care during the sampling period, myocardial injury classifications (i.e., T1MI, acute injury/type 2 myocardial infarction [T2MI], chronic injury, and no injury) were established via two machine learning algorithms. The temporal time course of increased hazard for mortality, recurrent myocardial infarction, heart failure, and arrhythmia over 3 years were explored.</div></div><div><h3>Results</h3><div>There were 176,787 index episodes; 6.9% were classified as T1MI, 6.0% as acute injury/T2MI, and 26.7% as chronic injury. Although each classification was associated with an early increased risk of all-cause mortality compared with no injury (incidence rate ratio [IRR]&lt;30 days: T1MI: 19.97 [95% confidence interval 12.50–32.69]; acute injury/T2MI: 26.51 [16.80–42.97]; chronic injury: 15.37 [10.22–23.95]), the instantaneous relative hazard for recurrent myocardial infarction was highest in those with initial T1MI (IRR&lt;30 days: T1MI: 28.81 [22.75–36.76]; acute injury/T2MI: 10.23 [7.60–13.77]; chronic injury:5.54 [4.34–7.41]). In contrast, the instantaneous hazard for heart failure in those with initial acute injury/T2MI and chronic injury remained increased over long-term follow up unlike in T1MI (IRR1 3 yrs: T1MI: 5.52 [4.99–6.09]; acute injury/T2MI: 10.36 [9.51–11.30]; chronic injury:7.40 [6.90–7.94]).</div></div><div><h3>Conclusions</h3><div>The substantial and persistent rate of late cardiac events highlights the need to establish an evidence base for the therapeutic management of “non-T1MI” diagnostic classifications and suggests opportunity to improve late outcomes using existing and emerging therapies.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages 497-505"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414105","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}