Heart, Lung and Circulation最新文献

{"title":"Trends and Outcomes in the Use of Adjunctive Fractional Flow Reserve From a Large Multicentre PCI Registry","authors":"Edward J. Quine MBBS ,&nbsp;Angela Brennan RN ,&nbsp;Diem Dinh PhD ,&nbsp;Jeffrey Lefkovits MBBS ,&nbsp;Dion Stub MBBS, PhD ,&nbsp;Chin Hiew MBBS","doi":"10.1016/j.hlc.2025.08.002","DOIUrl":"10.1016/j.hlc.2025.08.002","url":null,"abstract":"<div><h3>Aim</h3><div>Increasing evidence supports the use of fractional flow reserve (FFR) to accurately identify which coronary artery lesions are appropriate for intervention. We aim to describe the use of FFR-guided percutaneous coronary intervention (PCI) in a large Australian PCI registry.</div></div><div><h3>Method</h3><div>We assessed data from consecutive patients in the Victorian Cardiac Outcomes Registry from 2014 to 2020 who presented with stable coronary artery disease or non–ST-elevation acute coronary syndrome and underwent FFR-guided PCI in a single procedure. They were compared with a cohort who underwent standard angiographically guided PCI over the same period.</div></div><div><h3>Results</h3><div>A total of 59,401 patients were included in the study with 2,455 (4.1%) undergoing FFR-guided PCI. Patients who underwent FFR-guided PCI less often presented with a non–ST-elevation acute coronary syndrome (22% vs 39%, p&lt;0.001), were less probable to have their procedure out of hours (4.8% vs 10.6%, p&lt;0.001), and more probable to have radial access (70% vs 59%, p&lt;0.001). The use of FFR increased over the study period (2.8% of all cases in 2014 vs 4.7% in 2020, p&lt;0.001). FFR-guided PCI was more often performed on the left anterior descending artery (65% of all cases vs 42%, p&lt;0.001). The 30-day mortality was less in the FFR-guided group (0.2% vs 0.6%, p=0.005) but the overall mortality was very low.</div></div><div><h3>Conclusions</h3><div>This observational study demonstrates that the frequency of use of FFR to guide PCI was low in the Australian context; however, use is increasing. Patients in the FFR-guided group had lower 30-day mortality, although the overall rates of mortality in the study were very low.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 2","pages":"Pages 244-248"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833861","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":"Safety and Workflow Using Rotational Atherectomy in Non-Surgical Centres—The SWAN Study","authors":"Samantha L. Saunders MD ,&nbsp;Ganeev Malhotra MBBS ,&nbsp;Kelsey Gardiner MD ,&nbsp;Michael Tierney MD ,&nbsp;Adam Perkovic MD ,&nbsp;Eunice Chuah MBBS ,&nbsp;Eleanor Redwood MBBS ,&nbsp;William Meere MBBS ,&nbsp;Dominic Cooper MD ,&nbsp;Angus Higgins MD ,&nbsp;Patrick Sutton MD ,&nbsp;Adam Bland MBBS ,&nbsp;Philopatir Mikhail MBBS ,&nbsp;Gregory Starmer MBBS ,&nbsp;Andrew Boyle PhD ,&nbsp;Astin Lee MBBS ,&nbsp;Ritin Fernandez PhD ,&nbsp;Peter Stewart MBBS ,&nbsp;Roberto Spina MBBS ,&nbsp;Thomas J. Ford PhD","doi":"10.1016/j.hlc.2025.08.008","DOIUrl":"10.1016/j.hlc.2025.08.008","url":null,"abstract":"<div><h3>Background</h3><div>Historically, high-risk percutaneous coronary intervention (PCI) procedures such as rotational atherectomy (RA) required on-site surgical backup. However, advancements in PCI techniques, coupled with the geographic realities of Australia’s dispersed population, warrant a reassessment of RA in the context of contemporary clinical practice.</div></div><div><h3>Aim</h3><div>We aimed to establish the safety and outcomes after RA at non-surgical centres.</div></div><div><h3>Method</h3><div>Consecutive RA PCI cases from September 2012 to February 2024 at seven Australian hospitals without on-site cardiac surgery were analysed. Primary outcomes were referrals for emergency cardiac surgery (bailout) and 30-day mortality.</div></div><div><h3>Results</h3><div>A total of 943 patients (1,010 lesions) were included, with a mean age of 74.4±9.6 years. A total of 72.6% were male and the average body mass index was 28.7±7.1 kg/m². Common comorbidities included diabetes (35.1%), a history of smoking (48.7%), and acute coronary syndrome or emergency presentation (32.9%). Off-site surgical bailout was necessary for four patients (0.4%) (temporary pacing wire-related right ventricular perforation with tamponade [n=2]; burr entrapment not retrievable percutaneously [n=2]). Major coronary perforations occurred in 0.8% (n=8; Ellis III). Minor perforations occurred in 2.3% (n=22). Tamponade occurred in eight (0.8%) patients. Burr entrapment occurred in six (0.6%) patients. A total of 32 patients (3.4%) died within 30 days of the procedure; 13 cases (1.4%) were PCI-related, but only eight of these (0.8%) were directly attributable to RA (significant ischaemia, e.g., no/slow reflow [n=4]; perforation with tamponade unable to be temporised percutaneously [n=2]; burr entrapment [n=1]; extensive coronary dissection [n=1]). Female sex and acute coronary syndrome presentation were predictors of poorer outcome.</div></div><div><h3>Conclusions</h3><div>RA can be safely conducted without on-site surgical backup, including in regional Australian areas. In geographically dispersed populations, regional access to RA-assisted PCI is critical. Immediate percutaneous management remains the mainstay of management of rare but potentially severe complications such as tamponade, perforations, and burr entrapment.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 2","pages":"Pages 249-258"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846635","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":"Mitral Valve Surgery for Rheumatic Heart Disease in Indigenous Australians: A 27-Year Cohort Study of Repair Versus Replacement Outcomes","authors":"Rohen Skiba BMBS ,&nbsp;Tim Soon Cheok BMBS ,&nbsp;Craig Morrison BMBS ,&nbsp;Stewart R. Anderson BMBS ,&nbsp;Gregory Rice BMBS ,&nbsp;Jayme Bennetts MBBS ,&nbsp;Robert A. Baker PhD ,&nbsp;D-Yin Lin","doi":"10.1016/j.hlc.2025.06.1021","DOIUrl":"10.1016/j.hlc.2025.06.1021","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to evaluate long-term outcomes of mitral valve surgery for rheumatic heart disease (RHD) in Indigenous Australians, comparing survival and revision rates between valve repair and replacement, and between mechanical and bioprosthetic prostheses.</div></div><div><h3>Method</h3><div>We conducted a retrospective analysis of 365 consecutive Indigenous Australian patients who underwent mitral valve surgery for RHD at a single tertiary centre from 1992 to 2023. Patients were grouped by procedure type: mitral valve repair, mechanical replacement, or bioprosthetic replacement. The primary outcomes were all-cause mortality and need for revision surgery. Multivariate Cox regression was used to identify independent predictors of outcomes. Kaplan–Meier survival analysis compared event-free survival between groups.</div></div><div><h3>Results</h3><div>During a mean follow-up of 8.5±6.0 years, 85 patients (23.3%) died and 59 (16.2%) required revision surgery. No significant difference in all-cause mortality was observed between repair and replacement (p=0.70), or between mechanical and bioprosthetic prostheses (p=0.24). Valve repair was associated with a higher unadjusted risk of revision (p=0.01), but this was not significant after adjustment (hazard ratio [HR] 1.41; p=0.30). Bioprosthetic valves were associated with a significantly increased risk of revision compared with mechanical valves (HR 7.22; p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>In this cohort of young Indigenous Australians with RHD, mitral valve repair and bioprosthetic valves were associated with increased revision rates but showed no survival advantage over mechanical prostheses. These findings support the consideration of mechanical valves in appropriately selected patients to optimise long-term durability.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 2","pages":"Pages 192-201"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833826","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":"New-Onset Postoperative Atrial Fibrillation After Surgical Repair of Post-infarction Ventricular Septal Rupture Is Associated With Increased In-Hospital Mortality","authors":"Yang Zhao MD ,&nbsp;Shibo Zhu MD ,&nbsp;Xiaolong Ma MD ,&nbsp;Lisong Wu MD ,&nbsp;Liang Zhang MD","doi":"10.1016/j.hlc.2025.09.007","DOIUrl":"10.1016/j.hlc.2025.09.007","url":null,"abstract":"<div><h3>Background</h3><div>It is well-established that postoperative atrial fibrillation (POAF) can lead to adverse clinical outcomes after major cardiovascular operations. The current study was performed to investigate the occurrence of new-onset POAF after successful surgical repair of post-infarction ventricular septal rupture (VSR) and the association between POAF and in-hospital mortality.</div></div><div><h3>Method</h3><div>All consecutive patients who followed surgical repair of VSR from two medical centres in China from January 2008 to December 2023 were finally enrolled in this study (n=113). Patients who developed new-onset POAF after VSR repair were assigned to the POAF group, and those who did not develop POAF were assigned to the non-POAF group. The unadjusted and adjusted odds ratio (OR) for in-hospital mortality was derived by logistic regression. Then, multivariate logistic regression analyses were used to assess the risk of POAF, ORs and corresponding 95% confidence intervals (CIs) were reported.</div></div><div><h3>Results</h3><div>POAF was diagnosed in 31.9% (36/113) of this cohort population, and was related to age (OR 1.06; 95% CI 1.05–1.07; p&lt;0.001), male sex (OR 0.46; 95% CI 0.25–0.66; p=0.034), Killip class III/IV (OR 1.37; 95% CI 1.07–1.84; p=0.003), size of VSR (OR 1.54; 95% CI 1.26–1.63; p=0.015), systolic pulmonary artery pressure &gt;45 mmHg (OR 1.65; 95% CI 1.36–1.92; p=0.001), and operation time (OR 1.13; 95% CI 1.12–1.29; p&lt;0.001). Patients with POAF exhibited a significantly higher in-hospital mortality than those without POAF (52.7% vs 19.5%; p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>POAF following surgical repair of VSR was related to significantly higher rates of in-hospital mortality. More careful attention should be given to POAF after surgical repair of VSR. The older female patient who had Killip class III/IV, a larger size of VSR, systolic pulmonary artery pressure &gt;45 mmHg, and experienced longer surgery time was at the highest risk for POAF.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 2","pages":"Pages 212-218"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145943531","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":"Comprehensive Symptom Assessment of Patients With End-Stage Heart Failure Referred to Palliative Care","authors":"Brian R. Fernandes MHPol, FRACP, FAChPM ,&nbsp;Janet A. Newton RN ,&nbsp;Kim Betts PhD, MBiostats, MPH ,&nbsp;Caitlin Sheehan BMed, FRACP, FAChPM","doi":"10.1016/j.hlc.2025.08.024","DOIUrl":"10.1016/j.hlc.2025.08.024","url":null,"abstract":"<div><h3>Background</h3><div>Patients with end-stage heart failure experience a significant symptom burden that is often poorly controlled. Although palliative care can improve symptom management and reduce hospital admissions, many patients still die in acute care settings. The unpredictable course of end-stage heart failure complicates the identification of patients who would benefit from early palliative care referral. To address this challenge, an integrated cardiac supportive care service was developed to engage these patients early, optimise symptom control, and ensure timely access to palliative care.</div></div><div><h3>Aim</h3><div>The aim of this study is to document the symptom burden, using Patient-Reported Outcome Measures, for patients with end-stage heart failure on admission to the cardiac supportive care service.</div></div><div><h3>Method</h3><div>A prospective observational study was undertaken in a tertiary hospital service in Sydney, Australia between January 2020 and July 2022. Patients were included if they had a recent admission for heart failure or had heart failure with breathlessness or chest pain at rest or on minimal effort. The cardiac supportive care service, consisting of initial home visits and follow-up reviews conducted by a palliative care physician and cardiac nurse practitioner, collected information using the Dyspnoea-12 (D-12) Questionnaire and the Integrated Palliative Care Outcome Scale (IPOS). Symptom scores from these tools were analysed in relation to patient mortality, with Kaplan–Meier survival curves and Cox regression used to assess the association between symptom burden and time to death.</div></div><div><h3>Results</h3><div>A total of 114 patients were included in this study. Both the IPOS and D-12 scores indicated a substantial and clinically relevant symptom burden for this cohort of patients. High mean scores on the IPOS were observed for weakness (2.6, standard deviation [SD] 1.2), shortness of breath (2.6, SD 1.2), and sore/dry mouth (2.5, SD 1.3). Sore/dry mouth was the most frequent severe or overwhelming symptom (59%). The D-12 showed that descriptors of breathlessness most commonly rated as severe were “My breathing is exhausting” (40%), “My breathing is distressing” (39%), and “I feel short of breath” (38%). Patients with an IPOS score in the highest quartile had an elevated mortality risk. The survival of patients in this cohort was 17.1 months.</div></div><div><h3>Conclusions</h3><div>Patients with end-stage heart failure experience a substantial and frequently severe symptom burden, including breathlessness, dry mouth, and weakness. This study demonstrates the significant unmet need in this patient population and highlights the opportunity for integrated and proactive palliative care, delivered through a cardiac supportive care service. This model of care can optimise symptom management, facilitate advance care planning, and ensure timely referral to palliative care.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 2","pages":"Pages 283-291"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751759","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":"Reducing Healthcare Costs by Predicting the Spontaneous Termination of Atrial Fibrillation: A Simulation Study","authors":"Brandon Wadforth MD ,&nbsp;Taylor Strube MD ,&nbsp;Jing Soong Goh BEng ,&nbsp;Anand N. Ganesan MBBS, PhD","doi":"10.1016/j.hlc.2025.06.1023","DOIUrl":"10.1016/j.hlc.2025.06.1023","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) significantly contributes to rising healthcare costs in Australia, with inpatient care accounting for most expenses. Recent literature has explored the use of a “wait-and-see” approach to managing patients presenting to emergency departments with primary AF given the high rate of spontaneous cardioversion (SCV), thereby avoiding invasive cardioversion and costly hospital admission. Limited adoption of this model of care may stem from challenges in identifying patients who truly need admission. To address this, predictive models for SCV are being explored. Our study aims to determine the accuracy threshold at which such models achieve cost savings by preventing unnecessary AF admissions.</div></div><div><h3>Method</h3><div>A decision-analytic model was used alongside Monte Carlo simulations to estimate the variability in cost per patient with changes in prediction model accuracy and expected rates of SCV. Estimated costs were derived from a sample of patients presenting to Flinders Medical Centre or Noarlunga Hospital, South Australia in 2022–2023 with primary AF.</div></div><div><h3>Results</h3><div>There were 669 admissions at Flinders Medical Centre or Noarlunga Hospital for primary AF in 2022–2023. SCV occurred in 240 (35.9%) cases, representing potentially avoidable admissions. The base case cost per admission was AUD$5,793.94, further increasing to $7,009.42 if interhospital transfer was required. The point at which cost benefit would be observed in our patient cohort was between 60% and 70% accuracy. There was an incremental reduction in cost in relation to increasing prediction model accuracy or population SCV rate.</div></div><div><h3>Conclusions</h3><div>Predicting SCV with an accuracy of 60%–70% in patients presenting with primary AF results in cost savings and reduced hospital bed utilisation through avoiding unnecessary admissions.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 2","pages":"Pages 219-225"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145700731","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":"The Preoperative and Intraoperative Risk Factors With 1-Year Recurrence of New-Onset Paroxysmal Atrial Fibrillation After Thoracoscopic Surgery in Older Patients","authors":"Huiying Zhou MMed ,&nbsp;Yue Han MMed ,&nbsp;Zijia Liu MD ,&nbsp;Yu Zhang MMed ,&nbsp;Yuelun Zhang PhD ,&nbsp;Le Shen MD","doi":"10.1016/j.hlc.2025.06.1025","DOIUrl":"10.1016/j.hlc.2025.06.1025","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative atrial fibrillation (AF) after video-assisted thoracoscopic surgery (VATS) is the most prevalent form of secondary AF in older patients, which is likely to recur or even cause persistent AF and may receive long-term clinical treatment in clinically. We aimed to analyse the preoperative and intraoperative risk factors for the recurrence of paroxysmal postoperative AF.</div></div><div><h3>Method</h3><div>Data were collected from patients who underwent VATS and experienced paroxysmal postoperative AF at Peking Union Medical College Hospital between June 2013 and December 2022. We studied the incidence of AF recurrence within 1 year after initial occurrence and the potential preoperative and intraoperative risk factors using multivariable logistic regression analyses.</div></div><div><h3>Results</h3><div>Of the 2,920 patients who underwent VATS in this study, 122 (4.2%) suffered paroxysmal postoperative AF within 30 days after surgery. The recurrence incidence of paroxysmal postoperative AF was 21.3% (26 of 122) within 1 year. Multiple logistic regression analysis revealed that left atrial diameter (odds ratio [OR] 1.13; 95% confidence interval [CI] 1.01–1.27; p=0.040), left ventricular ejection fraction (OR 0.91; 95% CI 0.83-0.98; p=0.013), and intraoperative hypotension (OR 5.04; 95% CI 1.20–21.69; p=0.025) were significant risk factors for paroxysmal postoperative AF recurrence.</div></div><div><h3>Conclusions</h3><div>Larger left atrial diameter, lower left ventricular ejection fraction, and intraoperative hypotension may be associated with AF recurrence in older patients with paroxysmal postoperative AF after thoracoscopic surgery. It could be helpful to identify patients at high risk of AF recurrence and advise active monitoring.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 2","pages":"Pages 202-211"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833877","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":"Unlocking Potential: Advancing Integrated Palliative Care in Heart Failure Through Supportive Care Clinics","authors":"Gursharan K. Singh BMedSc, PhD ,&nbsp;Louise D. Hickman MPH, PhD ,&nbsp;Claudia Virdun BN, MSc, PhD","doi":"10.1016/j.hlc.2025.09.003","DOIUrl":"10.1016/j.hlc.2025.09.003","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 2","pages":"Pages 190-191"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142151","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":"Pulmonary Embolism Interventions: The Next Frontier","authors":"Khansa Ahmad MD ,&nbsp;Saraschandra Vallabhajosyula MSc, MD ,&nbsp;Vinayak Nagaraja MD","doi":"10.1016/j.hlc.2026.01.003","DOIUrl":"10.1016/j.hlc.2026.01.003","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 2","pages":"Pages 155-156"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142104","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":"Mechanical Thrombectomy Reduces Increased High Sensitivity Troponin Levels in Intermediate-High Risk Pulmonary Embolism","authors":"Richard Schell MD ,&nbsp;Felix Alban MD ,&nbsp;Norbert Frey MD ,&nbsp;Christian Erbel MD","doi":"10.1016/j.hlc.2025.08.023","DOIUrl":"10.1016/j.hlc.2025.08.023","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary embolism is associated with significant mortality and remarkably often subject to misdiagnosis, which further adversely affects prognosis. Disease severity and corresponding prognosis are strongly dependent on the risk constellation and determine the therapy. Therefore, we sought to analyse how mechanical thrombectomy influences short term clinical, laboratory, and haemodynamic findings in patients with symptomatic pulmonary artery embolism.</div></div><div><h3>Method</h3><div>In this study, we retrospectively analysed clinical, laboratory, and haemodynamic parameters in 32 patients with symptomatic pulmonary embolism who underwent mechanical thrombectomy using the FlowTriever device. Only patients with pulmonary embolism confirmed by computed tomography pulmonary angiography and classified as intermediate-high or high risk according to the current European Society of Cardiology guidelines were included. The main outcome measures were periprocedural changes in troponin, lactate, pulmonary artery pressures, and vital signs.</div></div><div><h3>Results</h3><div>Reductions of increased heart rate, pulmonary arterial pressure, and right ventricle–to–left ventricle ratio were observed immediately after the procedure and in early clinical follow-up, as well as improvement in arterial oxygen saturation and demand. Interventional thrombectomy further resulted in a reduction of increased levels of high-sensitivity troponin and lactate. In summary, the analysis of this study shows consistent respiratory and haemodynamic improvements in line with other published data on mechanical thrombectomy with this device.</div></div><div><h3>Conclusions</h3><div>Mechanical thrombectomy in patients with pulmonary artery embolism at intermediate-high risk was associated with an immediate and significant decrease in both specific myocardial and systemic biomarkers, for which prognostic relevance has been repeatedly demonstrated.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 2","pages":"Pages 259-270"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648361","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}