Heart, Lung and Circulation最新文献

{"title":"Endocarditic Pseudoaneurysm Mimicking Coronary Syndrome Due to Compression of the Left Anterior Descending Artery","authors":"Lorenzo Giovannico MD, Giuseppe Fischetti MD, Federica Mazzone MD, Domenico Parigino MD, Luca Savino MD, Emanuela De Cillis MD, PhD, Tommaso Acquaviva MD, Aldo Domenico Milano MD, PhD, Tomaso Bottio MD, PhD","doi":"10.1016/j.hlc.2025.02.105","DOIUrl":"10.1016/j.hlc.2025.02.105","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 7","pages":"Pages e83-e85"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017343","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":"Unilateral Versus Bilateral Antegrade Cerebral Perfusion in Aortic Arch Surgery: Systematic Review and Meta-Analysis of Randomised Controlled Trials and Propensity-Matched Studies.","authors":"Kristine Santos, Emmanuel Mark Velasco, Mohammad Mawasi, Tomasz Płonek","doi":"10.1016/j.hlc.2025.03.018","DOIUrl":"https://doi.org/10.1016/j.hlc.2025.03.018","url":null,"abstract":"<p><strong>Background: </strong>Selective antegrade cerebral perfusion, via unilateral antegrade cerebral perfusion (uACP) or bilateral antegrade cerebral perfusion (bACP) approaches, is used in aortic arch surgery to protect the brain during circulatory arrest. Previous meta-analyses, based on unmatched observational data, found no differences between these techniques. Our updated meta-analysis exclusively examines high-quality evidence from randomised controlled trials and propensity-matched studies.</p><p><strong>Method: </strong>A literature search of MEDLINE, Scopus, and Cochrane databases identified relevant studies up to November 2024. Pooled odds ratios (ORs) and mean differences with 95% confidence intervals (CIs) were calculated using RevMan version 8.13.0.</p><p><strong>Results: </strong>We included eight studies comprising 2,072 patients, with 1,025 (49.5%) patients in the uACP group. The pooled analysis revealed that uACP was associated with a shorter hospital length of stay (mean differences -2.2 days; 95% CI -3.6 to -0.7; p<0.05) and a reduced incidence of permanent neurological dysfunction (OR 0.7; 95% CI 0.5 to 0.9; p<0.05). However, uACP was linked to a higher incidence of acute kidney injury (OR 1.5; 95% CI 1.1 to 2.0; p<0.05). No statistically significant differences were observed between uACP and bACP in terms of aortic cross-clamp time, cardiopulmonary bypass duration, ventilation time, transient neurological deficits, intensive care unit length of stay, 30-day mortality, and re-exploration for bleeding.</p><p><strong>Conclusions: </strong>Our meta-analysis confirmed several comparable outcomes between uACP and bACP as reported in previous reviews. However, our study identified additional findings, such as a reduced hospital length of stay and lower incidence of permanent neurological dysfunction associated with uACP, alongside a higher risk of acute kidney injury.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540047","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":"Wire Cerclage Versus Rigid Plate Fixation: A Retrospective Cohort Study and Cost-Benefit Analysis on Method of Sternotomy Closure After Cardiac Surgery","authors":"Vikash Dhanapathy MD ,&nbsp;Mark Jones PhD ,&nbsp;Andrie Stroebel MBChB ,&nbsp;Cheng He MBBS","doi":"10.1016/j.hlc.2025.03.013","DOIUrl":"10.1016/j.hlc.2025.03.013","url":null,"abstract":"<div><h3>Background</h3><div>Despite increasing evidence demonstrating the merits of rigid plate fixation over wire cerclage for sternotomy closure, wire cerclage remains the predominant standard of care, largely because of the substantial cost of plating systems and the perceived lack of difference to outcomes.</div></div><div><h3>Aim</h3><div>This study aimed to compare the incidence of sternal complications between patients receiving rigid plate fixation vs wire cerclage and thereby assess the cost vs benefit of said sternal closure methods.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis was performed on patients who underwent open cardiac surgery at a single Australian tertiary centre between January 2019 and January 2023. Data were obtained from the Queensland Cardiac Outcomes Registry. The rate of readmissions for sternal complications were compared between those receiving wire cerclage sternal closure vs rigid plate fixation. Index admissions of each cohort were compared to assess secondary outcomes of hospital length of stay, intensive care unit length of stay, and admission costs, using marginal treatment effects analysis to adjust for differences in the two patient groups. Costs associated with each method of sternal closure were assessed, including those pertaining to readmissions.</div></div><div><h3>Results</h3><div>A total of 941 patients underwent sternotomy closure with wire cerclage and 67 patients received rigid plate fixation. Patients in the plate fixation group were at higher risk of sternal complications because of a higher body mass index (33 vs 29, p&lt;0.001), bilateral internal mammary artery graft use (22.4% vs 6.9%, p&lt;0.001), and rate of diabetes (37.7% vs 22.2%, p=0.007). Comparing index admissions, the use of rigid plate fixation was associated with a trend towards reduced hospital length of stay (12 vs 14 days) and intensive care unit length of stay (33 vs 45 hours), with similar total admission costs. There were 37 readmissions for sternal wound complications in the study period, all of which occurred in the wire cerclage group (incidence rate 3.9% vs 0%, p=0.17). Majority of readmissions were attributed to deep sternal wound infection (n=21). Each readmission was associated with an average hospital length of stay of 17 days and admission cost of $42,326 Australian dollars. Over the study period, the total cost of readmissions for sternal complications was $1,661,414 Australian dollars.</div></div><div><h3>Conclusion</h3><div>The use of rigid plate fixation compared with wire cerclage for sternotomy closure was associated with a strong trend towards reduced sternal wound complications, such that the higher initial costs of rigid plate fixation were offset by the substantial costs of said complications. Thus, an argument is made for considering rigid plate fixation as a first-line method of sternotomy closure, regardless of risk profile.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 8","pages":"Pages 856-862"},"PeriodicalIF":2.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540048","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":"Scimitar Syndrome","authors":"Chia-Yun Chang MD ,&nbsp;Shao-Hua Lee MD ,&nbsp;Chia-Ying Lin MD","doi":"10.1016/j.hlc.2025.02.109","DOIUrl":"10.1016/j.hlc.2025.02.109","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 8","pages":"Pages e87-e88"},"PeriodicalIF":2.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496084","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":"Physiological Responses to Sit-to-Stand and Six-Minute Walk Tests in Heart Failure: A Randomised Trial","authors":"Fergus K. O’Connor PhD ,&nbsp;Dongyi Chen BPhty ,&nbsp;Pramod Sharma PhD ,&nbsp;Julie Adsett PhD ,&nbsp;Rita Hwang PhD ,&nbsp;Llion Roberts PhD ,&nbsp;Aaron Bach PhD ,&nbsp;Menaka Louis MPH ,&nbsp;Norman Morris PhD","doi":"10.1016/j.hlc.2025.03.002","DOIUrl":"10.1016/j.hlc.2025.03.002","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Short-duration sit-to-stand tests are utilised in rehabilitation settings to alleviate logistical challenges associated with the six-minute walk test (6MWT). We assessed the utility of the 30-second sit-to-stand (30-STST) and 60-second sit-to-stand (60-STST) tests as surrogate measures of the 6MWT.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;On separate days, 16 male participants (71 [7] years) with stable heart failure with reduced ejection fraction (36.9 [4.9] %) completed two 6MWT and the 30-STST and 60-STST. Pulmonary gas exchange (oxygen consumption, carbon dioxide production [&lt;span&gt;&lt;math&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mi&gt;V&lt;/mi&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;/math&gt;&lt;/span&gt;CO&lt;sub&gt;2&lt;/sub&gt;], ventilation [&lt;span&gt;&lt;math&gt;&lt;mrow&gt;&lt;msub&gt;&lt;mover&gt;&lt;mi&gt;V&lt;/mi&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;mi&gt;E&lt;/mi&gt;&lt;/msub&gt;&lt;/mrow&gt;&lt;/math&gt;&lt;/span&gt;], respiratory exchange ratio, ventilatory equivalent for CO&lt;sub&gt;2&lt;/sub&gt; [&lt;span&gt;&lt;math&gt;&lt;mrow&gt;&lt;msub&gt;&lt;mover&gt;&lt;mi&gt;V&lt;/mi&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;mi&gt;E&lt;/mi&gt;&lt;/msub&gt;&lt;/mrow&gt;&lt;/math&gt;&lt;/span&gt;/&lt;span&gt;&lt;math&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mi&gt;V&lt;/mi&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;/math&gt;&lt;/span&gt;CO&lt;sub&gt;2&lt;/sub&gt;] and partial pressure of end-tidal CO&lt;sub&gt;2&lt;/sub&gt; [P&lt;sub&gt;ET&lt;/sub&gt;CO&lt;sub&gt;2&lt;/sub&gt;]) was measured using a portable metabolic system. Non-invasive haemodynamics (cardiac output, stroke volume, arteriovenous oxygen difference) were measured using impedance cardiography. Mean arterial pressure, heart rate, oxygen saturation and dyspnoea (0–10 scale, arbitrary units) were also monitored. Mixed-effects models (Bonferroni corrected) accounting for time (pre-exercise rest, end-exercise) and test (6MWT, 30-STST, and 60-STST) were used to assess the relation between results observed during each testing modality.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;While P&lt;sub&gt;ET&lt;/sub&gt;CO&lt;sub&gt;2&lt;/sub&gt; (mean difference [95% confidence interval], −4.9 [−8.9 to −0.8] mmHg), and dyspnoea (1 [0-2] arbitrary units) differed between the 6MWT and 60-STST, no other differences were observed between these tests. In contrast, oxygen consumption (−0.5 [−0.6 to −0.3] L.min&lt;sup&gt;-1&lt;/sup&gt;), &lt;span&gt;&lt;math&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mi&gt;V&lt;/mi&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;/math&gt;&lt;/span&gt;CO&lt;sub&gt;2&lt;/sub&gt; (−0.5 [−0.7 to −0.4] L.min&lt;sup&gt;-1&lt;/sup&gt;), &lt;span&gt;&lt;math&gt;&lt;mrow&gt;&lt;msub&gt;&lt;mover&gt;&lt;mi&gt;V&lt;/mi&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;mi&gt;E&lt;/mi&gt;&lt;/msub&gt;&lt;/mrow&gt;&lt;/math&gt;&lt;/span&gt; (−18.3 [−26.0 to −10.0] L.min&lt;sup&gt;-1&lt;/sup&gt;), P&lt;sub&gt;ET&lt;/sub&gt;CO&lt;sub&gt;2&lt;/sub&gt; (−5.1 [−9.6 to −0.7] mmHg), cardiac output (−2.4 [−4.9 to −0.3] L.min&lt;sup&gt;-1&lt;/sup&gt;), heart rate (−20 [−33 to −7] beats/min) differed between the 6MWT and the 30-STST, however, no other differences were observed between the 6MWT and the 30-STST.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Cardiopulmonary, non-invasive haemodynamic and dyspnoea responses differed between the 30-STST and the 6MWT. However, the lack of test-specific differences between the 6MWT and the 60-STST highlights the strong physiological stimulus elicited by this short-duration test modality. The 60-STST has promising utility as a functional measure of heart and lung capacity within cardiac","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 8","pages":"Pages 789-797"},"PeriodicalIF":2.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340061","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":"A Systematic Review of Minimally Invasive Approaches to Surgical Atrial Septal Defect Repair","authors":"Ryaan EL-Andari MD ,&nbsp;Abeline R. Watkins BSc ,&nbsp;Nicholas M. Fialka MD ,&nbsp;Abdulaziz Mohammed AlAklabi MBBS ,&nbsp;Jimmy J.H. Kang MD ,&nbsp;Sabin J. Bozso MD, PhD ,&nbsp;Devilliers Jonker MD ,&nbsp;Darren H. Freed MD, PhD ,&nbsp;Mohammed AlAklabi MD ,&nbsp;Denis Bouchard MD, MSc, PhD ,&nbsp;Michael W.A. Chu MD, MEd ,&nbsp;Michael C. Moon MD ,&nbsp;Jeevan Nagendran MD, PhD","doi":"10.1016/j.hlc.2025.01.010","DOIUrl":"10.1016/j.hlc.2025.01.010","url":null,"abstract":"<div><h3>Aim</h3><div>Atrial septal defects (ASD) are the most common congenital cardiac malformations. Over the preceding decades, a host of minimally invasive and interventional techniques for ASD closure have emerged. Minimally invasive ASD (MIASD) repair utilises thoracotomies, endoscopic, robotic, and even beating heart approaches to facilitate MIASD repair. We performed a systematic review to summarise the literature describing the outcomes of patients following MIASD repair.</div></div><div><h3>Method</h3><div>PubMed, Medline, and Scopus were searched by two authors for manuscripts describing outcomes following MIASD repair. Overall, 1,972 titles were screened, 1,945 were excluded, and 27 were included in the review. The primary outcome was mortality and secondary outcomes included postoperative morbidity.</div></div><div><h3>Results</h3><div>Measures of mortality were largely limited to 30 days postoperatively, with 0% mortality reported for MIASD up to 30 days. Rates of postoperative morbidity were low in both sternotomy and MIASD groups, with no consistent differences identified. Rates of intensive care unit and hospital stay were consistently reported to be lower with MIASD than with the conventional approach.</div></div><div><h3>Conclusions</h3><div>MIASD repairs have continued to evolve and improve. Among the various approaches to MIASD repair, all have been associated with low rates of morbidity and mortality. Surgical ASD repair continues to be versatile, allowing for repair of all manner of ASDs, and allowing for the concomitant management of other cardiac conditions. Regular advancements in this field, including the optimisation and development of surgical techniques with regular evaluation of patient outcomes, will ensure appropriate patient selection and optimisation of outcomes for patients with ASD.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 8","pages":"Pages 764-776"},"PeriodicalIF":2.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293666","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":"Computed Tomography Coronary Angiography Versus Stress Echocardiography in a Rapid Access Chest Pain Clinic","authors":"Jacob P. George MBBS ,&nbsp;Kate A. Grunseit MD ,&nbsp;Manoj Rajamohan FRACP ,&nbsp;Kevin Yang HSC ,&nbsp;Clara K. Chow FRACP, PhD ,&nbsp;Gemma A. Figtree FRACP, PhD ,&nbsp;Rebecca Kozor FRACP, PhD","doi":"10.1016/j.hlc.2025.01.006","DOIUrl":"10.1016/j.hlc.2025.01.006","url":null,"abstract":"<div><h3>Background</h3><div>Outpatient rapid-access chest pain clinics (RACPCs) investigate and manage low-to intermediate-risk chest pain. Several non-invasive investigations have been employed for RACPCs, including stress echocardiography (SE) and computed tomography coronary angiography (CTCA). However, research on the influence of these tests on diagnosis and management in this setting is limited. This study aimed to determine whether patients who underwent CTCA differed in their risk profile, diagnosis, and management compared to those who underwent SE in RACPC.</div></div><div><h3>Method</h3><div>This retrospective single-centre observational study included 903 patients who presented to the RACPC with low-to-intermediate-risk chest pain. Patients were investigated using SE and/or CTCA at the discretion of the treating cardiologist.</div></div><div><h3>Results</h3><div>Overall, 68.4% of the patients were initially investigated using SE vs CTCA. Individuals with cardiac risk factors, including male patients and those using lipid-lowering agents before the RACPC review, were more likely to be initially investigated with CTCA. Patients who underwent CTCA at any point during their clinic visit had higher rates of invasive angiography, coronary intervention, and cardiac specialist referral than those who underwent SE alone. Patients who received CTCA at any time had higher prescription rates of antiplatelet, antihypertensive, and lipid-lowering medications, irrespective of whether they underwent invasive angiography, compared to the SE-only group.</div></div><div><h3>Conclusions</h3><div>SE remains a popular initial screening method for patients with RACPC with low-to-intermediate-risk profiles. More men had CTCA, and more women had SE in their initial investigation. Patients investigated using a CTCA strategy were more likely to undergo invasive coronary angiography, procedural intervention, and the initiation of antiplatelet, antihypertensive, and lipid-lowering medications.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 8","pages":"Pages 805-811"},"PeriodicalIF":2.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293667","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":"Requirements for the Delivery of an Australian Rapid Access Chest Pain Clinic","authors":"Annika Wilson MPH ,&nbsp;Laura Sutton PhD ,&nbsp;Rose Nash PhD ,&nbsp;Senali Jayasinghe MPH ,&nbsp;James E. Sharman PhD ,&nbsp;J. Andrew Black MBBS ,&nbsp;Niamh Chapman PhD","doi":"10.1016/j.hlc.2025.02.108","DOIUrl":"10.1016/j.hlc.2025.02.108","url":null,"abstract":"<div><h3>Background</h3><div>Rapid access chest pain clinics (RACPCs) are outpatient cardiac services designed to promptly assess and manage patients experiencing chest pain. Despite the establishment of 25 RACPCs across Australia, a standardised implementation framework has yet to be developed. This study aimed to identify the core components of successful delivery of an existing RACPC.</div></div><div><h3>Method</h3><div>A qualitative process assessment study was conducted at an RACPC in a metropolitan, tertiary hospital in Tasmania, Australia from November 2022 to July 2023. Clinical observations and semi-structured interviews were conducted with seven RACPC clinicians. Deductive data analysis was undertaken according to a Context-Mechanism-Outcome framework.</div></div><div><h3>Results</h3><div>Core components of successful RACPC delivery included (1) a multidisciplinary team-based approach to care with discreet clinical roles, (2) timely patient review by RACPC clinicians within 30 days of referral, (3) embedded patient education, (4) ongoing clinical team training and education, and (5) a shared understanding of the RACPC service’s identity and purpose. Challenges to RACPC delivery were also identified and included resource constraints and administrative burdens.</div></div><div><h3>Conclusions</h3><div>Successful delivery of an RACPC model of care relies on a range of interrelated factors. These findings align with the broader theme of ongoing health service assessment as a driver for continuous quality improvement and care standards within RACPCs. Further research aimed at developing and implementing effective strategies to enhance service delivery is needed to determine a national model of care.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 8","pages":"Pages 812-820"},"PeriodicalIF":2.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293668","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":"Emergency Medical Service Use for Acute Coronary Syndrome in Culturally and Linguistically Diverse Immigrant Populations","authors":"Ararso Baru Olani MSc, MHS ,&nbsp;Kathryn Eastwood PhD ,&nbsp;Stuart Howell PhD ,&nbsp;Janet E. Bray PhD","doi":"10.1016/j.hlc.2025.01.007","DOIUrl":"10.1016/j.hlc.2025.01.007","url":null,"abstract":"<div><h3>Background</h3><div>In acute coronary syndrome (ACS), emergency medical service (EMS) use reduces pre-hospital delay and increases the chances of survival. However, evidence regarding EMS use in culturally and linguistically diverse (CALD) patients is conflicting. This study aimed to i) examine whether EMS use in patients with ACS varies between CALD and non-CALD populations and ii) identify characteristics associated with EMS and non-EMS use in CALD patients.</div></div><div><h3>Method</h3><div>This is a retrospective analysis of ACS cases presented to emergency departments of public hospitals in Victoria, Australia between January 2016 and June 2021, as recorded in the Victorian Emergency Minimum Dataset maintained by the Victorian Department of Health. Country of birth, preferred language, and the need for an interpreter defined CALD status. Logistic regression was used to describe the characteristics associated with EMS and non-EMS use.</div></div><div><h3>Results</h3><div>Of the 51,101 eligible ACS cases, 15,580 (30.5%) were from the CALD group. EMS use was lower in CALD than in non-CALD groups (61.9% vs 65.3%; p&lt;0.001; adjusted odds ratio [aOR] 0.78; 95% confidence Interval [CI] 0.75–0.81). In CALD patients, the odds of EMS use increased with advancing age, living alone (aOR 1.45; 95% CI 1.24–1.70), self-referral (aOR 4.53; 95% CI 3.97–5.17), hospital presentation in the year 2020 (aOR 1.16; 95% CI 1.03–1.31) or 2021 (aOR 1.20; 95% CI 1.30–1.39), and being diagnosed with acute myocardial infarction (aOR 1.36; 95% CI 1.26–1.39). Reduced odds of EMS use were associated with being born in Southeast Asia (aOR 0.71; 95% CI 0.57–0.89), Northeast Asia (aOR 0.57; 95% CI 0.42–0.77), and the Americas (aOR 0.59; 95% CI 0.43–0.80); speaking a South Asian language (aOR 0.65; 95% CI 0.51–0.83); and hospital presentation in summer (aOR 0.90; 95% CI 0.82–0.99).</div></div><div><h3>Conclusions</h3><div>EMS use was lower in patients with ACS with CALD backgrounds. Our findings have identified CALD population subgroups to target with education.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 8","pages":"Pages 838-847"},"PeriodicalIF":2.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247652","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: ANZSCTS ASM advert","authors":"","doi":"10.1016/S1443-9506(25)00432-9","DOIUrl":"10.1016/S1443-9506(25)00432-9","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 6","pages":"Page 648"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241735","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}