Heart, Lung and Circulation最新文献

{"title":"Centralised Management System and Hot Transfer for ST-Elevation Myocardial Infarction in Western NSW: Closing the Gap in Current Models of Rural ST-Elevation Myocardial Infarction Care","authors":"Ruth Arnold FRACP ,&nbsp;Georgina M. Luscombe PhD ,&nbsp;Sarah Edwards MFDS ,&nbsp;Estelle Ryan MNg(Cardiac) ,&nbsp;Steven Faddy MScMed ,&nbsp;Ryan Gadeley BMed ,&nbsp;Gabrielle Larnach ,&nbsp;Harry Lowe PhD ,&nbsp;Craig Juergens DMedSc ,&nbsp;Catherine Hawke MBBS ,&nbsp;Chris Doran PhD ,&nbsp;Alex Elder FRACP ,&nbsp;Mark Adams PhD ,&nbsp;David Amos FRACP","doi":"10.1016/j.hlc.2024.11.029","DOIUrl":"10.1016/j.hlc.2024.11.029","url":null,"abstract":"<div><h3>Background</h3><div>Rural vs metropolitan ST-elevation myocardial infarction (STEMI) patients experience delayed access to percutaneous coronary intervention (PCI). Existing New South Wales (NSW) Statewide Cardiac Reperfusion Strategy protocols provide thrombolysis and ambulance diversion for patients within 90 minutes of a PCI centre in regional and rural NSW. Rural patients presenting to non-PCI hospitals and those more than 90 minutes from PCI are not routinely, urgently, diverted under existing protocols.</div></div><div><h3>Method</h3><div>Western NSW Local Health District, covering 250,000 km² and a population of 278,759, implemented a centralised management system (CMS) in 2019, in partnership with NSW Ambulance, utilising existing STEMI thrombolysis protocols and extending “drip and ship” protocols for “hot transfer” of all patients to the 24/7 PCI centre, by direct ambulance diversion up to 120 minutes by road, or via multi-stage transfer by road or air, or via interhospital transfer. Data for 2 years post-CMS was compared to historical controls. Time from first clinical contact (FCC) to reperfusion, FCC to PCI centre, major adverse clinical events and percentage of patients undergoing angiography within 24 hours were compared in “medium” (90–120 minutes) and “long” (&gt;120 minutes) transfer zones, not covered by existing protocols.</div></div><div><h3>Results</h3><div>Outcomes were recorded for 274 patients before and 348 after CMS implementation (17% medium and 31% long transfer zones). Medium and long transfer zones had greater proportions of smokers and Indigenous patients than short transfer zones. There was significantly lower ambulance utilisation in the long (38%) compared with the short transfer zone (55%, p&lt;0.001). In the long transfer zone, there were significant improvements in FCC to reperfusion (40 vs 48 minutes, p&lt;0.05), FCC to PCI centre (296 vs 344 minutes, p&lt;0.01), and angiography in 24 hours (77% vs 58%, p&lt;0.01), with no significant differences in major adverse clinical events.</div></div><div><h3>Conclusions</h3><div>A rural STEMI CMS, with “hot transfer”, can deliver patients from a vast geographical area directly to a rural PCI centre. Patients furthest away, with the greatest risk profile, benefit the most. Extension of this program and development of 24/7 PCI in NSW rural cardiac hubs stands to improve timely, definitive treatment, including access to angiography within 24 hours.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 6","pages":"Pages 585-595"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476142","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":"Survival Analysis of Early-Stage NSCLC Patients Following Lobectomy: Impact of Surgical Techniques and Other Variables on Long-Term Outcomes","authors":"Kaushalendra Rathore FRACS ,&nbsp;William Weightman FANZCA ,&nbsp;Kyle Palmer MBBS ,&nbsp;Kathryn Hird PhD ,&nbsp;Pragnesh Joshi FRACS","doi":"10.1016/j.hlc.2024.11.032","DOIUrl":"10.1016/j.hlc.2024.11.032","url":null,"abstract":"<div><h3>Background</h3><div>Surgical resection is a frontline management option for early-stage non-small cell lung cancer (NSCLC). Evolving techniques may be refining patient outcomes. This study compares the long-term survival of patients undergoing lobectomy for a primary NSCLC between video-assisted thoracoscopic surgery (VATS) and open thoracotomy (OT). The secondary aim of this study is to identify the variables that influence immediate and long-term patient outcomes.</div></div><div><h3>Method</h3><div>This is a single-centre retrospective cohort analysis spanning 20 years. The study reports on the outcomes of 743 patients who underwent lobectomy for primary NSCLC. There are 598 VATS cases and 145 OT cases. Variables likely to influence long-term survival were assessed with Kaplan–Meier survival analysis. The effect of VATS on long-term survival was assessed using a propensity-adjusted analysis.</div></div><div><h3>Results</h3><div>Chronic obstructive pulmonary disease, history of other cancers, coronary artery disease, type 2 diabetes, and emphysema were the most common comorbidities reported in this cohort. The VATS technique showed shorter postoperative length of stay and fewer surgical complications compared with OT. There were no differences between VATS and OT in early mortality or completeness of the resection. Additionally, 32% of patients showed variable visceral pleural invasion (P1–P2), and their 5-year survival was significantly worse compared with P0 patients (18.75% and 36.85%, respectively). Major pulmonary complications were responsible for prolonging the length of hospital stay after index surgery and it was inversely related to the survival at 5 and 10 years (p&lt;0.0004). Lymph node involvement was an important predictor for long-term survival (50% overall survival rate was 9.4 years, 4.5 years and 4.2 years for N0, N1, and N2, respectively). We observed longer median survival in the VATS group (10.04 years vs 8.99 years) and a lower risk of mortality after propensity analysis (odds ratio 0.86; 95% confidence interval 0.67–1.11), but neither observation was statistically significant.</div></div><div><h3>Conclusions</h3><div>Early surgical outcomes were significantly better in the VATS group, whereas long-term outcomes were not notably different between the groups. Regardless of the surgical techniques used, positive surgical margins, visceral pleural invasion, larger tumours, positive lymph nodes, age &gt;70 years, and prolonged hospital stay were common variables responsible for the poor overall long-term survival.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 6","pages":"Pages 639-646"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624444","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)00433-0","DOIUrl":"10.1016/S1443-9506(25)00433-0","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 6","pages":"Pages 649-650"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241736","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":"Our Heart, Our Genes, Our Story / Ō Tātou Ngākau, Ō Tātou Ira, Ō Tātou Kōrero","authors":"S. Hogan ∗ ,&nbsp;R. Stiles ,&nbsp;R. Kerr ,&nbsp;S. Burcher ,&nbsp;T. Kerekere ,&nbsp;J. Agnew ,&nbsp;P. Jones ,&nbsp;M. Stiles ,&nbsp;C. Print ,&nbsp;K. Taiuru ,&nbsp;P. Le Quesne Stabej","doi":"10.1016/j.hlc.2025.05.016","DOIUrl":"10.1016/j.hlc.2025.05.016","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 ","pages":"Page S63"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144229534","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":"Te Mauri o te Mana Māori","authors":"P. Tohu-Hapati ∗ ,&nbsp;J. Camp ,&nbsp;T. Russell-Camp ,&nbsp;M. Lyndon ,&nbsp;E. Korohina","doi":"10.1016/j.hlc.2025.05.071","DOIUrl":"10.1016/j.hlc.2025.05.071","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 ","pages":"Pages S87-S88"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144229565","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":"Embedding Kaupapa Māori in Cardiovascular Health Research: A HeartOtago Case Study","authors":"T. Russell-Camp ∗","doi":"10.1016/j.hlc.2025.05.030","DOIUrl":"10.1016/j.hlc.2025.05.030","url":null,"abstract":"<div>Cardiovascular disease (CVD) remains a leading cause of inequitable health outcomes for Māori. HeartOtago, through its partnership with Ōtākou Whakaihu Waka, seeks to integrate kaupapa Māori approaches into cardiovascular research to improve outcomes for Māori communities. This study applies the four pou of the Edgar Diabetes and Obesity Research Centre (EDOR)—Tino Rakatirataka, Kokiritaka, Whānau Ora, and Taiao—to HeartOtago’s research strategy.</div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 ","pages":"Pages S69-S70"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230069","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":"Total TRL Particle Numbers and Concentrations of Very Small Triglyceride-Rich Lipoproteins are Associated With Systemic Inflammation in Indigenous Australians","authors":"M. Kockx ∗ ,&nbsp;J. Wang ,&nbsp;N. Howard ,&nbsp;A. Suryawanshi ,&nbsp;S. Nicholls ,&nbsp;A. Brown ,&nbsp;L. Kritharides","doi":"10.1016/j.hlc.2025.05.055","DOIUrl":"10.1016/j.hlc.2025.05.055","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 ","pages":"Page S81"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144229743","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":"He Oranga Manawa: Identifying CV Resource Gaps to Strengthen Māori Digital Health Solutions","authors":"J. Anderson ∗,&nbsp;E. Korohina","doi":"10.1016/j.hlc.2025.05.038","DOIUrl":"10.1016/j.hlc.2025.05.038","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 ","pages":"Page S73"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144229966","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":"Champions4Change: Empowering First Nations Lived Experience to End Rheumatic Heart Disease","authors":"J. Hegarty ∗","doi":"10.1016/j.hlc.2025.05.081","DOIUrl":"10.1016/j.hlc.2025.05.081","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 ","pages":"Pages S72-S73"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230211","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":"Self-Determining Health Systems","authors":"A. Rolleston ∗","doi":"10.1016/j.hlc.2025.05.028","DOIUrl":"10.1016/j.hlc.2025.05.028","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 ","pages":"Page S69"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230315","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}