{"title":"Reply to Letter to the Editor Regarding: “Chronobiological Patterns and Risk of Acute Aortic Dissection: A Clinical Retrospective and Two-Sample Mendelian Randomisation Study”","authors":"Xiangyang Xu PhD, Yangfeng Tang PhD","doi":"10.1016/j.hlc.2025.02.099","DOIUrl":"10.1016/j.hlc.2025.02.099","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages e44-e46"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924900","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":"Reply to Letter to the Editor Regarding: “Association of Preoperative Oxygen Saturation and McGoon Ratio With Early Prognosis of Tetralogy of Fallot: A Propensity Score-Matched Analysis”","authors":"Rong Liufu MD , Jian Zhuang MD","doi":"10.1016/j.hlc.2025.01.015","DOIUrl":"10.1016/j.hlc.2025.01.015","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages e49-e50"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924902","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":"Chronobiological Patterns and Risk of Acute Aortic Dissection: A Clinical Retrospective and Two-Sample Mendelian Randomisation Study","authors":"Xiangyang Xu PhD , Yizhi Yu MD , Jiefu Fan PhD , Shuaikang Shen MD , Zhimin Zhao PhD , Sufan Ding MD , Jiajun Zhang MD , Zhiyun Xu PhD , Yangkai Wang PhD , Lin Han PhD , Yangfeng Tang PhD","doi":"10.1016/j.hlc.2024.10.010","DOIUrl":"10.1016/j.hlc.2024.10.010","url":null,"abstract":"<div><h3>Aim</h3><div>Acute aortic dissection (AAD) represents a cardiovascular ailment characterised by a notable mortality rate. Chronobiological patterns can offer a predictive framework for anticipating the onset of AAD.</div></div><div><h3>Method</h3><div>Data were gathered from 1,151 patients diagnosed with AAD at Changhai Hospital in Shanghai, China, spanning 2000–2023. The χ<sup>2</sup> test was used to assess whether specific periods exhibited significantly different seasonal/weekly distributions compared with others. Fourier models were utilised for the analysis of rhythmicity in monthly/circadian distribution. Publicly available genome-wide association studies datasets were used to establish the causal relationship between chronotype and AAD. Two sets of genetics instruments were used for analysis, derived from publicly available genetic summary data: 75 single-nucleotide polymorphisms (SNPs) significantly associated with chronotype; and SNPs associated with AAD in the FinnGen consortium.</div></div><div><h3>Results</h3><div>The mean age was 51.5±13.8 years, with 665 patients (57.8%) aged <55 years. Among the 1,151 patients, 80.9% were male. The distribution of DeBakey types was 73.2% (843) for DeBakey I, 21% (242) for DeBakey II, and 5.7% (66) for DeBakey III. Comorbidities included hypertension in 58.5% (673 cases) and diabetes in 7.8% (90 cases). A peak occurred during colder periods (winter/December), and a trough was noted in warmer periods (summer/June). Weekly distribution exhibited no significant variation. Fourier analysis revealed a statistically significant circadian variation (p<0.0001) with a trough between 23:00 and 00:00, a prominent peak from 07:00 to 08:00, and a minor peak between 20:00 and 21:00. Subgroup analyses identified circadian rhythmicity in all subgroups, except for the DeBakey III group and the female group. Using the 75 chronotype-related SNPs, evidence was found of a potential causal effect of chronotype on the risk of AAD, as the inverse-variance weighting analysis showed that self-report chronotype of morningness was associated with a decreased risk of AAD.</div></div><div><h3>Conclusions</h3><div>The findings substantiate that the initiation of AAD displays noteworthy seasonal, monthly, and circadian patterns. The Mendelian randomisation analysis also indicated that the onset of acute aortic dissection is related to circadian rhythm. These findings offer a fresh perspective, facilitating the identification of triggering factors for AAD and bolstering preventive measures for this catastrophic event.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages 444-455"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871868","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}
Dion Stub MBBS, PhD , Jennifer Y. Zhou MBBS, BMedSc , Shane Nanayakkara MBBS, PhD , David M. Kaye MBBS, PhD
{"title":"The Road to Quality Is Paved With Data: Insights From the Australian TAVI Registry","authors":"Dion Stub MBBS, PhD , Jennifer Y. Zhou MBBS, BMedSc , Shane Nanayakkara MBBS, PhD , David M. Kaye MBBS, PhD","doi":"10.1016/j.hlc.2025.04.078","DOIUrl":"10.1016/j.hlc.2025.04.078","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages 416-418"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924713","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}
Caleb Ferguson PhD , Scott William BMedSci , Sabine M. Allida PhD , Pankaj Jain PhD , Mark Dennis PhD , ESCAPE-CS investigator team
{"title":"Clinician Perspectives of Barriers and Enablers to Quality Cardiogenic Shock Care: A Focus Group Study","authors":"Caleb Ferguson PhD , Scott William BMedSci , Sabine M. Allida PhD , Pankaj Jain PhD , Mark Dennis PhD , ESCAPE-CS investigator team","doi":"10.1016/j.hlc.2024.12.002","DOIUrl":"10.1016/j.hlc.2024.12.002","url":null,"abstract":"<div><h3>Background & Aim</h3><div>Cardiogenic shock is a medical emergency that is associated with high mortality rates. It is a resource-intensive and costly condition that is complicated by comorbidities and clinical deterioration. However, the barriers and enablers to quality cardiogenic shock care are relatively unknown from the perspective of Australian clinicians. This study aimed to i) To explore clinicians’ perspectives on the barriers to delivering these best practice care and optimal outcomes for patients with cardiogenic shock; and ii) To understand priorities to overcome these barriers, with the intent of using the findings to inform the development and implementation of a clinical trial for cardiogenic shock management—ESCAPE-CS: Evaluation of a Standardised ClinicAl Pathway to improve Equity and outcomes in Cardiogenic Shock (ESCAPE-CS).</div></div><div><h3>Method</h3><div>A qualitative focus group study was conducted via videoconference with experienced clinicians, and audio-recorded and transcribed verbatim. Data were analysed using thematic analysis in NVivo.</div></div><div><h3>Results</h3><div>Five focus groups were conducted, including 19 participants (11 male and eight female), comprising seven intensive care unit physicians, seven nurse consultants/educators, three cardiologists, and two emergency department physicians working in metropolitan and rural, regional, or remote health settings. Five themes were identified:</div><div><ul><li><span>1)</span><span><div>Referral and retrieval pathways and systems;</div></span></li><li><span>2)</span><span><div>The importance of clinical recognition and response to deterioration;</div></span></li><li><span>3)</span><span><div>Geographical differences in resources and expertise;</div></span></li><li><span>4)</span><span><div>Increased inter-disciplinary collaborations; and</div></span></li><li><span>5)</span><span><div>The use of guidelines, data, and protocolised care and technologies.</div></span></li></ul></div></div><div><h3>Conclusions</h3><div>This study provided critical insights into the barriers and possible enablers to delivering best practice care and optimal outcomes for patients with cardiogenic shock. There is scope for an improved model of care in cardiogenic shock management to address inequalities emerging from multifactorial complexities.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages 515-525"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370785","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}