Heart, Lung and Circulation最新文献

{"title":"Available now! Comprehensive Australian clinical guideline for diagnosing and managing acute coronary syndromes 2025","authors":"","doi":"10.1016/j.hlc.2025.04.074","DOIUrl":"10.1016/j.hlc.2025.04.074","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Page 529"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924903","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":"Letter to the Editor Regarding “Chronobiological Patterns and Risk of Acute Aortic Dissection: A Clinical Retrospective and Two-Sample Mendelian Randomisation Study” by Xu et al. Heart Lung Circ. 2025;34(5):444–455","authors":"Hisato Takagi MD, PhD","doi":"10.1016/j.hlc.2025.01.013","DOIUrl":"10.1016/j.hlc.2025.01.013","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages e42-e43"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924917","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":"Elucidating the Causal Link Between Treg-Related Immune Traits and Atherosclerosis-Related Cardiovascular Diseases: A Bidirectional Mendelian Randomisation Analysis","authors":"Zheng-Qi Song MD ,&nbsp;Yi-Qi Chen MD ,&nbsp;Tao Yu MD ,&nbsp;Yu-Peng Xu MD ,&nbsp;Yan-Jiong Chen MD ,&nbsp;Xin-Yu Lu MD ,&nbsp;Zhen-Ya Chen MD ,&nbsp;Chen-Yu Wang MD ,&nbsp;Meng-Ying Zhang MD ,&nbsp;Rong Chen MD ,&nbsp;Yi-He Chen MD, PhD","doi":"10.1016/j.hlc.2024.10.016","DOIUrl":"10.1016/j.hlc.2024.10.016","url":null,"abstract":"<div><h3>Aim</h3><div>Regulatory T cells (Tregs) play a crucial role in the development and progression of atherosclerosis. However, the specific association between Treg immune traits and atherosclerosis and related cardiovascular diseases remains unclear, impeding their potential for clinical therapeutic application.</div></div><div><h3>Method</h3><div>Fifty-eight Treg-related immune traits were obtained from the latest summary level genome-wide association study, which included 3,757 individuals from Sardinia. Additionally, three atherosclerosis subsets and three atherosclerosis-related cardiovascular diseases were obtained from the FinnGen database. Subsequently, comprehensive bidirectional Mendelian randomisation (MR) analysis was performed using inverse-variance weighting as the primary method. Sensitivity analyses were performed to verify the robustness, heterogeneity, and horizontal pleiotropy of the results. Co-localisation analysis was performed to detect whether the exposure and outcome shared causal variants.</div></div><div><h3>Results</h3><div>Four significant Treg-related immune traits linked to a lower risk of three cardiovascular diseases were identified in the forward MR analysis. Specifically, two traits were identified for cerebral atherosclerosis: CD39⁺ activated CD4⁺ Treg absolute count (OR 0.70, 95% CI 0.57–0.87, p_FDR=0.040 [false discovery rate]) and activated CD4 Tregs % CD4⁺ T cells (OR 0.64, 95% CI 0.48–0.84, p_FDR=0.040). In addition, CD28 on secreting CD4 Tregs (OR 0.95, 95% CI 0.93–0.98, p_FDR=0.014) was detected for other atherosclerosis. In ischaemic heart disease, CD28 on activated CD4 Tregs was protective (OR 0.96, 95% CI 0.95–0.98, p_FDR=0.020). An increased intensity of CD3 and CD4 was observed in reverse MR after the occurrence of stroke and ischaemic heart disease, respectively, whereas a lower number and proportion of CD39⁺-secreting CD4 Tregs were noted after ischaemic heart disease. Co-localisation analysis indicated that there were no shared causal variants among significant associations in forward MR.</div></div><div><h3>Conclusion</h3><div>This study revealed a potential causal relationship between Tregs and atherosclerosis and related cardiovascular diseases, providing a plausible hypothesis for future clinical and basic research.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages 435-443"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143038170","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":"Practice Change in Surgical Treatment Strategies for Ischaemic Mitral Regurgitation and Late Outcomes","authors":"Yaerhim Shin BMed/MD ,&nbsp;John K. French MBCHB, MSc, PhD ,&nbsp;Mahnoor Mian BMed, FRACP ,&nbsp;Dominic Y. Leung FRACP, PhD ,&nbsp;Nguyen Giang Tien Tran BMed/MD ,&nbsp;Hugh D. Wolfenden FRACS ,&nbsp;Rebecca Dignan MD, FRACS","doi":"10.1016/j.hlc.2024.11.024","DOIUrl":"10.1016/j.hlc.2024.11.024","url":null,"abstract":"<div><h3>Background</h3><div>Ischaemic mitral regurgitation (IMR) results from dysfunctional myocardial remodelling, which portends a poor clinical prognosis. This study assessed the surgical treatment of IMR and its associations with clinical and echocardiographic outcomes in the context of 2014 reports suggesting non-surgical management of non-severe IMR.</div></div><div><h3>Method</h3><div>Patients who underwent mitral valve (MV) procedures for IMR at Liverpool Hospital (Sydney, Australia) between 2008 and 2020 were included based on coronary disease and echocardiographic criteria. Data were obtained from patient records and linkage with the Australian Institute of Health and Welfare National Death Index. The primary outcome was the type of MV surgery performed in 2008–2014 and 2015–2020. Secondary outcomes were survival and freedom from combination of mortality and congestive heart failure (CHF) readmission, comparing MV repair and MV replacement and the outcomes for two periods by MV procedure.</div></div><div><h3>Results</h3><div>Of 106 patients treated surgically for IMR, 78 had MV repair (59 in 2008–2014, 19 in 2015–2020) and 28 had MV replacement (14 in 2008–2014, 14 in 2015–2020). Patients were followed up for 7.2 years (interquartile range 5.2–9.1). Compared to 2008–2014, there was a reduced proportion of MV procedures for IMR (4.2% and 2.0%; p&lt;0.001) and MV repair for IMR (80.8% and 57.6%; p=0.012) post-2014. Freedom from a combination of mortality and CHF readmission over 10 years was significantly better in the MV repair than in the MV replacement group (log rank p&lt;0.001). Over 5 years, freedom from mortality and the combination of mortality and CHF readmission were similar in both periods (log rank p=0.675 and p=0.433). In the earlier period, freedom from combined outcome was better in the MV repair group than the MV replacement group (log rank p&lt;0.001) but not different in the second period (log rank p=0.149). Mitral regurgitation recurrence was less in the later period (25.8% and 3.6%; p=0.013).</div></div><div><h3>Conclusions</h3><div>The proportion of MV procedures and MV repairs performed for IMR declined significantly after 2014, indicating a significant change in practice towards conservative surgical correction of IMR. The combined long-term outcomes were unchanged after the change in practice, but the incidence of mitral regurgitation recurrence was significantly improved.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages 485-496"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448938","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":"Imaging and Surveillance of Chronic Aortic Dissection: Current Practice and Future Directions","authors":"Samad A. Raza MBBS ,&nbsp;Abid Khan MBBS ,&nbsp;Aman B. Williams MBBS ,&nbsp;Zoheb Williams FRACS ,&nbsp;Allan Wesley FRANZCR ,&nbsp;Bruce Thomson FRACS","doi":"10.1016/j.hlc.2024.11.035","DOIUrl":"10.1016/j.hlc.2024.11.035","url":null,"abstract":"<div><div>Chronic aortic dissection is a complex disease with a heterogenous clinical course. Specialised imaging is necessary for the long-term surveillance of this disease to identify patients who meet the criteria for intervention, and to monitor surgically treated patients for complications. Whilst computed tomography and magnetic resonance imaging are the most widely utilised modalities, providing a high degree of anatomical detail and reproducible aortic measurements, they are not without significant limitations. These techniques cannot accurately predict patients that are at risk of late complications who may benefit from early intervention. Emerging techniques such as four-dimensional magnetic resonance imaging and computational fluid dynamics have identified multiple haemodynamic variables with potential prognostic value for identifying adverse events such as rupture, malperfusion, or aneurysmal degeneration, and may in the future become integrated into routine clinical practice. This review provides a detailed analysis of current diagnostic and surveillance imaging modalities in chronic aortic dissection and discusses future paradigms in aortic imaging to enable better prognostication and earlier intervention for high-risk patients.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages 426-434"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630063","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":"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” by Liufu et al., Heart Lung Circ. 2025;34(3):289–296","authors":"Rohan Magoon DM, MD ,&nbsp;Jes Jose DM, MD","doi":"10.1016/j.hlc.2025.01.014","DOIUrl":"10.1016/j.hlc.2025.01.014","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages e47-e48"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924901","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":"Upfront Combination Therapy for LDL-C Lowering in Acute Coronary Syndrome: The Rule Rather than the Exception?","authors":"Alexander P. Bate MBBS ,&nbsp;Peter J. Psaltis MBBS, PhD ,&nbsp;Stephen J. Nicholls MBBS, PhD ,&nbsp;Adam J. Nelson MBBS, MPH, MBA, PhD","doi":"10.1016/j.hlc.2025.04.076","DOIUrl":"10.1016/j.hlc.2025.04.076","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages 409-411"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924717","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":"Right Ventricle: The Underappreciated Key to Transcatheter Aortic Valve Implantation Success","authors":"Mohammad Sarraf MD,&nbsp;Vinayak Nagaraja MBBS, MBiostat, FRACP","doi":"10.1016/j.hlc.2025.04.080","DOIUrl":"10.1016/j.hlc.2025.04.080","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages 422-425"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924718","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":"Impact of Transcatheter Aortic Valve Implantation on Right Ventricular Function","authors":"Seshika Ratwatte BMed ,&nbsp;Bianca Coelho DMU ,&nbsp;Martin K. Ng PhD ,&nbsp;David S. Celermajer PhD","doi":"10.1016/j.hlc.2024.11.017","DOIUrl":"10.1016/j.hlc.2024.11.017","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence and predictors of right ventricular (RV) dysfunction before and after transcatheter aortic valve implantation (TAVI) are not known. We aimed to document this and sought to identify specific RV echo thresholds, below which RV improvement was unlikely to occur.</div></div><div><h3>Method</h3><div>Consecutive patients who underwent TAVI between 2017 and 2021 at Macquarie University Hospital (MUH) were included if ≥2 RV functional parameters were available on baseline echo; tricuspid annular plane systolic excursion, tissue Doppler (S’) and/or RV fractional area change. Prevalence and predictors of baseline RV dysfunction were documented. Patients with a repeat echo performed at MUH at 1–3 months post-TAVI were included in further analyses to assess serial changes in RV function.</div></div><div><h3>Results</h3><div>Overall, 343 patients had an eligible baseline echo and 97 of these patients (28.2%) had RV dysfunction, pre-TAVI. These patients had significantly higher rates of atrial fibrillation, ischaemic heart disease, and chronic lung disease, than those without (p&lt;0.05 for all). Of 239 patients with 1–3 month follow-up echo data, 66 of these had had baseline RV dysfunction; of these, 20 (30.3%) patients showed improvement and 46 (69.7%) patients showed persistent RV dysfunction. Thresholds with a greater than 90% predictive value for persistent RV dysfunction were identified for each baseline RV functional parameter: tricuspid annular plane systolic excursion &lt;1.4 cm, S’&lt;6, fractional area change &lt;25%.</div></div><div><h3>Conclusions</h3><div>Baseline RV dysfunction was present in over a quarter of pre-TAVI patients and persisted at short-term follow-up in over two-thirds of such patients. There were clear thresholds to identify patients where RV recovery was unlikely, after TAVI.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 5","pages":"Pages 456-466"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457788","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":"Defining Gaps in the Management of Familial Hypercholesterolaemia Using Electronic Health Records in Rural General Practice.","authors":"Kyle Selga, Maverick Daniel, Samuel Moffatt, Louis Steyn, Benjamin Whittaker, Jennene Greenhill, Ian Hamilton-Craig","doi":"10.1016/j.hlc.2025.03.004","DOIUrl":"https://doi.org/10.1016/j.hlc.2025.03.004","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993389","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}