Heart, Lung and Circulation最新文献

{"title":"V˙O2RR: A Potential Quantitative Marker for GDMT Titration in HFrEF","authors":"Jinyue Du, Yuanyuan Wen, Hui Liu","doi":"10.1016/j.hlc.2026.04.116","DOIUrl":"10.1016/j.hlc.2026.04.116","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Page e139"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149095745","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 the Letter to the Editor regarding: “V˙O2RR: A Potential Quantitative Marker for GDMT Titration in HFrEF”","authors":"Iain W. Smith BClinExPhys, Glenn M. Stewart PhD, Surendran Sabapathy PhD, Annette G. Dent PhD, Norman R. Morris PhD","doi":"10.1016/j.hlc.2026.04.002","DOIUrl":"10.1016/j.hlc.2026.04.002","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Pages e140-e141"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149095503","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":"Ensuring Transparency: Data Sharing Challenges in Clinical Trials","authors":"Ashish H. Shah MD, MD-Research, FRCP","doi":"10.1016/j.hlc.2025.12.033","DOIUrl":"10.1016/j.hlc.2025.12.033","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Pages e142-e143"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149095746","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":"Feasibility and Safety of Rotational Atherectomy in a Rural Centre Without On-Site Cardiac Surgery","authors":"Roshan A. Ananda MD, MPH,&nbsp;Lin Ling Wong MD,&nbsp;Muntaser Musameh MD, PhD, MRCP,&nbsp;Zhihua Zhang MBBS, FRSANZ","doi":"10.1016/j.hlc.2026.01.023","DOIUrl":"10.1016/j.hlc.2026.01.023","url":null,"abstract":"<div><h3>Background</h3><div>Rotational atherectomy has become increasingly common in centres without on-site cardiac surgery to treat heavily calcified coronary artery disease. However, there is limited evidence on its safety in rural centres with significant travel distances from tertiary centres with cardiac surgery.</div></div><div><h3>Method</h3><div>This is a retrospective cohort study of all consecutive patients treated with rotational atherectomy in Mackay Base Hospital (MBH), Australia between March 2021 and September 2023. MBH is located 385 km away from the nearest tertiary centre with on-site cardiac surgery. The primary outcomes were procedural success, major peri-procedural complications, and all-cause mortality during hospitalisation. Secondary outcomes were major adverse cardiovascular events and complications at 30-day follow-up</div></div><div><h3>Results</h3><div>Of 20 patients treated with rotational atherectomy, the mean age was 72.3 years (standard deviation [SD]=9.9) and one-quarter were female. Their mean SYNTAX score was 20 (SD=9), while their mean EuroSCORE was 1.60 (SD=1.22). Target vessels included the right coronary artery (n=12; 60%), left anterior descending artery (n=7; 35%), and left circumflex artery (n=1; 5%). The mean rotablation burr diameter was 1.5 mm (SD=0.1), and all patients received at least one drug-eluting stent following atherectomy. The procedural success rate was 100%. Two major peri-procedural complications were observed; one may be attributable to rotational atherectomy, while the other was not specific: one intra-procedural cardiac arrest related to coronary slow-flow, and one upper mediastinal haematoma most likely related to accidental injury to a small arterial branch during the negotiation of a tortuous right brachiocephalic artery with a hydrophilic guidewire. No patient required emergency coronary artery bypass surgery. There was no all-cause mortality during hospitalisation and no major adverse cardiovascular event at 30-day follow-up.</div></div><div><h3>Conclusions</h3><div>Rotational atherectomy is feasible and safe in rural centres without on-site cardiac surgery. Careful case selection and a team-based approach with two operators are advised. Factors contributing to atherectomy safety, including operator volumes, adequate catheterisation laboratory team training, and strong partnership with the tertiary cardiac surgical centre, should be considered before establishing high-risk procedures in these centres.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Pages 1455-1460"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619642","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":"Aortic Angulation Distribution and Effects on the Outcomes of Self-Expanding Transcatheter Aortic Valve Replacement","authors":"Qianbei He,&nbsp;Yuanyuan Yu,&nbsp;Ruitao Li,&nbsp;Tianyuan Xiong,&nbsp;Fei Chen,&nbsp;Yanbiao Liao,&nbsp;Zhengang Zhao,&nbsp;Zhicheng Chen,&nbsp;Xuechen Qiao,&nbsp;Zhixiang Yu,&nbsp;Yijian Li,&nbsp;Yuan Feng","doi":"10.1016/j.hlc.2026.01.022","DOIUrl":"10.1016/j.hlc.2026.01.022","url":null,"abstract":"<div><h3>Background</h3><div>Aortic angulation (AA), defined as the angle between the horizontal plane on the coronal plane and the plane of the aortic valve annulus, is an important anatomical factor in transcatheter aortic valve replacement (TAVR). Whether AA affects early clinical outcomes and complications in self-expanding (SE)-TAVR procedures is still controversial.</div></div><div><h3>Method</h3><div>We conducted a retrospective cohort study of 519 consecutive patients who underwent SE-TAVR at our centre from January 2016 to January 2021. Preoperative AA, technique success, and one-year postoperative survival rates were primarily analysed.</div></div><div><h3>Results</h3><div>The AA of patients undergoing SE-TAVR ranged from 25° to 93°, with a mean value of 55.4°±9.7°. There was a statistically significant difference in technique success between AA≤55.5° and AA&gt;55.5° groups (84.3% vs 75.1%, p=0.009), mainly driven by the higher proportion of second-valve implantation during TAVR (8.8% vs 19.6%, p&lt;0.001). In valve-type subgroup analysis, larger AA demonstrated good predictive value for second-valve implantation (area under the curve 0.690; 95% confidence interval 0.617–0.763). However, AA showed limited predictive efficacy for technical success in patients with bicuspid aortic valve, and it was not associated with major complications or unplanned interventions in patients with tricuspid aortic valve.</div></div><div><h3>Conclusions</h3><div>A larger AA is associated with a lower rate of technical success of SE-TAVR, mainly due to an increased frequency of second-valve implantation. The impact of AA is more evident in patients with tricuspid aortic valve rather than in those with bicuspid aortic valve.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Pages 1471-1477"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholesterol Efflux Capacity and Coronary Plaque Composition After Non–ST-Elevation Myocardial Infarction","authors":"Thalia Salagaras BSc,&nbsp;Mau T. Nguyen MBBS,&nbsp;Sanuri Liyanage BSc, PhD,&nbsp;Shiwani Sharma BSc, PhD,&nbsp;Joanne T.M. Tan BSc, PhD,&nbsp;Giuseppe Di Giovanni BSc,&nbsp;Yu Kataoka MD, PhD,&nbsp;Jessica A. Marathe MBBS, PhD,&nbsp;Stephen J. Nicholls MBBS, PhD,&nbsp;Christina A. Bursill BSc, PhD,&nbsp;Peter J. Psaltis MBBS, PhD","doi":"10.1016/j.hlc.2026.03.067","DOIUrl":"10.1016/j.hlc.2026.03.067","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Pages e133-e136"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Video-Assisted Thoracic Surgery Compared to Open Thoracic Surgery for Pulmonary Hydatid Disease: A Systematic Review and Meta-Analysis","authors":"Ayham Mohammad Hussein MD,&nbsp;Bara M. Hammadeh MD,&nbsp;Abdullah Yousef Aldalati MD,&nbsp;Moath Albliwi MD,&nbsp;Ramez M. Odat MMD,&nbsp;Amin Shabaneh MD","doi":"10.1016/j.hlc.2026.02.021","DOIUrl":"10.1016/j.hlc.2026.02.021","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background &amp; Aim&lt;/h3&gt;&lt;div&gt;Pulmonary echinococcosis, or pulmonary hydatid disease, caused by &lt;em&gt;Echinococcus&lt;/em&gt; larvae, presents a significant health challenge, particularly in endemic areas. While surgery is the primary treatment for viable cysts, the optimal approach for this remains under debate. There is a lack of comparative evidence comparing traditional open thoracic surgery (OTS) with minimally invasive video-assisted thoracic surgery (VATS). This systematic review and meta-analysis aims to comprehensively compare the efficacy and safety of VATS versus OTS for pulmonary hydatid disease; it will expand on prior research by including patients of all ages and conducting detailed subgroup analyses, sensitivity analyses, and publication bias assessments.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and International Prospective Register of Systematic Reviews registration (CRD420251012764), major databases (PubMed, Scopus, Cochrane Library, Web of Science) were searched up to 5 March 2025, without language or date restrictions. Comparative studies (randomised controlled trials and observational studies) reporting perioperative, postoperative, and recovery outcomes for VATS versus OTS were included. Data were synthesised using random-effects models (calculating mean differences [MDs] or risk ratios with 95% confidence intervals). Heterogeneity (I&lt;sup&gt;2&lt;/sup&gt;), risk of bias (Risk Of Bias In Non-randomised Studies of Interventions) and publication bias (Doi plots, Luis Furuya-Kanamori index) were assessed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Nine retrospective cohort studies met the inclusion criteria. Compared with OTS, VATS was associated with significantly shorter operation times (MD −38.08 min; p&lt;0.001; I&lt;sup&gt;2&lt;/sup&gt;=92%), lower perioperative blood loss (MD −64.02 mL; p=0.006; I&lt;sup&gt;2&lt;/sup&gt;=98%), reduced postoperative drainage volume (MD −124.46 mL; p=0.003; I&lt;sup&gt;2&lt;/sup&gt;=85%), earlier chest drain removal (MD −2.27 days; p&lt;0.001; I&lt;sup&gt;2&lt;/sup&gt;=92%), and shorter hospital stays (MD −3.68 days; p&lt;0.001; I&lt;sup&gt;2&lt;/sup&gt;=98%). Although VATS showed a trend towards fewer postoperative complications, the difference was not statistically significant (risk ratio 0.72; p=0.13; I&lt;sup&gt;2&lt;/sup&gt;=0%). Significant heterogeneity (I&lt;sup&gt;2&lt;/sup&gt;&gt;85%) was present for most continuous outcomes, and risk of bias assessment indicated high risks in confounding and reporting domains for several studies. Potential publication bias favouring VATS was detected for multiple outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;VATS appears to offer significant perioperative and recovery advantages over OTS for the surgical management of pulmonary hydatid disease. However, these findings must be interpreted with caution. While this review incorporates recently available randomised evidence, the majority of the data remains retrospective, and the pooled results are affected by","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Pages 1395-1411"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Use of Intracoronary Imaging and Invasive Physiological Assessment During Coronary Angiography Procedures in New Zealand: ANZACS-QI 91","authors":"Michael Dick MBChB,&nbsp;Mildred Lee BTech, MSc,&nbsp;Wil Harrison MBChB, MMedSci, FRACP,&nbsp;Kok-Lam Chow MBChB, FRACP,&nbsp;Jen-Li Looi MBChB, FRACP","doi":"10.1016/j.hlc.2026.01.021","DOIUrl":"10.1016/j.hlc.2026.01.021","url":null,"abstract":"<div><h3>Background</h3><div>Intracoronary imaging (ICI) with intravascular ultrasound (IVUS) or optical coherence tomography (OCT), along with invasive physiological assessments (IPA - fractional flow reserve [FFR] or the adenosine-free pressure indices), complement conventional angiography for coronary artery disease assessment. Increasing evidence demonstrates that these technologies improve percutaneous coronary intervention (PCI) outcomes and reduce complications. We reviewed the contemporary use of ICI and IPA in New Zealand.</div></div><div><h3>Methods</h3><div>Data was extracted from the All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) ACS and Cath-PCI registries from 1 July 2017 until 31 October 2023. ICI and IPA use were analysed for patients who underwent coronary angiography for a non-ST elevation acute coronary syndrome (NSTEACS) or non-acute coronary syndrome chest pain.</div></div><div><h3>Results</h3><div>The ‘NSTEACS’ cohort included 31,599 patients (69.1% male, mean age 66.1±11.4 years) undergoing 35,251 procedures. ICI and IPA usage increased over the study period (p&lt;0.001). IVUS was most frequently used for complex multi-vessel and left main stem (LMS) disease (7.6% and 15.5%, respectively); OCT mostly for single vessel disease (4.7%); and IPA use mostly for multi-vessel disease (10.7%). ICI guidance for PCI is low overall (IVUS 12.3%, OCT 4.7%); however, PCI rates are higher in ICI cases (p&lt;0.001), and lower when IPA is used (p=0.003).</div><div>The ‘chest pain syndrome’ cohort included 34,446 patients (66.5% male, mean age 66.4±11.2 years) undergoing 40,148 procedures. ICI and IPA usage increased over the study period (p&lt;0.001). IVUS was most often used for complex coronary disease, particularly LMS (15.3%); OCT mostly for single vessel disease (3.7%); with IPA use similar for single (14.0%) and multi-vessel disease (13.1%). ICI guidance for PCI is low overall (IVUS 18.7%, OCT 5.7%); however, PCI rates are higher when ICI or IPA are used (p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>ICI and IPA are infrequently used for NSTEACS and chest pain syndrome patients in New Zealand. Utilisation is increasing in-keeping with growing evidence and guideline recommendations.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Pages 1461-1470"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684349","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 Efficacy of Transcatheter Aortic Valve Implantation at Centres With Versus Without On-Site Cardiac Surgery: A Systematic Review and Meta-Analysis","authors":"Abdelrahman M. Elettreby MD,&nbsp;Omnia Samy El-Sayed MD,&nbsp;Nour Eddin M. Al-Hawari MD,&nbsp;Basel F. Alqeeq MD,&nbsp;Ahmed Farid Gadelmawla MD,&nbsp;Ahmed A. Abo Elnaga MD,&nbsp;Mohammad M. Abushanap MD,&nbsp;Jenan A. Alkasasbeh MD,&nbsp;Lama Jreisat MD,&nbsp;Ibraheem M. Alkhawaldeh MD,&nbsp;Osama Bisht PhD","doi":"10.1016/j.hlc.2026.04.015","DOIUrl":"10.1016/j.hlc.2026.04.015","url":null,"abstract":"<div><h3>Background</h3><div>Aortic stenosis (AS) is the most common heart valve disorder causing significant complications. While transcatheter aortic valve implantation (TAVI) offers a less invasive alternative to surgery, debate remains about whether it should require on-site cardiac surgery backup. This systematic review and meta-analysis evaluate existing literature comparing outcomes of TAVI performed at centres with versus without on-site cardiac surgery, aiming to guide optimal patient management and institutional decision-making.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted in multiple databases up to May 2025 to retrieve relevant studies. Random-effects meta-analyses pooled risk ratios (RR) or mean differences. Because definitions of surgical backup varied across studies, backup organisation was extracted for each study. Risk of bias was assessed with the Newcastle–Ottawa Scale and certainty of evidence with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.</div></div><div><h3>Results</h3><div>Six observational cohort studies (n=6,109 patients) were included. No statistically significant differences were observed for in-hospital mortality (four studies; n=3,463; RR= 0.94), 30-day mortality (five studies; n=4,880; RR= 0.87), or emergent conversion to open-heart surgery (four studies; n=4,136; RR= 0.78). Most secondary outcomes were likewise not statistically different, but several had substantial heterogeneity or unstable leave-one-out results. In one matched registry study from the included studies, in-hospital mortality among patients requiring emergent cardiac surgery after intraprocedural complications was high in both settings (50% vs 62.5%).</div></div><div><h3>Conclusions</h3><div>This observational meta-analysis did not detect statistically significant differences in short-term mortality, emergent conversion, or major complications between centres with and without on-site cardiac surgery. However, the absence of statistically significant differences does not establish safety equivalence. Certainty of evidence was low to very low, and findings should be interpreted cautiously in light of residual confounding, publication bias, and variation in backup models. Accordingly, future high-quality studies are needed to validate these findings.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Pages 1382-1394"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the Growing Prevalence and Ongoing Symptoms of Atrial Fibrillation","authors":"","doi":"10.1016/j.hlc.2026.09.001","DOIUrl":"10.1016/j.hlc.2026.09.001","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Page 1498"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149094597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}