Heart, Lung and Circulation最新文献

{"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":"149095747","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":"Cardiac Society of Australia and New Zealand","authors":"","doi":"10.1016/S1443-9506(26)01742-7","DOIUrl":"10.1016/S1443-9506(26)01742-7","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Pages 1499-1502"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149095750","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":"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":"149095502","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":"Incidence and Follow-Up of Extracardiac Findings on Cardiac Computed Tomography: A Single Tertiary Centre Experience.","authors":"Jennifer Sun, Kristyan Guppy-Coles, Paul Tesar, Jason Davis, John F Younger, Paul Martin","doi":"10.1016/j.hlc.2026.05.015","DOIUrl":"https://doi.org/10.1016/j.hlc.2026.05.015","url":null,"abstract":"<p><strong>Background: </strong>Extracardiac findings (ECF) are frequently detected on cardiac computed tomography (CT), yet their clinical follow-up in contemporary practice is variable. We sought to describe their incidence and assess whether clinically significant findings were associated with documented follow-up or further investigation.</p><p><strong>Method: </strong>We conducted a retrospective observational study of consecutive patients undergoing cardiac CT, including CT coronary angiograms (CTCA) and CT left atrial mapping (CTLA), at a single tertiary centre between January 2021 and December 2022. ECF data were extracted from formal reports. For patients with clinically significant findings, electronic medical records were reviewed to determine whether findings were documented as acknowledged and whether further investigation or follow-up was recorded.</p><p><strong>Results: </strong>A total of 402 patients underwent cardiac CT. Most ECF were low risk, including hiatus hernia (39.8%) and small pulmonary nodules <6 mm (13.4%). Clinically significant ECF were identified in 41 patients (10.2%), including pulmonary nodules measuring 6-8 mm (2.7%), pulmonary nodules >8 mm (2.5%), indeterminate liver lesions (1.5%), other mass lesions (1.5%), and pulmonary emboli (1.2%). Twenty-two patients (5.5%) met criteria for Fleischner guideline-directed surveillance, of whom 15 had documented follow-up, including one subsequent diagnosis of malignancy. Overall, 12 patients (29.2%) with clinically significant ECF had no documented follow-up. Clinically significant ECF were more frequently observed in patients undergoing CTLA (odds ratio 2.4; 95% confidence interval 1.1-5.1; p=0.03) and were associated with higher odds of lacking documented follow-up compared with CTCA (odds ratio 4.8; 95% confidence interval 1.1-21.2; p=0.05). Missed clinically significant ECF predominantly occurred in the outpatient setting.</p><p><strong>Conclusions: </strong>ECF on cardiac CT are common, and approximately 10% represent clinically significant abnormalities. In this cohort, clinically significant findings identified on CT left atrial mapping were associated with lower rates of documented follow-up compared with CTCA. These findings suggest a potential vulnerability in outpatient CTLA mapping pathways and support consideration of strategies to reduce unacknowledged ECF.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108802","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":"Heart-on-a-Chip: Theory, Evidence, and Personalised Medicine","authors":"Priya Joshi BS,&nbsp;Yu Shrike Zhang PhD,&nbsp;Suyog Mokashi MD, MBA","doi":"10.1016/j.hlc.2026.03.060","DOIUrl":"10.1016/j.hlc.2026.03.060","url":null,"abstract":"<div><div>Cardiovascular research traditionally relies on animal models or isolated cell cultures, each having limitations in accurately mimicking human heart function and disease. Organ-on-chip technology is the future of translational research studying clinical pathophysiology, drug testing, and personalised medicine. Organs are precisely replicated via their microenvironment and function. This review introduces clinicians to the heart-on-a-chip (HOC) technology, an advanced approach that replicates critical features of the human heart through engineered, microfluidic platforms. HOC models provide clinicians with a more accurate, reliable alternative for studying heart disease and evaluating drug safety, thus reducing dependence on animal testing. The review begins with an explanation of cardiac anatomy and electrophysiology, emphasising their complexities and challenges in traditional modelling. It then describes current advancements in scaffold-based HOC methods, particularly, using decellularised extracellular matrix and innovative techniques such as three-dimensional bioprinting to realistically reconstruct heart tissue architecture and cellular orientation. Special attention is given to electrophysiological considerations, including artificial stimulation methods designed to replicate the heart’s intrinsic electrical conduction pathways. The article also discusses significant improvements in real-time and non-invasive monitoring of cardiomyocyte function. By understanding these developments, clinicians will gain insights into how HOC technology can transform cardiovascular research, enhance patient safety by reducing drug-induced cardiotoxicity risks, and pave the way for personalised medicine through patient-specific cardiac models using induced pluripotent stem cells. Ultimately, this review equips clinician readers with the knowledge to understand the milieu of HOC technology, research, diagnostics, and personalised patient care.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Pages 1374-1381"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684344","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":"Investigating Novel Inflammatory Biomarkers and Pathways in Cardiac Cachexia","authors":"Mansimran Singh Dulay MRCP(UK),&nbsp;Ramey Assaf MBBS,&nbsp;Nahal Raza MBBS,&nbsp;Michael Marber FRCP,&nbsp;Rakesh Sharma PhD,&nbsp;Peter Kelleher PhD,&nbsp;Owais Dar MD(Res)","doi":"10.1016/j.hlc.2026.03.064","DOIUrl":"10.1016/j.hlc.2026.03.064","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac cachexia (CC) is an indicator of advanced heart failure (AHF), with significant unintentional weight loss (UWL) and poor prognosis. Its diagnostic criteria incorporate upregulation of established inflammatory cytokines. Identification of novel biomarkers, for example, via proteomic analyses, could unearth unstudied mechanisms behind CC formation with future applications in disease therapeutics. This study, therefore, aimed to explore the presence of contemporary, novel biomarkers, and mechanistic pathways in CC using targeted proteomics.</div></div><div><h3>Methods</h3><div>Patients with AHF or stable heart failure were recruited and the presence of CC/UWL was identified. AHF was identified using the American Heart Association “I NEED HELP” criteria, and CC was identified using the contemporary 2008 consensus definition. All patients underwent phlebotomy, with plasma proteomic analyses using Olink Target 96 Cardiovascular II panel. Median proteins concentrations were compared between the CC/UWL group and the rest of cohort, with enrichment analyses conducted to identify potential novel pathways behind disease formation. Area under the receiver operator curve analysis was conducted to determine whether significant biomarkers had potential in identifying CC/UWL.</div></div><div><h3>Results</h3><div>Six proteins were differentially expressed in the CC/UWL group, of which four were novel: interleukin-27 and interleukin-4, vascular endothelial growth factor D, and bone morphogenetic protein-6. All were suitable biomarkers (area under the receiver operator curve range 0.741–0.826). Protein enrichment analyses yielded significant pathways in disease formation relating to immune regulation and cytokine signalling.</div></div><div><h3>Conclusion</h3><div>We identified four novel biomarkers in CC, all of which are feasible biomarkers of disease identification, with proposed pathways of potential pathogenesis. Further research should be undertaken to validate our findings to better understand the mechanistic pathways in functional studies, with onward consideration regarding whether our findings have therapeutic applications.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Pages 1412-1421"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602391","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":"Transfemoral TAVI in the Contemporary Era: From High-Risk Innovation to Mainstream Cath-Lab Procedure","authors":"Ashish H. Shah MD, MD-Research","doi":"10.1016/j.hlc.2026.03.055","DOIUrl":"10.1016/j.hlc.2026.03.055","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Pages e144-e145"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149095749","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":"Interventions to Promote Utilisation of Cardiac Rehabilitation: 2026 Cochrane Systematic Review and Meta-Analysis.","authors":"Linda Long, Cho Zin Lin, Philippa Davies, Valerie Wells, Sherry L Grace, Rod S Taylor","doi":"10.1016/j.hlc.2026.03.068","DOIUrl":"https://doi.org/10.1016/j.hlc.2026.03.068","url":null,"abstract":"<p><strong>Background: </strong>Despite strong evidence of benefit and guideline recommendation, access to cardiac rehabilitation remains low across global healthcare systems. We provide a 2026 analysis of our previous Cochrane review of randomised trial evidence for interventions designed to increase cardiac rehabilitation enrolment, adherence, and completion.</p><p><strong>Methods: </strong>We searched CENTRAL, MEDLINE, Embase, CINAHL, CPCI-S, and trial registries up to 10 March 2025, without language restrictions. We included randomised controlled trials involving adults eligible for cardiac rehabilitation following myocardial infarction, angina, coronary revascularisation, or heart failure. Risk of bias was assessed using the Cochrane tool, and certainty of evidence assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Data on cardiac rehabilitation enrolment, adherence, and completion were pooled using random-effects meta-analysis.</p><p><strong>Results: </strong>A total of 47 trials involving 10,803 participants were included. Most common intervention strategies included: education, self-management training, or motivational interviewing; alternative delivery models (home-based, digital, or hybrid); invitation letters or messaging prompts; and peer support. Compared to control, interventions showed improvements in cardiac rehabilitation program enrolment (relative risk [RR]: 1.19, 95% confidence interval [CI]: 1.11 to 1.29; participants; 27 trials, 7,216 participants; low-certainty evidence), cardiac rehabilitation program adherence (standardised mean difference: 0.32, 95% CI: 0.15 to 0.49; 18 trials, 3,024 participants; moderate-certainty evidence), and cardiac rehabilitation completion (RR:1.22, 95% CI: 1.10 to 1.35; 19 trials, participants: 5,432; moderate-certainty evidence).</p><p><strong>Conclusions: </strong>To overcome the persistent challenge of suboptimal cardiac rehabilitation utilisation, global healthcare systems should consider a multifaceted approach to improving cardiac rehabilitation utilisation that combines patient- and system-level intervention strategies identified in this review. Further high-quality trials targeting underserved populations are needed in order to optimise equity in future cardiac rehabilitation access.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108733","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":"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":"149095748","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":"Long-Term Outcomes of Valve Sparing Aortic Root Replacement in New Zealand","authors":"Kei Woldendorp BMed, MD, MPhil,&nbsp;Krish Chaudhuri MBBS, MSurg, PhD,&nbsp;Jens Lund MD,&nbsp;David Haydock MBBS","doi":"10.1016/j.hlc.2026.02.019","DOIUrl":"10.1016/j.hlc.2026.02.019","url":null,"abstract":"<div><h3>Background</h3><div>Valve-sparing aortic root replacement (VSARR) has been shown to provide excellent long-term results for patients with aneurysmal aortic roots or aortic dissection and functionally normal aortic valves other than regurgitation (absence of leaflet calcium, no large leaflet free-edge fenestrations). New Zealand has a higher incidence of genetic aortopathies and aortic dissection compared with other countries. This study investigates the long-term outcomes of VSARR in this population.</div></div><div><h3>Method</h3><div>All patients undergoing VSARR at our institution over a 20-year period (2003–2023) were included. National registries were used for follow-up and survival data. A generalised additive model was used to define experienced surgeons as those who had performed &gt;15 cases. Median follow-up was 6.6 years (interquartile range 4.5–10.6 years; maximum 20.5 years).</div></div><div><h3>Results</h3><div>In total, 147 patients were included with a mean age of 47 years; 77% were male, and 37% were Māori or Pasifika. Furthermore, 39% had a genetic aortopathy, 45% had preoperative moderate-to-severe aortic regurgitation (AR), and 18% presented with an acute type A aortic dissection (ATAAD). Operations included Valsalva-graft VSARR (73.5%), straight-graft VSARR (21.1%), and Yacoub remodelling (5.4%). Early mortality was 4.8% (3.3% after elective surgery and 11.5% after dissection, p=0.2) and late mortality was 10.7%. Overall survival probability was 95.8% at five years, 90.3% at 10 years, and 65.8% at 20 years and was worsened by older age (hazard ratio [HR] 1.05), Māori/Pasifika status (HR 3.20), and ATAAD (HR 8.64). Progression to moderate or greater AR occurred in 11.9% of patients at a median time of 5.1 years (interquartile range 4.5–10.6 years) after surgery. The incidence was higher in patients who underwent Yacoub-style remodelling procedures compared with David-style reimplantation procedures; however, the difference was not statistically significant (25.0 vs 10.1%; p=0.46). Preoperative severe AR increased the risk of late moderate-to-severe AR (HR 3.20), while experienced surgeons had fewer patients develop progressive AR (HR 0.28). Five patients (3.4%) required a reintervention on the aortic valve during follow-up, with no variable impacting this outcome.</div></div><div><h3>Conclusions</h3><div>VSARR provides excellent long-term results for young patients with genetic aortopathies in the New Zealand setting. Inexperience of the operating surgeon and presentation with severe AR both result in higher rates of future progression to clinically significant AR, but long-term reintervention and overall survival remain excellent.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Pages 1447-1454"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602317","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}