Heart, Lung and Circulation最新文献

{"title":"Clarifying the CSANZ Expert Position Statement on Appropriate Training for AF Ablation: Mentoring for Qualified Electrophysiologists Adopting New Techniques.","authors":"Peter M Kistler, Prashanthan Sanders, Stuart P Thomas, Jonathan M Kalman","doi":"10.1016/j.hlc.2025.08.011","DOIUrl":"https://doi.org/10.1016/j.hlc.2025.08.011","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145052944","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":"A Fluoroless Workflow Using Transoesophageal Echocardiography for Catheter Ablation of Atrial Fibrillation Using Pulsed Field Ablation.","authors":"Yehuan Zhou, Wee Kian Kenny Tan, Stuart P Thomas, Pierre C Qian","doi":"10.1016/j.hlc.2025.04.088","DOIUrl":"https://doi.org/10.1016/j.hlc.2025.04.088","url":null,"abstract":"<p><strong>Background: </strong>Catheter ablations are increasingly performed with zero or minimal fluoroscopy, enabled by ultrasound imaging and electro-anatomical mapping. Pulsed field ablation (PFA) using Farawave has been dependent on fluoroscopic assessment of catheter conformation and contact. We aimed to demonstrate the feasibility of a PFA workflow for pulmonary vein isolation (PVI) and extrapulmonary ablation.</p><p><strong>Method: </strong>Patients with paroxysmal or persistent atrial fibrillation who underwent fluoroless PVI between August 2023 to October 2024 were included in this study. After transoesophageal echocardiography-guided transeptal puncture, the PentaRay catheter was used to acquire left atrial and pulmonary branch anatomy. The Farawave catheter and Rosen wire, clipped using alligator clips, were visualised using the CARTO 3D Electroanatomical Mapping System (https://www.jnjmedtech.com/en-US/product/carto-3-system). Arrhythmia induction and mapping were routinely performed after PVI to guide further extrapulmonary ablation.</p><p><strong>Results: </strong>A total of 36 patients were included in this study, with a median age of 60 (52-67) years. All pulmonary veins (PVs) were antrally isolated (130/130 PVs) and 16 patients (44.4%) underwent further extrapulmonary ablations with 13 of 13 successful posterior wall isolations (100%), six of seven linear line ablations achieving bidirectional block (85.7%) and two of two successful superior vena cava isolations (100%). The median total procedure time was 77 (65-93) minutes, left atrial dwelling time of 54 (46-74) minutes, with ablation time of 24 (20-29) minutes.</p><p><strong>Conclusions: </strong>A fluoroless PFA workflow is feasible and rapid in achieving successful PVI and extrapulmonary ablation to treat atrial fibrillation and induced organised atrial tachyarrhythmias.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006013","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":"Comparison of Outcomes of Transcatheter Edge-to-Edge Repair With Early Versus Latest Generation MitraClip for Severe Mitral Regurgitation.","authors":"Khin May Thaw, William Scalia, Ronan Petersen, Su Hnin Hlaing, Michael Savage, Dale Murdoch, Karl Poon, O Christopher Raffel, Katherine Lau, Stephen Tomlinson, Lisa Walters, Gregory Scalia, Darren L Walters","doi":"10.1016/j.hlc.2025.06.1033","DOIUrl":"https://doi.org/10.1016/j.hlc.2025.06.1033","url":null,"abstract":"<p><strong>Background: </strong>The fourth-generation MitraClip G4 system is the latest version of the transcatheter edge-to-edge repair (TEER) system for mitral regurgitation (MR).</p><p><strong>Aim: </strong>This study aimed to evaluate the effectiveness of the MitraClip G4 in the reduction of MR compared to the early-generation MitraClip.</p><p><strong>Method: </strong>We performed a retrospective analysis of consecutive patients undergoing TEER for MR with either the early-generation or newer-generation MitraClip G4 from a single-centre registry. Baseline patient characteristics and echocardiographic data were compared between groups.</p><p><strong>Results: </strong>Between December 2011 and February 2024, a total of 183 patients underwent mitral TEER. Of these, 140 patients were treated with early-generation MitraClip, and 43 patients were treated with the G4 system. Reduction of MR to grade≤1 was achieved in 59.5% of patients treated with the G4 MitraClip compared to 25.7% in the early-generation cohort (p<0.001). There was a significant reduction in median MR severity post-TEER in the G4 cohort compared to the early-generation group (p=0.006) (median change: 3 grades in the G4 group). There was no significant difference in post-TEER (moderate or severe) mitral stenosis (p=0.743). No significant difference was noted in the median number of clips used. No significant difference was noted in baseline characteristics, although a proportionally higher number of previous coronary interventions and coronary artery bypass grafts were observed in the early-generation MitraClip group.</p><p><strong>Conclusions: </strong>The MitraClip G4 system achieved significantly greater reduction of MR severity compared to the earlier generation mitral TEER device.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000437","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":"Timing, Diagnosis, and Potential Preventability of 30-Day Unplanned Readmissions After a Heart Failure Hospitalisation: Implications for Care Quality.","authors":"James Fryar, Sunnya Khawaja, Trang Dang, Wandy Chan, Maryam Khorramshahi Bayat, William Parsonage, Isuru Ranasinghe","doi":"10.1016/j.hlc.2025.04.085","DOIUrl":"https://doi.org/10.1016/j.hlc.2025.04.085","url":null,"abstract":"<p><strong>Aim: </strong>To assess timing, causes, and potential preventability of unplanned readmissions within 30 days of heart failure hospitalisation and how they vary by age and sex across the population.</p><p><strong>Method: </strong>We conducted a cohort study using hospitalisation data from 2013 to 2017 from all public and most private hospitals in Australia and New Zealand, including 197,648 patients aged ≥18 years (mean age 78.2 [standard deviation 12.3] years, 52.4% male, 13.3% <65 years) with a primary diagnosis of heart failure. The main outcomes included the timing of 30-day unplanned readmissions, the diagnoses associated with these, and their potential preventability. Preventability was determined by categorising readmission diagnoses into the following: 1) potential hospital-acquired complication, 2) recurrent heart failure, 3) clinically related to heart failure, and 4) all other diagnoses. Groups 1 and 2 were deemed most preventable.</p><p><strong>Results: </strong>A total of 43,011 (21.8%) patients had one or more unplanned readmissions within 30 days. The peak readmission risk occurred on days 2-4 post-discharge with 25,318 (58.9%) occurring within 2 weeks. When grouped, diagnoses consistent with a potential hospital-acquired complication (group 1) accounted for 41.7% (most commonly pneumonia, atrial fibrillation/flutter, and myocardial infarction), readmission for recurrent heart failure (group 2) comprised 38.2%, and groups 3 and 4 consisted of 11.5% and 8.6%, respectively. Although heart failure hospitalisation occurred more frequently in older adults, the risk of readmission exceeded 20% in all age groups, and the timing and potential preventability were not clinically significantly different across age and sex.</p><p><strong>Conclusions: </strong>The peak risk of unplanned readmission occurred in the first few days after discharge, often for potentially preventable reasons such as hospital-acquired complications and recurrent heart failure. Such early and potentially preventable readmissions suggest many may be related to suboptimal quality of hospital care and discharge practices. Future clinical and policy interventions should target improving hospital-based heart failure care quality to reduce avoidable readmissions.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992335","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: ANZSCTS ASM advert","authors":"","doi":"10.1016/S1443-9506(25)01594-X","DOIUrl":"10.1016/S1443-9506(25)01594-X","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 9","pages":"Page 985"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005269","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":"Outcomes of Septal Myectomy Associated With Surgical Volume","authors":"Yantong Wang BMedSc ,&nbsp;Michael Bailey PhD ,&nbsp;Andris Ellims PhD, FRACP ,&nbsp;Lavinia Tran PhD ,&nbsp;Christopher M. Reid PhD, MSc ,&nbsp;Silvana F. Marasco PhD, FRACS","doi":"10.1016/j.hlc.2025.01.008","DOIUrl":"10.1016/j.hlc.2025.01.008","url":null,"abstract":"<div><h3>Background &amp; Aim</h3><div>Previous studies have reported an inverse relationship between hospital septal myectomy (SM) volume and outcomes, without assessments of surgeon volume and SM outcomes. This Australia and New Zealand–based study sought to appraise the relationships between hospital volume, surgeon volume, and SM outcomes.</div></div><div><h3>Methods</h3><div>Data were collected from the Australian and New Zealand Society of Cardiac and Thoracic Surgeons Database, from the time of inception of the Australian and New Zealand Society of Cardiac and Thoracic Surgeons Database (2001) until 1 January 2021. Hospitals were divided into the lowest (one to three cases), middle (four to six cases), and highest tertiles (more than six cases) based on their annual SM case volume.</div></div><div><h3>Results</h3><div><span><span>This study cohort included 1,132 patients and 115 surgeons. The surgeon volume ranged from one to 91 cases in total. The overall 30-day mortality after SM was 2.2%, and the rate of new-onset </span>complete heart block<span> requiring permanent pacemaker was 7.5%. Concomitant </span></span>mitral valve repair<span> and mitral valve replacement were performed in 8.1% and 11.7% of patients, respectively. Concomitant mitral valve replacement was associated with increased mortality. Septal myectomy performed at low-volume centres had a significantly higher mortality rate (4.9%) than at the middle- (1.3%, p=0.002) and the high-volume centres (1.1%, p=0.004). Surgeons who performed SM on patients who subsequently died within 30 days of SM had a significantly lower case volume than surgeons who performed SM on patients who were alive.</span></div></div><div><h3>Conclusion</h3><div>This study highlights the importance of centre and surgeon case volume in outcomes after SM.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 9","pages":"Pages 918-925"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132348","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":"Short- and Long-Term Outcomes of Obstructive and Non-Obstructive Hypertrophic Cardiomyopathy: A Systematic Review and Meta-Analysis","authors":"Hui Zhen Lo BMedSci, MD ,&nbsp;Chen Ee Low MBBS ,&nbsp;Chun En Yau MBBS ,&nbsp;Yao Hao Teo MBBS ,&nbsp;Yao Neng Teo MBBS ,&nbsp;Tony YW. Li MBBS ,&nbsp;Nicholas L. Syn MBBS ,&nbsp;Ping Chai MBBS ,&nbsp;Weiqin Lin MBBS ,&nbsp;Tiong-Cheng Yeo MBBS ,&nbsp;William K.F. Kong MBChB ,&nbsp;Raymond C.C. Wong MBBS ,&nbsp;Ching-Hui Sia MBBS","doi":"10.1016/j.hlc.2025.03.011","DOIUrl":"10.1016/j.hlc.2025.03.011","url":null,"abstract":"<div><h3>Background</h3><div>Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac condition, but the risk factors and outcomes of patients with obstructive (HOCM) and non-obstructive hypertrophic cardiomyopathy (NOCM) remain unclear. This systematic review and meta-analysis was conducted to investigate the risk ratio (RR), incidence, and risk factors of all-cause and HCM-specific mortality.</div></div><div><h3>Methods</h3><div>This PRISMA-adherent systematic review involved a systematic search of PubMed, SCOPUS, and Embase for studies published from 1 January 2001 to 31 August 2023 that reported outcomes of patients with HOCM and NOCM. Random effects meta-analyses and meta-regressions were used for primary analysis.</div></div><div><h3>Results</h3><div>Sixty-one observational studies with 52,020 participants were included. All-cause, HCM-related, and heart failure-related mortality had no difference in HOCM vs NOCM patients (RR 0.85, 95% CI 0.58–1.25), (RR 0.95, 95% CI 0.68–1.32), and (RR 0.95, 95% CI 0.58–1.58), respectively. Sudden cardiac death (SCD) was significantly higher in HOCM vs NOCM patients (RR 1.69, 95% CI 1.19–2.42). Incidence of all-cause mortality (NOCM 95.47, 95% CI 63.96–140.18 vs HOCM 65.75, 95% CI 48.04–89.37) per 1,000 observations, HCM-related mortality (NOCM 59.72, 95% CI 41.91–84.42 vs HOCM 55.51, 95% CI 39.42–77.64), and SCD (NOCM 32.17, 95% CI 22.42–45.96 vs HOCM: 25.39 95% CI 15.24–42.01) were higher in NOCM patients, while heart failure-related mortality (HOCM 55.51, 95% CI 39.42–77.64 vs NOCM 30.04, 95% CI 14.78–60.11) was higher in HOCM patients.</div></div><div><h3>Conclusions</h3><div>The RR of SCD was significantly higher in HOCM vs NOCM patients. All-cause mortality, HCM-related mortality, and SCD were of higher incidence in NOCM patients. Only heart failure-related mortality was higher in HOCM patients.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 9","pages":"Pages e104-e124"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698421","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":"Fluorodeoxyglucose Positron Emission Tomography Detects Persistent Arterial Inflammation After Symptomatic COVID-19","authors":"Heidi Espedal PhD ,&nbsp;Shipra Verma MD ,&nbsp;Ambuj Roy MD ,&nbsp;Nick S.R. Lan MBBS, MClinRes, MSc ,&nbsp;Sheeraz Mohd PhD ,&nbsp;Benjamin Bartlett PhD ,&nbsp;Kamar Ali MSc ,&nbsp;Natalie C. Ward PhD ,&nbsp;Martin A. Ebert PhD ,&nbsp;Dick C. Chan MD, PhD ,&nbsp;Gerald F. Watts MD, PhD ,&nbsp;Girish Dwivedi MD, PhD ,&nbsp;Roslyn J. Francis MD, PhD","doi":"10.1016/j.hlc.2025.03.005","DOIUrl":"10.1016/j.hlc.2025.03.005","url":null,"abstract":"<div><h3>Background</h3><div>There is limited knowledge of persisting vascular and systemic inflammation in adults recovered from COVID-19. This study aimed to assess whether inflammation from symptomatic mild-to-moderate COVID-19 persists beyond the apparent clinical resolution of disease using fluorodeoxyglucose positron emission tomography (FDG-PET).</div></div><div><h3>Method</h3><div>This observational single-centre cohort study invited adults (aged &gt;40 years) who had clinically recovered from mild-to-moderate COVID-19. Whole-body FDG-PET imaging and C-reactive protein test were performed on the same day after a minimum of 30 days after COVID-19 diagnosis. COVID-19–naive adults at high-risk for cardiovascular disease (CVD) were included for comparison (n=8); thoracic FDG-PET imaging was performed for these participants.</div></div><div><h3>Results</h3><div>FDG-PET imaging was performed after a median of 97 days (interquartile range [IQR] 75–113 days) after COVID-19 diagnosis. Participants who recovered from COVID-19 showed an increased arterial inflammation (median standard uptake value [SUV]_max 3.1; IQR 2.7–3.3) compared with the high-risk participants with CVD (median SUV_max 2.5; IQR 2.2–2.8; p&lt;0.001). There was a moderate positive correlation between the total thoracic SUV_max and the bone marrow SUV_mean (Spearman r=0.58; p&lt;0.001) and the spleen mean SUV_max (Spearman r=0.62, p&lt;0.001) for participants who recovered from COVID-19.</div></div><div><h3>Conclusions</h3><div>Ongoing arterial inflammation is detected by FDG-PET imaging after mild-to-moderate COVID-19. Larger prospective studies are needed to assess the implications on CVD risk.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 9","pages":"Pages 969-976"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505485","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":"Can Australia Tackle its Failure in Research Translation to Reduce Cardiovascular Disease, Improve Equity and Deliver Better Health and Economic Outcomes?","authors":"Clara Chow AM MBBS, PhD ,&nbsp;Jason Kovacic MBBS, PhD ,&nbsp;Bruce Neal MB ChB, PhD ,&nbsp;Geoffrey Donnan AO MBBS, PhD ,&nbsp;Alex Brown MBBS, PhD ,&nbsp;Louise Maple-Brown PhD ,&nbsp;Karen Carey BA ,&nbsp;Richard Taggart MBA ,&nbsp;Pamu Kularathna PhD ,&nbsp;Sally McNeill MPH ,&nbsp;Stephen Nicholls MBBS, PhD","doi":"10.1016/j.hlc.2025.04.095","DOIUrl":"10.1016/j.hlc.2025.04.095","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 9","pages":"Pages 877-882"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717848","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":"Rural and Remote Acute STEMI Diagnosis and Management: Current Status and Future Directions.","authors":"Ryan Gadeley, Ruth Arnold, David Amos, Stuart Moss, Alex Elder, Sameer Karve, Mark Adams, David Brieger, Harry C Lowe","doi":"10.1016/j.hlc.2025.06.1035","DOIUrl":"10.1016/j.hlc.2025.06.1035","url":null,"abstract":"<p><p>Current European, American and Australasian guidelines recommend revascularisation for acute ST elevation myocardial infarction (STEMI) by immediate or \"primary\" percutaneous coronary intervention (pPCI), or if pPCI cannot be performed within 120 minutes, by thrombolysis followed by rescue PCI. This latter approach, despite its limitations, remains a cornerstone of STEMI care in rural and remote settings, where pPCI is not immediately available, and where one-third of the Australian population live. This review evaluates the current status of thrombolysis and rescue PCI in rural and remote settings, examines the multiple changes that have occurred since its inception, and highlights persisting gaps in knowledge, to provide an up-to-date evaluation of this field, and an outlook for future directions, in this area of ongoing change.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952038","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}