Heart, Lung and Circulation最新文献

{"title":"Growth and Rupture of Descending Thoracic Aortic Aneurysm","authors":"Hisato Takagi MD, PhD","doi":"10.1016/j.hlc.2026.02.012","DOIUrl":"10.1016/j.hlc.2026.02.012","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Pages e137-e138"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149509","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":"External Validation of a Post-Cardiac Arrest Risk Score (SLANT) for In-Hospital Mortality in Patients Receiving Targeted Temperature Management.","authors":"Chih-Wei Sung, Cheng-Yi Fan, Chun-Ju Lien, Chien-Tai Huang, Chun-Hsiang Huang, Chi-Hsin Chen, Sih-Shiang Huang, Yi-Ju Ho, Yun-Chang Chen, Edward Pei-Chuan Huang","doi":"10.1016/j.hlc.2026.05.017","DOIUrl":"https://doi.org/10.1016/j.hlc.2026.05.017","url":null,"abstract":"<p><strong>Background: </strong>Despite improvements in cardiopulmonary resuscitation and post-cardiac arrest care, in-hospital mortality among survivors of out-of-hospital cardiac arrest (OHCA) remains high, particularly in Asia. The SLANT score was developed to predict outcomes in patients with comatose OHCA receiving targeted temperature management (TTM), but its performance outside the original derivation cohort remains uncertain. We aimed to externally validate the SLANT score for predicting in-hospital mortality in an East Asian population.</p><p><strong>Method: </strong>We conducted a multicentre retrospective cohort study across three tertiary hospitals in Taiwan between 2016 and 2023. Adult patients with OHCA who achieved sustained return of spontaneous circulation, remained comatose, and received TTM were included. The SLANT score-comprising initial non-shockable rhythm, post-TTM leukocyte abnormality, total adrenaline dose ≥5 mg, absence of bystander cardiopulmonary resuscitation, and resuscitation duration ≥20 minutes-was calculated using original definitions. The outcome was in-hospital mortality. Discrimination was assessed using the area under the receiver operating characteristic curve (AUC), and calibration was evaluated with calibration plots.</p><p><strong>Results: </strong>Among 451 eligible patients, 300 (66.5%) died during hospitalisation. The SLANT score demonstrated good discrimination for in-hospital mortality (AUC 0.746; 95% confidence interval 0.696-0.796), with acceptable calibration, particularly in moderate- to high-risk ranges. A score threshold ≥14 provided the optimal balance between sensitivity (65.7%) and specificity (78.2%), with a positive predictive value of 85.7%.</p><p><strong>Conclusions: </strong>In this East Asian cohort, the SLANT score showed reasonable discrimination and calibration for predicting in-hospital mortality. These findings support its potential role in post-cardiac arrest risk stratification, while underscoring the need for contextual clinical judgment.</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":"149108807","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":"Transcatheter vs Surgical Replacement of Degenerated Bioprosthetic Aortic Valve: A Meta-Analysis of Propensity-Score-Matched Studies","authors":"Pouya Ebrahimi MD,&nbsp;Maryam Taheri MD,&nbsp;Mehrdad Mahalleh MD,&nbsp;Hamidreza Soleimani MD, MPH,&nbsp;Homa Taheri MD,&nbsp;Ali Moradi MD,&nbsp;Babak Sattartabar MD, MPH,&nbsp;Morvarid Taebi MD,&nbsp;Iman Bhia MD,&nbsp;Reza Pirdehghan MD,&nbsp;Mohsen Anafje MD,&nbsp;Mohamad Alkhouli MD,&nbsp;Masih Tajdini MD,&nbsp;Amr Mohsen MD,&nbsp;Islam Elgendy MD,&nbsp;Robert J. Siegel MD,&nbsp;Mohammad Hossein Mandegar MD,&nbsp;Kaveh Hosseini MD, MPH","doi":"10.1016/j.hlc.2026.02.014","DOIUrl":"10.1016/j.hlc.2026.02.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Degeneration of bioprosthetic aortic valves is a common late complication. While redo surgical aortic valve replacement (redo-SAVR) has traditionally been the standard of care, transcatheter valve-in-valve implantation (ViV-TAVR) has emerged as a less invasive alternative. This meta-analysis aimed to compare outcomes between ViV-TAVR and redo-SAVR using propensity-score-matched studies.</div></div><div><h3>Methods</h3><div>A systematic search of Cochrane CENTRAL, Scopus, MEDLINE (via PubMed) Embase, and Scopus was conducted from inception through to 1 September 2024. Propensity-score matched cohort studies comparing ViV-TAVR and redo-SAVR were included. Risk ratios (RRs) and mean differences (MDs) or standardised mean differences (SMD), as appropriate, were pooled using a random-effects model.</div></div><div><h3>Results</h3><div>Thirteen propensity score–matched studies encompassing 16,223 patients (8,463 ViV-TAVR; 7,760 redo-SAVR) with a weighted mean follow-up of 16.6 months were included. Compared to redo-SAVR, ViV-TAVR was associated with significantly lower short-term all-cause mortality (RR: 0.47; 95% confidence interval [CI]: 0.34–0.66; p&lt;0.0001), major bleeding (RR: 0.45; 95% CI: 0.33–0.59), acute kidney injury (RR: 0.56; 95% CI: 0.38–0.84), and shorter hospital stay (SMD: –0.79; 95% CI: –1.00 to –0.57). ViV-TAVR was also associated with a significantly lower incidence of new-onset atrial fibrillation (RR: 0.22; 95% CI: 0.13–0.37) but higher post-procedural mean transvalvular gradients (SMD: 0.45; 95% CI: 0.20–0.69). No significant differences were observed in 1- or ≥2-year mortality, stroke/transient ischaemic attack, myocardial infarction, permanent pacemaker implantation, or early readmission. Results remained consistent across sensitivity and subgroup analyses.</div></div><div><h3>Conclusion</h3><div>ViV-TAVR offers significant short-term benefits over redo-SAVR, including lower early mortality and shorter hospitalisation. Long-term clinical outcomes remain comparable, while postprocedural mean gradients are higher after ViV-TAVR, underscoring the need for randomised trials and individualised patient selection to guide treatment decisions for degenerated bioprosthetic valves.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Pages 1422-1437"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919805","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":"Mitral Valvular-Ventricular Interactions: Relative Importance and Clinical Implications","authors":"Hugh S. Paterson FRACS,&nbsp;Laurencie M. Brunel DVM, MSc,&nbsp;Fiona C. Schnitzler BSc,&nbsp;Konstantin Yastrebov FICUM, PhD,&nbsp;Benjamin M. Robinson FRACS, MPhil,&nbsp;Paul G. Bannon FRACS, PhD","doi":"10.1016/j.hlc.2026.03.073","DOIUrl":"10.1016/j.hlc.2026.03.073","url":null,"abstract":"<div><div>An understanding of the numerous ways in which the mitral valve supports left ventricle (LV) function is important to clinicians who evaluate interventions on the mitral valve. Knowledge of the relative contributions to LV function provided by the various support mechanisms allows clinicians to balance the benefits against the adverse effects of mitral interventions. Although much of the research into the valvular-ventricular interaction has been undertaken in animals with normal hearts, the known mechanics of the interaction can be logically translated to human cardiomyopathic hearts. The systolic force applied through the marginal chordae of the anterior mitral leaflet (AML) is the dominant mechanism supporting LV function, and any intervention that inhibits AML closure (immobilisation, splitting, partial resection, etc.) sacrifices some level of LV contractility. Such interventions might provide limited overall benefit in cardiomyopathic hearts that poorly tolerate further LV impairment. This narrative review presents a summary of the existing evidence on the relative contributions of the various valvular-ventricular support mechanisms and their clinical application.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 10","pages":"Pages 1367-1373"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873986","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":"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":"149094595","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":"Association of Cardiometabolic Index With Cardiometabolic Disease Prevalence and Mortality: Evidence From Two National Surveys.","authors":"Zhen-Yu Liu, Zhi-Xin Li, Si-Yan Huo, Jia-Xin Xu, Fang-Jun Xu","doi":"10.1016/j.hlc.2026.05.012","DOIUrl":"https://doi.org/10.1016/j.hlc.2026.05.012","url":null,"abstract":"<p><strong>Background: </strong>The cardiometabolic index (CMI), a composite marker derived from the product of waist-to-height ratio and triglyceride-to- high-density lipoprotein cholesterol ratio, has emerged as a potential indicator of metabolic risk. However, the prognostic value of the CMI across diverse populations and the continuum from cardiometabolic disease prevalence to mortality remains poorly characterised.</p><p><strong>Method: </strong>This study integrated data from two nationally representative datasets: 17,922 adults from the US National Health and Nutrition Examination Survey (NHANES; 1999-2018; longitudinal) and 9,313 adults from the China Health and Retirement Longitudinal Study (CHARLS; 2011; cross-sectional). Multivariate Cox regression models estimated hazard ratios (HRs) for mortality, whereas logistic regression models estimated odds ratios (ORs) for disease prevalence. Restricted cubic splines (RCSs) were used to evaluate dose-response relationships.</p><p><strong>Results: </strong>In the NHANES cohort, elevated CMI was significantly associated with increased risks of all-cause mortality (HR 1.35; 95% confidence interval [CI] 1.26-1.44), cardiovascular disease (CVD) mortality (HR 1.30; 95% CI 1.17-1.45), and diabetes mortality (HR 1.91; 95% CI 1.56-2.34). Age significantly modified these associations (p for interaction <0.001), with stronger predictive power observed in adults aged <60 years. In the CHARLS cohort, CMI was strongly associated with prevalent CVD (OR 1.06; 95% CI 1.01-1.11) and diabetes (OR 1.66; 95% CI 1.56-1.77). RCS analyses revealed a nonlinear threshold effect for all-cause mortality in the US population and a steep linear increase in diabetes prevalence in the Chinese population.</p><p><strong>Conclusions: </strong>CMI is a robust, low-cost indicator for predicting mortality in US adults and cardiometabolic disease burden in Chinese adults. Its greater predictive utility in younger populations supports its clinical implementation for early-onset risk stratification and targeted prevention globally.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108804","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":"Administration of Enoximone for the Optimisation of Renal Function in Cardiac Surgery: Final Results of a Multicentre Study.","authors":"Francesco Zito, Kacper Piasecki, Marco Coli, Emiliano Angeloni, Francesco Paneni, Monica Rocco, Mario Gaudino, Federico Ranocchi, Giovanni Melina","doi":"10.1016/j.hlc.2026.05.027","DOIUrl":"https://doi.org/10.1016/j.hlc.2026.05.027","url":null,"abstract":"<p><strong>Background & aims: </strong>Postoperative renal failure remains a major determinant of morbidity and mortality after cardiac surgery, with limited preventive pharmacological options. Enoximone, a phosphodiesterase III inhibitor with inotropic and anti-inflammatory properties, has shown potential for organ protection during cardiopulmonary bypass. We aimed to evaluate the effect of perioperative enoximone administration on renal function and clinical outcomes in patients undergoing on-pump cardiac surgery.</p><p><strong>Method: </strong>This multicentre prospective observational study included adult patients undergoing on-pump cardiac surgery. Patients with severe preoperative kidney failure were excluded. Renal function was assessed at postoperative days 2, 7, and 30 using estimated glomerular filtration rate (eGFR) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) stage. Perioperative administration of enoximone was compared with untreated controls using propensity score matching.</p><p><strong>Results: </strong>A total of 237 patients were included, of whom 110 (46.4%) received enoximone. After matching, 72 treated patients were compared with 72 controls. No differences in eGFR were observed at day 2 and day 7. At day 30, enoximone was associated with greater eGFR improvement (+8.1 vs -3.7 mL/min/1.73 m²; p<0.001). CKD-EPI stage improved in the Enoximone-treated group at day 7 (-0.3±0.6; p=0.037) and day 30 (-0.3±0.5; p<0.001). Enoximone was an independent predictor of 30-day eGFR improvement (β=+10.65; p<0.001) and CKD-EPI reduction (β=-0.26; p=0.002). Enoximone was also associated with reduced use of additional inotropes (4.2% vs 26.4%; p<0.001) and shorter hospital stay (13.2±7.2 vs 17.1±10.5 days; p=0.008).</p><p><strong>Conclusions: </strong>Perioperative enoximone administration was associated with improved renal function and reduced hospital length of stay in patients undergoing on-pump cardiac surgery. These findings support its potential role in preventing postoperative renal failure. Further studies are warranted to confirm these results.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024723","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":"Achieving ≥90% of the Age-Predicted Treadmill Time for Commercial Vehicle Operation Does Not Predict Future Cardiovascular Events.","authors":"Mark Whitman, Carly Jenkins, Arun Dahiya","doi":"10.1016/j.hlc.2026.05.013","DOIUrl":"https://doi.org/10.1016/j.hlc.2026.05.013","url":null,"abstract":"<p><strong>Background: </strong>Functional capacity (FC) has been shown to be a strong independent predictor of all-cause and cardiovascular (CV) mortality. Nomograms based on age and sex have been developed to standardise exercise times and FC during treadmill testing (TT). Many patients with prior CV disease perform TT as a requirement for commercial vehicle operation. The current recommendations state a level ≥90% of FC for age should be achieved during testing. Whether this level predicts future CV outcomes is not known.</p><p><strong>Method: </strong>Maximal exercise stress echocardiography was performed on 196 patients with prior treated CV disease for the assessment of returning to commercial vehicle operation. Patients were followed for 5.8±2.4 years with future CV events as the outcome variable.</p><p><strong>Results: </strong>There were 55 patients with a CV event during the census period. No significant differences were found between those with and without a CV event regarding medication use, CV risk factors or TT data. Cox proportional hazards analysis revealed only statin use (HR 0.49 (0.01-0.91); p=0.02) and inability to reach a maximal rate pressure product (MRPP) of 25,020 (HR 2.81 (1.6-5.0); p<0.001) as independent predictors of CV events, with MRPP the only multivariate predictor (HR 2.5 (1.01-6.28); p=0.04).</p><p><strong>Conclusions: </strong>Achieving an age-predicted FC ≥90% following maximal TT does not predict CV outcome (p=0.536) in patients with previous CV disease being assessed for commercial vehicle operation. Inability to reach an MRPP of 25,020 was a strong predictor of future CV events.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001530","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":"Atrial Septal Aneurysm Complicated With an Intracardiac Thrombus in a Neonate: A Rare Presentation.","authors":"Vineesh Chandra Segaran, Amine Mazine, Edward Buratto","doi":"10.1016/j.hlc.2026.04.128","DOIUrl":"https://doi.org/10.1016/j.hlc.2026.04.128","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001564","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":"Cardiovascular Risk, Comorbidity and Frailty in Patients Undergoing Sleeve Gastrectomy: A Population-Based Study.","authors":"Thomas Goubar, Christopher Goubar, Douglas Fenton-Lee, Aneta Stefanidis, Peter Macdonald, R Louise Rushworth","doi":"10.1016/j.hlc.2026.05.018","DOIUrl":"https://doi.org/10.1016/j.hlc.2026.05.018","url":null,"abstract":"<p><strong>Background: </strong>Cardiometabolic conditions and frailty influence perioperative risk in bariatric surgery; however, contemporary population-level studies describing these factors are limited. This study characterised the cardiometabolic burden, comorbidity, and frailty of adults undergoing laparoscopic sleeve gastrectomy (LSG), with comparisons according to sex and hospital setting.</p><p><strong>Method: </strong>A population-based cohort study was conducted using statewide administrative hospital data from all public and private hospitals in New South Wales, Australia, between 1 July 2017 and 30 June 2022. Adults (≥18 years) undergoing primary LSG were included. The prevalence of cardiometabolic comorbidities and trends in age-adjusted disease rates were assessed. Subgroup analyses according to sex and hospital setting were performed for cardiovascular risk factors, comorbidity, and frailty.</p><p><strong>Results: </strong>Among 34,738 patients (78.3% female; 96.6% treated in private hospitals; mean age 41.3±11.5 years), nearly three-quarters (72.3%, n=25,130) had one or more cardiovascular risk factors. The prevalence of type 2 diabetes mellitus (T2DM) declined by 24.4% (148.8-112.5 per 1,000; p<0.001). Males had a higher cardiovascular risk burden (44.3% vs 28.0% with ≥2 risk factors; p<0.001), greater comorbidity burden (Elixhauser index: 1.35 vs 1.07; p<0.001), and higher frailty scores (Claims Frailty Index: 0.12 vs 0.11; p<0.001). Public hospital patients, particularly males, had the highest burden across all measures.</p><p><strong>Conclusions: </strong>There was substantial variation in cardiometabolic burden among LSG recipients according to sex and hospital sector. The observed decline in T2DM suggests a change in the clinical profile of patients undergoing surgery. These findings warrant further investigation into the factors influencing access to surgery and patient selection.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001636","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}