Heart, Lung and Circulation最新文献

{"title":"The Lp(a) Revolution in Dyslipidaemia Management, From Obscurity to Class 1 Recommendation: Aligning Australian Practice With Global Guidelines","authors":"David L. Hare OAM, DPM, FRACP","doi":"10.1016/j.hlc.2026.08.001","DOIUrl":"10.1016/j.hlc.2026.08.001","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 9","pages":"Pages 1187-1189"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148862005","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":"Early Clinical Outcome of Perceval Aortic Valve Implantation in Townsville, Australia","authors":"Pouya Nezafati MD,&nbsp;Lalita Gunasagaran MBBS,&nbsp;Sumit Yadav FRACS","doi":"10.1016/j.hlc.2026.01.013","DOIUrl":"10.1016/j.hlc.2026.01.013","url":null,"abstract":"<div><h3>Background &amp; Aim</h3><div>Sutureless aortic valve replacement (AVR) using the Perceval valve has emerged as a valuable alternative to conventional surgical valves, offering procedural and recovery advantages. This study presents 30-day clinical outcomes from a single-centre Australian experience with Perceval AVR.</div></div><div><h3>Methods</h3><div>Between September 2014 and June 2023, a total of 297 patients underwent sutureless AVR with the Perceval valve (Corcym) across two hospitals in Townsville, Australia. Of these, 117 patients underwent AVR combined with concomitant procedures. This is a retrospective cross-sectional analysis of perioperative data and 30-day postoperative outcomes.</div></div><div><h3>Results</h3><div>The mean patient age was 72.9 years, and 64.1% were female. A minimally invasive mini-sternotomy approach was used in 27 patients (9.1%). Large or extra-large Perceval valves were implanted in 204 patients (68.7%). For isolated AVR, the median aortic cross-clamp (ACC) time and cardiopulmonary bypass (CPB) time were 54.9 minutes and 72.4 minutes, respectively. In combined procedures, median ACC and CPB times were 69.9 and 94.7 minutes, respectively. Intraoperative transesophageal echocardiography confirmed the absence of paravalvular leak (PVL) in 291 patients (98%), with trivial PVL observed in six patients (2%). At 30-day follow-up, no PVL was detected in any patient. The mean intensive care unit stay was 2.3 days, and the average hospital stay was 6.8 days. Permanent pacemaker implantation was required in 19 patients (6%), and cardiac mortality within 30 days occurred in two patients (0.6%). Two-year survival, based on Kaplan–Meier analysis, was 89.2%.</div></div><div><h3>Conclusions</h3><div>This study demonstrates excellent early outcomes with Perceval sutureless AVR, including high procedural success, minimal PVL, and low postoperative complication rates. These results support Perceval as a safe and effective alternative to conventional bioprosthetic valves, particularly in high-risk patients where minimising CPB and ACC time is advantageous.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 9","pages":"Pages 1331-1336"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156297","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":"Nature and Heart Health: Conversations With Your Patients","authors":"","doi":"10.1016/j.hlc.2026.08.002","DOIUrl":"10.1016/j.hlc.2026.08.002","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 9","pages":"Page 1366"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148861878","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":"Haemodynamically Threatened Pulmonary Embolism (PE-HT): A Proposed Sub-Classification for Regional ICUs","authors":"Prashant Maan MBBS, MD, EDIC, FCICM","doi":"10.1016/j.hlc.2026.01.017","DOIUrl":"10.1016/j.hlc.2026.01.017","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 9","pages":"Pages e131-e132"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148861877","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":"Overlap Between Heart Failure and Menopause: Diagnostic Challenges and Clinical Implications","authors":"Timothy Nathan Kwan MD,&nbsp;Aimy Yan MD,&nbsp;Pankaj Jain MBBS, PhD,&nbsp;Hariharan Raju MBChB, PhD,&nbsp;Kavitha Muthiah MBChB, PhD","doi":"10.1016/j.hlc.2026.05.011","DOIUrl":"10.1016/j.hlc.2026.05.011","url":null,"abstract":"<div><div>Heart failure and menopause commonly coexist in middle-aged women, but overlapping symptomatology often complicates diagnosis. Moreover, physiological changes during menopause and normal ageing can predispose patients to cardiac symptoms and cardiovascular disease. Oestrogen exerts cardioprotective effects through anti-inflammatory and vasodilatory pathways and its decline has been proposed as a mechanistic explanation for myocardial fibrosis and diastolic dysfunction. Epidemiological studies consistently show that early menopause independently predicts incident heart failure with a graded increase in risk at younger ages of onset. Despite this, many traditional symptoms during the perimenopausal period including fatigue, shortness of breath, sleep disturbance, and palpitations may represent unrecognised cardiac pathology. Heightened awareness of this overlap is essential for timely identification and management. Objective investigations including natriuretic peptides, echocardiography, electrocardiography, and chest X-ray remain reliable diagnostic tools in this group. When identified, both heart failure and menopause can be treated independently with guideline directed therapies. This review synthesises current evidence on the intersection between menopause and heart failure, elucidates shared pathophysiological mechanisms, and proposes strategies to enhance diagnostic accuracy and therapeutic decision-making in perimenopausal women.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 9","pages":"Pages 1203-1213"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470304","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":"Incidental Septal Lipoma in a Patient Evaluated for PFO Closure: What is the Best Approach?","authors":"Arjun Athreya Raghavan MD,&nbsp;Ryan Foyle MD,&nbsp;Malek Kass MD,&nbsp;Michael Raabe MD,&nbsp;Ashish H. Shah MD, MD-Research","doi":"10.1016/j.hlc.2026.01.015","DOIUrl":"10.1016/j.hlc.2026.01.015","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 9","pages":"Pages e123-e124"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054206","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 TAVR Plus TEVAR Versus TAVR Alone in Patients with Concomitant Aortic Stenosis and Thoracic Aortic Aneurysm","authors":"Ankit Agrawal MD,&nbsp;Akshat Banga MBBS, MD,&nbsp;Umesh Bhagat MD,&nbsp;Akiva Rosenzveig MD,&nbsp;David Bull MD,&nbsp;Joshua B. Goldberg MD,&nbsp;Andrew M. Goldsweig MD, MS","doi":"10.1016/j.hlc.2026.02.011","DOIUrl":"10.1016/j.hlc.2026.02.011","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 9","pages":"Pages e115-e119"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054145","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":"Quantification of Sarcopenia using Chest Computed Tomography of the Pectoralis Major Muscle as a Prognostic Tool for Cardiac Surgery Outcomes","authors":"Pouya Nezafati MD,&nbsp;Pankaj Saxena MD, PhD, FRACS,&nbsp;Jai Raman MD, PhD, FRACS,&nbsp;Lionel Hebbard PhD,&nbsp;Narelle Draper,&nbsp;Craig McFarlane PhD","doi":"10.1016/j.hlc.2025.12.031","DOIUrl":"10.1016/j.hlc.2025.12.031","url":null,"abstract":"<div><h3>Background and Aim</h3><div>Cardiac surgery is increasingly performed on elderly, frail patients, making objective frailty markers critical for predicting outcomes. Sarcopenia, as defined by the progressive loss of muscle mass and strength, is linked to poorer outcomes after surgery. The pectoralis major (PM) muscle cross-sectional area from chest computed tomography (CT) may offer a novel quantitative method for assessing sarcopenia in cardiac surgery patients.</div></div><div><h3>Methods</h3><div>This study includes data from 237 individuals, who had preoperative chest CT scans and underwent cardiac surgery involving sternotomy from 2019 to 2023 at the Townsville University Hospital, Queensland, Australia. PM muscle area, density, and thickness were measured using chest CT scans. Sarcopenia was defined by the lowest sex-specific quartile in PM area. Demographic data, intraoperative, and postoperative outcomes up to 30 days were collected. Logistic regression analysis assessed the association of sarcopenia with postoperative outcomes. Receiver operating characteristic (ROC) analysis evaluated the clinical value of PM thickness and density in predicting sarcopenia.</div></div><div><h3>Results</h3><div>Cut-off values for PM area were 1,045 mm² for males and 609 mm² for females, with 59 individuals (25.1%) meeting the criteria for sarcopenia. Sarcopenic patients were significantly older than non-sarcopenic patients (p&lt;0.001) and had a lower body mass index (p=0.008). Logistic regression showed sarcopenia significantly increased the risk of extended hospital stays (Odds ratio; OR=5.08), longer intensive care unit (ICU) stays (OR=3.16), and prolonged intubation times (OR=2.49; all p&lt;0.05). ROC analysis showed high accuracy for muscle thickness (area under the curve; AUC=0.85) in distinguishing sarcopenia, with cut-off values of 12.2 mm for males and 8.1 mm for females. Muscle density had moderate accuracy (AUC=0.64).</div></div><div><h3>Conclusions</h3><div>Our study demonstrates that defining sarcopenia based on the PM cross-sectional area measured from chest CT scans provides a significant predictor of postoperative outcomes in cardiac surgery patients. The established sex-specific cut-off values for muscle area, density and thickness effectively identified sarcopenia, which is associated with prolonged hospitalisation, extended ICU stay, longer intubation time, and an increased risk of postoperative complications.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 9","pages":"Pages 1321-1330"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873951","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":"Cryptogenic Young Stroke Associated With Bilateral Pulmonary Arteriovenous Malformations","authors":"Naimisha Yenduri MD, DM,&nbsp;Hisham Ahamed MD, DM,&nbsp;Vivek Nambiar MD, DM,&nbsp;Navaneetha Sasikumar MD, DM","doi":"10.1016/j.hlc.2026.02.007","DOIUrl":"10.1016/j.hlc.2026.02.007","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 9","pages":"Pages e120-e122"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054213","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":"Smartwatch-Based Heart Rate Detection in Atrial, Ventricular and Pulseless Arrhythmias","authors":"Samual Turnbull BSc,&nbsp;Anunay Gupta MD, DM,&nbsp;Kartheek Garikapati MBBS,&nbsp;Ashwin Bhaskaran MBBS, PhD,&nbsp;Kasun De Silva MBBS, PhD,&nbsp;Yasuhito Kotake MD, PhD,&nbsp;Richard G. Bennett MBBS, PhD,&nbsp;Timothy Campbell PhD,&nbsp;Stuart P. Thomas BMed, PhD,&nbsp;Clara K. Chow MBBS, PhD,&nbsp;Saurabh Kumar MBBS, PhD","doi":"10.1016/j.hlc.2026.02.016","DOIUrl":"10.1016/j.hlc.2026.02.016","url":null,"abstract":"<div><h3>Background &amp; Aim</h3><div>Smartwatches can provide a non-invasive heart rate (HR) monitoring to aid screening for atrial fibrillation, however, the accuracy of HR detections in the context of other arrhythmias requires further investigation. We aimed to assess the accuracy of HR measurements of two commonly used wearables at onset, during and termination of various induced and paced arrhythmias.</div></div><div><h3>Method</h3><div>Patients undergoing an electrophysiology study were fitted intraprocedurally with both the Apple Watch Series 4 (AW) and Fitbit Versa (FB). Detected HRs on the devices were recorded at initiation, during, and at termination of various paced and induced arrhythmias. True HR was confirmed via intracardiac electrograms and 12-lead electrocardiogram. Detected HRs on the AW and FB were assessed for accuracy, defined as HR with in ±10% of the true rate.</div></div><div><h3>Results</h3><div>A total 322 cardiac rhythms from 32 patients were analysed. Both AW and FB demonstrated reasonable HR detection during sinus rhythm (100% vs 87%; p=0.04) and supraventricular tachycardia (SVT) (89% vs 86%; p=1). Both devices performed poorly at detecting SVT termination (62% vs 41%; p=0.04) and ventricular tachycardia (41% vs 16%; p=0.007). Neither device identified changes in HR during ventricular fibrillation or asystole.</div></div><div><h3>Conclusions</h3><div>Both the Apple Watch and Fitbit demonstrate reasonable accuracy in HR detection during regular rhythms of supraventricular origin, however, struggle with arrhythmia terminations and ventricular arrhythmias. Care should be taken when assessing HR trends for presence of cardiac arrhythmias.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 9","pages":"Pages 1298-1305"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329028","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}