Heart, Lung and Circulation最新文献

{"title":"Serum Interleukin-6 and Ventricular Tachycardia as Predictors of Mortality in Children With Fulminant Myocarditis","authors":"Yu-Long Zhang MM ,&nbsp;Sheng Zhao MM ,&nbsp;Cui-Ping Qian MM ,&nbsp;Xiao-Bi Huang MD","doi":"10.1016/j.hlc.2025.08.018","DOIUrl":"10.1016/j.hlc.2025.08.018","url":null,"abstract":"<div><h3>Background</h3><div>Fulminant myocarditis (FM) is still associated with a high mortality in children. This study aims to provide clinical indicators that will enable early identification of children with FM at high risk of death and predict the mortality.</div></div><div><h3>Method</h3><div>A total of 40 children diagnosed with FM from January 2014 to March 2024 at our hospital were retrospectively analysed. Baseline demographic characteristics and relevant clinical data including basic vital signs, clinical presentation, and clinical findings were collected at admission and follow-up. Binary logistic regression analysis and receiver operating characteristic curves were used to screen for factors with clinical predictive value. Spearman correlation analysis was used to detect the correlation between interleukin-6 (IL-6) and disease severity.</div></div><div><h3>Results</h3><div>A total of 40 children with FM were included in this study and were divided into a survival group (n=34) and a death group (n=6). The most common clinical symptom was circulatory disorders (n=28; 70.0%). There were significant differences between the two groups in creatine kinase (CK) (p=0.031), serum IL-6 (p&lt;0.001), left ventricular end-systolic diameters (p=0.041), and ventricular tachycardia (VT) (p=0.019). The multivariate logistic regression analysis of serum IL-6 and VT showed that IL-6 (odds ratio [OR] 1.094; 95% confidence interval [CI] 1.027–1.166; p=0.006), and VT (OR, 0.096; 95% CI 0.010–0.920; p=0.042) were independently associated with mortality. The results of receiver operating characteristic curve analysis showed that serum IL-6 (area under the curve [AUC] 0.975; 95% CI 0.894–1), VT (AUC 0.755; 95% CI 0.541–0.868), with a cut-off value of IL-6 of 24.60 pg/mL, a sensitivity of 100%, a specificity of 97.1%, and a Youden index of 0.971, suggesting that high levels of serum IL-6 (&gt;24.60 pg/mL) and an electrocardiogram manifesting as VT have a predictive value for mortality, in which serum IL-6 has a very high accuracy. Spearman correlation analysis showed that CK, CK-MB, and aspartate aminotransferase were positively correlated with IL-6 levels, whereas left ventricular ejection fraction was negatively correlated with IL-6 levels, indicating that IL-6 levels are related to disease severity.</div></div><div><h3>Conclusions</h3><div>Serum IL-6 levels and VT manifestations on electrocardiogram at admission enable accurate early identification of children with FM at high mortality risk.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 3","pages":"Pages 366-374"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040573","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 Disease, Frailty, and Multimorbidity as Predictors of Adverse Outcomes in Older Adults Admitted to Acute Geriatric Settings: A Secondary Analysis.","authors":"Julee McDonagh, Henok Mulugeta Teshome, Richard I Lindley, Reejamol John, Caleb Ferguson","doi":"10.1016/j.hlc.2025.11.015","DOIUrl":"https://doi.org/10.1016/j.hlc.2025.11.015","url":null,"abstract":"<p><strong>Background: </strong>Despite the high prevalence of concomitant cardiovascular disease (CVD), multimorbidity and frailty, the clinical characteristics and longer-term outcomes for older adults admitted to acute geriatric settings remain poorly understood.</p><p><strong>Method: </strong>A secondary analysis of the Western Sydney Clinical Frailty Registry was undertaken. Frailty was assessed using the Clinical Frailty Scale. CVD was defined as a history of either heart failure (HF), stroke, or atrial fibrillation. Multimorbidity was assessed using the updated Charlson Comorbidity Index. Adverse outcomes of interest included rehospitalisation and mortality. The incidence rate and the survival probabilities were calculated for the occurrence of adverse outcomes. Cox proportional hazard models were fitted to identify the predictors of rehospitalisation and mortality.</p><p><strong>Results: </strong>The mean age of the 592 older adults was 81.20±7.76 years, and 59.0% of the participants were female. Almost half had a history of CVD (n=265), 174 were classified as non-frail, 295 were mild-to-moderately frail, and 123 were severely frail. The incidence rate of rehospitalisation and mortality was 12.15 per 100 person-months. Participants with a history of HF or atrial fibrillation had significantly lower event-free survival (χ² (1)=19.27; p=0.00, χ² (1)=5.22; p=0.02, respectively), whereas a history of stroke was not significantly associated with reduced event-free survival (χ² (1)=0.04, p=0.84). Key predictors of rehospitalisation and mortality included severe frailty, the strongest predictor overall (adjusted hazard ratio [aHR] 2.12; 95% confidence interval [CI] 1.59-2.84), followed by mild to moderate frailty (aHR 1.57; 95% CI 1.23-2.00), HF (aHR 1.47; 95% CI 1.06-2.03) and a higher Charlson score (aHR 1.05; 95% CI 1.01-1.90).</p><p><strong>Conclusions: </strong>Frailty, CVD, and multimorbidity are significant predictors of rehospitalisation and mortality in older adults. These results underscore the importance of routine frailty and multimorbidity assessments during hospitalisation to identify high-risk individuals and inform clinical decision-making.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283440","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":"Motivational Interviewing and Cognitive Behavioural Therapy in the Auckland Cardiac Rehabilitation Programme: A Propensity Score-Matched Study.","authors":"Paul W Marshall, Jocelyne R Benatar, Paul O'Halloran, Natalie M V Morrison, Tia Lindbom, Michael Kingsley","doi":"10.1016/j.hlc.2025.10.006","DOIUrl":"https://doi.org/10.1016/j.hlc.2025.10.006","url":null,"abstract":"<p><strong>Aim: </strong>Suboptimal enrolment and engagement in cardiac rehabilitation remains a persistent issue worldwide. This study evaluated the impact of a nurse-specialist-delivered motivational interviewing (MI) and cognitive behavioural therapy (CBT) intervention on cardiac rehabilitation enrolment, attendance, all-cause mortality, and readmission in Auckland's 2022 cardiac rehabilitation programme compared with a propensity score-matched historical cohort.</p><p><strong>Method: </strong>This study included all patients (n=797) referred to Auckland's outpatient cardiac rehabilitation programme in 2022. Outcomes were compared with a retrospective cohort of 3,331 patients enrolled in the Auckland cardiac rehabilitation programme (2016-2020), from which a propensity score-matched historical cohort was created (n=779 per group, 97.7% retention). Data were extracted from the Auckland health district medical database. Primary outcomes included cardiac rehabilitation enrolment and attendance, all-cause mortality, and readmissions (1.5-year average follow-up). Analysis included comparisons of proportions, inferential statistics, Cox proportional hazards, and logistic regression.</p><p><strong>Results: </strong>Cardiac rehabilitation enrolment in 2022 was 54.4%, with 40.2% of patients attending at least one lifestyle session (mean 4.0±2.7 sessions) and 32.8% attending at least one exercise session (mean 10.2±6.9 sessions). The intervention did not improve enrolment, attendance, mortality, or readmission rates. Patients in 2022 attended fewer lifestyle rehabilitation sessions than historical counterparts (mean difference: -2 sessions, p<0.001). No significant differences were observed in exercise rehabilitation attendance, mortality, or readmission risk after propensity score matching.</p><p><strong>Conclusions: </strong>A nurse-delivered MI-CBT intervention did not enhance cardiac rehabilitation enrolment or attendance. However, programme stability despite pandemic-related challenges suggests resilience. Future research should explore alternative patient engagement strategies and assess MI-CBT fidelity. Findings contribute to understanding participation barriers and inform ongoing service improvements.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283420","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":"Sociodemographic, Clinical and Behavioural Predictors of Change in Health-Related Quality of Life in Ambulatory Patients With Heart Failure.","authors":"Bruno Besteiro, Pedro Ribeirinho Soares, Catarina Elias, Catarina Vale, Claudemira Pinto, Joana Tender Vieira, Maria Inês Matos, Maria Teresa Brito, Paula Matias, Filipa Gomes, João Pedro Ferreira, Pedro Marques, Fernando Friões","doi":"10.1016/j.hlc.2025.10.007","DOIUrl":"https://doi.org/10.1016/j.hlc.2025.10.007","url":null,"abstract":"<p><strong>Background: </strong>Health-related quality of life (HRQoL) is an important clinical measure in heart failure (HF), but little is known about the factors associated with changes in HRQoL.</p><p><strong>Method: </strong>This is a prospective, single-centre study of patients with HF who completed the Kansas City Cardiomyopathy Questionnaire (KCCQ-23) to assess HRQoL at baseline and 6-months follow-up. Patients were categorised into baseline KCCQ-Clinical Symptom Score (CSS) tertiles and compared for their baseline to 6-month change. Factors associated with baseline to a 6-month change in KCCQ-CSS were determined by multivariable ordered logistic regression. Other KCCQ domains were studied as secondary outcomes.</p><p><strong>Results: </strong>We included 246 patients, 32% women, mean age 73±11 years and mean left ventricular ejection fraction of 34±16%. Factors independently associated with worsening KCCQ-CSS at 6 months were higher potassium levels (odds ratio [OR] 1.6; 95% confidence interval [CI] 1.0-2.7 per 1 mmol/L increase in potassium), being retired (OR 2.1; 95% CI 1.2-3.5), a history of stroke (OR 3.2; 95% CI 1.6-6.5), and follow-up duration >1 year (OR 1.7; 95% CI 1.0-2.7). Conversely, smoking cessation was associated with KCCQ-CSS improvement (OR 0.5; 95% CI 0.3-0.8). KCCQ-CSS, total symptom score, and overall summary score was well correlated (Rho≥0.9) with similar results across KCCQ domains.</p><p><strong>Conclusions: </strong>Factors associated with HRQoL changes included clinical and social aspects. While some factors, such as smoking cessation, can be targeted for intervention, others-like potassium levels, employment status, and stroke-reflect underlying disease progression or demographic characteristics. HRQoL in HF is likely influenced by a multitude of factors, underscoring the importance of a multifactorial management approach.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197400","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":"Participation of Aboriginal and Torres Strait Islander People in Conventional Cardiac Rehabilitation Programs: Analysis of the Queensland Cardiac Outcomes Registry.","authors":"Emma E Thomas, Michael Le Grande, Lidya A Jokhu, Andrew Goodman, Samara Phillips, Anthony C Smith, Ray Mahoney, William Y S Wang, Victor M Oguoma","doi":"10.1016/j.hlc.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.hlc.2025.09.011","url":null,"abstract":"<p><strong>Aims: </strong>High-quality, culturally safe, secondary prevention care has the potential to improve the cardiovascular health of Aboriginal and Torres Strait Islander People in Australia (hereafter collectively referred to as First NationsPeoples). Despite this, there is a paucity of comprehensive data on cardiac rehabilitation (CR) participation among First Nations Peoples. The Queensland Cardiac Outcome Registry is a clinical registry that routinely collects point-of-care CR data. Therefore, the aim of this study is to (i) describe the First Nations populations referred to CR across Queensland, (ii) quantify rates of participation, and (iii) determine factors associated with CR attendance and completion.</p><p><strong>Methods: </strong>The cohort comprised 2,383 patients who identified as Aboriginal and/or Torres Strait Islander and were referred to one of 56 Queensland CR service extracted from Queensland Cardiac Outcome Registry (2020-2022). Bivariate and multivariable logistic regression analyses were used to identify factors associated with CR attendance and completion.</p><p><strong>Results: </strong>Over the study period, 50% (n=1,185) of First Nations patients in Queensland participated in at least one CR session. Of those who attended, 28% (n=333) completed CR (14% of the total cohort). The strongest predictors of CR attendance were having a coronary artery bypass graft or percutaneous coronary intervention procedure, living regionally (as opposed to remotely/very remotely), and coming from areas of higher socio-economic advantage. CR completion was more likely among men, those in older age groups (particularly 55-64 years), living in a major city, and non-smokers.</p><p><strong>Conclusions: </strong>This study provides the first known large-scale analysis of the uptake of CR programs among First Nations cardiac patients in Australia. We demonstrate that rates of attendance are higher among this cohort than previously reported. Barriers to attendance are described and highlight an important socio-economic gradient. There are clear opportunities for improving access to evidence-based secondary prevention programs for First Nations Peoples and benefits in collectively considering how unmet needs can be supported.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157032","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":"The Evolution of Cardiac Rehabilitation Since COVID-19.","authors":"Susan Marzolini, Gabriela Ocampo, Andrée-Anne Hébert, Rachel Barbieri, Lisa Cotie, Danielle Barry-Hickey, Merrisa Martinuzzi, Renee Konidis, Paul Oh","doi":"10.1016/j.hlc.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.hlc.2025.09.006","url":null,"abstract":"<p><strong>Background & aim: </strong>During the COVID-19 pandemic, cardiac rehabilitation programs (CRPs) rapidly transitioned to virtual, mostly one-to-one, care. Four years later, the lasting effects on contemporary program delivery are unknown. Therefore, this study aimed to examine the evolution of CRPs pre-COVID-19 to present (February-August 2024) in Canada.</p><p><strong>Methods: </strong>A questionnaire was disseminated to Canadian CRP managers.</p><p><strong>Results: </strong>Of 260 CRPs, 108 representatives of 150 CRPs (57.7%) responded. Since pre-COVID-19, there has been a reduction in proportion of CRPs offering a traditional in-person program model from 92.8% to 67.6% (p<0.001), an increase offering hybrid models (i.e., in-person with virtual components) from 12.0% to 43.7% (p<0.001), and an increase in virtual models from 24.6% to 50% (p<0.001). Pre-COVID-19, 71.5% of programs relied on one delivery model, declining to 51.1% post-COVID-19. CRPs offering 2-3 models rose from 28.5% to 48.9% (p<0.04). These models will continue in >89% of CRPs for ≥1 to 2 years. Program model allocation was based mainly on patient preference (41%) or patient/clinician collaborative discussions (35%), with 73.9% of these programs recommending in-person programming to higher-risk patients. There was an increase in CRPs that were under capacity pre-COVID-19 to present (6.3%-40.5%; p<0.001), yet the mean number of patients enrolled/month increased (+5.8%; 77±91 to 81.5±98; p<0.001). Exercise delivery is mostly group-based (>61%). Of all CRPs, >84% perceived that patients were at least somewhat satisfied with all model components, except fully virtual telephone (57.8%), unless the telephone was within hybrid models (72.2%). Resource and education barrier scores were lower for virtual and hybrid than for in-person programming (p<0.001). Patients with language/communication barriers presented the greatest challenge to exercise program delivery, with <54% of programs offering spoken language translation services for the in-person component.</p><p><strong>Conclusions: </strong>The pandemic accelerated a shift towards diversified program models. Virtual, hybrid, and group-based models may be driving increased accessibility and reduced resource barriers, ultimately expanding patient reach. Further resource allocation is needed for language translation services to better serve diverse populations and accommodate in-person programming for people at higher medical risk and those with mobility deficits. A more widespread triaging process for tailored model allocation should be implemented by all CRPs. Leveraging technology to provide confidence that virtual-based programs are suitable for higher-risk and vulnerable populations, improving connectedness/peer support, and removing barriers for using technology for those who lack experience and/or have cognitive impairment are important initiatives.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131333","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 Nomogram to Predict Patient Mortality After Linear Ventriculoplasty for Left Ventricular Aneurysm","authors":"Xieraili Tiemuerniyazi MD,&nbsp;Yangwu Song MD,&nbsp;Liangcai Chen MD,&nbsp;Shicheng Zhang MD,&nbsp;Hao Ma MD,&nbsp;Yifeng Nan MD,&nbsp;Ziang Yang MD,&nbsp;Wei Zhao MD,&nbsp;Wei Feng MD, PhD","doi":"10.1016/j.hlc.2025.06.1026","DOIUrl":"10.1016/j.hlc.2025.06.1026","url":null,"abstract":"<div><h3>Background</h3><div>The long-term mortality of patients undergoing linear ventriculoplasty (LVP) for ischaemic left ventricular aneurysm (LVA) varies. This study aimed to develop a risk prediction model for mortality after LVP.</div></div><div><h3>Method</h3><div>A total of 741 patients with an ischaemic anterior-wall LVA who underwent LVP between January 1999 and March 2021 at Fuwai Hospital were retrospectively enrolled, and 22 clinical features were assessed. The entire cohort was randomly grouped into training and validation cohorts in a ratio of 8:2. Backward stepwise elimination approach and the least absolute shrinkage and selection operator regression were used for feature selection. A nomogram was developed based on a multivariable Cox regression model. The performance of the model was evaluated using discrimination and calibration. Decision curve analysis was performed to test the clinical usefulness.</div></div><div><h3>Results</h3><div>The mean age was 58.6 (standard deviation 9.6) years, and 15.8% of the patients were female. The mean ejection fraction was 42.8% (8.5%). Coronary artery bypass grafting was performed in 93.4% of the patients. During a median follow-up of 60 months, 105 patients died. Eight features were selected and included in the multivariable Cox regression-based nomogram. The model achieved good calibration and discriminative ability as indicated by the concordance index (training 0.71; validation 0.77). Decision curve analysis showed the model had good clinical usefulness.</div></div><div><h3>Conclusions</h3><div>In this study, a nomogram with relatively good performance was developed to predict individualised long-term mortality after LVP in patients with an ischaemic anterior-wall LVA. However, external validation is needed.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 2","pages":"Pages 226-235"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145742154","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":"Post Infarct Ventricular Septal Rupture Demands Immediate Treatment by an Interventional Cardiologist or Cardiac Surgeon: A Call for Decisive Early Action","authors":"John M. Alvarez FRACS","doi":"10.1016/j.hlc.2026.01.002","DOIUrl":"10.1016/j.hlc.2026.01.002","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 2","pages":"Pages 153-154"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141911","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 the 2023 Australian Cardiovascular Risk Calculator","authors":"Grace Barwick BPharm(Hons) ,&nbsp;Stephen Hancock MScStud ,&nbsp;Shu Ren PhD ,&nbsp;Alexis Hure PhD ,&nbsp;John Attia PhD","doi":"10.1016/j.hlc.2025.08.029","DOIUrl":"10.1016/j.hlc.2025.08.029","url":null,"abstract":"<div><h3>Background</h3><div>The Australian Cardiovascular (CVD) Disease Risk Calculator is used to estimate the individual risk of developing cardiovascular disease in the next 5 years. A new version was recently published (July 2023), with the aim of improving on the predictive performance of its predecessor (released in 2012). We present the findings of an external validation study comparing the predictive performance of the 2023 and 2012 Australian CVD risk calculators using data prospectively collected in the Hunter Community Study (HCS; NSW Australia), a longitudinal community-based cohort of people aged 55–85 years.</div></div><div><h3>Methods</h3><div>We compared the risk predicted by the two calculators to the observed 5-year events in the HCS, in terms of discrimination (using area under the receiver operator characteristic curve, AUROC), calibration (using observed vs expected, O/E, ratio), sensitivity, and specificity.</div></div><div><h3>Results</h3><div>Discrimination was very similar for the 2023 and 2012 calculators, with AUROC measured to be 0.71 95% confidence interval (CI; 0.66, 0.75) and 0.71 95% CI (0.67, 0.75), respectively. With the updated calculator, sensitivity was better in males, while specificity was better in females; there were also modest improvements in positive likelihood ratios for both males and females. The 2023 calculator was found to overpredict risk for males (O/E ratio 0.57, p&lt;0.001), but was better calibrated for females (O/E ratio 1.02, p=0.46).</div></div><div><h3>Conclusions</h3><div>We conclude that the 2023 calculator provides some improvements in the prediction of CVD, specifically the positive likelihood ratios. However, there are also benefits in observing the old 2012 calculator for some purposes and specific population groups. We find that there is a need for a larger, nationwide cohort to allow further external validation of the 2023 Australian CVD Risk Calculator.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 2","pages":"Pages 271-282"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774421","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":"Consensus Statement on Optimisation of Patient Care After Hospitalisation for Acute Heart Failure","authors":"Andrew P. Sindone BMed(Hons), MD, FRACP, FCSANZ, FNHFA ,&nbsp;John Amerena MBBS, FRACP, FCSANZ ,&nbsp;Carmine G. De Pasquale BMBS, PhD, FRACP, FCSANZ ,&nbsp;Alicia W.P. Chan MBBS, PhD, FRACP, FCSANZ ,&nbsp;Gary C.H. Gan BSc(Med), MBBS, PhD, FRACP, FCSANZ, FESC ,&nbsp;Sriram D. Rao MBBS, PhD, FRACP, FCSANZ ,&nbsp;Christine Burdeniuk BSc(Hons), BMBS, FRACP, FCSANZ ,&nbsp;Amit Shah MBChB, AMC, FRACP, FCSANZ ,&nbsp;John J. Atherton MBBS, PhD, FRACP, FCSANZ","doi":"10.1016/j.hlc.2025.09.019","DOIUrl":"10.1016/j.hlc.2025.09.019","url":null,"abstract":"<div><div>Following guideline-directed medical therapy (GDMT) is crucial for managing acute heart failure (AHF). Australia has poor adherence to GDMT with only a small proportion of eligible patients receiving optimal HF therapy. Therefore, there is a real need for unified recommendations to optimise GDMT for patients hospitalised with AHF in Australia. Using a modified DELPHI method, an expert panel of nine Australian clinicians with expertise in HF management convened to develop consensus statements aimed at guiding healthcare professionals in Australia on optimising GDMT. This document outlines a strategy for ensuring patients are started on GDMT while they are in hospital and that GDMT is optimised to maximum tolerated doses rapidly after discharge. This is especially critical because rapid optimisation of heart failure (HF) therapies and close follow-up in the early period after HF hospitalisation has been found to decrease all-cause mortality and reduce the risk of HF readmission. These consensus statements provide a practical framework to help Australian healthcare professionals in optimising GDMT for their patients. This framework is designed to enhance the current AHF guidelines. The consensus statements support the ongoing priority of optimising GDMT for AHF management aiming to ensure that eligible patients receive the optimal therapy for their clinical presentation.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 2","pages":"Pages 157-170"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989076","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}