International heart journal最新文献

{"title":"Characteristics of Incident Coronary Artery Disease in Patients Undergoing Atrial Fibrillation Ablation.","authors":"Hiroyuki Ikeda, Kanae Hasegawa, Hiroyasu Uzui, Moe Mukai, Naoto Tama, Kentaro Ishida, Hiroshi Tada","doi":"10.1536/ihj.24-676","DOIUrl":"10.1536/ihj.24-676","url":null,"abstract":"<p><p>Few reports have provided detailed characteristics of incident coronary artery disease (CAD) and its risk factors in patients undergoing ablation (ABL) for atrial fibrillation (AF).Patients undergoing ablation for AF with no documented CAD were retrospectively studied at our institution. Patients were divided into 2 groups: those in whom significant stenosis was detected incidentally on coronary angiography (CAG) performed at the same time as ablation, and those without. The detection rate and its predictors were examined.Of the 550 patients, 20 had incidental CAD (detection rate: 3.6%). We compared the clinical data between these 20 patients (ABL-CAD group) and the 530 patients who displayed no significant stenosis on CAG. In multivariate analysis, age, hemoglobin A1c (HbA1c), and high-density lipoprotein cholesterol (HDL-chol) were predictive factors (odds ratio: 1.08, 2.43, 1.58, 95% CIs: 1.01-1.14, 1.53-3.86, 0.92-0.99; P = 0.014, 0.004, 0.024, respectively) for identification of CAD. Multivariate analysis based on cut-off values from receiver operating characteristic analysis identified age, HbA1c ≥ 6.1%, and HDL-chol ≤ 49 mg/dL as predictors (odds ratios: 1.06, 4.04, 3.07; 95% CIs: 1.00-1.12, 1.58-10.3, 1.1-8.01; P = 0.04, 0.01, 0.021, respectively). The area under the curve was significantly greater for age and HbA1c ≥ 6.1% and HDL-chol ≤ 49 mg/dL than for age alone (0.810 versus 0.672; P = 0.005).Patients undergoing ablation for AF appear likely to have CAD if HbA1c is ≥ 6.1% and HDL-chol is ≤ 49 mg/dL.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 2","pages":"220-225"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752608","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":"Relationship between Uric Acid and All-Cause and Cardiovascular Mortality in Individuals with Hypertension.","authors":"Tian-Ming Gan, Yingjie Yang, Guan-Lian Mo, Shi-Rong Wang, Shu-Hu Li, Jin-Yi Li","doi":"10.1536/ihj.24-220","DOIUrl":"https://doi.org/10.1536/ihj.24-220","url":null,"abstract":"<p><p>Hypertension is a common disease in the general population. Serum uric acid (SUA) levels have been linked to the occurrence and worsening of hypertension. However, it is unclear whether SUA has an impact on all-cause mortality (ACM) and cardiovascular mortality (CVM) in hypertensive individuals. This research aimed to assess the relation between SUA and mortality in a hypertensive population using data from the National Health and Nutrition Examination Survey (NHANES) database.The research comprised 13,363 hypertensive patients from NHANES during 2001-2018. A weighted Cox proportional risk model and restricted cubic spline (RCS) were used for the analysis.During the follow-up period among the 13,363 participants, there were 3,066 deaths from all causes, of which 846 were from CVD. After adjusting for variables, HRs and corresponding 95% CIs were calculated for different SUA categories (Q1: SUA < 285.5 μmol/L, Q2: 285.5 μmol/L ≤ SUA < 339.0 μmol/L, Q3: 339.0 μmol/L ≤ SUA < 404.5 μmol/L, Q4: SUA ≥ 404.5 μmol/L). The ACM was 1 (reference), 1.557 (1.387, 1.747), 1.312 (1.154, 1.492), and 1.393 (1.228, 1.580) (all P < 0.01); while the CVM was 1 (reference), 1.308 (1.043, 1.641) (P = 0.041), 1.182 (0.938, 1.490) (P = 0.261), and 1.151 (0.904, 1.464) (P = 0.410). The RCS showed that both high and low levels of SUA were related to an elevated risk of ACM and CVM in a population of hypertensive individuals.In hypertensive individuals, an elevated risk of both ACM and CVM is associated with high and low levels of SUA.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 3","pages":"427-435"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199007","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":"Tandem Mass Tag-Labeling Proteomics Reveals TLN1 as a Potential Factor in Cardiogenic Pulmonary Edema.","authors":"Yan Tan, Zhiwei Xu, Zhihua Wang, Dongming Gu","doi":"10.1536/ihj.24-264","DOIUrl":"10.1536/ihj.24-264","url":null,"abstract":"<p><p>Heart failure (HF) is a complex disease. The reduced blood flow associated with HF triggers the activation of neurohormonal systems, leading to symptoms such as pulmonary congestion and peripheral edema. The precise mechanisms responsible for edema in HF are poorly understood. In this study, we aimed to analyze the differentially expressed proteins in HF-induced pulmonary edema (HF-PE) and explore the potential underlying mechanisms. Proteins in the serum of patients with HF-PE (n = 10) and patients with HF without PE or those who have not developed PE yet (n = 10) were screened using tandem mass tag-labeling proteomics. The identified proteins were screened for differentially expressed proteins, which were then analyzed using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses as well as protein-protein interaction (PPI) visualization. Rats with HF were induced by myocardial infarction, whereas PE was induced by LPS. Finally, the rats were injected with lentiviruses to manipulate the expression of differentially expressed proteins. A total of 1796 proteins were identified. In the serum of patients with HF-PE, there were 143 significantly upregulated proteins and 147 significantly downregulated proteins. TLN1 interacted with multiple proteins and was upregulated in patients with HF-PE. TLN1 was significantly upregulated in the lung tissues of rats with HF-PE, and the progression of HF-PE was inhibited by TLN1 knockdown. This tandem mass tag-labeling proteomics profiling study revealed that TLN1 upregulation contributes to the progression of PE in patients with HF.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 2","pages":"313-322"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752500","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":"Prognostic Factors After Bone Marrow-Derived Mononuclear Cell Implantation in No-Option Chronic Limb-Threatening Ischemia Patients with Atherosclerotic Lower Extremity Artery Disease.","authors":"Hirofumi Kawamata, Kenji Yanishi, Jun Yoshimura, Takaaki Ozawa, Daiki Goto, Yusuke Hori, Ayumu Fujioka, Keisuke Shoji, Arito Yukawa, Satoaki Matoba","doi":"10.1536/ihj.24-440","DOIUrl":"10.1536/ihj.24-440","url":null,"abstract":"<p><p>Previous studies have reported the efficacy and safety of therapeutic angiogenesis through bone marrow-derived mononuclear cell (BM-MNC) implantation in patients with no-option chronic limb-threatening ischemia (CLTI) from atherosclerotic lower extremity artery disease (LEAD). However, uncertain clinical prognostic factors impact treatment outcomes. This study aimed to elucidate the long-term outcomes of patients with atherosclerotic LEAD-derived no-option CLTI after BM-MNC implantation and to identify prognostic factors.In this retrospective, single-center, observational study, the primary endpoints included the long-term prognosis of BM-MNC implantation and factors influencing 1-year outcomes. A total of 92 limbs in 84 patients were analyzed in the final cohort (mean age: 67 years; male, 65%). The 5- and 10-year overall survival rates were 50.0% and 31.0%, respectively, while the 5- and 10-year amputation-free survival rates were 37.6% and 23.3%, respectively. Multivariate logistic analysis linked all-cause mortality to age ≥ 70 years, hemodialysis, smoking, and a controlling nutrition status score ≥ 5. Major amputation or mortality was associated with male sex, hemodialysis, and C-reactive protein levels ≥ 3.0 mg/dL. No adverse events were associated with therapeutic angiogenesis.These findings endorse the feasibility and safety of BM-MNC implantation for patients with no-option CLTI due to atherosclerotic LEAD. Moreover, the study highlights the significance of several prognostic factors, including advanced age, hemodialysis, smoking, and inflammatory markers, in influencing the long-term outcomes of this treatment.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 1","pages":"96-105"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079184","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":"High-Fat Diet during Mouse Pregnancy Impairs Fetal Heart Development.","authors":"Kaixin Ge, Diyaerjiang Aierken, Defang Deng, Zhen Jiang, Teng Feng, Jufeng Meng, Hui Zhang, Jinjun Cao, Chen Liu","doi":"10.1536/ihj.24-245","DOIUrl":"10.1536/ihj.24-245","url":null,"abstract":"<p><p>Maternal overnutrition correlates with detrimental outcomes in offspring. However, the specific effects of gestational exposure to a high-fat diet (HFD) on fetal development remain unclear. This study aimed to elucidate the developmental phenotypes of neonatal organs and cardiomyocytes of mice exposed to gestational HFD, revealing growth retardation and a notable reduction in cardiomyocyte cell cycle activity. In this study, an HFD model was used to investigate the effects of maternal HFD on offspring development. Defective development was observed in the offspring, and severe restriction of cell proliferation was noted in the neonatal organs as a result of maternal HFD. Based on this evidence, we detected a reduction in cardiomyocyte proliferation in offspring exposed to maternal HFD. Moreover, RNA sequencing analysis revealed that HFD diminished fatty acid metabolism, enhanced the inflammatory response, and upregulated the transcription of genes involved in Tp53-regulated cell cycle arrest in postnatal day 0 (P0) cardiomyocytes. Furthermore, our results showed that the effects of the maternal diet during gestation are profound and normal lactation and feeding after delivery cannot help adult offspring recover from defective heart development. These findings highlight the diverse pathways affected by maternal HFD, particularly implicating a potential TP53-dependent mechanism contributing to cardiac defects in offspring.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 1","pages":"144-156"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079894","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":"High Plasma Levels of Sestrin2 Are Associated with Cardiovascular Events in Patients Undergoing Coronary Angiography.","authors":"Yoshimi Kishimoto, Emi Saita, Reiko Ohmori, Kazuo Kondo, Yukihiko Momiyama","doi":"10.1536/ihj.24-407","DOIUrl":"10.1536/ihj.24-407","url":null,"abstract":"<p><p>Atherosclerotic diseases, like coronary artery disease (CAD), are recognized to be associated with oxidative stress and inflammation. Sestrin2 is a stress-inducible protein that has anti-oxidant and anti-inflammatory properties. We previously reported that plasma sestrin2 levels were high in patients with CAD. However, no study has shown their prognostic value in patients with CAD. We investigated the association between plasma sestrin2 levels and major adverse cardiovascular events (MACE) (cardiovascular death, myocardial infarction, unstable angina, coronary revascularization, heart failure, or stroke) in 320 patients undergoing coronary angiography, of whom 191 had CAD. During a mean follow-up of 7.0 ± 4.2 years, 58 patients had MACE. Plasma sestrin2 levels were higher in patients with CAD than without CAD (median 16.4 versus 14.2 ng/mL, P < 0.05). Notably, patients with MACE had higher sestrin2 levels (19.5 versus 14.9 ng/mL) and more often had sestrin2 > 15.0 ng/mL (79% versus 49%) than those without MACE (P < 0.001). Kaplan-Meier analysis showed lower event-free survival in patients with sestrin2 > 15.0 ng/mL than in those with ≤ 15.0 ng/mL (P < 0.001). In multivariate Cox hazards analysis, sestrin2 level (> 15.0 ng/mL) was a significant predictor of MACE (hazard ratio: 2.44; 95%CI: 1.28-4.67), independent of CAD and atherosclerotic risk factors. Moreover, among 191 patients with CAD, sestrin2 level was also a significant predictor of MACE (hazard ratio: 2.51; 95%CI: 1.28-4.82), independent of the severity of CAD and coronary revascularization. Thus, high plasma levels of sestrin2 at baseline angiography were found to be associated with an increased risk of cardiovascular events in patients with CAD and patients undergoing coronary angiography.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 1","pages":"28-35"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079888","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":"Catheter Ablation in Older Patients with Atrial Fibrillation.","authors":"Tadashi Yamamoto, Takuya Kishi, Ayako Takamori, Toshio Katagiri, Masataka Kajiwara, Takashi Fujimura, Tomohiro Imamura, Tomohito Inage, Yoshitaka Hirooka","doi":"10.1536/ihj.24-368","DOIUrl":"10.1536/ihj.24-368","url":null,"abstract":"<p><p>The prevalence of atrial fibrillation (AF) increases with age and treatment with catheter ablation is performed frequently. Catheter ablation may have a lower rate of success and a higher rate of complications in older patients.We compared the characteristics, success rates, and complications of catheter ablation in patients with AF categorized into late old-aged (≥ 75 years, n = 148), early old-aged (65-74 years), n = 129), and middle-aged (< 65 years, n = 91) groups. Effects of catheter ablation on cardiac function in the left ventricle (LV) and left atrium (LA), and plasma B-type natriuretic peptide levels were evaluated at baseline and 1 year.AF ablation was successfully performed in older patients and the recurrence rate did not differ between groups (late old-aged: 29.7%, early old-aged: 15.5%, middle-aged: 23.1%). Procedural complications did not statistically differ among the groups (late old-aged: 9.5%, early old-aged: 6.2%, middle-aged: 3.3%). The LA volume index was greater in the late old-aged patients than in the other 2 groups. As comorbidities, hypertension and history of heart failure and stroke were more common in late old-aged patients. At 1 year after ablation, the LV ejection fraction, the LA volume index, and LA emptying fraction were improved, even in late old-aged patients. Plasma B-type natriuretic peptide levels were reduced in both the late old-aged and early-old-aged groups.Our findings indicate that AF ablation in late old-aged patients is effective, particularly with regard to LA structure and function, and the complication rate is similar to that in middle-aged patients.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 1","pages":"44-50"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079809","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":"Anterior Upper Lateral Versus Anterior-Lateral Electrode Positions for External Cardioversion in Atrial Fibrillation.","authors":"Dengke Ou, Wei Cai, Yongchun Zeng, Mingyang Tang","doi":"10.1536/ihj.23-274","DOIUrl":"10.1536/ihj.23-274","url":null,"abstract":"<p><p>Electrical cardioversion is the first-line rhythm control therapy for symptomatic persistent atrial fibrillation (AF). Although the anterior-posterior and anterior-lateral electrode positions are widely used as the standard for external cardioversion in the current guidelines, they are ineffective in > 10% of patients. Therefore, we assessed the efficacy of the anterior upper lateral electrode positioning on defibrillation electrodes during cardioversion in AF.In this randomized, investigator-initiated, open-label trial, we randomly assigned patients with AF scheduled for elective cardioversion to either the anterior-lateral or anterior-posterior electrode positioning groups. The primary outcome was the proportion of patients with sinus rhythm after the first shock. The secondary outcome was the proportion of patients in sinus rhythm after up to 3 shocks escalating to maximum energy. Safety outcomes included arrhythmia during or after cardioversion, skin redness, and patient-reported periprocedural pain.We randomly selected 333 patients. The primary outcome occurred in 125 (75%) patients in the anterior upper lateral electrode position group and 88 (53%) patients in the anterior-lateral electrode position group (risk difference, 22 percentage points, 95% CI: 14-35; P < 0.001). After the final cardioversion shock, 155 (93%) patients were in the anterior upper lateral electrode positioning group and 141 (85%) patients were in the anterior-posterior electrode positioning group (risk difference, 8 percentage points, 95% CI: 2-15). There were no significant differences in any safety outcomes between the groups.The anterior upper lateral electrode positioning was more effective than the anterior-lateral electrode positioning for biphasic cardioversion in AF. There were no significant differences in the safety outcomes.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 2","pages":"234-240"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752543","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":"Human Umbilical Cord Mesenchymal Stem Cell-Derived Exosomes Modulate the NLRP3 Inflammasome/Caspase-1 Pathway to Repress Pyroptosis Induced by Hypoxia/Reoxygenation in Cardiac Microvascular Endothelial Cells.","authors":"Liwei Diao, Yi Wu, Xiuzheng Jiang, Bojiao Chen, Wen Zhang, Li Chen, Weijin Zhou, Lihong Jiang, Xinyuan Liu, Jingang Deng, Zhongqun Zhan, Benqing Wu, Xiaoshen Zhang","doi":"10.1536/ihj.23-500","DOIUrl":"10.1536/ihj.23-500","url":null,"abstract":"<p><p>Human umbilical cord mesenchymal stem cell-derived exosomes (hUCMSC-Exos) have the ability to treat cardiovascular diseases (CVDs). We explored their mechanism on pyroptosis modulation in cardiac microvascular endothelial cells (CMECs).Exosomes were extracted from hUCMSCs using a differential high-speed centrifugation method, and then identified by transmission electron microscopy, nanoparticle tracking analysis, and Western blot analysis. Later, the CMECs were induced by hypoxia/reoxygenation (H/R) in vitro and processed with hUCMSC-Exos or the NLRP3 inflammasome inhibitor CY-09 and the NLRP3 inflammasome activator Nigerian sodium sulfate (NSS). A rat model of ischemia/reperfusion (I/R) injury was established in vivo, followed by hUCMSC-Exo injection. Cell viability and death, and myocardial injury were assessed by CCK-8 and LDH assays and H&E staining. Levels of GSDMD-N, NLRP3, cleaved Caspase-1, IL-1β and IL-18 proteins, and inflammatory factors (IL-1β, IL-18) were determined by Western blot analysis and ELISA.H/R-induced CMECs represented attenuated cell viability and increased cell death, as well as up-regulated levels of pyroptosis proteins (cleaved Caspase-1, GSDMD-N, IL-18, IL-1β), inflammasome key protein (NLRP3) and cell supernatant inflammatory factors (IL-18, IL-1β), while hUCMSC-Exos amplified H/R-induced CMEC viability and lowered cell death, and diminished levels of NLRP3, cleaved Caspase-1, GSDMD-N, IL-18 and IL-1β proteins, and cell supernatant inflammatory factors IL-1β and IL-18. Activating the NLRP3 inflammasome/Caspase-1 pathway partially reversed the inhibitory effect of hUCMSC-Exos on CMEC pyroptosis. hUCMSC-Exos alleviated myocardial injury in I/R rats by modulating the NLRP3 inflammasome/Caspase-1 pathway.hUCMSC-Exos weakened CMEC pyroptosis by inactivating the NLRP3 inflammasome/Caspase-1 pathway.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":" ","pages":"1107-1117"},"PeriodicalIF":1.2,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545272","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":"Clinical Features and Postoperative Mobilization following Total Aortic Arch Replacement.","authors":"Yuya Shirai, Yoshiyuki Tokuda, Yohei Tsuchikawa, Kiyonori Kobayashi, Shinya Tanaka, Natsumi Yoshito, Yuto Hori, Daichi Takagi, Yoshihiro Nishida, Masato Mutsuga","doi":"10.1536/ihj.24-261","DOIUrl":"10.1536/ihj.24-261","url":null,"abstract":"<p><p>Open thoracic aortic surgery is believed to necessitate more intensive rehabilitation. This study aimed to compare the progress of postoperative rehabilitation between standard and delayed mobilization. A retrospective review was conducted on 199 patients who underwent isolated total aortic arch replacement via median sternotomy. Cases of in-hospital mortality and postoperative stroke were excluded. Based on the current guidelines for cardiovascular rehabilitation of the Japanese Circulation Society, patients were categorized into standard mobilization (could sit on the edge of bed within 2 days) and delayed mobilization (could not do so) groups. Rehabilitation progress was compared among both groups. Initial mobilization was delayed in 100 patients (delayed mobilization group), primarily because of respiratory failure (46.0%). Preoperative risk characteristics, including EuroSCORE II (median, 2.9 versus 3.5), were similar between the standard and delayed mobilization groups. The delayed mobilization group had longer operation (median, 6.1 versus 8.0 hours, P < 0.001) and cardiopulmonary bypass (median, 3.2 versus 4.1 hours, P < 0.001) times. Independent ambulation occurred earlier in the standard mobilization group (median, 6.0 versus 8.0 days, P < 0.001).In conclusion, early initiation of sitting on the edge of the bed within 2 days was associated with earlier independent ambulation during postoperative rehabilitation, which supports the current guidelines. Longer operation and cardiopulmonary bypass times were associated with delayed mobilization initiation, suggesting the need for more tailored approaches in such cases.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":" ","pages":"1075-1078"},"PeriodicalIF":1.2,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619487","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}