Reviews in cardiovascular medicine最新文献

{"title":"Mean Platelet Volume as a Predictor of Left Atrial Appendage Thrombus Resistance to Lysis in Patients With Atrial Fibrillation: Results of a 12-Month Follow-Up.","authors":"Tatiana P Gizatulina, Alfira V Belokurova, Aleksandra V Mamarina, Natalia Yu Khorkova, Elena A Gorbatenko","doi":"10.31083/RCM38943","DOIUrl":"10.31083/RCM38943","url":null,"abstract":"<p><strong>Background: </strong>Left atrial appendage thrombosis (LAAT), a contraindication to catheter ablation (CA), is a major problem in patients with non-valvular atrial fibrillation (AF). This study aimed to investigate the dynamics of LAAT and identify the factors associated with resistance to LAAT resolution over a 12-month period.</p><p><strong>Methods: </strong>A total of 83 of the 2766 patients with AF who underwent transesophageal echocardiography (TEE) before CA (median age, 62 years; 49 men) participated in follow-up studies. All patients received oral anticoagulants (OACs) and underwent a general clinical examination, which included a complete blood count, biochemical tests, and transthoracic echocardiography. In total, 39 patients (47%) had paroxysmal AF, and 44 patients (53%) had persistent AF.</p><p><strong>Results: </strong>Patients were divided into two groups based on dynamic TEE monitoring: Group 1 (n = 45), comprising patients whose LAAT resolved within 12 months, and Group 2 (n = 38), consisting of patients whose LAAT persisted until the end of the follow-up study. No significant differences were observed in age, sex, and incidence of cardiovascular disease between the groups. However, Group 2 patients were more likely to administer beta-blockers, diuretics, and rivaroxaban at the start of the study. The OACs were altered in 65 patients due to the repeated detection of LAAT. Comparative analysis revealed that Group 2 patients had higher right atrial volume index, N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, mean platelet volume (MPV), platelet distribution width, and platelet-large cell ratio. Multivariate logistic regression analysis was used to derive a prediction model for LAAT resistance, which included three independent predictors: diuretics intake (odds ratio (OR) 3.800, 95% confidence interval (CI) 1.281-11.275; <i>p</i> = 0.016), NT-proBNP level (OR 1.001, 95% CI 1.000-1.001; <i>p</i> = 0.015), and MPV (OR 1.892, 95% CI 1.056-3.387; <i>p</i> = 0.032). The receiver operating characteristic (ROC) analysis confirmed the good quality of the model: Area under the ROC curve (AUC) 0.789, specificity 72.7%, and sensitivity 73.3%.</p><p><strong>Conclusions: </strong>This study confirmed that approximately 47% LAAT remains resistant to lysis 1 year after initial detection in patients with AF, regardless of the use of OACs. To our knowledge, this is the first time that platelet morphofunctional parameters, particularly MPV, have been identified as predictors of LAAT lysis resistance, and further research in this direction is needed.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"38943"},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592083","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":"Wearable Technology in Cardiology: Advancements, Applications, and Future Prospects.","authors":"Nihar Jena, Prabhat Singh, Deepak Chandramohan, Hari N Garapati, Jyotsna Gummadi, Maneeth Mylavarapu, Bushra Firdous Shaik, Athmananda Nanjundappa, Dinesh Reddy Apala, Christian Toquica, Boney Lapsiwala, Prathap Kumar Simhadri","doi":"10.31083/RCM39025","DOIUrl":"10.31083/RCM39025","url":null,"abstract":"<p><p>As the use of wearable devices continues to expand, their integration into various aspects of healthcare becomes increasingly prevalent. Indeed, significant advancements have been made in the field of cardiology through the application of wearable technology to monitor heart rate, rhythm, and other biological signals. This review examines the various applications of wearable technology in cardiology, with the goal of improving patient care. We evaluate the accuracy and functionality of existing wearable electrocardiograms, defibrillators, blood pressure monitors, fitness trackers, activity trackers, and sleep trackers, including their roles in cardiac rehabilitation. Furthermore, we highlight the significant advancements in wearable electrocardiograms, demonstrating their accuracy comparable to that of traditional monitoring devices, as shown by studies such as the Apple Heart Study and the Fitbit Heart Study. Recent research suggests that wearable electrocardiograms are comparable to conventional monitoring devices in terms of performance and can help reduce healthcare costs. However, as technological improvements continue to evolve, challenges related to accessibility, patient privacy, and the need for improved accuracy are also emerging. This review highlights recent advancements that aim to address these challenges. Nonetheless, further research is crucial to critically assess and identify shortcomings, as wearable devices possess significant potential to enhance cardiovascular and overall health.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"39025"},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592089","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":"Application of Machine Learning in the Prediction of the Acute Aortic Dissection Risk Complicated by Mesenteric Malperfusion Based on Initial Laboratory Results.","authors":"Zhechuan Jin, Jiale Dong, Jian Yang, Chengxiang Li, Zequan Li, Zhaofei Ye, Yuyu Li, Ping Li, Yulin Li, Zhili Ji","doi":"10.31083/RCM37827","DOIUrl":"10.31083/RCM37827","url":null,"abstract":"<p><strong>Background: </strong>Mesenteric malperfusion (MMP) represents a severe complication of acute aortic dissection (AAD). Research on risk identification models for MMP is currently limited.</p><p><strong>Methods: </strong>Based on a retrospective study of medical records from the Beijing Anzhen Hospital spanning from January 2016 to June 2022, we included 435 patients with AAD and allocated their data to training and testing sets at a ratio of 7:3. Key preoperative predictive variables were identified through the least absolute shrinkage and selection operator (LASSO) regression. Subsequently, six machine learning algorithms were used to develop and validate an MMP risk identification model: logistic regression (LR), support vector classification (SVC), random forest (RF), extreme gradient boosting (XGBoost), naive Bayes (NB), and multilayer perceptron (MLP). To determine the optimal model, the performance of the model was evaluated using various metrics, including the area under the receiver operating characteristic curve (AUROC), accuracy, sensitivity, specificity, and the Brier score.</p><p><strong>Results: </strong>LASSO regression identified white blood cell count (WBC), neutrophil count (NE), lactate dehydrogenase (LDH), serum lactate levels, and arterial blood pH as key predictive variables. Among these, the WBC (OR 1.169, 95% confidence interval [CI] 1.086, 1.258; <i>p</i> < 0.001) and LDH levels (OR 1.001, 95% CI 1.000, 1.003; <i>p</i> = 0.008) were identified as independent risk factors for MMP. Among the six assessed machine learning algorithms, the RF model exhibited the best predictive capabilities, yielding AUROCs of 0.888 (95% CI 0.887, 0.889) and 0.797 (95% CI 0.794, 0.800) in the training and testing datasets, respectively, as well as sensitivities of 0.864 (95% CI 0.862, 0.867) and 0.811 (95% CI 0.806, 0.816), respectively, in the corresponding datasets.</p><p><strong>Conclusions: </strong>This study employed machine learning algorithms to develop a model capable of identifying MMP risk based on initial preoperative laboratory test results. This model can serve as a basis for making decisions in the treatment and diagnosis of MMP.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"37827"},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592041","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":"Congenital Long QT Syndrome: A Focus on Risk Stratification and Management.","authors":"Deepti Ranganathan, Steffany Grondin, Raouane Hadjeres, Jacqueline Joza","doi":"10.31083/RCM36779","DOIUrl":"10.31083/RCM36779","url":null,"abstract":"<p><p>Congenital long QT syndrome (LQTs) is an inherited cardiac condition resulting from cardiac repolarization abnormalities. Since the initial description of congenital LQTs by Jervell and Lange-Nielsen in 1957, our understanding of this condition has increased dramatically. A diagnosis of congenital LQTs is based on the medical history of the patient, alongside electrogram features, and a genetic variant that is identified in approximately 75% of cases. The appropriate risk stratification involves a multitude of factors, with β-blockers being the cornerstone of therapy. Recent developments, such as the incorporation of artificial intelligence (AI) for electrocardiogram (ECG) interpretation, genotype-phenotype-specific therapies, and emerging gene therapies, may potentially make personalized medicine in LQTs a reality in the near future. This review summarizes our current understanding of congenital LQTs, with a focus on risk stratification, current therapeutic interventions, and emerging developments in the management of congenital LQTs.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"36779"},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592062","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":"The Impact of Age and Sex on Left Ventricular Function Based on Transthoracic Echocardiograms.","authors":"Lu Tang, Rui Wu, Chen Cheng, Zheng Li, Yang Hua, Jin-Yu Sun, Yan-Juan Zhang, Wei Sun, Xiang-Qing Kong","doi":"10.31083/RCM38779","DOIUrl":"10.31083/RCM38779","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to reveal the age- and gender-related differences in left ventricular function among patients with normal cardiac structure.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 10,853 individuals with normal cardiac structures undergoing transthoracic echocardiography (2017-2020). We performed distribution analysis using kernel density estimation with Gaussian kernels and created smooth trajectories based on generalized additive models. Moreover, correlation analysis and multivariable regression were applied to evaluate the impact of age and gender on ventricular function.</p><p><strong>Results: </strong>A weak but statistically significant correlation was found between age and ejection fraction (B-coefficient = -0.077, <i>p</i> < 0.001). Females presented with a higher early diastolic mitral inflow velocity (E)/ early diastolic mitral annular tissue velocity (e') ratio than males across all age decades (<i>p</i> < 0.001). However, age demonstrated stronger associations with functional parameters in individuals below 51.4 years (both genders, <i>p</i> < 0.001). Multivariable regression analysis indicated that age and the male gender were independent predictors of reduced septal and lateral e' velocities (both <i>p</i> < 0.001), with males showing lower values (septal B-coefficient = -0.290; lateral B-coefficient = -0.463).</p><p><strong>Conclusion: </strong>This study provided the distribution of left ventricular systolic/diastolic function across age decades in males and females and highlighted the clinical importance of monitoring ventricular function even for patients with normal cardiac structure.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"38779"},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592086","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":"Anticoagulation for Stroke Prevention in Patients with Atrial Fibrillation: A Review of the Literature and Current Guidelines.","authors":"Vrinda Vyas, Vandita Vyas, Akash Sharma, Prashanth Ashok Kumar","doi":"10.31083/RCM39233","DOIUrl":"10.31083/RCM39233","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is the most common arrhythmia worldwide, characterized by uncoordinated atrial activation leading to a loss of effective atrial contraction and increased risk for atrial thrombi formation, promoting an increased risk of cardioembolic strokes and mortality, and associated increased healthcare expenditure. Therefore, stroke prevention represents a key focus in managing patients with atrial fibrillation, and strategies to achieve this aim have drastically evolved over the years. Previously, aspirin and warfarin were the cornerstone of stroke prophylaxis. However, direct oral anticoagulants have emerged and are now recognized as a safer and more effective alternative for non-valvular AF. Meanwhile, newer non-pharmacological methods to prevent AF related strokes, such as left atrial appendage occlusion devices, have been approved to ameliorate the need for lifelong anticoagulation in patients with elevated bleeding risks. This review outlines the current recommendations and provides an overview of the literature on stroke prevention in patients with atrial fibrillation, particularly focusing on using direct-acting oral anticoagulants. Comparisons between these agents and special considerations for use are also reviewed.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"39233"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592077","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":"Identification of Anticoagulation Benefit Subgroups of Patients With Left Ventricular Thrombus.","authors":"Zechen Liu, Boqun Shi, Rui Zhang, Kefei Dou, Weihua Song","doi":"10.31083/RCM27179","DOIUrl":"10.31083/RCM27179","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular thrombus (LVT) is associated with major adverse cardiovascular and cerebrovascular events (MACCEs). Anticoagulation represents the current primary management for LVT; however, current studies in some Asian populations suggest that the anticoagulation benefit in LVT patients is not significant. Given the heterogeneity of clinical phenotypes in LVT patients, the population of LVT patients who benefit from anticoagulation needs to be further explored.</p><p><strong>Methods: </strong>This study included patients diagnosed with LVT at the FuWai Hospital from 2009 to 2021. We performed a latent class analysis (LCA) based on important clinical characteristics to objectively determine the number and dimensionality of clusters. Additionally, Kaplan-Meier curves and a Cox analysis were used to explore the relationship between anticoagulation therapy and MACCEs and major bleeding events in LVT patients.</p><p><strong>Results: </strong>A total of 1085 patients were enrolled in this study, and during a median follow-up time of 36.5 months, 206 patients developed MACCEs, while 16 patients developed major bleeding events. Moreover, 1085 patients were categorized into four clusters following the LCA. In the adjusted model, the risk of MACCEs was significantly lower in LVT patients receiving anticoagulation in cluster 4 (hazard ratio (HR): 0.486, 95% confidence interval (CI): 0.243-0.971) than in the group not receiving anticoagulation; however, there were no differences in the other three clusters or the whole population. There was a significant interaction between anticoagulation and the clustered subgroups (<i>p</i> for interaction in MACCEs: 0.046). However, no significant correlation was found for major bleeding events across clusters or for anticoagulant therapy.</p><p><strong>Conclusions: </strong>Our study suggests that not all LVT patients benefit from anticoagulation therapy; younger LVT patients with fewer complications and more cardiomyopathies are more likely to benefit from anticoagulation therapy.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"27179"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592078","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":"Voltage-Gated Sodium Channels: A Therapeutic Target in Ischemic Heart Disease.","authors":"Xiao-Lu Zhang, Tian-Peng Wei, Fan Yang, Huan-Huan Liu, Ling-Ling Qian, Ru-Xing Wang","doi":"10.31083/RCM27140","DOIUrl":"10.31083/RCM27140","url":null,"abstract":"<p><p>Myocardial infarction (MI)-related arrhythmias are an essential risk factor in sudden cardiac death. Aberrant cardiac the cardiac voltage-gated sodium channel (Nav1.5) is important in the development of ventricular arrhythmias after an MI. These mechanisms are profoundly complex and involve sodium voltage-gated channel α subunit 5 (<i>SCN5A</i>) and sodium voltage-gated channel α subunit 10 (<i>SCN10A</i>) single nucleotide polymorphisms, aberrant splicing of <i>SCN5A</i> mRNAs, transcriptional and post-transcriptional regulation, translation, post-translational transport, and modification, along with protein degradation. These mechanisms ultimately promote a decrease in peak sodium currents, an increase in late sodium currents, and changes in sodium channel kinetics. This review aimed to explore the specific mechanisms of Nav1.5 in post-MI arrhythmias and summarize the potential of therapeutic drugs. An in-depth study of the effect of Nav1.5 on arrhythmias after myocardial ischemia is of crucial clinical significance.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"27140"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592088","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":"Blood Transfusions are Associated With Prolonged Mechanical Ventilation Following Cardiac Surgery in Neonates.","authors":"Yansong Zuo, Han Zhang, Lizhi Lv, Gang Li, Ju Zhao, Qiang Wang","doi":"10.31083/RCM36566","DOIUrl":"10.31083/RCM36566","url":null,"abstract":"<p><strong>Background: </strong>To investigate the factors that influence blood transfusions after neonatal cardiac surgery and their association with prolonged mechanical ventilation (PMV) to provide a basis for optimizing blood transfusion strategies.</p><p><strong>Methods: </strong>This study retrospectively analyzed the clinical data of 202 neonates who had undergone cardiac surgery with cardiopulmonary bypass (CPB) in Beijing Anzhen Hospital from 2019 to 2023. Demographic data, preoperative parameters (body weight, hemoglobin, Risk-Adjusted Classification of Congenital Heart Surgery 1 (RACHS-1) score), intraoperative data (CPB time, aortic cross-clamp time, deep hypothermic circulatory arrest (DHCA)), and transfusions of red blood cells (RBCs), fresh frozen plasma (FFP), and platelet concentrate (PC) within 48 hours after surgery were collected. PMV was defined as mechanical ventilation ≥96 hours after surgery. Multivariate logistic regression was used to analyze independent risk factors for PMV, and the dose-response relationship between transfusion volume and PMV was evaluated by restricted cubic splines (RCSs).</p><p><strong>Results: </strong>Within 48 hours postoperation, 50.00% of patients were transfused with RBCs, 37.62% were transfused with FFP, and 27.72% were transfused with PC. The PMV incidence was 36.63% in patients with lower body weight (odds ratio (OR) = 0.38, 95% confidence interval (CI): 0.20-0.74; <i>p</i> = 0.005), lower preoperative hemoglobin (OR = 0.99; 95% CI: 0.97-0.99; <i>p</i> = 0.041), and a RACHS-1 score of 4 (OR = 2.56; 95% CI: 1.04-6.27; <i>p</i> = 0.040), and RBCs (OR = 2.02; 95% CI: 1.02-4.00; <i>p</i> = 0.043), and FFP infusion (OR = 1.98; 95% CI: 1.02-3.85; <i>p</i> = 0.043) were independent risk factors. The RCS demonstrated a linear dose-response relationship between the volume of RBCs infused and PMV (<i>p</i> nonlinear = 0.668), whereas there was no association for FFP. The duration of intensive care unit (ICU) stay in patients with PMV (14 days vs. 8 days) and the hospitalization (18 days vs. 13 days) were significantly longer (both <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Blood transfusion after neonatal cardiac surgery is an important controllable risk factor for the development of PMV, and its risk increases linearly with the volume of RBC transfusion. Future multicenter prospective studies are needed to validate the causal association further.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"36566"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592045","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":"Pleural Effusion Trajectories and Clinical Outcomes in Cardiac Surgery Patients.","authors":"Jun Zhong, Jing-Chao Luo, Jin-Ling Lin, Ming-Hao Luo, Jian Gao, Kai Liu, Guo-Wei Tu, Yan Xue","doi":"10.31083/RCM37210","DOIUrl":"10.31083/RCM37210","url":null,"abstract":"<p><strong>Background: </strong>Pleural effusion (PE) commonly occurs in cardiac surgery patients, often requiring tube drainage. This study aimed to investigate associations between PE drainage trajectories and clinical outcomes in patients undergoing cardiac surgery.</p><p><strong>Methods: </strong>Patients who underwent cardiac surgery and subsequent tube drainage during hospitalization in the intensive care unit, due to substantial PE, were enrolled. PE drainage volumes were recorded daily. The relationships between PE drainage and poor outcome or mortality risks were examined using logistic regression analysis. Latent class growth analysis (LCGA) was used to classify PE trajectories, and the characteristics of each latent class were compared.</p><p><strong>Results: </strong>In total, 386 patients were enrolled over 3 years, of whom 113 (29.3%) developed poor outcomes. These patients had significantly higher average PE drainage volumes on days 2-4 (1.7 <i>vs</i>. 1.2 mL/kg/day; <i>p</i> = 0.002) and days 5-7 (0.9 <i>vs</i>. 0 mL/kg/day; <i>p</i> < 0.001). Average PE drainage volumes during the first 2-4 and 5-7 days were associated with poor outcomes (odds ratio (OR) = 1.10 (95% confidence interval (CI): 1.02-1.20); <i>p</i> = 0.014 and 1.19 (95% CI: 1.08-1.32); <i>p</i> < 0.001, respectively). LCGA identified three distinct PE drainage trajectory classes: persistently high (Class 1, n = 39), gradually declining from high to low (Class 2, n = 128), and persistently low (Class 3, n = 219). Among these, Class 1 had the highest mortality and poor outcome risks.</p><p><strong>Conclusions: </strong>A trend in PE formation demonstrated a strong correlation with mortality and poor outcomes in patients who underwent cardiac surgery. Patients with persistently high PE drainage volumes required close monitoring and attention.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 6","pages":"37210"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592084","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}