CJC Open最新文献

{"title":"Exploring the Mechanisms of How Excess Androgens Adversely Impact Lipid Metabolism in Women with Polycystic Ovarian Syndrome","authors":"M. Wang, S. Proctor, M. Ghosh, D. Vine","doi":"10.1016/j.cjco.2025.04.027","DOIUrl":"10.1016/j.cjco.2025.04.027","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 6","pages":"Page S4"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and Experiences in Implementing Early Hospital Discharge for Patients with Low-Risk ST-Elevation Myocardial Infarction","authors":"Vinay Jayachandiran MD ,&nbsp;Elnaz Assadpour MD ,&nbsp;Sofia Babapulle ,&nbsp;Ryan Davey MD ,&nbsp;Sabe De MD ,&nbsp;Daniel Durocher MD ,&nbsp;Ashlay Huitema MD ,&nbsp;Nikolaos Tzemos MD ,&nbsp;Rodrigo Bagur MD, PhD ,&nbsp;Sarah Blissett MD, MHPE","doi":"10.1016/j.cjco.2025.03.012","DOIUrl":"10.1016/j.cjco.2025.03.012","url":null,"abstract":"<div><h3>Background</h3><div>Our institution implemented a clinical pathway to facilitate early hospital discharge (EHD) in &lt; 48 hours post–primary percutaneous coronary intervention for low-risk ST elevation myocardial infarction. This study characterizes the exclusion criteria, barriers, safety profile, and patient satisfaction for EHD.</div></div><div><h3>Methods</h3><div>We prospectively identified all patients with ST-elevation myocardial infarction between January 2023 and March 2024. Patient characteristics, potential EHD barriers and 30-day readmission rates were recorded. A postdischarge telephone survey assessed patient satisfaction. Patients discharged at ≤ 48 hours formed the EHD cohort; those discharged later comprised the non-EHD cohort. Statistical comparisons were performed using the chi-squared and Mann-Whitney <em>U</em> tests, with logistic regression assessing EHD barriers.</div></div><div><h3>Results</h3><div>Among 433 STEMI patients, 65% (n = 282) were ineligible for EHD, primarily due to revascularization needs (29%) or infarct-related complications (47%). Of 151 eligible patients, 72% (n = 109) achieved EHD. Afternoon presentations were associated with higher EHD rates (82% vs 61%, odds ratio = 3.5, 95% confidence interval 1.57-7.83, <em>P</em> = 0.002). Rates of 30--day readmission were lower in the EHD cohort (0% vs 7%, <em>P</em> = 0.007). Patient satisfaction (96% vs 95%, <em>P</em> = 0.841), perceived appropriate length of stay (91% vs 82%, <em>P</em> = 0.15), and intention to attend cardiac rehabilitation (63% vs 67%, <em>P</em> = 0.73) were comparable between cohorts.</div></div><div><h3>Conclusions</h3><div>Revascularization considerations and infarct-related complications were the most common reason for exclusion. Morning or overnight admissions were potential barriers to EHD, suggesting a role for optimized discharge planning. No adverse impacts on safety or patient satisfaction occurred.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 6","pages":"Pages 719-724"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Accuracy and Intraprocedural Use of a Holographic Display for 3-Dimensional Transesophageal Echocardiography","authors":"Elchanan Bruckheimer MBBS ,&nbsp;Alexander Lowenthal MD ,&nbsp;Nili Schamroth Pravda MD ,&nbsp;Hana Vaknin-Assa MD ,&nbsp;Mordehay Vaturi MD ,&nbsp;Gabriel Amir MD ,&nbsp;Leor Perl MD ,&nbsp;Pablo Codner MD ,&nbsp;Yaron Shapira MD ,&nbsp;Tamir Dagan MD ,&nbsp;Ran Kornowski MD, FACC ,&nbsp;Einat Birk MD","doi":"10.1016/j.cjco.2025.03.014","DOIUrl":"10.1016/j.cjco.2025.03.014","url":null,"abstract":"<div><h3>Background</h3><div>Real-time 3-dimensional transesophageal echocardiography (3DTEE) data acquired during interventional procedures are displayed on 2-dimensional screens, limiting intuitive depth perception and spatial comprehension. The study objectives were to evaluate the feasibility of intraprocedural use of a holography display during structural cardiology procedures employing 3DTEE, and to assess the accuracy of offline linear measurements in 3DTEE datasets.</div></div><div><h3>Methods</h3><div>A prospective single-center study was conducted using the HOLOSCOPE-i to guide catheter-based procedures using intraprocedural 3DTEE. Qualitative measures of recognition of anatomic structures, 3D spatial comprehension, and interaction with intracardiac anatomic structures and catheter position were evaluated using a Likert scale. Additionally, a retrospective analysis of offline 3DTEE datasets of mitral valve measurements were performed using the HOLOSCOPE-i vs QLAB. Intra- and interobserver variability was assessed, assuming an intraclass correlation coefficient &gt; 0.75 indicates adequate reliability.</div></div><div><h3>Results</h3><div>A total of 13 patients were enrolled. In all cases, anatomic structures were identified in real time, and spatial comprehension was enhanced (Likert scale). No nausea or headache was reported by the operators. Retrospective analysis of 41 mitral valve 3DTEE datasets was performed. Annular diameter measurements (anteroposterior [AP] and anterolateral-posteromedial [AL-PM]) demonstrated a Pearson correlation of 0.89 (HOLOSCOPE-i) and 0.91 (QLAB). Intraobserver ICC for AP, AL-PM was 0.97, 0.94 (HOLOSCOPE-i) and 0.95, 0.97 (QLAB); interobserver ICC for AP and AL-PM was 0.77 and 0.88 (HOLOSCOPE-i) and 0.96 and 0.98 (QLAB).</div></div><div><h3>Conclusions</h3><div>Holographic display of intraprocedural real-time 3DTEE data is feasible and augments the experience of the operator. Linear measurements in the 3D holographic display are accurate, with good correlation to those using 2-dimensional multiplanar reconstruction 3DTEE software.</div></div><div><h3>Clinical Trial Registration</h3><div>MOH_2021-09-13_010255.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 6","pages":"Pages 728-735"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Resource Utilization and Outcomes Among Patients Who Receive Extracorporeal Membrane Oxygenation","authors":"Vicki Papanikolaou BBiomedSc, MPH ,&nbsp;Ethan Goh BMedSc, MD ,&nbsp;Alayna Carrandi BSc, MPH ,&nbsp;Anaïs Charles-Nelson PhD ,&nbsp;Kiran Kottakkal BMedSc, MD ,&nbsp;Lorena Romero BA, MBIT ,&nbsp;Carol L. Hodgson BAppSc(Physio), PGDip(Cardio), M(Research), PhD ,&nbsp;Alisa M. Higgins BPhysio(Hons), GDipBiostat, MPH, PhD","doi":"10.1016/j.cjco.2025.03.019","DOIUrl":"10.1016/j.cjco.2025.03.019","url":null,"abstract":"<div><h3>Background</h3><div>Extracorporeal membrane oxygenation (ECMO) is a high-cost, resource-intensive intervention for severe cardiac and respiratory failure. Survivors of ECMO have healthcare needs that extend beyond their acute hospitalization, placing significant demands on healthcare systems and society. As ECMO use increases globally, understanding the healthcare and economic burden of ECMO survivorship is needed to improve long-term outcomes of ECMO survivors and optimize resource allocation within healthcare systems.</div></div><div><h3>Methods</h3><div>We systematically searched Ovid MEDLINE, Ovid Embase, Ovid Emcare, Scopus, and Web of Science from inception to October 1, 2024. We included studies published in English that reported post-discharge healthcare resource utilization and costs for adult survivors of ECMO.</div></div><div><h3>Results</h3><div>From 1889 articles screened, 24 studies met our inclusion criteria. Most were retrospective cohort studies conducted in North America between 2010 and 2024. Sample sizes ranged from 12 to 23,876 patients, with in-hospital mortality rates between 28.5% and 67.4%. Thirty-day readmission rates ranged from 10.0% to 43.8%, with 90-day rates ranging from 21.1% to 53.0%. One study reported a mean 30-day readmission cost of $62,150 (in 2023 US dollars). Only 5 studies (20.8%) reported total healthcare costs up to 6 months and 1 year.</div></div><div><h3>Conclusions</h3><div>ECMO survivorship is gaining increased attention in research and clinical practice, yet significant gaps remain in our understanding of long-term healthcare resource utilization and costs. Our review reveals very limited information, indicating an urgent need for more comprehensive and granular data to guide clinical and policy decisions and achieve healthcare system efficiency.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 6","pages":"Pages 750-758"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Center-Level Variation in the Development of Acute Kidney Injury Following Cardiac Operation","authors":"Troy N. Coaston BS ,&nbsp;Joanna Curry BA ,&nbsp;Amulya Vadlakonda BS ,&nbsp;Saad Mallick MD ,&nbsp;Giselle Porter BS ,&nbsp;Corynn Branche ,&nbsp;Nguyen Le MS ,&nbsp;Peyman Benharash MD","doi":"10.1016/j.cjco.2025.04.003","DOIUrl":"10.1016/j.cjco.2025.04.003","url":null,"abstract":"<div><h3>Background</h3><div>Acute kidney injury (AKI) is a frequent complication following cardiac surgery. However, factors associated with AKI remain poorly understood. In this national study, we evaluated centre-level variation in the incidence of AKI after elective cardiac surgery.</div></div><div><h3>Methods</h3><div>Adult patients undergoing elective coronary artery bypass graft or valve operations with normal baseline renal function were identified in the 2010-2020 National Inpatient Sample. Multilevel mixed-effects models were utilized to rank hospitals based on estimated rate of AKI. The intraclass coefficient was used to estimate the level of variation attributable to hospital factors. High AKI centres (HACs) were defined as those within the highest decile of estimated AKI rate. The association between HAC status, in-hospital mortality, perioperative complications, length of stay, and hospitalization costs also were analyzed.</div></div><div><h3>Results</h3><div>Of 1,324,083 hospitalizations across an annual average of 703 centres, 4.9% of patients received their operation at an HAC (annual average of 70 centres). Compared to non-HACs, HACs had a lower annual cardiac case volume (62 [interquartile range: 40-115] vs 145 [interquartile range: 80-265] cases; <em>P</em> &lt; 0.001) and served a larger proportion of non-White patients (20.0% vs 15.1%; <em>P</em> &lt; 0.001). After adjustment, HAC was associated with increased odds of respiratory complications (adjusted odds ratio [AOR] 1.72, 95% confidence interval [CI] 1.57-1.90), infectious complications (AOR 1.57, 95% CI 1.40-1.76), and cardiac complications (AOR 1.27, 95% CI 1.18-1.36). Additionally, HAC was associated with an incremental increase in hospitalization costs (β coefficient +$4151, 95% CI $2305-$5997).</div></div><div><h3>Conclusions</h3><div>We demonstrated significant hospital-level variation in perioperative AKI. HACs were associated with inferior clinical outcomes and higher levels of resource utilization.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 6","pages":"Pages 759-767"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PET Imaging of Cardiac SNS Function with [18F]mFBG in Heart Failure Models","authors":"E.L. Hoddinott,&nbsp;U.S. Ismailani,&nbsp;B.H. Rotstein","doi":"10.1016/j.cjco.2025.04.023","DOIUrl":"10.1016/j.cjco.2025.04.023","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 6","pages":"Page S3"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Women’s Involvement in Cardiac Rehabilitation: Women in the Heart of Recovery","authors":"J. Harris,&nbsp;K. Wolf,&nbsp;C.D. O’Neill,&nbsp;G. Davies","doi":"10.1016/j.cjco.2025.04.049","DOIUrl":"10.1016/j.cjco.2025.04.049","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 6","pages":"Page S12"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender, Alterations in Social Connections, and Changes in Healthy Eating: A Prospective Study of Aging Canadians","authors":"S. Mehranafar,&nbsp;G. Ceolin,&nbsp;R. Madani Civi,&nbsp;A.I. Conklin","doi":"10.1016/j.cjco.2025.04.071","DOIUrl":"10.1016/j.cjco.2025.04.071","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 6","pages":"Pages S20-S21"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing Trends of Hospital Discharge Medications for Secondary Prevention in Patients With Myocardial Infarction With Nonobstructive Coronary Arteries (MINOCA)","authors":"J. Chai,&nbsp;E. Théberge,&nbsp;T. Sedlak","doi":"10.1016/j.cjco.2025.04.037","DOIUrl":"10.1016/j.cjco.2025.04.037","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 6","pages":"Page S8"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceleration Postpartum (ACCEL-PP): A Pilot Feasibility Study","authors":"L. Cotie,&nbsp;C. Pollock,&nbsp;S. Gundy,&nbsp;K. Nerenberg,&nbsp;G. Smith,&nbsp;P. Oh,&nbsp;T.J.F. Colella","doi":"10.1016/j.cjco.2025.04.038","DOIUrl":"10.1016/j.cjco.2025.04.038","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 6","pages":"Page S8"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}