Journal of the American Heart Association最新文献

{"title":"Neutrophil Extracellular Traps and Delayed Cerebral Ischemia in Patients With Subarachnoid Hemorrhage.","authors":"Hauke Schneider, Diana Münch, Valérie Spalart, Mathias Stroobants, Ansgar Berlis, Christoph J Maurer, Ulrich Jaschinski, Scott E Kasner, Quy Cao, Kimberly Martinod, Jens Witsch","doi":"10.1161/JAHA.124.041325","DOIUrl":"10.1161/JAHA.124.041325","url":null,"abstract":"<p><strong>Background: </strong>Delayed cerebral ischemia (DCI) after spontaneous subarachnoid hemorrhage (SAH) is not well understood. Recent studies suggest the involvement of neutrophil-mediated immunothrombosis via neutrophil extracellular traps (NETs). We aimed to assess whether trajectories of NET biomarkers in patients with acute SAH are associated with DCI.</p><p><strong>Methods: </strong>This was a prospective single-center study of patients within 48 hours of SAH onset. We collected clinical, laboratory, imaging, and 3-month outcome data. NET markers (H3Cit [citrullinated histone H3]-DNA complexes, myeloperoxidase-DNA complexes, cell-free DNA), along with peptidylarginine deiminase 4, and deoxyribonuclease activity were measured in plasma collected on admission (baseline), and post-SAH days 5 and 10. DCI was defined by clinical and imaging criteria. Generalized estimating equations examined differences in NET trajectories comparing patients with and without DCI.</p><p><strong>Results: </strong>We enrolled 40 patients with SAH (mean age, 57 years; n=21 [53%] women; 32 [80%] aneurysmal). DCI occurred in 12 (30%) patients. All NET levels were similar between groups at baseline. On day 5, those with DCI compared with those without DCI had elevated median H3Cit-DNA complex (63 ng/mL versus 31 ng/mL, <i>P</i>=0.049), myeloperoxidase-DNA complex (5.9 ng/mL versus 0.4 ng/mL, <i>P</i>=0.029), and cell-free DNA (651 ng/mL versus 515 ng/mL, <i>P</i>=0.04) levels, which trended back down on day 10. In the DCI group, generalized estimating equations indicated heightened trajectories of H3Cit-DNA complex (day 5 [compared with baseline]: β=0.7; SE, 0.3; <i>P</i>=0.01; day 10: β=0.5; SE, 0.3; <i>P</i>=0.09), and myeloperoxidase-DNA complex levels (day 5: β=3.1; SE, 0.4; <i>P</i><0.001; day 10: β=1.6; SE, 1.0; <i>P</i>=0.10).</p><p><strong>Conclusions: </strong>In patients with acute SAH, elevated plasma trajectories of NETs are associated with DCI.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e041325"},"PeriodicalIF":5.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Estimated Physical Activity Patterns From Youth to Middle Age and Left Ventricular Structure and Function: A 30-Year Longitudinal Study.","authors":"Shunyi Li, Jianpin Luo, Shen Zhao, Haobin Zhou, Rongyang Xi, Jun Chen, Shichao Li, Kaiwei Li, Lin Song, Xiaolin Duan, Minhui Xu, Dingli Xu, Qingchun Zeng","doi":"10.1161/JAHA.125.041256","DOIUrl":"10.1161/JAHA.125.041256","url":null,"abstract":"<p><strong>Background: </strong>The long-term effects of physical activity (PA) variability and cumulative PA (CPA) from young adulthood on cardiac remodeling remain controversial, and it is unclear whether these effects resemble those observed in elite athletes.</p><p><strong>Methods: </strong>A total of 1465 participants with recorded PA spanning a 30-year period were included in this study. PA levels were assessed at 9 follow-up visits using the CARDIA (Coronary Artery Risk Development in Young Adults) questionnaire. At year 30, left ventricular structure and function were evaluated using standardized echocardiography. CPA was calculated as the sum of average PA levels between consecutive visits multiplied by the corresponding intervisit intervals (in years). PA variability was quantified using average real variability (ARVPA). Additionally, participants were categorized into 4 groups: sustained low CPA and ARVPA group, low CPA and high ARVPA group, high CPA and low ARVPA group, and high CPA and high ARVPA group.</p><p><strong>Results: </strong>This study included 849 women (57.1%), 883 White participants (60.3%), and had a mean age of 55.3 years. Participants in the sustained high CPA group exhibited lower incidence of hypertension and diabetes. Multiple linear regression analyses showed that, compared with the sustained-low-CPA group, the sustained-high-CPA group and high-CPA and high-ARVPA group exhibited increased left ventricular end-diastolic dimension index, and the high-CPA and high-ARVPA group revealed an increased left ventricular mass index and left atrial volume index.</p><p><strong>Conclusions: </strong>Our study suggests that high CPA, even when accompanied with high variability in PA levels, is associated with alterations in left ventricular structure in midlife.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e041256"},"PeriodicalIF":5.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Phenylacetylglutamine and Cognitive Impairment After Ischemic Stroke.","authors":"Jiawen Fei, Xinyue Chang, Wenjing Yang, Yu He, Yi Liu, Mengyao Shi, Yang Liu, Xiaoxiao Wang, Hao Peng, Xiaoqing Bu, Tan Xu, Aili Wang, Tian Xu, Yonghong Zhang, Zhengbao Zhu","doi":"10.1161/JAHA.125.042955","DOIUrl":"10.1161/JAHA.125.042955","url":null,"abstract":"<p><strong>Background: </strong>Phenylacetylglutamine was reported to be associated with ischemic stroke and cognitive performance, but its association with poststroke cognitive impairment (PSCI) remained unclear. We aimed to prospectively investigate the association between plasma phenylacetylglutamine levels and PSCI at 3 months in a multicenter cohort study.</p><p><strong>Methods: </strong>A total of 617 patients with ischemic stroke were included on the basis of a preplanned ancillary study from CATIS (China Antihypertensive Trial in Acute Ischemic Stroke). PSCI was evaluated using the Mini-Mental State Examination scale and Montreal Cognitive Assessment scale. Logistic regression analyses were performed to evaluate the association between plasma phenylacetylglutamine and the risk of 3-month PSCI.</p><p><strong>Results: </strong>According to the Mini-Mental State Examination score, a total of 376 participants developed PSCI at 3 months. After adjustment for age, sex, education, and other important risk factors, the multivariable-adjusted odds ratio of PSCI for the highest tertile of phenylacetylglutamine was 2.16 (95% CI, 1.32-3.54; <i>P</i>_trend=0.002) compared with the lowest tertile. A multiple-adjusted spline regression model showed a positive linear association of plasma phenylacetylglutamine levels with PSCI at 3 months (<i>P</i> for linearity<0.001). Adding plasma phenylacetylglutamine to conventional risk factors significantly improved the risk reclassification of PSCI (net reclassification improvement: 21.35%, <i>P</i>=0.019; integrated discrimination index: 1.78%, <i>P</i>=0.003). Similar significant findings were observed when PSCI was defined by the Montreal Cognitive Assessment score.</p><p><strong>Conclusions: </strong>High plasma phenylacetylglutamine levels were associated with increased odds of PSCI at 3 months, suggesting that plasma phenylacetylglutamine might be a potential predictive biomarker for PSCI among patients with ischemic stroke.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e042955"},"PeriodicalIF":5.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residential Racial Segregation, Socioeconomic Status, and Hypertension Risk in Black and White Americans: The REGARDS Prospective Cohort Study.","authors":"Debora Kamin Mukaz, Andrew D Sparks, Timothy B Plante, Suzanne E Judd, George Howard, Virginia J Howard, Loni P Tabb, Lorraine T Dean, Mary Cushman","doi":"10.1161/JAHA.125.041339","DOIUrl":"10.1161/JAHA.125.041339","url":null,"abstract":"<p><strong>Background: </strong>Black adults experience the highest hypertension burden of any racial group. It is unclear whether different dimensions of residential segregation have different relationships with hypertension risk for Black and White people, or whether socioeconomic status explains any of the relationships.</p><p><strong>Methods: </strong>We studied 6787 Black and White participants from the REGARDS (Reasons for Geographic And Racial Differences in Stroke) study, without prevalent hypertension and with follow-up for hypertension 9.4 years later. County-level segregation was defined using dissimilarity, isolation, and interaction indices. Associations between residential segregation indices and incident hypertension were estimated. Racial differences in associations and mediating effects of socioeconomic factors were assessed.</p><p><strong>Results: </strong>Risk ratios (RRs) of incident hypertension were 1.06 per SD higher isolation index (95% CI, 1.03-1.09) and 0.96 per SD higher interaction index (95% CI, 0.93-0.99). The dissimilarity index was not associated with hypertension risk. Neighborhood socioeconomic status explained 19% of the association between the isolation index and hypertension incidence. Although there were no statistically significant racial differences in associations, the isolation index was marginally associated with higher risk of hypertension in Black people only (RR, 1.05 [95% CI, 0.98-1.12]), and neighborhood socioeconomic status was a marginally significant mediator of that association (RR indirect effects, 0.993 [95% CI, 0.98-1.0004]).</p><p><strong>Conclusions: </strong>Findings indicated that living in racially segregated counties was associated with higher risk of hypertension, particularly for Black people. Higher neighborhood socioeconomic status may mitigate the negative effects of that aspect of residential segregation on hypertension development.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e041339"},"PeriodicalIF":5.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitators and Barriers to Uptake of Remote Cardiac Monitoring in a Rural Setting: A Qualitative Analysis.","authors":"Emily P Zeitler, Jennifer Wenner, Laura Bernstein, Mark A Creager, Karen E Schifferdecker","doi":"10.1161/JAHA.125.042303","DOIUrl":"10.1161/JAHA.125.042303","url":null,"abstract":"<p><strong>Background: </strong>When part of a comprehensive cardiac implantable electronic device care program, remote monitoring (RM) is an effective strategy for maximizing clinical and patient satisfaction outcomes. In rural settings, however, there are multilevel influences that could simultaneously make RM care less attainable. We sought to identify facilitators and barriers to effective RM as part of a cardiac implantable electronic device care program in rural areas.</p><p><strong>Methods: </strong>Using a qualitative study design, semistructured interviews were conducted of patients with a cardiac implantable electronic device and physicians who treat these patients in rural New England inclusive of primary care doctors, cardiologists, and cardiac electrophysiologists. Data were analyzed using a mixed deductive and inductive approach to identify themes related to barriers and facilitators to RM.</p><p><strong>Results: </strong>The final group of patient interviewees (n=23) included a combination of those who do and do not participate in RM (n=14 and n=9, respectively). There was a total of 15 physician interviewees. Analysis resulted in 5 patient themes and 4 physician themes. Overall, there was general satisfaction with RM. Facilitators included ease of integration, adequate initial education, and clear communication. Barriers included resource constraints, incomplete communication, and inadequate ongoing education.</p><p><strong>Conclusions: </strong>This qualitative study of patients and physicians in rural New England identified facilitators and barriers to effective RM. Optimizing RM education, infrastructure, and staffing at local and national levels, including through policy changes, may have important and relevant applications beyond cardiac implantable electronic device care, including other emerging areas of digital health.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e042303"},"PeriodicalIF":5.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¹⁸F-FAPI-74 Positron Emission Tomography/Computed Tomography Noninvasively Monitoring the Fibrosis of Cardiac Allograft Vasculopathy.","authors":"Huiling Li, Yufei Wei, Zhuoqi Qin, Qiyao Cheng, Yu Hong, Huibin Ru, Tingrui Song, Li Li, Xinzhong Hao, Jianhua Jin, Yan Cheng, Zhifang Wu, Sijin Li","doi":"10.1161/JAHA.125.041169","DOIUrl":"10.1161/JAHA.125.041169","url":null,"abstract":"<p><strong>Background: </strong>Cardiac allograft vasculopathy (CAV) is the primary cause of limited long-term survival among heart transplant recipients. This study aimed to evaluate the feasibility of ¹⁸F-FAPI-74 positron emission tomography/computed tomography (PET/CT) imaging for monitoring the fibrosis of CAV.</p><p><strong>Methods: </strong>Rat models of CAV were established and 1 hour dynamic PET/CT imaging was performed in the 15th week postoperation. Serial static ¹⁸F-FAPI-74 PET/CT imaging in the allograft and isograft groups were performed from week 3 to 17. Blocking experiments were performed on allograft rats to confirm the tracer's targeting specificity. In vivo PET/CT imaging findings were further corroborated by ex vivo PET/CT imaging and biodistribution studies. Histological examination was conducted to validate the model's effectiveness, and the correlation between FAP expression levels and imaging results was ascertained.</p><p><strong>Results: </strong>Dynamic PET/CT imaging revealed peak graft heart (Ht) uptake in the allograft group at 60 minutes post ¹⁸F-FAPI-74 injection. PET/CT imaging and biodistribution studies at all time points confirmed significantly higher radioactivity uptake in Ht of the allograft group, as compared with both their native hearts and Ht of the isograft group, and peaking at week 15. There was almost no radioactive accumulation of Ht in the allograft rats blocked by FAPI. Histological analysis confirmed significantly elevated FAP expression in Ht of the allograft group compared with the isograft group, consistent with the severity of CAV.</p><p><strong>Conclusions: </strong>We successfully achieved molecular imaging of activated fibroblasts in CAV rat models, indicating that ¹⁸F-FAPI-74 PET/CT may be a valuable means of evaluating fibrosis progression of CAV.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e041169"},"PeriodicalIF":5.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lactylation in Cardiovascular Diseases: Current Progress and Perspectives.","authors":"Zhi-Mo Wang, Qing-Wen Yu, Cong Wang, Shu-Hui Wang, Pei Wang, Li-Rong Zhang, Sheng-Na Han","doi":"10.1161/JAHA.125.043801","DOIUrl":"10.1161/JAHA.125.043801","url":null,"abstract":"<p><p>Emerging evidence suggests that epigenetic modifications, including lactylation-a recently identified posttranslational modification-may play a role in cardiovascular diseases (CVDs). Lactylation occurs in both histone and nonhistone proteins and has been implicated in processes, such as inflammation, lipid metabolism, and angiogenesis, which are relevant to CVD pathogenesis. However, the mechanistic links between lactylation and CVDs remain poorly understood, with most supporting evidence derived from preclinical studies. This review summarizes the current knowledge on lactylation, including its regulatory enzymes and potential functional roles in CVDs. While preliminary, these insights may inform future research directions for therapeutic strategies, early diagnostics, and disease prevention. Further validation in clinical studies is needed to establish the significance of lactylation in CVDs.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e043801"},"PeriodicalIF":5.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiomics Analysis of Skeletal Muscle Identifies Dysregulation of Hypoxia-Induced Genes in Peripheral Artery Disease.","authors":"Ahmed Ismaeel, Emma Fletcher, Evlampia Papoutsi, Nicholas T Thomas, William T Bohannon, Iraklis I Pipinos, Yuan Wen, Dimitrios Miserlis, Panagiotis Koutakis","doi":"10.1161/JAHA.125.042350","DOIUrl":"10.1161/JAHA.125.042350","url":null,"abstract":"<p><strong>Background: </strong>Epigenetic modifications such as DNA methylation play a critical role in hypoxic cell programs. However, no previous studies have investigated the epigenetic regulation of gene expression in peripheral artery disease (PAD), a condition characterized by intermittent ischemia. Our study aims to examine how PAD affects the DNA methylome in skeletal muscle of patients with PAD with intermittent claudication or critical limb ischemia compared with non-PAD controls.</p><p><strong>Methods: </strong>This was a cross-sectional study evaluating differences in the DNA methylome and transcriptome using reduced representation bisulfite sequencing, and small and bulk RNA sequencing, in skeletal muscle from non-PAD controls, intermittent claudication, and critical limb ischemia. We also assessed changes in DNA methylation and gene expression by comparing patients with intermittent claudication at baseline and 6 months following revascularization operation.</p><p><strong>Results: </strong>The multiomics approach identified hypoxia-related genes in PAD skeletal muscle that are potentially regulated at the level of methylation. Specifically, binding and expression target analysis revealed that epigenetic modifications to the DNA methylome may contribute to modulation of the mRNA expression of family with sequence similarity 20, member C and endothelial PAS domain-containing protein 1, also known as hypoxia-inducible factor-2α. Furthermore, the AP-1 (activator protein-1) early response transcription factors <i>FOS</i> and <i>FOSB</i> emerged as the primary genes that may be influenced by revascularization operations.</p><p><strong>Conclusions: </strong>Our findings identify novel hypoxia-related genes potentially regulated by DNA methylation in PAD skeletal muscle.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e042350"},"PeriodicalIF":5.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Observations in Patients With Obstructive Hypertrophic Cardiomyopathy Treated With Mavacamten: Evidence of Favorable Disease Modification.","authors":"Milind Y Desai, Andrew Gaballa, Yuichiro Okushi, Mohammed Abusafia, Shada Jadam, Katy Rutkowski, Susan Ospina, Sanaa Sultana, Maran Thamilarasan, Craig Asher, Zoran B Popovic, Bo Xu","doi":"10.1161/JAHA.125.044537","DOIUrl":"10.1161/JAHA.125.044537","url":null,"abstract":"<p><strong>Background: </strong>Mavacamten is commercially approved for use in symptomatic patients with obstructive hypertrophic cardiomyopathy. This study evaluated its real-world impact on symptoms, echocardiographic changes, and the need for septal reduction therapy in patients with obstructive hypertrophic cardiomyopathy treated at a multihospital referral center.</p><p><strong>Methods: </strong>We included 244 patients with obstructive hypertrophic cardiomyopathy (mean age, 64 years; 57% women, 21% with atrial fibrillation, 51% New York Heart Association class III, 82% on β-blockers) treated with mavacamten for ≥3 months (171 for ≥12 months). Serial clinical and echocardiographic assessments were performed.</p><p><strong>Results: </strong>New York Heart Association class distribution improved over time: at 3 months 21% class I, 61% class II, and 18% class III; at 12 months 36% class I, 57% class II, and 8% class III. After a mean of 1.02 years, significant improvements were observed in resting and post-Valsalva left ventricular outflow tract gradients (-31±33 and -57±46 mm Hg), interventricular septal thickness (-1.7±4 mm), left ventricular mass index (-9.5±32 g/m²), left atrial volume index (-12±13 mL/m²), E/e' (-5.5±6.4), left ventricular global longitudinal strain (1.04%±3.1%), and various left atrial and right ventricular strain measures (all <i>P</i><0.05). Temporary interruption occurred in 8 patients (3.2%), and 3 (1.2%) discontinued mavacamten permanently. There were 2 noncardiac deaths, 7 heart failure admissions, 14 cases of new-onset atrial fibrillation, and 1 patient required septal reduction therapy. At the last visit, most patients were on 5 mg (49%) or 10 mg (26%) mavacamten.</p><p><strong>Conclusions: </strong>In this real-world cohort, mavacamten treatment was associated with sustained symptomatic and echocardiographic improvements, suggesting a favorable disease-modifying impact with minimal need for septal reduction therapy.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e044537"},"PeriodicalIF":5.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stroke Caregiver Needs in a Population-Based Study.","authors":"Roshanak Mehdipanah, Lewis B Morgenstern, Madeline Kwicklis, Melinda A Smith, Erin Case, Lynda D Lisabeth","doi":"10.1161/JAHA.124.038434","DOIUrl":"10.1161/JAHA.124.038434","url":null,"abstract":"<p><strong>Background: </strong>Most individuals who have experienced a stroke require comprehensive rehabilitation beyond initial medical care, with informal, unpaid caregivers playing a crucial role in aiding recovery and daily activities. Caregivers face significant burdens due to unmet care needs of their care recipients. This study examines the community needs of individuals who have experienced a stroke and their caregivers, while also exploring their awareness and use of existing services in Nueces County, Texas.</p><p><strong>Methods: </strong>The study used concept mapping and interviews. Concept mapping, a mixed-method approach, collected qualitative input on perceived needs by a subsample of caregivers from the parent study. Participants then sorted and rated perceived needs. Using this information, multidimensional scaling and cluster analyses mapped relationships between perceived needs and determined their importance and priority. Interviews were completed with all caregivers in the parent study. Responses were analyzed for ethnic differences when possible.</p><p><strong>Results: </strong>The following 5 clusters were derived from the concept mapping (N=16), listed in order of highest ratings of importance: medical care needs, financial and legal resource needs, caregiver support needs, daily care needs, and housing and transportation needs. Interview findings (N=228) showed that both Mexican American (n=168) and non-Hispanic White (n=60) caregivers had low awareness and use rates for services like caregiver support and senior centers, with significant ethnic disparities in stroke information awareness that disappeared upon adjustment.</p><p><strong>Conclusions: </strong>By understanding the needs of caregivers and individuals affected by stroke, we can better support caregivers in managing the condition and help them thrive in this role.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e038434"},"PeriodicalIF":5.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}