Heart & Lung最新文献

{"title":"Positive end-expiratory pressure optimization with esophageal pressure during prone position in severe acute respiratory distress syndrome: a physiologic study.","authors":"Laure Crognier, Arthur Villain-Amirat, Jean-Marie Conil, Baptiste Compagnon, Emilie Chambon, Adam Tuijnman, Michaël Poëtte, Juliette Joseph, Stéphanie Ruiz, Vincent Minville, Fanny Vardon","doi":"10.1016/j.hrtlng.2025.07.020","DOIUrl":"10.1016/j.hrtlng.2025.07.020","url":null,"abstract":"<p><strong>Background: </strong>Protective ventilation [tidal volume at 6 ml/kg of predicted body weight, plateau pressure ≤ 30 cm H₂O, optimal positive end expiratory pressure (PEEP)] and prone position (PP) improved survival in acute respiratory distress syndrome (ARDS), PEEP improves alveolar recruitment but may generate overdistension, requiring specific monitoring. Esophageal pressure is used to estimate pleural pressure and to calculate the transpulmonary pressures. There are few data on PEEP variations and optimization during PP.</p><p><strong>Objectives: </strong>To describe PEEP evolution through transpulmonary pressure monitoring during PP in severe ARDS patients.</p><p><strong>Methods: </strong>Prospective observational study in severe ARDS needing prone positioning. An esophageal pressure catheter was placed in every patient to monitor transpulmonary pressure. The targets were an end-expiratory transpulmonary pressure (PLEE) between 0 and 2 cmH₂O and an end-inspiratory transpulmonary pressure (PLEI) < 25 cmH₂O. We described the evolution of ventilator parameters during PP.</p><p><strong>Results: </strong>We included 35 patients with severe ARDS requiring prone positioning. Optimized PEEP decreased significantly during PP in the first eight hours then stabilized. We found significant interindividual variations. The transpulmonary pressures objectives were reached. PLEE measured before PEEP modification decreased significantly at H + 8.</p><p><strong>Conclusion: </strong>Our study shows that optimized PEEP during PP varies mainly within the first 8 h. Monitoring transpulmonary pressures through an esophageal catheter throughout a PP session allows for PEEP optimization and ensures maximum recruitment and minimal overdistension.</p><p><strong>Trial registration: </strong>RC 31/21/0514 - no 2021-A02752-39.</p>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"260-265"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818354","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":"Perioperative antifibrotic therapy for patients with idiopathic pulmonary fibrosis undergoing lung cancer surgery: A systematic review and meta-analysis.","authors":"Narat Srivali, Federica De Giacomi, Teng Moua, Jay H Ryu","doi":"10.1016/j.hrtlng.2025.08.002","DOIUrl":"10.1016/j.hrtlng.2025.08.002","url":null,"abstract":"<p><strong>Background: </strong>Patients with idiopathic pulmonary fibrosis (IPF) undergoing lung cancer surgery face a 4.4-20 % risk of acute exacerbation (AE-IPF) with mortality exceeding 50 %. The potential role of perioperative antifibrotic therapy in reducing surgical complications in this high-risk population remains unclear.</p><p><strong>Objectives: </strong>To evaluate whether perioperative antifibrotic therapy (pirfenidone/nintedanib) reduces complications, particularly acute exacerbations and mortality, in IPF patients undergoing lung cancer surgery through systematic review and meta-analysis.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we conducted a systematic review and meta-analysis of observational studies examining perioperative antifibrotic therapy in IPF patients undergoing lung cancer surgery. Four studies comprising 261 patients (124 treated, 137 controls) from Japan and Italy (2016-2024) were analyzed. Pooled risk ratios were calculated using Review Manager 5.4. The study protocol was registered with PROSPERO (ID: CRD42025649005).</p><p><strong>Results: </strong>Perioperative antifibrotic therapy achieved a 69 % reduction in AE-IPF risk (RR 0.31, 95 % CI 0.13-0.70) and an 81 % reduction in 90-day mortality (RR 0.19, 95 % CI 0.07-0.52). Additional benefits included significantly shorter hospital stays (5 vs 7 days, p = 0.029) and reduced complications, including decreased prolonged air leak rates (3.4 % vs 26.9 %). Adverse events were minimal, consisting primarily of mild nausea and photosensitivity.</p><p><strong>Conclusions: </strong>Perioperative antifibrotic therapy significantly reduces acute exacerbations and mortality in IPF patients undergoing lung cancer surgery. However, findings are limited by small observational studies concentrated in specific geographic regions. Randomized controlled trials are needed to confirm efficacy and establish standardized treatment protocols.</p>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"266-275"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823268","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":"Repurposing sodium glucose cotransporter-2 (SGLT-2) inhibitors in sarcoidosis: A potential strategy for reducing mortality.","authors":"A B M Nasibul Alam, Natasha Gill, Isabella Han, Reina Nagasaka, Wenting Hu, Laeeq Shamsuddin","doi":"10.1016/j.hrtlng.2025.10.001","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2025.10.001","url":null,"abstract":"<p><strong>Introduction: </strong>The renin-angiotensin-aldosterone system (RAAS) plays a key role in sarcoidosis pathogenesis. A recent study suggests that ACE inhibitors may worsen outcomes in sarcoidosis, whereas ARBs may be more beneficial. SGLT2 inhibitors modulate RAAS activity and have anti-inflammatory properties, making them a potential therapeutic option in this population.</p><p><strong>Objectives: </strong>To evaluate whether the addition of SGLT2 inhibitors to ARB therapy improves long-term survival outcomes in patients with sarcoidosis.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed adults diagnosed with sarcoidosis from the TrinetX database between 2015 and 2025. Patients receiving ARBs with or without SGLT2 inhibitors were compared following propensity score matching for demographics, comorbidities, and concurrent immunosuppressive therapies.</p><p><strong>Results: </strong>Patients receiving both ARBs and SGLT2 inhibitors had lower all-cause mortality over five years compared to those on ARBs alone. No significant differences were observed in secondary outcomes such as sepsis, respiratory failure, cardiovascular events, or renal complications.</p><p><strong>Conclusion: </strong>In patients with sarcoidosis treated with ARBs, the addition of SGLT2 inhibitors was associated with improved long-term survival. These findings support further investigation into the role of SGLT2 inhibitors as adjunctive therapy in sarcoidosis.</p>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"198-204"},"PeriodicalIF":2.6,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281809","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":"Transcatheter versus surgical treatment in aortic stenosis with coronary artery disease: A meta-analysis of time-to-event data on 162,305 patients","authors":"Ahmed Emara MD ,&nbsp;Mohamed Emara MD ,&nbsp;Ahmed Farid Gadelmawla MD ,&nbsp;Mohamed R. Murad MD ,&nbsp;Heba Aboeldahab PharmD ,&nbsp;Mohamed S. Elgendy MBBCh ,&nbsp;Mohamed Sabri Hassanin MD ,&nbsp;Mohamed A. Aldemerdash MD ,&nbsp;Ali M. Othman MD ,&nbsp;Mohamed Khaled MBBCh ,&nbsp;Abdalhakim Shubietah MD ,&nbsp;Abdalrahman Assaassa MD ,&nbsp;Vinayak N. Bapat MDMS","doi":"10.1016/j.hrtlng.2025.09.018","DOIUrl":"10.1016/j.hrtlng.2025.09.018","url":null,"abstract":"<div><h3>Background</h3><div>Severe aortic stenosis (AS) often coexists with coronary artery disease (CAD), present in about 50 % of patients undergoing valve intervention. Surgical aortic valve replacement (SAVR) with coronary artery bypass graft (CABG) has been the traditional standard, providing revascularization and durability, whereas transcatheter aortic valve replacement (TAVR) with percutaneous coronary intervention (PCI) offers a less invasive option. PCI + TAVR may lower perioperative risk, but SAVR + CABG may confer superior survival, with conflicting evidence.</div></div><div><h3>Objectives</h3><div>This meta-analysis of time-to-event data aimed to compare PCI + TAVR with CABG + SAVR in patients with concomitant AS and CAD.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Web of Science, Scopus, and Cochrane databases up to March 2025. Individual patient data (IPD) were reconstructed from published Kaplan–Meier curves to estimate hazard ratios (HRs) for all-cause mortality. Dichotomous outcomes were analyzed using risk ratios (RR) with 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>Fifteen studies including 162,305 patients were analyzed. PCI + TAVR was associated with higher all-cause mortality at 48 months (HR 1.29, 95 % CI 1.23–1.35, <em>p</em> &lt; 0.001), but lower in-hospital acute kidney injury (RR 0.37, 95 % CI 0.21–0.66, <em>p</em> = 0.0007), short-term (≤30 days) major adverse cardiovascular events (RR 0.67, 95 % CI 0.50–0.91, <em>p</em> = 0.0093), and new-onset atrial fibrillation (RR 0.23, 95 % CI 0.17–0.32, <em>p</em> &lt; 0.0001). Conversely, long-term (&gt;30 days) myocardial infarction risk was higher (RR 1.61, 95 % CI 1.08–2.39, <em>p</em> = 0.01).</div></div><div><h3>Conclusions</h3><div>PCI+TAVR was associated with higher mortality or adverse event rates compared to CABG+SAVR, but lower perioperative complications. High-quality randomized trials are warranted to confirm these findings.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 184-197"},"PeriodicalIF":2.6,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260235","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":"Impact of rhBNP and ivabradine on outcomes, cardiac markers, and microcirculation in ischemic heart failure","authors":"Liqin Zhang,&nbsp;Zhenhua Jiang,&nbsp;Hailiang Ma,&nbsp;Liang Dong,&nbsp;Shifen Feng,&nbsp;Jin Xu,&nbsp;Jie Chen","doi":"10.1016/j.hrtlng.2025.09.020","DOIUrl":"10.1016/j.hrtlng.2025.09.020","url":null,"abstract":"<div><h3>Background</h3><div>Ischemic cardiomyopathy (ICM) with heart failure (HF) is characterized by myocardial hypoxia, microcirculation dysfunction, and neuroendocrine activation. While ivabradine and recombinant human brain natriuretic peptide (rhBNP) are individually used for HF, their combined efficacy remains underexplored.</div></div><div><h3>Objective</h3><div>To evaluate the effects of rhBNP combined with ivabradine on cardiac function, myocardial microcirculation, endocrine hormones, and biomarkers (CysC, Gal-3, miR-19a) in ICM-HF patients.</div></div><div><h3>Methods</h3><div>In this prospective study, 126 ICM-HF patients were randomized 1:1 to either ivabradine alone (control) or rhBNP + ivabradine (intervention). Both groups received conventional therapy. Cardiac function (LVEF, LVESD, LVEDD), microcirculation parameters (ischemic burden, ST-segment shift), serum hormones (ALD, NE, Ang II), and biomarkers were assessed at baseline and after 1 month.</div></div><div><h3>Results</h3><div>The intervention group showed higher total efficacy (93.65%¦vs. 76.19%, P&lt;0.05), improved LVEF (51.76%¦vs. 46.68%), and reduced ventricular volumes (LVESD: 34.75 vs. 40.47 mm; P&lt;0.05). Myocardial microcirculation parameters (ischemic burden, time, frequency) and neuroendocrine levels (ALD: 38.31 vs. 65.02 ng/L; NE: 102.39 vs. 180.23 ng/L; P&lt;0.05) were significantly lower. Serum CysC, Gal-3, and miR-19a levels also decreased more prominently (P&lt;0.05). Adverse reactions were comparable (11.11%¦vs. 7.94%, P&gt;0.05).</div></div><div><h3>Conclusion</h3><div>rhBNP combined with ivabradine synergistically improves cardiac function, myocardial microcirculation, and neuroendocrine regulation in ICM-HF patients, with superior efficacy and safety.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 178-183"},"PeriodicalIF":2.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245770","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":"Blood urea nitrogen-to-left ventricular ejection fraction ratio as a prognostic indicator in non-ST-elevation myocardial infarction: Clinical utility as a mortality marker","authors":"Serdar Özdemir,&nbsp;İbrahim Altunok","doi":"10.1016/j.hrtlng.2025.09.019","DOIUrl":"10.1016/j.hrtlng.2025.09.019","url":null,"abstract":"<div><h3>Background</h3><div>Non-ST-elevation myocardial infarction (NSTEMI) accounts for the majority of acute coronary syndromes, and accurate early risk stratification is essential for guiding clinical management. Traditional scoring systems are complex and may not be feasible in emergency settings. The blood urea nitrogen-to-left ventricular ejection fraction ratio (BUN/LVEF) has recently been proposed as a simple biomarker reflecting the interaction between cardiac and renal function.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the prognostic value of BUN/LVEF in predicting 30-day all-cause mortality in patients with NSTEMI.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational study including 222 patients diagnosed with NSTEMI who presented to the emergency department of a tertiary university hospital between April 2024 and April 2025. Demographic, clinical, laboratory, and echocardiographic data were collected from hospital records. BUN/LVEF was calculated as BUN (mg/dL)/LVEF (%). Receiver operating characteristic (ROC) analysis was used to assess predictive performance.</div></div><div><h3>Results</h3><div>The median age was 61 years, and 70.3 % were male. The 30-day mortality rate was 13 %. Non-survivors had significantly higher BUN/LVEF compared with survivors (1.48 vs 0.64, <em>p</em> &lt; 0.001). ROC analysis revealed that BUN/LVEF had an AUC of 0.802 for predicting mortality. A cutoff value of 1.465 provided 93.3 % sensitivity, 51.7 % specificity, and 87.8 % overall diagnostic accuracy.</div></div><div><h3>Conclusion</h3><div>BUN/LVEF is a simple, accessible, and independent predictor of short-term mortality in NSTEMI patients. Its ease of calculation and strong prognostic performance suggest potential clinical utility as a rapid risk stratification tool in emergency practice.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 171-177"},"PeriodicalIF":2.6,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234254","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":"Asthma-chronic obstructive pulmonary disease overlap is associated with a higher degree of neuromuscular junction degradation than either disease alone","authors":"Rizwan Qaisar ,&nbsp;Imran Ullah Khan ,&nbsp;Firdos Ahmad ,&nbsp;Asima Karim","doi":"10.1016/j.hrtlng.2025.09.022","DOIUrl":"10.1016/j.hrtlng.2025.09.022","url":null,"abstract":"<div><h3>Background</h3><div>Patients with asthma, chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap (ACO) exhibit an advanced form of age-related decline of skeletal muscle and physical performance, termed sarcopenia. However, the relative contribution of neuromuscular junction (NMJ) degradation to sarcopenia in these patients remains partly elusive.</div></div><div><h3>Methods</h3><div>We recruited older men, including controls (n=68) and patients with asthma (n=61), COPD (n=74), and ACO (n=53), to measure handgrip strength (HGS), skeletal muscle mass index (SMI), gait speed (GS), and a short physical performance battery (SPPB). We also measured plasma C-terminal agrin-fragment-22 (CAF22; a marker of NMJ degradation) and neurofilament light-chain (NfL; a marker of neurodegeneration) in the study population.</div></div><div><h3>Results</h3><div>Patients with asthma, COPD, and ACO had lower HGS, SMI, GS, and SPPB scores and higher CAF22 levels than controls (all p&lt;0.05). Among individual diseases, ACO was associated with the lowest HGS and SPPB scores and highest CAF22 levels (all p&lt;0.05). We also observed significant correlations of CAF22 with HGS, GS, and SPPB in patients with asthma, COPD, and ACO (all p&lt;0.05). Lastly, CAF22 exhibited significant efficacy in diagnosing sarcopenia in all three diseases, with the highest AUC reported in ACO patients (all p&lt;0.05).</div></div><div><h3>Conclusion</h3><div>Altogether, we report a higher degree of sarcopenia and physical compromise with elevation of NMJ degradation biomarkers in patients with ACO than those with either disease alone. Our findings suggest NMJ as a therapeutic target to restore muscle health and functional capacity in patients with chronic airway diseases.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 164-170"},"PeriodicalIF":2.6,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221218","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":"Systematic review and meta-analysis of artificial intelligence models for diagnosing and subphenotyping ARDS in adults","authors":"Javier Muñoz MD, PhD ,&nbsp;Rocío Ruíz-Cacho MD ,&nbsp;Nerio José Fernández-Araujo MD ,&nbsp;Alberto Candela MD ,&nbsp;Lourdes Carmen Visedo MD ,&nbsp;Javier Muñoz-Visedo Math, BsC","doi":"10.1016/j.hrtlng.2025.09.017","DOIUrl":"10.1016/j.hrtlng.2025.09.017","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) has emerged as a promising tool to improve the diagnosis and characterization of ARDS, including the identification of subphenotypes.</div></div><div><h3>Objectives</h3><div>To evaluate the diagnostic performance and methodological quality of AI models for identifying ARDS and its subphenotypes in adults.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of 63 studies (<em>n</em> = 135,762) published between 2013 and 2024 in PubMed, Embase, and the Cochrane Library. Extracted outcomes included sensitivity, specificity, AUROC, and validation methods. Risk of bias was assessed with PROBAST, and AI-specific metrics (overfitting, generalization, interpretability, discrimination, calibration) were reported.</div></div><div><h3>Results</h3><div>Pooled sensitivity was 0.89 (95 % CI 0.84–0.93), specificity 0.88 (95 % CI 0.83–0.92), and AUROC 0.90 (95 % CI 0.86–0.94), with high heterogeneity (I² &gt; 85 %). Twenty-two studies (31 %) were rated high quality, with sensitivity 0.86 (95 % CI 0.82–0.89) and specificity 0.82 (95 % CI 0.78–0.85). Deep learning models (<em>n</em> = 14) achieved sensitivity 0.91, while machine learning models (<em>n</em> = 19) showed 0.87. Imaging-based models (<em>n</em> = 15) outperformed non-imaging approaches. COVID-19 studies (<em>n</em> = 9) reported sensitivity 0.90 with comparable AUROC and specificity. Only seven studies (18 %) investigated subphenotyping, identifying hyperinflammatory and hypoinflammatory profiles with potential therapeutic relevance. Calibration reporting was missing in 47 % and external validation in most (29/63).</div></div><div><h3>Conclusion</h3><div>AI models for ARDS demonstrate promising diagnostic accuracy but are limited by poor calibration and scarce external validation. Subphenotyping remains exploratory but suggests opportunities for real-time patient stratification. Prospective validation and standardized reporting are essential for clinical adoption.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 144-163"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of cardiac positron emission tomography in prediction of atrial fibrillation rhythm: A systematic review and meta-analysis","authors":"Shayan Shojaei MD, MPH, MBA ,&nbsp;Asma Mousavi MD, MPH, MBA ,&nbsp;Diar Zooravar MD ,&nbsp;Hanieh Radkhah MD ,&nbsp;Pedram Soltani MD","doi":"10.1016/j.hrtlng.2025.09.007","DOIUrl":"10.1016/j.hrtlng.2025.09.007","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF), the most common cardiac arrhythmia, is driven by inflammation-induced fibrosis and remodeling. Positron emission tomography (PET) offers a promising alternative by visualizing metabolic and inflammatory activity in cardiac tissue. Objectives: Evaluate PET's role in predicting AF to improve risk stratification and patient outcomes.</div></div><div><h3>Methods</h3><div>Systematic review of PubMed, Scopus, Web of Science, EMBASE was conducted using PRISMA guidelines. Our meta-analysis was registered in PROSPERO (CRD42024602021). Studies comparing quantitative PET scan parameters in AF versus non-AF patients were included. Random-effects models were performed using standardized mean differences (SMD) with 95 % Confidence intervals (CIs). Sensitivity analyses and publication bias with Egger's test and meta-regression analyses were performed.</div></div><div><h3>Results</h3><div>Ten studies with 1145 participants (661 with AF, 484 controls) were included. Patients with AF demonstrated significantly higher maximum SUV in the left atrium (LA) (SMD: 0.62, 95 % CI 0.41–0.83), left atrial appendage (LAA) (SMD: 0.78, 95 % CI 0.41–1.15), right atrium (RA) (SMD: 1.00, 95 % CI 0.72–1.27), and right atrial appendage (RAA) (SMD: 0.89, 95 % CI 0.63–1.14), but no significant differences in mean SUV or left ventricle (LV) metrics. Target-to-background ratios (TBR) were also significantly elevated in the LA, LAA, RA, and RAA in AF patients (<em>p</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Inflammation and AF suggest a bidirectional relationship as supported by cardiac FDG-PET imaging. Early detection using PET scans can enhance AF management by preventing irreversible cardiac damage.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 125-135"},"PeriodicalIF":2.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159422","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":"Association between multi inflammatory index and heart failure in patients with coronary heart disease: a RCSCD-TCM study in China","authors":"Yuanyuan He ,&nbsp;Tong Yang ,&nbsp;Yuting Li ,&nbsp;Mengnan Huang ,&nbsp;Lu Yu ,&nbsp;Lin Li ,&nbsp;Rongrong Yang ,&nbsp;Xianliang Wang ,&nbsp;Shan Gao ,&nbsp;Chunquan Yu","doi":"10.1016/j.hrtlng.2025.09.016","DOIUrl":"10.1016/j.hrtlng.2025.09.016","url":null,"abstract":"<div><h3>Background</h3><div>Anti-inflammatory therapy could become a new target for the treatment of heart failure (HF), and multi inflammatory index (MII) is a new index composed of an inflammatory index. Then, the relationship between MII and HF is not completely clear.</div></div><div><h3>Objectives</h3><div>The aim of this study was to investigate the association of MII and HF in coronary heart disease (CHD) patients.</div></div><div><h3>Methods</h3><div>In a cohort of 17,937 patients with CHD, 6386 had HF. Logistic regression analysis was used to analyze the relationship between the MII and HF in CHD patients. The relationship between MII and HF was also assessed according to sex, blood pressure, and blood glucose.</div></div><div><h3>Results</h3><div>Compared with T1 of MII, MII-1 had the highest T3 (OR: 1.33; 95% CI: 1.23–1.45; <em>P</em> &lt; 0.001), and MII-3 had the lowest T3 (OR: 1.25; 95% CI: 1.16–1.36; <em>P</em> &lt; 0.001). In both sexes, MII-1 was more associated with HF than MII-2 and MII-3. In binary logistic regression analysis, when MII was treated as a continuous variable, MII-1 was significantly associated with HF risk in CHD patients with hypertension (OR: 1.06; 95% CI: 1.02–1.10; <em>P</em> = 0.002) and in CHD patients with diabetes (OR: 1.04; 95% CI: 1.00–1.08; <em>P</em> = 0.040). All MII were associated with HF. The MII-1 proved to be superior.</div></div><div><h3>Conclusion</h3><div>In patients with CHD, the association between the MII and HF was stronger in female than in male. There was a association between MII and risk of HF in with CHD patients after multivariate adjustment.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 136-143"},"PeriodicalIF":2.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159455","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}