Heart & Lung最新文献

{"title":"Mechanisms, outcomes, and management of heart failure-associated dysphagia: a scoping review - revised marked.","authors":"Juvel-Lou P Velasco, Sherry Cazares, Ke Luo, Shu-Fen Wung","doi":"10.1016/j.hrtlng.2026.102930","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2026.102930","url":null,"abstract":"<p><strong>Background: </strong>More than 20% of patients with heart failure (HF) experience dysphagia, or difficulty swallowing. Although a previous review identified several risk factors and highlighted the bidirectional relationship between dysphagia and sarcopenia, it focused primarily on older hospitalized adults, leaving important knowledge gaps across the broader HF population.</p><p><strong>Methods: </strong>A scoping review was conducted using four electronic databases: PubMed, CINAHL, Embase, and Google Scholar, to identify studies involving adult patients with HF and dysphagia. No restrictions were placed on publication date, study duration, or geographical region.</p><p><strong>Results: </strong>Thirty-six articles met the inclusion criteria. Key mechanisms of HF-associated dysphagia (HFAD) included cardiomegaly-induced esophageal compression, esophageal dysmotility, and stricture formation. HFAD was associated with adverse outcomes, including dehydration, malnutrition, aspiration, prolonged hospitalization, non-home discharge, and mortality. Reported risk factors included advanced age, systemic inflammation, poor nutritional status, reduced functional independence, female sex, polypharmacy, prolonged hospitalization, dementia, prior cardiac surgeries, and valvular heart disease. Clinical presentations ranged from sudden to gradual onset and included dysphagia, globus sensation, and hoarseness. Reported management strategies included nutritional support, swallowing rehabilitation, HF optimization, pharmacologic therapy, procedural interventions, and follow-up monitoring.</p><p><strong>Conclusion: </strong>HFAD appears to be a common yet underrecognized comorbidity among individuals with HF and is associated with substantial adverse outcomes. Although early recognition and multidisciplinary management may be beneficial, evidence regarding optimal screening and treatment approaches remain limited. Further research is needed to establish standardized definitions, diagnostic criteria, screening approaches, and management pathways.</p>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"80 ","pages":"102930"},"PeriodicalIF":2.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893089","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 of common QT-prolonging medications with arrhythmic risk in patients with bundle branch block: A stratified cohort analysis in left bundle branch block vs. right bundle branch block phenotypes.","authors":"Evan Derector, Tirth Patel DO, Hiroto Watanabe, Diana Solomon, Christopher P Potestio","doi":"10.1016/j.hrtlng.2026.102935","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2026.102935","url":null,"abstract":"<p><strong>Background: </strong>Bundle branch block (BBB) affects 11-17% of adults over 80 and is associated with mortality and heart failure. Conventional QTc formulae overestimate repolarization in wide QRS complexes, with clinicians holding symptom-management therapies based on inaccurate measurements.</p><p><strong>Objectives: </strong>This retrospective study utilized the MIMIC-IV database to examine arrhythmogenic risk by drug class and BBB phenotype.</p><p><strong>Methods: </strong>Adult ICU admissions with BBB were stratified by drug exposure: amiodarone, high-risk anti-arrhythmics (sotalol, dofetilide, procainamide, ibutilide, quinidine, disopyramide), and common non-cardiac QT-prolonging agents (haloperidol, ondansetron, quetiapine, methadone, levofloxacin, azithromycin). The primary outcome was a composite of ventricular arrhythmia and cardiac arrest; a sensitivity analysis restricted to ventricular arrhythmia was performed. Propensity score matching (1:1) with time-varying Cox regression addressed confounding and immortal time bias.</p><p><strong>Results: </strong>The matched cohort included 1722 admissions (LBBB =1252; RBBB =470). Common non-cardiac agents were not associated with the composite outcome in LBBB (HR 0.96, p = 0.83) or RBBB (HR 0.61, p = 0.24; 28 events, hypothesis-generating). Amiodarone was associated with the composite (LBBB: HR 3.63, p < 0.01; RBBB HR: 3.90, p < 0.01), but not the LBBB sensitivity analysis (HR 1.61, p = 0.19), suggesting confounding by indication. Among patients with QTc >500 ms, common agents remained non-significant.</p><p><strong>Conclusion: </strong>Common non-cardiac QT-prolonging medications were not associated with increased risk in patients with BBB, even with prolonged QTc. The divergence between composite and sensitivity results for amiodarone highlights the influence of confounding by indication. Medication alerts should incorporate stratification by drug class rather than QTc alone.</p>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"80 ","pages":"102935"},"PeriodicalIF":2.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893028","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":"Beyond information: developing heart failure nurses as skilled educators.","authors":"Amy Corcoran","doi":"10.1016/j.hrtlng.2026.102925","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2026.102925","url":null,"abstract":"","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":" ","pages":"102925"},"PeriodicalIF":2.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889281","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":"New-onset atrial fibrillation or flutter during the ICU stay and mortality in patients with sepsis-associated myocardial injury: a time-varying cohort study.","authors":"Hongfei Ge, Sixing Li, Fangchao Chen, Huayi Ma, Xia Li, Qiuxing Wei, Song Lin","doi":"10.1016/j.hrtlng.2026.102929","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2026.102929","url":null,"abstract":"<p><strong>Background: </strong>New-onset atrial fibrillation or flutter (NOAF) is common during sepsis, but its prognostic significance in sepsis-associated myocardial injury remains unclear.</p><p><strong>Objectives: </strong>We examined its association with mortality using a time-varying analytic approach and assessed whether this association differed by onset timing.</p><p><strong>Methods: </strong>We conducted a single-centre retrospective cohort study of adult intensive care unit patients with coded sepsis and elevated high-sensitivity cardiac troponin T. Patients with pre-existing atrial fibrillation or atrial flutter were excluded. New-onset atrial fibrillation or flutter during the intensive care unit stay was modelled as a time-varying exposure in Cox models. Early onset was defined as within 48 h of intensive care unit admission and late onset as beyond 48 h.</p><p><strong>Results: </strong>Among 599 patients, 125 developed new-onset atrial fibrillation or flutter. In the fully adjusted model, the time-varying exposure was associated with higher in-hospital mortality (hazard ratio 1.69, 95% confidence interval 1.14-2.52) and intensive care unit mortality (hazard ratio 1.70, 95% confidence interval 1.07-2.70). Late-onset events were associated with higher in-hospital and intensive care unit mortality, whereas early-onset events showed no clear association with either outcome. In landmark analysis, early-onset events were not associated with subsequent in-hospital mortality.</p><p><strong>Conclusion: </strong>NOAF during the ICU stay was associated with higher mortality in patients with sepsis-associated myocardial injury. Late-onset NOAF was associated with mortality, whereas early-onset NOAF showed no clear association.</p>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"80 ","pages":"102929"},"PeriodicalIF":2.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882786","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":"Perspective of informal carers on a home-based physical activity programme (iLiFE) for individuals with interstitial lung disease.","authors":"Bárbara Costa, João Chagas, Cátia Paixão, Alda Marques","doi":"10.1016/j.hrtlng.2026.102932","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2026.102932","url":null,"abstract":"<p><strong>Background: </strong>Home-based physical activity (PA) programmes may help address barriers to regular PA and benefit individuals with interstitial lung disease (ILD) and their informal carer (IC). However, research on ICs perspectives regarding these interventions remains limited.</p><p><strong>Objective: </strong>Explore the impact of a home-based PA programme (iLiFE) for individuals with ILD, from the perspective of their IC.</p><p><strong>Methods: </strong>A qualitative study nested in the iLiFE trial (NCT04224233) was conducted. Data of IC on PA levels - steps/day with accelerometer, support needs with Carer Support Needs Assessment Tool (CSNAT) and quality of life with World Health Organization Quality of Life Assessment - short version (WHOQoL-Bref) were collected to characterise the sample. Short, individual, semi-structured interviews were conducted with ICs. Interviews were audio recorded, transcribed and analysed thematically.</p><p><strong>Results: </strong>Nine ICs (72±8years, 5 [55.6%] male) participated. They were physically inactive (3819±1782steps/day); their main need in CSNAT was \"knowing who to contact if they are concerned about their relative\"; and presented poor/unsatisfactory quality of life (WHOQol-Bref Physical domain: 49±10points; Psychological domain: 58±10points; Social domain: 63±18points; Environmental domain: 51±14points). Thematic analysis revealed that, from ICs' perspective, iLiFE programme improved ICs well-being, couple relationships, ILD patients' health, and reduced caregiving burden. Despite patient's fatigue, participants valued health professionals support and expressed interest in extending the programme duration.</p><p><strong>Conclusion: </strong>Home-based PA programmes, not specifically targeted at ICs of ILD individuals, may have some positive impact on their perceived well-being and burden of care. Further research on empowering ICs is needed, given their fundamental role in ILD management.</p>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"80 ","pages":"102932"},"PeriodicalIF":2.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882849","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":"Beyond arterial pressure: vasopressin and the quality of perioperative circulatory support.","authors":"Carlos Sanchez-Escalante, Patrick M Wieruszewski","doi":"10.1016/j.hrtlng.2026.102924","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2026.102924","url":null,"abstract":"","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":" ","pages":"102924"},"PeriodicalIF":2.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802131","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":"Effect of obesity in minimally invasive mitral valve surgery","authors":"Cristina Barbero MD, PhD ,&nbsp;Marco Pocar MD, PhD ,&nbsp;Stefano Salizzoni MD, PhD ,&nbsp;Dario Brenna MD ,&nbsp;Valentina Aloi MD ,&nbsp;Cecilia Capozza MD ,&nbsp;Claudia Filippini PhD ,&nbsp;Anna Chiara Trompeo MD ,&nbsp;Mauro Rinaldi MD","doi":"10.1016/j.hrtlng.2026.102730","DOIUrl":"10.1016/j.hrtlng.2026.102730","url":null,"abstract":"<div><h3>Background</h3><div>Obesity has tripled worldwide over the past 50 years. Existing evidence depicts conflicting relationships between body mass index and operative risk in cardiac surgery. Some large analyses have showed a shaped relationship between obesity and peri-operative mortality; others have found an inverse relationship, a so-called <em>obesity paradox</em>.</div></div><div><h3>Objectives</h3><div>We aimed to outline the effects of obesity on early outcome in minimally invasive mitral valve (MV) surgery.</div></div><div><h3>Methods</h3><div>One-thousand-seven-hundred-twenty consecutive patients who underwent mini-thoracotomy MV surgery at a single tertiary care academic centre since 2006 were retrospectively analysed. Multivariable logistic regression served to identify predictors of 30-day outcomes.</div></div><div><h3>Results</h3><div>Obesity (n=149/1695, 8.8%) was predictive of 30-day mortality (5.4% vs. 1.8%; p=0.010; odds ratio [OR] 3.14, 95% CI 1.36–7.27), but not when excluding patients with associated coronary and/or extracardiac arteriopathy (n=255/1695, 15%). Conversely, obesity was the sole predictor of death in this subgroup (4.3% vs. 1.9%; p=0.015; OR 3.65, 95% CI 1.01–13.17). Other predictors in the entire cohort were age, creatinine, reoperation and arteriopathy. Obese patients had more comorbidities and less degenerative MV prolapse, and parallel higher probability of MV replacement (p&lt;0.001). Cardiopulmonary bypass time, but not cardioplegic arrest time, was longer (p=0.007). Morbidity, primarily driven by respiratory and wound complications, was also higher, with longer intensive care and hospital length-of-stay (p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>Obesity confers additional operative risk in MV surgery despite a minimally invasive approach. However, increased risk is confined to patients with concomitant arteriopathy and atherosclerotic burden, for whom weight loss is advisable in a nonurgent scenario.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102730"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188776","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":"Mindfulness knowledge and practice in patients with cardiopulmonary conditions: A qualitative thematic analysis of adults living with pulmonary hypertension and chronic obstructive pulmonary disease✰","authors":"Tania T. Von Visger ,&nbsp;Amarjot Singh Gill ,&nbsp;Lea Ann Matura","doi":"10.1016/j.hrtlng.2026.102740","DOIUrl":"10.1016/j.hrtlng.2026.102740","url":null,"abstract":"<div><h3>Background</h3><div>Mindfulness practice has shown therapeutic benefits in symptom reduction and improved quality of life for adults with pulmonary hypertension (PH) and chronic obstructive pulmonary disease (COPD). Some studies testing mindfulness-based interventions often include patients’ perspectives about their engagement and acceptability of the tested intervention. Yet, a knowledge gap remains about those who have not participated in mindfulness clinical trials.</div></div><div><h3>Objective</h3><div>The purpose of this study is to explore the experiential insights of community-dwelling adults with PH and COPD regarding learning and practicing mindfulness. They were asked to reflect on their understanding of mindfulness, how they acquired the knowledge, and how they practice it, as well as its relationship to disease management.</div></div><div><h3>Methods</h3><div>Twenty adults (<em>n</em> = 10 PH and <em>n</em> = 10 COPD) provided their perspectives via one-on-one focused interviews after participating in a parent survey study. A qualitative thematic analysis of 20 transcripts was conducted to summarize the main themes relevant to their perspectives.</div></div><div><h3>Results</h3><div>Qualitative analysis revealed six main contextual themes related to mindfulness and disease management: (1) acceptability and accessibility, (2) benefits of mindfulness, (3) barriers to engagement, (4) understanding of mindfulness, (5) symptom management, and (6) introduction and promotion of mindfulness.</div></div><div><h3>Conclusion</h3><div>Understanding non-research participants’ mindfulness knowledge and practice through their experiences provides considerations for future research. Perspectives from these individuals, who were not self-selected for the research, are valuable because they inform the clinical implementation of creating appropriate mindfulness-based interventions that are likely to be successful in the real world.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102740"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189320","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":"Dysphagia in heart failure: Demographics, nutritional status, and patient-reported outcomes","authors":"Juvel-Lou P. Velasco ,&nbsp;Shenghao Xia ,&nbsp;Shu-Fen Wung","doi":"10.1016/j.hrtlng.2026.102724","DOIUrl":"10.1016/j.hrtlng.2026.102724","url":null,"abstract":"<div><h3>Background</h3><div>Dysphagia, or difficulty swallowing, is an often underrecognized comorbidity in individuals with heart failure (HF), which can potentially affect nutrition, symptom burden, and overall well-being. Patients with HF may experience dysphagia due to the anatomical proximity of the heart and esophagus. Cardiac remodeling, such as cardiomegaly and left ventricular dilation, can result in external compression of the esophagus, disrupting normal swallowing function. Despite these plausible mechanisms, there is limited large-scale data on evaluating the prevalence and clinical impact of dysphagia in HF populations.</div></div><div><h3>Objectives</h3><div>This study aimed to compare nutritional status, health perception, quality of life, and fatigue among HF patients with and without dysphagia.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on HF patients enrolled in the All of Us Research Program. Nutritional status was assessed using serum albumin levels, body weight, and body mass index (BMI). Health perception and fatigue were evaluated through responses to the Overall Health Survey.</div></div><div><h3>Results</h3><div>Within the analysis of the All of Us Research Program, 14,243 participants with HF were identified, of which 2,903 (20.4%) reported dysphagia after excluding those with a history of cerebrovascular accidents. The HF cohort was predominantly aged ≥65 years (53.2%), predominantly non-Hispanic or Latino (81.7%), and mainly White (51.3%), with a slight female predominance (55.1%). Among participants with available left ventricular ejection fraction (LVEF) data, 64.1% had preserved ejection fraction (&gt;50%). Dysphagia was more frequently observed in older individuals and women, and it was associated with significantly lower body weight (mean 89.3 vs. 93.5 kg) and serum albumin levels (35.3 g/L vs. 36.2 g/L; p &lt; 0.001), despite both groups having BMI (mean ∼32 kg/m², indicating Class I obesity). Individuals with dysphagia consistently reported poorer general, physical, and mental health, along with lower quality of life; and greater fatigue severity compared to those without dysphagia (all p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Dysphagia is a prevalent and clinically significant comorbidity in patients with HF, especially in those with preserved ejection fraction and advanced age. HF patients with dysphagia experience worse nutritional status and patient-reported outcomes compared to those without dysphagia. These findings underscore the need for routine screening for dysphagia and a comprehensive nutritional assessment to improve management and outcomes in HF populations.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102724"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980489","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 electronic cigarette use on blood pressure: A systematic review","authors":"Guilherme Nobre Nogueira ,&nbsp;Eanes Delgado Barros Pereira ,&nbsp;Sandra Nívea dos Reis Saraiva Falcão ,&nbsp;Cibele Isaac Saad Rodrigues ,&nbsp;Luana Darc de Menezes Braga ,&nbsp;Álvaro Ryan Matos de Oliveira ,&nbsp;Luana Souza Aragão Monteiro ,&nbsp;Letícia Pinheiro Amorim ,&nbsp;Jonatha Marcelino de Lima ,&nbsp;Elizabeth de Francesco Daher","doi":"10.1016/j.hrtlng.2026.102732","DOIUrl":"10.1016/j.hrtlng.2026.102732","url":null,"abstract":"<div><h3>Background</h3><div>The use of electronic cigarettes has increased significantly. Initially marketed as a safer alternative to traditional cigarettes, these devices have sparked growing concerns about their impact on cardiovascular health, particularly in contributing to the rise in hypertension.</div></div><div><h3>Objectives</h3><div>The objective is to review the available evidence on the effects of electronic cigarettes on blood pressure (BP) and other cardiovascular outcomes.</div></div><div><h3>Methods</h3><div>This is a systematic review conducted in accordance with PRISMA and Cochrane guidelines, including observational and randomized clinical trials comparing electronic cigarette users with non-users or traditional cigarette users. Participant demographics, intervention characteristics, device usage duration, and primary outcomes were evaluated.</div></div><div><h3>Results</h3><div>The systematic review analyzed data from seven studies exploring the relationship between electronic cigarette use and hypertension. The findings revealed consistent evidence of adverse effects on BP and other cardiovascular outcomes. The primary outcomes included changes in systolic and diastolic BP, while secondary outcomes focused on other cardiovascular effects such as heart rate. Data synthesis considered study quality, population heterogeneity, and confounding factors like concurrent nicotine use.</div></div><div><h3>Conclusion</h3><div>Contrary to the widespread belief that electronic cigarettes are a healthier alternative to traditional smoking, current evidence suggests significant adverse cardiovascular effects, including an increased risk of hypertension. This finding is critical for public health authorities when formulating guidelines and strategies to regulate nicotine-containing electronic devices.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102732"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159317","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}