Heart & Lung最新文献

{"title":"A prospective randomized comparison of a pulse-contour analysis monitor versus a non-invasive bioreactance monitor in a stroke-volume based goal-directed fluid resuscitation protocol in brain-dead organ donors","authors":"Gary F Marklin ,&nbsp;Elyssa Gansner ,&nbsp;Melissa Stephens ,&nbsp;Gregory Ewald ,&nbsp;William Dean Klinkenberg ,&nbsp;Thomas Ahrens","doi":"10.1016/j.hrtlng.2025.04.026","DOIUrl":"10.1016/j.hrtlng.2025.04.026","url":null,"abstract":"<div><h3>Background</h3><div>Brain-dead (BD) organ donors are frequently hypotensive and hypovolemic requiring fluid resuscitation. We previously published our four-hour stoke volume (SV)-based fluid resuscitation protocol that expeditiously corrected the fluid deficit and significantly decreased time on vasopressors. The SV was measured by pulse-contour analysis (PCA).</div></div><div><h3>Objective</h3><div>To determine if the measurement of stroke volume by bioreactance (BR) was equivalent to PCA in a goal-directed fluid resuscitation protocol in BD donors.</div></div><div><h3>Methods</h3><div>We performed a prospective randomized trial of fluid resuscitation in BD donors comparing the two monitors.</div></div><div><h3>Results</h3><div>In 169 deceased donors there were 1481 comparative measurements of SV. The correlation coefficient was 0.32. A Bland Altman analysis revealed a minimal bias (-1.8 ml) but large limits of agreement (±62.9 ml) and a percentage error of 80.5 %. A 10 % SV increase with a 500 ml fluid bolus had conflicting results between the monitors in 31.3 % of 1309 measurements. As a reference standard, the Fick method of measuring SV was used 49 times with simultaneous measurements of PCA-SV and BR-SV. The mean Fick SV (96.0 ± 30.6 ml) was significantly greater than BR (79.4 ± 18.1 ml; <em>p</em>&lt;.01) and the PCA (77.2 ± 22.5 ml; <em>p</em>&lt;.01). The mean SV differences for Fick-BR (16.6 ± 27.2, 95 % CI 8.78–24.42) and Fick-PCA (18.7 ± 29.0, 95 % CI 10.42–27.08) were not significantly different (<em>p</em>=.57).</div></div><div><h3>Conclusion</h3><div>Although this study demonstrated inaccuracies, imprecision, and disagreement between BR and PCA SV measurements, there was equipoise in clinical outcomes when used with our fluid resuscitation protocol, as previously published.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 56-63"},"PeriodicalIF":2.4,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876624","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 acute-to-chronic glucose ratio and acute kidney injury after emergency PCI in patients with acute myocardial infarction","authors":"Yifan Deng ,&nbsp;Yue Ma ,&nbsp;Jiapei Gao ,&nbsp;Qinyu Sun ,&nbsp;Jing Zhang ,&nbsp;Li Zhu","doi":"10.1016/j.hrtlng.2025.04.025","DOIUrl":"10.1016/j.hrtlng.2025.04.025","url":null,"abstract":"<div><h3>Background</h3><div>Contrast-induced acute kidney injury (CI-AKI) is a common complication in patients with acute myocardial infarction undergoing Percutaneous coronary intervention (PCI) treatment and is associated with poor prognosis. there is a lack of effective predictive biomarkers and functions.</div></div><div><h3>Objective</h3><div>To explore the correlation between the acute-to-chronic blood glucose ratio (ARC) and CI-AKI in patients with emergency PCI.</div></div><div><h3>Methods</h3><div>This study enrolled AMI patients undergoing emergency PCI from November 2018 to May 2024. Demographic characteristics, medical history, and perioperative laboratory parameters were systematically collected. Potential predictors were identified through least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression. Restricted cubic splines (RCS) were employed to examine nonlinear relationships, with subsequent subgroup analyses and nomogram construction.</div></div><div><h3>Results</h3><div>A total of 502 patients were included, with 84 developing postoperative CI-AKI and 418 remaining non-CI-AKI. ARC was found to be an independent risk factor for CI-AKI (OR = 1.06, 95 % CI 1.04–1.08). RCS analysis revealed a non-linear relationship between ARC and CI-AKI. In various adjusted models, ARC as a continuous variable showed a correlation with CI-AKI occurrence. In the third and fourth quantiles, ARC was independently associated with CI-AKI risk (OR = 2.95, 95 % CI 1.16–7.47 and OR = 7.17, 95 % CI 2.99–17.24, respectively). The nomogram model, based on LASSO regression, demonstrated good predictive accuracy for CI-AKI (AUC = 0.831, 95 % CI 0.778–0.884).</div></div><div><h3>Conclusion</h3><div>There is a non-linear positive correlation between ARC and the risk of acute kidney injury after emergency PCI in patients with AMI.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 48-55"},"PeriodicalIF":2.4,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869927","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":"Efficacy of colchicine in lower extremity peripheral arterial disease: A meta-analysis","authors":"Hritvik Jain MBBS ,&nbsp;Nandan Patel MBBS ,&nbsp;Maheen Erum MBBS ,&nbsp;Ramez M. Odat MD ,&nbsp;Siddhant Passey MD ,&nbsp;Rozi Khan MD ,&nbsp;Jyoti Jain MBBS ,&nbsp;Ameer Haider Cheema MD ,&nbsp;Sebastian Fox MBChB, BMSc ,&nbsp;Raheel Ahmed MBBS, MRCP","doi":"10.1016/j.hrtlng.2025.04.022","DOIUrl":"10.1016/j.hrtlng.2025.04.022","url":null,"abstract":"<div><h3>Background</h3><div>Lower-extremity peripheral arterial disease (LEPAD) significantly increases the risk of severe cardiovascular and limb complications, often due to the underlying inflammation from atherosclerosis. Colchicine has gained attention due to its efficacy in the primary and secondary prevention of cardiovascular events and may offer similar protective benefits for LEPAD.</div></div><div><h3>Objectives</h3><div>This meta-analysis aimed to evaluate outcomes with colchicine in LEPAD.</div></div><div><h3>Methods</h3><div>A systematic literature search was performed on the major bibliographic databases for studies until October 2024. Hazard ratios (HRs) with their corresponding 95% CIs were pooled using the inverse-variance random-effects model.</div></div><div><h3>Results</h3><div>Three studies were included with 226,804 patients [113,537: Colchicine and 113,267: Placebo]. The pooled analysis demonstrates colchicine use in patients with LEPAD was associated with a significantly lower risk of major adverse limb events (MALE) [HR: 0.84; 95 % CI: 0.75, 0.94; p = 0.002], major adverse cardiovascular events (MACE) [HR: 0.90; 95 % CI: 0.82, 0.98; p = 0.02], ischemic stroke [HR: 0.97; 95 % CI: 0.94, 0.99; p = 0.02], need for major amputations [HR: 0.81, 95 % CI: 0.75, 0.87; p&lt; 0.00001], and revascularization for lower limb ischemia [HR: 0.81; 95 % CI: 0.72, 0.90; p = 0.0001]. However, no significant reduction was noted for all-cause mortality [HR: 0.87; 95 % CI: 0.74, 1.02; p = 0.09] and myocardial infarction (MI) [HR: 0.98; 95 % CI: 0.95, 1.00; p = .10].</div></div><div><h3>Conclusion</h3><div>Colchicine may be a useful adjunctive therapy for reducing the risk of major cardiovascular and limb-related complications in patients with LEPAD, including lower rates of MACE, MALE, stroke, amputation, and limb ischemia. However, it did not significantly reduce all-cause mortality or MI. Notably, the only randomized trial evaluating colchicine's efficacy in LEPAD reported a similar risk of adverse outcomes. Multicenter, adequately powered randomized controlled trials are needed to confirm colchicine's effectiveness in this population.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 42-47"},"PeriodicalIF":2.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863386","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 patent foramen ovale and chronic obstructive pulmonary disease: A systematic review and meta-analysis","authors":"Sruthy Balakumar ,&nbsp;Naya Nadeem ,&nbsp;Areeba Asghar MSc ,&nbsp;Claudia Frankfurter ,&nbsp;Ashley Farrell MLIS, AHIP ,&nbsp;Eduardo Flores-Umanzor MD, PhD ,&nbsp;Eric Horlick MDCM ,&nbsp;Lusine Abrahamyan MD, MPH, PhD","doi":"10.1016/j.hrtlng.2025.04.024","DOIUrl":"10.1016/j.hrtlng.2025.04.024","url":null,"abstract":"<div><h3>Background</h3><div>Patent foramen ovale (PFO) is a defect in the intra-atrial septum that occurs when the foramen ovale does not close postnatally. Chronic obstructive pulmonary disease (COPD) is a respiratory condition that causes airflow obstruction.</div></div><div><h3>Objective</h3><div>This systematic review aimed to consolidate current evidence on the association between PFO and COPD outcomes.</div></div><div><h3>Methods</h3><div>We searched Medline, Embase, and Cochrane databases from inception to November 2023 for studies conducted among adults who have been diagnosed with COPD and underwent testing for PFO. A structured data extraction sheet was created to collect data from selected studies. A meta-analysis with a random effects model was considered when feasible.</div></div><div><h3>Results</h3><div>The initial search identified 765 records. After screening for eligibility, we included six cross-sectional and three case report studies. In cross-sectional studies, patients with COPD had almost three times higher odds of having PFO than controls (OR = 2.72, 95 % CI: 1.57 to 4.70, <em>I²</em> =0 %). When comparing COPD patients with and without PFO, the pooled mean difference was -2.99 mmHg; 95 % CI:5.55 to -0.44, <em>I²</em> =77 %) in oxygen saturation (SaO2), -6.85 mmHg (95 %CI:11.71 to -2.39, <em>I²</em> =35 %) in arterial oxygen partial pressure (PaO2) and 9.65 mmHg (95 %CI: 3.38 to 12.92, <em>I²</em> =0 %) in pulmonary arterial pressure.</div></div><div><h3>Conclusions</h3><div>Evidence, based on a few and small size studies, indicates that PFO presence may be associated with worse outcomes in COPD patients. The long-term impact of these findings on COPD outcomes and the need for identifying high-risk patients for PFO screening should be evaluated.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 33-41"},"PeriodicalIF":2.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859625","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":"Exercise-induced oxyhemoglobin desaturation is an independent risk factor for sustained nocturnal hypoxemia in adults with precapillary pulmonary hypertension: A cross-sectional study","authors":"Marcia S. Murta ,&nbsp;Ricardo L.M. Duarte ,&nbsp;Daniel Waetge ,&nbsp;David Gozal ,&nbsp;Alexandre P. Cardoso ,&nbsp;Fernanda C.Q. Mello","doi":"10.1016/j.hrtlng.2025.04.021","DOIUrl":"10.1016/j.hrtlng.2025.04.021","url":null,"abstract":"<div><h3>Background</h3><div>Nocturnal hypoxemia (NH) negatively impacts the prognosis of several chronic cardiopulmonary diseases.</div></div><div><h3>Objectives</h3><div>To assess the risk factors associated with sustained NH in adults with precapillary pulmonary hypertension (pPH).</div></div><div><h3>Methods</h3><div>This cross-sectional study was performed between June 2021 and June 2024. Outpatients with a hemodynamic diagnosis of pPH (Groups 1 and 4) were consecutively recruited. Sustained NH was defined as ≥ 30 % of the percentage of time spent with oxygen saturation (SpO₂) &lt;90 % during a home sleep apnea test (HSAT). Clinical, laboratory, hemodynamic, echocardiographic, functional, and exercise-related variables were collected blindly regarding the HSAT data. We considered a difference in SpO₂ [resting – final] (Δ SpO₂) ≥ 3 % as indicative of exercise-induced oxyhemoglobin desaturation (EID) by the six-minute walk test. Multiple logistic regression analysis was used to identify possible predictive factors for the occurrence of NH.</div></div><div><h3>Results</h3><div>Fifty-two pPH adults were included (71.2 % were females). Thirty-one patients (59.6 %) were classified as having NH. In the univariate logistic regression analysis, four parameters were identified as risk factors for the presence of NH: mean pulmonary artery pressure (<em>p</em> = 0.023), right atrial mean pressure (<em>p</em> = 0.037), systolic pulmonary arterial pressure (<em>p</em> = 0.042) and EID (<em>p</em> = 0.003). However, only EID was an independent predictor for detecting NH with an adjusted odds ratio of 10.590 (95 % confidence interval: 1.095–102.420); <em>p</em> = 0.042.</div></div><div><h3>Conclusions</h3><div>EID is an easily implementable risk factor for prolonged NH, suggesting that adults with pPH who experience EID have a high probability of also experiencing NH.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 26-32"},"PeriodicalIF":2.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860088","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":"Machine learning-based return-to-work assessment system for acute myocardial infarction patients within 12 months","authors":"Xiaojun Wu ,&nbsp;Shiyu Wang ,&nbsp;Haoning Cui ,&nbsp;Xianghui Zheng ,&nbsp;Xinyu Hou ,&nbsp;Zhuozhong Wang ,&nbsp;Qifeng Li ,&nbsp;Qi Liu ,&nbsp;Tianhui Cao ,&nbsp;Yang Zheng ,&nbsp;Jian Wu ,&nbsp;Bo Yu","doi":"10.1016/j.hrtlng.2025.04.020","DOIUrl":"10.1016/j.hrtlng.2025.04.020","url":null,"abstract":"<div><h3>Background</h3><div>Returning to work is a critical indicator of recovery after acute myocardial infarction (AMI), and accurate identification of patients with low return-to-work rates is critical for timely intervention.</div></div><div><h3>Objectives</h3><div>To develop a machine learning (ML) model for predicting the return-to-work in AMI patients.</div></div><div><h3>Methods</h3><div>A retrospective study of data from 539 AMI patients was conducted using the Incidence Rate of Heart Failure After Acute Myocardial Infarction With Optimal Treatment database. Patients were randomly divided into training cohort and validation cohort (7:3). Seven ML algorithms were used to establish a prediction model for the training cohort. Model performance is evaluated by the area under the receiver operating characteristic curve (AUC), accuracy, F1 score, and Brier score.</div></div><div><h3>Results</h3><div>This study included 539 AMI patients (median [IQR] age, 50.0 [45.0, 54.0] years; 505 (93.7 %) were male, and 431 (80.0 %) returned to work within one year after discharge. The best-performing model was eXtreme gradient boosting, which achieved an AUC of 0.821 (95 % CI, 0.736–0.907), an accuracy of 0.802 (95 % CI, 0.733–0.861), and an F1 score of 0.873. The return-to-work score and stratification established based on this model can effectively distinguish patients into low, medium, and high probability groups (33.3 % vs. 60.0 % vs. 91.7 %, <em>P</em> &lt; 0.001). The model was deployed on an open website <span><span>https://amirtw.streamlit.app/</span><svg><path></path></svg></span>, providing a convenient evaluation and analysis tool for medical staff.</div></div><div><h3>Conclusion</h3><div>A new return-to-work ML model was developed, which may help identify patients with low return-to-work rates and may become an effective management tool for AMI patients.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 19-25"},"PeriodicalIF":2.4,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850733","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":"Out-of-hospital cardiac arrest: A 10-year analysis of survival and neurological outcomes","authors":"Daniel Schwaiger,&nbsp;Armin Krösbacher,&nbsp;Christine Eckhardt,&nbsp;Lukas Schausberger,&nbsp;Michael Baubin,&nbsp;Sasa Rajsic","doi":"10.1016/j.hrtlng.2025.04.003","DOIUrl":"10.1016/j.hrtlng.2025.04.003","url":null,"abstract":"<div><div><strong>Background</strong> Out-of-hospital cardiac arrest (OHCA) is a major public health issue with low survival rates.</div><div><strong>Objective</strong> Identification of predictors for survival and good neurological outcomes following OHCA.</div><div><strong>Methods</strong> This retrospective study included all OHCA patients between January 2014 and December 2023. Data was collected from the local resuscitation registry and hospital electronic medical records. Neurological outcomes were measured using the Cerebral Performance Category (CPC) scale.</div><div><strong>Results</strong> At hospital admission return of spontaneous circulation (ROSC) was achieved in 36 % of cases (411/1128), with overall survival rates of 29 % (328/1128) at 24 h and 16 % (178/1128) at 30 days, respectively. Good neurological outcomes (CPC 1 and 2) were observed in 13 % (144/1128) of patients. The main suspected cause of cardiac arrest was cardiac origin (54 %, 608/1128), followed by hypoxia (11 %, 127/1128). Survivors were significantly younger (60 vs 71 years, <em>p</em> &lt; 0.001), were less disabled (<em>p</em> &lt; 0.001), had a higher incidence of witnessed cardiac arrest (80 % vs 69 %, <em>p</em> = 0.018), received more often bystander cardiopulmonary resuscitation (CPR, 62 % vs 47 %, <em>p</em> = 0.003) or Dispatcher Assisted-CPR (44 % vs 32 %, <em>p</em> = 0.004). Moreover, patients who survived at least 30 days had a higher incidence of shockable initial rhythm (57 % vs 24 %, <em>p</em> &lt; 0.001).</div><div><strong>Conclusions</strong> Patients who survived at least 30 days were younger and male, had less disability, a shockable initial rhythm, and a cardiac arrest in public.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 1-8"},"PeriodicalIF":2.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845147","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":"Non-invasive monitoring strategies for atrial fibrillation detection in adult cardiac surgery patients after hospital discharge: A scoping review","authors":"Osama Jaradat ,&nbsp;Peta Drury ,&nbsp;John Rihari-Thomas ,&nbsp;Steven Frost","doi":"10.1016/j.hrtlng.2025.04.023","DOIUrl":"10.1016/j.hrtlng.2025.04.023","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is a common complication after cardiothoracic surgery, affecting up to 50 % of patients. It can develop after discharge, leading to frequent hospital readmissions. There is a growing need for effective monitoring strategies to detect AF in the post-discharge period.</div></div><div><h3>Objectives</h3><div>To synthesis the available literature on various mobile monitoring devices used to detect AF in adult cardiac surgery patients post-discharge from the hospital.</div></div><div><h3>Methods</h3><div>Following Arksey and O’Malley’s framework and the PRISMA-ScR guidelines. A comprehensive search of six databases (PubMed; MEDLINE; CINAHL; Scopus; ProQuest; and Web of Science) was performed, including studies published between 2009 and 2024. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS).</div></div><div><h3>Results</h3><div>A total of 1256 de-duplicated studies were screened, and 102 studies underwent full-text review. Five studies were included: four prospective cohort studies, and one randomised clinical trial. Samples sizes ranged from 23 to 730 adults undergoing cardiac surgery, with follow-up between four weeks to three months post-discharge. Handheld and wearable ECG-based devices were the most used tools for AF detection, demonstrating high sensitivity and specificity. Their use effectively reduced unplanned hospital visits and improved clinical outcomes. Patient adherence to monitoring protocols was generally high, though variability in engagement was noted.</div></div><div><h3>Conclusions</h3><div>Handheld and wearable ECG- based devices, are effective for post-discharge AF detection in cardiac surgery patients. Integrating these tools into routine post-discharge care can improve patient outcomes. Future research should focus on long-term effectiveness and strategies to optimise patient engagement and implementation in clinical practice.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 9-18"},"PeriodicalIF":2.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845146","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":"Amiodarone Prophylaxis against postoperative atrial fibrillation in off-pump coronary artery bypass","authors":"Jaskirat Gill MD ,&nbsp;Ami G Shah PharmD, BCCCP ,&nbsp;Gabriele Di Luozzo MD ,&nbsp;Julie Mei PharmD ,&nbsp;Justin Carale PharmD ,&nbsp;Kristy Huang PharmD ,&nbsp;Anna S. Mueller MD ,&nbsp;Marcelina Victory-Stewart RN ,&nbsp;Seana Friedman DNP, RN ,&nbsp;Emilia Bagiella PhD ,&nbsp;Omar Lattouf MD ,&nbsp;John D. Puskas MD ,&nbsp;Mekeleya Yimen MD ,&nbsp;Himani V. Bhatt DO, MPA","doi":"10.1016/j.hrtlng.2025.03.009","DOIUrl":"10.1016/j.hrtlng.2025.03.009","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, with incidence increasing based on surgical complexity. While the CHA₂DS₂-VASc score has been validated to predict POAF risk, standardized prophylactic strategies remain unclear. This study evaluates the safety and efficacy of a low-dose oral amiodarone protocol for POAF prevention in high-risk patients undergoing isolated OPCAB procedures.</div></div><div><h3>Objective</h3><div>To evaluate the impact of low-dose amiodarone prophylaxis against POAF in high-risk patients undergoing OPCAB procedures.</div></div><div><h3>Methods</h3><div>This IRB-approved prospective study included all adult inpatients undergoing isolated OPCAB procedures at a single tertiary care facility between June 2018-June 2021 identified as high risk for POAF (preoperative CHA₂DS₂VASc score <u>&gt;</u> 2). Patients treated with amiodarone prophylaxis were compared to a retrospective historical control group which underwent similar OPCAB procedures in the same center prior to the implementation of amiodarone prophylaxis. Preoperative hospitalized inpatients received a weight-adjusted dose of oral amiodarone on each preoperative day until the day prior to surgery. Patients who were inadequately loaded (&lt;1 g) received 150 mg of amiodarone intravenously in the operating room. Patients with intraoperative symptomatic bradycardia received temporary prophylactic epicardial pacing wires. Postoperatively, all patients received an amiodarone regimen of 200 mg orally twice daily, continued for 15 doses or until discharge. Multivariate logistic models were used to determine the effect of low-dose oral amiodarone prophylaxis on new-onset POAF.</div></div><div><h3>Results</h3><div>A 10.7 % reduction in incidence of POAF requiring treatment was noted in the study group (OR=0.4; 95 % CI [0.167–0.958], <em>p</em> = 0.04), as well as a 12 % decrease in patients requiring AF treatment at discharge (<em>p</em> = 0.017), and significantly reduced time to extubation. All baseline characteristics and safety parameters were similar between groups.</div></div><div><h3>Conclusions</h3><div>The use of a low-dose amiodarone prophylaxis regimen led to significant reduction in new POAF, without apparent adverse effects. This regimen may be considered safe, effective, and feasible for implementation in high-risk OPCAB patients. Further studies in on-pump CABG and valvular patients are needed.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"72 ","pages":"Pages 85-94"},"PeriodicalIF":2.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820493","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":"Corrigendum to “The association between posttraumatic stress symptoms and hope following intensive care unit discharge: Findings from a longitudinal cohort study” [Heart & Lung Volume 70, MarchApril 2025, Pages 223-229]","authors":"Klara Friberg MSc, RN, CCN ,&nbsp;Kristin Hofsø PhD, RN, CCN ,&nbsp;Tone Rustøen PhD, RN ,&nbsp;Johan Ræder PhD, MD ,&nbsp;Milada Hagen PhD ,&nbsp;Kathleen Puntillo PhD, RN, FCCM ,&nbsp;Brita Fosser Olsen PhD, RN, CCN","doi":"10.1016/j.hrtlng.2025.04.001","DOIUrl":"10.1016/j.hrtlng.2025.04.001","url":null,"abstract":"","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"72 ","pages":"Pages 83-84"},"PeriodicalIF":2.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817608","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}