Heart & Lung最新文献

{"title":"Validity and reliability of the thirst distress scale and the short version of the xerostomia inventory for use in German patients with chronic heart failure: A multicenter cross-sectional study","authors":"Franziska Wefer ,&nbsp;Lars Krüger ,&nbsp;Nina Kolbe ,&nbsp;Melanie Seel ,&nbsp;Maria Lutao ,&nbsp;Franziska Ottenbreit ,&nbsp;Samee Anton ,&nbsp;Elena Wuzel-Samimi ,&nbsp;Anne Richter ,&nbsp;Irina Stuth ,&nbsp;Sascha Köpke ,&nbsp;Stefan Köberich","doi":"10.1016/j.hrtlng.2024.11.013","DOIUrl":"10.1016/j.hrtlng.2024.11.013","url":null,"abstract":"<div><h3>Background</h3><div>Thirst and xerostomia are prevalent and distressing symptoms in patients with chronic heart failure (CHF). Evaluation of interventions to alleviate these symptoms requires valid and reliable instruments. Such instruments are currently lacking for German patients with CHF.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to evaluate the structural and convergent validity, and internal consistency reliability of the German versions of the Thirst Distress Scale for Patients with Heart Failure (G-TDS-HF) and the short form of the Xerostomia Inventory (G-SXI).</div></div><div><h3>Methods</h3><div>A cross-sectional, multicenter study was conducted involving patients with CHF. Participants completed a questionnaire containing the G-TDS-HF, G-SXI, and a visual analog scale (VAS) to indicate intensity of thirst and xerostomia. Exploratory and confirmatory factor analyses were conducted to assess structural validity. To assess internal consistency reliability, McDonald's Omega total was calculated, and Pearson´s r was used to examine convergent validity.</div></div><div><h3>Results</h3><div>A total of 371 patients (62.4 (± 14.9) years, 28.3 % female) participated in the study. Factor analysis of the G-TDS-HF revealed a two-factor structure. One factor represents symptom occurrence, and the second factor is symptom distress. Internal consistency reliability was deemed adequate, with McDonald's Omega total coefficients of 0.81. The correlation between the sum scores of the G-TDS-HF and thirst intensity (VAS) was <em>r</em> = 0.44 (<em>p</em> &lt; 0.001). The G-SXI demonstrated a single-factor structure with a McDonald's Omega total of 0.71. The correlation between the G-SXI and xerostomia intensity (VAS) was <em>r</em> = 0.36 (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Results suggest that the G-TDS-HF and the G-SXI are valid and reliable instruments. Further research is warranted to assess responsiveness and test-retest reliability to strengthen the evidence.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 65-72"},"PeriodicalIF":2.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Board of Directors","authors":"","doi":"10.1016/S0147-9563(24)00217-6","DOIUrl":"10.1016/S0147-9563(24)00217-6","url":null,"abstract":"","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Page v"},"PeriodicalIF":2.4,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698974","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":"Acute decompensated pulmonary hypertension outcomes in pulmonary arterial hypertension patients: systematic review and meta-analysis of proportions","authors":"Marcos Vinicius Fernandes Garcia MD PhD ,&nbsp;Abdelrahman Nanah MD ,&nbsp;Pedro Caruso MD PhD","doi":"10.1016/j.hrtlng.2024.11.009","DOIUrl":"10.1016/j.hrtlng.2024.11.009","url":null,"abstract":"<div><h3>Background</h3><div>Acute decompensated pulmonary arterial hypertension (ADPH) is characterized by right heart failure due to elevated afterload and inadequate cardiac output, and it presents a significant mortality risk. Understanding mortality proportions and the impact of life-sustaining therapies is crucial for informing clinical practice and patient prognosis.</div></div><div><h3>Objectives</h3><div>To assess mortality proportions in ADPH across different clinical settings and to assess how they vary depending on the type of life-sustaining interventions used.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis of proportions were conducted, examining mortality in ADPH focusing on three primary outcomes: ICU mortality, hospital mortality, and hospital mortality in patients requiring extracorporeal membrane oxygenation (ECMO). Common and random-effects meta-analyses were performed to calculate pooled mortality proportions with 95% confidence intervals (CI95%). Temporal trends were analyzed using meta-regression.</div></div><div><h3>Results</h3><div>Twenty-five observational studies conducted between 2003 and 2023, involving 1,249 ADPH patients, were included. The random-effect analysis revealed an ICU pooled mortality proportion of 29% (CI95% 25–34, <em>I</em>²=40%, <em>p</em>=0.12) and a pooled hospital mortality proportion of 38% (CI95% 31–47, <em>I</em>²=70%, <em>p</em>&lt;0.01). Pooled mortality proportion for patients on ECMO was 45% (CI95% 38–52, <em>I</em>²=0%, <em>p</em>=0.96). Patients receiving inotropes or vasopressors had pooled mortality proportion of 56% (CI95% 44–68, <em>I</em>²=42%, <em>p</em>=0.18) and 57% (CI95% 48–65, <em>I</em>²=57%, <em>p</em>=0.02), respectively. Meta-regression analysis revealed no significant trend in hospital mortality over the span of twenty years.</div></div><div><h3>Conclusions</h3><div>Variation in ADPH mortality across hospital settings and life-sustaining therapies underscores the complexity of managing ADPH. These findings inform clinical practice and support prognostic discussions with patients and families.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 57-64"},"PeriodicalIF":2.4,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696058","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":"Pulmonary arterial stiffness and vascular tone in pulmonary hypertension: Insights from waveform-derived reflection index and hemodynamic correlations","authors":"Mustafa Oğuz MD ,&nbsp;Mehmet Uzun MD ,&nbsp;İrem Yılmaz MD ,&nbsp;Almina Erdem MD ,&nbsp;Murat Demirci MD ,&nbsp;Nilüfer Ekşi Duran MD","doi":"10.1016/j.hrtlng.2024.11.007","DOIUrl":"10.1016/j.hrtlng.2024.11.007","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary hypertension (PH) involves increased arterial stiffness and reduced vascular tone, affecting pulmonary arterial wave reflections. The Reflection Index (RI) may provide insights into these changes.</div></div><div><h3>Objective</h3><div>This study examines the utility of RI in PH patients by correlating it with key right heart catheterization (RHC) parameters.</div></div><div><h3>Methods</h3><div>Patients who underwent RHC with a preliminary diagnosis of PH, including those with normal RHC findings and those diagnosed with Group 1 and Group 4 PH, were included in the study. RI was defined as the ratio of systolic to diastolic pressure differences from pulmonary arterial waveforms and compared with hemodynamic, clinical, and echocardiographic parameters.</div></div><div><h3>Results</h3><div>The study included 115 patients (mean age 53.92 ± 16.43 years; 43.5% male). RI showed significant correlations with key RHC parameters, such as sPAP (r=0.359, p&lt;0.001), dPAP (r=0.322, p&lt;0.001), mPAP (r=0.339, p&lt;0.001), PVR (r=0.431, p&lt;0.001), and pSO2 (r=-0.243, p=0.011). Among echocardiographic measures, RI correlated with TRV (r=0.377, p&lt;0.001) and echo sPAP (r=0.359, p&lt;0.001). In multivariable analysis, RI (OR:1.032, p=0.003) and NT-proBNP (OR:1.004, p=0.049) remained significant predictors of PH. ROC analysis demonstrated the moderate predictive power for RI (AUC=0.806, p&lt;0.001), with 76.4% sensitivity and 78.5% specificity at a cut-off of 232.05.</div></div><div><h3>Conclusion</h3><div>RI is a valuable parameter for assessing pulmonary arterial stiffness and vascular tone in patients with PAH and CTEPH. Significant correlations were observed with key hemodynamic parameters, including PVR and mPAP. Additionally, RI demonstrated moderate predictive power for PH. These findings highlight the potential of RI as an independent marker of vascular health, providing direct insights into the pulmonary arterial bed.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 50-56"},"PeriodicalIF":2.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689447","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":"Comparing the in-hospital outcomes of patients with Takotsubo cardiomyopathy and chronic obstructive pulmonary disease","authors":"Chenlin Li MD ,&nbsp;Pengyang Li MD ,&nbsp;Xiaojia Lu MD ,&nbsp;Yan Chen MD ,&nbsp;Peng Cai MD ,&nbsp;Catherine Teng MD ,&nbsp;Jie Jing MS ,&nbsp;Jingkun Zhang MD ,&nbsp;Shiyan Jiang MD ,&nbsp;Yue Liu MD ,&nbsp;Jing Liang MD ,&nbsp;Yanxuan Wang MD ,&nbsp;Bin Wang MD, PhD","doi":"10.1016/j.hrtlng.2024.11.008","DOIUrl":"10.1016/j.hrtlng.2024.11.008","url":null,"abstract":"<div><h3>Background</h3><div>Secondary Takotsubo syndrome (TTS) differs from primary TTS in terms of clinical characteristics, management, and prognosis. COPD exacerbation has been recognized as a physical trigger for TTS, but its prognostic implications for secondary TTS are poorly understood.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to examine the effects of COPD on in-hospital outcomes in TTS patients.</div></div><div><h3>Methods</h3><div>Using data from the National Inpatient Sample, patients with a primary diagnosis of COPD and a secondary diagnosis of TTS were identified (COPD-TTS group). Patients with a primary diagnosis of TTS and comorbid COPD were selected as a control group (TTS-COPD group). Then, we compared the in-hospital mortality and the incidence of adverse events before and after propensity score matching.</div></div><div><h3>Results</h3><div>603 patients were included in each of the TTS-COPD and COPD-TTS groups after matching. In both groups, the average age of included patients was about 68 years, and more than 85 percent of them were female. There were no statistically significant differences in the in-hospital mortality or the incident of cardiac arrest, ventricular arrhythmias, and AKI, between the two groups (All, p &gt; 0.05). Patients with COPD-TTS had a higher rate of acute respiratory failure (ARF) (p &lt; 0.001), a lower rate of cardiogenic shock (p = 0.001), and a longer length of hospital stay (LOS) (p &lt; 0.001) compared to patients with TTS-COPD.</div></div><div><h3>Conclusions</h3><div>Patients with COPD-TTS had a higher rate of ARF and a longer LOS but a lower risk of cardiogenic shock compared to patients with TTS-COPD.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 43-49"},"PeriodicalIF":2.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689172","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":"Door-to-Diuretic Time is related to length of hospital stay independent of diuretic dose among acute decompensated heart failure patients","authors":"Dillon J Dzikowicz PhD, RN, PCCN ,&nbsp;Mehmed Aktas ,&nbsp;Sunita Pokhrel Bhattarai PhD, RN ,&nbsp;Leway Chen MD, MPH ,&nbsp;Mary G. Carey PhD, RN, FAHA, FAAN","doi":"10.1016/j.hrtlng.2024.11.002","DOIUrl":"10.1016/j.hrtlng.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Acute decompensated heart failure (ADHF) treatment guidelines recommend initial dosages for diuretic drugs but lack guidance on treatment timing. Recent evidence indicates that faster treatment, or shorter Door-to-Diuretic (D2D) Time, may improve outcomes.</div></div><div><h3>Objectives</h3><div>This study assessed how diuretic dose, D2D Time, and their interaction affect hospital length of stay.</div></div><div><h3>Methods</h3><div>Data were analyzed from medical records of ADHF patients in the emergency department of a large academic center. We calculated the odds of longer hospitalization (&gt;7 days) based on diuretic dose, D2D Time, and their interaction, adjusting for age, sex, race, NYHA class, creatinine levels, systolic blood pressure, and comorbidity burden.</div></div><div><h3>Results</h3><div>Our sample of 198 patients who were hospitalized a total of 275 times (mean: 1.48±0.99 hospitalizations) were predominantly male (57 %), older (71, IQR:18.5), years), overweight/obese (30.12, IQR: 11.66 kg/m²), had multiple comorbidities (5.6 ± 2.1), and had a reduced ejection fraction (58 %, <em>n</em> = 159). The median length of hospital stay was 7.0 days (8.0). Peripheral edema was significantly higher among ADHF patients with prolonged hospitalization (28.69% vs. 15.68 %, <em>p</em> = 0.01). D2D Time was a statistically significant predictor of prolonged hospitalization without (OR=1.011609, <em>p</em> = 0.041) and with (OR=1.012409, <em>p</em> = 0.034) covariate adjustment. Neither the diuretic dose nor the interaction between the D2D Time and dose were significant predictors.</div></div><div><h3>Conclusion</h3><div>D2D Time significantly predicts prolonged hospitalization independently of diuretic dosing, highlighting a need for revised ADHF guidelines that include both diuretic dosing and timely administration. Further research is essential to refine these recommendations.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 36-42"},"PeriodicalIF":2.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683799","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":"Reliability, internal consistency, and validity of the World Health Organization disability assessment schedule (WHODAS) 2.0 among adults with heart failure","authors":"Georgia de Melo Castro Gondim ,&nbsp;Julia Maria Sales Bedê ,&nbsp;Cristiany Azevedo Martins ,&nbsp;Francisco Vandecir da Silva ,&nbsp;Brenno Lucas Rodrigues da Silveira ,&nbsp;Vitória Fonteles Ribeiro ,&nbsp;Scheidt Martins da Saúde ,&nbsp;Almino Cavalcante Rocha Neto ,&nbsp;Rafael Mesquita ,&nbsp;Daniela Gardano Bucharles Mont'Alverne","doi":"10.1016/j.hrtlng.2024.11.003","DOIUrl":"10.1016/j.hrtlng.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure (HF) imposes significant disability. The World Health Organization Disability Assessment Schedule (WHODAS) 2.0 is a generic instrument that measures disability. Although it has been used in HF, no previous study has investigated its measurement properties in this group.</div></div><div><h3>Objective</h3><div>To assess the test-retest reliability, internal consistency, convergent, and discriminant validity of WHODAS 2.0 in individuals with HF.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study that included individuals with HF treated at the outpatient cardiology center. Data included sociodemographic and clinical (e.g., New York Heart Association - NYHA) characteristics, estimated functional capacity (Duke Activity Status Index - DASI), quality of life (Minnesota Living with Heart Failure Questionnaire - MLHFQ), and disability (the WHODAS 2.0 36-item version). We assessed associations, using Pearson's correlation coefficient or the Kruskal-Wallis test, between the WHODAS 2.0 scores and the MLHFQ, DASI, and NYHA. The WHODAS 2.0 results were collected again seven days after the initial assessment for reliability (intraclass correlation coefficient - ICC).</div></div><div><h3>Results</h3><div>Participants were 100 people with HF (M age = 57.8 ± 14 years, 57 % men), of whom 84 % were literate. The WHODAS 2.0 was reliable (ICC = 0.789) and had good internal consistency (Cronbach's alpha &gt;0.7 in all domains). Convergent validity was observed through moderate correlations with DASI and MLHFQ and discriminant validity with statistically different results according to NYHA classes.</div></div><div><h3>Conclusion</h3><div>WHODAS 2.0 is a reliable, consistent, and valid instrument for measuring disability in individuals with HF. Further research is needed to evaluate other properties, such as its responsiveness to interventions.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 30-35"},"PeriodicalIF":2.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649874","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":"Lymphocyte-based inflammatory markers: Novel predictors of significant coronary artery disease✰,✰✰","authors":"Dania A. Bani Hani RN, MSN, PhD ,&nbsp;Jafar A. Alshraideh PhD ,&nbsp;Akram Saleh MD, FRCP ,&nbsp;Hamza Alduraidi PhD, MPH, RN ,&nbsp;Abeer A. Alwahadneh RN, PhD (c) ,&nbsp;Salah S. Al-Zaiti PhD","doi":"10.1016/j.hrtlng.2024.11.006","DOIUrl":"10.1016/j.hrtlng.2024.11.006","url":null,"abstract":"<div><h3>Background</h3><div>Lymphocyte-based inflammatory indices such as monocyte-to-lymphocyte ratio (MLR) have long been recognized as reliable coronary artery disease (CAD) predictors. More recently, novel indices like the Systemic Inflammatory Index (SII), Systemic Inflammatory Response Index (SIRI), and Systemic Immune-Inflammation Index (SIIRI) have emerged. These newer markers offer a more comprehensive assessment of inflammation by integrating multiple immune cell types, potentially enhancing the prediction of cardiovascular outcomes.</div></div><div><h3>Objectives</h3><div>We evaluated the predictive value of novel inflammatory markers in estimating the pretest probability of severe CAD in high-risk patients.</div></div><div><h3>Methods</h3><div>We enrolled consecutive patients undergoing diagnostic coronary angiography in a single tertiary care hospital. Inflammatory markers were calculated based on pre-procedural complete blood count laboratory measurements. Severe CAD was defined as critical (&gt;70 %) and actionable narrowing of a primary coronary artery. Classification performance was assessed using multivariate logistic regression.</div></div><div><h3>Results</h3><div>The study sample included 363 patients (age 58.9± 11 years, 44.9 % females, 30 % severe CAD). In univariate analysis, MLR, SIRI, and SIIRI were significant predictors of severe CAD, with age- and sex-adjusted OR of 1.98 [1.25–3.14], 1.79 [1.24–2.59], and 1.63 [1.11–2.38], respectively. In multivariate analysis, SIRI remained an independent predictor of severe CAD (OR = 1.98, 95 % CI 1.13–3.46, <em>p</em> = 0.02).</div></div><div><h3>Conclusion</h3><div>Our results suggest that novel inflammatory markers derived from routine blood tests are predictive of severe CAD in high-risk patients. Such simple, practical, and cost-effective inflammatory markers may enhance cardiac risk stratification and prediction of severe CAD.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 23-29"},"PeriodicalIF":2.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645230","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":"Preliminary efficacy of the vidatalkTM communication application on family psychological symptoms in the intensive care unit: A pilot study","authors":"Ji Won Shin PhD, RN ,&nbsp;Alai Tan PhD ,&nbsp;Judith Tate PhD, RN, ATS-F ,&nbsp;Michele Balas PhD, RN, CCRN-K, FCCM, FAAN ,&nbsp;Holly Dabelko-Schoeny PhD ,&nbsp;Mary Beth Happ PhD, RN, FGSA, FANN","doi":"10.1016/j.hrtlng.2024.11.001","DOIUrl":"10.1016/j.hrtlng.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Family caregivers of ICU patients experience difficulty communicating with patients during mechanical ventilation. Little is known about patient-family communication in the ICU and the associated emotional distress.</div></div><div><h3>Objectives</h3><div>To examine the preliminary effects of the VidaTalk™ communication app on anxiety, depression, and PTSD-related symptoms among family caregivers.</div></div><div><h3>Methods</h3><div>We conducted a prospective study using repeated measures to compare VidaTalk™ to an attention control condition. Twenty-eight family caregivers of nonvocal adult ICU patients participated in this study. The intervention group received VidaTalk™, whereas the attention control group received a standard tablet loaded with MyChart Bedside (EPIC) and game apps during the patient's mechanical ventilation treatment. Family caregiver anxiety and depression (Hospital Anxiety and Depression Scale) were measured at baseline, at extubation/ICU discharge, and 1-, 3-, and 6-months post-ICU discharge. PTSD-related symptoms (Impact of Event Scale-revised) were measured at 1-, 3-, and 6-months. T-tests were used for group comparisons for families’ perceived communication difficulty, anxiety, and depression, and Mann-Whitney U tests were used for PTSD-related symptom comparisons.</div></div><div><h3>Results</h3><div>No statistically significant difference was found between groups in changes in family psychological outcomes, the VidaTalk™ was associated with a small to medium improvement in anxiety symptoms (<em>d</em> = 0.43) at one month. The VidaTalk™ group had lower PTSD-related symptoms than the AC group with a medium effect size (ɳ2=0.07) at one month and a medium-to-large effect size (ɳ2=0.09) at three months.</div></div><div><h3>Conclusions</h3><div>: The VidaTalk™ demonstrated potential as a family caregiving intervention that may be associated with reduced family psychological symptoms.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 14-22"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640320","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":"Bone mineral density and TAVR outcome: A comparative analysis between patients with enhanced and non-enhanced TAVR CT scans","authors":"Caglayan Demirel MD ,&nbsp;Kevin Hamzaraj MD ,&nbsp;Anna Seeber ,&nbsp;Rayyan Hemetsberger MD ,&nbsp;Sophia Koschatko MD ,&nbsp;Charlotte Jantsch MD ,&nbsp;Kseniya Halavina MD ,&nbsp;Carolina Dona MD ,&nbsp;Matthias Koschutnik MD ,&nbsp;Katharina Mascherbauer MD ,&nbsp;Gregor Heitzinger MD ,&nbsp;Varius Dannenberg MD ,&nbsp;Christian Nitsche MD ,&nbsp;Martin Andreas MD, PhD ,&nbsp;Christian Hengstenberg MD ,&nbsp;Philipp E Bartko MD, PhD ,&nbsp;Andreas Kammerlander MD, PhD","doi":"10.1016/j.hrtlng.2024.10.014","DOIUrl":"10.1016/j.hrtlng.2024.10.014","url":null,"abstract":"<div><h3>Background</h3><div>Preprocedural evaluation, including frailty estimation, is crucial in managing patients undergoing Transcatheter Aortic Valve Replacement (TAVR). This involves mandatory computed tomography (CT) scans for assessing body composition parameters. The impact of low bone mineral density (BMD) on TAVR outcomes remains unclear, especially when measured using both non-enhanced and contrast-enhanced CT scans.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to evaluate the influence of low bone mineral density (BMD) on survival following TAVR and to assess the feasibility of BMD measurement conducted with non-enhanced and enhanced TAVR CT scans.</div></div><div><h3>Methods</h3><div>A cohort of consecutive TAVR-scheduled patients (<em>n</em> = 725, November 2015 to March 2022) with available enhanced and non-enhanced CT scans were included. BMD was quantified on a single axial image at the thoracic vertebrae level in both unenhanced and enhanced CT scans, and low BMD was defined as &lt;200 HU. Cox regression was performed for cofounders, which are mainly associated with osteoporosis.</div></div><div><h3>Results</h3><div>A total of 725 patients were included in the study, with 54.1 % being male and a mean age of 80.7 ± 7.3 years. Out of these, 175 patients died during a median follow-up period of 837 days. Lower BMD in patients assessed using non-enhanced CT scans was significantly associated with reduced survival, even after adjusting for predictors of osteoporosis (<em>p</em> = 0.046). However, this association was not observed in patients who underwent contrast-enhanced CT scans (<em>p</em> = 0.830).</div></div><div><h3>Conclusion</h3><div>Opportunistic BMD measurements on non-enhanced TAVR-CT scans are feasible and a predictor for poor adverse after TAVR, providing valuable insights for comprehensive frailty assessments. This underscores the significance of incorporating non-enhanced BMD assessments into the preprocedural evaluations of TAVR patients. However, this association was not observed in contrast-enhanced CT scans.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 8-13"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631635","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}