Heart & Lung最新文献

{"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}

{"title":"Takostubo syndrome: A mind-body response to stress","authors":"Tamera Pearson PhD, FNP","doi":"10.1016/j.hrtlng.2026.102734","DOIUrl":"10.1016/j.hrtlng.2026.102734","url":null,"abstract":"<div><h3>Background</h3><div>Takostubo Syndrome (TTS) is a unique form of heart dysfunction usually proceeded by an experience of intense stress. This unusual cardiac abnormality is a remarkable example of the mind-body connection and the intricate functioning of the autonomic nervous system. Despite global research and increased recognition of TTS, the exact cause and subsequent clinical diagnosis and treatment guidelines remain lacking</div></div><div><h3>Objectives</h3><div>Due to evolving knowledge, this review aims to present a current state of the science overview of TTS. The most current evidence on prevalence, risks, recognition, diagnosis and treatment for TTS is introduced and synthesized. While a holistic approach that recognizes mind-body interconnectedness in TTS supports the discussion of mind-body therapies that could benefit patients in recovery and rehabilitation.</div></div><div><h3>Methods</h3><div>Literature searches were conducted in the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed and EBSCO Host interfaces to MEDLINE. Resources were searched using terms, Takostubo cardiomyopathy, broken-heart syndrome, acute stress and mind-body cardiac event. Limitations for English language, peer-review articles published within the past 5-year was applied initially, then publication date was extended to 10-years. Reference lists of identified articles were examined for additional key studies and publications.</div></div><div><h3>Results</h3><div>Expansion of the literature search provided a dynamic understanding of TTS as a stress-induced cardiac phenomenon that most commonly affects women in their later years following an major emotional trigger. Natural disasters and physical episodes of stress can also trigger TTS. The result is damage to the cardiomyocytes due to the overstimulation of the autonomic sympathetic nervous system. This stunning of the heart produces signs and symptoms very similar to cardiac ischemia. Yet, a diagnostic cardiac work-up reveal a misshapen left apical area but no ischemia. Research is continuing provide insights to delineate the best treatment options for TTS patients. A flexible holistic approach to all aspects of evaluating, diagnosing and managing TTS patients is recommended.</div></div><div><h3>Conclusion</h3><div>TTS is complex cardiac phenomenon that exemplifies the mind-body-heart interconnectedness. For the past three decades experts have been trying to decipher the specific pathophysiology underlying TTS and are attempting to develop clear evidence-based clinical treatment guidelines. However, a complete comprehension of TTS remains elusive.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102734"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183438","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":"Negotiating illness, culture, and care: A qualitative study of heart failure self-management in Jordan","authors":"Walaa Hasan Qarqodah ,&nbsp;Ahmad Rajeh Saifan ,&nbsp;Nabeel Al-Yateem ,&nbsp;Mohannad Eid AbuRuz ,&nbsp;Dena Bani Amer ,&nbsp;Nader Mahmoud Bani Younis ,&nbsp;Omar Qasim Alkolane ,&nbsp;Dana Anwer Abujaber ,&nbsp;Hanan F. Alharbi ,&nbsp;Atika Khalaf","doi":"10.1016/j.hrtlng.2026.102738","DOIUrl":"10.1016/j.hrtlng.2026.102738","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure (HF) requires ongoing patient engagement in self-care to manage symptoms and improve outcomes. However, limited research explores how self-care behaviors are shaped by cultural, personal, and contextual factors in Middle Eastern settings, particularly in Jordan.</div></div><div><h3>Objective</h3><div>To explore the self-care behaviors of Jordanian patients living with HF and examine the factors that influence their self-management practices.</div></div><div><h3>Methods</h3><div>A qualitative explorative design was employed. Semi-structured interviews were conducted with 25 patients recruited from four hospitals across Jordan using purposive sampling. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically using NVivo 15. Trustworthiness was ensured through reflexivity, peer debriefing, and audit trail documentation.</div></div><div><h3>Results</h3><div>Three interrelated themes were identified: (1) Negotiating daily life under constraint, reflecting the ongoing tension between self-care demands and cultural, physical, and occupational limitations; (2) Reconstructing control and identity through self-management, highlighting patients’ personalized strategies, resilience, and evolving self-care; and (3) Family as the backbone of self-care, emphasizing the essential role of familial support in enabling or impeding self-care practices. These findings were interpreted through the Situation-Specific Theory of HF Self-Care.</div></div><div><h3>Conclusion</h3><div>Self-care among Jordanian HF patients is a dynamic, culturally embedded process influenced by personal capacity, family involvement, and contextual barriers. Nursing interventions should adopt family-centered, culturally tailored approaches that support patients' lived realities and enhance sustained self-care engagement.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102738"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167985","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 inflammation‑based index and acute deep vein thrombosis and thrombus burden","authors":"Yifei Bai ,&nbsp;Da Li ,&nbsp;Xin Huang ,&nbsp;Kai Wang ,&nbsp;Zhongzhi Jia ,&nbsp;Hui Qin ,&nbsp;Aijiao Lu","doi":"10.1016/j.hrtlng.2026.102737","DOIUrl":"10.1016/j.hrtlng.2026.102737","url":null,"abstract":"<div><h3>Background</h3><div>Inflammation is pivotal in venous thrombogenesis. Complete blood count (CBC)-derived inflammation indexes are emerging biomarkers, but their value for diagnosing acute deep vein thrombosis (DVT) and stratifying thrombus burden requires further investigation.</div></div><div><h3>Objective</h3><div>To evaluate CBC-derived inflammation indexes—neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), lymphocyte-to-monocyte ratio (LMR), and systemic inflammation response index (SIRI)—for diagnosing acute DVT and stratifying thrombus burden.</div></div><div><h3>Methods</h3><div>In this retrospective study, 360 patients referred for venous Doppler ultrasound were categorized into non-DVT (<em>n</em> = 200), isolated distal DVT (IDDVT, <em>n</em> = 114), and proximal DVT (PDVT, <em>n</em> = 46) groups. Demographic data, comorbidities, and CBC parameters were collected to calculate the indexes. Predictive ability was assessed using receiver operating characteristic (ROC) curve analysis, and group differences were evaluated with the Kruskal-Wallis and Dunn's tests.</div></div><div><h3>Results</h3><div>Acute DVT patients showed significantly elevated NLR, PLR, SII, and SIRI, and reduced LMR. ROC analysis indicated LMR had the highest predictive efficacy for acute DVT (AUC: 0.737) with high specificity (85.5%). For distinguishing IDDVT from PDVT, only NLR and LMR showed significant discriminative value.</div></div><div><h3>Conclusion</h3><div>NLR and LMR are valuable biomarkers for diagnosing acute DVT and assessing thrombus burden. Their high specificity supports adjunctive use in risk stratification, but their low sensitivity necessitates integration with comprehensive clinical assessment.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102737"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168019","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":"Arterial stiffness and left ventricular diastolic dysfunction: insights from the cardio-ankle vascular index","authors":"Tuan Hoang Nguyen MD,&nbsp;Takamitsu Nakamura MD, PhD,&nbsp;Takeo Horikoshi MD, PhD,&nbsp;Manabu Uematsu MD, PhD,&nbsp;Tsuyoshi Kobayashi MD, PhD,&nbsp;Toru Yoshizaki MD, PhD,&nbsp;Yosuke Watanabe MD, PhD,&nbsp;Kazuto Nakamura MD, PhD,&nbsp;Akira Sato MD, PhD","doi":"10.1016/j.hrtlng.2026.102741","DOIUrl":"10.1016/j.hrtlng.2026.102741","url":null,"abstract":"<div><h3>Background</h3><div>Arterial stiffness is a contributor to cardiovascular morbidity, but its role in elevated left ventricular (LV) filling pressure and heart failure with preserved ejection fraction (HFpEF) remains incompletely understood.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the relationship between arterial stiffness and the ratio of early diastolic transmitral flow velocity (E) to early diastolic mitral annulus velocity (e'), as well as its association with LV diastolic dysfunction.</div></div><div><h3>Methods</h3><div>This study cross-sectionally analyzed 335 patients with cardiovascular disease and an ejection fraction ≥50% who underwent the Cardio-Ankle Vascular Index (CAVI) measurement. Multivariable logistic regression was used to identify independent associated factors of elevated LV filling pressure, defined as E/e' &gt;14. Smoothing spline analysis was used to assess the dose-response relationship between CAVI, age, and elevated E/e'. Mediation analysis was used to assess the direct and indirect effects of CAVI, age, and hypertension on elevated filling pressure.</div></div><div><h3>Results</h3><div>CAVI was independently associated with E/e' &gt;14 (odds ratio (OR) 1.43; 95% confidence interval (CI): 1.17–1.74, <em>p</em> <em>&lt;</em> 0.001) and diastolic dysfunction (OR 1.25; 95% CI 1.03–1.52, <em>p</em> = 0.024). CAVI enhanced risk stratification for elevated filling pressure (net reclassification index = 0.588, <em>p</em> &lt; 0.001; integrated discrimination improvement = 0.035, <em>p</em> <em>=</em> 0.008). Smoothing spline analysis revealed a near-exponential increase in E/e' &gt;14 risk above a CAVI threshold of 9.275. Mediated analysis indicated that CAVI accounted for 18.7% of the effect of age on elevated E/e' (<em>p</em> = 0.006).</div></div><div><h3>Conclusion</h3><div>Arterial stiffness, as quantified by CAVI, independently increases the LV filling pressure and mediates age-related effects.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102741"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183513","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":"Sedentary behavior and physical health status explain the relationship between years of residence in socioeconomically distressed counties and risk for Cardiovascular diseases","authors":"Ifeanyi Madujibeya PhD, APRN, AGACNP-BC ,&nbsp;Debra K. Moser PhD, RN, FAHA, FAAN","doi":"10.1016/j.hrtlng.2026.102726","DOIUrl":"10.1016/j.hrtlng.2026.102726","url":null,"abstract":"<div><h3>Background</h3><div>Residents of rural, socioeconomically distressed counties,such as Appalachian Kentucky, experience disproportionately high cardiovascular disease (CVD) risk, compounded by sedentary behavior and poor self-reported physical health.</div></div><div><h3>Objectives</h3><div>This study investigates whether sedentary behavior and poor self-reported physical health serially mediate the relationship between years of residence in rural Appalachian Kentucky counties and CVD risk.</div></div><div><h3>Methods</h3><div>This secondary analysis included 309 adults residing in rural Appalachian counties. Sedentary behavior was measured as daily minutes in sedentary activity using an Actiwatch. Self-reported physical health was assessed using the Short-Form Health Survey-12, and CVD risk was measured using the Framingham risk score. Serial mediation analysis with two mediators was conducted using the PROCESS macro, controlling sociodemographic and lifestyle covariates.</div></div><div><h3>Results</h3><div>The participants’ mean age was 57.3 (±15) years, with an average residence duration of 42.7 (±22.2) years. Participants spent an average of 751.6 (±215.3) minutes per day in sedentary behavior, and the mean CVD risk was 15.3% (±10.4%). Years of residence were directly associated with increased CVD risk (direct effect = 0.168; 95% Boot CI [.117, 0.219]) and indirectly associated through sedentary behavior (indirect effect = 0.016; 95% Boot CI [.006, 0.039]). An additional indirect effect emerged through sedentary behavior leading to poorer self-reported physical health (indirect effect = 0.002; 95% Boot CI [.001, 0.004]).</div></div><div><h3>Conclusion</h3><div>These findings indicate that interventions targeting CVD risk reduction in rural socioeconomically distressed counties should include strategies to reduce sedentary behavior, which may improve self-reported physical health status and decrease CVD risk.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102726"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047464","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":"A retrospective study on the association between C-Reactive Protein-Albumin-Lymphocyte (CALLY) index and adverse prognosis in patients with chronic heart failure (CHF) at different glucose metabolic states","authors":"Yuting Liu ,&nbsp;Guo Song ,&nbsp;Heyu Chu ,&nbsp;Xiaoli Liu ,&nbsp;Xue Bao ,&nbsp;Rong Gu","doi":"10.1016/j.hrtlng.2025.102693","DOIUrl":"10.1016/j.hrtlng.2025.102693","url":null,"abstract":"<div><h3>Background</h3><div>C-Reactive Protein-Albumin-Lymphocyte (CALLY) Index has been proposed as a novel composite predictor based on inflammation, nutrition and immunity. And its clinical significance in patients with chronic heart failure (CHF) at different glucose metabolism states has not previously been studied.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the association between the CALLY index and adverse cardiovascular outcomes in CHF patients, and to examine its interaction with glucose metabolic status.</div></div><div><h3>Methods</h3><div>This retrospective cohort study enrolled 1674 hospitalized CHF patients between December 2018 and August 2022. The primary endpoints were cardiovascular (CV) death and major adverse cardiac and cerebrovascular events (MACCEs). The CALLY index was used to stratify patients into tertiles. Regression models with multivariable Cox proportional hazards were employed to evaluate the association between CALLY levels and primary endpoints.</div></div><div><h3>Results</h3><div>During median follow-up of 876 days, MACCEs were observed in 580 patients (34.6%) and CV death were 219 patients (13.1%). After adjustment, the highest CALLY(&gt;2.05) was linked to the lowest incidence of MACCEs (HR=0.74 CI= 0.60 - 0.92 <em>p</em> = 0.021) and CV death (HR=0.36 CI= 0.25–0.53 <em>p</em> &lt; 0.001). At various glucose metabolic stages, the highest CALLY reduced MACCE risk in diabetic patients (HR = 0.64, 95% CI =0.47–0.86,<em>P</em> = 0.004), but patients with prediabetes and normoglycemia groups did not have the same connection (both <em>P</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Higher CALLY values were correlated with a protective effect against adverse prognosis in CHF, particularly against MACCEs in diabetic individuals, highlighting the importance of inflammation, nutrition, and immunity in this patient population.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102693"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967936","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}