Heart & Lung最新文献

{"title":"A novel nurse-led, multidisciplinary, and guideline-directed disease intensive management program improves long-term survival of pulmonary hypertension patients","authors":"Jiajun Guo ,&nbsp;Juan He ,&nbsp;Jiaqi Wang ,&nbsp;Yaodan Liang ,&nbsp;Yangjie Li ,&nbsp;Chen Chen ,&nbsp;Bi Wen ,&nbsp;Lidan Yin ,&nbsp;Shoufang Pu ,&nbsp;Ke Wan ,&nbsp;Jie Wang ,&nbsp;Weihao Li ,&nbsp;Yuanwei Xu ,&nbsp;Yuchi Han ,&nbsp;Yucheng Chen","doi":"10.1016/j.hrtlng.2025.05.011","DOIUrl":"10.1016/j.hrtlng.2025.05.011","url":null,"abstract":"<div><h3>Background</h3><div>Although the overall survival of pulmonary hypertension (PH) patients improved in the current era, better management strategy for PH patients still needs further exploration.</div></div><div><h3>Objectives</h3><div>Here, we proposed a novel nurse-led, multidisciplinary, and guideline-directed disease intensive management program and hypothesized this strategy would improve the overall survival of PH patients.</div></div><div><h3>Methods</h3><div>Patients were prospectively enrolled and divided into the intensive management group (IDM) and the conventional disease care (CDC) group voluntarily. Intensive management was nurse-led and delivered by multidisciplinary teams, including patient education, symptoms monitoring, and patient adherence improvement with careful outpatient or inpatient assessment every 3 months and medicine prescription whenever needed. Patients with conventional care were treated by primary cardiologists’ consultants and telephone follow-ups every year.</div></div><div><h3>Results</h3><div>Overall, 413 PH patients were finally included. Both total survival (p&lt;0.001) and event-free survival (p=0.008) of the IDM group were significantly higher than the CDC group. After adjustment of age and sex, intensive management was also an independent protective predictor for both primary [all-cause mortality, HR 0.378, 95% CI (0.214-0.668), p&lt;0.001] and composite endpoints [all-cause mortality and re-hospitalization, HR 0.648, 95% CI (0.454-0.927), p=0.017]. In subgroup analysis, IDM was beneficial in prolonging the overall survival of patients in high-risk situations (HR 0.283, 95% CI 0.125-0.641, p=0.002) and with advanced RV dysfunction (HR 0.250, 95% CI 0.123-0.510, p&lt;0.001).</div></div><div><h3>Conclusion</h3><div>Nurse-led, multidisciplinary, and guideline-directed disease intensive management program represented an ideal method to strengthen the overall and event-free survival of PH patients, especially for those in advanced stages of PH.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 190-196"},"PeriodicalIF":2.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of adequate urinary output to the first diuretic dose on length of stay in patients hospitalized for acute decompensated heart failure","authors":"Gagan Gupta MD ,&nbsp;Adam Stein MD ,&nbsp;Matthew Konerman MD ,&nbsp;Nicole Farquhar MEng ,&nbsp;Sarah Adie PharmD, BCCP","doi":"10.1016/j.hrtlng.2025.05.009","DOIUrl":"10.1016/j.hrtlng.2025.05.009","url":null,"abstract":"<div><h3>Background</h3><div>Intravenous (IV) diuretic use is one of the mainstays of therapy for patients admitted with acute decompensated heart failure (ADHF). While current guidelines recommend administration of at least 2.5 times the daily home diuretic dose for IV diuresis, there is no literature evaluating outcomes for patients reaching their diuretic threshold on their first dose.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate adequate urinary output (UOP) to first IV diuretic dose and length of stay (LOS).</div></div><div><h3>Methods</h3><div>This single center retrospective study included patients admitted to the University of Michigan for ADHF (05/2023–11/2024). Patients received diuretics within their first day of hospitalization and their UOP was tracked at 3-, 6-, 12-, and 24-hours post administration. Adequate UOP was defined as an average of &gt;150 mL/hr 3-hours post diuretic administration. The primary outcome studied was LOS. Secondary endpoints included urinary output volume at 6-, 12-, and 24-hours and 30-day readmission.</div></div><div><h3>Results</h3><div>A total of 988 patients were included. There were 547 patients with adequate UOP and 441 patients with inadequate UOP. Patients with adequate UOP had a median LOS of 5.20 (3.26–8.51) days while patients with inadequate UOP had a median LOS of 5.93 (3.73–9.72) days (<em>p</em> = 0.007). The adequate UOP cohort had higher volumes of UOP at the interval 6-, 12-, and 24-hour marks. There were no observed differences in 30-day readmissions between the adequate and inadequate UOP cohorts (17.0 % vs 17.6 %, <em>p</em> = 0.445).</div></div><div><h3>Conclusion</h3><div>Patients admitted for ADHF who had an adequate UOP had a significantly shorter LOS.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 170-173"},"PeriodicalIF":2.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124099","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":"Prognostic implications of takotsubo cardiomyopathy in cardiogenic shock: A propensity score-matched analysis of the national inpatient sample (2016–2020)","authors":"Bekure B. Siraw MD, MPH ,&nbsp;Mouaz Oudih MD ,&nbsp;Yonas Gebrecherkos MD ,&nbsp;Neiberg A Lima MD ,&nbsp;Titilope Olanipekun MD, MPH ,&nbsp;Juveriya Yasmeen MD ,&nbsp;Mohammed Haroun MD ,&nbsp;Shahin Isha MD ,&nbsp;Yordanos T. Tafesse MD, MPH ,&nbsp;Mohammed Hussein MD ,&nbsp;Jose Medina-Inojosa MD, MS","doi":"10.1016/j.hrtlng.2025.05.004","DOIUrl":"10.1016/j.hrtlng.2025.05.004","url":null,"abstract":"<div><h3>Background</h3><div>Takotsubo cardiomyopathy (TTC), also called stress-induced cardiomyopathy, characterized by transient acute systolic dysfunction mimicking myocardial infarction in the absence of obstructive coronary artery disease, is a recognized cause of cardiogenic shock.</div></div><div><h3>Objectives</h3><div>This study aimed to investigate whether TTC is associated with favorable in-hospital outcomes in patients admitted for cardiogenic shock.</div></div><div><h3>Methods</h3><div>We used National Inpatient Sample (2016–2020) data to identify admissions with cardiogenic shock and Takotsubo syndrome (TTC) using ICD-10 codes. A 1:1 nearest-neighbor propensity score matching was performed with sociodemographic and clinical variables as matching factors. All-cause in-hospital mortality was the primary outcome, and secondary outcomes included in-hospital complications, length of stay (LOS), and total cost of hospitalization.</div></div><div><h3>Results</h3><div>The final sample included 22,594 admissions, evenly distributed between the groups with and without TTC. The cohort’s mean age was 65.4 years (SD = 15.9), with 74.7 % being males. The overall in-hospital mortality rate was 32.7 %. The TTC group had a lower overall in-hospital mortality rate (OR = 0.60; 95 % CI [0.56, 0.63]) and 30-day in-hospital mortality rate (HR = 0.61; 95 % CI [0.59, 0.64]). Admissions with TTC had lower odds of in-hospital complications, including cardiac arrest, ventricular arrhythmia, and acute kidney injury. However, they were noted to have higher odds of deep vein thrombosis, ischemic stroke, intracranial hemorrhage, and a marginally higher LOS, and total cost of hospitalizations.</div></div><div><h3>Conclusion</h3><div>Our study suggests that TTC is associated with significantly lower in-hospital mortality rates among cardiogenic shock admissions.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 162-169"},"PeriodicalIF":2.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124100","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 SGLT2 inhibitors on inflammatory markers and oxygen consumption in non-diabetic patients with STEMI undergoing primary PCI: A parallel design single blind controlled trial","authors":"Huijuan Li ,&nbsp;Xiaoming Qin ,&nbsp;Leiguang Zhang ,&nbsp;Shuai Liu ,&nbsp;Jieyun Liu","doi":"10.1016/j.hrtlng.2025.05.010","DOIUrl":"10.1016/j.hrtlng.2025.05.010","url":null,"abstract":"<div><h3>Background</h3><div>The sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated potential benefits, including anti-inflammatory effects, reverse left ventricular remodeling, improved myocardial fibrosis, and enhanced microcirculation. However, the potential of these drugs to improve cardiac remodeling and function in non-diabetic patients without heart failure remains unclear.</div></div><div><h3>Objective</h3><div>This study aims to evaluate the impact of the SGLT2 inhibitor (empagliflozin) on inflammatory markers and maximum oxygen consumption (VO₂ max) in non-diabetic patients experiencing acute ST-segment elevation myocardial infarction (STEMI) and undergoing percutaneous coronary intervention (PCI).</div></div><div><h3>Methods</h3><div>The expression levels of tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), high-sensitivity C-reactive protein (hs-CRP), and VO₂ max were measured and compared before and after surgery in both groups.</div></div><div><h3>Results</h3><div>Baseline levels of TNF-α, IL-10, and hs-CRP did not differ significantly between the two groups prior to treatment. One month post-treatment, both groups demonstrated reductions in TNF-α and hs-CRP levels relative to preoperative values, with the experimental group showing significantly lower levels of TNF-α and hs-CRP compared to the control group (<em>P</em> &lt; 0.05). Additionally, the VO₂ max values measured one week post-surgery revealed a statistically significant difference between the two groups (<em>t</em> = 2.4, <em>P</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>Empagliflozin administration in non-diabetic patients with STEMI undergoing emergency PCI may effectively reduce inflammatory markers and improve oxygen consumption capacity. These findings suggest a potential cardioprotective role for empagliflozin in this patient population.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 174-179"},"PeriodicalIF":2.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130862","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":"Video education for patients with heart failure: A systematic review and meta-analysis","authors":"Shuri Nakao PT ,&nbsp;Hidehiro Someko MD ,&nbsp;Masatsugu Okamura PT, PhD ,&nbsp;Tomohiko Kamo PT, PhD ,&nbsp;Yasushi Tsujimoto MD, MPH ,&nbsp;Hirofumi Ogihara PT, PhD ,&nbsp;Shinya Sato PT, MSc ,&nbsp;Sokichi Maniwa MD, PhD","doi":"10.1016/j.hrtlng.2025.05.002","DOIUrl":"10.1016/j.hrtlng.2025.05.002","url":null,"abstract":"<div><h3>Background</h3><div>Education is essential for disease management in patients with Heart Failure (HF). Video education, based on adult learning and self-efficacy theories, may enhance outcomes by combining visual and auditory information. No study has comprehensively reviewed the impact of video education on mortality, HF) hospitalization, and Quality of Life (QOL) in patients with HF.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of video education in improving the clinical outcomes of patients with HF.</div></div><div><h3>Methods</h3><div>This systematic review followed the 2020 PRISMA guidelines. We included randomized controlled trials that assessed the effectiveness of video education combined with usual care for patients with HF compared with those receiving usual care only. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov, PEDro, and CINAHL until December 2023. We pooled data on mortality, HF hospitalization, and QOL as the primary outcomes.</div></div><div><h3>Results</h3><div>The certainty of evidence was evaluated by the GRADE approach. We included 22 studies with a total of 6614 patients with HF. The evidence is very uncertain about the effect of video education, compared with usual care, on mortality (risk ratio 0.90, 95 % CI 0.70 to 1.15; I² = 10 %; very low certainty evidence), HF hospitalization (risk ratio 1.10, 95 % CI 0.85 to 1.44; I² = 14 %; very low certainty evidence), and QOL (standardized mean difference -0.35, 95 % CI -1.07 to 0.37; I² = 89 %; very low certainty evidence).</div></div><div><h3>Conclusion</h3><div>Currently, video education may not take precedence over established interventions in the management of HF.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 153-161"},"PeriodicalIF":2.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124098","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":"Artificial intelligence in the management of patient-ventilator asynchronies: A scoping review","authors":"Javier Muñoz ,&nbsp;Rocío Ruíz-Cacho ,&nbsp;Nerio José Fernández-Araujo ,&nbsp;Alberto Candela ,&nbsp;Lourdes Carmen Visedo ,&nbsp;Javier Muñoz-Visedo","doi":"10.1016/j.hrtlng.2025.05.003","DOIUrl":"10.1016/j.hrtlng.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Patient-ventilator asynchronies (PVAs) are frequent complications in mechanically ventilated patients, contributing to adverse outcomes such as ventilator-induced lung injury, prolonged mechanical ventilation, and increased mortality. Artificial intelligence (AI) has emerged as a promising tool for enhancing PVA detection, prediction, and optimization. Despite its growing potential, the full scope of AI applications in this field and persistent gaps in evidence remain inadequately explored.</div></div><div><h3>Objective</h3><div>This scoping review examines the breadth of AI-based approaches for managing PVAs, identifying key methodologies, evaluating research trends, and highlighting limitations in the current literature.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in PubMed, Embase, Science Direct, IEEE Xplore, and the Cochrane Library without time restrictions. Extracted data included study objectives, AI methodologies, patient populations, performance metrics, and clinical outcomes. The findings were synthesized into thematic categories to map advancements and research gaps.</div></div><div><h3>Results</h3><div>Twenty-six studies were identified that applied AI techniques to detect, predict, or optimize PVAs. The included studies employed a range of AI methodologies, including convolutional neural networks, long short-term memory networks, and hybrid algorithms. These models demonstrated high predictive performance, with accuracy ranging from 87 % to 99 % and AUROC values exceeding 0.98 for detecting complex asynchronous events. AI systems also showed promise in predicting weaning success and optimizing ventilatory settings through real-time patient-specific adjustments. However, challenges such as reliance on single-center datasets, inconsistencies in calibration, and limited implementation of explainable AI frameworks restrict their clinical applicability.</div></div><div><h3>Conclusions</h3><div>AI holds transformative potential in managing PVAs by enabling real-time detection, improved weaning prediction, and personalized ventilatory strategies. However, significant challenges remain, particularly the need for multi-center validation, standardized reporting protocols, and randomized controlled trials to evaluate clinical efficacy. Addressing these gaps is essential for integrating AI into routine critical care practice and transitioning from theoretical models to practical, real-world applications in intensive care units.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 139-152"},"PeriodicalIF":2.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114945","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":"Interaction of smoking and domestic animal exposure associated with decreased lung function in adults of Southeastern China","authors":"Le-Yun Tan ,&nbsp;Li Yang ,&nbsp;Ming-Tao Yu ,&nbsp;Mei-Ling Jin ,&nbsp;Xiao-Ping Lin ,&nbsp;Yu-Hui Chen ,&nbsp;Li Dong ,&nbsp;Hui Cai ,&nbsp;Xiao-Yang Chen ,&nbsp;Shuai Huang ,&nbsp;Cheng-Shui Chen ,&nbsp;Fan Zhang ,&nbsp;Qing-Ying Zhang","doi":"10.1016/j.hrtlng.2025.05.007","DOIUrl":"10.1016/j.hrtlng.2025.05.007","url":null,"abstract":"<div><h3>Background</h3><div>Exposure to smoking and domestic animals often occur simultaneously. However, epidemiological evidence on the independent and combined effects of smoking and domestic animal exposure on adult lung function is limited.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to explore the interaction of smoking and domestic animal exposure on adult lung function.</div></div><div><h3>Methods</h3><div>A total of 6,277 adults were recruited from Southeastern China in this study. Lung function measurements included forced expiratory volume in 1 s (FEV1); forced vital capacity (FVC); FEV1/FVC ratio; peak expiratory flow (PEF); and forced expiratory flow (FEF)25 %, FEF50 %, and FEF75 %. The interaction between smoking and domestic animal exposure was assessed by including a product term in the linear regressions, with the coefficient of the product term (β_interaction) used as a measure of interaction. Stratified analysis was conducted for smoking behavior and animal types.</div></div><div><h3>Results</h3><div>Among smokers, lung function declined more in those with domestic animal exposure than in those without: the β_interactions for FVC, FEV1, FEV1/FVC ratio, and PEF were -0.13 (95 % CI: -0.23, -0.03), -0.15 (-0.23, -0.08), -1.78 (-3.29, -0.27), and -0.43 (-0.67, -0.20), respectively, with them varied with smoking behavior and was greatest on FEV1/FVC ratio. Moreover, we found that only poultry exposure exhibited an interaction with smoking, the β_interactions for FVC; FEV1; FEV1/FVC ratio; PEF; FEF25 %, and FEF50 % were -0.22 (-0.35, -0.08); -0.24 (-0.34, -0.15); -2.93 (-4.86, -1.00); -0.64 (-0.94, -0.35); -0.51 (-0.86, -0.15), and -0.32 (-0.53, -0.11), respectively.</div></div><div><h3>Conclusions</h3><div>Poultry exposure exacerbated the adverse effects of smoking on lung function in adults. This study suggests that individuals engaged in poultry-related industries should quit smoking to reduce lung function decline.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 131-138"},"PeriodicalIF":2.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107679","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 Fresh Look and New Horizons: Key Developments in Heart & Lung for 2025","authors":"","doi":"10.1016/j.hrtlng.2025.05.001","DOIUrl":"10.1016/j.hrtlng.2025.05.001","url":null,"abstract":"","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"72 ","pages":"Page A1"},"PeriodicalIF":2.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113015","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":"Depression, mutuality, and self-care behaviors in patients with heart failure and their caregivers: An actor–partner interdependence model extended to mediation","authors":"Youn-Jung Son ,&nbsp;JiYeon Choi ,&nbsp;Da-Young Kim ,&nbsp;So Hyun Park","doi":"10.1016/j.hrtlng.2025.05.006","DOIUrl":"10.1016/j.hrtlng.2025.05.006","url":null,"abstract":"<div><h3>Background</h3><div>Mutuality may serve as a protective factor against depression for both patients with heart failure (HF) and their caregivers. Mutuality, a sense of positive interaction, is associated with better self-care for HF patients and for lower levels of depression. The mechanism linking mutuality to improved self-care and lowered depression is unclear.</div></div><div><h3>Objectives</h3><div>To examine whether mutuality, the quality of interactions between HF dyads, functions as a mediator in the association between depression and self-care behaviors.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among 202 HF dyads from two university-affiliated tertiary hospitals in Seoul, South Korea. Dyadic data were analyzed by the actor–partner interdependence model extended to mediation analysis. We tested whether depression influenced HF self-care behaviors and caregiver contributions through mutuality. Mutuality, measured via self-reported perceptions from both dyad members, was assessed as a potential mediator at both individual and dyadic levels.</div></div><div><h3>Results</h3><div>Patients’ depression had significant direct effects (actor effects) on their own self-care behaviors (β = -0.61, 95 % confidence interval (CI) = –1.22 to –0.12) and caregivers’ contribution to self-care behaviors (partner effects) (β = –0.92, 95 % CI = –1.65 to –0.19). Patients’ mutuality mediated the association between patients’ depression and self-care behaviors (β = –0.27, 95 % CI = –0.57 to –0.07). Caregivers’ mutuality mediated the relationship between caregivers’ depression and contribution to self-care behaviors (β = –0.26, 95 % CI = –0.61 to –0.01).</div></div><div><h3>Conclusion</h3><div>Mutuality may serve as a protective factor against depression in HF dyads. The relationship quality in HF dyads should be assessed, with psychosocial interventions implemented to enhance dyadic self-care behaviors.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 123-130"},"PeriodicalIF":2.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089530","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 and safety of Nintedanib in idiopathic pulmonary fibrosis: A systematic review and meta-analysis","authors":"Shamikha Cheema MBBS ,&nbsp;Muhammad Nabeel Saddique MBBS ,&nbsp;Anurag Jha MBBS ,&nbsp;Ayesha Sehar MBBS ,&nbsp;Umaima Cheema MBBS ,&nbsp;Fatima Shahid MBBS ,&nbsp;Muhammad Faique Hassan MBBS ,&nbsp;Hammad Javaid MBBS ,&nbsp;Valeria Chiara Lanari MBBS ,&nbsp;Ali Nawaz MBBS","doi":"10.1016/j.hrtlng.2025.05.008","DOIUrl":"10.1016/j.hrtlng.2025.05.008","url":null,"abstract":"<div><h3>Background</h3><div>Idiopathic pulmonary fibrosis (IPF) is a progressive, potentially fatal lung disorder characterized by scarring, leading to reduced lung function and respiratory failure. Nintedanib, a tyrosine kinase inhibitor, shows potential in slowing IPF progression, but uncertainties remain about its long-term efficacy and safety.</div></div><div><h3>Objective</h3><div>To evaluate the efficacy and safety of Nintedanib in idiopathic pulmonary fibrosis.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across PubMed, Cochrane, Scopus, Embase, and ClinicalTrials.gov from inception to August 2024, selecting studies based on predefined eligibility criteria. Dichotomous outcomes were pooled as risk ratios (RR) and continuous outcomes as mean differences (MD), both with 95% confidence intervals (CI), using random-effects models to account for potential heterogeneity. Heterogeneity was assessed using I² and X² statistics, with a p-value of &lt;0.05 considered statistically significant. All calculations were performed using RevMan 5.4.</div></div><div><h3>Results</h3><div>This meta-analysis included 4 randomized controlled trials with 1,665 patients, 79.7% of whom were male smokers. There was no significant difference in IPF progression (RR=0.61, 95% CI 0.34-1.08, I²=41%) or in nasopharyngitis (RR=0.82, 95% CI 0.62-1.08, I²=0%), cough (RR=0.98, 95% CI 0.71-1.33, I²=0%), bronchitis (RR=0.90, 95% CI 0.63-1.28, I²=0%), respiratory infections (RR=1.01, 95% CI 0.59-1.75, I²=0%), dyspnea (RR=0.68, 95% CI 0.46-1.00, I²=0%), or cardiac disorders (RR=0.89, 95% CI 0.50-1.58, I²=0%), indicating nintedanib does not notably alter these risks. However, nintedanib significantly increased gastrointestinal adverse events, potentially affecting adherence and quality of life.</div></div><div><h3>Conclusion</h3><div>Nintedanib shows promise in slowing disease progression but carries a higher risk of adverse events. Limited sample sizes and short follow-up necessitate larger studies to confirm its efficacy and safety.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 114-122"},"PeriodicalIF":2.4,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071188","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}