Heart & Lung最新文献

{"title":"The Impact Of Increased Early Utilization Of Angiotensin Receptor Neprilysin Inhibitor (ARNi) And Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i) In New Onset And Chronic HFrEF","authors":"Gladys F. Baksh NP-C","doi":"10.1016/j.hrtlng.2025.04.008","DOIUrl":"10.1016/j.hrtlng.2025.04.008","url":null,"abstract":"<div><h3>Background</h3><div>Despite strong evidence of randomized clinical trials on GDMT for HFrEF in improving mortality and outcomes and reducing HF-related hospitalization, we continue to experience suboptimal use of GDMT. The beneficial medical effects of the 4 pillars of HFrEF cannot be ignored. Considerable efforts, such as guidelines and quality improvement (QI) initiatives, are implemented to mitigate the gaps, and results remain unsatisfactory. Aggressive initiation of GDMT should be a high priority.</div></div><div><h3>Purpose</h3><div>We analyzed the impact of early GDMT initiation with intensified use of ARNi and SGLT2 in new-onset and chronic HFrEF patients with ischemic and nonischemic cardiomyopathy.</div></div><div><h3>Setting/Population</h3><div>From 2020 to 2023, 284 patients with HFrEF were enrolled in the GDMT optimization program as a QI initiative led by HF NP and pharmacist.</div></div><div><h3>Method/Process</h3><div>Patients were followed until they achieved the target or maximum tolerated dose of triple or quadruple therapy. Data collected included echocardiography, laboratory values, NYHA, and HF-related hospital readmissions. Follow-up echocardiography was completed between 3 and 6 months, and HF-related readmission was assessed up to 6 months after completion of the program.</div></div><div><h3>Outcome Measures</h3><div>Among the participants, 94.9% were enrolled within 3 months after being evaluated in the HF clinic. The average age was 64; 70% were male. There were more patients with new onset HF (55%), and the majority were nonischemic (62.3%). Upon completion, there was a similar increase in both groups of those who were on triple and quadruple therapy. The use of ARNi (79.2% vs 84.9%) and SGLT2i (64.8% vs 65.6%) was higher in the two groups at the end of evaluation. A higher percentage of the new onset group had improvement of LVEF, and their absolute degree of improvement was also greater. NYHA Class improved in both groups over the course of therapy. A reduction of BNP was observed, and HF-related readmissions were significantly lower in the new-onset (7.5%) vs the chronic group (19.2%).</div></div><div><h3>Practical Implications</h3><div>The outcome of intensified use of ARNi and SGLT2i underscores the urgency of initiating treatment immediately after diagnosis of HFrEF. Despite etiology, early initiation of GDMT in newly diagnosed HFrEF demonstrates a greater improvement of LVEF, reduction in BNP, and HF-related readmission compared to chronic HFrEF.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"72 ","pages":"Page 103"},"PeriodicalIF":2.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170658","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":"Unite to Thrive: Building an Interdisciplinary Team for Heart Failure Care","authors":"Jacqueline Fitzgerald MSN, APRN, AGCNS-BC, CHFN,&nbsp;Katie Konopacz MSN, APRN, CNP, CHFN","doi":"10.1016/j.hrtlng.2025.04.010","DOIUrl":"10.1016/j.hrtlng.2025.04.010","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;In 2018 Northwestern Lake Forest Hospital initiated the hospital's first Heart Failure program. At that time, it was a suburban hospital with 114 licensed beds. The program was developed in response to enrollment with the Medicare Bundled Payment initiative and high readmission rates within the heart failure patient population. At that time the readmission rate was over 18% for 30-day all-cause readmissions and the hospital saw 292 patients with a primary diagnosis of heart failure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;We recognized the need to develop a structured interdisciplinary Heart Failure team that would be able to improve access to clinical care and provide interventions to reduce readmission rates for multiple different angles. In turn the goal was to improve patient outcomes and satisfaction.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting/Population&lt;/h3&gt;&lt;div&gt;The team cared for patients in the acute hospital setting as well as in the ambulatory clinic post discharge. We focused interventions on patients admitted with a heart failure exacerbation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method/Process&lt;/h3&gt;&lt;div&gt;Developed an interdisciplinary team that consists of RNs (ambulatory clinic, navigators, Clinical Documentation Specialist), APRNs, MDs, PharmD, Pharmacy Technician. The inpatient Heart Failure team consists of a Heart Failure MD, APP, PharmD, and navigator; this team evaluates all patients with a primary heart failure diagnosis provided both medical care and self-management education. The interdisciplinary team meets weekly to review heart failure readmissions, currently admitted patients, patients within the 30-day window of discharge, and all CardioMEMs patients. A heart failure Epic InBasket Pool was created to allow for streamlined communication between with entire team.&lt;/div&gt;&lt;div&gt;Outpatient interventions implemented to assist in reducing readmissions were discharge callbacks within 72 hours, APP run heart failure clinic with hospital follow up appointments as well as urgent appointment slots for new or worsening symptoms, ability to administer IV push diuretics in the outpatient setting, PharmD run Medication Adjustment and Titration (MAT) clinic, Pharmacy Technician assistance with medication access and affordability, free transportation to assist patient is coming to the scheduled appointments, and development of CardioMEMs program.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcome Measures&lt;/h3&gt;&lt;div&gt;Since the inception of the interdisciplinary Heart Failure team, the program saw an 82.5% growth in patient volumes while working to decrease the readmission rate by 27.7%. Furthermore, patients with CardioMEMs reduced their number of heart failure hospitalizations by 82% post implant and the patients that utilized the IV diuretic infusion clinic had a 30 day all cause readmission rate of 6.8%. While introducing a PharmD MAT Clinic allowed for fewer APP visits for GDMT titration, which in turn increased access on the APP clinic schedules for other types of pat","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"72 ","pages":"Pages 104-105"},"PeriodicalIF":2.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170041","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":"Personal, Social and Clinical Factors Affecting Self-Care Maintenance and Management in People with Heart Failure","authors":"Kristen A. Sethares (she/her/hers) PhD, RN, CNE, FAHA, FHFSA,&nbsp;Cheryl Westlake (she/her/hers) PhD, RN, FAHA, FHFSA, FAAN","doi":"10.1016/j.hrtlng.2025.04.011","DOIUrl":"10.1016/j.hrtlng.2025.04.011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Heart failure affects over 6 million people in the US. It is characterized by distressing symptoms typically managed with medications, diet and monitoring. Self-care maintenance includes health-promoting behaviors such as taking medications, following medical recommendations and a specialized diet. Self-care management includes monitoring symptoms and acting when symptoms occur. Personal, social and clinical factors affect self-care maintenance and management behaviors; however, research findings are mixed about these relationships.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aim&lt;/h3&gt;&lt;div&gt;The aim of this study is to determine the influence of personal (age, education level and health literacy), social (marital status and social support) and clinical (NYHA, comorbidity index, and EF) factors on self-care maintenance and management.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Demographics (age, gender, education, marital status, socioeconomic status (SES), HYHA, ejection fraction (EF), comorbidity (Charlson Comorbidity Index (CCI), higher poor), social support (Strogatz Scale, 4-16, lower more support), self-care (SCHFI v6.2, maintenance and management 0-100, &gt; 70 adequate), and health literacy (S-TOFHLA, 0-16 inadequate, 17-22 marginal, 23-36 adequate) were collected in a convenience sample of 116 people with HF admitted to a community hospital. Hierarchical regression explored the influence of personal (step 1: age, education, and health literacy), clinical (step 2: NYHA, EF, CCI) and social (step 3: social support and marital status) factors on levels of self-care maintenance and management.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Subjects had a mean (Mn) age of 74.8+12.3 years and education of 11.9+3.7 years, 41% female, 60% married, and 46% reported having enough to make ends meet. Clinically, subjects had a Mn NYHA of 3 + 0.61, EF of 42.1+14.7, CCI of 3.0 +1.7. Mean social support was 6.1 + 3.8 and health literacy (46% inadequate, 16% marginal, 38% adequate). Self-care maintenance (Mn of 55.5 + 17) and management (Mn of 35 + 20.5) were inadequate. Women had higher EF and were older than males. Comorbidity (r = .22, p = .01) and EF (r = -.27, p = .002) were related to self-care management. Comorbidity (r= .17, p=.03) and literacy level (r= -.15, p = .05) were related to self-care maintenance. Self-care maintenance: Personal variables explained 4.7% of variance in self-care maintenance at step 1. Clinical variables accounted for 5.7% of the variance at step 2 and the addition of social support and marital status in step 3 added 2.1% for a total of 12.5 % explained variance for self-care maintenance overall. EF was the only significant predictor of self-care maintenance (p=.05). Self-care management: In the second regression equation, personal variables explained 4.2% of variance in self-care management at step 1. Clinical variables accounted for 6.3% of the variance at step 2 and the addition of social support and marital status in step 3 added 0","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"72 ","pages":"Page 95"},"PeriodicalIF":2.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170692","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 doctor-patient communication on blood pressure control in hypertensive patients: Mediating role of medication adherence","authors":"Tao Liu MD ,&nbsp;Xinchun Liu PhD ,&nbsp;Jianwei Zeng MM ,&nbsp;Xiexiong Zhao MD ,&nbsp;Liping Peng MD ,&nbsp;Huizhen Zhou MM ,&nbsp;Xiaogang Li MD, PhD ,&nbsp;Weihong Jiang MD, PhD","doi":"10.1016/j.hrtlng.2025.05.005","DOIUrl":"10.1016/j.hrtlng.2025.05.005","url":null,"abstract":"<div><h3>Background</h3><div>Both doctor‒patient communication and medication adherence are related to blood pressure control in hypertensive patients. The connections among doctor‒patient communication, medication adherence, and blood pressure control have not been fully explained.</div></div><div><h3>Objective</h3><div>This study aimed to investigate the effect of doctor-patient communication on blood pressure control and to test the hypothesis of medication adherence as a mediator.</div></div><div><h3>Methods</h3><div>In Changsha, China, this cross-sectional study was carried out in 10 affiliated communities of community health centers from January to October 2023. A multistage stratified sampling method gathered a diverse population. A structured questionnaire utilized the Set-Elicitation-Give-Understand-End (SEGUE) framework to evaluate doctor-patient communication and the Morisky Medication Adherence Scale-8 (MMAS-8) scale to assess medication adherence. Binary logistic regression was used to analyze the effect of doctor‒patient communication on blood pressure control. Stepwise regression was used to test the mediating effect of medication adherence on this effect.</div></div><div><h3>Results</h3><div>A total of 431 valid questionnaires were analyzed. A total of 66.8 % of the participants experienced poor doctor‒patient communication, and 142 participants (32.9 %) demonstrated good blood pressure control. Both univariate and multivariable logistic analyses revealed that patients with better doctor–patient communication had better blood pressure control (OR=6.93, <em>P</em> &lt; 0.001; OR=6.52, <em>P</em> &lt; 0.001). A total of 214 participants (49.7 %) exhibited good medication adherence. Medication adherence had a mediating effect of 0.13 (26.5 % of the total effect, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Doctor-patient communication had a significant positive effect on blood pressure control in patients with hypertension and medication adherence was a partial mediator.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 197-206"},"PeriodicalIF":2.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167149","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":"Suppressed autophagy of thymic cells promotes apoptosis and thymic atrophy in COPD","authors":"Shengyang He ,&nbsp;Zhipeng Yang ,&nbsp;Lihua Xie","doi":"10.1016/j.hrtlng.2025.05.012","DOIUrl":"10.1016/j.hrtlng.2025.05.012","url":null,"abstract":"<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD) is a prevalent and incurable condition characterized by persistent inflammation and systemic complications. Although the thymus is traditionally believed to undergo involution in adulthood, it continues to play a critical role in immune regulation and tumor surveillance. However, its specific involvement in COPD remains largely unexplored.</div></div><div><h3>Objectives</h3><div>This study aimed to investigate the presence and mechanisms of thymic atrophy in COPD.</div></div><div><h3>Methods</h3><div>Thymic atrophy was assessed in COPD patients through chest CT imaging and further validated in a cigarette smoke-induced COPD mouse model. We examined thymic cell counts, levels of apoptosis, epithelial-mesenchymal transition (EMT) markers, expression of aging-related markers (p53 and p21), and autophagy activity with related pathway signals.</div></div><div><h3>Results</h3><div>Chest CT scans from 251 subjects revealed progressive thymic atrophy in COPD patients, correlating with disease severity. In COPD model mice, histological analysis showed reduced thymocyte counts, increased apoptosis, and selective loss of CD8⁺ T cells. EMT features were observed, along with decreased autophagy markers and disrupted PI3K/mTOR signaling.</div></div><div><h3>Conclusion</h3><div>COPD is associated with severe thymic atrophy potentially driven by impaired autophagy and aging-related apoptosis, offering new insights into immune dysfunction and potential therapeutic targets.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 180-189"},"PeriodicalIF":2.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138829","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 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}