Heart & Lung最新文献

{"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":"Board of Directors","authors":"","doi":"10.1016/j.hrtlng.2026.102856","DOIUrl":"10.1016/j.hrtlng.2026.102856","url":null,"abstract":"","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102856"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148523840","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":"Successful cardioneural ablation for deglutition syncope","authors":"Kyle Steiger MD,&nbsp;Anthony H. Kashou MD,&nbsp;Caroline B. Ledet MD,&nbsp;Guru G. Kowlgi MBBS MS","doi":"10.1016/j.hrtlng.2026.102819","DOIUrl":"10.1016/j.hrtlng.2026.102819","url":null,"abstract":"<div><div>Neurocardiogenic syncope—also known as vasovagal syncope—affects up to 40% of adults in their lifetime. Deglutition or “swallow” syncope is a rare subtype of neurocardiogenic syncope induced by distension of the vagally innervated esophagus during swallowing. We report the case of a patient with swallow syncope who underwent cardioneural ablation, leading to a significant reduction in symptom burden and improvement in his quality of life.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102819"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876652","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":"Mobilizing Heart Failure Care: The Impact of Leader-Led Mobility Rounds","authors":"Allison Fox MSN, APRN, AGCNS-BC, PCCN,&nbsp;Katherine Adams MSN, RN, CNML, PCCN,&nbsp;Taylan Doherty DPT,&nbsp;Krystan Coble BSN, RN","doi":"10.1016/j.hrtlng.2026.102815","DOIUrl":"10.1016/j.hrtlng.2026.102815","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Promoting mobility prevents functional decline, supports discharge readiness, and decreases length of stay. This project occurred at a &gt;1,000 bed academic medical center with tertiary and quaternary services, on a 17-bed cardiology stepdown unit caring for acute HF, cardiogenic shock, and advanced HF (LVAD and transplant candidates). The aim was to establish mobility practice standards via leader-led mobility rounds, identify and address barriers, and assess impact on patient outcomes. The Banner Mobility Assessment tool (BMAT) standardized mobility assessment and guided the level-specific mobility.</div></div><div><h3>PURPOSE</h3><div>The aim was to establish mobility practice standards via leader led mobility rounds, identify and address barriers, and assess impact on patient outcomes.</div></div><div><h3>SETTING/POPULATION</h3><div>This project occurred at a &gt;1,000 bed academic medical center with tertiary and quaternary services, on a 17 bed cardiology stepdown unit caring for acute HF, cardiogenic shock, and advanced HF (LVAD and transplant candidates).</div></div><div><h3>METHOD/PROCESS</h3><div>A total of 205 patients, randomly selected each week from hospitalized HF patients, were included in this pre–post quality improvement study evaluating the implementation of weekly mobility rounds aligned with heart failure guidelines for early, progressive mobility. Baseline data were collected over a 2 month period, followed by a 13 month intervention during which weekly audits captured BMAT scores, mobility performed per BMAT level, frequency, barriers, and countermeasures. Performance metrics were posted on the improvement board and reviewed during weekly multidisciplinary huddles. Balancing measures included fall rates and discharge disposition.</div></div><div><h3>OUTCOME MEASURES</h3><div>Mobility ≥3 times/day increased from 49% at baseline (n=28) to 80% post intervention (n=177). Fall with injury rates decreased from 0.89 to 0.31. Rehab discharges decreased from 9.5% at baseline to 5.9%. Average observed length of stay decreased from 7.1 to 6.9 days.</div></div><div><h3>PRACTICAL IMPLICATIONS</h3><div>Standardized mobility rounds substantially improved mobility frequency and patient safety, demonstrating that evidence-based protocols and nursing-led engagement effectively advance mobility practices for heart failure care.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102815"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148523311","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":"S-S.M.A.R.T score for mortality prediction in sepsis: Comparative analysis with qSOFA and a novel SSMART-MC model","authors":"Serdar Özdemir,&nbsp;İbrahim Altunok,&nbsp;Merve Osoydan Satıcı M.D.,&nbsp;Hilal Sümeyye Körelçiner MD","doi":"10.1016/j.hrtlng.2026.102735","DOIUrl":"10.1016/j.hrtlng.2026.102735","url":null,"abstract":"<div><h3>Background</h3><div>Early risk stratification in sepsis is essential for guiding timely clinical decisions in the emergency department (ED). While several prognostic scores exist, many rely on laboratory parameters that may not be immediately available at triage.</div></div><div><h3>Objective</h3><div>To evaluate the prognostic performance of the S-S.M.A.R.T score for predicting 30-day mortality in patients with Sepsis-3–defined sepsis and to assess whether incorporating comorbidity and biomarker data enhances predictive accuracy.</div></div><div><h3>Methods</h3><div>This prospective observational study included adult patients (≥18 years) presenting to a ED with sepsis defined by Sepsis-3 criteria. Demographic, clinical, and laboratory data were collected at ED presentation. The S-S.M.A.R.T score, SOFA score, and a novel SSMART-MC model (S-S.M.A.R.T plus malignancy and CRP) were calculated. Logistic regression identified independent predictors of 30-day mortality. Prognostic performance was assessed using area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and overall accuracy.</div></div><div><h3>Results</h3><div>Among 180 patients, 104 (57.8%) died within 30 days. Median S-S.M.A.R.T and SOFA scores were higher in non-survivors (3 vs. 2 and 9 vs. 6; <em>p</em> &lt; .001). S-S.M.A.R.T predicted 30-day mortality with an AUC of 0.718, similar to SOFA (AUC 0.735; <em>p</em> = .701). Incorporating malignancy and CRP, the SSMART-MC model achieved an AUC of 0.867, with 87.3% sensitivity, 72.0% specificity, and 80.8% overall accuracy.</div></div><div><h3>Conclusions</h3><div>In this Sepsis-3 cohort, the S-S.M.A.R.T score showed performance comparable to qSOFA for predicting 30-day mortality. The incorporation of malignancy and CRP appeared to improve prognostic accuracy. However, given the limited sample size and lack of external validation, the SSMART-MC model should be considered a promising tool that requires confirmation in larger, multicenter studies before routine clinical use.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102735"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144714","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":"Where there's a will, there's a way: The relationship among will to live, hope, illness representations, and heart failure self-care","authors":"Stephanie Turrise PhD, MBA, RN-BC, APRN, CNE, CHFN, FAHA,&nbsp;Kayla Alderson,&nbsp;Carolyn Kleman PhD, MHA, RN, CNE, BCPA,&nbsp;Caroline Jenkins BSN, RN,&nbsp;Nia Lewis SN,&nbsp;Christopher Evonko PhD(c)","doi":"10.1016/j.hrtlng.2026.102818","DOIUrl":"10.1016/j.hrtlng.2026.102818","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND&lt;/h3&gt;&lt;div&gt;Heart failure (HF) is a life-limiting, chronic condition that affects 6.7 million Americans. According to the Common Sense Model of Self-Regulation (CSM), individuals take action and make decisions about illness management based on their perceptions and interpretations (illness representations), including illness threat. Representations shape coping responses that guide self-care behaviors. Will to live (WTL) and hope are motivational coping responses linked to adaptation in chronic and cardiovascular illness. However, their roles in heart failure self-care (HFSC) (monitoring, management, maintenance, and self-efficacy) and their relationship to illness representations remain unclear.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;AIM&lt;/h3&gt;&lt;div&gt;The purpose of this study was to examine relationships among illness representations, hope, will to live, and HFSC, and to test whether hope and WTL moderate the relationship between illness threat and HFSC.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;Using a cross-sectional survey design in Qualtrics, a national sample of US adults with HF (N=204) was recruited using Prolific Academic Ltd. Participants completed five measures, the Trait Hope Scale, Brief Illness Perception Questionnaire, Will to Live (WTL) Scale, Self Care in Heart Failure Index v8, and a demographic inventory. Descriptive statistics, bivariate Pearson correlations, and a regression-based moderation approach were conducted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Participants ranged in age from 19-86 years (M=49), were majority male (56%), well-educated (72% bachelor’s degree or higher), partnered (68%), and White (74%). They had lived with HF ranging from 6 months to 30 years (M=5.8 years). Overall, participants had adequate HFSC maintenance (M=73.18, SD=14.06), monitoring (M=73.42, SD=16.27), management (M=71.24, SD=18.82), and efficacy (M=77.99, SD=15.7). The WTL was fairly strong (M = 3.73, SD = 0.84, range 1-5), and individuals were hopeful (M = 49.43, SD = 9.1, range 16-64). Higher WTL and greater hope were significantly associated with better HFSC maintenance, monitoring, management, and self-efficacy (p&lt;.001), and jointly accounted for more variance in HFSC outcomes than either construct alone. Illness threat was not significantly related to HFSC behaviors nor did it moderate the relationship of WTL or hope on HFSC.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSION&lt;/h3&gt;&lt;div&gt;Contrary to CSM predictions, illness threat perceptions were not associated with HFSC. Traditional HF education often emphasizes illness threat (e.g., hospitalization risk, mortality), yet findings suggest threat alone does not drive HFSC. In contrast, WTL and hope emerged as salient psychosocial resources underpinning HFSC. Assessing and leveraging these motivational factors may enhance the individualization and effectiveness of HFSC interventions. Clinically, HF nurses can incorporate brief assessments of hope and WTL into routine encounters, such as during HF education sessions, tra","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102818"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148523317","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":"Cardiovascular disease-associated admissions in patients with Cystic Fibrosis: A 7-Year U.S. National Inpatient Sample Analysis","authors":"Adnan Bhat ,&nbsp;Anchit Chauhan ,&nbsp;Maulinkumar Patel ,&nbsp;Mariam Shahabi ,&nbsp;Umar Iqbal ,&nbsp;Mohammed Elzeneini ,&nbsp;Waseem Nabi ,&nbsp;Muzamil Khan ,&nbsp;Nouman Aziz ,&nbsp;Cesar A. Trillo ,&nbsp;Jorge E. Lascano","doi":"10.1016/j.hrtlng.2025.102701","DOIUrl":"10.1016/j.hrtlng.2025.102701","url":null,"abstract":"<div><h3>Background</h3><div>As survival improves for people with cystic fibrosis (PwCF) in the era of CFTR modulators, cardiovascular (CV) diseases are emerging as clinically important comorbidities. Beyond age-related risks, mechanistic pathways such as systemic inflammation, chronic hypoxia, CF-related diabetes, and CFTR-related endothelial dysfunction may contribute to CV injury. However, national-level data on CV outcomes in PwCF remain limited.</div></div><div><h3>Objectives</h3><div>We hypothesized that primary cardiac admissions in PwCF are increasing over time and associated with worse in-hospital outcomes compared to non-cardiac admissions.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed adult (≥18 years) PwCF hospitalizations in the U.S. National Inpatient Sample (2016–2022). Primary cardiac admissions were defined by a principal diagnosis of atrial fibrillation (AF), heart failure (HF), or myocardial infarction (MI) using ICD-10 codes. Outcomes included in-hospital mortality, length of stay (LOS), charges, and discharge disposition. Temporal trends in cardiac admissions were modeled using negative binomial regression with an offset for total CF hospitalizations; Joinpoint regression was performed as a complementary method. Descriptive statistics and multivariable regression models adjusted for age, sex, and race were used. A p-value &lt;0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Among 121,290 PwCF hospitalizations, 520 (0.43%) were for cardiac causes. PwCF with cardiac admissions were older (median 62 vs. 29 years, <em>p</em> &lt; 0.001) and had more traditional CV comorbidities. Cardiac admission rates increased by 16.4% per year from 2016 to 2022 (IRR 1.16 [1.04–1.29], <em>p</em> = 0.009) in negative binomial regression. Joinpoint regression detected no significant inflection points and estimated a non-significant APC of 16.4% per year (95% CI 10.9–57.4, <em>p</em> = 0.214). Unadjusted mortality was higher for cardiac vs. non-cardiac admissions (OR 3.70, 95% CI 1.61–8.53, <em>p</em> = 0.002), but not significant after adjustment (OR 1.36, 95% CI 0.55–3.34, <em>p</em> = 0.468).</div></div><div><h3>Conclusion</h3><div>Our findings indicated higher in-hospital mortality among PwCF admitted for cardiac causes, and more discharge to nursing facilities among PwCF admitted for cardiac causes. There is a need for greater CV screening, and geriatric care in PwCF.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102701"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145908903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise tolerance in patients with chronic thromboembolic pulmonary hypertension after balloon pulmonary angioplasty","authors":"Zhihui Lu MD ,&nbsp;Chen Zhang MD ,&nbsp;Jun Wan MD ,&nbsp;Yao Xiao MD ,&nbsp;Lei Zhao MD ,&nbsp;Guanyu Lu MD ,&nbsp;Hongbo Zhang MD ,&nbsp;Lanling Wang MD ,&nbsp;Yuhan Yi MD ,&nbsp;Lili Wang MD ,&nbsp;Xiaohai Ma MD","doi":"10.1016/j.hrtlng.2026.102725","DOIUrl":"10.1016/j.hrtlng.2026.102725","url":null,"abstract":"<div><h3>Background</h3><div>Balloon pulmonary angioplasty (BPA) is an effective therapeutic alternative for patients with chronic thromboembolic pulmonary hypertension (CTEPH), which improved pulmonary arterial compliance (C_PA) and pulmonary vascular resistance (PVR).</div></div><div><h3>Objective</h3><div>To investigate whether the C_PA is a predictor of exercise tolerance after BPA.</div></div><div><h3>Methods</h3><div>The correlations between changes in each parameter and changes in six-minute walking distance (6MWD) were evaluated by Pearson’s test. The determinants of functional capacity that was defined as 6MWD ≥440 m were assessed with a logistic regression model. Multiple linear regression analysis was used to identify the independent variables related to △6MWD.</div></div><div><h3>Results</h3><div>We enrolled 70 patients (female/male: 40/30, mean age: 64 years) who underwent a total of 271 BPA sessions which significantly increased C_PA [1.0 (0.7, 1.3) vs. 2.1 (1.7, 2.5) mL/mmHg], and decreased PVR [6.7 (3.6, 9.7) vs. 3.0 (2.1, 4.3) wood units]. The correlation coefficient between improvement in 6MWD and changes in C_PA was r = 0.328 (<em>P</em> = 0.006). At univariate analysis, duration of pulmonary hypertension symptoms and pulmonary arterial compliance were found to be associated with good exercise tolerance. Multivariate analysis demonstrated that C_PA (95 %CI: 1.23 to 3.75, <em>P</em> = 0.026) was an independent predictor of exercise tolerance after BPA. The multiple linear regression analysis demonstrated that △C_PA (β= 0.292, <em>P</em> = 0.019) was an independent predictor of △6MWD.</div></div><div><h3>Conclusion</h3><div>BPA significantly improved C_PA in inoperable patients with CTEPH and the resistance-compliance relationship maintained inversely associated. After successful BPA, baseline C_PA is an important determinant of exercise tolerance.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102725"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039329","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 effects of norepinephrine infusion on electrocardiographic parameters: A prospective study focusing on the frontal QRS-T angle","authors":"Tuğçe Yılmaz,&nbsp;Serdar Özdemir","doi":"10.1016/j.hrtlng.2026.102742","DOIUrl":"10.1016/j.hrtlng.2026.102742","url":null,"abstract":"<div><h3>Background</h3><div>Norepinephrine is widely used as a first-line vasopressor in acute hypotension and septic shock. Its acute effects on electrocardiographic (ECG) parameters, particularly the frontal QRS-T angle, remain unclear.</div></div><div><h3>Objectives</h3><div>To evaluate the short-term impact of therapeutic-dose norepinephrine infusion on ECG parameters, with a focus on the frontal QRS-T angle, in the emergency department.</div></div><div><h3>Methods</h3><div>This prospective observational study included 135 adult patients clinically indicated for norepinephrine in the emergency department of a tertiary training and research hospital. ECG recordings were obtained at baseline and at the first and second hours after norepinephrine initiation. Parameters assessed included heart rate, P-wave duration, PR interval, QRS duration, QT, QTcB, P axis, QRS axis, T axis, and frontal QRS-T angle. Temporal changes were analyzed using the Friedman test.</div></div><div><h3>Results</h3><div>The median age of the patients was 77 (68–84) years, and 52% were male. When ECG parameters were compared over time, no statistically significant change was detected in any parameter, including heart rate, P-wave duration, PR interval, QRS duration, QT, QTcB, and frontal QRS-T angle (<em>p</em> &gt; 0.05 for all). The frontal QRS-T angle was recorded as 91° (31–159) at baseline, 86° (28.5–152) at the first hour, and 76° (30–150) at the second hour (<em>p</em> = 0.273). Similarly, no significant change in ECG parameters was observed in the sepsis subgroup.</div></div><div><h3>Conclusion</h3><div>Short-term therapeutic-dose norepinephrine infusion in the emergency department did not significantly affect ECG parameters, including the frontal QRS-T angle. These findings suggest that norepinephrine does not acutely alter ventricular repolarization heterogeneity.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102742"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188775","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":"Antiplatelet pretreatment effects in patients with non-ST-segment elevation acute coronary syndromes in a center without daily 24 hours access to the catheter laboratory","authors":"Gabriel Torres-Ruiz M.D,&nbsp;Jordi Sans-Roselló M.D, PhD,&nbsp;Eduard Bosch-Peligero M.D,&nbsp;Paola Rojas-Flores M.D,&nbsp;Jordi Cahís-Vela M.D,&nbsp;Meritxell Lloreda-Surribas M.D,&nbsp;Mario Sutil-Vega M.D,&nbsp;Marcelo Rizzo M.D,&nbsp;Nuria Mallofré-Vila M.D,&nbsp;Josep Guindo-Soldevila M.D,&nbsp;Victor García-Hernando M.D,&nbsp;Gala Caixal-Vila M.D, PhD,&nbsp;Pablo Del Castillo-Vázquez M.D,&nbsp;Pablo Carrión-Montaner M.D,&nbsp;Daniel Valcárcel-Paz M.D, PhD,&nbsp;Antoni Martínez-Rubio M.D, FESC, FACC","doi":"10.1016/j.hrtlng.2026.102728","DOIUrl":"10.1016/j.hrtlng.2026.102728","url":null,"abstract":"<div><h3>Background</h3><div>Pretreatment in patients with non-ST elevation acute coronary syndrome (NSTE-ACS) is controversial.</div></div><div><h3>Objectives</h3><div>Evaluate the safety and efficacy of pretreatment in a center without daily access to the catheter laboratory (CL).</div></div><div><h3>Methods</h3><div>This prospective observational single-center study (June 2021-June 2024) included patients with suspected NSTE-ACS undergoing coronary angiography (CAG). Clinical, biochemical and CL data were registered. Patients were monitored during their hospital stay for bleedings events (BE), ischemic events (IE) and misdiagnosis.</div></div><div><h3>Results</h3><div>443 consecutive patients with suspected NSTE-ACS were included. Median age was 70.0 years (IQR 60.0-77.0) and 71.8 % were male. 84.0 % were under pretreatment. IE, BE and cardiovascular death were of 5.0 %, 4.1 % and 1.8 %, respectively. IE were more frequent in the non-pretreatment group (10.3 % vs 4.1 %; <em>p</em> = 0.030), whereas there was no significant difference in BE (1.4 % vs 4.6 %; <em>p</em> = 0.216). Myocardial infarction (MI) before CAG and type 4b MI rate were lower in the pretreatment group (1.6 % vs 8.5 %; <em>p</em> &lt; 0.001 and 0.3 % vs 2.8 %; <em>p</em> = 0.016, respectively). After adjusting for covariates, pretreatment was associated with a lower incidence of IE (OR 0.35 95 % CI 0.135-0.928; <em>p</em> = 0.035) whereas it was not associated with BE (OR 3.68 95 % CI 0.427-31.651; <em>p</em> = 0.236). A lower estimated glomerular filtration rate and active malignancy were associated with BE, while chronic ischemic heart disease was associated with IE.</div></div><div><h3>Conclusions</h3><div>Pretreatment was associated with a lower incidence of IE in NSTE-ACS patients with lower rates of MI before CAG and type 4b MI, without a significant increase in BE.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102728"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159270","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}