Heart & Lung最新文献

{"title":"Direct oral anticoagulants versus Vitamin K antagonists for left ventricular thrombus management","authors":"Syed I. Khalid ,&nbsp;Pranav Mirpuri ,&nbsp;Joanna M. Roy ,&nbsp;Kyle B. Thomson ,&nbsp;Mishaal Hukamdad ,&nbsp;Farrah S. Nasrollahi ,&nbsp;Keshav R. Patel ,&nbsp;Gursant Atwal ,&nbsp;Ciro Ramos Estebanez ,&nbsp;Mona C. Soni ,&nbsp;Ankit I. Mehta","doi":"10.1016/j.hrtlng.2025.07.014","DOIUrl":"10.1016/j.hrtlng.2025.07.014","url":null,"abstract":"<div><h3>Background</h3><div>This study compared the rates of intracranial hemorrhage (ICH), ischemic stroke, transient ischemic attack (TIA), and major bleeding events between patients receiving direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs) for left ventricular thrombus (LVT) management.</div></div><div><h3>Methods</h3><div>In this retrospective analysis of claims data, 3152 patients receiving treatment for LVT were identified. Two cohorts were exactly matched on age, sex, and pertinent comorbidities. The primary outcomes were rates of ICH, ischemic stroke, TIA, and major bleeding events between the two groups at 12 months and 24 months. Differences were assessed using the Kaplan-Meier method. Data was analyzed using R (Version 4.1, R Foundation, Vienna, Austria).</div></div><div><h3>Results</h3><div>336 patients were compared after the match. The majority were aged between 50–75 (76.2%), were male (80.1%), and had hypertension (77.38%) and hyperlipidemia (66.07%). At 12 months, there were no differences in the rates of ICH (3/168 vs. 2/168, <em>p</em> = 0.7), ischemic stroke (22/168 vs. 15/168, <em>p</em> = 0.2), TIA (9/168 vs 3/168, <em>p</em> = 0.08), or major bleeding events (25/168 vs 35/168, <em>p</em> = 0.1) between DOAC and VKA groups, respectively. Similarly, there were no differences at 24 months in ICH (4/168 vs. 4/168, <em>p</em> = 1), ischemic stroke (26/168 vs. 26/168, <em>p</em> = 0.9), TIA (10/168 vs 4/168, <em>p</em> = 0.1), and major bleeding events (36/168 vs 45/168, <em>p</em> = 0.2) between DOAC and VKA groups, respectively.</div></div><div><h3>Conclusions</h3><div>DOACs appear to be safe alternatives to VKAs, substantiating their use for LVT management. Further evaluation is nevertheless warranted.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 193-197"},"PeriodicalIF":2.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144685572","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":"Using lightweight convolutional neural network to identify ventilation/perfusion scintigraphy for acute pulmonary embolism","authors":"Wenjing Ye ,&nbsp;Jingcheng Yang ,&nbsp;Xiaoming Li ,&nbsp;Xi Chen ,&nbsp;Futai Zou ,&nbsp;Wen Gu","doi":"10.1016/j.hrtlng.2025.07.012","DOIUrl":"10.1016/j.hrtlng.2025.07.012","url":null,"abstract":"<div><h3>Background</h3><div>Quantifying ventilation/perfusion (V/Q) scintigraphy and reducing errors caused by subjective interpretation of approximate grayscale images are clinically and analytically challenging.</div></div><div><h3>Objectives</h3><div>This study aims to objectively quantify V/Q results by developing a novel convolutional neural network architecture.</div></div><div><h3>Methods</h3><div>In this retrospective study, we collected data from patients with acute pulmonary embolism (PE). We proposed PENet, a lightweight neural network architecture based on depthwise separable convolution for identifying defect areas in V/Q scans. The defect area percentage (DA%) was obtained through threshold setting to quantify the mismatch range. The significance and accuracy of our model were verified by combining clinical data. We collected 4608 original scans from 288 patients as the preliminary dataset. We set the pixel threshold value to 30.</div></div><div><h3>Results</h3><div>PENet demonstrated accuracy (87.47 %), precision (89.22 %), and F1-score (91.01 %), superior to those of classical and other lightweight models. Spearman’s rank correlation coefficient revealed correlations between DA%_max and N-terminal pro-brain natriuretic peptide, DA%_min and age, average DA% and age, average DA% and troponin I, DA%_sum and age, and DA%_sum and predicted percentage of diffusing lung capacity for carbon monoxide (<em>P</em> &lt; .05). DA%_max (<em>P</em> = .004), DA%_sum (<em>P</em> = .004), and average DA% (<em>P</em> = .006) differed significantly among PE risk groups. With the assistance of PENet, junior radiologists could achieve a high degree of consistency with senior radiologists (kappa=0.832, <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>The accuracy of PENet reached 87.47 %. DA% calculated automatically could reflect PE severity and correlate well with clinical data. PENet shows promising results for clinical use.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 198-205"},"PeriodicalIF":2.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144685573","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":"Baseline characteristics and in-hospital mortality predictors in female patients on venovenous extracorporeal membrane oxygenation: Impact of pregnancy","authors":"Sharmistha Dutta MBBS, MD ,&nbsp;Manas Das MBBS, MD ,&nbsp;Trishna Parikh MD, MBA ,&nbsp;Sabiha Armin MD ,&nbsp;Adishwar Rao MD, MPH ,&nbsp;Akriti Agrawal MD, MPH ,&nbsp;Angela Marinovic ,&nbsp;Aarohi Parikh MD ,&nbsp;Jeremy Walder DO ,&nbsp;Farah Kazzaz MD ,&nbsp;Kha Dinh MD ,&nbsp;Maulin Patel MD ,&nbsp;Syed Ghazi Rizvi MD ,&nbsp;Bela Patel MD ,&nbsp;Bindu Akkanti MD","doi":"10.1016/j.hrtlng.2025.07.007","DOIUrl":"10.1016/j.hrtlng.2025.07.007","url":null,"abstract":"<div><h3>Background</h3><div>Venovenous extracorporeal membrane oxygenation (VV-ECMO) is often used for lung rest in critically ill patients, including pregnant patients.</div></div><div><h3>Objectives</h3><div>We aimed to determine how pregnant and non-pregnant patients requiring VV-ECMO differed from each other and how pregnancy impacted in-hospital mortality.</div></div><div><h3>Methods</h3><div>We used the National Inpatient Sample to identify a cohort of female patients requiring VV-ECMO from 2016 to 2021, stratified by pregnancy status. Baseline characteristics were compared using Pearson chi-square test. Predictors of in-hospital mortality, including pregnancy and complications from VV-ECMO, were determined using multivariate analysis with a logistic regression model.</div></div><div><h3>Results</h3><div>Of 7365 female patients requiring VV-ECMO, 700 (9.5 %) were pregnant. Pregnant patients were younger. COVID-19 was more prevalent in pregnant patients (72.9 % versus 36.4 %, <em>p</em> &lt; 0.001). Infectious complications were more common in non-pregnant patients (64.1 % versus 43.6 %, <em>p</em> &lt; 0.001). Pregnant patients suffered from less in-hospital mortality (20.0 % versus 38.5 %, <em>p</em> &lt; 0.001), and pregnancy predicted survival (adjusted odds ratio (OR): 0.49 [0.27–0.89], <em>p</em> = 0.02). Length of stay ≥7 days and COPD were associated with reduced odds of in-hospital mortality; chronic heart failure, COVID-19, and VV-ECMO complications were associated with increased odds of in-hospital mortality.</div></div><div><h3>Conclusions</h3><div>These findings underscore the unique clinical profile and outcomes of pregnant females requiring VV-ECMO, highlighting the need for tailored management strategies. Prospective studies are essential to validate these observations and optimize care for this vulnerable patient population.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 186-192"},"PeriodicalIF":2.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679364","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":"Indirect evaluation of lung condition by means of LF-NMR following chest physiotherapy or ETI administration in cystic-fibrosis patients.","authors":"Michela Abrami, Alice Biasin, Massimo Maschio, Massimo Conese, Marco Confalonieri, Fabio Gerin, Francesco Salton, Paola Confalonieri, Barbara Ruaro, Roberto Casalaz, Claudia Venditti, Domenico Tierno, Gabriele Grassi, Mario Grassi","doi":"10.1016/j.hrtlng.2025.07.008","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2025.07.008","url":null,"abstract":"<p><strong>Background: </strong>As most cystic fibrosis (CF) patients progress to respiratory failure, lung functionality assessment is pivotal. We previously developed a test that monitors airways measuring the spin-spin relaxation time (T_2m) of water hydrogens present in sputum using Low Field-Nuclear Magnetic resonance (LF-NMR).</p><p><strong>Objectives: </strong>To investigate further the significance of T_2m exploring: 1) T_2m correlation with the effects of chest physiotherapy (CP); 2) the influence of sputum contamination by saliva on T_2m; 3) T_2m relation with sputum mesh size; 4) T_2m correlation with the effects of the CFTR-modulator Elexa-caftor/Tezacaftor/Ivacaftor (ETI).</p><p><strong>Methods: </strong>T_2m was measured in the sputum of 16 CF-patients before/after CP and in 9/16 patients before/after ETI administration. FEV₁/C reactive protein (CRP)/erythrocyte-sedimentation rate (ESR) and sweat chloride concentration were measured using standard techniques. Sputum contamination by saliva/sputum mesh size were determined mathematically.</p><p><strong>Results: </strong>We prove that T_2m can be used to detect the lack of significant effects on lung function by CP (confirmed by FEV₁). Moreover, we developed of a mathematical approach to correct T_2m value in sputum samples contaminated by saliva and to determine the relationship between T_2m and sputum mesh size. Finally, we show that T_2m can effectively detect the positive effects of ETI on lung function (evaluated by FEV₁) and that T_2m inversely correlates with the CRP/ESR/chloride sweat concentration.</p><p><strong>Conclusion: </strong>This data strengthens the rationale for T_2m employment in CF lung disease monitoring and show that T_2m can be profitably used to complement the FEV₁ test.</p>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676612","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":"Associations between lung and endothelial function in long COVID: Two years after acute infection","authors":"Lêda Leonôr Mendonça Carvalho ,&nbsp;Cássia da Luz Goulart ,&nbsp;Gabriele Da Dalto Pierazzo ,&nbsp;Ester Laura Cordeiro-Costa ,&nbsp;Audrey Borghi-Silva ,&nbsp;Adriana Sanches Garcia-Araújo","doi":"10.1016/j.hrtlng.2025.07.011","DOIUrl":"10.1016/j.hrtlng.2025.07.011","url":null,"abstract":"<div><h3>Background</h3><div>endothelial cells may be a primary source for the initiation and spread of Acute Respiratory Distress Syndrome (ARDS) caused by SARS-CoV-2, resulting in severe endothelial injury and widespread thrombosis.</div></div><div><h3>Objective</h3><div>The objective of this study was to evaluate the influence of lung function on the vascular response of patients with long COVID.</div></div><div><h3>Methods</h3><div>This is an observational and cross-sectional study. Only one visit was performed, during which the evaluation form was completed and the post-COVID-19 Functional Status Scale (PCFS) was applied. In addition, participants underwent the assessment of flow-mediated vasodilation in the brachial artery and the assessment of pulmonary function.</div></div><div><h3>Results</h3><div>A total of 32 participants were included, of which 19 (59 %) were women. The mean age was 55.8 ± 8.6 years, with a mean weight of 88.96 ± 21.66 kg. The participants had an average time of 32.25 months since the acute phase. The patients had an average of FEV₁/FVC 81.15±14.7 ( %) and KCO 93.72±7.95 ( %). FMD had an average of -0.21±11.24 ( %), indicating still impaired endothelial function. We found correlation between basal diameter (-0.21 [-4.26 to 3.84]) vs lung function variables, especially with the variable KCO ( %) (<em>p</em> &lt; 0.001; <em>r</em> = 0.560). When we perform simple linear regression KCO ( %) indicates that this variable alone influences 29 % of the response to the basal diameter of the participants.</div></div><div><h3>Conclusion</h3><div>Two years after recovery from COVID-19 infection, the patients present changes in endothelial function, which have important implications for individuals when it comes to cardiovascular health.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 168-173"},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655792","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":"Cardiometabolic effects of GLP-1 analogs in obese and overweight patients with preexisting cardiovascular disease: A systematic review and meta analysis of randomized controlled trials","authors":"Lucas Destefani Natali ,&nbsp;Luis Gustavo Menegardo Siqueira de Oliveira ,&nbsp;Imara Correia de Queiroz Barbosa ,&nbsp;Natanael de Paula Portilho","doi":"10.1016/j.hrtlng.2025.07.009","DOIUrl":"10.1016/j.hrtlng.2025.07.009","url":null,"abstract":"<div><div>Background: Obesity is escalating global concerns, strongly associated with cardiovascular (CV) diseases. Lifestyle interventions often prove insufficient, driving interest in new treatments like GLP-1 analogs (GLP1a). Objectives: This study assesses the efficacy of GLP1a in patients with obesity and pre-existing CV disease. Methods: A systematic search in PubMed, Scopus, and Cochrane databases identified randomized controlled trials comparing GLP1a with placebo for CV risk reduction. Statistical analyses were conducted using Review Manager 5.4.1, employing a random-effects model for outcomes with high heterogeneity. RoB 2 was used to assess the risk of bias. Results: Four RCTs with 19,480 patients were included, 9740 of whom received GLP1a. The GLP1a group showed reduced all-cause mortality (OR, 0.82; 95 % CI, 0.72–0.94; <em>p</em> = 0.004) and waist circumference (MD, -7.02; 95 % CI, -8.31–-5.84; <em>p</em> &lt; 0.00001). Significant decreases were also observed in systolic blood pressure (MD, -3.32; 95 % CI, -3.76–-2.89; <em>p</em> &lt; 0.00001), serious adverse events (OR, 0.7; 95 % CI, 0.5–0.99; <em>p</em> = 0.04), and hospitalization for heart failure (OR, 0.47; 95 % CI, 0.25–0.89; <em>p</em> = 0.02). C-reactive protein (CRP) level levels were significantly lower (MD, -36.92; 95 % CI, -39.56–-34.27; <em>p</em> &lt; 0.00001). However, no significant difference was observed for CV-related mortality (OR, 0.85; 95 % CI, 0.71–1.02; <em>p</em> = 0.08). Conclusions: GLP1a reduces all-cause mortality, waist circumference, systolic blood pressure and CRP levels, highlighting its therapeutic potential for CV disease.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 174-179"},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655791","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 lung resections on lung transplant grafts due to size discrepancy","authors":"Víctor M. Mora-Cuesta ,&nbsp;Diego Alejandro Murillo-Brito ,&nbsp;Pedro José Argos-Vélez ,&nbsp;David Iturbe-Fernández ,&nbsp;Sara Naranjo-Gozalo ,&nbsp;Laura Sánchez-Moreno ,&nbsp;Sandra Tello-Mena ,&nbsp;Loreto Berjón-de la Vega ,&nbsp;Sheila Izquierdo-Cuervo ,&nbsp;Claudia Poo-Fernández ,&nbsp;Daniela Andia-Torrico ,&nbsp;Pilar Alonso-Lecue ,&nbsp;María A. Ballesteros-Sanz ,&nbsp;Roberto J. Mons-Lera ,&nbsp;José M Cifrián-Martínez","doi":"10.1016/j.hrtlng.2025.07.010","DOIUrl":"10.1016/j.hrtlng.2025.07.010","url":null,"abstract":"<div><h3>Background</h3><div>Lung transplantation (LT) is a well-established therapeutic option for patients with advanced respiratory diseases. However, the impact of size discrepancy between donor and recipient remains controversial.</div></div><div><h3>Objective</h3><div>This study aims to evaluate the impact of lung graft volume reduction due to size mismatch between donor and recipient.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted at a single reference center, including all LT procedures performed between January 1, 2015, and July 30, 2024. Surgical protocols were reviewed, and the need for graft volume reduction was recorded. The decision to perform graft reduction was made intraoperatively by the lead surgeon.</div></div><div><h3>Results</h3><div>A total of 420 patients were included. Lung graft resection was performed in 14 cases (3.3 %). Patients requiring graft resection had longer operative times, prolonged intubation and ICU stays, and increased tracheostomy requirements. The donor-to-recipient predicted total lung capacity (pTLC) ratio was significantly higher among patients requiring resection. While 5-year survival was not significantly different, 1- and 3-year survival rates were worse for patients requiring resection.</div></div><div><h3>Conclusion</h3><div>Lung graft resection due to donor-recipient size discrepancy can be a viable option for suitable recipients, although it is associated with increased postoperative morbidity. Given the small sample size (14 patients), these findings should be interpreted cautiously, and larger studies are needed to confirm these results. Early referral to transplant centers and careful donor-recipient matching are crucial to minimize the need for graft resection and improve outcomes.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 180-185"},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655793","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":"Symptom cluster profiles among community-residing older adults with heart failure: Findings from the U.S. health and retirement study","authors":"Zequan Wang PhD, RN ,&nbsp;Sangchoon Jeon PhD ,&nbsp;Christine Tocchi PhD, APRN, BC-GNP ,&nbsp;Samantha Conley PhD, RN ,&nbsp;Stephen Walsh ScD ,&nbsp;Kyounghae Kim PhD, RN ,&nbsp;Deborah Chyun PhD, RN, FAHA, FAAN ,&nbsp;Nancy Schmieder Redeker PhD, RN, FAHA, FAAN","doi":"10.1016/j.hrtlng.2025.07.006","DOIUrl":"10.1016/j.hrtlng.2025.07.006","url":null,"abstract":"<div><h3>Background</h3><div>As people grow older, years of exposure to cardiovascular risk factors progressively damage the heart’s structure and function, causing the incidence of heart failure (HF) to rise with age. Among older adults with HF, symptoms are manifested as clusters. Few studies have addressed symptoms specifically in older adults with HF, and most have been conducted with small samples.</div></div><div><h3>Objectives</h3><div>(1) describe symptom cluster profiles in older adults with HF in a nationally representative sample of community-dwelling older adults, and (2) determine the associations between demographic and clinical characteristics and membership in symptom cluster profiles.</div></div><div><h3>Methods</h3><div>Data from the Health and Retirement Study were used for a secondary analysis. Fatigue, shortness of breath, pain, swelling, depressive symptoms, and dizziness were measured. Latent class analysis was used to identify symptom cluster profiles. Bivariate associations and multinomial logistic regression were used to determine the associations between symptom cluster profiles and demographic and clinical characteristics.</div></div><div><h3>Results</h3><div>The sample included 690 participants. Three symptom cluster profiles were identified [high-burden, low-burden, and cardiopulmonary-depressive]. Age, gender, BMI, marital status, alcohol consumption, diabetes, lung disease, and arthritis were significantly different across the three profiles. People in the high-burden and cardiopulmonary-depressive profiles, compared to those in low-burden, had higher odds of having lung disease and arthritis, yet lower odds of higher alcohol consumption.</div></div><div><h3>Conclusions</h3><div>Older adults with HF residing in the community experienced distinct symptom cluster profiles. Research is needed to identify and test targeted interventions for specific symptom cluster profiles.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 161-167"},"PeriodicalIF":2.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631542","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":"Self-reported symptom trajectories among chronic cardiopulmonary disease","authors":"Walter Wills PhD, RN ,&nbsp;Andrew Bugajski PhD, RN ,&nbsp;Arch Amon MD ,&nbsp;Christopher Lee PhD ,&nbsp;Ayesha Johnson PhD ,&nbsp;Ponrathi Athilingam PhD ,&nbsp;Theresa Beckie PhD","doi":"10.1016/j.hrtlng.2025.07.002","DOIUrl":"10.1016/j.hrtlng.2025.07.002","url":null,"abstract":"<div><h3>Background</h3><div>Individuals living with Chronic Obstructive Pulmonary Disease (COPD) or Heart Failure may experience similar symptom experiences. However, it remains unclear how self-reported symptom trajectories develop following exacerbation states, particularly when considering the potential for the existence of concomitant disease.</div></div><div><h3>Objectives</h3><div>To identify a plausible number of self-reported symptom trajectories over a two-month recovery period following acute exacerbation requiring hospitalization of either or both COPD or Heart Failure.</div></div><div><h3>Methods</h3><div>A longitudinal prospective cohort study of 155 participants was conducted. Persons were enrolled in the study within 24 h of ED presentation for exacerbation or decompensation of either disease. Symptoms were assessed upon admission, discharge, and after 1- and 2-months post-discharge. Growth mixture modeling was employed to identify symptom trajectories longitudinally.</div></div><div><h3>Results</h3><div>A linear, two trajectory solution demonstrated the most appropriate model fit, which illustrated the presence of a low overall and moderate overall symptom burden trajectory, each decreasing longitudinally over the sampled two-month period of recovery.</div></div><div><h3>Conclusion</h3><div>Identifying these trajectories allows clinicians to identify those who may benefit from targeted services based on their reported symptom burden during this critical period of recovery following exacerbation or decompensation of either disease.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 152-160"},"PeriodicalIF":2.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631200","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":"Smoking prevalence among stroke patients in Saudi Arabia: A systematic review and meta-analysis","authors":"Jaber S. Alqahtani ,&nbsp;Abdulelah M. Aldhahir ,&nbsp;Ibrahim A. AlDraiwiesh ,&nbsp;Asma O. Alamoudi ,&nbsp;Abdullah A. Alqarni ,&nbsp;Saeed M. Alghamdi ,&nbsp;Rayan A. Siraj ,&nbsp;Saad M. AlRabeeah ,&nbsp;Abdallah Y. Naser ,&nbsp;Hassan Alwafi ,&nbsp;Ahmed M. Hjazi ,&nbsp;Yousef S. Aldabayan ,&nbsp;Ahmed M. Al Rajeh ,&nbsp;Reynie Purnama Raya ,&nbsp;Tope Oyelade","doi":"10.1016/j.hrtlng.2025.07.005","DOIUrl":"10.1016/j.hrtlng.2025.07.005","url":null,"abstract":"<div><h3>Background</h3><div>Stroke represents a significant global health issue, consistently identified as one of the leading causes of disability and mortality worldwide. Smoking constitutes a major risk factor for stroke development.</div></div><div><h3>Objectives</h3><div>This study evaluated the prevalence of smoking among stroke patients in Saudi Arabia.</div></div><div><h3>Methods</h3><div>Embase, Medline, and SCOPUS were systematically searched from inception to December 2024. Data was screened and synthesized following the PRISMA guidelines. Stratified meta-analysis was performed to pool the prevalence of smokers among stroke patients across various provinces of Saudi Arabia.</div></div><div><h3>Results</h3><div>There were 19,499 stroke patients in 42 included studies; 2695 (14 %) were smokers, and 14,701 were male. The overall pooled prevalence of smoking among stroke patients in Saudi Arabia is 18 % (95 % CI, 14–22 %). The Western and Northern provinces demonstrate the highest percentages of smokers among stroke patients, at 33 % (95 % CI, 21–47 %) and 23 % (95 % CI, 19–27 %), respectively. The sensitivity analysis using leave-one-out methodologies shows that the pooled percentage estimate is robust, with no one research substantially influencing the conclusions. The meta-regression shows no link between smoking prevalence in stroke patients and age (p-value = 0.17). The results of Egger's test (<em>t</em> = 0.74, bias estimate = 0.7109, p-value = 0.4645) indicate no publication bias in this meta-analysis.</div></div><div><h3>Conclusion</h3><div>Smoking is prevalently high among stroke patients in Saudi Arabia, with significant regional variations. To reduce the impact of smoking on stroke incidence and outcomes, it is essential to implement targeted preventive programs that include integrating smoking cessation into stroke treatment plans and launching public health campaigns.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 142-151"},"PeriodicalIF":2.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144613993","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}