Heart & Lung最新文献

{"title":"Board of Directors","authors":"","doi":"10.1016/S0147-9563(25)00021-4","DOIUrl":"10.1016/S0147-9563(25)00021-4","url":null,"abstract":"","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Page vii"},"PeriodicalIF":2.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444928","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":"Letter to the Editor: Efficacy and safety of iloprost in the treatment of pulmonary arterial hypertension: A systematic review and meta-analysis","authors":"Mustafa Oğuz MD , Murat Demirci MD","doi":"10.1016/j.hrtlng.2025.02.005","DOIUrl":"10.1016/j.hrtlng.2025.02.005","url":null,"abstract":"","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Page 106"},"PeriodicalIF":2.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470019","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":"Natriuretic peptide testing in veterans hospitalized with heart failure: Potential differences by sex","authors":"Parul U. Gandhi MD ,&nbsp;Tessa Runels MPH ,&nbsp;Ling Han MD, PhD, MS ,&nbsp;Melissa Skanderson MSW ,&nbsp;Lori A. Bastian MD, MPH ,&nbsp;Cynthia A. Brandt MD, MPH ,&nbsp;Ronald G. Hauser MD ,&nbsp;Shelli L. Feder PhD, FNP-C ,&nbsp;Benjamin Rodwin MD ,&nbsp;Melissa M. Farmer PhD ,&nbsp;Bevanne Bean-Mayberry MD ,&nbsp;Sebastian Placide MD ,&nbsp;Allison E. Gaffey PhD ,&nbsp;Kathleen M. Akgün MD, MS","doi":"10.1016/j.hrtlng.2025.02.001","DOIUrl":"10.1016/j.hrtlng.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Natriuretic peptide testing (NPT) is recommended to assist in diagnosis and prognostication during heart failure hospitalization (HFH). NPT on admission for HFH and sex-based variation in NPT are unknown.</div></div><div><h3>Objectives</h3><div>We investigated the utilization of NPT among Veterans with HFH, evaluated for sex-based differences, and examined associations with demographic, clinical, and facility characteristics.</div></div><div><h3>Methods</h3><div>Among Veterans with HFH in the Veterans Affairs Healthcare System between October 2015-September 2020, we assessed the rate of NPT on admission and sex-based differences in NPT. We determined associations with demographic, clinical covariates, (comorbidities, laboratory values, loop diuretic use), and facility characteristics using logistic regression.</div></div><div><h3>Results</h3><div>Of 55,935 patients with HFH (women=1237 (2.2 %)), women were younger (68.3 versus 72.8 years, <em>p</em> &lt; 0.001), less likely to have cardiac comorbidities, and more likely to have ejection fraction &gt;40 %. Admission NPT occurred in 78.3 % of patients (men=78.4 %, women=74.7 %; <em>p</em> = 0.002). In adjusted analyses for clinical and facility-related factors, women were 15 % less likely to receive NPT compared with men [odds ratio =0.85, 95 % CI (0.75, 0.98)]. In sex-stratified models, atrial fibrillation and prior loop diuretic use were associated with increased likelihood of NPT and previous NPT was associated with decreased likelihood in both sexes. Overall associations were similar in both sexes.</div></div><div><h3>Conclusions</h3><div>Women were less likely to receive NPT during HFH compared to men, potentially risking greater delays in HF diagnosis and treatment. Further investigation should examine the impact of the absence of admission NPT on clinical outcomes and identify strategies to improve obtaining NPT in all patients.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 25-31"},"PeriodicalIF":2.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436595","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":"ECMO cannulation across New England","authors":"Ammar Bhatti DO ,&nbsp;Chaitan K. Narsule MD ,&nbsp;Michael A. Frakes APRN, EMT-P ,&nbsp;Vahé Ender EMT-P ,&nbsp;Jason E. Cohen DO ,&nbsp;Susan R. Wilcox MD","doi":"10.1016/j.hrtlng.2025.01.015","DOIUrl":"10.1016/j.hrtlng.2025.01.015","url":null,"abstract":"<div><h3>Background</h3><div>Over the last 15 years, clinicians have increasingly used extracorporeal membrane oxygenation (ECMO) as a rescue technique, including cannulating patients in community hospitals without ECMO capabilities, leading to secondary ECMO transports.</div></div><div><h3>Objectives</h3><div>The objective was to evaluate the changes in cannulations and the number of cannulating centers over time.</div></div><div><h3>Methods</h3><div>This is a retrospective review of transports across New England to ECMO centers in Boston from 2011 to 2022.</div></div><div><h3>Results</h3><div>Over the years studied, 202 patients were cannulated and transported. VA ECMO was the most common configuration. This was a high-acuity cohort, with 26.4 % of VA ECMO patients having undergone cannulation during cardiopulmonary resuscitation (ECPR) and 6.1 % having central cannulation. The number of cannulations per year increased from 6 patients in 2011 to 36 in 2019 (<em>p</em> = 0.055). Cannulating centers also increased from 3 in 2011 to 14 in 2022. ECPR showed a similar trend, with increases in both ECPR patients and ECPR sites per year (<em>p</em> = 0.055).</div></div><div><h3>Conclusions</h3><div>The number of ECMO cannulations in the community has increased, with a high-acuity cohort of many patients undergoing ECPR. The number of patients cannulated at non-ECMO centers highlights the need for transport organizations and ECMO centers to address the needs of this high-acuity patient population.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 20-24"},"PeriodicalIF":2.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394456","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":"Effects of breathing exercises performed with virtual reality on dyspnea, anxiety and quality of life in COPD patients: A randomized controlled trial","authors":"Derya Şimşekli ,&nbsp;Mehtap Tan","doi":"10.1016/j.hrtlng.2025.01.014","DOIUrl":"10.1016/j.hrtlng.2025.01.014","url":null,"abstract":"<div><h3>Background</h3><div>Breathing exercises can reduce dyspnea and anxiety in COPD patients and improve quality of life. To ensure these benefits are sustained, it is essential to incorporate engaging and innovative applications that capture patients' attention.</div></div><div><h3>Objectives</h3><div>This study aimed to determine the effects of breathing exercises performed with virtual reality on dyspnea, anxiety, and quality of life in COPD patients.</div></div><div><h3>Methods</h3><div>The research was conducted in randomized controlled experimental design with 48 COPD patients. In collecting research data, the COPD Patient Information Form, the Respiratory Function Test Evaluation Form, the COPD Assessment Test (CAT), the Modified Medical Research Council (mMRC) Dyspnea Scale, the Hospital Anxiety and Depression Scale (HAD-A), the St. George Respiratory Questionnaire (SGRQ) and the Virtual Reality Experience Evaluation Form were used. The Virtual Reality Breathing Exercise Group (VRBE-G) and control group (CG) were created by block randomization. VRBE-G performed breathing exercises with virtual reality 3 times a week for 8 weeks. The participants and the statistician were blinded. Repeated measures ANOVA test was performed to determine the group-time interaction, and independent samples <em>t</em>-test and Man Whitney U test were used for comparison between groups.</div></div><div><h3>Results</h3><div>In intra- and inter-group comparisons, it was determined that there was a statistically significant difference in VRBE-G compared to CG in terms of CAT score, mMRC dyspnea score, HAD-A and SGRQ total score (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>It was determined that breathing exercises applied to COPD patients with virtual reality reduced dyspnea and anxiety and increased the quality of life.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 7-13"},"PeriodicalIF":2.4,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163976","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":"Beyond first-day biomarkers: The critical role of peak cardiac troponin I in sepsis prognosis","authors":"Dandan Zhao ,&nbsp;Huimin Li ,&nbsp;Yongdi Lin ,&nbsp;Lizhen Liu ,&nbsp;Lina Xu ,&nbsp;Dan Zhang ,&nbsp;Yu Fu ,&nbsp;Jiang Hong ,&nbsp;Congliang Miao","doi":"10.1016/j.hrtlng.2025.01.013","DOIUrl":"10.1016/j.hrtlng.2025.01.013","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis is a global health challenge with high mortality rates. It demands timely risk identification and biomarker-based strategies to optimize ICU management and outcomes.</div></div><div><h3>Objectives</h3><div>To explore the prognostic value of cardiac troponin I (cTnI) and B-type natriuretic peptide (BNP) in predicting 28-day mortality in septic patients.</div></div><div><h3>Methods</h3><div>We analyzed clinical data of septic ICU patients at Shanghai General Hospital. We used Cox models and ROC curves to assess the association between cTnI and BNP levels and 28-day mortality, and their prognostic accuracy.</div></div><div><h3>Results</h3><div>A total of 333 septic patients were included in this study (mean age [SD], 64.7 [15.2] years; 65.8 % male), of whom 63 (18.9 %) patients died during 28 days. Elevated peak cTnI levels, identified in 233 patients (70.0 %), were independently associated with higher 28-day mortality in septic patients, even after adjusting for SOFA scores, BNP, and other confounding variables. (adjusted HR 2.33, 95 % CI 1.08–5.04, <em>P</em> = 0.03). However, neither first-day cTnI nor BNP levels remained independent predictors of 28-day mortality. Sensitivity analyses for the magnitude of cTnI elevation as a predictive variable also yielded similar results. Compared to first-day cTnI, first-day BNP, and peak BNP, the peak cTnI had the most significant and modest area under the ROC curve (AUC: 0.64 [0.57–0.71]).</div></div><div><h3>Conclusion</h3><div>Elevated peak cTnI or the magnitude of cTnI, rather than first-day, could independently predict the risk of 28-day mortality in septic patients. This finding highlighted the importance of dynamic monitoring cTnI levels for risk stratification identification and management in septic patients.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 14-19"},"PeriodicalIF":2.4,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143314191","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":"AAHFN Leadership Message","authors":"S․Craig Thomas MSN, ACNP-BC, ACNS-BC, CHFN","doi":"10.1016/j.hrtlng.2025.01.011","DOIUrl":"10.1016/j.hrtlng.2025.01.011","url":null,"abstract":"","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Page A1"},"PeriodicalIF":2.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191175","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 mixed methods study of backup behavior among interprofessional ICU teams","authors":"Deena Kelly Costa PhD, RN, FAAN ,&nbsp;Kathryn A. Lee PhD, RN ,&nbsp;Nathan C. Wright MA ,&nbsp;Emily M. Boltey PhD, RN ,&nbsp;Hannah C. Ratliff PhD, RN ,&nbsp;Deanna J. Marriott PhD ,&nbsp;Olga Yakusheva PhD","doi":"10.1016/j.hrtlng.2025.01.012","DOIUrl":"10.1016/j.hrtlng.2025.01.012","url":null,"abstract":"<div><h3>Background</h3><div>Backup behavior—when clinicians help each other via verbal assistance or task completion in their roles–is essential for effective teamwork in the intensive care unit (ICU) but is not well understood. Exploring how interprofessional team members provide backup may guide future interventions.</div></div><div><h3>Objective</h3><div>To examine who, how often, why, and under what circumstances ICU clinicians provide backup in mechanical ventilation care.</div></div><div><h3>Methods</h3><div>Using a convergence, triangulation mixed methods design in 2 medical ICUs (2017–2019), we collected qualitative data (observation, shadowing, interviews) to understand how ICU teams provide backup; and patient-shift level surveys of ICU nurses, physicians, and respiratory therapists, to identify whom clinicians contacted for help that shift. We analyzed and compared these data to gain insight into the frequency, and circumstances surrounding ICU clinicians’ requests for and receipt of backup when providing mechanical ventilation care.</div></div><div><h3>Results</h3><div>Backup behavior was common. Interprofessional backup (e.g. nurse to respiratory therapist) related to specific patient care tasks. Intraprofessional backup (e.g. nurse to nurse) involved team members ‘checking in’ to assist their colleague. Most (57%) survey respondents reported at least one interprofessional contact on day and night shifts, and approximately 25% reported at least one intraprofessional backup contact. We identified distinct backup behavior patterns on day and night shifts.</div></div><div><h3>Conclusions</h3><div>While backup behavior was common, interprofessional backup focused on care aligning with professional roles whereas intraprofessional backup entailed checking-in with team members. Examining how to enhance interprofessional backup through trainings or interventions may improve how teams work and patient care.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 1-6"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082319","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":"Synthesis of expert opinions on fluid management in severe sepsis: A contextual review of human albumin and crystalloids","authors":"Christian J. Wiedermann MD ,&nbsp;Arian Zaboli RN ,&nbsp;Gianni Turcato MD","doi":"10.1016/j.hrtlng.2025.01.010","DOIUrl":"10.1016/j.hrtlng.2025.01.010","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis is a critical condition associated with high mortality rates that necessitates effective fluid resuscitation. Crystalloids are widely utilized; however, human albumin solutions have been attributed potential oncotic and anti-inflammatory benefits. Given the ongoing debate and the absence of definitive empirical evidence, expert opinions provide valuable insights into the contextual and practical aspects of fluid management.</div></div><div><h3>Objectives</h3><div>This review synthesizes expert opinions on the utilization of albumin compared to crystalloids in critically ill sepsis patients, emphasizing the contextual and practical considerations rather than drawing conclusions about clinical efficacy.</div></div><div><h3>Methods</h3><div>Following the Joanna Briggs Institute (JBI) guidelines for systematic reviews of text and opinions, databases and registries were searched from 2015 to 2024. Two reviewers independently screened sources. Data extraction was conducted by one reviewer and verified by another reviewer. Of 1,917 sources, 38 met the inclusion criteria. Findings were synthesized narratively.</div></div><div><h3>Results</h3><div>Expert consensus emphasizes crystalloids as the preferred first-line fluid for sepsis due to their safety, cost-effectiveness, and availability. Albumin is conditionally recommended in specific scenarios such as severe hypoalbuminemia, high vasopressor requirements, or volume-sensitive conditions. While theoretical benefits of albumin, including enhanced volume expansion and reduced fluid overload, are recognized, evidence for consistent clinical outcomes remains limited. Experts underscore the importance of individualized management tailored to patient-specific factors and dynamic monitoring, aligning with guideline recommendations that advise against routine albumin use.</div></div><div><h3>Conclusions</h3><div>This review highlights the contextual and practical aspects of fluid management in sepsis, underscoring the predominance of crystalloids as the initial choice. Expert insights suggest that albumin may have a supplementary role in specific clinical scenarios. These findings provide a refined understanding of current practice and serve as a foundation for informed decision-making and future research.</div></div><div><h3>Trial Registry</h3><div>PROSPERO; Registration Number: CRD42024580521; URL: <span><span>https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=580521</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 339-359"},"PeriodicalIF":2.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069839","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 naples prognostic score as a new predictor for heart failure: A cross-sectional study","authors":"Ziyan Guo ,&nbsp;Futao Zhang ,&nbsp;Shuai Chai","doi":"10.1016/j.hrtlng.2025.01.009","DOIUrl":"10.1016/j.hrtlng.2025.01.009","url":null,"abstract":"<div><h3>Background</h3><div>The Naples prognostic score (NPS), a novel nutritional and inflammatory index, holds great promise for predicting the prognosis of heart failure (HF), but research on its association with HF outcomes is limited.</div></div><div><h3>Objective</h3><div>To analyze the relationship between the NPS and the incidence rate and long-term prognosis of HF.</div></div><div><h3>Methods</h3><div>Participants from the National Health and Nutrition Examination Survey (NHANES) data were allocated into three groups (group 0 (the NPS=0), group 1–2 (the NPS=1–2), and group 3–4 (the NPS=3–4)) based on the NPS level. Regression analysis was conducted to examine the relationship between the NPS and HF prevalence, and ROC curve analysis was employed to determine the prediction accuracy. The Cox proportional hazards model and Kaplan-Meier survival curves analyzed mortality risk, with subgroup and sensitivity analyses for model stability.</div></div><div><h3>Results</h3><div>The study included 47,300 individuals (mean age 47.18 years; 51.07% female; 68.86% non-Hispanic white). The HF prevalence was 2.30% (95% CI: 1.66, 3.17). Among 1,581 HF patients, 851 all-cause deaths occurred during a median follow-up of 6.84 years. In groups 3–4, the risk of all-cause, cardiovascular, and cancer mortality was significantly higher (4.18, 4.89, and 16.93, respectively, all <em>p</em> &lt; 0.05) compared to group 0. Furthermore, a significant difference was observed in the association between the NPS and cancer mortality across age subgroups (<em>p</em> &lt; 0.05). In contrast, there was no significant interaction between the NPS and all-cause mortality or cardiovascular mortality in subgroup analyses.</div></div><div><h3>Conclusions</h3><div>The NPS is a low-cost and easy-to-calculate prognostic score that helps predict the clinical course of patients with HF.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 360-367"},"PeriodicalIF":2.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069844","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}