Heart & Lung最新文献

{"title":"The Scottish inflammatory prognostic score: A novel biomarker for predicting in-hospital mortality in acute heart failure with reduced ejection fraction","authors":"Alperen Taş ,&nbsp;Çağatay Tunca ,&nbsp;Veysel Ozan Tanık ,&nbsp;Bülent Özlek","doi":"10.1016/j.hrtlng.2025.08.009","DOIUrl":"10.1016/j.hrtlng.2025.08.009","url":null,"abstract":"<div><h3>Background</h3><div>Acute heart failure with reduced ejection fraction (AHF) remains a leading cause of ED visits, hospitalizations, and in-hospital mortality.</div></div><div><h3>Objectives</h3><div>To evaluate the prognostic utility of the Scottish Inflammatory Prognostic Score (SIPS) in patients with AHF.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 508 patients admitted with AHF between November 2022 and November 2024. The SIPS was calculated based on albumin and neutrophil levels. Clinical and laboratory parameters were compared between survivors and non-survivors to identify predictors of all-cause in-hospital mortality.</div></div><div><h3>Results</h3><div>At a median follow-up of 10 days (range 4–28), 63 patients (12.4 %) died. The mean age of the study population was 63 years, with non-survivors being older on average. Multivariable Cox proportional regression analysis revealed high SIPS values (HR: 2.335, 95 % CI: 1.044 - 5.221, <em>p</em> = 0.039), advanced age, elevated NT-pro-BNP levels, chronic renal failure, and low serum sodium as independent predictors of in-hospital mortality. When patients were categorized by SIPS scores of 0, 1, and 2, the associated mortality rates were 5.1 %, 14.0 %, and 46.0 %, respectively (<em>p</em> &lt; 0.001). Additionally, ROC curve analysis indicated that a SIPS threshold of 0.5 effectively predicted in-hospital mortality, demonstrating a sensitivity of 77 % and a specificity of 58 % (95 % CI: 0.661–0.803, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>This study is the first to analyze the association between SIPS and in-hospital mortality in patients with AHF. Integrating SIPS with other established risk factors may help improve the identification of high-risk AHF patients who could benefit from closer monitoring and intensified therapy, though further validation is warranted.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 291-299"},"PeriodicalIF":2.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996450","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":"Early Extubation failure predicts neurodevelopmental delay in infants after cardiac surgery: A retrospective cohort study","authors":"Abdullah Al-Murad ,&nbsp;Rovnat Babazade","doi":"10.1016/j.hrtlng.2025.08.003","DOIUrl":"10.1016/j.hrtlng.2025.08.003","url":null,"abstract":"<div><h3>Background</h3><div>Infants who undergo cardiac surgery are at increased risk of adverse neurological outcomes. Extubation failure, often seen in the immediate postoperative period, may be an early clinical sign of underlying physiologic instability. However, its long-term impact on neurodevelopment remains poorly understood.</div></div><div><h3>Objectives</h3><div>This study aimed to determine whether early extubation failure independently predicts neurodevelopmental delay (NDD) in infants 12–24 months following cardiac surgery.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study involving 154 infants under 12 months of age who underwent cardiopulmonary bypass surgery between January 2016 and December 2022. Early extubation failure was defined as reintubation within 72 h after planned extubation. Neurodevelopmental outcomes were assessed using standardized developmental evaluations. Multivariate logistic regression was used to analyze the association between extubation failure and subsequent NDD.</div></div><div><h3>Results</h3><div>Extubation failure occurred in 16.9% of infants. Among those, 42.3% demonstrated NDD, compared to 18.6% in the successful extubation group. After adjusting for potential confounders, early extubation failure remained a significant independent predictor of NDD. Additional associations included prolonged ICU stays, higher sedative exposure, and increased readmission rates.</div></div><div><h3>Conclusions</h3><div>Early extubation failure following infant cardiac surgery is strongly associated with future neurodevelopmental impairment. This highlights the need for targeted extubation strategies, perioperative optimization, and structured developmental surveillance in this high-risk group.</div><div>Extubation failure may serve as a sentinel marker for early developmental surveillance.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 283-290"},"PeriodicalIF":2.6,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891949","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":"Performance of objective cough measurement, diaphragmatic contraction velocity, and spontaneous breathing trial for predicting extubation success in critically ill patients stratified by BMI: A prospective multicentre study","authors":"Fabio Varón-Vega ,&nbsp;Eduardo Tuta-Quintero ,&nbsp;Adriana Rincón ,&nbsp;Luis F. Giraldo-Cadavid ,&nbsp;Jonathan Palacios ,&nbsp;Stephanie Crevoisier ,&nbsp;Marcela Poveda ,&nbsp;Pablo Monedero","doi":"10.1016/j.hrtlng.2025.08.001","DOIUrl":"10.1016/j.hrtlng.2025.08.001","url":null,"abstract":"<div><h3>Background</h3><div>The transition from Invasive mechanical ventilation (IMV) to spontaneous breathing, known as the weaning-process (WP), requires careful evaluation. In obese patients, WP may be compromised due to altered respiratory mechanics, increasing the risk of weaning failure.</div></div><div><h3>Objective</h3><div>to evaluate the predictive capacity of objective cough measurement (OCM), spontaneous breathing trial (SBT), and diaphragmatic contraction velocity (DCV) in predicting WP success in obese patients.</div></div><div><h3>Methods</h3><div>A prospective, multicenter cohort study was conducted in critically ill patients requiring IMV who were undergoing the extubation process. The predictive ability of SBT, DCV, and OCM for determining SBT and extubation success was evaluated. The analysis was stratified by body mass index (BMI &lt;30 kg/m² vs. ≥30 kg/m²) to assess predictive performance across different weight categories.</div></div><div><h3>Results</h3><div>A total of 367 patients were included, of whom 70 % (279/367) had a BMI &lt;30 kg/m². OCM and DCV showed an AUC-ROC of 0.49 (95 % CI: 0.39–0.60) and 0.50 (95 % CI: 0.40–0.60) in the BMI &lt;30 kg/m² and ≥30 kg/m² groups for predicting success in the SBT, respectively (<em>p</em> = 0.9510). The SBT showed an AUC-ROC of 0.83 (95 % CI: 0.70–0.98) and 0.87 (95 % CI: 0.82–0.92) in the BMI &lt;30 kg/m² and ≥30 kg/m² groups for predicting successful extubation, respectively (<em>p</em> = 0.252). The SBT and DCV showed an AUC-ROC of 0.86 (95 % CI: 0.80–0.92) and 0.74 (95 % CI: 0.61–0.87) in the BMI &lt;30 kg/m² and ≥30 kg/m² groups for predicting successful extubation, respectively (<em>p</em> = 0.113). The SBT and OCM showed an AUC-ROC of 0.90 (95 % CI: 0.86–0.94) and 0.85 (95 % CI: 0.77–0.93) in the BMI &lt;30 kg/m² and ≥30 kg/m² groups for predicting successful extubation, respectively (<em>p</em> = 0.243).</div></div><div><h3>Conclusion</h3><div>The SBT demonstrated the highest predictive accuracy for successful extubation across BMI groups, while OCM and DCV had limited predictive value. No significant differences were observed between BMI categories.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 276-282"},"PeriodicalIF":2.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829727","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":"Evaluation of pharmacological thromboprophylaxis in critically Ill elderly patients: A multicenter cohort Study","authors":"Rahaf Alqahtani ,&nbsp;Khalid Al Sulaiman ,&nbsp;Ohoud Aljuhani ,&nbsp;Abdullah F. Alharthi ,&nbsp;Samiah Alsohimi ,&nbsp;Mohammed Alzahrani ,&nbsp;Ghazwa B. Korayem ,&nbsp;Ali F. Altebainawi ,&nbsp;Lena Alghamdi ,&nbsp;Asma Atti Alsahafi ,&nbsp;Rehab A Almotairi ,&nbsp;Bushra A. Alrashidi ,&nbsp;Amal A. Alhazom ,&nbsp;Nasser Alkhushaym ,&nbsp;Shahad Hamad Samkari ,&nbsp;Abdullah Salem Alharthi ,&nbsp;Shoug Alhinti ,&nbsp;Mohammed Ali Alwadai ,&nbsp;Abdulrahman Alissa ,&nbsp;Abdulrahman Alanazi ,&nbsp;Shmeylan Al Harbi","doi":"10.1016/j.hrtlng.2025.07.013","DOIUrl":"10.1016/j.hrtlng.2025.07.013","url":null,"abstract":"<div><h3>Background</h3><div>Older adults are at a higher risk of developing venous thromboembolism (VTE), particularly when admitted to the Intensive Care Units (ICUs). Parenteral anticoagulation is the primary method used for thromboprophylaxis in critically ill patients.Nonetheless, there is limited evidence on the most effective pharmacological agents for thromboprophylaxis and their dosages specifically for older adults in critical care settings..</div></div><div><h3>Objective</h3><div>This study aims to evaluate the effectiveness and safety of pharmacological VTE prophylaxis in critically ill older adults.</div></div><div><h3>Method</h3><div>This multi-center retrospective cohort study involved critically ill older adults aged 65 and above who were admitted to ICUs and received pharmacological thromboprophylaxis. Patients were categorized into two sub-cohorts based on the type of pharmacological thromboprophylaxis they received: subcutaneous unfractionated heparin (UFH) or low molecular weight heparin (LMWH); enoxaparin. The primary endpoint was major bleeding, while secondary endpoints were minor bleeding, all thrombosis cases, ICU and hospital length of stay, mechanical ventilation (MV) duration, and other ICU complications. A propensity score (PS) matching was utilized using a (2:1) ratio between patients who received UFH and enoxaparin as prophylaxis.</div></div><div><h3>Results</h3><div>After PS matching, we included 210 patients based on predefined criteria, with 140 patients in the UFH group and 70 in the enoxaparin group. The major bleeding events were lower in the enoxaparin group compared with UFH (10.7 % to 2.9 %; p-value=0.05); however, it failed to reach the statistical significance at regression analysis (OR: 0.25, 95 %CI: 0.10, 1.13; <em>P</em> = 0.07). All thrombotic events and rate of minor bleeding were not statistically significantly different between the two groups (OR 1.29, 95 % CI: 0.58, 2.84; P-value= 0.53 and OR: 0.54, 95 % CI: 0.25, 1.14, <em>P</em> = 0.11, respectively). In addition, the 30-day and in-hospital mortality rates were not statistically significantly different between the two groups (OR: 0.75, 95 %CI: 0.37, 1.52, <em>P</em> = 0.43 and OR: 0.65, 95 %CI: 0.33, 1.30, <em>P</em> = 0.21, respectively).</div></div><div><h3>Conclusion</h3><div>Enoxaparin as VTE prophylaxis in critically ill older adults showed a trend towards lower rates of major bleeding, although the difference was not statistically significant. In contrast, there were no notable differences in thrombosis rates among this patient group. Future randomized controlled trials are required to confirm our findings and explore long-term outcomes.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 253-259"},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779605","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":"Current status and influencing factors of kinesiophobia in elderly patients with chronic obstructive pulmonary disease: A cross-sectional study","authors":"Yaru Wang ,&nbsp;Chen Xiong ,&nbsp;Xiaoqiao Xie ,&nbsp;Guilian He ,&nbsp;Xiaofang Zou","doi":"10.1016/j.hrtlng.2025.07.017","DOIUrl":"10.1016/j.hrtlng.2025.07.017","url":null,"abstract":"<div><h3>Background</h3><div>Kinesiophobia is an important psychological barrier that prevents chronic obstructive pulmonary disease(COPD) patients from participating in activities, and there is a lack of research on kinesiophobia in elderly COPD patients.</div></div><div><h3>Objective</h3><div>This study aimed to investigate the current situation of kinesiophobia in elderly COPD patients and to analyze its related influencing factors.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted on 271 elderly patients with COPD recruited from a tertiary hospital in Guangzhou, China. General information and disease conditions of the patients were collected using questionnaires. Breathlessness Beliefs Questionnaire(BBQ) was used to measure the patients' kinesiophobia. Univariate and multivariate linear regression analyses were employed to analyze further factors associated with kinesiophobia.</div></div><div><h3>Results</h3><div>The total kinesiophobia score of elderly COPD patients was (37.43±4.61) and the incidence of kinesiophobia was 88.93 %. Multifactorial analysis showed that duration of COPD, anxiety, dyspnoea, fatigue, regularity of exercise, and exercise self-efficacy were the main influencing factors of kinesiophobia in elderly patients with COPD (all <em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Elderly patients with COPD have higher levels of kinesiophobia, and healthcare professionals should develop targeted interventions that incorporate the appropriate influencing factors to reduce the incidence of kinesiophobia in patients.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 247-252"},"PeriodicalIF":2.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738564","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 and mediating mechanisms between lung cancer and chronic comorbidities: a matched case-control study","authors":"Yuan Sheng ,&nbsp;Kai Di ,&nbsp;Yuzhao Liu ,&nbsp;Deshan Liu ,&nbsp;Baogeng Huai ,&nbsp;Yan Wang ,&nbsp;Lunping Pan ,&nbsp;Mengmeng Zhang ,&nbsp;Changling Li","doi":"10.1016/j.hrtlng.2025.07.016","DOIUrl":"10.1016/j.hrtlng.2025.07.016","url":null,"abstract":"<div><h3>Background</h3><div>Respiratory and cardio-cerebrovascular comorbidities are common in patients with lung cancer (LC), yet their clinical correlates and potential mediating mechanisms remain poorly understood.</div></div><div><h3>Objectives</h3><div>This study investigates the associations between respiratory and cardio-cerebrovascular comorbidities and LC and explores subtype-specific tumor biomarkers.</div></div><div><h3>Methods</h3><div>A 1:1 matched case-control study was conducted at Qilu Hospital of Shandong University from April 2023 to March 2024. Conditional logistic regression models, adjusted for potential confounders, and causal mediation analysis were used to assess the associations and mediating pathways between chronic comorbidities and LC, including subtype-specific tumor biomarkers. Comorbidity data and blood biomarkers were extracted from electronic medical records.</div></div><div><h3>Results</h3><div>Respiratory and cardio-cerebrovascular comorbidities were significantly associated with LC (model 4: p = 0.029 and p = 0.045). After adjustment for the total number of chronic comorbidities, these associations were no longer significant (model 5: p = 0.507 and p = 0.875). Lymphocyte percentage (Lym %) and <span>d</span>-dimer (DDi) partially mediated both associations (single-mediator models: all p &lt; 0.05). CYFRA21–1 was linked to respiratory comorbidities (p = 0.001), whereas PRO-GRP was associated with cardio-cerebrovascular comorbidities (p = 0.031), indicating subtype-specific patterns related to non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC).</div></div><div><h3>Conclusions</h3><div>LC is associated with both respiratory and cardio-cerebrovascular comorbidities, and immune- and coagulation-related biomarkers may partially mediate these associations. Total comorbidity burden shows a stronger association with LC risk than any individual comorbidity, underscoring the value of incorporating comorbidity assessment into LC risk evaluation.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 238-246"},"PeriodicalIF":2.6,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724669","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":"Association of advanced stages of Cardiovascular-kidney-metabolic syndrome with the risk of developing chronic lung disease: evidence from a nationwide prospective cohort study","authors":"Baolu Yang ,&nbsp;Haifan Zhang ,&nbsp;Xinglu Zhang ,&nbsp;Feng Wang ,&nbsp;Zhaohui Tong","doi":"10.1016/j.hrtlng.2025.07.019","DOIUrl":"10.1016/j.hrtlng.2025.07.019","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between Cardiovascular-Kidney-Metabolic syndrome (CKM) and Chronic Lung Disease (CLD) has not been elaborated.</div></div><div><h3>Objectives</h3><div>To investigate the associations between advanced stages of CKM and the risk of developing CLD, and to explore the potential mediating role of inflammation in this relationship.</div></div><div><h3>Methods</h3><div>This study analyzed data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018. Cox regression models were used to assess the relationships between different stages of CKM and CLD. Mediation analysis was performed to assess the role of high-sensitivity C-reactive protein (hsCRP) in the CKM-CLD relationship.</div></div><div><h3>Results</h3><div>Our findings demonstrated that, after adjustment for confounding factors, CKM Stage 3 (HR = 2.215, 95 % CI: 1.202–4.082) and Stage 4 (HR = 3.231, 95 % CI: 1.743–5.990) were significantly associated with an increased risk of developing chronic lung disease (CLD). Kaplan-Meier survival analysis indicated that participants at CKM Stages 3–4 had a higher incidence of CLD compared to those at Stages 0–2 (HR = 1.662, 95 % CI: 1.441–1.917, <em>P</em> &lt; 0.001). Mediation analysis further suggested that hsCRP levels partially mediated the relationship between CKM and peak expiratory flow (PEF), accounting for 2.25 % of the effect (95 % CI: 0.42 % -5.00 %, <em>p</em> = 0.022).</div></div><div><h3>Conclusion</h3><div>Advanced stages of CKM, specifically stages 3 and 4, are significantly associated with an increased risk of developing CLD. It is critical to recognize and manage CKM as a multifaceted syndrome that extends beyond the cardiovascular, metabolic, and renal systems to impact respiratory health.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 230-237"},"PeriodicalIF":2.6,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721228","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":"Ventricular arrhythmia in patients with acute myocarditis: A cohort study","authors":"Jasmin Büchel MD ,&nbsp;Gianmarco M. Balestra MD ,&nbsp;Alessia Schuler ,&nbsp;Philip Haaf MD ,&nbsp;Christian Mueller MD ,&nbsp;Patrick Badertscher MD ,&nbsp;Stephan Marsch PhD ,&nbsp;Michael Kühne PhD ,&nbsp;Christian Sticherling MD ,&nbsp;Philipp Krisai MD","doi":"10.1016/j.hrtlng.2025.07.018","DOIUrl":"10.1016/j.hrtlng.2025.07.018","url":null,"abstract":"<div><h3>Background</h3><div>Patients with acute myocarditis (AM) are at increased risk of arrhythmias.</div></div><div><h3>Objectives</h3><div>We aimed to characterize the timing and potential predictors associated with ventricular arrhythmias (VA).</div></div><div><h3>Methods</h3><div>A total of 351 consecutive patients hospitalized with AM on the intensive care unit with continuous monitoring between 2000–2023 were included into a retrospective cohort study. We analyzed predictors, temporal occurrence and different forms of VA in patients with AM.</div></div><div><h3>Results</h3><div>Mean age was 41.3 years and 74.4 % were men. Overall, 45 VA occurred in 36 (10.3 %) patients: 26 (58 %) non-sustained ventricular tachycardia (VT), 10 (22 %) sustained VT, 6 (13 %) cardiac arrest and 3 (7 %) ventricular fibrillation. The majority of VA (79 %) occurred within the first 24 h, but 11.9 % occurred only after 72 h. Among the analyzed variables cardiac troponin T (cTnT), left ventricular ejection fraction (LVEF), syncope at presentation and female sex were independent predictors for VA. A combined model including these four variables showed good discrimination, with an area under the curve of 0.80. Compared to patients without VA, patients with VA more often received advanced therapies (30.6 vs 5.7 %, <em>p</em> &lt; 0.001), and experienced a higher rate of incident or worsening heart failure (52.8 vs 16.5 %, <em>p</em> &lt; 0.001) and increased mortality (19.4 vs 0.3 %, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>In patients with AM, VA occur in 1 out of ten patients, most often manifested within the first 24 h. A model including cTnT, LVEF, syncope and female sex performed well in predicting VA.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 224-229"},"PeriodicalIF":2.4,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711649","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":"Therapeutic targets in lung diseases identified through single-cell analysis and mendelian randomization","authors":"Zhantao Jiang ,&nbsp;Yiting Lu ,&nbsp;Xiaoyi Wang","doi":"10.1016/j.hrtlng.2025.07.015","DOIUrl":"10.1016/j.hrtlng.2025.07.015","url":null,"abstract":"<div><h3>Background</h3><div>The global rise in lung diseases necessitates identification of therapeutic targets, yet systematic studies integrating diverse pathologies and lung function traits to uncover causal targets remain limited.</div></div><div><h3>Objectives</h3><div>To identify causal therapeutic targets across 12 lung traits (10 diseases, 2 functional measures: Forced Vital Capacity [FVC] and the FEV1/FVC ratio) and validate their genetic roles.</div></div><div><h3>Methods</h3><div>Single-cell transcriptomic data from the Human Lung Cell Atlas were analyzed via Geneformer, a deep learning model, to simulate in silico perturbations and generate a pan-lung disease target spectrum. Cis-expression quantitative trait loci (<em>cis-eQTL</em>) data from lung tissue and whole blood were integrated with Mendelian randomization (MR) and colocalization analyses to prioritize causal genes. An independent validation cohort confirmed reproducibility.</div></div><div><h3>Results</h3><div>The <em>in silico</em> treatment analysis identified a therapeutic target spectrum of 3570 genes across 12 lung traits. Of these traits, three—lung cancer, FVC, and the FEV1/FVC ratio—had genes with causal relationships established. Specifically, 2 genes were linked to lung cancer, 8 to FVC, and 20 to the FEV1/FVC ratio. These findings were validated via colocalization testing and confirmed in an independent validation set.</div></div><div><h3>Conclusions</h3><div>This study identified 30 putative causal therapeutic targets for lung cancer and lung function traits, offering a systematic and robust foundation for the development of targeted therapies for lung diseases.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 211-223"},"PeriodicalIF":2.4,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711648","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":"Socioeconomic disparities in In-hospital outcomes and readmission rates among patients hospitalized with infective endocarditis: A national analysis from the United States","authors":"Nadhem Abdallah MD ,&nbsp;Mahmoud Ismayl MBBS ,&nbsp;Abdilahi Mohamoud MBBS ,&nbsp;Mohammed Samra MD ,&nbsp;Andrew M. Goldsweig MD, MS","doi":"10.1016/j.hrtlng.2025.07.021","DOIUrl":"10.1016/j.hrtlng.2025.07.021","url":null,"abstract":"<div><h3>Background</h3><div>Contemporary data elucidates an association between adverse outcomes and low socioeconomic status (SES) in patients with cardiovascular related hospitalizations. Despite this, the impact of SES status on infective endocarditis (IE) outcomes remains unknown.</div></div><div><h3>Objectives</h3><div>To assess the impact of SES on hospitalized IE cases.</div></div><div><h3>Methods</h3><div>We queried the Nationwide Readmission Database (2016–2020) to identify adult patients with IE and stratified them based on mean income quartiles (≤2 quartile vs. ≥3 quartiles). The primary outcome was in-hospital mortality. Secondary outcomes included 30-day and 90-day readmissions, sepsis, mechanical circulatory support (MCS) use, acute kidney injury (AKI), pacemaker and valve replacement interventions, length of stay (LOS), and total hospital charges. Multivariable regression models adjusted for confounders.</div></div><div><h3>Results</h3><div>Among 41,175 IE hospitalizations, 24,581 (59.7 %) included patients with low income. Low income was associated with higher odds of in-hospital mortality (aOR 1.21, 95 % CI 1.04–1.41, <em>p</em> = 0.012), 30-day readmissions (aOR 1.09, 95 % CI 1.01–1.17, <em>p</em> = 0.021), 90-day readmissions (aOR 1.1, 95 % CI 1.02–1.19, <em>p</em> = 0.012), sepsis (aOR 1.11, 95 % CI 1.03–1.19, <em>p</em> = 0.008), MCS use (aOR 1.48, 95 % CI 1.04–2.09, <em>p</em> = 0.027) and lower odds of stroke (aOR 0.86, 95 % CI 0.78–0.96, <em>p</em> = 0.005) compared with high-income. No differences were observed in odds of AKI, valve replacement intervention, pacemaker use, mean LOS and total hospital charges between both income groups.</div></div><div><h3>Conclusion</h3><div>Among IE hospitalizations, lower income was associated with higher odds of in-hospital mortality and non-fatal adverse outcomes compared to higher income individuals.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"74 ","pages":"Pages 206-210"},"PeriodicalIF":2.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703004","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}