Heart & Lung最新文献

{"title":"How usual is usual care in Chronic Obstructive Pulmonary Disease trials? A systematic review on quality of reporting and validity of comparator interventions","authors":"Ana Paula Coelho Figueira Freire ,&nbsp;Mark R Elkins ,&nbsp;Marceli Rocha Leite ,&nbsp;Ryan Galindo ,&nbsp;Italo Ribeiro Lemes ,&nbsp;Hailey McNeill ,&nbsp;Bo Warner ,&nbsp;Jacob Crumb ,&nbsp;Nathan Herde ,&nbsp;Heloisa Rocha Reverte Siqueira Ribeiro ,&nbsp;Karen Roemer ,&nbsp;Francis Lopes Pacagnelli ,&nbsp;Rafael Z Pinto","doi":"10.1016/j.hrtlng.2026.102733","DOIUrl":"10.1016/j.hrtlng.2026.102733","url":null,"abstract":"<div><h3>Background</h3><div>‘Usual care’ is a term that can refer to a variety of control conditions in randomized controlled trials (RCTs). The lack of standardization of usual care groups can lead to problems for clinical decision-making.</div></div><div><h3>Objectives</h3><div>1) Systematically describe the types and characterizations of “usual care” interventions in COPD RCTs. 2) Determine how well RCTs report usual care interventions and the extent to which COPD guideline-recommended treatment components are a part of usual care interventions.</div></div><div><h3>Methods</h3><div>Systematic review design. Two investigators screened studies and independently extracted data. We extracted type of usual care described, quality of reporting, and classification of usual care components as validated (i.e., aligned with guidelines) or unvalidated comparators.</div></div><div><h3>Results</h3><div>We included 233 studies. The most frequently described usual care intervention included patient education (n = 72, 31%) and continued care with the general practitioner (n = 67, 29%). Only 7% of the studies provided a complete description of the usual care intervention. Almost half of usual care interventions (49%) were deemed unvalidated. Higher PEDro scores were associated with greater odds of the intervention being validated (Exp(B) = 1.32; 95% CI: 1.04 to 1.66).</div></div><div><h3>Conclusion</h3><div>There is significant variability and frequent lack of reporting in the characterization of ‘usual care’ comparators in RCTs involving patients with COPD. Usual care is often poorly described, inconsistently delivered, and commonly not aligned with clinical guidelines. Higher quality trials had better odds of providing valid usual care.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102733"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133681","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":"Pre-discharge readiness of hospitalised patients with heart failure and associated factors: A cross-sectional study","authors":"Mina Nozawa ,&nbsp;Soichiro Hotta ,&nbsp;Miki Arahata ,&nbsp;Kaoru Kizawa ,&nbsp;Tetsuo Sasano ,&nbsp;Makoto Tanaka","doi":"10.1016/j.hrtlng.2025.102722","DOIUrl":"10.1016/j.hrtlng.2025.102722","url":null,"abstract":"<div><h3>Background</h3><div>The increase in patients with heart failure is a global issue, and various symptoms of heart failure, such as fatigue and shortness of breath, are associated with a decline in quality of life and high readmission rates. Many patients experience difficulties in managing heart failure at home. Readiness before discharge, including physical, psychological status, knowledge and ability to care, and expected support, is important.</div></div><div><h3>Objectives</h3><div>To determine the level of and factors associated with readiness for hospital discharge among inpatients with heart failure</div></div><div><h3>Methods</h3><div>A cross-sectional study design was used. We included adult patients admitted to a tertiary referral hospital in Tokyo, Japan, for heart failure treatment. The Readiness for Hospital Discharge Scale-Japanese version was used to measure the patients’ readiness before hospital discharge. Hierarchical multiple regression analysis was used to assess the impact of independent variables such as patient and clinical characteristics on the Readiness for Hospital Discharge Scale.</div></div><div><h3>Results</h3><div>The readiness score for one of the subscales, ‘expected support’, was below 7 in the pre-discharge readiness scale. Younger age, living with someone, higher ‘self-care maintenance’ scores, and absence of history of hospitalisation for heart failure were associated with good pre-discharge readiness in patients with heart failure.</div></div><div><h3>Conclusion</h3><div>This study revealed that hospitalised patients with heart failure generally had low readiness before discharge and identified its relevant factors. The results can be used to identify at-risk patients at an early stage for additional and continuous support.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102722"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145908714","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":"Wide variability in studies reporting on digital education interventions for patients undergoing cardiac procedures: A patient-commissioned mixed methods systematic review","authors":"Robert Wells ,&nbsp;Leah Boulos ,&nbsp;Megan Gray ,&nbsp;Sarah E. Keeping ,&nbsp;Emily Jane Devereaux ,&nbsp;Tatjana Brauer-Chapin ,&nbsp;Ash Hariharan ,&nbsp;Gabriella Fera ,&nbsp;Kelly DeCoste ,&nbsp;Madison Hickey ,&nbsp;Catie Johnson ,&nbsp;Donna Rubenstein ,&nbsp;Gregory M. Hirsch ,&nbsp;Ryan Gainer ,&nbsp;Janet A. Curran","doi":"10.1016/j.hrtlng.2025.102702","DOIUrl":"10.1016/j.hrtlng.2025.102702","url":null,"abstract":"<div><h3>Background</h3><div>Although cardiac rehabilitation is widely acknowledged as the gold standard for improved outcomes in cardiac procedures, it remains underutilized. Digital education tools have the potential to improve access and adherence to cardiac rehabilitation.</div></div><div><h3>Objectives</h3><div>The primary objective of this review is to determine the impact of digital education interventions for patients undergoing cardiac procedures on patient-level and health system-level outcomes.</div></div><div><h3>Methods</h3><div>Conceptualized by a patient partner, a mixed methods systematic review was conducted using JBI methodology. MEDLINE, Embase, CINAHL, and Scopus were searched. Studies were included if they reported on a digital education intervention for adult patients preparing for or recovering from cardiac procedures, and if they reported primary outcomes related to healthcare utilization, learning/knowledge, and/or patient-level health. Interventions were mapped onto the WHO taxonomy of Digital Health Interventions for Persons.</div></div><div><h3>Results</h3><div>41 studies were included, and most reported a positive effect across several outcome categories: knowledge; behavior, attitude, and self-efficacy; physiological; healthcare utilization; mental health; quality of life; physical function and activity; and other. Considerable variation in outcomes, measurement instruments, and intervention characteristics hindered meta-analysis and made it challenging to draw broad conclusions.</div></div><div><h3>Conclusion</h3><div>Overall, interventions included in this review resulted in a positive effect on a wide range of outcomes. However, most studies did not report the use of an educational theory or underlying framework, leading to wide variability in intervention design and implementation. Future developers should consider using an educational framework to design and evaluate digital interventions. Additionally, engaging patients and knowledge users as co-designers could increase relevance, acceptability, and uptake.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102702"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967923","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 journey with AAHFN: Growing together to improve heart failure care","authors":"Jennifer Fox MSN, RN-BC, ACNPC-AG, CCRN, CHFN","doi":"10.1016/j.hrtlng.2026.102772","DOIUrl":"10.1016/j.hrtlng.2026.102772","url":null,"abstract":"","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102772"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596300","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":"Palliative Care Interventions and Outcomes in Patients with Heart Failure: An Umbrella Review","authors":"Jane Kim BSN, RN","doi":"10.1016/j.hrtlng.2026.102816","DOIUrl":"10.1016/j.hrtlng.2026.102816","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>An expanding research base of systematic reviews has evaluated the effect of palliative care (PC) interventions delivered by primary or specialty PC providers for patients with heart failure (HF) and their caregivers. However, the overall evidence base has not been systematically examined.</div></div><div><h3>AIM</h3><div>This umbrella review synthesizes the evidence regarding PC interventions among patients with HF to: 1) Describe interventions based on the PC domains in the AHA/ACC/HFSA HF guidelines, 2) Examine the effect of interventions on patient-centered and healthcare utilization outcomes, and 3) Provide recommendations for practice, policy and future research.</div></div><div><h3>METHODS</h3><div>Using the Joanna Briggs Institute methodology for umbrella reviews, we comprehensively searched for systematic reviews in MEDLINE, CINAHL, and Embase databases with no date restrictions. Published, peer-reviewed reviews were included.</div></div><div><h3>RESULTS</h3><div>The search identified 19 reviews (high-quality, 11 with meta-analyses), of 104 nonoverlapping primary studies (low quality). Primary and specialty PC was associated with improvements in quality of life, depression, advanced care planning, and reduced hospitalizations. The effect of PC on reducing symptom burden was inconclusive. Limited evidence demonstrated improvements in anxiety, satisfaction with care, caregiver burden, and hospital length of stay. PC did not significantly impact mortality rates or hospice referral.</div></div><div><h3>CONCLUSIONS</h3><div>The concordance of the overall evidence was high, and although the quality of primary studies was overall low, findings confirm that primary and specialty PC offer meaningful benefits for patients with HF. Future research is required on caregiver outcomes, medically complex illness trajectories, intervention timing and fidelity, standardized outcome measurements, and longitudinal study designs with larger sample sizes.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102816"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148523314","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":"Non-rheumatic calcific aortic valve disease as a global driver of heart failure: Burden and three-decade trends","authors":"Lin Zhu ,&nbsp;Yanqing Gong ,&nbsp;Zijie An ,&nbsp;Liumei Mo ,&nbsp;Jian Rong ,&nbsp;Zhenhao Liu","doi":"10.1016/j.hrtlng.2025.102690","DOIUrl":"10.1016/j.hrtlng.2025.102690","url":null,"abstract":"<div><h3>Background</h3><div>Global aging and lifestyle shifts raise cardiovascular disease burden, but the specific contribution of non-rheumatic calcific aortic valve disease (nrCAVD) to heart failure (HF) in older adults is incompletely defined.</div></div><div><h3>Objectives</h3><div>To quantify global trends, drivers, inequalities, and future projections of HF attributable to nrCAVD among persons aged ≥60 and to assess causality.</div></div><div><h3>Methods</h3><div>Using GBD 2021 estimates (1990–2021) for prevalence, Years Lived with Disability(YLDs), and age-standardized rates across 204 countries, we applied decomposition analysis, Social Inequality Index (SII), and Bayesian age-period-cohort forecasting to 2040. Two-sample Mendelian randomization (FinnGen GWAS) evaluated causality.</div></div><div><h3>Results</h3><div>In 2021 an estimated 1.38 million persons aged ≥60 had HF due to nrCAVD with 123,907 YLDs—cases rose 123 % since 1990 though age-standardized prevalence fell ∼16.7 %. Male burden was ∼1.5 × female. High-SDI regions had the highest rates but burdens are rising in middle/low-SDI areas. Decomposition attributed increases to population growth (+100.9 %) and aging (+20.0 %), partially offset by epidemiological improvement (−20.9 %). Cross-country inequality declined. Forecasts project ∼79 % increases in cases and YLDs by 2040. Mendelian randomization supported a causal effect of nrCAVD on HF.</div></div><div><h3>Conclusions</h3><div>These findings demonstrate that heart failure due to non-rheumatic calcific aortic valve disease represents a growing global health burden in aging populations, particularly in lower-SDI settings. Targeted preventive measures, early screening, and equitable access to effective interventions are urgently needed to mitigate this trend.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"77 ","pages":"Article 102690"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835316","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 of modifiable lifestyle behaviors with cardiovascular–kidney–metabolic syndrome across risk categories: Findings from a U.S. national survey","authors":"Xin Chen ,&nbsp;Xinyu Tao ,&nbsp;Zhonghua Sun ,&nbsp;Hanning Xiong ,&nbsp;Yameng Xu ,&nbsp;Ying Xu ,&nbsp;Zhengxia Liu ,&nbsp;Chen Qu ,&nbsp;Biao Xu","doi":"10.1016/j.hrtlng.2025.102712","DOIUrl":"10.1016/j.hrtlng.2025.102712","url":null,"abstract":"<div><h3>Background</h3><div>Poor cardiovascular–kidney–metabolic (CKM) health is highly prevalent and strongly associated with premature mortality. Although healthy lifestyle behaviors are linked to cardiovascular, renal, and metabolic outcomes, evidence on their associations with CKM syndrome risk categories, particularly by sex, remains limited.</div></div><div><h3>Objectives</h3><div>To examine the associations of five modifiable lifestyle behaviors with CKM syndrome risk categories in a nationally representative U.S. sample and to explore potential sex-specific patterns.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional analysis of 9447 adults from the 2007–2018 National Health and Nutrition Examination Survey. CKM stages (0–4) were grouped into low-, moderate-, and high-risk categories. Physical activity, diet quality, smoking status, sleep duration, and alcohol intake were assessed using standardized questionnaires. Weighted logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) for moderate- and high-risk CKM; a 0–5 lifestyle score assessed dose–response; sex-stratified and sensitivity analyses were performed.</div></div><div><h3>Results</h3><div>Physical inactivity, current smoking, short or long sleep, and nondrinking (vs light drinking) were associated with higher odds of moderate- or high-risk CKM. Poor diet quality was associated with moderate- but not high-risk CKM. Higher lifestyle scores showed an inverse dose–response pattern, and several associations varied by sex.</div></div><div><h3>Conclusion</h3><div>In this nationally representative cross-sectional study, modifiable lifestyle behaviors were strongly associated with CKM syndrome risk categories, with important sex-specific patterns. These findings support incorporating lifestyle information into CKM risk stratification and motivate future longitudinal and interventional studies.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"77 ","pages":"Article 102712"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884904","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":"Left atrial diameter to left atrial appendage emptying velocity ratio predicts risk of recurrence of atrial fibrillation after all-zero fluoroscopy ablation","authors":"Xiaoran Cui,&nbsp;Yichen Li,&nbsp;Ruibin Li,&nbsp;Wenli Zhou,&nbsp;Jidong Zhang","doi":"10.1016/j.hrtlng.2025.102721","DOIUrl":"10.1016/j.hrtlng.2025.102721","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>This study evaluated the ability of intraprocedural intracardiac echocardiography (ICE)-measured left atrial appendage (LAA) flow characteristics to predict the long-term risk of recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation.</div></div><div><h3>Methods</h3><div>The study included 105 patients who underwent radiofrequency catheter ablation for AF at our institution between October 2020 and December 2021. Eighty-seven of these patients completed 12 months of follow-up. The anteroposterior left atrial diameter to LAA emptying velocity (LAD/LAAEV) ratio was calculated. The patients were stratified into a recurrence group (n=18) and a non-recurrence group (n=69) based on the 12-month outcome. Predictive performance was evaluated by Cox regression and by receiver-operating characteristic curve and Kaplan–Meier survival analyses.</div></div><div><h3>Results</h3><div>The LAD/LAAEV ratio (<em>P</em>&lt;0.001) was significantly higher in the recurrence group than in the non-recurrence group. Multivariate Cox analysis identified the LAD/LAAEV ratio (hazard ratio 1.36, 95 % confidence interval [CI] 1.02–1.83) and New York Heart Association functional class (hazard ratio 2.75, 95 % CI 1.19–6.35) as independent predictors of recurrence by one year. Receiver-operating characteristic curve analysis confirmed that the LAD/LAAEV ratio predicted recurrence with an area under the curve of 0.806 (95 % CI 0.707–0.906); the optimal cutoff was 1.42 (sensitivity 70.4 %, specificity 87.5 %). Kaplan–Meier analysis showed that the cumulative recurrence rate was significantly higher in the group with an LAD/LAAEV ratio of ≥1.42 (<em>P</em>&lt;0.001, log-rank test).</div></div><div><h3>Conclusions</h3><div>The ICE-measured LAD/LAAEV ratio may predict recurrence of AF post-ablation, providing a basis for intensified post-procedural management in high-risk patients.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"77 ","pages":"Article 102721"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913957","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":"Effectiveness of the hippotherapy simulator in children and adolescents with cystic fibrosis: A randomized controlled trial","authors":"Betul Cinar ,&nbsp;Rengin Demir ,&nbsp;Melih Zeren ,&nbsp;Erkan Cakir ,&nbsp;Hulya Nilgun Gurses","doi":"10.1016/j.hrtlng.2025.102688","DOIUrl":"10.1016/j.hrtlng.2025.102688","url":null,"abstract":"<div><h3>Background</h3><div>Patients with cystic fibrosis (CF) frequently experience both pulmonary and extrapulmonary complications that impair physical function and quality of life, highlighting the need for multidimensional rehabilitation strategies.</div></div><div><h3>Objectives</h3><div>The study aims to investigate the effects of hippotherapy simulator (HS) added to comprehensive chest physiotherapy (CCP) on pulmonary and extrapulmonary manifestations in cystic fibrosis (CF).</div></div><div><h3>Methods</h3><div>Thirty-two patients (8–14 years) with CF were randomized into either CCP group (received CCP only), or CCP+HS group (received HS alongside CCP). CCP was performed twice daily. The HS program consisted of two 30-minute sessions per week. Functional capacity, pulmonary functions, amount of sputum, ease of expectoration, sense of chest congestion, core muscle endurance, postural stability, dynamic balance, peripheral muscle strength, flexibility, physical activity (PA), and quality of life (QoL) were assessed at baseline and after the 8-week treatment.</div></div><div><h3>Results</h3><div>Functional capacity, pulmonary functions, amount of sputum, core muscle endurance, postural stability, peripheral muscle strength, PA, and emotional functioning and body image scores in QoL improved only in the CCP+HS group (<em>p</em> &lt; 0.05). Improvements in extensor and lateral group core muscle endurance and dynamic balance were greater in the CCP+HS group compared to the CCP group (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>HS alone appears insufficient to improve functional capacity, pulmonary functions, amount and ease of expectoration, postural stability, flexibility, and PA in children and adolescents with CF; however, it may be used as an adjunctive approach to enhance core muscle endurance and dynamic balance.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"77 ","pages":"Article 102688"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738477","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":"Diaphragmatic ultrasound in guiding weaning from invasive mechanical ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease","authors":"Shunnan Sun ,&nbsp;Liuhua Pan ,&nbsp;Xiaofang Wang ,&nbsp;Jing Zhao","doi":"10.1016/j.hrtlng.2025.102692","DOIUrl":"10.1016/j.hrtlng.2025.102692","url":null,"abstract":"<div><h3>Background</h3><div>Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) often necessitates invasive mechanical ventilation (IMV), and timely weaning is critical to improving patient outcomes. However, reliable predictors of weaning success in this population remain unclear.</div></div><div><h3>Objectives</h3><div>To assess the predictive value of diaphragmatic function indicators for successful weaning from IMV in AECOPD patients.</div></div><div><h3>Methods</h3><div>This single-center, prospective observational study enrolled 120 AECOPD patients admitted to the intensive care unit (ICU) who received IMV. Based on weaning outcomes, patients were categorized into successful weaning (<em>n</em> = 84) and failed weaning (<em>n</em> = 36) groups. Clinical data, including baseline characteristics, diaphragmatic thickening fraction (DTF), diaphragmatic excursion (DE), rapid shallow breathing index (RSBI), and arterial blood gas parameters, were collected. Independent predictors of successful weaning were identified using logistic regression analysis. Receiver operating characteristic (ROC) curves were used to evaluate the predictive performance of these parameters. Correlation between DTF and RSBI was also analyzed.</div></div><div><h3>Results</h3><div>Compared with the failed group, patients in the successful weaning group demonstrated significantly higher DE and DTF, and lower RSBI values (all <em>P</em> &lt; 0.05). Logistic regression revealed that DE, DTF, and RSBI were independent predictors of successful weaning. ROC analysis showed that the combined model of DE, DTF, and RSBI yielded an area under the curve (AUC) of 0.961, with 88.89% sensitivity and 92.86% specificity. Additionally, the failed group experienced longer mechanical ventilation duration, prolonged ICU stay, and higher complication rates.</div></div><div><h3>Conclusion</h3><div>DTF, DE, and RSBI are reliable predictors of successful IMV weaning in AECOPD patients. Early assessment of diaphragmatic function may enhance clinical decision-making in ventilator liberation.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"77 ","pages":"Article 102692"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841387","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}