Heart & Lung最新文献

{"title":"NYHA classification deterioration and quality of life in heart failure inpatients: A chain mediation analysis of cognitive impairment and depression","authors":"Jin Yang ,&nbsp;You Pu ,&nbsp;Mingjun He ,&nbsp;Tianyi Wang ,&nbsp;Ting Ye ,&nbsp;Yunman Huang ,&nbsp;Yunfeng Di ,&nbsp;Xianqin Zhang ,&nbsp;Zheng Yang","doi":"10.1016/j.hrtlng.2025.04.033","DOIUrl":"10.1016/j.hrtlng.2025.04.033","url":null,"abstract":"<div><h3>Background</h3><div>Health-related quality of life (HRQoL) is a key indicator of the prognosis of heart failure (HF) patients. Although the association between the New York Heart Association (NYHA) class and HRQoL has been widely recognized, the underlying mechanisms of this association have not been fully elucidated.</div></div><div><h3>Objectives</h3><div>This study aimed to investigate the mediating role of cognitive impairment and depressive symptoms in NYHA class and HRQoL in HF patients.</div></div><div><h3>Methods</h3><div>We used a convenience sampling method to select HF patients hospitalized between December 2023 and April 2024 in China. General information, NYHA class, cognitive function, depressive symptoms, and HRQoL were assessed. We conducted mediated effects analyses using the \"Bruce\" package in the R software.</div></div><div><h3>Results</h3><div>A total of 313 HF patients were included in this study. The HRQoL scores of the patients were 62.60 ± 13.94. NYHA class, cognitive impairment, and depressive symptoms were positively correlated with the HRQoL scores. Mediation effect analysis showed that the mediation effects of cognitive impairment, depressive symptoms, and the combination of the two between NYHA class and HRQoL were 0.059, 0.119, and 0.044, accounting for 9.08 %, 18.30 %, and 6.77 % of the total effect, respectively.</div></div><div><h3>Conclusion</h3><div>NYHA class in HF patients directly and indirectly impacts HRQoL through cognitive impairment and depressive symptoms. Healthcare providers should prioritize joint assessment of cognitive function and depression symptoms, implementing comprehensive interventions to mitigate NYHA class effects on HRQoL.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 95-103"},"PeriodicalIF":2.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928282","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":"Can ChatGPT accurately detect atrial fibrillation using smartwatch ECG?","authors":"Yuval Avidan ,&nbsp;Ibrahim Naoum ,&nbsp;Razi Khoury ,&nbsp;Sameha Zahra ,&nbsp;Nissan Ben Dov ,&nbsp;Jorge E Schliamser ,&nbsp;Asaf Danon ,&nbsp;Amir Aker","doi":"10.1016/j.hrtlng.2025.04.032","DOIUrl":"10.1016/j.hrtlng.2025.04.032","url":null,"abstract":"<div><h3>Background</h3><div>Current guidelines require physician confirmation for smartwatch-diagnosed atrial fibrillation (AF), increasing telemedicine workloads. The newest ChatGPT-4o (GPT-4o) incorporates advanced image input capabilities.</div></div><div><h3>Objective</h3><div>To assess GPT-4o’s performance in identifying AF from smartwatch recordings.</div></div><div><h3>Methods</h3><div>Consecutive 120 patients with AF and 60 controls with sinus rhythm (SR), confirmed by conventional 12-lead ECG, recorded single-lead ECGs using an Apple Watch (AW) Series 6®. Two blinded cardiologists independently classified the smartwatch recordings as AF, SR, or undetermined. GPT-4o was subsequently prompted to analyze all smartwatch ECGs.</div></div><div><h3>Results</h3><div>Six AF cases were excluded due to undetermined AW-ECG recordings, leaving 114 AF patients (mean age: 73.4 ± 10.4 years) and 60 controls. The AW algorithm achieved 97.3 % and 100 % accuracy for AF and SR, respectively, while GPT-4o correctly analyzed 47.3 % of AF and 71.6 % of SR tracings. None of the AF characteristics—chronicity, heart rate, QRS width, fibrillatory wave amplitude, or R-wave amplitude and polarity—were predictive of GPT-4o's diagnostic accuracy.</div></div><div><h3>Conclusion</h3><div>The current capabilities of GPT-4o are insufficient to make a reliable diagnosis of AF from smartwatch ECGs. Despite the theoretical appeal of leveraging this innovative technology for such purpose, the findings highlight that human expertise remains indispensable. Consumers must remain aware of the current limitations of this technology.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 90-94"},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918367","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":"Gender differences in the public’s conceptions of acute coronary syndrome-related chest pain","authors":"John R. Blakeman ,&nbsp;MyoungJin Kim ,&nbsp;Ann L. Eckhardt","doi":"10.1016/j.hrtlng.2025.04.029","DOIUrl":"10.1016/j.hrtlng.2025.04.029","url":null,"abstract":"<div><h3>Background</h3><div>Symptoms often propel individuals to seek care. Chest pain is the most common acute coronary syndrome symptom, but an understanding of the public’s conceptions about chest pain is lacking.</div></div><div><h3>Objectives</h3><div>The objectives were to describe the general public’s conceptions of ACS-related chest pain, including the symptom dimensions quality, distress, intensity, and timing, and to compare those conceptions between women and men.</div></div><div><h3>Methods</h3><div>A descriptive, cross-sectional study design was used, leveraging on online survey. Data were collected using the Chest Pain Conception Questionnaire, and conceptions were compared between women and men.</div></div><div><h3>Results</h3><div>The 597 participants were a mean 54.0 (SD 11.5) years of age and lived across the U.S. Based on 5-point Likert scales, specific descriptors of chest pain, such as pressure and tightness, were rated as more likely to represent ACS-related chest pain (<em>M</em> 4.23) than general descriptors, such as discomfort (<em>M</em> 3.28). Though common descriptors of ACS-related chest pain (e.g., pressure, tightness) were selected by &gt; 70 % of the sample, only 13 % selected indigestion. Most participants (<em>n</em> = 503, 84.3 %) associated ACS-related chest pain with the left chest. Participants believed that ACS-related chest pain would be “intense” (MDN 4.0) and distress them “a lot” (MDN 4.0). Few differences were identified between women and men.</div></div><div><h3>Conclusions</h3><div>Participants believed that ACS-related chest pain would be sudden, overwhelming, and experienced in the left chest. Given these findings, health care professionals are advised to address misconceptions about chest pain through individual education and public health messaging campaigns.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 81-89"},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918366","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":"Sex-based long-term outcome for atrial fibrillation patients post catheter ablation","authors":"Mingjie Lin ,&nbsp;Wenqiang Han ,&nbsp;Bing Rong ,&nbsp;Kai Zhang ,&nbsp;Tongshuai Chen ,&nbsp;Juntao Wang ,&nbsp;Yihan Li ,&nbsp;Changli Chen ,&nbsp;Lin Wu ,&nbsp;Jingquan Zhong","doi":"10.1016/j.hrtlng.2025.04.028","DOIUrl":"10.1016/j.hrtlng.2025.04.028","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have demonstrated sex-based disparities in atrial fibrillation (AF) recurrence and procedural complications post-catheter ablation among female patients; however, sex-specific long-term outcomes remain insufficiently characterized.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate long-term outcomes of AF recurrence and major adverse cardiovascular/cerebrovascular events (MACE) after catheter ablation, with the objectives of identifying sex-specific risk factors and providing evidence for personalized clinical strategies.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis using data from a prospectively observational registry of AF ablation procedures at our institution from 2015 to 2020. Patients were followed up for MACE and AF recurrence. The risk factors of AF recurrence and MACE were further explored.</div></div><div><h3>Results</h3><div>The cohort comprised 2293 patients (62.8 % male; 37.2 % female) with a median follow-up of 50.36 months. Female patients demonstrated significantly higher AF recurrence rates compared to males (HR 1.305, 95 % CI 1.101 to 1.547; <em>p</em> = 0.0014), a disparity consistent across early (&lt;1 year from diagnosis) and late ablation subgroups (both <em>p</em> &lt; 0.05). In contrast, MACE incidence did not differ by sex (<em>p</em> = 0.23). Multivariable analysis identified female sex (adjust HR 1.358, <em>p</em> = 0.003), diabetes mellitus (HR 1.413, <em>p</em> = 0.005), and left atrial diameter ≥40 mm (HR 1.356, <em>p</em> = 0.001) as independent predictors of recurrence</div></div><div><h3>Conclusions</h3><div>Sex differences significantly impact the long-term outcomes of AF recurrence, but not MACE rates post-catheter ablation. The study highlights the necessity to integrate sex considerations into AF management strategies.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 74-80"},"PeriodicalIF":2.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918365","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":"Clinical outcomes of sacubitril-valsartan versus angiotensin converting enzyme inhibitor or angiotensin receptor blocker among patients with heart failure and ejection fraction at/less than 60 %: A retrospective, observational, parallel cohort, multi-group study","authors":"Nancy M. Albert ,&nbsp;James F. Bena ,&nbsp;Shannon L Morrison ,&nbsp;J. Bradley Williams ,&nbsp;Kathleen Faulkenberg ,&nbsp;Rahul Khairnar ,&nbsp;Trejeeve Martyn","doi":"10.1016/j.hrtlng.2025.04.027","DOIUrl":"10.1016/j.hrtlng.2025.04.027","url":null,"abstract":"<div><h3>Background</h3><div>Real-world heart failure (HF) and all-cause hospitalization, HF-related emergency care visits, all-cause mortality and the composite of all-cause or HF hospitalization or HF-related emergency visit remain high, due to underuse of core HF medications.</div></div><div><h3>Objectives</h3><div>A better understanding of real-world clinical outcomes is needed based on sacubitril-valsartan vs. angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) use among patients with HF and a wide range of ejection fractions.</div></div><div><h3>Methods</h3><div>Data retrieved from a multi-center, multi-state healthcare system database of patients prescribed sacubitril-valsartan were matched to those on ACEI/ARB based on age, sex, EF, comorbidity status, systolic blood pressure and index date site (hospital or ambulatory). Six- and 12-month outcomes based on sacubitril-valsartan vs. ACEI/ARB were assessed using linear, logistic, and Poisson models with generalized estimating equations.</div></div><div><h3>Results</h3><div>Patients (<em>N</em> = 4188; 2094/cohort) were well matched based on characteristics; 29.8 % were female, mean (SD) age was 64.3 (13.1) years, systolic blood pressure was 122.0 (16.2) mmHg, EF% was 29.1 (9.9); nearly half were in NYHA FC II and 422 (10.1 %) had EF of 41–60 %. Frequency of non-study medications at baseline was 92.6 % beta-blocker, 43.2 % mineralocorticoid receptor antagonist and 64.2 % loop diuretic. Compared to ACEI/ARB, all 6 and 12-month clinical outcomes were improved among patients using sacubitril-valsartan (all 12-month <em>p</em>&lt;.001).</div></div><div><h3>Conclusions</h3><div>Among patients with HF and EF up to 60 %, sacubitril-valsartan use was associated with lower 12-month morbidity and mortality. Providers and clinicians need to advocate for use of sacubitril-valsartan per hierarchical renin angiotensin system inhibitor national guideline recommendations.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 64-73"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891274","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 prospective randomized comparison of a pulse-contour analysis monitor versus a non-invasive bioreactance monitor in a stroke-volume based goal-directed fluid resuscitation protocol in brain-dead organ donors","authors":"Gary F Marklin ,&nbsp;Elyssa Gansner ,&nbsp;Melissa Stephens ,&nbsp;Gregory Ewald ,&nbsp;William Dean Klinkenberg ,&nbsp;Thomas Ahrens","doi":"10.1016/j.hrtlng.2025.04.026","DOIUrl":"10.1016/j.hrtlng.2025.04.026","url":null,"abstract":"<div><h3>Background</h3><div>Brain-dead (BD) organ donors are frequently hypotensive and hypovolemic requiring fluid resuscitation. We previously published our four-hour stoke volume (SV)-based fluid resuscitation protocol that expeditiously corrected the fluid deficit and significantly decreased time on vasopressors. The SV was measured by pulse-contour analysis (PCA).</div></div><div><h3>Objective</h3><div>To determine if the measurement of stroke volume by bioreactance (BR) was equivalent to PCA in a goal-directed fluid resuscitation protocol in BD donors.</div></div><div><h3>Methods</h3><div>We performed a prospective randomized trial of fluid resuscitation in BD donors comparing the two monitors.</div></div><div><h3>Results</h3><div>In 169 deceased donors there were 1481 comparative measurements of SV. The correlation coefficient was 0.32. A Bland Altman analysis revealed a minimal bias (-1.8 ml) but large limits of agreement (±62.9 ml) and a percentage error of 80.5 %. A 10 % SV increase with a 500 ml fluid bolus had conflicting results between the monitors in 31.3 % of 1309 measurements. As a reference standard, the Fick method of measuring SV was used 49 times with simultaneous measurements of PCA-SV and BR-SV. The mean Fick SV (96.0 ± 30.6 ml) was significantly greater than BR (79.4 ± 18.1 ml; <em>p</em>&lt;.01) and the PCA (77.2 ± 22.5 ml; <em>p</em>&lt;.01). The mean SV differences for Fick-BR (16.6 ± 27.2, 95 % CI 8.78–24.42) and Fick-PCA (18.7 ± 29.0, 95 % CI 10.42–27.08) were not significantly different (<em>p</em>=.57).</div></div><div><h3>Conclusion</h3><div>Although this study demonstrated inaccuracies, imprecision, and disagreement between BR and PCA SV measurements, there was equipoise in clinical outcomes when used with our fluid resuscitation protocol, as previously published.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 56-63"},"PeriodicalIF":2.4,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876624","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 between acute-to-chronic glucose ratio and acute kidney injury after emergency PCI in patients with acute myocardial infarction","authors":"Yifan Deng ,&nbsp;Yue Ma ,&nbsp;Jiapei Gao ,&nbsp;Qinyu Sun ,&nbsp;Jing Zhang ,&nbsp;Li Zhu","doi":"10.1016/j.hrtlng.2025.04.025","DOIUrl":"10.1016/j.hrtlng.2025.04.025","url":null,"abstract":"<div><h3>Background</h3><div>Contrast-induced acute kidney injury (CI-AKI) is a common complication in patients with acute myocardial infarction undergoing Percutaneous coronary intervention (PCI) treatment and is associated with poor prognosis. there is a lack of effective predictive biomarkers and functions.</div></div><div><h3>Objective</h3><div>To explore the correlation between the acute-to-chronic blood glucose ratio (ARC) and CI-AKI in patients with emergency PCI.</div></div><div><h3>Methods</h3><div>This study enrolled AMI patients undergoing emergency PCI from November 2018 to May 2024. Demographic characteristics, medical history, and perioperative laboratory parameters were systematically collected. Potential predictors were identified through least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression. Restricted cubic splines (RCS) were employed to examine nonlinear relationships, with subsequent subgroup analyses and nomogram construction.</div></div><div><h3>Results</h3><div>A total of 502 patients were included, with 84 developing postoperative CI-AKI and 418 remaining non-CI-AKI. ARC was found to be an independent risk factor for CI-AKI (OR = 1.06, 95 % CI 1.04–1.08). RCS analysis revealed a non-linear relationship between ARC and CI-AKI. In various adjusted models, ARC as a continuous variable showed a correlation with CI-AKI occurrence. In the third and fourth quantiles, ARC was independently associated with CI-AKI risk (OR = 2.95, 95 % CI 1.16–7.47 and OR = 7.17, 95 % CI 2.99–17.24, respectively). The nomogram model, based on LASSO regression, demonstrated good predictive accuracy for CI-AKI (AUC = 0.831, 95 % CI 0.778–0.884).</div></div><div><h3>Conclusion</h3><div>There is a non-linear positive correlation between ARC and the risk of acute kidney injury after emergency PCI in patients with AMI.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 48-55"},"PeriodicalIF":2.4,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869927","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":"Efficacy of colchicine in lower extremity peripheral arterial disease: A meta-analysis","authors":"Hritvik Jain MBBS ,&nbsp;Nandan Patel MBBS ,&nbsp;Maheen Erum MBBS ,&nbsp;Ramez M. Odat MD ,&nbsp;Siddhant Passey MD ,&nbsp;Rozi Khan MD ,&nbsp;Jyoti Jain MBBS ,&nbsp;Ameer Haider Cheema MD ,&nbsp;Sebastian Fox MBChB, BMSc ,&nbsp;Raheel Ahmed MBBS, MRCP","doi":"10.1016/j.hrtlng.2025.04.022","DOIUrl":"10.1016/j.hrtlng.2025.04.022","url":null,"abstract":"<div><h3>Background</h3><div>Lower-extremity peripheral arterial disease (LEPAD) significantly increases the risk of severe cardiovascular and limb complications, often due to the underlying inflammation from atherosclerosis. Colchicine has gained attention due to its efficacy in the primary and secondary prevention of cardiovascular events and may offer similar protective benefits for LEPAD.</div></div><div><h3>Objectives</h3><div>This meta-analysis aimed to evaluate outcomes with colchicine in LEPAD.</div></div><div><h3>Methods</h3><div>A systematic literature search was performed on the major bibliographic databases for studies until October 2024. Hazard ratios (HRs) with their corresponding 95% CIs were pooled using the inverse-variance random-effects model.</div></div><div><h3>Results</h3><div>Three studies were included with 226,804 patients [113,537: Colchicine and 113,267: Placebo]. The pooled analysis demonstrates colchicine use in patients with LEPAD was associated with a significantly lower risk of major adverse limb events (MALE) [HR: 0.84; 95 % CI: 0.75, 0.94; p = 0.002], major adverse cardiovascular events (MACE) [HR: 0.90; 95 % CI: 0.82, 0.98; p = 0.02], ischemic stroke [HR: 0.97; 95 % CI: 0.94, 0.99; p = 0.02], need for major amputations [HR: 0.81, 95 % CI: 0.75, 0.87; p&lt; 0.00001], and revascularization for lower limb ischemia [HR: 0.81; 95 % CI: 0.72, 0.90; p = 0.0001]. However, no significant reduction was noted for all-cause mortality [HR: 0.87; 95 % CI: 0.74, 1.02; p = 0.09] and myocardial infarction (MI) [HR: 0.98; 95 % CI: 0.95, 1.00; p = .10].</div></div><div><h3>Conclusion</h3><div>Colchicine may be a useful adjunctive therapy for reducing the risk of major cardiovascular and limb-related complications in patients with LEPAD, including lower rates of MACE, MALE, stroke, amputation, and limb ischemia. However, it did not significantly reduce all-cause mortality or MI. Notably, the only randomized trial evaluating colchicine's efficacy in LEPAD reported a similar risk of adverse outcomes. Multicenter, adequately powered randomized controlled trials are needed to confirm colchicine's effectiveness in this population.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 42-47"},"PeriodicalIF":2.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863386","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 between patent foramen ovale and chronic obstructive pulmonary disease: A systematic review and meta-analysis","authors":"Sruthy Balakumar ,&nbsp;Naya Nadeem ,&nbsp;Areeba Asghar MSc ,&nbsp;Claudia Frankfurter ,&nbsp;Ashley Farrell MLIS, AHIP ,&nbsp;Eduardo Flores-Umanzor MD, PhD ,&nbsp;Eric Horlick MDCM ,&nbsp;Lusine Abrahamyan MD, MPH, PhD","doi":"10.1016/j.hrtlng.2025.04.024","DOIUrl":"10.1016/j.hrtlng.2025.04.024","url":null,"abstract":"<div><h3>Background</h3><div>Patent foramen ovale (PFO) is a defect in the intra-atrial septum that occurs when the foramen ovale does not close postnatally. Chronic obstructive pulmonary disease (COPD) is a respiratory condition that causes airflow obstruction.</div></div><div><h3>Objective</h3><div>This systematic review aimed to consolidate current evidence on the association between PFO and COPD outcomes.</div></div><div><h3>Methods</h3><div>We searched Medline, Embase, and Cochrane databases from inception to November 2023 for studies conducted among adults who have been diagnosed with COPD and underwent testing for PFO. A structured data extraction sheet was created to collect data from selected studies. A meta-analysis with a random effects model was considered when feasible.</div></div><div><h3>Results</h3><div>The initial search identified 765 records. After screening for eligibility, we included six cross-sectional and three case report studies. In cross-sectional studies, patients with COPD had almost three times higher odds of having PFO than controls (OR = 2.72, 95 % CI: 1.57 to 4.70, <em>I²</em> =0 %). When comparing COPD patients with and without PFO, the pooled mean difference was -2.99 mmHg; 95 % CI:5.55 to -0.44, <em>I²</em> =77 %) in oxygen saturation (SaO2), -6.85 mmHg (95 %CI:11.71 to -2.39, <em>I²</em> =35 %) in arterial oxygen partial pressure (PaO2) and 9.65 mmHg (95 %CI: 3.38 to 12.92, <em>I²</em> =0 %) in pulmonary arterial pressure.</div></div><div><h3>Conclusions</h3><div>Evidence, based on a few and small size studies, indicates that PFO presence may be associated with worse outcomes in COPD patients. The long-term impact of these findings on COPD outcomes and the need for identifying high-risk patients for PFO screening should be evaluated.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 33-41"},"PeriodicalIF":2.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise-induced oxyhemoglobin desaturation is an independent risk factor for sustained nocturnal hypoxemia in adults with precapillary pulmonary hypertension: A cross-sectional study","authors":"Marcia S. Murta ,&nbsp;Ricardo L.M. Duarte ,&nbsp;Daniel Waetge ,&nbsp;David Gozal ,&nbsp;Alexandre P. Cardoso ,&nbsp;Fernanda C.Q. Mello","doi":"10.1016/j.hrtlng.2025.04.021","DOIUrl":"10.1016/j.hrtlng.2025.04.021","url":null,"abstract":"<div><h3>Background</h3><div>Nocturnal hypoxemia (NH) negatively impacts the prognosis of several chronic cardiopulmonary diseases.</div></div><div><h3>Objectives</h3><div>To assess the risk factors associated with sustained NH in adults with precapillary pulmonary hypertension (pPH).</div></div><div><h3>Methods</h3><div>This cross-sectional study was performed between June 2021 and June 2024. Outpatients with a hemodynamic diagnosis of pPH (Groups 1 and 4) were consecutively recruited. Sustained NH was defined as ≥ 30 % of the percentage of time spent with oxygen saturation (SpO₂) &lt;90 % during a home sleep apnea test (HSAT). Clinical, laboratory, hemodynamic, echocardiographic, functional, and exercise-related variables were collected blindly regarding the HSAT data. We considered a difference in SpO₂ [resting – final] (Δ SpO₂) ≥ 3 % as indicative of exercise-induced oxyhemoglobin desaturation (EID) by the six-minute walk test. Multiple logistic regression analysis was used to identify possible predictive factors for the occurrence of NH.</div></div><div><h3>Results</h3><div>Fifty-two pPH adults were included (71.2 % were females). Thirty-one patients (59.6 %) were classified as having NH. In the univariate logistic regression analysis, four parameters were identified as risk factors for the presence of NH: mean pulmonary artery pressure (<em>p</em> = 0.023), right atrial mean pressure (<em>p</em> = 0.037), systolic pulmonary arterial pressure (<em>p</em> = 0.042) and EID (<em>p</em> = 0.003). However, only EID was an independent predictor for detecting NH with an adjusted odds ratio of 10.590 (95 % confidence interval: 1.095–102.420); <em>p</em> = 0.042.</div></div><div><h3>Conclusions</h3><div>EID is an easily implementable risk factor for prolonged NH, suggesting that adults with pPH who experience EID have a high probability of also experiencing NH.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 26-32"},"PeriodicalIF":2.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860088","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}