Heart & Lung最新文献

{"title":"Residing in areas with high residential greenspace is associated with increased COPD risk and decreased lung function of adults in eastern China","authors":"Le-Yun Tan ,&nbsp;Yao Wang ,&nbsp;Li Yang ,&nbsp;Cheng-Shui Chen ,&nbsp;Fan Zhang ,&nbsp;Ming-Tao Yu ,&nbsp;Pi Guo ,&nbsp;Qing-Ying Zhang","doi":"10.1016/j.hrtlng.2025.01.008","DOIUrl":"10.1016/j.hrtlng.2025.01.008","url":null,"abstract":"<div><h3>Background</h3><div>Evidence for a relation between residential greenspace and respiratory health is scarce and controversial.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to explore the association between residential greenspace and its interaction with particulate matter (PM_2.5) and risk of chronic obstructive pulmonary disease (COPD) and lung function.</div></div><div><h3>Methods</h3><div>A total of 3,759 adults were recruited from Wenzhou in this study. Lung function measurements included forced expiratory volume in 1 s (FEV1); forced vital capacity (FVC); FEV1/FVC ratio; peak expiratory flow (PEF); forced expiratory flow (FEF) at 25 %, 50 %, and 75 %; and maximal mid-expiratory flow (MMEF). The Normalized Difference Vegetation Index (NDVI) was used to characterize the greenspace.</div></div><div><h3>Results</h3><div>The mean (SD) age of study participants was 62.8(10.2) years, with 51.8 % female. NDVI was positively associated with risk of COPD (odds ratio [OR]: 1.26, 95 % CI: 1.04–1.54) and inversely with lung function: the βs (95 % CIs) for FEV1; FVC; FEV1/FVC ratio; PEF; FEF25 %, 50 %, and 75 %; and MMEF were -0.09 (-0.12, -0.06); -0.07 (-0.10, -0.04); -1.39 (-2.06, -0.72); -0.66 ( -0.74, -0.57); -0.52 (-0.61, -0.43), -0.22 (-0.28, -0.15), and -0.05 (-0.09, -0.01); and -0.17 (-0.22, -0.12), respectively. In high PM_2.5 areas, NDVI was positively associated with COPD risk (OR: 5.40, 95 % CI: 3.45–8.58) and inversely with FEV1/FVC ratio (β:8.29, 95 % CI:9.82, -6.76) and FVC (β:0.13, 95 %CI:0.21, 0.06), and in low PM_2.5 areas, was positively associated with risk of COPD (OR: 1.75, 95 % CI: 1.12–2.80) and inversely with FEV1/FVC ratio (β:3.45, 95 % CI:4.80, 2.11).</div></div><div><h3>Conclusions</h3><div>High residential greenspace may be associated with increased risk of COPD and decreased lung function in adults, particularly in areas with high PM_2.5.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 329-338"},"PeriodicalIF":2.4,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048901","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 rapid shallow breathing index (RSBI) as a predictor for extubation success in medical and surgical ICU patients: A retrospective cohort study","authors":"Shaykhah M. Albashir ,&nbsp;Rebecca C. Robert ,&nbsp;Nalini N. Jairath ,&nbsp;Christopher B. Raub ,&nbsp;Omar A. Alzumai ,&nbsp;Samah Saad Salem","doi":"10.1016/j.hrtlng.2025.01.007","DOIUrl":"10.1016/j.hrtlng.2025.01.007","url":null,"abstract":"<div><h3>Background</h3><div>Endotracheal intubation and mechanical ventilation comprise common life support interventions for patients in intensive care units (ICUs). Premature or delayed extubation increases the risk of morbidity and mortality. Despite following weaning protocols, 10–20 % of patients fail extubation within 48 h. To improve extubation success, predictors such as the rapid shallow breathing index (RSBI–the ratio of respiratory rate to tidal volume) are needed. The current RSBI value (&lt;105 breaths/min/L) comes from clinically outdated methods and small samples.</div></div><div><h3>Objective</h3><div>To identify the highest-performing RSBI threshold value associated with extubation success using current weaning protocols in a large sample of medical and surgical ICU patients.</div></div><div><h3>Methods</h3><div>Using secondary data from hospital records, receiver operating characteristic (ROC) analysis of the RSBI, measured immediately after a spontaneous breathing trial, was conducted for 1313 mechanically ventilated (≥ 48 h and ≤ 21 days) patients at one hospital in Saudi Arabia.</div></div><div><h3>Results</h3><div>The sample of 61.5 % medical and 38.5 % surgical patients included 65 % males with a mean age of 53 years and an extubation failure rate of 12 %. Ideal RSBI threshold values differed by medical and surgical samples. For each sample, the area under the ROC curve approximated 0.5 for the RSBI, and multivariable logistic regression identified a unique set of physiologic parameters to predict successful extubation.</div></div><div><h3>Conclusion</h3><div>The RSBI alone demonstrated low diagnostic performance for predicting successful extubation using current weaning protocols. However, results suggest needed updates for RSBI threshold values in current weaning protocols to optimize RSBI use with other predictors for extubation success.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 321-328"},"PeriodicalIF":2.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030421","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":"Reducing heart failure events via individualized patient education program in patients with reduced ejection fraction","authors":"Anu Philip Pharm.D ,&nbsp;Chakrakodi Shasidhara Shastry M.Pharm, PhD ,&nbsp;Basavaraj Utagi MD, DM ,&nbsp;Anjusha Alex M.Sc","doi":"10.1016/j.hrtlng.2025.01.001","DOIUrl":"10.1016/j.hrtlng.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Disease management programs for heart failure (HF) often include various strategies such as medication management and lifestyle modifications, and are known to improve clinical outcomes.</div></div><div><h3>Objectives</h3><div>To evaluate the effectiveness of an individualized patient education program (IPEP) specifically designed for patients with reduced ejection fraction (HFrEF) on clinical outcomes.</div></div><div><h3>Methods</h3><div>In our prospective interventional study involving 164 patients, participants were divided into control (CG) and intervention (IG) groups. The IG received the IPEP facilitated by the academic pharmacist, while both the IG and the CG continued to receive standard care from the healthcare team without any differences in the care provided. Self-care practices, medication adherence, quality of life, and clinical outcomes were assessed at both the 6th and 12th months. Statistical analysis included Chi-square tests, Kaplan-Meier survival plots, and Multivariable Cox proportional regression analysis. Data analysis was conducted using JAMOVI and R software.</div></div><div><h3>Results</h3><div>The demographic and clinical characteristics of sample population were largely homogeneous in both the groups. The unadjusted 1-year rehospitalization (RH) rate was significantly lower in the IG at 33 % compared to 48 % in the CG, with a hazard ratio of 0.55 (95 % CI: 0.34–0.90, <em>p</em> = 0.018). Kaplan-Meier survival analysis depicts a higher RH rate for HFrEF participants over time, with a significant difference observed between CG and IG (log-rank <em>P</em> = 0.017). Notable disparities in self-care practices emerged &amp; at the 6th and 12th-month assessments medication adherence &amp; QoL were significantly improved in the IG (<em>p</em> ≤ 0.001).</div></div><div><h3>Conclusion</h3><div>IPEP led by an academic pharmacist resulted in improved self-care practices, enhanced quality of life, and reduced one-year rehospitalization rates.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 313-320"},"PeriodicalIF":2.4,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016791","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 a nurse training intervention in the emergency department to improve the diagnosis and treatment of stemi patients: EDUCAMI study","authors":"Gemma Berga Congost MsC, RN ,&nbsp;Salvatore Brugaletta PhD, MD ,&nbsp;Paloma Garcimartin Cerezo PhD, MsC, RN ,&nbsp;Jonatan Valverde Bernal MsC, RN ,&nbsp;Mariona Berrocal Comalat RN ,&nbsp;Sonia Mena Mejías RN ,&nbsp;Lorena Muñoz Millán RN ,&nbsp;Selma Rodriguez Evangelista RN ,&nbsp;Judit Ruiz Gabalda RN ,&nbsp;Jordi Torralbas Ortega PhD, RN, MsC ,&nbsp;Joan Garcia-Picart MD ,&nbsp;Marcelo Jimenez-Kockar MD ,&nbsp;Dabit Arzamendi Aizpurua PhD, MD ,&nbsp;Mireia Puig Campmany PhD, MD ,&nbsp;María Antonia Martinez Momblan PhD, MsC, RN","doi":"10.1016/j.hrtlng.2025.01.006","DOIUrl":"10.1016/j.hrtlng.2025.01.006","url":null,"abstract":"<div><h3>Background</h3><div>Clinical practice guidelines for acute coronary syndrome recommend an interval between electrocardiogram (ECG) and balloon of &lt;60 min in patients attending the emergency department (ED) of a hospital with primary angioplasty capacity. Compliance with this can be complex, especially in atypical presentations.</div></div><div><h3>Objective</h3><div>To assess the effectiveness of specific training for ED triage nurses in reducing ECG-balloon time in STEMI.</div></div><div><h3>Methods</h3><div>Quasi-experimental study with a pre-test-post-test design. In June 2021, a training intervention was implemented in the diagnosis of STEMI in the ED. The EDUCAMI program included complex presentations, emphasising disparities in women and elderly people. A historical sample was compared with a post-intervention sample.</div><div>All patients consecutively activated as code STEMI in the ED were included, excluding those activated out-of-hospital. The main variable was ECG-balloon time, which was compared according to sex and age.</div></div><div><h3>Results</h3><div>The final sample consisted of 447 patients distributed into historical sample (<em>n</em> = 327) and post-test groups (<em>n</em> = 120). A reduction from 88 (65–133) to 60 (50–116) minutes in ECG-balloon time was observed in the post-test group together with a shorter hospital stay of 5 (3-8) vs 4 (3–5.5) days (<em>p</em> <em>=</em> 0.013).</div><div>When comparing according to sex and age, a decrease in ECG-balloon time (<em>p</em> &lt; 0.001) was observed in men and patients under 65 years of age (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The training intervention proved effective, reducing the ECG-balloon time by 32 %. EDUCAMI reduces the time in men and young people, however, the bias persists in women and those over 65 years of age.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 305-312"},"PeriodicalIF":2.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016780","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":"ICU-Acquired Superinfections Before And During The COVID-19 Pandemic: Similarities And Differences","authors":"Sasha-Jane Abi-Aad MD ,&nbsp;Hind Eid MD ,&nbsp;Carine Harmouche MD ,&nbsp;Tara Daoud MD ,&nbsp;Maissa Safieddine PHD ,&nbsp;Georges Dabar MD","doi":"10.1016/j.hrtlng.2025.01.002","DOIUrl":"10.1016/j.hrtlng.2025.01.002","url":null,"abstract":"<div><h3>Background</h3><div>During the COVID-19 pandemic, intensive care units (ICUs) experienced a surge in patients with viral pneumonia, often leading to acute respiratory failure. A global rise in ICU superinfections was observed; however, it remains unclear whether the extensive use of broad-spectrum antibiotics, corticosteroids, and immunosuppressants contributed to this rise.</div></div><div><h3>Objectives</h3><div>We aim to identify clinical factors associated with these superinfections while analyzing epidemiologic patterns of superinfections in two different periods.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study comparing ICU patients admitted between January 2016 and December 2018 (control group) with those admitted due to hypoxemic respiratory failure from SARS-CoV-2 between September 2020 and February 2022. Clinical characteristics were analyzed after propensity score matching, and a subsequent multivariate analysis was conducted on the COVID-19 population to identify independent risk factors for superinfections.</div></div><div><h3>Results</h3><div>1456 patients were identified in the pre-COVID group and 164 in the COVID-19 group. The mean age was similar (64 years), but the pre-COVID-19 group was sicker. After matching, 427 pre-COVID-19 and 163 COVID-19 patients were analyzed. COVID-19 patients experienced higher superinfection rates (42 % vs. 12 %, <em>p</em> &lt; 0.001), were more obese, and had greater exposure to antibiotics and corticosteroids. After multivariate analysis of the COVID-19 population, ICU length of stay (OR=1.09, <em>p</em> = 0.01) and mechanical ventilation (OR=5.05, <em>p</em> = 0.008) were independent risk factors for superinfections.</div></div><div><h3>Conclusion</h3><div>Increased superinfection rates in COVID-19 patients were linked to mechanical ventilation and prolonged ICU stays, potentially influenced by MDR infections linked to antibiotics and corticosteroids. Further investigations are needed to establish causality.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 298-304"},"PeriodicalIF":2.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016787","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":"Comparing the Effectiveness of Single Exercises on Improving Exercise Capacity in Chronic Obstructive Pulmonary Disease Patients: Network Meta-Analysis of Randomized Controlled Trials","authors":"Xiuhai Shang ,&nbsp;Xiangning Yan ,&nbsp;Yuanyuan Ma","doi":"10.1016/j.hrtlng.2025.01.003","DOIUrl":"10.1016/j.hrtlng.2025.01.003","url":null,"abstract":"<div><h3>Background</h3><div>Chronic Obstructive Pulmonary Disease (COPD) is a common respiratory disease that significantly impairs the quality of life of patients. Single exercises can help COPD patients focus on enhancing specific physical abilities, and enable a more precise analysis of the specific effects of single exercises on improving exercise capacity in COPD patients.</div></div><div><h3>Objectives</h3><div>To evaluate the effectiveness of single exercises in improving the exercise capacity of COPD patients and to conduct an indirect comparison to identify the most efficacious intervention.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive search for randomized controlled trials in the following databases: PubMed, Web of Science, Scopus, Cochrane Library, Embase, and Chinese National Knowledge Infrastructure, from their inception to July 1, 2024. A network meta-analysis was used. We calculated mean differences and their corresponding 95% confidence intervals to quantify the effect sizes and assess the precision of the estimates.</div></div><div><h3>Results</h3><div>65 studies that met the inclusion criteria, encompassing a total sample size of 5,034 participants. The meta-analysis demonstrated that single exercises significantly enhanced the exercise capacity in COPD patients. Upon direct comparison, several exercises showed significant improvements in exercise capacity compare to conventional therapy. Core muscle Elastic band exercise appeared to provide the most substantial benefit in enhancing exercise capacity in COPD patients.</div></div><div><h3>Conclusion</h3><div>Healthcare providers are encouraged to consider incorporating Core muscle Elastic band exercise into their intervention plans, given its demonstrated efficacy. However, the presence of substantial heterogeneity among the included studies highlights the need for caution in interpreting these results.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 278-292"},"PeriodicalIF":2.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973335","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":"Factors related to the decision to perform synchronized cardioversion for supraventricular tachyarrhythmias by prehospital emergency medical services workers","authors":"Cengiz Durmuş ,&nbsp;Ali Ekşi ,&nbsp;Yusuf Yürümez","doi":"10.1016/j.hrtlng.2024.12.013","DOIUrl":"10.1016/j.hrtlng.2024.12.013","url":null,"abstract":"<div><h3>Background</h3><div>While clinical indicators for synchronized cardioversion in regular supraventricular tachycardias are well-established, their application by prehospital emergency medical services (EMS) still needs to be explored.</div></div><div><h3>Objective</h3><div>The purpose of this study was to evaluate the factors influencing the decision-making process of prehospital EMS personnel to perform synchronized cardioversion in adults with narrow QRS regular tachyarrhythmias.</div></div><div><h3>Methods</h3><div>This descriptive study included 598 paramedics actively engaged in prehospital EMS. Data were collected using a form that included questions about their experiences with synchronized cardioversion and presented three cases involving narrow QRS regular tachyarrhythmias. Since the data did not exhibit a normal distribution, the Mann-Whitney U test was employed to evaluate the significance of differences between the variables \"number of previous SC applications\" and \"not performing SC despite recognizing unstable findings\".</div></div><div><h3>Results</h3><div>The participants comprised 320 males (53.5 %) and 278 females (46.5 %). A majority (93.8 %, <em>n</em> = 561) had attended postgraduate training on synchronized cardioversion (SC) for adult patients, and 220 participants (36.8 %) reported prior experience performing synchronized cardioversion, with an average of three applications each. Despite recognizing sufficient clinical findings of unstable status for synchronized cardioversion in narrow QRS regular tachyarrhythmias, 177 participants (29.6 %) reported instances where they chose not to perform the procedure. Immediate synchronized cardioversion was preferred by 319 participants (53.3 %) in cases of altered mental status; however, this rate decreased to 16.9 % (<em>n</em> = 101) for ischemic chest discomfort and 30.4 % (<em>n</em> = 182) for acute heart failure cases.</div></div><div><h3>Conclusions</h3><div>Previous experience with synchronized cardioversion and the proximity to the receiving hospital are key factors in the decision-making process. Additionally, the type of unstable finding is critical in making the decision for synchronized cardioversion.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 293-297"},"PeriodicalIF":2.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973336","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":"L-shaped association between leisure-time physical activity and depressive symptoms in individuals with chronic inflammatory airway disease: Data from the NHANES (2007–2018)","authors":"Na Xiang ,&nbsp;Jingshan Bai ,&nbsp;Wenqiang Li ,&nbsp;Yanlei Ge ,&nbsp;Zhiping Deng","doi":"10.1016/j.hrtlng.2025.01.004","DOIUrl":"10.1016/j.hrtlng.2025.01.004","url":null,"abstract":"<div><h3>Background</h3><div>Chronic inflammatory airway diseases (CIAD) are well-known risk factors for depression symptoms. There exists a complex interplay between leisure-time physical activity (LTPA) and depressive symptoms. However, the relationship between LTPA duration and depressive symptoms in CIAD patients remains unclear.</div></div><div><h3>Objectives</h3><div>This study investigated NHANES data from 2007 to 2018 to investigate the relationship between LTPA and depressive symptoms in CIAD patients.</div></div><div><h3>Methods</h3><div>We collected data from National Health and Nutrition Examination Survey (NHANES) 2007–2018. Weighted logistic regression was employed to analyze the correlation between CIAD and depressive symptoms. Next, CIAD patients with LTPA information, the similar method was also employed to examine the association between LTPA and depressive symptoms. Finally, the dose-response relationship between LTPA duration and depressive symptoms was explored using restricted cubic spline (RCS) plot.</div></div><div><h3>Results</h3><div>Consistent with previous research findings, patients with CIAD are more prone to experiencing symptoms of depression (<em>P</em> &lt; 0.0001). Compared to CIAD patients without LTPA, patients who engage in LTPA have a lower probability of experiencing depressive symptoms (<em>P</em> &lt; 0.0001). Interestingly, we had discovered that there is an l-shaped relationship between the duration of LTPA and the prevalence of depressive symptoms (non-linear <em>P</em> = 0.001). There is a threshold effect between the duration of LTPA and depressive symptoms. Within12 h/week, the risk of depressive symptoms in CIAD patients decreases with increased duration of LTPA. However, beyond 12 h/week, this association no longer exists.</div></div><div><h3>Conclusion</h3><div>Our research indicates that CIAD patients can increase the prevalence of depressive symptoms. And LTPA over a period of time is negatively correlated with depressive symptoms, but only up to a total duration of 12 h/week.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 263-270"},"PeriodicalIF":2.4,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973337","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":"Rising cardiovascular mortality among obstructive sleep apnea patients: United States epidemiological trends (1999–2019)","authors":"Dua Ali ,&nbsp;Shaheer Qureshi ,&nbsp;Hibah Siddiqui ,&nbsp;Muhammad Salik Uddin ,&nbsp;Saad Ahmed Waqas ,&nbsp;Muhammad Khalid Afridi ,&nbsp;Muhammad Umer Sohail ,&nbsp;Sarah MacKenzie Picker ,&nbsp;Farhan Shahid ,&nbsp;Raheel Ahmed","doi":"10.1016/j.hrtlng.2025.01.005","DOIUrl":"10.1016/j.hrtlng.2025.01.005","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive sleep apnea (OSA) prevalence has risen significantly, affecting millions globally and posing a major healthcare burden. OSA is strongly associated with cardiovascular diseases (CVD) such as heart failure, stroke, and ischemic heart disease. However, trends in CVD-related mortality among individuals with OSA remain underexplored.</div></div><div><h3>Objective</h3><div>This study aims to assess the trends of OSA and CVD related mortality rates and variations in mortality based on demographics and regions in the US.</div></div><div><h3>Methods</h3><div>Mortality data for adults aged ≥25 with OSA and CVD were extracted from the CDC WONDER database. Age-adjusted mortality rates (AAMRs) per 100,000 and annual percent change (APC) with 95 % confidence intervals (CIs) were calculated, stratified by year, sex, race/ethnicity, age, urbanization, and Census regions.</div></div><div><h3>Results</h3><div>Between 1999 and 2019, 168,111 OSA-related CVD deaths were recorded. Overall AAMRs rose significantly, particularly for hypertensive disease (1999–2006 APC: 13.2 %, 95 % CI: 11.6–15.7). Men consistently had higher AAMRs than women, and Black individuals showed the highest racial disparities. AAMRs varied geographically, with the Midwest recording the highest rates and rural areas showing notable increases. States like Oregon and Montana had rates three times higher than New York and Massachusetts.</div></div><div><h3>Conclusions</h3><div>OSA-related CVD mortality has risen substantially, with marked disparities by sex, race, and region. These findings emphasize the need for targeted public health interventions to reduce mortality in high-risk groups.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 271-277"},"PeriodicalIF":2.4,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973338","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":"Assessment of COVID-19 incidence after performing pulmonary function tests during the pandemic: Findings from a real-life cohort","authors":"Artur Z Santos ,&nbsp;Pierangelo T Baglio MD ,&nbsp;Gabriel da S Viana MD ,&nbsp;Guilherme M Hetzel MD ,&nbsp;Carla T de Souza PT ,&nbsp;Marcelo B Gazzana MD PhD ,&nbsp;Cristiano F Andrade MD PhD ,&nbsp;Danilo C Berton MD PhD","doi":"10.1016/j.hrtlng.2024.12.012","DOIUrl":"10.1016/j.hrtlng.2024.12.012","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary function testing (PFT) is paramount in assessing patients with respiratory symptoms and chronic cardiopulmonary diseases. Although seminal studies have demonstrated that PFT generates aerosols, this simple observation does not confirm the potential for enhanced pathogen transmission.</div></div><div><h3>Objective</h3><div>We aimed to describe the frequency of patients who developed suspected symptoms of COVID-19, prompting SARS-CoV-2 testing after undergoing PFT during the reopening of a laboratory amid the deceleration of the pandemic.</div></div><div><h3>Methods</h3><div>We analyzed a retrospective cohort of individuals referred for PFT between May and August 2021. Two weeks post-PFT, phone calls were made asking about suspected symptoms of COVID-19, leading to SARS-CoV-2 testing. The medical data of the participants who did not answer the phone calls were reviewed through institutional electronic records. The minimum sample size of 338 individuals was calculated to detect an incidence of COVID-19 at least ten times higher than the surrounding local rate (0.08 %).</div></div><div><h3>Results</h3><div>Three hundred and sixty patients (40.6 % men; 56.5 ± 17.6 years) were included. PFT was primarily indicated for functional and prognostic assessments of chronic respiratory diseases. Three hundred and sixteen patients answered the follow-up phone calls. Following PFT, most patients (357/360) did not report suspected symptoms leading to COVID-19 confirmation testing. Three patients underwent RT-PCR testing, which yielded negative results.</div></div><div><h3>Conclusion</h3><div>Patients in this real-life cohort, after performing PFT, did not experience an outbreak (with a rate of at least ten times the surrounding local rate) or a cluster (with two or more cases) of symptomatic COVID-19.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 258-262"},"PeriodicalIF":2.4,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959265","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}