Heart & Lung最新文献

{"title":"Artificial intelligence in the management of patient-ventilator asynchronies: A scoping review","authors":"Javier Muñoz ,&nbsp;Rocío Ruíz-Cacho ,&nbsp;Nerio José Fernández-Araujo ,&nbsp;Alberto Candela ,&nbsp;Lourdes Carmen Visedo ,&nbsp;Javier Muñoz-Visedo","doi":"10.1016/j.hrtlng.2025.05.003","DOIUrl":"10.1016/j.hrtlng.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Patient-ventilator asynchronies (PVAs) are frequent complications in mechanically ventilated patients, contributing to adverse outcomes such as ventilator-induced lung injury, prolonged mechanical ventilation, and increased mortality. Artificial intelligence (AI) has emerged as a promising tool for enhancing PVA detection, prediction, and optimization. Despite its growing potential, the full scope of AI applications in this field and persistent gaps in evidence remain inadequately explored.</div></div><div><h3>Objective</h3><div>This scoping review examines the breadth of AI-based approaches for managing PVAs, identifying key methodologies, evaluating research trends, and highlighting limitations in the current literature.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in PubMed, Embase, Science Direct, IEEE Xplore, and the Cochrane Library without time restrictions. Extracted data included study objectives, AI methodologies, patient populations, performance metrics, and clinical outcomes. The findings were synthesized into thematic categories to map advancements and research gaps.</div></div><div><h3>Results</h3><div>Twenty-six studies were identified that applied AI techniques to detect, predict, or optimize PVAs. The included studies employed a range of AI methodologies, including convolutional neural networks, long short-term memory networks, and hybrid algorithms. These models demonstrated high predictive performance, with accuracy ranging from 87 % to 99 % and AUROC values exceeding 0.98 for detecting complex asynchronous events. AI systems also showed promise in predicting weaning success and optimizing ventilatory settings through real-time patient-specific adjustments. However, challenges such as reliance on single-center datasets, inconsistencies in calibration, and limited implementation of explainable AI frameworks restrict their clinical applicability.</div></div><div><h3>Conclusions</h3><div>AI holds transformative potential in managing PVAs by enabling real-time detection, improved weaning prediction, and personalized ventilatory strategies. However, significant challenges remain, particularly the need for multi-center validation, standardized reporting protocols, and randomized controlled trials to evaluate clinical efficacy. Addressing these gaps is essential for integrating AI into routine critical care practice and transitioning from theoretical models to practical, real-world applications in intensive care units.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 139-152"},"PeriodicalIF":2.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114945","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":"Interaction of smoking and domestic animal exposure associated with decreased lung function in adults of Southeastern China","authors":"Le-Yun Tan ,&nbsp;Li Yang ,&nbsp;Ming-Tao Yu ,&nbsp;Mei-Ling Jin ,&nbsp;Xiao-Ping Lin ,&nbsp;Yu-Hui Chen ,&nbsp;Li Dong ,&nbsp;Hui Cai ,&nbsp;Xiao-Yang Chen ,&nbsp;Shuai Huang ,&nbsp;Cheng-Shui Chen ,&nbsp;Fan Zhang ,&nbsp;Qing-Ying Zhang","doi":"10.1016/j.hrtlng.2025.05.007","DOIUrl":"10.1016/j.hrtlng.2025.05.007","url":null,"abstract":"<div><h3>Background</h3><div>Exposure to smoking and domestic animals often occur simultaneously. However, epidemiological evidence on the independent and combined effects of smoking and domestic animal exposure on adult lung function is limited.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to explore the interaction of smoking and domestic animal exposure on adult lung function.</div></div><div><h3>Methods</h3><div>A total of 6,277 adults were recruited from Southeastern China 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); and forced expiratory flow (FEF)25 %, FEF50 %, and FEF75 %. The interaction between smoking and domestic animal exposure was assessed by including a product term in the linear regressions, with the coefficient of the product term (β_interaction) used as a measure of interaction. Stratified analysis was conducted for smoking behavior and animal types.</div></div><div><h3>Results</h3><div>Among smokers, lung function declined more in those with domestic animal exposure than in those without: the β_interactions for FVC, FEV1, FEV1/FVC ratio, and PEF were -0.13 (95 % CI: -0.23, -0.03), -0.15 (-0.23, -0.08), -1.78 (-3.29, -0.27), and -0.43 (-0.67, -0.20), respectively, with them varied with smoking behavior and was greatest on FEV1/FVC ratio. Moreover, we found that only poultry exposure exhibited an interaction with smoking, the β_interactions for FVC; FEV1; FEV1/FVC ratio; PEF; FEF25 %, and FEF50 % were -0.22 (-0.35, -0.08); -0.24 (-0.34, -0.15); -2.93 (-4.86, -1.00); -0.64 (-0.94, -0.35); -0.51 (-0.86, -0.15), and -0.32 (-0.53, -0.11), respectively.</div></div><div><h3>Conclusions</h3><div>Poultry exposure exacerbated the adverse effects of smoking on lung function in adults. This study suggests that individuals engaged in poultry-related industries should quit smoking to reduce lung function decline.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 131-138"},"PeriodicalIF":2.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107679","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 Fresh Look and New Horizons: Key Developments in Heart & Lung for 2025","authors":"","doi":"10.1016/j.hrtlng.2025.05.001","DOIUrl":"10.1016/j.hrtlng.2025.05.001","url":null,"abstract":"","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"72 ","pages":"Page A1"},"PeriodicalIF":2.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113015","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":"Depression, mutuality, and self-care behaviors in patients with heart failure and their caregivers: An actor–partner interdependence model extended to mediation","authors":"Youn-Jung Son ,&nbsp;JiYeon Choi ,&nbsp;Da-Young Kim ,&nbsp;So Hyun Park","doi":"10.1016/j.hrtlng.2025.05.006","DOIUrl":"10.1016/j.hrtlng.2025.05.006","url":null,"abstract":"<div><h3>Background</h3><div>Mutuality may serve as a protective factor against depression for both patients with heart failure (HF) and their caregivers. Mutuality, a sense of positive interaction, is associated with better self-care for HF patients and for lower levels of depression. The mechanism linking mutuality to improved self-care and lowered depression is unclear.</div></div><div><h3>Objectives</h3><div>To examine whether mutuality, the quality of interactions between HF dyads, functions as a mediator in the association between depression and self-care behaviors.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among 202 HF dyads from two university-affiliated tertiary hospitals in Seoul, South Korea. Dyadic data were analyzed by the actor–partner interdependence model extended to mediation analysis. We tested whether depression influenced HF self-care behaviors and caregiver contributions through mutuality. Mutuality, measured via self-reported perceptions from both dyad members, was assessed as a potential mediator at both individual and dyadic levels.</div></div><div><h3>Results</h3><div>Patients’ depression had significant direct effects (actor effects) on their own self-care behaviors (β = -0.61, 95 % confidence interval (CI) = –1.22 to –0.12) and caregivers’ contribution to self-care behaviors (partner effects) (β = –0.92, 95 % CI = –1.65 to –0.19). Patients’ mutuality mediated the association between patients’ depression and self-care behaviors (β = –0.27, 95 % CI = –0.57 to –0.07). Caregivers’ mutuality mediated the relationship between caregivers’ depression and contribution to self-care behaviors (β = –0.26, 95 % CI = –0.61 to –0.01).</div></div><div><h3>Conclusion</h3><div>Mutuality may serve as a protective factor against depression in HF dyads. The relationship quality in HF dyads should be assessed, with psychosocial interventions implemented to enhance dyadic self-care behaviors.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 123-130"},"PeriodicalIF":2.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089530","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 and safety of Nintedanib in idiopathic pulmonary fibrosis: A systematic review and meta-analysis","authors":"Shamikha Cheema MBBS ,&nbsp;Muhammad Nabeel Saddique MBBS ,&nbsp;Anurag Jha MBBS ,&nbsp;Ayesha Sehar MBBS ,&nbsp;Umaima Cheema MBBS ,&nbsp;Fatima Shahid MBBS ,&nbsp;Muhammad Faique Hassan MBBS ,&nbsp;Hammad Javaid MBBS ,&nbsp;Valeria Chiara Lanari MBBS ,&nbsp;Ali Nawaz MBBS","doi":"10.1016/j.hrtlng.2025.05.008","DOIUrl":"10.1016/j.hrtlng.2025.05.008","url":null,"abstract":"<div><h3>Background</h3><div>Idiopathic pulmonary fibrosis (IPF) is a progressive, potentially fatal lung disorder characterized by scarring, leading to reduced lung function and respiratory failure. Nintedanib, a tyrosine kinase inhibitor, shows potential in slowing IPF progression, but uncertainties remain about its long-term efficacy and safety.</div></div><div><h3>Objective</h3><div>To evaluate the efficacy and safety of Nintedanib in idiopathic pulmonary fibrosis.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across PubMed, Cochrane, Scopus, Embase, and ClinicalTrials.gov from inception to August 2024, selecting studies based on predefined eligibility criteria. Dichotomous outcomes were pooled as risk ratios (RR) and continuous outcomes as mean differences (MD), both with 95% confidence intervals (CI), using random-effects models to account for potential heterogeneity. Heterogeneity was assessed using I² and X² statistics, with a p-value of &lt;0.05 considered statistically significant. All calculations were performed using RevMan 5.4.</div></div><div><h3>Results</h3><div>This meta-analysis included 4 randomized controlled trials with 1,665 patients, 79.7% of whom were male smokers. There was no significant difference in IPF progression (RR=0.61, 95% CI 0.34-1.08, I²=41%) or in nasopharyngitis (RR=0.82, 95% CI 0.62-1.08, I²=0%), cough (RR=0.98, 95% CI 0.71-1.33, I²=0%), bronchitis (RR=0.90, 95% CI 0.63-1.28, I²=0%), respiratory infections (RR=1.01, 95% CI 0.59-1.75, I²=0%), dyspnea (RR=0.68, 95% CI 0.46-1.00, I²=0%), or cardiac disorders (RR=0.89, 95% CI 0.50-1.58, I²=0%), indicating nintedanib does not notably alter these risks. However, nintedanib significantly increased gastrointestinal adverse events, potentially affecting adherence and quality of life.</div></div><div><h3>Conclusion</h3><div>Nintedanib shows promise in slowing disease progression but carries a higher risk of adverse events. Limited sample sizes and short follow-up necessitate larger studies to confirm its efficacy and safety.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 114-122"},"PeriodicalIF":2.4,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071188","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":"Intravascular lithotripsy and temporary mechanical circulatory support for the treatment of heavily calcified coronary artery disease: insights from the BENELUX-IVL registry","authors":"Federico Oliveri MD ,&nbsp;Isabel Merino MD ,&nbsp;Martjn J.H. van Oort ,&nbsp;Ibtihal Al Amri MD, PhD ,&nbsp;Brian O. Bingen MD, PhD ,&nbsp;Fatih Arslan MD, PhD ,&nbsp;Bimmer E. Claessen MD, PhD ,&nbsp;Aukelien C. Dimitriu-Leen MD, PhD ,&nbsp;Joelle Kefer MD, PhD ,&nbsp;Hany Girgis MD ,&nbsp;Tessel Vossenberg MD, PhD ,&nbsp;Frank van der Kley MD, PhD ,&nbsp;J. Wouter Jukema MD, PhD ,&nbsp;Josè Montero-Cabezas MD, PhD.","doi":"10.1016/j.hrtlng.2025.04.030","DOIUrl":"10.1016/j.hrtlng.2025.04.030","url":null,"abstract":"<div><h3>Background</h3><div>Intravascular lithotripsy (IVL) is increasingly utilized for the treatment of heavily calcified coronary lesions. However its use in conjunction with temporary mechanical circulatory support (tMCS) remains underexplored.</div></div><div><h3>Objective</h3><div>This study aims to evaluate the current use of tMCS and IVL for the treatment of heavily calcified coronary lesions.</div></div><div><h3>Method</h3><div>From the BENELUX-IVL prospective registry, patients who underwent IVL during PCI and required tMCS during the procedure were selected. The primary technical endpoint was procedural success &lt;30%, defined as a composite of device success (the ability to deliver the IVL catheter across the target lesion, and delivery of IVL pulses without angiographic complications) with residual stenosis &lt;30%, final Thrombolysis In Myocardial Infarction grade 3 flow, and no in-hospital major adverse cardiovascular events (MACE). The primary clinical outcome was in-hospital MACE, including cardiac death, non-fatal myocardial infarction, or target lesion revascularization.</div></div><div><h3>Results</h3><div>Between May 2019 and March 2024, a total of 454 patients were included, of whom 12 (2.6%) necessitated tMCS (for a total of 13 tMCS devices). Upon admission, the mean LV-EF was 39.5 ± 11.9%. The median Syntax score was 37 (25-49). A bail-out indication was the most common reason for tMCS initiation (58.3%), even if none was directly started due to IVL-related complications. Microaxial Flow Pump was the main utilized device (75%), followed by VA-ECMO (25%) and IABP (8.3%). One case required both VA-ECMO and Impella due to a coronary perforation complicated by cardiac tamponade. Procedural success &lt; 30% was achieved in 91.6% of the cases. MACE occurred in one patient (8.3%).</div></div><div><h3>Conclusion</h3><div>In a large cohort of patients with complex heavily calcified coronary lesions requiring IVL, the need for tMCS was low (2.6%), with the main indication being bail-out.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 108-113"},"PeriodicalIF":2.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934679","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":"Incidence, outcome and trends of in-hospital cardiac arrest over a ten-year period in a Swiss tertiary hospital","authors":"Luca Oechslin ,&nbsp;Jan Abplanalp ,&nbsp;Patric Biaggi ,&nbsp;Hasan Hadzalic ,&nbsp;Daniel Britschgi ,&nbsp;Christian Luz ,&nbsp;Alfons Url ,&nbsp;Reto Stocker ,&nbsp;Christophe Wyss","doi":"10.1016/j.hrtlng.2025.04.031","DOIUrl":"10.1016/j.hrtlng.2025.04.031","url":null,"abstract":"<div><h3>Background</h3><div>Although in-hospital cardiac arrest (IHCA) occurs frequently, it is less well described in the literature and data is rare compared to out-of-hospital cardiac arrest (OHCA), especially with regard to incidence and outcomes.</div></div><div><h3>Objective</h3><div>The aim of this retrospective study was to analyze the incidence, characteristics, outcomes and potential predictors of outcome of IHCA occurring from 2012 to 2022 at a tertiary hospital in Switzerland.</div></div><div><h3>Methods</h3><div>All in-hospital cardiac arrest missions over a ten-year period were retrospectively analyzed. Subsequently, statistical analysis was conducted to identify variables influencing the outcome (outcomes of interest were return of spontaneous circulation (ROSC) and survival after 6 and 12 months).</div></div><div><h3>Results</h3><div>Over a ten-year period, there were 364 resuscitations, resulting in an overall incidence of 1.87 resuscitation per 1000 hospitalizations. ROSC was achieved in 63.4 % and 37.4 % were alive at 12 months. In 71.2 % the initial rhythm was non-shockable. Observed cardiac arrest and continuous ECG monitoring were significant positive predictors for ROSC and improved survival. Older age was associated with worse survival throughout the study period. Over the ten-year study period both incidence and outcomes of IHCA were unchanged.</div></div><div><h3>Conclusion</h3><div>HCA was infrequent but associated with high mortality rates. Continuous ECG monitoring emerged as a robust predictor for achieving ROSC and for improved survival following IHCA.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"73 ","pages":"Pages 104-107"},"PeriodicalIF":2.4,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143931457","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":"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}