Heart & Lung最新文献

{"title":"The association between food environments and cardiovascular disease outcomes: A systematic review","authors":"Yu Jia Liu ,&nbsp;Xiao Qin Wang ,&nbsp;Guiqin Zhang ,&nbsp;Qiansheng Zhao ,&nbsp;Yu Xin Cheng ,&nbsp;Shuo Liu ,&nbsp;Bing Xiang Yang ,&nbsp;Dan Luo ,&nbsp;Qian Liu ,&nbsp;Huijing Zou","doi":"10.1016/j.hrtlng.2024.08.019","DOIUrl":"10.1016/j.hrtlng.2024.08.019","url":null,"abstract":"<div><h3>Background</h3><p>Cardiovascular disease (CVD) is the leading cause of death worldwide, particularly affecting low- and middle-income countries. Food environments may be linked with the risk of CVD; however, current study findings regarding their relationship are inconsistent. A systematic review of their associations is needed to guide interventions to improve cardiovascular health.</p></div><div><h3>Objective</h3><p>This systematic review aimed to comprehensively assess the relationship between food environments and CVD outcomes, including incidence, hospitalization, mortality, and recurrence rates.</p></div><div><h3>Method</h3><p>According to PRISMA guidelines, a systematic search was conducted until 28th March 2024, using eight databases, including PubMed, Embase, Ovid, CINAHL, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data. The review quality was assessed according to the Agency for Healthcare Research and Quality (AHRQ) and Newcastle-Ottawa Scale (NOS). The included studies were categorized based on their exposure factors into unhealthy, healthy, and comprehensive food environments, encompassing facilities that offer healthy and unhealthy foods. The findings were narratively synthesized according to this classification.</p></div><div><h3>Result</h3><p>A total of 23 studies, encompassing 13 cross-sectional studies and 10 cohort-longitudinal studies, were included in this review. Among the 20 studies on unhealthy food environments, 13 found a positive association with CVD outcomes. Of the seven studies on healthy food environments, 3 found a negative association with CVD outcomes. Additionally, 4 out of 8 studies on comprehensive food environments found a significant but inconsistent association with CVD outcomes.</p></div><div><h3>Conclusion</h3><p>This study suggested that unhealthy food environments are probably associated with CVD outcomes. At the same time, there is currently no conclusive evidence to indicate a relationship between healthy food environments or comprehensive food environments and CVD outcomes.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 359-366"},"PeriodicalIF":2.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162303","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 differences in the outcome of critically Ill patients with COVID-19 - An international multicenter critical care consortium study","authors":"Lavienraj Premraj BMsc ,&nbsp;Natasha Anne Weaver PhD ,&nbsp;Syed Ameen Ahmad BSc ,&nbsp;Nicole White PhD ,&nbsp;Glenn Whitman MD ,&nbsp;Rakesh Arora MD ,&nbsp;Denise Battaglini MD ,&nbsp;Jonathon Fanning PhD ,&nbsp;Heidi Dalton MD ,&nbsp;Jacky Suen BSc, PhD ,&nbsp;Gianluigi Li Bassi MD ,&nbsp;John F. Fraser MBChB ,&nbsp;Chiara Robba PhD ,&nbsp;Matthew Griffee MD ,&nbsp;Sung-Min Cho MHS, DO ,&nbsp;COVID-19 CCC investigators","doi":"10.1016/j.hrtlng.2024.09.001","DOIUrl":"10.1016/j.hrtlng.2024.09.001","url":null,"abstract":"<div><h3>Background</h3><p>Sex differences in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) susceptibility, illness severity, and hospital course are widely acknowledged. The effects of sex on outcomes experienced by patients with severe Coronavirus Disease 2019 (COVID-19) admitted to the intensive care unit (ICU) remains unknown.</p></div><div><h3>Objectives</h3><p>To determine the effects of sex on ICU mortality in patients with COVID-19</p></div><div><h3>Methods</h3><p>This retrospective analysis of an international multi-center prospective observational database included adults admitted to ICU for treatment of acute COVID-19 between 1st January 2020 and 30th June 2022. The primary outcome was ICU mortality. Multivariable Cox regression was used to ascertain the hazard of death (Hazard Ratio=HR) adjusted for pre-selected covariates. The secondary outcome was sex differences in complications of COVID-19 during hospital stay.</p></div><div><h3>Results</h3><p>Overall, 10,259 patients (3,314 females, 6,945 males) were included with a median age of 60 (interquartile range [IQR]=49–68) and 59 (IQR=49–67) years, respectively. Baseline characteristics were similar between sexes. More females were non-smokers (65% vs. 44 %, <em>p</em> &lt; 0.01) and obese (39% vs. 30 %, <em>p</em> &lt; 0.01), compared to males. Also, males received greater ICU intervention (mechanical ventilation, prone ventilation, vasopressors, and tracheostomy) than females. Males had a greater hazard of death (compared to females, HR=1.14; 95 % CI=1.02–1.26). Adjustment for complications during hospital stay did not alter the hazard of death (HR=1.16; 95 % CI=1.05–1.28). Males had a significantly elevated hazard of death among patients who received ECMO (HR=1.24; 95 % CI=1.01–1.53). Male sex was associated with cardiac arrest (adjusted OR [aOR]=1.37; 95 % CI=1.16–1.62) and PE (aOR=1.28; 95 % CI=1.06–1.55).</p></div><div><h3>Conclusion</h3><p>Among patients admitted to ICU for severe COVID-19, males experienced higher severity of illness and more frequent intervention than females. Ultimately, the hazard of death was moderately elevated in males compared to females despite greater PE and cardiac arrest.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 373-380"},"PeriodicalIF":2.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324001602/pdfft?md5=2bb3d4feb84a5337323b3a081a70f8ef&pid=1-s2.0-S0147956324001602-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162307","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":"Cardiometabolic Index and chronic obstructive pulmonary disease: A population-based cross-sectional study","authors":"Lina Wang ,&nbsp;Xiaojun Liu ,&nbsp;Zhongyan Du ,&nbsp;Jiaqi Tian ,&nbsp;Ling Zhang ,&nbsp;Lijuan Yang","doi":"10.1016/j.hrtlng.2024.09.002","DOIUrl":"10.1016/j.hrtlng.2024.09.002","url":null,"abstract":"<div><h3>Background</h3><p>Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide and constitutes a global health problem. The cardiometabolic index (CMI) is a new metric that combines abdominal obesity and lipid levels. Studies have shown that the prevalence of lipid metabolism disorders is greater among COPD patients and that the CMI can help reveal the potential role of lipid metabolism in disease progression by assessing the body's metabolic status; however, the association between the CMI and COPD is not known.</p></div><div><h3>Objective</h3><p>To explore the association between the CMI and the prevalence of COPD.</p></div><div><h3>Methods</h3><p>A cross-sectional study was conducted with 14,340 participants aged ≥ 20 years from the 2007–2018 NHANES databases. To assess the relationship between the CMI and the odds of COPD prevalence, we performed multivariate logistic regression analyses, subgroup analysis interaction tests, smoothed curve fitting, and threshold effect analyses.</p></div><div><h3>Results</h3><p>The study included a total of 14,340 participants, 48.49 % male and 51.51 % female, and the average age was 49.75 ± 17.49 years. According to the regression model adjusted for all confounding variables, participants in the highest quartile of the CMI had 22 % greater odds of having COPD than did those in the lowest quartile (OR = 1.22, 95 % CI: 1.03, 1.21, <em>p</em> = 0.010). A nonlinear association was found between the CMI and COPD, with an inflection point of 0.26. The OR (95 % CI) before the inflection point was 1.27 (1.12, 1.44), <em>p</em> = 0.0002. The interaction was statistically significant only in the sex analysis.</p></div><div><h3>Conclusions</h3><p>The level of the CMI and the odds of COPD prevalence were positively correlated in our study. These findings suggest that managing abdominal obesity and lipid levels may help prevent or mitigate COPD, emphasizing the potential value of the CMI as an indicator for early intervention and precision therapy.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 342-349"},"PeriodicalIF":2.4,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142149835","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 American Association of Heart Failure Nurses","authors":"Maureen Flattery RN, MS, ANP","doi":"10.1016/j.hrtlng.2024.08.017","DOIUrl":"10.1016/j.hrtlng.2024.08.017","url":null,"abstract":"","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Page A1"},"PeriodicalIF":2.4,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146914","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":"Serum uric acid and pulmonary arterial hypertension: A two-sample Mendelian randomization study","authors":"Yingjie Tan Master Degree,&nbsp;Yusi Chen Doctor of Philosophy Degree,&nbsp;Tianyu Wang Master Degree,&nbsp;Jiang Li Doctor of Philosophy Degree","doi":"10.1016/j.hrtlng.2024.08.018","DOIUrl":"10.1016/j.hrtlng.2024.08.018","url":null,"abstract":"<div><h3>Background</h3><p>Observational studies have suggested a correlation between hyperuricemia and pulmonary arterial hypertension (PAH), yet the causal relationship remains uncertain. We aimed to establish this link using Mendelian Randomization (MR) methods.</p></div><div><h3>Objectives</h3><p>Based on publicly accessible data, our study employs MR to determine the causal relationship between uric acid (UA) and PAH.</p></div><div><h3>Method</h3><p>MR analysis was conducted among individuals of European descent. Genetic instruments linked to UA (p-value &lt; 5 × 10^–8) were extracted from the Chronic Kidney Disease Genetic Consortium and genome-wide association study databases. PAH risk genetic associations were sourced separately. We employed four MR methods (MR-Egger, weighted median, inverse variance weighted, and weighted mode) with selected instrumental variables to assess the causal association between UA and PAH. MR-PRESSO was used to evaluate pleiotropy and outlier Single Nucleotide Polymorphisms (SNPs), while Cochran's Q test and funnel plot assessed SNP heterogeneity. Leave-one-out analysis examined SNP impacts on causal assessment.</p></div><div><h3>Result</h3><p>Two-sample MR analysis revealed a positive, causal relationship between UA levels and PAH.</p></div><div><h3>Conclusion</h3><p>Our MR analysis provides robust evidence of a causal link between serum UA and PAH, suggesting UA's potential as a biomarker and therapeutic target for PAH.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 337-341"},"PeriodicalIF":2.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324001560/pdfft?md5=b2c51408b92f30e04ecf31d3e98ce172&pid=1-s2.0-S0147956324001560-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142136551","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":"Sleep and blood pressure variability: A systematic literature review","authors":"Yeonsu Kim Ph.D, BSN, RN ,&nbsp;Meghan Kathleen Mattos Ph.D, RN, CNL ,&nbsp;Jill Howie Esquivel Ph.D, RN, NP ,&nbsp;Eric M. Davis MD ,&nbsp;Jeongok Logan Ph.D, MSN, RN","doi":"10.1016/j.hrtlng.2024.08.016","DOIUrl":"10.1016/j.hrtlng.2024.08.016","url":null,"abstract":"<div><h3>Background</h3><p>Blood pressure variability (BPV) is a prognostic marker of cardiovascular disease (CVD). Sleep is recognized as a significant risk factor for CVD; however, little is known about the relationship between sleep characteristics and BPV.</p></div><div><h3>Objective</h3><p>In this systematic review, we aimed to (1) describe methods used to measure BPV and sleep and (2) describe the current evidence in the literature on the association between sleep and BPV.</p></div><div><h3>Methods</h3><p>A systematic search was conducted using the search terms “sleep” <em>AND</em> (“blood pressure variability” <em>OR</em> “ambulatory blood pressure monitor”) in CINAHL, PubMed, Web of Science, and PsycINFO databases.</p></div><div><h3>Results</h3><p>Twenty-two studies were included in this systematic review. Sleep was measured using various methods, including polysomnography, actigraphy, sleep diaries, and questionnaires, while BPV was measured over various time intervals using different monitoring devices such as a beat-to-beat blood pressure (BP) monitoring device, a 24-h ambulatory BP monitor, or an automatic upper arm BP monitor. The studies demonstrated mixed results on the associations between sleep parameters (sleep quality, architecture, and duration) and increased BPV.</p></div><div><h3>Conclusions</h3><p>Although the mechanisms that explain the relationship between sleep and BPV are still unclear, accumulating evidence suggests potential associations between increased BPV with poor sleep quality and longer sleep duration. Given the recent development of sleep and BP monitoring technologies, further research is warranted to assess sleep and BPV under free-living conditions. Such studies will advance our understanding of complex interactions between sleep and CVD risk.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 323-336"},"PeriodicalIF":2.4,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095387","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":"Safety and effectiveness of interference RNA (RNAi) based therapeutics in cardiac failure: A systematic review","authors":"Muhammad Nabeel Saddique MBBS ,&nbsp;Maria Qadri MBBS ,&nbsp;Noor ul Ain MBBS ,&nbsp;Eesha Farhan MBBS ,&nbsp;Fatima Shahid MBBS ,&nbsp;Javeria Benyamin MBBS ,&nbsp;Muhammad Atif Bashir MBBS ,&nbsp;Hritvik Jain MBBS ,&nbsp;Javed Iqbal PhD","doi":"10.1016/j.hrtlng.2024.08.015","DOIUrl":"10.1016/j.hrtlng.2024.08.015","url":null,"abstract":"<div><h3>Background</h3><p>Heart failure is a major worldwide health concern and leading cause of mortality. RNAi interventions hold promise for patients resistant to conventional drugs due to their off-target effects and lack of specificity.</p></div><div><h3>Objectives</h3><p>To examine the safety and effectiveness of RNAi therapeutics in treating heart failure.</p></div><div><h3>Methods</h3><p>The PubMed, Embase, Scopus and Cochrane databases were searched using appropriate keyword from inception until December 31, 2023. A total of 14 studies fulfilling predefined selection criteria were included for qualitative synthesis.</p></div><div><h3>Results</h3><p>We found that in patients with cardiac amyloidosis, patisiran and revusiran showed considerable improvements in cardiac output and left ventricular wall thickness. In animal studies, <em>Nox2-siRNA</em> showed effectiveness in regaining heart function. Furthermore, cardiomyocyte count and left ventricular function were improved by <em>DUSP5 siRNA + T3</em> therapy and meg3 inhibition after myocardial infarction (MI). RNAi showed minimal adverse effects like peripheral neuropathy, hepatotoxicity, urinary tract infection, vaginal infection, diarrhea, abdominal pain arrhythmias, conduction disorders, and cardiotoxicity (LV wall thinning, heart failure) and improved cardiac biomarkers.</p></div><div><h3>Conclusion</h3><p>RNAi therapeutics are novel treatment option for improving cardiac function because their high target specificity, ability to target genes that conventional drugs struggle to reach and potential for long-lasting effects. Further research on optimizing delivery methods, improving target specificity, evaluating long-term safety profiles and cost-effectiveness to fully realize their potential.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 298-304"},"PeriodicalIF":2.4,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324001523/pdfft?md5=80dbbcf3ba5a43228ce58c21a66c0889&pid=1-s2.0-S0147956324001523-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095277","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":"Personalized ventilation adjustment in ARDS: A systematic review and meta-analysis of image, driving pressure, transpulmonary pressure, and mechanical power","authors":"Javier Muñoz MD, PhD ,&nbsp;Jamil Antonio Cedeño MD ,&nbsp;Galo Francisco Castañeda MD ,&nbsp;Lourdes Carmen Visedo MD","doi":"10.1016/j.hrtlng.2024.08.013","DOIUrl":"10.1016/j.hrtlng.2024.08.013","url":null,"abstract":"<div><h3>Background</h3><p>Acute Respiratory Distress Syndrome (ARDS) necessitates personalized treatment strategies due to its heterogeneity, aiming to mitigate Ventilator-Induced Lung Injury (VILI). Advanced monitoring techniques, including imaging, driving pressure, transpulmonary pressure, and mechanical power, present potential avenues for tailored interventions.</p></div><div><h3>Objective</h3><p>To review some of the most important techniques for achieving greater personalization of mechanical ventilation in ARDS patients as evaluated in randomized clinical trials, by analyzing their effect on three clinically relevant aspects: mortality, ventilator-free days, and gas exchange.</p></div><div><h3>Methods</h3><p>Following PRISMA guidelines, we conducted a systematic review and meta-analysis of Randomized Clinical Trials (RCTs) involving adult ARDS patients undergoing personalized ventilation adjustments. Outcomes were mortality (primary end-point), ventilator-free days, and oxygenation improvement.</p></div><div><h3>Results</h3><p>Among 493 identified studies, 13 RCTs (<em>n</em> = 1255) met inclusion criteria. No personalized ventilation strategy demonstrated superior outcomes compared to traditional protocols. Meta-analysis revealed no significant reduction in mortality with image-guided (RR 0.88, 95 % CI 0.70–1.11), driving pressure-guided (RR 0.61, 95 % CI 0.29–1.30), or transpulmonary pressure-guided (RR 0.85, 95 % CI 0.58–1.24) strategies. Ventilator-free days and oxygenation outcomes showed no significant differences.</p></div><div><h3>Conclusion</h3><p>Our study does not support the superiority of personalized ventilation techniques over traditional protocols in ARDS patients. Further research is needed to standardize ventilation strategies and determine their impact on mechanical ventilation outcomes.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 305-315"},"PeriodicalIF":2.4,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of upper extremity functional capacity and activities of daily living in patients with heart failure: A cross-sectional study","authors":"Zelal Apaydin ,&nbsp;Rengin Demir ,&nbsp;Rustem Mustafaoglu ,&nbsp;Umit Yasar Sinan ,&nbsp;Hidayet Ozan Arabaci ,&nbsp;Mehmet Serdar Kucukoglu","doi":"10.1016/j.hrtlng.2024.08.014","DOIUrl":"10.1016/j.hrtlng.2024.08.014","url":null,"abstract":"<div><h3>Background</h3><p>Considering the limitations in activities of daily living (ADL) and the impact of improvements in patients with heart failure (HF), appropriate assessment of upper extremity functional capacity and ADL is important.</p></div><div><h3>Objectives</h3><p>To evaluate upper extremity functional capacity and ADL in patients with HF and compare them with healthy controls.</p></div><div><h3>Methods</h3><p>This study included 30 HF patients and healthy controls. Upper extremity functional capacity was assessed with the 6-Minute Pegboard Ring Test (6PBRT), ADL by the Londrina protocol, exercise capacity by 6-Minute Walk Test (6MWT), peripheral muscle strength by hand dynamometer, and dyspnea by Modified Medical Research Council Scale (MMRC). For performance tests, pre-test (resting) and post-test (after performance) values ​​were also measured.</p></div><div><h3>Results</h3><p>Patients with HF with ejection fraction ≤50 % and controls were similar in terms of age (52.63±6.2 and 50.03±6.5 years, respectively) and gender (25 females for each group) (<em>p</em> &gt; 0.05). Patients showed a statistically significant increase in total test time in the Londrina protocol and fewer rings moved in 6PBRT (<em>p</em> &lt; 0.0001). The post-test dyspnea (<em>p</em> = 0.03) and pre-test arm fatigue (<em>p</em> &lt; 0.0001) were observed to be higher in patients in the Londrina protocol. There was a statistically significant group by time interaction in the patients’ pre- and post-test lower heart rate (<em>F</em>= 4.80, <em>p</em> = 0.03), post-test dyspnea (<em>p</em> &lt; 0.0001), and post-test arm fatigue (<em>p</em> = 0.005) were observed to be higher in patients in 6PBRT.</p></div><div><h3>Conclusions</h3><p>The evidence showed a decrease in upper extremity functional capacity in patients with HF. Patients required more time to perform their ADLs compared with healthy controls.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 316-322"},"PeriodicalIF":2.4,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095386","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":"Heart failure related fatigue: An exploratory analysis of serum osmolality from the national health and nutrition examination survey","authors":"Christine R. Hoch PhD, RN, ACNS-BC ,&nbsp;N. Jennifer Klinedinst PhD, RN, MPH, FAHA ,&nbsp;Karen Larimer PhD, ACNP-BC, FAHA ,&nbsp;Stephen S. Gottlieb MD","doi":"10.1016/j.hrtlng.2024.08.012","DOIUrl":"10.1016/j.hrtlng.2024.08.012","url":null,"abstract":"<div><h3>Background</h3><p>Fatigue is a prominent symptom of heart failure (HF). However, underlying mechanisms remain poorly understood. Fluid volume status has been suggested as a physiologic mechanism of HF-related fatigue. Serum osmolality may fluctuate with changes in volume status associated with neurohormonal dysregulation. The relationship of fatigue to serum osmolality has not been assessed in adults with HF.</p></div><div><h3>Objectives</h3><p>Describe the relationship between serum osmolality and fatigue in adults with HF.</p></div><div><h3>Methods</h3><p>We analyzed two waves of cross-sectional data from the National Health and Nutrition Examination Survey (2015–2016 and 2017–2018). Adults who self-reported having HF without select co-morbid conditions known to contribute to fatigue were included. Data were weighted to provide US national estimates, and complex sample design used for analyses. Sequential logistic regression was used to isolate the effect of serum osmolality on the odds of having fatigue.</p></div><div><h3>Results</h3><p>Data from the sample represented 1.4 million Americans with HF (58.5 % male; median age 68 years), of whom 1,001,589 (67.9 %) reported fatigue. Participants with fatigue had lower serum osmolality compared to those without fatigue (<em>t</em> = -3.04, <em>p</em> = .009). Higher serum osmolality was associated with 8.8 % lower odds of experiencing fatigue when controlling for sex and body mass index (OR = 0.912, <em>p</em> = .007, CI 0.857 - 0.972).</p></div><div><h3>Conclusions</h3><p>HF-related fatigue is associated with lower serum osmolality. Low serum osmolality may indicate excess volume and the presence of a heightened neurohormonal response, both of which may influence fatigue. Alternatively, serum osmolality may directly affect other physiologic changes that may contribute to fatigue.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 284-290"},"PeriodicalIF":2.4,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049955","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}