Heart, Lung and Circulation最新文献

{"title":"Cardiac Society of Australia and New Zealand","authors":"","doi":"10.1016/S1443-9506(25)01731-7","DOIUrl":"10.1016/S1443-9506(25)01731-7","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 12","pages":"Page 1489"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145658391","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":"Evolution and Contemporary Predictors of Outcomes in Out-of-Hospital Cardiac Arrest Patients Admitted to Intensive Cardiovascular Care Units: The Multicentric PCR-Cat Registry","authors":"Rut Andrea MD, PhD ,&nbsp;Marc Izquierdo-Ribas MD ,&nbsp;Esther Sanz MD ,&nbsp;Cosme García-García MD, PhD ,&nbsp;Antonia Sambola MD, PhD ,&nbsp;Alessandro Sionis MD, PhD ,&nbsp;José Carlos Sánchez-Salado MD, PhD ,&nbsp;Pablo Pastor MD ,&nbsp;Youcef Azeli MD, PhD ,&nbsp;Gil Bonet Pineda MD ,&nbsp;Maria José Martínez-Membrive MD ,&nbsp;Toni Soriano-Colomé MD ,&nbsp;Jordi Sans-Roselló MD, PhD ,&nbsp;Eva Moreno-Monterde MD ,&nbsp;Carlos Roca-Guerrero MD ,&nbsp;José Ortiz-Pérez MD, PhD ,&nbsp;Teresa López-Sobrino MD ,&nbsp;Oriol de Diego MD, PhD ,&nbsp;Xavier Freixa MD, PhD ,&nbsp;Pablo Loma-Osorio MD, PhD","doi":"10.1016/j.hlc.2025.07.004","DOIUrl":"10.1016/j.hlc.2025.07.004","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) remains a leading cause of cardiovascular mortality, yet significant gaps persist in understanding how contemporary management strategies influence long-term outcomes.</div></div><div><h3>Aim</h3><div>We sought to provide novel insights into the characteristics, management variability, and 6-month outcomes of patients with OHCA admitted to eight intensive cardiovascular care units during a contemporary period.</div></div><div><h3>Method</h3><div>This was a prospective multicentre registry of patients with OHCA admitted to intensive cardiovascular care units from October 2020 to December 2021. Patients were categorised by prognosis as either favourable outcome (Cerebral Performance Category [CPC] 1–2) or non-favourable outcome, including death (CPC 3–5). A multinomial logistic regression identified independent predictors of CPC 3–5.</div></div><div><h3>Results</h3><div>Among 288 patients, only 17.36% were women. Most arrests (88.93%) were witnessed, yet bystander cardiopulmonary resuscitation was initiated in just 69.18% of cases. Despite 80% of patients presenting with a shockable rhythm, an automated external defibrillator was used in only 58%. Median time to return of spontaneous circulation (ROSC) was 28 minutes. Marked variability in post-resuscitation care was observed across centres in the use of targeted temperature management, emergent coronary angiography, and multimodal neuroprognostication. At 6 months, 49% of patients exhibited CPC 1–2. Ninety-three per cent of discharged patients maintained a favourable neurological outcome, and 15% improved their CPC score. Independent predictors of CPC 3-5 included older age (p=0.005), male sex (p=0.016), previous stroke (p=0.046), prolonged time to ROSC (p&lt;0.001), and a non-shockable initial rhythm (p&lt;0.001). Hypoxic-ischaemic brain injury was the leading cause of in-hospital death (72.90%).</div></div><div><h3>Conclusions</h3><div>Nearly half of the patients with OHCA survived with a favourable neurological outcome, which persisted after 6 months. Despite significant in-hospital interventions, pre-hospital factors remained the strongest predictors of neurological outcome. The high degree of management variability suggests an urgent need for standardised protocols and supports the creation of cardiac arrest centres.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 12","pages":"Pages 1389-1398"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318140","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":"CardioHepatology: Exploring the Interplay Between Cirrhosis, Cirrhotic Cardiomyopathy, Coronary Artery Disease, and Liver Transplantation","authors":"Claudia R. Brick BMedSc, MBBS ,&nbsp;Benjamin Cailes BMedSci, FRACP ,&nbsp;Avik Majumdar MPHTM, PhD, FRACP ,&nbsp;Adam Testro FRACP, PhD ,&nbsp;Marie Sinclair BMedSci, FRACP, PhD ,&nbsp;Ali Al-Fiadh FRACP, PhD ,&nbsp;Laurence Weinberg MD, FANZCA, PhD ,&nbsp;Jeyamani Ramachandran FRACP, PhD ,&nbsp;Madeleine Gill FRACP ,&nbsp;Omar Farouque FACC, PhD ,&nbsp;Anoop N. Koshy FRACP, PhD","doi":"10.1016/j.hlc.2025.06.1022","DOIUrl":"10.1016/j.hlc.2025.06.1022","url":null,"abstract":"<div><div>Cardiac comorbidities in patients with cirrhosis are common yet frequently under-recognised. Cirrhotic cardiomyopathy, a subclinical state of cardiac dysfunction, is emerging as a critical contributor to major adverse cardiac events in this patient population, as well as liver events such as hepatorenal syndrome. The increasing prevalence of patients with metabolic dysfunction-associated steatotic liver disease and concomitant coronary artery disease also poses significant management challenges for these patients. This review focuses on the considerable burden of cardiac disease in patients with cirrhosis, most notably in those undergoing assessment for liver transplantation. Our findings highlight the importance of early detection and the use of appropriate management strategies to enhance post-transplant cardiovascular outcomes.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 12","pages":"Pages 1362-1372"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444698","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 Aortic Arch Calcification With Zero Coronary Artery Calcium","authors":"Mugdha A. Joshi MD ,&nbsp;Venkat S. Manubolu MD, MPH ,&nbsp;April Kinninger MPH ,&nbsp;Rui Wang MS ,&nbsp;Robyn L. McClelland PhD ,&nbsp;Sion K. Roy MD ,&nbsp;Matthew J. Budoff MD","doi":"10.1016/j.hlc.2025.05.087","DOIUrl":"10.1016/j.hlc.2025.05.087","url":null,"abstract":"<div><h3>Background</h3><div>Studies have linked aortic calcification to an increased risk of all-cause mortality and cardiovascular mortality. There is minimal evidence evaluating the sex differences in the prevalence of aortic arch calcification (AAC) in relation to zero coronary artery calcium (CAC).</div></div><div><h3>Method</h3><div>This study included participants from the Multi-Ethnic Study of Atherosclerosis (MESA) exam 5, of which 2,564 underwent non-contrast chest computed tomography scans. We utilised the CAC and AAC scores measured by the Agatston method to evaluate sex differences in AAC among participants overall, and among those with zero CAC. Regression analysis was performed, adjusting for covariates, to evaluate the sex difference.</div></div><div><h3>Results</h3><div>The average age of the 2,564 participants was 69.2±9.2 years, 46% were women, 38% were White, 13% were Chinese, 27% were Black, and 22% were Hispanic/Latino. A total of 813 (32%) had a CAC of zero. The prevalence of AAC was higher in women than men, both in the zero CAC population (87% vs 80%) and overall (92% vs 90%). The median AAC was additionally higher in women in the overall population (217 vs 212) and in the CAC zero population (60 vs 20). After controlling for covariates, the estimated average AAC was 0.51 times lower in men than women (95% confidence interval 0.36–0.72; p&lt;0.001) in the CAC zero population.</div></div><div><h3>Conclusions</h3><div>This study demonstrated that the prevalence of aortic arch calcium is higher in women compared to men. In a subset of the population with zero CAC, the average amount of AAC is significantly higher in women. In the future, event analysis should be done to determine whether these sex differences in AAC may partially explain the sex differences in the prediction of atherosclerotic cardiovascular disease events.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 12","pages":"Pages 1424-1429"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421578","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":"Incremental Value of Echocardiography Modalities–Papillary Muscle Rupture","authors":"Ahthavan Narendren MBBS, MMed, GradCertDigitHlth ,&nbsp;Nigel Sutherland BPhysio, MD, FRACP, FCSANZ ,&nbsp;Naveen Sharma MBBS FRACP FCSANZ ,&nbsp;William van Gaal MD, FRACP, FCSANZ, FESC","doi":"10.1016/j.hlc.2025.06.1034","DOIUrl":"10.1016/j.hlc.2025.06.1034","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 12","pages":"Pages e167-e169"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471066","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":"From Evidence to Outcomes: The Evolving Continuum of Cardiovascular Care","authors":"Irene Vargas MD ,&nbsp;Saraschandra Vallabhajosyula MSc, MD ,&nbsp;Vinayak Nagaraja MBBS, MBiostat, FRACP","doi":"10.1016/j.hlc.2025.11.002","DOIUrl":"10.1016/j.hlc.2025.11.002","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 12","pages":"Pages 1307-1309"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145658392","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":"Rural and Remote Acute STEMI Diagnosis and Management: Current Status and Future Directions","authors":"Ryan Gadeley BMed ,&nbsp;Ruth Arnold FRACP ,&nbsp;David Amos FRACP ,&nbsp;Stuart Moss FRACP ,&nbsp;Alex Elder FRACP ,&nbsp;Sameer Karve FRACP ,&nbsp;Mark Adams FRACP, PhD ,&nbsp;David Brieger FRACP PhD ,&nbsp;Harry C. Lowe FRACP, PhD","doi":"10.1016/j.hlc.2025.06.1035","DOIUrl":"10.1016/j.hlc.2025.06.1035","url":null,"abstract":"<div><div>Current European, American and Australasian guidelines recommend revascularisation for acute ST elevation myocardial infarction (STEMI) by immediate or “primary” percutaneous coronary intervention (pPCI), or if pPCI cannot be performed within 120 minutes, by thrombolysis followed by rescue PCI. This latter approach, despite its limitations, remains a cornerstone of STEMI care in rural and remote settings, where pPCI is not immediately available, and where one-third of the Australian population live.</div><div>This review evaluates the current status of thrombolysis and rescue PCI in rural and remote settings, examines the multiple changes that have occurred since its inception, and highlights persisting gaps in knowledge, to provide an up-to-date evaluation of this field, and an outlook for future directions, in this area of ongoing change.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 12","pages":"Pages 1332-1343"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952038","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":"Central Obesity: An Emerging Player in Cardiac Remodelling and Dysfunction","authors":"Kylychbek Suiunov MD ,&nbsp;Argen Mamazhakypov PhD ,&nbsp;Andrey Polupanov MD, PhD ,&nbsp;Kyialbek Sakibaev MD, PhD ,&nbsp;Meerimgul Sherikbai kyzy MD ,&nbsp;Chyngyzbek Asanbaev MD ,&nbsp;Akylbek Sydykov MD, PhD ,&nbsp;Roman Kalmatov MD, PhD","doi":"10.1016/j.hlc.2025.05.096","DOIUrl":"10.1016/j.hlc.2025.05.096","url":null,"abstract":"<div><div>Abnormal or excessive fat accumulation is defined as obesity. The prevalence of obesity has risen worldwide in the last years. Obesity increases cardiovascular disease risk, affecting cardiac and vascular systems. Accordingly, the health burden related to obesity has been increased. Notably, even individuals with normal body weight can present with excessive accumulation of visceral fat, also known as central obesity. Population-based studies demonstrated associations between central obesity measures, including waist circumference, waist-to-hip ratio, and visceral adipose tissue, and adverse cardiovascular events and increased all-cause mortality. It has been shown that central obesity induces cardiac remodelling and dysfunction. Moreover, central obesity measures proved to be more reliable predictors of cardiac remodelling and dysfunction than traditional obesity measures such as body mass index. This review presents recent evidence of the detrimental effects of central obesity on cardiac function and structure.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 12","pages":"Pages 1344-1361"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451786","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":"Percutaneous Femoral Arterial Closure Following Decannulation of Venoarterial Extracorporeal Membrane Oxygenation Using the MANTA Vascular Closure Device","authors":"Riley J. Batchelor FRACP ,&nbsp;Arne Diehl FACEM, FCICM ,&nbsp;Thodur Vasudevan FRACS ,&nbsp;Shane Nanayakkara PhD, FRACP ,&nbsp;Nay Htun PhD, FRACP ,&nbsp;Vincent Pellegrino FRACP, FCICM ,&nbsp;David McGiffin FRACS ,&nbsp;Silvana Marasco PhD, FRACS ,&nbsp;Carol Hodgson BAppSc, PhD, FACP ,&nbsp;David Kaye PhD, FRACP ,&nbsp;Dion Stub PhD, FRACP ,&nbsp;Antony Walton FRACP","doi":"10.1016/j.hlc.2025.06.006","DOIUrl":"10.1016/j.hlc.2025.06.006","url":null,"abstract":"<div><h3>Background</h3><div>Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a life-saving therapy for patients with severe cardiac failure. If patients can be weaned, withdrawal and closure of the large-bore arterial access are required, which historically have been achieved through surgical closure. The MANTA vascular closure device (VCD) is a percutaneous, collagen-based plug device used following large-bore arterial access. We sought to evaluate the efficacy and safety of the MANTA VCD for percutaneous arterial closure following VA-ECMO decannulation.</div></div><div><h3>Method</h3><div>A non-randomised, open-label pilot study of patients who underwent decannulation from VA-ECMO with percutaneous closure using the MANTA VCD.</div></div><div><h3>Results</h3><div>Eight patients presenting with cardiogenic shock (mean age 46.5±11.4 years, 37.5% female) underwent percutaneous closure following VA-ECMO decannulation using the 18 Fr MANTA VCD. The mean duration of VA-ECMO support prior to decannulation was 4.8±2.6 days, with arterial cannula sizes ranging from 15 to 19 Fr. There were two major adverse events: one patient had acute limb ischaemia due to superficial femoral artery occlusion, which was detected during percutaneous closure and treated surgically; another patient developed a femoral pseudoaneurysm and infected hematoma that subsequently required surgical repair 17 days after percutaneous closure.</div></div><div><h3>Conclusions</h3><div>In a centre with immediate access to vascular surgical backup, and in highly selected patients, percutaneous closure following VA-ECMO decannulation using the MANTA VCD is feasible; however, major vascular complications raise concerns regarding safety prior to its adoption as an alternative to up-front surgical closure.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 12","pages":"Pages 1409-1416"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426808","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 Ultra-Short-Term Heart Rate Variability and Atrial Fibrillation in Heart Failure Population: A Retrospective Cohort Study","authors":"Xiaodi Tang MD,&nbsp;Rong He MD, PhD","doi":"10.1016/j.hlc.2025.05.089","DOIUrl":"10.1016/j.hlc.2025.05.089","url":null,"abstract":"<div><h3>Background</h3><div>Patients with heart failure are at high risk for atrial fibrillation (AF) due to impaired heart function and sympathetic excitation. Ultra-short-term heart rate variability (usHRV), a parameter that reflects autonomic nervous system activation, has been proposed. However, the association between usHRV and AF has not been investigated in the heart failure with reduced ejection fraction (HFrEF) population.</div></div><div><h3>Objective</h3><div>This study explored the association between usHRV and AF risk in the HFrEF population.</div></div><div><h3>Method</h3><div>We conducted a retrospective cohort study involving 2,122 participants from the Critical Care Medical Information Mark-IV (MIMIC-IV) database with 2 years’ observation. We used Cox proportional hazards models, subgroup analysis, interaction effect evaluation and E-value to exclude confounding factors. Furthermore, the Kaplan–Meier curve was used to describe the survival probability in different usHRV quantiles.</div></div><div><h3>Results</h3><div>During an average follow-up of 1.67 years, 475 participants (22.4%) developed AF. A negative association between usHRV and the risk of AF was evident after adjusting for multiple variables. In the fully adjusted Cox proportional hazard models, for every 1 unit increase, the hazard ratio (HR) for incident AF was 0.84 for log(standard deviation of normal-to-normal RR intervals) (95% confidence intervals [CI] 0.66–1.07), 1.05 for log(standard deviation of successive differences) (95% CI 0.84–1.32), 1.04 for log(root mean square of successive differences) (95% CI 0.83–1.31), 0.88 for log(low frequency [LF]) (95% CI 0.80–0.96), 0.93 for log(high frequency [HF]) (95% CI 0.84–1.04), 0.82 for log(LF/HF) (95% CI 0.70–0.95), 0.79 for log(LF normalised units) (95% CI 0.65–0.97), 2.48 for log(HF normalised units) (95% CI 1.42–4.35), and 0.90 for log(total power) (95% CI 0.80–0.98). The Kaplan–Meier curve shows that the lower the frequency-domain index of usHRV, the higher the risk of AF occurrence in the HFrEF population. Subsequent subgroup analysis and E-value implied the current associations tended to be more stable.</div></div><div><h3>Conclusions</h3><div>Our study findings suggest that decreased usHRV frequency domain metrics levels may be linked to an increased risk of AF in the HFrEF population.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 12","pages":"Pages 1439-1448"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145658756","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}