Pressure-volume (PV) loop analysis remains the gold standard for studying cardiac physiology by offering a comprehensive analysis and quantitative assessment of the heart. The PV loop analysis uncovers the complex interplay between pressure and volume within the ventricle during each cardiac cycle and provide clinicians and researchers with invaluable insights into the efficiency and performance of the heart. By plotting ventricular pressure against ventricular volume, PV loops create a closed curve, signifying the dynamic changes occurring throughout the entire cardiac cycle. This review examines the importance of mastering the fundamentals of the PV loop and understanding valvular heart disease impacting the left heart.
{"title":"Understanding the Pressure-Volume Loop in Valvular Heart Disease","authors":"Mohammad Sarraf MD , Omar Chehab MD , Vinayak Nagaraja MBBS, MBiostat, FRACP","doi":"10.1016/j.hlc.2025.05.101","DOIUrl":"10.1016/j.hlc.2025.05.101","url":null,"abstract":"<div><div>Pressure-volume (PV) loop analysis remains the gold standard for studying cardiac physiology by offering a comprehensive analysis and quantitative assessment of the heart. The PV loop analysis uncovers the complex interplay between pressure and volume within the ventricle during each cardiac cycle and provide clinicians and researchers with invaluable insights into the efficiency and performance of the heart. By plotting ventricular pressure against ventricular volume, PV loops create a closed curve, signifying the dynamic changes occurring throughout the entire cardiac cycle. This review examines the importance of mastering the fundamentals of the PV loop and understanding valvular heart disease impacting the left heart.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 1","pages":"Pages 31-44"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145742215","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}
Community-based peer-support exercise programs are important for enhancing the quality of life for older people with chronic lung disease. Given the strong evidence base for these programs, it is important to have a strong understanding of the factors that facilitate participation and engagement from the perspective of participants. This study aimed to derive empirical evidence from qualitative studies on the facilitating factors supporting the participation of older people with chronic lung disease in community-based peer-support exercise programs.
Methods
Five online databases (Scopus, Medline, CINAHL, PsychInfo, and Web of Science) were searched post-2012. Data were analysed using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Studies were assessed for quality and data extracted. Results were synthesised using qualitative metasynthesis techniques.
Results
A total of 12 studies met the inclusion criteria and were included in the review. Three themes were identified as facilitators that support the participation of older people with chronic lung disease in community exercise programs: 1. benefits of pulmonary rehabilitation, with subthemes of health benefits, psychosocial benefits, supportive safe environment, and sustained benefits; 2. barriers to pulmonary rehabilitation, with subthemes of access barriers and personal barriers; and 3. overcoming barriers and building resilience, with subthemes building knowledge and awareness and regaining independence.
Conclusions
The review highlights that physical and psychosocial benefits of pulmonary rehabilitation community-based exercise programs for older people with chronic lung disease are facilitators for participation. Peer support in understanding the experiences of others can help increase engagement. There is a need to construct approaches that address the social determinants of health in overcoming barriers to participation in community peer-support exercise programs. A limitation is a risk of losing the nuances of contextual and theoretical aspects of individual studies.
背景与目的：以社区为基础的同伴支持运动项目对提高老年慢性肺病患者的生活质量非常重要。鉴于这些项目有强有力的证据基础，从参与者的角度对促进参与和参与的因素有一个深刻的理解是很重要的。本研究旨在从定性研究中获得支持慢性肺病老年人参与社区同伴支持运动项目的促进因素的经验证据。方法：检索2012年后的Scopus、Medline、CINAHL、PsychInfo和Web of Science 5大数据库。使用系统评价和元分析指南的首选报告项目对数据进行分析。评估了研究的质量和提取的数据。结果采用定性合成技术合成。结果：共有12项研究符合纳入标准并被纳入本综述。三个主题被确定为支持患有慢性肺病的老年人参与社区锻炼计划的促进因素：1。肺康复的益处，分主题为健康益处、社会心理益处、支持性安全环境和持续益处；2. 肺部康复障碍，分主题为获取障碍和个人障碍；和3。克服障碍，建立复原力，分主题是建立知识和意识，重获独立。结论：该综述强调，肺康复社区运动项目对慢性肺病老年人的身体和心理社会益处是促进参与的因素。在理解他人经历方面的同伴支持有助于提高参与度。有必要建立解决健康的社会决定因素的方法，以克服参与社区同伴支持运动项目的障碍。限制是一种失去个体研究的背景和理论方面的细微差别的风险。
{"title":"Factors Facilitating Participation of Older Adults With Chronic Lung Disease in Community-Based, Peer-Support Exercise Programs: A Metasynthesis","authors":"Rebekkah Middleton RN, MN(Res), PhD , Christine Metusela PhD , Patricia M. Davidson RN, PhD","doi":"10.1016/j.hlc.2025.07.011","DOIUrl":"10.1016/j.hlc.2025.07.011","url":null,"abstract":"<div><h3>Background & Aim</h3><div>Community-based peer-support exercise programs are important for enhancing the quality of life for older people with chronic lung disease. Given the strong evidence base for these programs, it is important to have a strong understanding of the factors that facilitate participation and engagement from the perspective of participants. This study aimed to derive empirical evidence from qualitative studies on the facilitating factors supporting the participation of older people with chronic lung disease in community-based peer-support exercise programs.</div></div><div><h3>Methods</h3><div>Five online databases (Scopus, Medline, CINAHL, PsychInfo, and Web of Science) were searched post-2012. Data were analysed using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Studies were assessed for quality and data extracted. Results were synthesised using qualitative metasynthesis techniques.</div></div><div><h3>Results</h3><div>A total of 12 studies met the inclusion criteria and were included in the review. Three themes were identified as facilitators that support the participation of older people with chronic lung disease in community exercise programs: 1. benefits of pulmonary rehabilitation, with subthemes of health benefits, psychosocial benefits, supportive safe environment, and sustained benefits; 2. barriers to pulmonary rehabilitation, with subthemes of access barriers and personal barriers; and 3. overcoming barriers and building resilience, with subthemes building knowledge and awareness and regaining independence.</div></div><div><h3>Conclusions</h3><div>The review highlights that physical and psychosocial benefits of pulmonary rehabilitation community-based exercise programs for older people with chronic lung disease are facilitators for participation. Peer support in understanding the experiences of others can help increase engagement. There is a need to construct approaches that address the social determinants of health in overcoming barriers to participation in community peer-support exercise programs. A limitation is a risk of losing the nuances of contextual and theoretical aspects of individual studies.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 1","pages":"Pages 45-61"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145603922","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}
Pub Date : 2026-01-01DOI: 10.1016/j.hlc.2025.07.013
Juan Mundisugih MBBS , Ashwin Bhaskaran MBBS, MSc , Kaimin Huang MBBS , Kasun De Silva MBBS , Samual Turnbull BSc , Tai Chung So MBBS , Kenji Hashimoto MD, PhD , Anunay Gupta MD, DM , Richard G. Bennett BSc, MBChB, PhD , Yasuhito Kotake MD, PhD , Max Bickley BSc , Timothy Campbell BSc, PhD , Saurabh Kumar MBBS, PhD
Catheter ablation has emerged as a pivotal therapeutic strategy for managing scar-related ventricular tachycardia (VT) in patients with structural heart disease (SHD). However, VT ablation can be complex and challenging because of the nature of VT circuit configurations and their interplay with the underlying SHD. This review outlines our systematic approach to VT ablation within the context of SHD, focusing on preprocedural assessment, procedural techniques, and postprocedural care. By adopting a systematic approach and leveraging technological advancements, successful VT ablation outcomes can be achieved in patients with SHD.
{"title":"Stepwise Approach to Ventricular Tachycardia Ablation in Structural Heart Disease","authors":"Juan Mundisugih MBBS , Ashwin Bhaskaran MBBS, MSc , Kaimin Huang MBBS , Kasun De Silva MBBS , Samual Turnbull BSc , Tai Chung So MBBS , Kenji Hashimoto MD, PhD , Anunay Gupta MD, DM , Richard G. Bennett BSc, MBChB, PhD , Yasuhito Kotake MD, PhD , Max Bickley BSc , Timothy Campbell BSc, PhD , Saurabh Kumar MBBS, PhD","doi":"10.1016/j.hlc.2025.07.013","DOIUrl":"10.1016/j.hlc.2025.07.013","url":null,"abstract":"<div><div>Catheter ablation has emerged as a pivotal therapeutic strategy for managing scar-related ventricular tachycardia (VT) in patients with structural heart disease (SHD). However, VT ablation can be complex and challenging because of the nature of VT circuit configurations and their interplay with the underlying SHD. This review outlines our systematic approach to VT ablation within the context of SHD, focusing on preprocedural assessment, procedural techniques, and postprocedural care. By adopting a systematic approach and leveraging technological advancements, successful VT ablation outcomes can be achieved in patients with SHD.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 1","pages":"Pages 62-73"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145695929","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}
Pub Date : 2026-01-01DOI: 10.1016/j.hlc.2025.12.010
Paloma Remior Pérez MD a,b, Robyn J. Hylind MS, CGC a, Thomas M. Roston MD, PhD a,c, Vassilios J. Bezzerides MD, PhD a,1,∗∗, Dominic J. Abrams MBBS, MD, MBA a,1,∗
{"title":"Corrigendum to: “Gene Therapy for Catecholaminergic Polymorphic Ventricular Tachycardia” [Heart Lung Circ. 32(7), (2023) 790–797.]","authors":"Paloma Remior Pérez MD a,b, Robyn J. Hylind MS, CGC a, Thomas M. Roston MD, PhD a,c, Vassilios J. Bezzerides MD, PhD a,1,∗∗, Dominic J. Abrams MBBS, MD, MBA a,1,∗","doi":"10.1016/j.hlc.2025.12.010","DOIUrl":"10.1016/j.hlc.2025.12.010","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 1","pages":"Page e14"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904124","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}
Pub Date : 2026-01-01DOI: 10.1016/j.hlc.2025.12.005
Salvatore Pepe PhD, FAHA, FESC, FCSANZ
{"title":"Innovations in Cardiovascular Care: From AI to Community Support, Celebrating 35 Years of Heart Lung and Circulation","authors":"Salvatore Pepe PhD, FAHA, FESC, FCSANZ","doi":"10.1016/j.hlc.2025.12.005","DOIUrl":"10.1016/j.hlc.2025.12.005","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 1","pages":"Pages 1-4"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904180","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}
Pub Date : 2026-01-01DOI: 10.1016/j.hlc.2025.04.089
Andrey V. Protopopov MD , Alexander V. Bogachev-Prokophiev MD, PhD , Alexander V. Afanasyev MD, PhD , Dmitry A. Sirota MD, PhD , Sergey Ye. Khrushchev PhD , Pavel S. Ruzankin PhD , Maxim O. Zhulkov MD, PhD , Aleksandr M. Chernyavskiy MD, PhD
Aim
The optimal surgical strategy for patients with post-infarction left ventricular aneurysms remains unclear. The superiority of the Dor technique over the Cooley repair has not been demonstrated in terms of long-term outcomes. This study aimed to compare the clinical outcomes between the Dor and Cooley repair techniques.
Methods
Patients who underwent left ventricular repair between 2003 and 2021 were retrospectively recruited. All the patients underwent left ventricular aneurysm repair and coronary artery bypass grafting. For comparative assessment of outcomes between the Cooley and Dor groups, 1:2 propensity score matching was applied. The primary study endpoint was long-term mortality, whereas the secondary endpoints included major adverse cardiac and cerebrovascular events (MACCEs), defined as a combination of cardiac death, myocardial infarction, stroke, readmission due to nonfatal myocardial infarction, and repeat revascularisation.
Results
The median follow-up period was 106 months (interquartile range: 41–148). Eight hospital deaths (2.1%) occurred in the Cooley group and 11 (5.1%) in the Dor group within 30 days postoperatively. For the entire follow-up period, the Dor group had lower mortality (hazard ratio [HR] 0.67; 95% confidence interval [CI] 0.45–0.99; p=0.043) and greater freedom from myocardial infarction (HR 0.41; 95% CI 0.18–0.93; p=0.033). The overall incidence of MACCEs was significantly lower in the Dor group (HR 0.65; 95% Cl 0.48–0.88; p=0.005). The Dor group showed a notably lower readmission rate (HR 0.63; 95% Cl 0.42–0.94; p=0.022).
Conclusions
For long-term survival and MACCEs, the Dor procedure demonstrated better outcomes than the Cooley reconstruction.
{"title":"Long-Term Outcomes of Dor Versus Cooley Procedure in Patients With Post-Infarction Left Ventricular Aneurysm Repair: A Propensity Score-Matched Study","authors":"Andrey V. Protopopov MD , Alexander V. Bogachev-Prokophiev MD, PhD , Alexander V. Afanasyev MD, PhD , Dmitry A. Sirota MD, PhD , Sergey Ye. Khrushchev PhD , Pavel S. Ruzankin PhD , Maxim O. Zhulkov MD, PhD , Aleksandr M. Chernyavskiy MD, PhD","doi":"10.1016/j.hlc.2025.04.089","DOIUrl":"10.1016/j.hlc.2025.04.089","url":null,"abstract":"<div><h3>Aim</h3><div>The optimal surgical strategy for patients with post-infarction left ventricular aneurysms remains unclear. The superiority of the Dor technique over the Cooley repair has not been demonstrated in terms of long-term outcomes. This study aimed to compare the clinical outcomes between the Dor and Cooley repair techniques.</div></div><div><h3>Methods</h3><div>Patients who underwent left ventricular repair between 2003 and 2021 were retrospectively recruited. All the patients underwent left ventricular aneurysm repair and coronary artery bypass grafting. For comparative assessment of outcomes between the Cooley and Dor groups, 1:2 propensity score matching was applied. The primary study endpoint was long-term mortality, whereas the secondary endpoints included major adverse cardiac and cerebrovascular events (MACCEs), defined as a combination of cardiac death, myocardial infarction, stroke, readmission due to nonfatal myocardial infarction, and repeat revascularisation.</div></div><div><h3>Results</h3><div>The median follow-up period was 106 months (interquartile range: 41–148). Eight hospital deaths (2.1%) occurred in the Cooley group and 11 (5.1%) in the Dor group within 30 days postoperatively. For the entire follow-up period, the Dor group had lower mortality (hazard ratio [HR] 0.67; 95% confidence interval [CI] 0.45–0.99; p=0.043) and greater freedom from myocardial infarction (HR 0.41; 95% CI 0.18–0.93; p=0.033). The overall incidence of MACCEs was significantly lower in the Dor group (HR 0.65; 95% Cl 0.48–0.88; p=0.005). The Dor group showed a notably lower readmission rate (HR 0.63; 95% Cl 0.42–0.94; p=0.022).</div></div><div><h3>Conclusions</h3><div>For long-term survival and MACCEs, the Dor procedure demonstrated better outcomes than the Cooley reconstruction.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 1","pages":"Pages 127-136"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137367","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}
Same-day discharge (SDD) following elective percutaneous coronary intervention (PCI) has gained popularity; however, uptake varies worldwide, and existing SDD consensus documents have largely been developed without input from clinicians and consumers. We aimed to develop an SDD clinical pathway in collaboration with clinicians, patients, and carers.
Method
This was a mixed-methods study. The AGREE II instrument was used to guide the development of the SDD clinical pathway to ensure rigour. A hybrid workshop, allowing both online and in-person attendance, was conducted with participants from six public hospitals in Queensland, Australia. The project funded all participants’ travel to the workshop to maximise in-person attendance. A modified seven-step nominal group technique was used to guide the workshop and refine the clinical pathway. Sessions in Step 4 (participants presented ideas one by one) and Step 5 (researchers provided clarification) were audio-recorded and transcribed verbatim. Deductive content analysis was undertaken. We counted and recorded numbers for quantitative data.
Results
A total of 15 participants took part in the study, including nurses (n=6), medical officers (n=5), patients (n=3), and a carer representative (n=1). Consensus was achieved for six out of seven pre-PCI factors, all 14 post-PCI factors, all nine pre-discharge checklist statements, and all five risk management statements. All participants agreed that, despite the consensus, the final SDD decision should remain with the interventional cardiologist performing the procedure.
Conclusions
Our approach has demonstrated that the developed clinical pathway is not only evidence-based but also considers contextual factors and the needs of consumers. It will assist clinicians in making decisions about SDD in hospitals, thereby enhancing the efficiency of cardiac service delivery and improving patient satisfaction.
{"title":"Developing a Same-Day Discharge Clinical Pathway for Patients Undergoing Elective Percutaneous Coronary Intervention Using a Nominal Group Technique","authors":"Yingyan Chen PhD , Jacqueline Peet PhD , Natalie Hausin MSc , David Hinds GradDipNurs(CritCare) , Rohan Jayasinghe MBBS , Wendy Kennedy MSc , Suzanne Morris MSc , Rohan Poulter MBBS , Gregory Starmer MBBS , Yash Singbal MBBS , Anna Townsend MSc , Paul Wallis GradCertNurs(CritCare) , Raibhan Yadav FRACP , Zhihua Zhang MBBS , Karen Wardrop CertNursing , Junel Padigos PhD , Frances Fengzhi Lin PhD","doi":"10.1016/j.hlc.2025.07.006","DOIUrl":"10.1016/j.hlc.2025.07.006","url":null,"abstract":"<div><h3>Background</h3><div>Same-day discharge (SDD) following elective percutaneous coronary intervention (PCI) has gained popularity; however, uptake varies worldwide, and existing SDD consensus documents have largely been developed without input from clinicians and consumers. We aimed to develop an SDD clinical pathway in collaboration with clinicians, patients, and carers.</div></div><div><h3>Method</h3><div>This was a mixed-methods study. The AGREE II instrument was used to guide the development of the SDD clinical pathway to ensure rigour. A hybrid workshop, allowing both online and in-person attendance, was conducted with participants from six public hospitals in Queensland, Australia. The project funded all participants’ travel to the workshop to maximise in-person attendance. A modified seven-step nominal group technique was used to guide the workshop and refine the clinical pathway. Sessions in Step 4 (participants presented ideas one by one) and Step 5 (researchers provided clarification) were audio-recorded and transcribed verbatim. Deductive content analysis was undertaken. We counted and recorded numbers for quantitative data.</div></div><div><h3>Results</h3><div>A total of 15 participants took part in the study, including nurses (n=6), medical officers (n=5), patients (n=3), and a carer representative (n=1). Consensus was achieved for six out of seven pre-PCI factors, all 14 post-PCI factors, all nine pre-discharge checklist statements, and all five risk management statements. All participants agreed that, despite the consensus, the final SDD decision should remain with the interventional cardiologist performing the procedure.</div></div><div><h3>Conclusions</h3><div>Our approach has demonstrated that the developed clinical pathway is not only evidence-based but also considers contextual factors and the needs of consumers. It will assist clinicians in making decisions about SDD in hospitals, thereby enhancing the efficiency of cardiac service delivery and improving patient satisfaction.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 1","pages":"Pages 116-126"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458435","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}
Pub Date : 2026-01-01DOI: 10.1016/j.hlc.2025.07.017
Maria Giulia Bellicini MD
{"title":"What is HFpEF? Why it may not be Real Heart Failure","authors":"Maria Giulia Bellicini MD","doi":"10.1016/j.hlc.2025.07.017","DOIUrl":"10.1016/j.hlc.2025.07.017","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 1","pages":"Page e3"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582111","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}
Pub Date : 2026-01-01DOI: 10.1016/S1443-9506(25)01788-3
{"title":"Cardiac Society of Australia and New Zealand","authors":"","doi":"10.1016/S1443-9506(25)01788-3","DOIUrl":"10.1016/S1443-9506(25)01788-3","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 1","pages":"Page 149"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904229","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}
Pub Date : 2025-12-01DOI: 10.1016/j.hlc.2025.07.004
Rut Andrea MD, PhD , Marc Izquierdo-Ribas MD , Esther Sanz MD , Cosme García-García MD, PhD , Antonia Sambola MD, PhD , Alessandro Sionis MD, PhD , José Carlos Sánchez-Salado MD, PhD , Pablo Pastor MD , Youcef Azeli MD, PhD , Gil Bonet Pineda MD , Maria José Martínez-Membrive MD , Toni Soriano-Colomé MD , Jordi Sans-Roselló MD, PhD , Eva Moreno-Monterde MD , Carlos Roca-Guerrero MD , José Ortiz-Pérez MD, PhD , Teresa López-Sobrino MD , Oriol de Diego MD, PhD , Xavier Freixa MD, PhD , Pablo Loma-Osorio MD, PhD
Background
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.
Aim
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.
Method
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.
Results
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<0.001), and a non-shockable initial rhythm (p<0.001). Hypoxic-ischaemic brain injury was the leading cause of in-hospital death (72.90%).
Conclusions
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.
{"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 , Marc Izquierdo-Ribas MD , Esther Sanz MD , Cosme García-García MD, PhD , Antonia Sambola MD, PhD , Alessandro Sionis MD, PhD , José Carlos Sánchez-Salado MD, PhD , Pablo Pastor MD , Youcef Azeli MD, PhD , Gil Bonet Pineda MD , Maria José Martínez-Membrive MD , Toni Soriano-Colomé MD , Jordi Sans-Roselló MD, PhD , Eva Moreno-Monterde MD , Carlos Roca-Guerrero MD , José Ortiz-Pérez MD, PhD , Teresa López-Sobrino MD , Oriol de Diego MD, PhD , Xavier Freixa MD, PhD , 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<0.001), and a non-shockable initial rhythm (p<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}
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