Heart, Lung and Circulation最新文献

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Safety of Early Coronary Surgery in Antiplatelet Non-Responders: A Retrospective Cohort Study 抗血小板无应答者早期冠状动脉手术的安全性：一项回顾性队列研究。

IF 2.2 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart, Lung and Circulation

Pub Date : 2026-02-01 Epub Date: 2025-12-26 DOI: 10.1016/j.hlc.2025.06.1028

John D.L. Brookes MBBS, MSc, PGDipAnat , Shazhad Sadiqi MBBS, PhD, MSc , Manoras Chengalath MBBS, MS, MCh , Henry Ring MD , Christopher Morley BSc, Dip Perf , Kyri Hogan MSc, Dip Perf , Cheng-Hon Yap MS, FRACS , Michael Seitz BMedSc, FRACS

Background

Dual antiplatelet therapy (DAPT) is frequently prescribed to patients with acute coronary syndromes on presentation. If these patients require inpatient surgical revascularisation, current guidelines suggest they await several days’ DAPT washout prior to proceeding to operation. However, the rate of non-response to DAPT is significant, and there is minimal research available to assess if patients who are non-responders can safely proceed to surgery without waiting for washout.

Method

A retrospective cohort study of prospectively collected data was undertaken, examining patients who proceeded to surgery before the guideline-recommended washout time compared to those with no DAPT exposure.

Results

One hundred patients had Thromboelastogram (TEG) assessment of response to DAPT. There was a high rate of DAPT non- and low-response, 56% (n=56). Thirty-five non- and low-response patients proceeded to theatre prior to the guideline-recommended waiting time following DAPT. There was no statistically significant increase in bleeding or transfusion requirements (any transfusion, p=0.79), and no difference in morbidity and mortality (p=0.46). Non-responders proceeding early to surgery had a significantly shorter length of stay - non-responder 8.8±3.3 vs no DAPT 10.7±4.7 vs awaited washout 12.1±4.7 days (p<0.01).

Conclusions

There is a high rate of non-/low-response to DAPT, particularly clopidogrel. Non-responder patients do not have significant increase in overall morbidity and mortality, bleeding outcomes or transfusion requirements, and have the advantage of a significantly shorter length of hospital stay.

背景：双重抗血小板治疗（DAPT）常用于急性冠状动脉综合征患者。如果这些患者需要住院手术血运重建，目前的指南建议他们等待几天的DAPT冲洗后再进行手术。然而，对DAPT无反应的比率是显著的，并且很少有可用的研究来评估无反应的患者是否可以安全地进行手术而无需等待冲洗。方法：对前瞻性收集的数据进行回顾性队列研究，将在指南推荐的洗脱时间之前进行手术的患者与未接受DAPT治疗的患者进行比较。结果：100例患者采用血栓弹性图（TEG）评估DAPT的疗效。DAPT无应答率高，低应答率56% （n=56）。35例无反应和低反应患者在指南推荐的DAPT等待时间之前进入了手术室。出血或输血需求没有统计学上的显著增加（任何输血，p=0.79），发病率和死亡率也没有差异（p=0.46）。无反应者早期手术的住院时间明显缩短——无反应者8.8±3.3天vs无DAPT者10.7±4.7天vs等待洗脱期12.1±4.7天(结论：DAPT无反应/低反应率高，尤其是氯吡格雷。无应答患者在总体发病率和死亡率、出血结局或输血需求方面没有显著增加，并且具有住院时间明显缩短的优势。

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引用次数: 0

Securing Long-Term Heart Health for Australians: Understanding How Funding Structures in Cardiac Rehabilitation Influence Cardiovascular Inequities 确保澳大利亚人的长期心脏健康：了解心脏康复的资金结构如何影响心血管不公平。

IF 2.2 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart, Lung and Circulation

Pub Date : 2026-02-01 Epub Date: 2025-11-04 DOI: 10.1016/j.hlc.2025.07.016

Sarah Gauci PhD , Lan Gao PhD , Robyn Gallagher PhD , Julie Redfern PhD , Susie Cartledge PhD , Adrienne O’Neil PhD

引用次数: 0

Cardiac Society of Australia and New Zealand 澳大利亚和新西兰心脏学会

IF 2.2 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart, Lung and Circulation

Pub Date : 2026-02-01 Epub Date: 2026-02-06 DOI: 10.1016/S1443-9506(26)00027-2

引用次数: 0

A Heart of Stone: A Rare Finding in Multimodality Imaging 石之心：多模态成像的罕见发现。

IF 2.2 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart, Lung and Circulation

Pub Date : 2026-02-01 Epub Date: 2026-01-13 DOI: 10.1016/j.hlc.2025.08.032

Mariana Pereira Santos MD , David Sá Couto MD , Sónia Magalhães MD , Patrícia Rodrigues MD, PhD

引用次数: 0

Heart Smart From the Start: The Strength of Childhood Fitness 心脏从一开始就聪明：儿童健康的力量

IF 2.2 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart, Lung and Circulation

Pub Date : 2026-02-01 Epub Date: 2026-02-06 DOI: 10.1016/j.hlc.2026.01.001

引用次数: 0

TAVR in Bicuspid Aortic Valve Disease: A Meta-Analysis of Surgical Comparison and Anatomic Predictors. 二尖瓣主动脉瓣疾病的TAVR：手术比较和解剖学预测因素的荟萃分析。

IF 2.2 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart, Lung and Circulation

Pub Date : 2026-01-30 DOI: 10.1016/j.hlc.2025.11.014

Shanmukh Sai Pavan Lingamsetty, Harshith Thyagaturu, Sahas Reddy Jitta, Kesar Prajapati, Ademola Ajibade, Waleed Alruwaili, Hassan Muntazir, Irfan Zeb

Background: Despite the proven efficacy of transcatheter aortic valve replacement (TAVR) in treating tricuspid aortic valve stenosis, the bicuspid aortic valve (BAV) population has been excluded from most of the landmark trials.

Aim: This study aimed to assess the outcomes of TAVR compared with those of surgical aortic valve replacement (SAVR) and examine the impact of BAV type, aortopathy, excess leaflet calcification, and raphe calcification on BAV TAVR outcomes.

Method: We searched PubMed/MEDLINE, Embase, and Cochrane Library for studies that assessed the outcomes of TAVR in the BAV population. We also included studies of patients with BAV undergoing TAVR and SAVR, and those assessing anatomical predictors of TAVR outcomes. Random-effects models were used to calculate the pooled risk ratios, mean differences, and hazard ratios.

Results: Patients with BAV who underwent TAVR showed significantly lower risks of major bleeding and acute kidney injury, and shorter hospital stays than those who underwent SAVR. However, BAV TAVR had a higher pacemaker implantation rate. Among the BAV types, Type 0 showed a higher risk of coronary obstruction, whereas Type 1 had a lower risk of pacemaker implantation following BAV TAVR. Additionally, BAV TAVR had a higher risk of long-term mortality in patients with aortopathy (ascending aortic diameter >4.5 cm) and excessive leaflet calcification.

Conclusions: Compared with SAVR, TAVR in BAV is associated with favourable in-hospital outcomes. Anatomical features, such as BAV type, aortopathy, excess leaflet calcification, and calcified raphe, significantly influence the outcomes of TAVR in the BAV population.

背景：尽管经导管主动脉瓣置换术（TAVR）治疗三尖瓣主动脉瓣狭窄的疗效已被证实，但大多数具有里程碑意义的试验都将二尖瓣主动脉瓣（BAV）人群排除在外。目的：本研究旨在评估TAVR与外科主动脉瓣置换术（SAVR）的结果，并研究BAV类型、主动脉病变、过度小叶钙化和中叶钙化对BAV TAVR结果的影响。方法：我们检索PubMed/MEDLINE， Embase和Cochrane图书馆，以评估BAV人群中TAVR的结果。我们还纳入了BAV患者接受TAVR和SAVR的研究，以及评估TAVR结果的解剖学预测因素的研究。随机效应模型用于计算合并风险比、平均差异和风险比。结果：BAV患者行TAVR的大出血和急性肾损伤风险明显低于行SAVR的患者，住院时间明显缩短。而BAV TAVR起搏器植入率较高。在BAV类型中，0型患者冠脉阻塞的风险较高，而1型患者BAV TAVR后起搏器植入的风险较低。此外，BAV TAVR在主动脉病变（升主动脉直径4.5 cm）和小叶钙化过度的患者中具有更高的长期死亡风险。结论：与SAVR相比，BAV患者的TAVR与良好的住院预后相关。解剖特征，如BAV类型、主动脉病变、过度小叶钙化和裂口钙化，显著影响BAV人群TAVR的预后。

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引用次数: 0

Getting to the guts of hypertension 了解高血压的本质

IF 2.2 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart, Lung and Circulation

Pub Date : 2026-01-01 Epub Date: 2026-01-06 DOI: 10.1016/j.hlc.2025.12.008

引用次数: 0

Pulse Arrival Velocity for Tracking Exercise-Induced Blood Pressure Changes in Children and Adolescents 脉搏到达速度用于追踪儿童和青少年运动引起的血压变化。

IF 2.2 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart, Lung and Circulation

Pub Date : 2026-01-01 Epub Date: 2025-10-30 DOI: 10.1016/j.hlc.2025.09.005

Luke E. Ryan BEng , Melanie M. Clarke PhD , Daniel Ray PhD , Jonathan P. Glenning BBiomed , Hilary A. Harrington MN , Joseph J. Smolich PhD , Michael M.H. Cheung MD , Jonathan P. Mynard PhD

Background

The potential of cuffless blood pressure (BP) monitoring in children and adolescents is unclear. Although measurement of pulse arrival time (PAT) underlies many cuffless BP technologies, the pulse propagation distance (L) (from heart to measurement location) varies significantly during childhood growth and is likely to confound the desired relationship between PAT and BP in population-based algorithms. This study investigated whether the newly proposed pulse arrival velocity (PAV) (PAV=L/PAT) holds potential for improved tracking of exercise-induced BP changes in children and adolescents.

Method

In 38 included paediatric participants (aged 12.3±3.9 years) undergoing Bruce protocol exercise testing, regression and leave-one-out cross-validation analyses were used to assess performance of PAT and PAV for estimating exercise-induced BP changes. The results were contextualised to BP validation standards.

Results

With exercise, systolic BP increases of 36.1±15.8 mmHg were estimated by PAT-based and PAV-based models, with errors of 0.0±9.1 and 0.0±7.6 mmHg, respectively; the latter falling within the Association for the Advancement of Medical Instrumentation (AAMI) criteria of 5±8 mmHg, with high correlation (r=0.87). Diastolic BP changes (12.1±9.7 mmHg) were also estimated by PAV within the AAMI criteria (0.0±7.0 mmHg) but with modest correlation (r=0.51). Including heart rate, age, sex, or height did not improve model performance. PAV outperformed baseline models for systolic but not diastolic BP.

Conclusions

PAV shows potential for systolic BP tracking during exercise in children and adolescents. By accounting for variability in propagation length, PAV may provide better results than PAT in cuffless BP technology.

背景：在儿童和青少年中进行无套管血压（BP）监测的潜力尚不清楚。尽管脉搏到达时间（PAT）的测量是许多无袖帽BP技术的基础，但脉搏传播距离(L)（从心脏到测量位置）在儿童生长过程中变化很大，并且可能会混淆基于人群的算法中PAT和BP之间的期望关系。本研究探讨了新提出的脉搏到达速度（PAV）（PAV=L/PAT）是否具有改善儿童和青少年运动引起的血压变化跟踪的潜力。方法：纳入38名接受布鲁斯方案运动测试的儿童参与者（12.3±3.9岁），采用回归分析和留一交叉验证分析来评估PAT和PAV的表现，以估计运动引起的血压变化。结果与BP验证标准相关联。结果：运动时，基于pat和pav的模型估计收缩压升高36.1±15.8 mmHg，误差分别为0.0±9.1和0.0±7.6 mmHg；后者符合美国医疗器械进步协会（AAMI） 5±8 mmHg的标准，相关性高（r=0.87）。PAV也可在AAMI标准（0.0±7.0 mmHg）内估计舒张压变化（12.1±9.7 mmHg），但相关性不高（r=0.51）。包括心率、年龄、性别或身高并不能提高模型的表现。PAV在收缩压而不是舒张压方面优于基线模型。结论：PAV显示了儿童和青少年运动时收缩压追踪的潜力。考虑到传播长度的可变性，PAV在无断口BP技术中可能比PAT提供更好的结果。

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引用次数: 0

Reply to Letter to the Editor “Reconsidering the Roles of Computed Tomography Coronary Angiography and Stress Echocardiography in Acute Chest Pain” regarding “Computed Tomography Coronary Angiography Versus Stress Echocardiography in a Rapid Access Chest Pain Clinic” 关于“快速进入胸痛门诊的计算机断层冠状动脉造影和应激超声心动图在急性胸痛中的作用”的回复编辑“重新考虑计算机断层冠状动脉造影和应激超声心动图的作用”

IF 2.2 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart, Lung and Circulation

Pub Date : 2026-01-01 Epub Date: 2026-01-06 DOI: 10.1016/j.hlc.2025.10.011

Jacob P. George MBBS , Rebecca Kozor PhD, FRACP, FCSANZ

引用次数: 0

Corrigendum to: Abstract 402, Vol 34, Supplement 4, Page S359 (2025) (Abstracts for the 73rd Annual Scientific Meeting of the Cardiac Society of Australia and New Zealand, 14–17 August 2025) entitled ‘Validation of Device-Detected Sleep Apnoea Using Polysomnography in a Subset of Heart Failure Patients’ 摘要402，Vol 34, Supplement 4, Page S359(2025)（澳大利亚和新西兰心脏学会第73届年度科学会议摘要，2025年8月14-17日）题为“在心力衰竭患者中使用多导睡眠图验证设备检测睡眠呼吸暂停”的更正。

IF 2.2 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart, Lung and Circulation

Pub Date : 2026-01-01 Epub Date: 2026-01-06 DOI: 10.1016/j.hlc.2025.12.013

C. Lac, H. Dimitri, J. Assad, J. Tan

引用次数: 0

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