Progress in cardiovascular diseases最新文献

英文中文

Building a culture of healthy living in the workplace 在工作场所建立健康的生活文化。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.02.006

Nicolaas P. Pronk , Laurie P. Whitsel , Elizabeth Ablah , Robert E. Anderson III , Mary Imboden

Workplace settings, including hybrid, remote, and home-based environments, are key places to support employees and their families to live healthfully since so many adults spend significant amounts of time at work. Employers can create a culture of healthy living at their workplaces and do so intentionally through process and practice. They can establish organizational policies, systems, work processes, architectural design practices, and employment benefits designs to support healthy behaviors for their employees and their families. Employers also can ensure health insurance approaches that provide equitable access to quality health care. They can ensure livable wages for all staff and provide a host of other important healthy living support mechanisms, using incentives and communications. Organizational executives and upper managers play a critical role in modeling these shared values at the workplace and participatory approaches need to be implemented to give all workers opportunity to meaningfully engage. Corporate leaders can reinforce a healthy living culture with role modeling and by ensuring resources are available and accessible—to do so, a set of workplace factors should be implemented that, cumulatively, reach a tipping point toward the creation of a healthy workplace culture. Employers can both influence and be influenced by the communities in which they are located. Recognizing regional culture, participating in strategic relationships, investing in the community, and providing volunteer and civic engagement opportunities all contribute to the support of healthy living strategies in the workplace. When employers pursue a workplace culture of health, they not only do good by their employees, but they also increase the likelihood that their company may outperform their market competition.

工作场所环境，包括混合、远程和家庭环境，是支持员工及其家人健康生活的关键场所，因为许多成年人花费大量时间在工作上。雇主可以在他们的工作场所创造一种健康的生活文化，并通过过程和实践有意识地这样做。他们可以建立组织政策、系统、工作流程、建筑设计实践和就业福利设计，以支持员工及其家人的健康行为。雇主还可以确保提供公平获得高质量医疗保健的医疗保险办法。它们可以确保所有工作人员获得可维持生活的工资，并通过奖励和沟通提供一系列其他重要的健康生活支助机制。组织高管和高层管理人员在工作场所塑造这些共同价值观方面发挥着关键作用，需要实施参与式方法，让所有员工都有机会有意义地参与其中。企业领导人可以通过树立榜样来加强健康的生活文化，并通过确保资源的可用性和可获得性来做到这一点，应实施一套工作场所因素，这些因素累积起来达到创建健康工作场所文化的临界点。雇主既可以影响所在社区，也可以被所在社区影响。认识到区域文化、参与战略关系、投资于社区以及提供志愿者和公民参与机会，这些都有助于在工作场所支持健康生活战略。当雇主追求健康的职场文化时，他们不仅对员工有好处，而且还增加了公司在市场竞争中胜出的可能性。

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引用次数: 0

The American Nations model: An analytical tool for understanding the influence of U.S. regional cultures on health and the social and political determinants of health 美国国家模式：了解美国地区文化对健康的影响以及健康的社会和政治决定因素的分析工具。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.03.014

Colin Woodard , Ross Arena , Nicolaas P. Pronk

Cardiovascular disease (CVD) represents a significant health crisis, leading to premature morbidity and mortality, that is largely preventable. A decade ago, the World Health Organization formally acknowledged the powerful role culture plays in health and well-being, a key factor in preventing CVD, prompting increased attention on how shared values, norms, symbols, ethics and life practices effect the decisions and behaviors of patients, populations and practitioners alike. Cultural contexts affect human behaviors and health outcomes, and the United States (U.S.) is divided between dominant regional cultures. The American Nations model, informed by the work of cultural geographers, historians, and anthropologists, provides an analytical framework for understanding regional cultural contexts within the U.S. This model has been used to demonstrate significant regional differences in health outcomes, wellbeing, lifestyle behaviors, lifespan, and social vulnerability, with communitarian cultures consistently outperforming individualistic cultures across a broad range of phenomena. This model has significant implications for how a nation approaches health and health care, shifting from the traditional, national level one-size-fits-all paradigm to one that considers distinct regional differences based on historical settlement patterns. In this context, the American Nations model can help improve the effectiveness of health interventions by supporting a better understanding of cultural differences and the dominant U.S. cultural landscapes.

心血管疾病是一种主要的健康危机，导致过早发病和死亡，这在很大程度上是可以预防的。十年前，世界卫生组织正式承认文化在健康和福祉方面发挥的强大作用，这是预防心血管疾病的一个关键因素，促使人们更加关注共同的价值观、规范、符号、伦理和生活实践如何影响患者、人群和从业者的决策和行为。文化背景影响人类行为和健康结果，美国（美国）被划分为主要的区域文化。在文化地理学家、历史学家和人类学家的工作基础上，美国民族模型为理解美国的区域文化背景提供了一个分析框架。该模型已被用来证明在健康结果、福祉、生活方式行为、寿命和社会脆弱性方面存在显著的区域差异，在广泛的现象中，社区主义文化始终优于个人主义文化。这一模式对一个国家如何处理健康和医疗保健具有重要意义，从传统的、国家层面的“一刀切”模式转变为考虑基于历史定居模式的明显地区差异的模式。在这种背景下，美国国家模式可以通过支持更好地理解文化差异和主导的美国文化景观来帮助提高卫生干预的有效性。

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引用次数: 0

Impact of cardiac rehabilitation participation on functional capacity in patients with hypertrophic obstructive cardiomyopathy following septal myectomy surgery 心脏康复参与对肥厚性梗阻性心肌病患者中隔肌切除术后功能能力的影响。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.04.008

Gizem Cifci, Katherine R. Malterer, Elizabeth C. Arendt, Tedy Sawma, Steve R. Ommen, Hartzell V. Schaff, Ray W. Squires, Amanda R. Bonikowske, Joshua R. Smith

引用次数: 0

From illness to wellness: A focus on healthy living 从疾病到健康：关注健康生活。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.06.007

Leandro Slipczuk

引用次数: 0

Global longitudinal strain as an early marker of cardiac damage after cardiotoxic medications, a state-of-the-art review 全球纵向应变作为心脏毒性药物治疗后心脏损伤的早期标志物，最新进展综述。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-03-01 DOI: 10.1016/j.pcad.2025.01.001

Andrea Sartorio , Luca Cristin , Chiara Dal Pont , Afshin Farzaneh-Far , Simone Romano

Ejection fraction (EF) is the principal parameter used clinically to assess cardiac function and provides prognostic information. However, significant myocardial damage can be present despite preserved EF. Recently, the measurement of left ventricle (LV) deformation by global longitudinal strain (GLS) has been introduced as a novel early marker of cardiac dysfunction. Cardiotoxicity is a frequent side effect of several drugs most notably those used in the treatment of cancer. Although oncology drugs remain the best known cardiotoxic medications, many other drugs can potentially affect LV function. The early recognition of LV dysfunction due to cardiotoxicity is important and of increasing clinical relevance particularly with the rapid pace of development of new drugs.

The aim of our review is to provide an overview of the current literature regarding utility of GLS to assess drug-induced myocardial damage. We propose that GLS is a sensitive early marker of myocardial dysfunction associated with the use of certain medications with high risk of cardiotoxicity. Thus, the use of this technique can potentially alert the clinician to myocardial toxicity before reductions in EF are seen.

射血分数（EF）是临床上用于评估心功能和提供预后信息的主要参数。然而，尽管保留了EF，仍可能出现明显的心肌损伤。近年来，全球纵向应变（GLS）测量左心室（LV）变形已被引入作为一种新的心功能障碍的早期标志。心脏毒性是几种药物的常见副作用，尤其是用于治疗癌症的药物。虽然肿瘤药物仍然是最著名的心脏毒性药物，但许多其他药物也可能影响左室功能。早期识别由心脏毒性引起的左室功能障碍是很重要的，特别是随着新药的快速发展，其临床意义越来越大。我们回顾的目的是提供关于GLS在评估药物性心肌损伤中的应用的当前文献综述。我们认为，GLS是心肌功能障碍的敏感早期标志物，与使用某些具有心脏毒性高风险的药物有关。因此，使用这种技术可以在EF降低之前提醒临床医生注意心肌毒性。

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引用次数: 0

Are ORBITA trials practice-changing? ORBITA的试验会改变实践吗？

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-03-01 DOI: 10.1016/j.pcad.2025.03.005

Florian Zores , Sanjay Kaul

引用次数: 0

Survival of the fittest? Peak oxygen uptake and all-cause mortality among older adults in Norway 适者生存？挪威老年人的峰值摄氧量和全因死亡率。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-03-01 DOI: 10.1016/j.pcad.2024.11.004

Atefe R. Tari , Daniel E. Brissach , Emma M.L. Ingeström , Javaid Nauman , Tristan Tyrell , Carl Foster , Kimberley Radtke , John P. Porcari , Stian Lydersen , Leonard A. Kaminsky , Jonathan Myers , Tara L. Walker , Jeff S. Coombes , Dorthe Stensvold , Ulrik Wisløff

Objective

To determine the cardiorespiratory fitness (CRF) levels needed to avoid the Grim Reaper (Death) among older adults. We hypothesized that an above average peak oxygen uptake (VO_2peak) is needed for 70–77-year-old men and women to delay the encounter with Death.

Design

Prospective cohort study.

Setting

General population of older adults in Norway.

Participants

788 women and 777 men aged 70–77 years.

Intervention

Clinical assessments, including a test of VO_2peak. Participants were categorised based on their baseline VO_2peak and changes after 1 year. This study explored associations between VO_2peak and 5-year all-cause mortality using Cox proportional hazard models.

Main outcome measure

All-cause mortality.

Results

Death caught up with 5.3 % of men and 3.7 % of women. Compared to unfit men and women, fewer men (Hazard Ratio [HR]: 0.34, 95 % Confidence Interval [CI] 0.15–0.78) and women (HR: 0.41, 95 % CI 0.17–0.98) classified as moderately fit encountered Death with no additional risk reduction among those classified as being more fit. It appears to be easier for the Grim Reaper to claim those in poorer physical condition, specifically VO_2peak levels <26.5 mL/kg/min for men and 22.2 mL/kg/min for women (corresponding to ≥85 % of the observed age- and sex-specific average).

Conclusion

The Grim Reaper typically targets individuals with VO_2peak levels <26.5 mL/kg/min/ and <22.2 mL/kg/min when chasing male and female souls aged 70–77 years, respectively, reflecting his penchant for limited CRF. These data underscore the importance of maintaining or enhancing CRF throughout life, providing clear targets for clinicians in assessing patient CRF levels.

Trial registration: ClinicalTrials.gov NCT01666340.

目的：确定老年人避免死神（死亡）所需的心肺健康（CRF）水平。我们假设70-77岁的男性和女性需要高于平均的峰值摄氧量（vo2峰值）来延迟与死亡的接触。设计：临床前瞻性队列研究。背景：挪威的普通老年人。参与者：年龄在70-77岁之间的788名女性和777名男性 岁。干预措施：临床评估，包括vo2峰值测试。参与者根据他们的基线vo2峰值和1 年后的变化进行分类。本研究使用Cox比例风险模型探讨了vo2峰值与5年全因死亡率之间的关系。主要结局指标：全因死亡率。结果：男性死亡率为5.3% %，女性死亡率为3.7% %。与不适合的男性和女性相比，被分类为中度适合的男性（危险比[HR]: 0.34, 95 %可信区间[CI] 0.15-0.78）和女性（危险比：0.41,95 % CI 0.17-0.98）较少死亡，而被分类为更适合的男性和女性没有额外的风险降低。似乎死神更容易宣称那些身体状况较差的人，特别是vo2峰值水平的人结论：死神通常针对vo2峰值水平的人试验注册：ClinicalTrials.govNCT01666340。

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引用次数: 0

Association of neighborhood median income to outcomes in hypertrophic cardiomyopathy 社区中等收入与肥厚性心肌病预后的关系。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-03-01 DOI: 10.1016/j.pcad.2025.03.002

Raoul R. Wadhwa , Rohan M. Desai , Shilpa Rao , Ala Alashi , Bo Xu , Susan Ospina , Nicholas G. Smedira , Maran Thamilarasan , Zoran B. Popovic , Milind Y. Desai

Background

Neighborhood median household income (NMHI), a key social determinant of health, is being recognized as a major source of inequity in healthcare. Its impact on patients with hypertrophic cardiomyopathy (HCM) is uncertain.

Objective

We sought to study the association between NMHI and long-term outcomes of HCM patients.

Methods

This was an observation registry of 6368 HCM patients (median age 56 years, 58 % men, 83 % white, 32 % with ≥1 sudden death risk factor) who underwent a clinical evaluation at a tertiary care center between 2002 and 18. NMHI (US$) was calculated from each patient's zip code, using data from the US Census Bureau and Department of Housing & Urban Development. The primary outcome was death, appropriate internal cardioverter defibrillator (ICD) discharge or heart transplant in follow up.

Results

Patients were categorized as obstructive (oHCM, n = 3827 or 60 %, 65 % symptomatic, median NMHI $51,600) and nonobstructive (nHCM, n = 2541 or 40 %, 73 % asymptomatic, median NMHI $53,700) using echocardiography. At a median of 6 years (interquartile range or IQR 2.91, 9.74), there were 998 (16 %) primary events (deaths = 939), with breakdown as follows: 599/3827 (16 %) in oHCM and 399/2541 (16 %) in nHCM, respectively. On multivariable Cox survival analysis, a higher NMHI was independently associated with improved long-term freedom from primary events (oHCM [Hazard ratio or HR 0.84 95 % Confidence Interval or CI 0.80–0.88] and nHCM [HR 0.95 95 % CI 0.91–9.97]), both p < 0.01. On penalized spline analysis, the NMHI at which the hazard for primary events crossed 1 was ∼$52,000 for both oHCM and nHCM. In nHCM patients, NMHI greater than $52,000 was associated with improved longer-term freedom from primary events vs. those whose NMHI was lower than $52,000 (196/1398 [14 %] vs. 203/1143 [18 %], log-rank p-value<0.01). Similarly, oHCM patients with NMHI greater than $52,000 had significantly improved longer-term freedom from primary events vs. those whose NMHI was lower than $52,000 (186/2067 [9 %] vs. 413/1760 [23 %] vs., log-rank p-value<0.001).

Conclusions

NMHI, a marker of socioeconomic status, is independently associated with outcomes in patients with HCM. oHCM patients below the NMHI cutoff had significantly worse long-term outcomes vs. the nHCM patients similarly below the NMHI cutoff.

背景：社区家庭收入中位数（NMHI）是健康的一个关键社会决定因素，正被认为是卫生保健不公平的一个主要来源。它对肥厚性心肌病（HCM）患者的影响尚不确定。目的：我们试图研究NMHI与HCM患者长期预后之间的关系。方法：这是对6368例HCM患者（中位年龄56 岁，58% %男性，83% %白人，32% %具有≥1个猝死风险因素）的观察登记，这些患者在2002年至2018年期间在三级保健中心接受了临床评估。NMHI（美元）是根据每个患者的邮政编码计算的，使用的数据来自美国人口普查局和住房与城市发展部。主要结局为死亡、适当的内转复除颤器（ICD）出院或心脏移植。结果：超声心动图将患者分为梗阻性（oHCM, n = 3827或60 %，65 %有症状，NMHI中位数51,600美元）和非梗阻性（nHCM, n = 2541或40 %，73 %无症状，NMHI中位数53,700美元）。在中位数为6 年（四分位间距或IQR为2.91,9.74）时，有998例（16 %）主要事件（死亡 = 939），细分如下：oHCM为599/3827(16 %)，nHCM为399/2541（16 %）。在多变量Cox生存分析中，较高的NMHI与改善长期免于原发事件的独立相关（oHCM[风险比或HR 0.84 95 %可信区间或CI 0.80-0.88]和nHCM [HR 0.95 95 % CI 0.91-9.97]），均为p 结论：NMHI是社会经济地位的标志，与HCM患者的预后独立相关。低于NMHI临界值的oHCM患者与低于NMHI临界值的nHCM患者相比，其长期预后明显更差。

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Assorted topics in cardiovascular disease 2025: Novel insights in prevention, diagnosis, and treatment 2025年心血管疾病分类主题：预防、诊断和治疗方面的新见解。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-03-01 DOI: 10.1016/j.pcad.2025.03.008

Leandro Slipczuk

引用次数: 0

Stepping up physical activity and fitness is needed for longevity 要想长寿，就必须加强体育锻炼，增强体质。

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Progress in cardiovascular diseases

Pub Date : 2025-03-01 DOI: 10.1016/j.pcad.2025.03.012

Carl J. Lavie , Fabian Sanchis-Gomar , Andre La Gerche , Jari A. Laukkanen

引用次数: 0

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