Heart & Lung最新文献

{"title":"Door-to-Diuretic Time is related to length of hospital stay independent of diuretic dose among acute decompensated heart failure patients.","authors":"Dillon J Dzikowicz, Mehmed Aktas, Sunita Pokhrel Bhattarai, Leway Chen, Mary G Carey","doi":"10.1016/j.hrtlng.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.11.002","url":null,"abstract":"<p><strong>Background: </strong>Acute decompensated heart failure (ADHF) treatment guidelines recommend initial dosages for diuretic drugs but lack guidance on treatment timing. Recent evidence indicates that faster treatment, or shorter Door-to-Diuretic (D2D) Time, may improve outcomes.</p><p><strong>Objectives: </strong>This study assessed how diuretic dose, D2D Time, and their interaction affect hospital length of stay.</p><p><strong>Methods: </strong>Data were analyzed from medical records of ADHF patients in the emergency department of a large academic center. We calculated the odds of longer hospitalization (>7 days) based on diuretic dose, D2D Time, and their interaction, adjusting for age, sex, race, NYHA class, creatinine levels, systolic blood pressure, and comorbidity burden.</p><p><strong>Results: </strong>Our sample of 198 patients who were hospitalized a total of 275 times (mean: 1.48±0.99 hospitalizations) were predominantly male (57 %), older (71, IQR:18.5), years), overweight/obese (30.12, IQR: 11.66 kg/m²), had multiple comorbidities (5.6 ± 2.1), and had a reduced ejection fraction (58 %, n = 159). The median length of hospital stay was 7.0 days (8.0). Peripheral edema was significantly higher among ADHF patients with prolonged hospitalization (28.69% vs. 15.68 %, p = 0.01). D2D Time was a statistically significant predictor of prolonged hospitalization without (OR=1.011609, p = 0.041) and with (OR=1.012409, p = 0.034) covariate adjustment. Neither the diuretic dose nor the interaction between the D2D Time and dose were significant predictors.</p><p><strong>Conclusion: </strong>D2D Time significantly predicts prolonged hospitalization independently of diuretic dosing, highlighting a need for revised ADHF guidelines that include both diuretic dosing and timely administration. Further research is essential to refine these recommendations.</p>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"36-42"},"PeriodicalIF":2.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683799","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":"Reliability, internal consistency, and validity of the World Health Organization disability assessment schedule (WHODAS) 2.0 among adults with heart failure","authors":"Georgia de Melo Castro Gondim ,&nbsp;Julia Maria Sales Bedê ,&nbsp;Cristiany Azevedo Martins ,&nbsp;Francisco Vandecir da Silva ,&nbsp;Brenno Lucas Rodrigues da Silveira ,&nbsp;Vitória Fonteles Ribeiro ,&nbsp;Scheidt Martins da Saúde ,&nbsp;Almino Cavalcante Rocha Neto ,&nbsp;Rafael Mesquita ,&nbsp;Daniela Gardano Bucharles Mont'Alverne","doi":"10.1016/j.hrtlng.2024.11.003","DOIUrl":"10.1016/j.hrtlng.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure (HF) imposes significant disability. The World Health Organization Disability Assessment Schedule (WHODAS) 2.0 is a generic instrument that measures disability. Although it has been used in HF, no previous study has investigated its measurement properties in this group.</div></div><div><h3>Objective</h3><div>To assess the test-retest reliability, internal consistency, convergent, and discriminant validity of WHODAS 2.0 in individuals with HF.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study that included individuals with HF treated at the outpatient cardiology center. Data included sociodemographic and clinical (e.g., New York Heart Association - NYHA) characteristics, estimated functional capacity (Duke Activity Status Index - DASI), quality of life (Minnesota Living with Heart Failure Questionnaire - MLHFQ), and disability (the WHODAS 2.0 36-item version). We assessed associations, using Pearson's correlation coefficient or the Kruskal-Wallis test, between the WHODAS 2.0 scores and the MLHFQ, DASI, and NYHA. The WHODAS 2.0 results were collected again seven days after the initial assessment for reliability (intraclass correlation coefficient - ICC).</div></div><div><h3>Results</h3><div>Participants were 100 people with HF (M age = 57.8 ± 14 years, 57 % men), of whom 84 % were literate. The WHODAS 2.0 was reliable (ICC = 0.789) and had good internal consistency (Cronbach's alpha &gt;0.7 in all domains). Convergent validity was observed through moderate correlations with DASI and MLHFQ and discriminant validity with statistically different results according to NYHA classes.</div></div><div><h3>Conclusion</h3><div>WHODAS 2.0 is a reliable, consistent, and valid instrument for measuring disability in individuals with HF. Further research is needed to evaluate other properties, such as its responsiveness to interventions.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 30-35"},"PeriodicalIF":2.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649874","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":"Lymphocyte-based inflammatory markers: Novel predictors of significant coronary artery disease✰,✰✰","authors":"Dania A. Bani Hani RN, MSN, PhD ,&nbsp;Jafar A. Alshraideh PhD ,&nbsp;Akram Saleh MD, FRCP ,&nbsp;Hamza Alduraidi PhD, MPH, RN ,&nbsp;Abeer A. Alwahadneh RN, PhD (c) ,&nbsp;Salah S. Al-Zaiti PhD","doi":"10.1016/j.hrtlng.2024.11.006","DOIUrl":"10.1016/j.hrtlng.2024.11.006","url":null,"abstract":"<div><h3>Background</h3><div>Lymphocyte-based inflammatory indices such as monocyte-to-lymphocyte ratio (MLR) have long been recognized as reliable coronary artery disease (CAD) predictors. More recently, novel indices like the Systemic Inflammatory Index (SII), Systemic Inflammatory Response Index (SIRI), and Systemic Immune-Inflammation Index (SIIRI) have emerged. These newer markers offer a more comprehensive assessment of inflammation by integrating multiple immune cell types, potentially enhancing the prediction of cardiovascular outcomes.</div></div><div><h3>Objectives</h3><div>We evaluated the predictive value of novel inflammatory markers in estimating the pretest probability of severe CAD in high-risk patients.</div></div><div><h3>Methods</h3><div>We enrolled consecutive patients undergoing diagnostic coronary angiography in a single tertiary care hospital. Inflammatory markers were calculated based on pre-procedural complete blood count laboratory measurements. Severe CAD was defined as critical (&gt;70 %) and actionable narrowing of a primary coronary artery. Classification performance was assessed using multivariate logistic regression.</div></div><div><h3>Results</h3><div>The study sample included 363 patients (age 58.9± 11 years, 44.9 % females, 30 % severe CAD). In univariate analysis, MLR, SIRI, and SIIRI were significant predictors of severe CAD, with age- and sex-adjusted OR of 1.98 [1.25–3.14], 1.79 [1.24–2.59], and 1.63 [1.11–2.38], respectively. In multivariate analysis, SIRI remained an independent predictor of severe CAD (OR = 1.98, 95 % CI 1.13–3.46, <em>p</em> = 0.02).</div></div><div><h3>Conclusion</h3><div>Our results suggest that novel inflammatory markers derived from routine blood tests are predictive of severe CAD in high-risk patients. Such simple, practical, and cost-effective inflammatory markers may enhance cardiac risk stratification and prediction of severe CAD.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 23-29"},"PeriodicalIF":2.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645230","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":"Preliminary efficacy of the vidatalkTM communication application on family psychological symptoms in the intensive care unit: A pilot study","authors":"Ji Won Shin PhD, RN ,&nbsp;Alai Tan PhD ,&nbsp;Judith Tate PhD, RN, ATS-F ,&nbsp;Michele Balas PhD, RN, CCRN-K, FCCM, FAAN ,&nbsp;Holly Dabelko-Schoeny PhD ,&nbsp;Mary Beth Happ PhD, RN, FGSA, FANN","doi":"10.1016/j.hrtlng.2024.11.001","DOIUrl":"10.1016/j.hrtlng.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Family caregivers of ICU patients experience difficulty communicating with patients during mechanical ventilation. Little is known about patient-family communication in the ICU and the associated emotional distress.</div></div><div><h3>Objectives</h3><div>To examine the preliminary effects of the VidaTalk™ communication app on anxiety, depression, and PTSD-related symptoms among family caregivers.</div></div><div><h3>Methods</h3><div>We conducted a prospective study using repeated measures to compare VidaTalk™ to an attention control condition. Twenty-eight family caregivers of nonvocal adult ICU patients participated in this study. The intervention group received VidaTalk™, whereas the attention control group received a standard tablet loaded with MyChart Bedside (EPIC) and game apps during the patient's mechanical ventilation treatment. Family caregiver anxiety and depression (Hospital Anxiety and Depression Scale) were measured at baseline, at extubation/ICU discharge, and 1-, 3-, and 6-months post-ICU discharge. PTSD-related symptoms (Impact of Event Scale-revised) were measured at 1-, 3-, and 6-months. T-tests were used for group comparisons for families’ perceived communication difficulty, anxiety, and depression, and Mann-Whitney U tests were used for PTSD-related symptom comparisons.</div></div><div><h3>Results</h3><div>No statistically significant difference was found between groups in changes in family psychological outcomes, the VidaTalk™ was associated with a small to medium improvement in anxiety symptoms (<em>d</em> = 0.43) at one month. The VidaTalk™ group had lower PTSD-related symptoms than the AC group with a medium effect size (ɳ2=0.07) at one month and a medium-to-large effect size (ɳ2=0.09) at three months.</div></div><div><h3>Conclusions</h3><div>: The VidaTalk™ demonstrated potential as a family caregiving intervention that may be associated with reduced family psychological symptoms.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 14-22"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640320","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":"Bone mineral density and TAVR outcome: A comparative analysis between patients with enhanced and non-enhanced TAVR CT scans","authors":"Caglayan Demirel MD ,&nbsp;Kevin Hamzaraj MD ,&nbsp;Anna Seeber ,&nbsp;Rayyan Hemetsberger MD ,&nbsp;Sophia Koschatko MD ,&nbsp;Charlotte Jantsch MD ,&nbsp;Kseniya Halavina MD ,&nbsp;Carolina Dona MD ,&nbsp;Matthias Koschutnik MD ,&nbsp;Katharina Mascherbauer MD ,&nbsp;Gregor Heitzinger MD ,&nbsp;Varius Dannenberg MD ,&nbsp;Christian Nitsche MD ,&nbsp;Martin Andreas MD, PhD ,&nbsp;Christian Hengstenberg MD ,&nbsp;Philipp E Bartko MD, PhD ,&nbsp;Andreas Kammerlander MD, PhD","doi":"10.1016/j.hrtlng.2024.10.014","DOIUrl":"10.1016/j.hrtlng.2024.10.014","url":null,"abstract":"<div><h3>Background</h3><div>Preprocedural evaluation, including frailty estimation, is crucial in managing patients undergoing Transcatheter Aortic Valve Replacement (TAVR). This involves mandatory computed tomography (CT) scans for assessing body composition parameters. The impact of low bone mineral density (BMD) on TAVR outcomes remains unclear, especially when measured using both non-enhanced and contrast-enhanced CT scans.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to evaluate the influence of low bone mineral density (BMD) on survival following TAVR and to assess the feasibility of BMD measurement conducted with non-enhanced and enhanced TAVR CT scans.</div></div><div><h3>Methods</h3><div>A cohort of consecutive TAVR-scheduled patients (<em>n</em> = 725, November 2015 to March 2022) with available enhanced and non-enhanced CT scans were included. BMD was quantified on a single axial image at the thoracic vertebrae level in both unenhanced and enhanced CT scans, and low BMD was defined as &lt;200 HU. Cox regression was performed for cofounders, which are mainly associated with osteoporosis.</div></div><div><h3>Results</h3><div>A total of 725 patients were included in the study, with 54.1 % being male and a mean age of 80.7 ± 7.3 years. Out of these, 175 patients died during a median follow-up period of 837 days. Lower BMD in patients assessed using non-enhanced CT scans was significantly associated with reduced survival, even after adjusting for predictors of osteoporosis (<em>p</em> = 0.046). However, this association was not observed in patients who underwent contrast-enhanced CT scans (<em>p</em> = 0.830).</div></div><div><h3>Conclusion</h3><div>Opportunistic BMD measurements on non-enhanced TAVR-CT scans are feasible and a predictor for poor adverse after TAVR, providing valuable insights for comprehensive frailty assessments. This underscores the significance of incorporating non-enhanced BMD assessments into the preprocedural evaluations of TAVR patients. However, this association was not observed in contrast-enhanced CT scans.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 8-13"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631635","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 triglyceride glucose index and asthma exacerbation: A population-based study","authors":"Zhou Jin,&nbsp;Wen Sun,&nbsp;Junjun Huang,&nbsp;Mengyun Zhou,&nbsp;Chunbo Zhang,&nbsp;Bangchao Zhao,&nbsp;Guangfa Wang","doi":"10.1016/j.hrtlng.2024.11.005","DOIUrl":"10.1016/j.hrtlng.2024.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction is associated with respiratory diseases, and the triglyceride-glucose (TyG) index is an important indicator of metabolic dysfunction.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to explore the possible relationship between TyG and asthma exacerbation, while also investigating potential subgroup differences in this relationship.</div></div><div><h3>Methods</h3><div>Data from the 2009–2018 National Health and Nutrition Examination Survey (NHANES) were included. Multifactorial logistic regression, subgroup analysis, smoothed curve fitting, and threshold effect analysis models were used to explore the relationship between TyG and asthma exacerbations.</div></div><div><h3>Results</h3><div>A total of 964 participants were included in the analysis (34.13 % male, 65.87 % female, 45.4 % Non-Hispanic White, 25.3 % Non-Hispanic Black), with a mean age of 50.57 ± 17.32 years. We found a nonlinear positive relationship between TyG and asthma exacerbation, which was maintained in all three models. In the fully adjusted model, the risk of asthma exacerbation increased by 25 % with each unit increase in the patient's TyG level (OR:1.25, 95 %CI: 1.21–1.30). Subgroup analysis showed significant associations between TyG and asthma exacerbations among females, as well as in individuals aged 20–59, body mass index (BMI) &lt;25 or BMI≥30. Furthermore, a U-shaped relationship between TyG and asthma exacerbation was identified in males using smoothed curve fitting, with an inflection point at the TyG level of 9.15.</div></div><div><h3>Conclusions</h3><div>We found a nonlinear positive association between TyG and asthma exacerbation. Our study highlights the potential clinical value of TyG in managing asthma exacerbations, particularly emphasizing the need for gender-specific risk management strategies.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 1-7"},"PeriodicalIF":2.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631630","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":"Latent profile analysis of dyspnea-related kinesiophobia in older adults with chronic obstructive pulmonary disease","authors":"Li-chen Peng ,&nbsp;Min Xu ,&nbsp;Ying Wang ,&nbsp;Run-ling Guo ,&nbsp;Liang Wang ,&nbsp;Xin-xin Wang ,&nbsp;Li-ling Xu","doi":"10.1016/j.hrtlng.2024.10.016","DOIUrl":"10.1016/j.hrtlng.2024.10.016","url":null,"abstract":"<div><h3>Background</h3><div>Dyspnea-related kinesiophobia refers to restrictions or avoidance of activities due to fear of dyspnea and is prevalent among older adults with chronic obstructive pulmonary disease (COPD). Hence, there is a need to identify subgroups of dyspnea-related kinesiophobia among older adults with COPD to support the development of strategies to increase activity levels.</div></div><div><h3>Objective</h3><div>The purpose of this study was to investigate dyspnea-related kinesiophobia among older adults with COPD, explore heterogeneity in kinesiophobia within subgroups of this population, and analyze the characteristics of different subgroups of kinesiophobia.</div></div><div><h3>Method</h3><div>This cross-sectional study was conducted from November to December 2023 in Fenyang City, Shanxi Province, China, via face-to-face questionnaire surveys of hospitalized adults with COPD aged over 60 years in four secondary or tertiary hospitals. The Breathlessness Beliefs Questionnaire (BBQ) was used to measure dyspnea-related kinesiophobia. Latent profile analysis was employed to classify the subgroups. CChi-square tests and binary logistic regression were used to examine the effects of sociodemographic factors, marital status, education, income, daily activities, general health, and COPD severity across different profiles.</div></div><div><h3>Results</h3><div>A total of 384 older adults with COPD (Male <em>N</em> = 228, aged 60–88) were included in the study. Their average BBQ score was (39.15±5.59). Latent profile analysis identified two groups: 230 participants (59.9 %) in the low-level kinesiophobia group (C1) and 154 participants (40.1 %) in the high-level kinesiophobia group (C2). Multivariable stepwise binary logistic regression analysis revealed that older adults with COPD who engaged in exercise less than three days weekly reported an average monthly household income of &lt;3000 CNY, unmarried status (including unmarried, divorced, or widowed), a Charlson Comorbidity Index (CCI) &gt;1, more than three exacerbations within one year or with moderate (GOLD 2 Criteria)-severe (GOLD3) COPD were more likely to be the high-level kinesiophobia group (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Dyspnea-related kinesiophobia manifests in two groups among older adults. Targeted interventions for different subgroups should be further developed to promote health and reduce nursing burdens.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Pages 241-247"},"PeriodicalIF":2.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631629","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":"Predictive potential of pre-procedural cardiac and inflammatory biomarkers regarding mortality following transcatheter aortic valve implantation: A systematic review and meta-analysis","authors":"Hani AziziKia ,&nbsp;Asma Mousavi ,&nbsp;Shayan Shojaei ,&nbsp;Farhad Shaker ,&nbsp;Dorsa Salabat ,&nbsp;Razman Arabzadeh Bahri ,&nbsp;Reza Hosseini Dolama ,&nbsp;Hanieh Radkhah MD","doi":"10.1016/j.hrtlng.2024.10.011","DOIUrl":"10.1016/j.hrtlng.2024.10.011","url":null,"abstract":"<div><h3>Background</h3><div>Aortic stenosis (AS) is a common heart valve disease, especially in aging populations. While surgical aortic valve replacement (SAVR) is the standard treatment, many patients are ineligible. Transcatheter aortic valve implantation (TAVI) offers an alternative, especially for high-risk patients, but is not without complications. Identifying biomarkers that predict post-TAVI mortality is essential for optimizing outcomes.</div></div><div><h3>Objectives</h3><div>The purpose of this systematic review and meta-analysis is to evaluate the role of cardiac and inflammatory biomarkers in predicting short-term and mid to long-term mortality following TAVI.</div></div><div><h3>Methods</h3><div>We searched PubMed, Scopus, Embase, and Web of Science for studies examining the impact of inflammatory and cardiac biomarkers on mortality following TAVI. Mean differences (MDs) and 95 % confidence interval (CI) were calculated using a random-effect model.</div></div><div><h3>Results</h3><div>Twenty-eight studies involving 10,560 patients were included, with 1867 in the mortality group. Mortality was significantly associated with higher pre-procedural levels of creatinine (0.41; 95 % CI: [0.35, 0.48]), brain natriuretic peptide (0.58; 95 % CI: [0.43, 0.73]), C-reactive protein (0.55; 95 % CI: [0.45, 0.64]), and white blood cell count (0.18; 95 % CI: [0.06, 0.31]), and lower pre-procedural levels of hemoglobin (−0.49; 95 % CI: [−0.60, −0.38]) and albumin (−0.18; 95 % CI: [−0.24, −0.13]). These associations remained statistically significant in subgroup analyses for both mid to long-term mortality and short-term mortality, except for WBC levels, which were not significantly associated with short-term mortality, and Hb, for which short-term data were insufficient. Platelet count showed no significant difference.</div></div><div><h3>Conclusion</h3><div>These findings highlight the importance of inflammatory and cardiac biomarkers in risk stratification and patient management in TAVI procedures.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Pages 229-240"},"PeriodicalIF":2.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593226","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 associated with chronic Chagas cardiomyopathy increases the risk of impaired lung function and reduced submaximal functional capacity","authors":"Patrício Braz da Silva ,&nbsp;Clara Pinto Diniz ,&nbsp;Mauro Felippe Felix Mediano ,&nbsp;Fernanda de Souza Nogueira Sardinha Mendes ,&nbsp;Alejandro Marcel Hasslocher-Moreno ,&nbsp;Luis Felipe Fonseca Reis ,&nbsp;Michel Silva Reis ,&nbsp;Roberto Magalhães Saraiva ,&nbsp;Marcelo Teixeira de Holanda ,&nbsp;Flavia Mazzoli-Rocha ,&nbsp;Andréa Silvestre de Sousa","doi":"10.1016/j.hrtlng.2024.10.009","DOIUrl":"10.1016/j.hrtlng.2024.10.009","url":null,"abstract":"<div><h3>Background</h3><div>With the evolution of chronic Chagas cardiomyopathy (CC) and the progression towards heart failure (HF), patients may show a decline in inspiratory muscle strength, lung function, and functional capacity.</div></div><div><h3>Objective</h3><div>We compared respiratory function and submaximal functional capacity in patients with CC with versus without HF.</div></div><div><h3>Methods</h3><div>This observational, cross-sectional study was carried out with CC patients divided into CCG, a group without HF (<em>n</em> = 28), and HFG, a group with HF (<em>n</em> = 27). Spirometry (percent predicted forced vital capacity (ppFVC), forced expiratory volume in one second of FVC (ppFEV₁), forced expiratory flow between 25 % and 75 % of FVC (ppFEF_25–75 _%), and maximum voluntary ventilation (ppMVV)) and submaximal functional capacity (six-minute step test: 6MST) were evaluated. Mann-Whitney (comparison of pulmonary function and functional capacity between groups) and linear regression (association between the presence of HF and other variables) were performed.</div></div><div><h3>Results</h3><div>We included 55 participants, with median age of 67 years (56.25–71.75) and 54.55 % males. Dyslipidemia was the most recurrent comorbidity (49.09 %). HFG presented lower ppFVC (<em>P</em> = 0.000), ppFEV₁ (<em>P</em> = 0.011), ppFEF_25–75 _% (<em>P</em> = 0.017), and ppMVV (<em>P</em> = 0.003) than the CCG. The ppFVC (<em>B</em> = -18.95; <em>P</em> = 0.000), ppFEV₁ (<em>B</em> = -16.29; <em>P</em> = 0.021), ppFEF_25–75 _% (<em>B</em> = -19.57; <em>P</em> = 0.014), ppMVV (<em>B</em> = -16.59; <em>P</em> = 0.003), and 6MST (<em>B</em> = -17.13; <em>P</em> = 0.034) were negatively associated with the presence of HF.</div></div><div><h3>Conclusion</h3><div>Our data suggest that impaired lung function, compatible with a restrictive pulmonary pattern, is present among adults with CC and HF.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Pages 222-228"},"PeriodicalIF":2.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592332","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":"Short (30 Minutes) versus long (120 Minutes) spontaneous breathing trial among patients with difficult weaning (SL-SBT Trial)","authors":"Vijay Hadda ,&nbsp;Arunachalam Meenakshisundaram ,&nbsp;Saurabh Mittal ,&nbsp;Karan Madan ,&nbsp;Pawan Tiwari ,&nbsp;Tejas Menon Suri ,&nbsp;Maroof Ahmad Khan ,&nbsp;Anant Mohan","doi":"10.1016/j.hrtlng.2024.10.008","DOIUrl":"10.1016/j.hrtlng.2024.10.008","url":null,"abstract":"<div><h3>Background</h3><div>The optimal duration of spontaneous breath trial (SBT) for patients with difficult extubation from mechanical ventilation is unknown.</div></div><div><h3>Objective</h3><div>This study compared extubation success with two different durations of SBT in patients who failed their first SBT.</div></div><div><h3>Methods</h3><div>This single-center randomized controlled trial included adults on mechanical ventilation who had failed their first SBT. The participants were randomized to receive pressure support ventilation (PSV) for either 30 or 120 min. Our primary outcome was the rate of successful extubation (without reintubation within 48 h). Key secondary outcomes were the length of intensive care unit (ICU) and hospital stay and in-hospital and 90-day mortality.</div></div><div><h3>Results</h3><div>A total of 119 patients (62.2 % male) with a mean age of 53.9 years were randomized to undergo SBT for either 30 min (<em>n</em> = 60) or 120 min (<em>n</em> = 59). Among them, 82.4 % of patients had hypercapnic respiratory failure. The rates of successful extubation were similar with SBT of 30 min and 120 min (58.3 % vs. 59.3 %, respectively; <em>p</em> = 0.91). There were no significant differences between the two groups in terms of the durations of ICU and hospital stay or in-hospital and 90-day mortality.</div></div><div><h3>Conclusions</h3><div>Extubation success and other clinically important outcomes were comparable between short (30 min) and long (120 min) SBT in difficult weaning. A 30-minute SBT may be acceptable in this setting.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Pages 217-221"},"PeriodicalIF":2.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586488","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}