Heart & Lung最新文献

英文中文

Comparing perceptions of leading causes of death in a diverse sample of community-dwelling women in the United States

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung

Pub Date : 2025-03-01 DOI: 10.1016/j.hrtlng.2025.02.007

Yoshimi Fukuoka PhD, RN, FAAN (Professor) , Diane Dagyong Kim MA, PhD (student) , Haruno Suzuki MS, RN, PhD (student) , Kenji Sagae PhD (Professor) , Holli A. DeVon PhD, RN, FAAN, FAHA (Professor) , Thomas J. Hoffmann PhD (Professor) , Jingwen Zhang PhD (Associate Professor)

Background

Heart disease is the leading cause of death (LCOD) for women in the United States. However, despite decades of public health campaigns, awareness of heart disease among women, especially those with racial/ethnic minority backgrounds and young women, significantly declined from 2009 to 2019.

Objectives

The aim of this study was to compare the differences in heart disease awareness as the LCOD among Black, Hispanic, White, and Asian/Other women groups.

Methods

In this cross-sectional, online survey study, 422 community-dwelling women were analyzed. Heart disease as the LCOD was categorized as the correct answer. We implemented log-linear models via a Poisson regression to estimate unadjusted and adjusted relative risks [RRs] of race in predicting correct knowledge of LCOD.

Results

The mean age was 41.2 (±12.9) years. The sample represents 39.8 % Hispanic, 28.4 % White, 19.9 % Black, 11.9 % Asian/others. After adjusting for age and cardiovascular disease risks, Black and Hispanic women, as compared to White women, had significantly lower awareness of heart disease as the LCOD [(Adjusted RR=0.69, 95 % CI: 0.52, 0.92); (Adjusted RR= 0.78, 95 % CI: 0.78 -0.94), respectively]. Additionally, physical inactivity and hypertension medication intake were significantly associated with this level of awareness (P < 0.5).

Conclusion

Lower heart disease awareness in Black and Hispanic women persists. It is crucial to develop more effective approaches to close this disparity. Testing new methods, such as applying artificial intelligence to send more culturally appropriate and personalized messages, is urgently needed to raise women's awareness of their heart disease risk.

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引用次数: 0

Effects of the oral probiotic Familact on dyspnea management in COPD patients: A randomized controlled trial

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung

Pub Date : 2025-02-27 DOI: 10.1016/j.hrtlng.2025.02.002

Mehdi Aghamohammadi , Samad Ghodrati , Nooshin Jalili , Roghayeh Jafari , Effat Rafiee , Koorosh Kamali , Mahsa Ghasemi , Javad Alizargar

Background

Emerging evidence suggests that oral probiotics may enhance the immune response in respiratory diseases, offering potential benefits in managing Chronic Obstructive Pulmonary Disease (COPD).

Objectives

This trial aims to evaluate whether the addition of the oral probiotic Familact to standard therapies significantly enhances dyspnea management in COPD patients compared to standard treatment alone.

Methods

In this single-blind randomized clinical trial 60 COPD patients randomly allocated into the control and intervention groups (n = 30). Over three months, the control group received standard treatment, while the intervention group received standard treatment plus oral Familact. Spirometry was conducted twice, and dyspnea was assessed four times using the Borg Scale Ratings (BORG) and Modified Medical Research Council Dyspnea Scale Scores in COPD patients (MMRC) scales and were evaluated using repeated measurement analysis.

Results

No significant change was observed in FEV1 post-intervention, but MMRC and BORG scores showed a statistically significant improvement in the intervention group compared to the control group (P < 0.01). Repeated measures tests based on estimated marginal means revealed significant MMRC differences within groups over time, with inter-group differences notable only between the first and second measurements. BORG showed significant within- and between-group differences at all time points, confirmed by post hoc tests.

Conclusion

This study demonstrates that Familact, as an oral probiotic can significantly alleviate dyspnea in COPD patients, as reflected in notable improvements in BORG and MMRC scores. These findings underscore the potential of probiotics as an adjunctive therapy for COPD, particularly in improving patient-reported outcomes related to respiratory difficulty.

{"title":"Effects of the oral probiotic Familact on dyspnea management in COPD patients: A randomized controlled trial","authors":"Mehdi Aghamohammadi , Samad Ghodrati , Nooshin Jalili , Roghayeh Jafari , Effat Rafiee , Koorosh Kamali , Mahsa Ghasemi , Javad Alizargar","doi":"10.1016/j.hrtlng.2025.02.002","DOIUrl":"10.1016/j.hrtlng.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>Emerging evidence suggests that oral probiotics may enhance the immune response in respiratory diseases, offering potential benefits in managing Chronic Obstructive Pulmonary Disease (COPD).</div></div><div><h3>Objectives</h3><div>This trial aims to evaluate whether the addition of the oral probiotic Familact to standard therapies significantly enhances dyspnea management in COPD patients compared to standard treatment alone.</div></div><div><h3>Methods</h3><div>In this single-blind randomized clinical trial 60 COPD patients randomly allocated into the control and intervention groups (<em>n</em> = 30). Over three months, the control group received standard treatment, while the intervention group received standard treatment plus oral Familact. Spirometry was conducted twice, and dyspnea was assessed four times using the Borg Scale Ratings (BORG) and Modified Medical Research Council Dyspnea Scale Scores in COPD patients (MMRC) scales and were evaluated using repeated measurement analysis.</div></div><div><h3>Results</h3><div>No significant change was observed in FEV1 post-intervention, but MMRC and BORG scores showed a statistically significant improvement in the intervention group compared to the control group (<em>P</em> < 0.01). Repeated measures tests based on estimated marginal means revealed significant MMRC differences within groups over time, with inter-group differences notable only between the first and second measurements. BORG showed significant within- and between-group differences at all time points, confirmed by post hoc tests.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that Familact, as an oral probiotic can significantly alleviate dyspnea in COPD patients, as reflected in notable improvements in BORG and MMRC scores. These findings underscore the potential of probiotics as an adjunctive therapy for COPD, particularly in improving patient-reported outcomes related to respiratory difficulty.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 63-68"},"PeriodicalIF":2.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510954","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}

引用次数: 0

Electrocardiogram parameters in predicting reversible ischemia in myocardial perfusion SPECT: A case-control study

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung

Pub Date : 2025-02-27 DOI: 10.1016/j.hrtlng.2025.02.010

Seda Gülbahar Ateş , Hüseyin Emre Tosun , Gamze Tatar

Background

Myocardial perfusion single photon emission computed tomography (SPECT) and electrocardiogram(ECG) are crucial modalities in the evaluation of coronary artery disease(CAD) in clinical practice.

Objective

To evaluate the relationship between ventricular repolarization parameters, index of cardiac electrophysiological balance (iCEB) from basal electrocardiograms (ECG), and reversible ischemia findings on SPECT.

Methods

A total of 45 patients with reversible ischemia on 99m technetium-sestamibi (^99mTc-MIBI) stress-rest myocardial perfusion SPECT and confirmed CAD by coronary angiography were included in the ischemia group. Forty-five patients with normal scans, matched by age and gender with the ischemia patient group, were included in the control group. The two-day 99mTc-MIBI SPECT protocol was performed with adenosine-pharmacologic stress. The presence of ischemia and reversible ischemia size (RIS) were recorded in the ischemia group. The summed stress scores (SSS) were recorded for the ischemia and control groups. The QRS, QTd, cQTd, Tp-Te, Tp-Te/QT, Tp-Te/cQT, iCEB (QT/QRS), and iCEBc (cQT/QRS) were calculated. Correlations between myocardial perfusion SPECT and ECG parameters were evaluated using the Spearman test. Predictors of reversible ischemia were assessed using logistic regression analysis.

Results

The ischemia group showed significantly higher values for QRS duration (p = 0.018), cQTmax (p = 0.006), QTd (p = 0.002), and cQTd (p = 0.003). Tp-Te (p = 0.004), Tp-Te/QT ratio (p = 0.003), and Tp-Te/cQT ratio (p = 0.002) were significantly lower in the ischemia group. The multivariate analysis showed that hyperlipidemia, QRS duration, cQTd, and Tp-Te/QTc ratio were found as independent predictors of ischemia.

Conclusion

The Tp-Te/cQT ratio, QRS duration, and cQTd might be valuable predictors of reversible ischemia in SPECT, warranting further study.

{"title":"Electrocardiogram parameters in predicting reversible ischemia in myocardial perfusion SPECT: A case-control study","authors":"Seda Gülbahar Ateş , Hüseyin Emre Tosun , Gamze Tatar","doi":"10.1016/j.hrtlng.2025.02.010","DOIUrl":"10.1016/j.hrtlng.2025.02.010","url":null,"abstract":"<div><h3>Background</h3><div>Myocardial perfusion single photon emission computed tomography (SPECT) and electrocardiogram(ECG) are crucial modalities in the evaluation of coronary artery disease(CAD) in clinical practice.</div></div><div><h3>Objective</h3><div>To evaluate the relationship between ventricular repolarization parameters, index of cardiac electrophysiological balance (iCEB) from basal electrocardiograms (ECG), and reversible ischemia findings on SPECT.</div></div><div><h3>Methods</h3><div>A total of 45 patients with reversible ischemia on 99m technetium-sestamibi (<sup>99m</sup>Tc-MIBI) stress-rest myocardial perfusion SPECT and confirmed CAD by coronary angiography were included in the ischemia group. Forty-five patients with normal scans, matched by age and gender with the ischemia patient group, were included in the control group. The two-day 99mTc-MIBI SPECT protocol was performed with adenosine-pharmacologic stress. The presence of ischemia and reversible ischemia size (RIS) were recorded in the ischemia group. The summed stress scores (SSS) were recorded for the ischemia and control groups. The QRS, QTd, cQTd, Tp-Te, Tp-Te/QT, Tp-Te/cQT, iCEB (QT/QRS), and iCEBc (cQT/QRS) were calculated. Correlations between myocardial perfusion SPECT and ECG parameters were evaluated using the Spearman test. Predictors of reversible ischemia were assessed using logistic regression analysis.</div></div><div><h3>Results</h3><div>The ischemia group showed significantly higher values for QRS duration (<em>p</em> = 0.018), cQTmax (<em>p</em> = 0.006), QTd (<em>p</em> = 0.002), and cQTd (<em>p</em> = 0.003). Tp-Te (<em>p</em> = 0.004), Tp-Te/QT ratio (<em>p</em> = 0.003), and Tp-Te/cQT ratio (<em>p</em> = 0.002) were significantly lower in the ischemia group. The multivariate analysis showed that hyperlipidemia, QRS duration, cQTd, and Tp-Te/QTc ratio were found as independent predictors of ischemia.</div></div><div><h3>Conclusion</h3><div>The Tp-Te/cQT ratio, QRS duration, and cQTd might be valuable predictors of reversible ischemia in SPECT, warranting further study.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 56-62"},"PeriodicalIF":2.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510694","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}

引用次数: 0

Association between brominated flame retardants and heart failure in U.S. adults: A cross-sectional analysis of national health and nutrition examination survey 2005-2016

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung

Pub Date : 2025-02-24 DOI: 10.1016/j.hrtlng.2025.02.004

Wei Wang , Jiaxin Bao , Yi Lu , Hao Jiang

Background

Brominated flame retardants (BFRs) are environmental pollutants widely used in consumer products, which accumulate in human tissues. Despite their prevalence, the potential impact of BFRs on cardiovascular health, particularly heart failure (HF), remains insufficiently explored.

Objectives

This study aims to investigate the association between BFR exposure and the prevalence of HF in U.S. adults.

Methods

Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2005–2016. To assess the relationship between BFR exposure and HF prevalence, weighted generalized linear regressions (GLMs) were applied. Restricted cubic splines (RCS) were used to examine potential nonlinear associations. Additionally, quantile-weighted quantile sum (WQS) regression and quantile g-computation (QGC) analysis were performed to evaluate the overall effect of BFR mixtures on HF.

Results

A total of 6,931 individuals participated, with 219 diagnosed with HF. In the adjusted Model 3, BFRs including PBDE28, PBDE47, PBDE85, PBDE99, PBDE100, PBDE154, and PBB153 were significantly associated with increased odds of HF (all p < 0.05). RCS analysis revealed a significant nonlinear relationship between serum BFRs and HF. The WQS analysis showed a positive association between combined BFR exposure and HF (OR: 1.694; 95 % CI: 1.264, 2.270; p < 0.001), and QGC analysis similarly showed a significant positive association (OR: 1.365; 95 % CI: 1.094, 1.705; p = 0.006).

Conclusion

This study suggests a link between BFR exposure and an increased risk of HF. Further research is needed to explore the causal relationship and underlying mechanisms.

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引用次数: 0

Investigating the effect of illness perception on motor function in cardioembolic stroke patients using the fear-avoidance model: The mediating role of kinesiophobia

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung

Pub Date : 2025-02-22 DOI: 10.1016/j.hrtlng.2025.02.006

Yunmei Ding , Shouwei Yue , Jing Li , Lu Wang , Jiayun Gu , Yan Cui

Background

Cardioembolic stroke is the most common cause of ischemic stroke, and patients frequently have motor dysfunction as well as psychological disorders. Both physical and psychological causes can have an impact on a patient's motor function.

Objectives

In this study, we used the fear-avoidance model to examine the impact of patients' illness perception and kinesiophobia (excessive fear of exercise) on their motor function.

Methods

Between June 2021 and February 2022, we conducted a cross-sectional study of 319 participants diagnosed with cardioembolic stroke in the selected hospitals. Correlation analyses and mediation effects tests were used to analyze the relationship between patients' illness perception, kinesiophobia, and motor function.

Results

The total motor function score of the patients was (21.39 ± 29.30), the total kinesiophobia score was (48.51 ± 8.33), and the total illness perception score was (53.37 ± 16.82). There was a negative correlation between illness perception and motor function (r = -0.734, P < 0.001), a negative correlation between kinesiophobia and motor function (r = -0.522, P < 0.001), and a positive correlation between illness perception and kinesiophobia (r = 0.508, P < 0.001); kinesiophobia played a mediating role between illness perception and motor function (β = -0.63, P < 0.001).

Conclusions

The findings revealed that individuals with cardioembolic strokes had poor motor function, as well as negative illness perception and kinesiophobia. Negative illness perception had a direct impact on patients' motor function as well as an indirect effect via kinesiophobia. The fear-avoidance model contributes to understanding the process of reduced motor function in cardioembolic stroke patients.

背景心血管栓塞性卒中是缺血性卒中最常见的病因，患者常伴有运动功能障碍和心理障碍。方法 2021 年 6 月至 2022 年 2 月，我们对选定医院中确诊为心肌栓塞性脑卒中的 319 名参与者进行了横断面研究。结果患者的运动功能总分为（21.39±29.30）分，运动恐惧总分为（48.51±8.33）分，疾病认知总分为（53.37±16.82）分。疾病认知与运动功能呈负相关（r = -0.734，P < 0.001），运动恐惧与运动功能呈负相关（r = -0.522，P < 0.001），疾病认知与运动恐惧呈正相关（r = 0.508, P < 0.001）；运动恐怖症在疾病认知与运动功能之间起中介作用（β = -0.63, P < 0.001）。消极的疾病认知对患者的运动功能有直接影响，也会通过运动恐惧产生间接影响。恐惧-回避模型有助于理解心血管栓塞性脑卒中患者运动功能减退的过程。

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引用次数: 0

Association between dental floss use and atherosclerotic cardiovascular disease in American adults

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung

Pub Date : 2025-02-21 DOI: 10.1016/j.hrtlng.2025.02.003

Jiaqing Fei MPH , Xiaoyan Gong MPH

Background

Atherosclerotic cardiovascular disease (ASCVD) remains a major cause of global morbidity and mortality. Emerging research suggests that oral hygiene practices, particularly dental floss use, may reduce the risk of ASCVD.

Objectives

The purpose of this study was to examine the association between dental floss use and ASCVD prevalence.

Methods

Data from NHANES participants who completed home interviews and dental evaluations were analyzed. ASCVD was defined as angina, stroke, myocardial infarction, or coronary artery disease. Dental floss use was self-reported over the past seven days. Covariates included demographic, socioeconomic, lifestyle, and clinical factors. Weighted logistic regression was used to assess the relationship between dental floss use and ASCVD prevalence.

Results

This study included a total sample of 7253 participants with a mean age of 53.8±14.6 years. The sample consisted of 47.6 % male participants. The ethnic composition included 64.3 % Non-Hispanic White. Regular dental floss use was correlated with a lower likelihood of developing ASCVD and Stringent Criteria (infarction or stroke), with ORs of 0.76 (95 % CI: 0.60, 0.97) p=0.028 and 0.68 (95 % CI: 0.49, 0.94) p=0.022, respectively. Flossing 3–4 days/week was associated with reduced ASCVD risk, OR = 0.57 (95 % CI: 0.38, 0.84) p=0.006. Similar reductions were seen for stringent criteria: flossing 3–4 days/week: OR = 0.57 (95 % CI: 0.32, 0.99) p=0.047, flossing ≥5 days/week: OR = 0.69 (95 % CI: 0.47, 1.00) p=0.049.

Conclusions

Regular dental floss use may reduce the risk of ASCVD. These results support the inclusion of oral hygiene practices in cardiovascular disease prevention strategies.

{"title":"Association between dental floss use and atherosclerotic cardiovascular disease in American adults","authors":"Jiaqing Fei MPH , Xiaoyan Gong MPH","doi":"10.1016/j.hrtlng.2025.02.003","DOIUrl":"10.1016/j.hrtlng.2025.02.003","url":null,"abstract":"<div><h3>Background</h3><div>Atherosclerotic cardiovascular disease (ASCVD) remains a major cause of global morbidity and mortality. Emerging research suggests that oral hygiene practices, particularly dental floss use, may reduce the risk of ASCVD.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to examine the association between dental floss use and ASCVD prevalence.</div></div><div><h3>Methods</h3><div>Data from NHANES participants who completed home interviews and dental evaluations were analyzed. ASCVD was defined as angina, stroke, myocardial infarction, or coronary artery disease. Dental floss use was self-reported over the past seven days. Covariates included demographic, socioeconomic, lifestyle, and clinical factors. Weighted logistic regression was used to assess the relationship between dental floss use and ASCVD prevalence.</div></div><div><h3>Results</h3><div>This study included a total sample of 7253 participants with a mean age of 53.8±14.6 years. The sample consisted of 47.6 % male participants. The ethnic composition included 64.3 % Non-Hispanic White. Regular dental floss use was correlated with a lower likelihood of developing ASCVD and Stringent Criteria (infarction or stroke), with ORs of 0.76 (95 % CI: 0.60, 0.97) <em>p</em>=0.028 and 0.68 (95 % CI: 0.49, 0.94) <em>p</em>=0.022, respectively. Flossing 3–4 days/week was associated with reduced ASCVD risk, OR = 0.57 (95 % CI: 0.38, 0.84) <em>p</em>=0.006. Similar reductions were seen for stringent criteria: flossing 3–4 days/week: OR = 0.57 (95 % CI: 0.32, 0.99) <em>p</em>=0.047, flossing ≥5 days/week: OR = 0.69 (95 % CI: 0.47, 1.00) <em>p</em>=0.049.</div></div><div><h3>Conclusions</h3><div>Regular dental floss use may reduce the risk of ASCVD. These results support the inclusion of oral hygiene practices in cardiovascular disease prevention strategies.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 32-38"},"PeriodicalIF":2.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Board of Directors

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung

Pub Date : 2025-02-20 DOI: 10.1016/S0147-9563(25)00021-4

引用次数: 0

Letter to the Editor: Efficacy and safety of iloprost in the treatment of pulmonary arterial hypertension: A systematic review and meta-analysis.

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung

Pub Date : 2025-02-19 DOI: 10.1016/j.hrtlng.2025.02.005

Mustafa Oğuz, Murat Demirci

引用次数: 0

Natriuretic peptide testing in veterans hospitalized with heart failure: Potential differences by sex

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung

Pub Date : 2025-02-18 DOI: 10.1016/j.hrtlng.2025.02.001

Parul U. Gandhi MD , Tessa Runels MPH , Ling Han MD, PhD, MS , Melissa Skanderson MSW , Lori A. Bastian MD, MPH , Cynthia A. Brandt MD, MPH , Ronald G. Hauser MD , Shelli L. Feder PhD, FNP-C , Benjamin Rodwin MD , Melissa M. Farmer PhD , Bevanne Bean-Mayberry MD , Sebastian Placide MD , Allison E. Gaffey PhD , Kathleen M. Akgün MD, MS

Background

Natriuretic peptide testing (NPT) is recommended to assist in diagnosis and prognostication during heart failure hospitalization (HFH). NPT on admission for HFH and sex-based variation in NPT are unknown.

Objectives

We investigated the utilization of NPT among Veterans with HFH, evaluated for sex-based differences, and examined associations with demographic, clinical, and facility characteristics.

Methods

Among Veterans with HFH in the Veterans Affairs Healthcare System between October 2015-September 2020, we assessed the rate of NPT on admission and sex-based differences in NPT. We determined associations with demographic, clinical covariates, (comorbidities, laboratory values, loop diuretic use), and facility characteristics using logistic regression.

Results

Of 55,935 patients with HFH (women=1237 (2.2 %)), women were younger (68.3 versus 72.8 years, p < 0.001), less likely to have cardiac comorbidities, and more likely to have ejection fraction >40 %. Admission NPT occurred in 78.3 % of patients (men=78.4 %, women=74.7 %; p = 0.002). In adjusted analyses for clinical and facility-related factors, women were 15 % less likely to receive NPT compared with men [odds ratio =0.85, 95 % CI (0.75, 0.98)]. In sex-stratified models, atrial fibrillation and prior loop diuretic use were associated with increased likelihood of NPT and previous NPT was associated with decreased likelihood in both sexes. Overall associations were similar in both sexes.

Conclusions

Women were less likely to receive NPT during HFH compared to men, potentially risking greater delays in HF diagnosis and treatment. Further investigation should examine the impact of the absence of admission NPT on clinical outcomes and identify strategies to improve obtaining NPT in all patients.

{"title":"Natriuretic peptide testing in veterans hospitalized with heart failure: Potential differences by sex","authors":"Parul U. Gandhi MD , Tessa Runels MPH , Ling Han MD, PhD, MS , Melissa Skanderson MSW , Lori A. Bastian MD, MPH , Cynthia A. Brandt MD, MPH , Ronald G. Hauser MD , Shelli L. Feder PhD, FNP-C , Benjamin Rodwin MD , Melissa M. Farmer PhD , Bevanne Bean-Mayberry MD , Sebastian Placide MD , Allison E. Gaffey PhD , Kathleen M. Akgün MD, MS","doi":"10.1016/j.hrtlng.2025.02.001","DOIUrl":"10.1016/j.hrtlng.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Natriuretic peptide testing (NPT) is recommended to assist in diagnosis and prognostication during heart failure hospitalization (HFH). NPT on admission for HFH and sex-based variation in NPT are unknown.</div></div><div><h3>Objectives</h3><div>We investigated the utilization of NPT among Veterans with HFH, evaluated for sex-based differences, and examined associations with demographic, clinical, and facility characteristics.</div></div><div><h3>Methods</h3><div>Among Veterans with HFH in the Veterans Affairs Healthcare System between October 2015-September 2020, we assessed the rate of NPT on admission and sex-based differences in NPT. We determined associations with demographic, clinical covariates, (comorbidities, laboratory values, loop diuretic use), and facility characteristics using logistic regression.</div></div><div><h3>Results</h3><div>Of 55,935 patients with HFH (women=1237 (2.2 %)), women were younger (68.3 versus 72.8 years, <em>p</em> < 0.001), less likely to have cardiac comorbidities, and more likely to have ejection fraction >40 %. Admission NPT occurred in 78.3 % of patients (men=78.4 %, women=74.7 %; <em>p</em> = 0.002). In adjusted analyses for clinical and facility-related factors, women were 15 % less likely to receive NPT compared with men [odds ratio =0.85, 95 % CI (0.75, 0.98)]. In sex-stratified models, atrial fibrillation and prior loop diuretic use were associated with increased likelihood of NPT and previous NPT was associated with decreased likelihood in both sexes. Overall associations were similar in both sexes.</div></div><div><h3>Conclusions</h3><div>Women were less likely to receive NPT during HFH compared to men, potentially risking greater delays in HF diagnosis and treatment. Further investigation should examine the impact of the absence of admission NPT on clinical outcomes and identify strategies to improve obtaining NPT in all patients.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 25-31"},"PeriodicalIF":2.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436595","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}

引用次数: 0

ECMO cannulation across New England

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung

Pub Date : 2025-02-12 DOI: 10.1016/j.hrtlng.2025.01.015

Ammar Bhatti DO , Chaitan K. Narsule MD , Michael A. Frakes APRN, EMT-P , Vahé Ender EMT-P , Jason E. Cohen DO , Susan R. Wilcox MD

Background

Over the last 15 years, clinicians have increasingly used extracorporeal membrane oxygenation (ECMO) as a rescue technique, including cannulating patients in community hospitals without ECMO capabilities, leading to secondary ECMO transports.

Objectives

The objective was to evaluate the changes in cannulations and the number of cannulating centers over time.

Methods

This is a retrospective review of transports across New England to ECMO centers in Boston from 2011 to 2022.

Results

Over the years studied, 202 patients were cannulated and transported. VA ECMO was the most common configuration. This was a high-acuity cohort, with 26.4 % of VA ECMO patients having undergone cannulation during cardiopulmonary resuscitation (ECPR) and 6.1 % having central cannulation. The number of cannulations per year increased from 6 patients in 2011 to 36 in 2019 (p = 0.055). Cannulating centers also increased from 3 in 2011 to 14 in 2022. ECPR showed a similar trend, with increases in both ECPR patients and ECPR sites per year (p = 0.055).

Conclusions

The number of ECMO cannulations in the community has increased, with a high-acuity cohort of many patients undergoing ECPR. The number of patients cannulated at non-ECMO centers highlights the need for transport organizations and ECMO centers to address the needs of this high-acuity patient population.

{"title":"ECMO cannulation across New England","authors":"Ammar Bhatti DO , Chaitan K. Narsule MD , Michael A. Frakes APRN, EMT-P , Vahé Ender EMT-P , Jason E. Cohen DO , Susan R. Wilcox MD","doi":"10.1016/j.hrtlng.2025.01.015","DOIUrl":"10.1016/j.hrtlng.2025.01.015","url":null,"abstract":"<div><h3>Background</h3><div>Over the last 15 years, clinicians have increasingly used extracorporeal membrane oxygenation (ECMO) as a rescue technique, including cannulating patients in community hospitals without ECMO capabilities, leading to secondary ECMO transports.</div></div><div><h3>Objectives</h3><div>The objective was to evaluate the changes in cannulations and the number of cannulating centers over time.</div></div><div><h3>Methods</h3><div>This is a retrospective review of transports across New England to ECMO centers in Boston from 2011 to 2022.</div></div><div><h3>Results</h3><div>Over the years studied, 202 patients were cannulated and transported. VA ECMO was the most common configuration. This was a high-acuity cohort, with 26.4 % of VA ECMO patients having undergone cannulation during cardiopulmonary resuscitation (ECPR) and 6.1 % having central cannulation. The number of cannulations per year increased from 6 patients in 2011 to 36 in 2019 (<em>p</em> = 0.055). Cannulating centers also increased from 3 in 2011 to 14 in 2022. ECPR showed a similar trend, with increases in both ECPR patients and ECPR sites per year (<em>p</em> = 0.055).</div></div><div><h3>Conclusions</h3><div>The number of ECMO cannulations in the community has increased, with a high-acuity cohort of many patients undergoing ECPR. The number of patients cannulated at non-ECMO centers highlights the need for transport organizations and ECMO centers to address the needs of this high-acuity patient population.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 20-24"},"PeriodicalIF":2.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394456","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}

引用次数: 0

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