Pub Date : 2026-01-01Epub Date: 2025-10-11DOI: 10.1016/j.hrtlng.2025.10.001
A B M Nasibul Alam MD , Natasha Gill MD , Isabella Han , Reina Nagasaka , Wenting Hu , Laeeq Shamsuddin MD
Introduction
The renin-angiotensin-aldosterone system (RAAS) plays a key role in sarcoidosis pathogenesis. A recent study suggests that ACE inhibitors may worsen outcomes in sarcoidosis, whereas ARBs may be more beneficial. SGLT2 inhibitors modulate RAAS activity and have anti-inflammatory properties, making them a potential therapeutic option in this population.
Objectives
To evaluate whether the addition of SGLT2 inhibitors to ARB therapy improves long-term survival outcomes in patients with sarcoidosis.
Methods
This retrospective cohort study analyzed adults diagnosed with sarcoidosis from the TrinetX database between 2015 and 2025. Patients receiving ARBs with or without SGLT2 inhibitors were compared following propensity score matching for demographics, comorbidities, and concurrent immunosuppressive therapies.
Results
Patients receiving both ARBs and SGLT2 inhibitors had lower all-cause mortality over five years compared to those on ARBs alone. No significant differences were observed in secondary outcomes such as sepsis, respiratory failure, cardiovascular events, or renal complications.
Conclusion
In patients with sarcoidosis treated with ARBs, the addition of SGLT2 inhibitors was associated with improved long-term survival. These findings support further investigation into the role of SGLT2 inhibitors as adjunctive therapy in sarcoidosis.
{"title":"Repurposing sodium glucose cotransporter-2 (SGLT-2) inhibitors in sarcoidosis: A potential strategy for reducing mortality","authors":"A B M Nasibul Alam MD , Natasha Gill MD , Isabella Han , Reina Nagasaka , Wenting Hu , Laeeq Shamsuddin MD","doi":"10.1016/j.hrtlng.2025.10.001","DOIUrl":"10.1016/j.hrtlng.2025.10.001","url":null,"abstract":"<div><h3>Introduction</h3><div>The renin-angiotensin-aldosterone system (RAAS) plays a key role in sarcoidosis pathogenesis. A recent study suggests that ACE inhibitors may worsen outcomes in sarcoidosis, whereas ARBs may be more beneficial. SGLT2 inhibitors modulate RAAS activity and have anti-inflammatory properties, making them a potential therapeutic option in this population.</div></div><div><h3>Objectives</h3><div>To evaluate whether the addition of SGLT2 inhibitors to ARB therapy improves long-term survival outcomes in patients with sarcoidosis.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed adults diagnosed with sarcoidosis from the TrinetX database between 2015 and 2025. Patients receiving ARBs with or without SGLT2 inhibitors were compared following propensity score matching for demographics, comorbidities, and concurrent immunosuppressive therapies.</div></div><div><h3>Results</h3><div>Patients receiving both ARBs and SGLT2 inhibitors had lower all-cause mortality over five years compared to those on ARBs alone. No significant differences were observed in secondary outcomes such as sepsis, respiratory failure, cardiovascular events, or renal complications.</div></div><div><h3>Conclusion</h3><div>In patients with sarcoidosis treated with ARBs, the addition of SGLT2 inhibitors was associated with improved long-term survival. These findings support further investigation into the role of SGLT2 inhibitors as adjunctive therapy in sarcoidosis.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 198-204"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281809","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 : 2026-01-01Epub Date: 2025-10-24DOI: 10.1016/j.hrtlng.2025.10.014
Yuanjin Tang, Junli Wang, Yuanqing Jiang
Background
Anxiety and depression are clinically common but are underestimated in chronic obstructive pulmonary disease (COPD) patients. Mind-body exercises like Qigong (e.g., Baduanjin), which combine gentle movements, breath control, and focused attention, have shown benefits for physical and psychological health, but comparative efficacy between different mind-body exercises remains unclear.
Objectives
To compare the efficacy of mind-body exercises on anxiety and depression in patients with COPD.
Methods
We searched 9 databases for randomized controlled trials of the effects of mind-body exercise on anxiety and depression in patients with chronic obstructive pulmonary disease up to January 13, 2025. A network meta-analysis was used to compare primary outcomes within a frequency theory framework, and all data analyses were performed in Stata 18.0. Each intervention was individually ranked using the surface under the cumulative ranking curve.
Results
A total of 23 studies with 2303 participants included. Compared to usual care and therapy, Mindfulness-Based Stress Reduction (MBSR) combined with Baduanjin showed the greatest benefit for anxiety (SMD = −1.93, 95 % CI −3.54 to −0.31) and for depression (SMD = −1.96, 95 % CI −3.52 to −0.41). SUCRA rankings placed MBSR combined with Baduanjin highest for anxiety at 83.5 % and for depression at 86.3 %.
Conclusion
In this study, mind-body exercise can significantly reduce anxiety and depression symptoms in patients with chronic obstructive pulmonary disease. By comparing multiple mind-body exercise methods, the results showed that the combination of MBSR and Baduanjin was the most effective modality for improving both anxiety and depression. Medical practitioners may consider combining MBSR and Baduanjin in the future to achieve the best therapeutic effect.
背景焦虑和抑郁在慢性阻塞性肺疾病（COPD）患者中很常见，但被低估了。气功（如八段锦）等身心锻炼结合了轻柔的动作、控制呼吸和集中注意力，已经显示出对身心健康的好处，但不同身心锻炼之间的比较效果尚不清楚。目的比较心身运动对慢性阻塞性肺病患者焦虑和抑郁的治疗效果。方法：我们检索了截至2025年1月13日的9个数据库，收集了身心运动对慢性阻塞性肺疾病患者焦虑和抑郁影响的随机对照试验。使用网络元分析比较频率理论框架内的主要结果，所有数据分析均在Stata 18.0中进行。利用累积排序曲线下的曲面对每个干预措施进行单独排序。结果共纳入23项研究，2303名受试者。与常规护理和治疗相比，正念减压（MBSR）联合八段金对焦虑（SMD = - 1.93, 95% CI - 3.54至- 0.31）和抑郁（SMD = - 1.96, 95% CI - 3.52至- 0.41）的疗效最大。SUCRA的排名显示，正念减压联合八段锦治疗焦虑症的比例最高，为83.5%，治疗抑郁症的比例最高，为86.3%。结论心身运动可显著减轻慢性阻塞性肺疾病患者的焦虑和抑郁症状。通过比较多种身心运动方法，结果表明正念减压和八段锦相结合是改善焦虑和抑郁的最有效方式。为了达到最佳的治疗效果，今后医生可以考虑将正念减压与八段锦联合使用。
{"title":"Comparative effects of mind-body exercises on anxiety and depression in patients with chronic obstructive pulmonary disease: A network meta-analysis of randomized controlled trials","authors":"Yuanjin Tang, Junli Wang, Yuanqing Jiang","doi":"10.1016/j.hrtlng.2025.10.014","DOIUrl":"10.1016/j.hrtlng.2025.10.014","url":null,"abstract":"<div><h3>Background</h3><div>Anxiety and depression are clinically common but are underestimated in chronic obstructive pulmonary disease (COPD) patients. Mind-body exercises like Qigong (e.g., Baduanjin), which combine gentle movements, breath control, and focused attention, have shown benefits for physical and psychological health, but comparative efficacy between different mind-body exercises remains unclear.</div></div><div><h3>Objectives</h3><div>To compare the efficacy of mind-body exercises on anxiety and depression in patients with COPD.</div></div><div><h3>Methods</h3><div>We searched 9 databases for randomized controlled trials of the effects of mind-body exercise on anxiety and depression in patients with chronic obstructive pulmonary disease up to January 13, 2025. A network meta-analysis was used to compare primary outcomes within a frequency theory framework, and all data analyses were performed in Stata 18.0. Each intervention was individually ranked using the surface under the cumulative ranking curve.</div></div><div><h3>Results</h3><div>A total of 23 studies with 2303 participants included. Compared to usual care and therapy, Mindfulness-Based Stress Reduction (MBSR) combined with Baduanjin showed the greatest benefit for anxiety (SMD = −1.93, 95 % CI −3.54 to −0.31) and for depression (SMD = −1.96, 95 % CI −3.52 to −0.41). SUCRA rankings placed MBSR combined with Baduanjin highest for anxiety at 83.5 % and for depression at 86.3 %.</div></div><div><h3>Conclusion</h3><div>In this study, mind-body exercise can significantly reduce anxiety and depression symptoms in patients with chronic obstructive pulmonary disease. By comparing multiple mind-body exercise methods, the results showed that the combination of MBSR and Baduanjin was the most effective modality for improving both anxiety and depression. Medical practitioners may consider combining MBSR and Baduanjin in the future to achieve the best therapeutic effect.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 254-262"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145363280","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 : 2026-01-01Epub Date: 2025-11-05DOI: 10.1016/j.hrtlng.2025.09.021
Montaser Elkholy MDMSc , Mohammad Akkawi MD , George G. Kidess , Zijin Lin , Ahmed K. Abdelrahman MD , Yousef Alsmairat MD , Yasemin Bahar MD , Zain UL Abideen Asad MDMS , M Chadi Alraies MDMPH
Background
Pulmonary embolism (PE) remains a significant cause of cardiovascular morbidity and mortality. Catheter-based PE thrombectomy has emerged as an important therapeutic option for high-risk PE patients. Still, sex-based disparities in the outcomes of this procedure are not well understood.
Objective
To evaluate sex-based differences in in-hospital outcomes among patients undergoing catheter-based PE thrombectomy.
Methods
A retrospective cohort analysis was conducted using National Inpatient Sample database. Adult patients who underwent catheter-based PE thrombectomy from January 1, 2018, to December 31, 2021, were included. Primary outcomes included in-hospital mortality, while secondary outcomes included complications such as acute kidney injury (AKI), bleeding, need for blood transfusion, and respiratory and vascular complications. Multivariate logistic regression was used to adjust for potential confounders.
Results
A total of 25,300 patients were included (11,680 females and 13,620 males). Females were older and had higher rates of obesity and anemia. In-hospital mortality was higher in females, but after multivariate adjustment, sex was not a significant independent predictor of mortality. Females had significantly higher odds of peri-procedural bleeding, while males had higher rates of AKI.
Conclusion
This study found significant sex-based differences in the in-hospital outcomes of PE thrombectomy. Female patients had higher rates of peri-procedural bleeding and lower rates of AKI, but no sex differences were observed in mortality after adjusting for confounders. Further studies are needed to explore the underlying mechanisms of these disparities and improve patients care.
{"title":"Sex differences in in-hospital outcomes following catheter-based pulmonary embolism thrombectomy: Insights from a National Cohort","authors":"Montaser Elkholy MDMSc , Mohammad Akkawi MD , George G. Kidess , Zijin Lin , Ahmed K. Abdelrahman MD , Yousef Alsmairat MD , Yasemin Bahar MD , Zain UL Abideen Asad MDMS , M Chadi Alraies MDMPH","doi":"10.1016/j.hrtlng.2025.09.021","DOIUrl":"10.1016/j.hrtlng.2025.09.021","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary embolism (PE) remains a significant cause of cardiovascular morbidity and mortality. Catheter-based PE thrombectomy has emerged as an important therapeutic option for high-risk PE patients. Still, sex-based disparities in the outcomes of this procedure are not well understood.</div></div><div><h3>Objective</h3><div>To evaluate sex-based differences in in-hospital outcomes among patients undergoing catheter-based PE thrombectomy.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis was conducted using National Inpatient Sample database. Adult patients who underwent catheter-based PE thrombectomy from January 1, 2018, to December 31, 2021, were included. Primary outcomes included in-hospital mortality, while secondary outcomes included complications such as acute kidney injury (AKI), bleeding, need for blood transfusion, and respiratory and vascular complications. Multivariate logistic regression was used to adjust for potential confounders.</div></div><div><h3>Results</h3><div>A total of 25,300 patients were included (11,680 females and 13,620 males). Females were older and had higher rates of obesity and anemia. In-hospital mortality was higher in females, but after multivariate adjustment, sex was not a significant independent predictor of mortality. Females had significantly higher odds of peri-procedural bleeding, while males had higher rates of AKI.</div></div><div><h3>Conclusion</h3><div>This study found significant sex-based differences in the in-hospital outcomes of PE thrombectomy. Female patients had higher rates of peri-procedural bleeding and lower rates of AKI, but no sex differences were observed in mortality after adjusting for confounders. Further studies are needed to explore the underlying mechanisms of these disparities and improve patients care.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 352-357"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460627","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 : 2026-01-01Epub Date: 2025-09-16DOI: 10.1016/j.hrtlng.2025.09.003
Jane Kim BSN, RN , Ha Do Byon PhD, MS, MPH, RN , Katherine Platz PhD, RN , Gabriela Toledo PhD , Jill Howie-Esquivel PhD, AC/FNP-BC, FAAN
Background
Few investigators have tested the effect of alternative, gentle exercise interventions among patients with stable heart failure (HF).
Objectives
In a 6-month online gentle exercise vs education only intervention program, we evaluated: 1) Change in physical and psychological function; 2) whether age or sex moderates the efficacy of the intervention on physical function; 3) the relationship between quality of life (QOL) and exercise adherence.
Methods
Data from the GEtting iNTo Light Exercise for HF (GENTLE-HF) randomized controlled trial (n = 61) was analyzed. Measures included physical function, psychological function, QOL, and exercise adherence. ANCOVA-approach general linear models were used to examine physical and psychological function, adjusting for age, years of education, baseline scores, and grouping (control or intervention). The moderating effects of age and sex were tested by incorporating interaction terms into the ANCOVA-based models. Pearson correlation analysis was used to examine the relationship between QOL and adherence.
Results
Compared to control, the intervention group had improved upper body strength (p = .004), lower body strength (p = .002), and endurance (p = .003). Age moderated the effect of the intervention on upper body strength (p = .012) and endurance (p = .028). Exercise adherence was high at 84.4 %. Greater QOL was associated with higher adherence (p = .039).
Conclusions
The online yoga intervention led to improved physical function, had an additional positive effect for participants over 65 years, and had high adherence rates. These findings can inform future large-scale yoga studies that may influence future study designs and supplement physical activity guidelines, ultimately improving patient outcomes.
{"title":"The impact of the getting into light exercise for heart failure (GENTLE-HF) randomized controlled trial on physical-psychological outcomes and exercise adherence","authors":"Jane Kim BSN, RN , Ha Do Byon PhD, MS, MPH, RN , Katherine Platz PhD, RN , Gabriela Toledo PhD , Jill Howie-Esquivel PhD, AC/FNP-BC, FAAN","doi":"10.1016/j.hrtlng.2025.09.003","DOIUrl":"10.1016/j.hrtlng.2025.09.003","url":null,"abstract":"<div><h3>Background</h3><div>Few investigators have tested the effect of alternative, gentle exercise interventions among patients with stable heart failure (HF).</div></div><div><h3>Objectives</h3><div>In a 6-month online gentle exercise vs education only intervention program, we evaluated: 1) Change in physical and psychological function; 2) whether age or sex moderates the efficacy of the intervention on physical function; 3) the relationship between quality of life (QOL) and exercise adherence.</div></div><div><h3>Methods</h3><div>Data from the GEtting iNTo Light Exercise for HF (GENTLE-HF) randomized controlled trial (<em>n</em> = 61) was analyzed. Measures included physical function, psychological function, QOL, and exercise adherence. ANCOVA-approach general linear models were used to examine physical and psychological function, adjusting for age, years of education, baseline scores, and grouping (control or intervention). The moderating effects of age and sex were tested by incorporating interaction terms into the ANCOVA-based models. Pearson correlation analysis was used to examine the relationship between QOL and adherence.</div></div><div><h3>Results</h3><div>Compared to control, the intervention group had improved upper body strength (<em>p</em> = .004), lower body strength (<em>p</em> = .002), and endurance (<em>p</em> = .003). Age moderated the effect of the intervention on upper body strength (<em>p</em> = .012) and endurance (<em>p</em> = .028). Exercise adherence was high at 84.4 %. Greater QOL was associated with higher adherence (<em>p</em> = .039).</div></div><div><h3>Conclusions</h3><div>The online yoga intervention led to improved physical function, had an additional positive effect for participants over 65 years, and had high adherence rates. These findings can inform future large-scale yoga studies that may influence future study designs and supplement physical activity guidelines, ultimately improving patient outcomes.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 47-57"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076645","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 : 2026-01-01Epub Date: 2025-09-13DOI: 10.1016/j.hrtlng.2025.08.007
Serkan GÜNAY MD , Ahmet ÖZTÜRK MD , Anılcan Tahsin KARAHAN MD , Mert BARINDIK MD , Seval KOMUT MD , Yavuz YİĞİT MD
Background
DeepSeek is a recently launched large language model (LLM), whereas GPT-4o is an advanced ChatGPT version whose electrocardiography (ECG) interpretation capabilities have been previously studied. However, DeepSeek’s performance in this domain remains unexplored.
Objectives
This study aims to evaluate DeepSeek’s accuracy in ECG interpretation and compare it with GPT-4o, emergency medicine specialists, and cardiologists. A secondary aim is to assess any performance changes in GPT-4o over one year.
Methods
Between February 9 and March 1, 2025, 40 ECG images (20 daily routine, 20 more challenging) from the book 150 ECG Cases were evaluated by both GPT-4o and DeepSeek, each model tested 13 times. The accuracy of their responses was compared with previously collected answers from 12 cardiologists and 12 emergency medicine specialists. GPT-4o’s 2025 performance was compared to its 2024 results on identical ECGs.
Results
GPT-4o outperformed DeepSeek with higher median correct answers on daily routine (14 vs. 12), more challenging (13 vs. 10), and total ECGs (27 vs. 22) with statistically significant differences (p=0.048, p<0.001, p<0.001). A moderate agreement was observed between the responses provided by GPT-4o (p<0.001, Fleiss Kappa=0.473), while a substantial agreement was observed in the responses provided by DeepSeek (p<0.001, Fleiss Kappa=0.712). No significant year-over-year improvement was observed in GPT-4o’s performance.
Conclusion
This first evaluation of DeepSeek in ECG interpretation reveals its performance is lower than that of GPT-4o and human experts. While GPT-4o demonstrates greater accuracy, both models fall short of expert-level performance, underscoring the need for caution and further validation before clinical integration.
{"title":"Comparing DeepSeek and GPT-4o in ECG interpretation: Is AI improving over time?","authors":"Serkan GÜNAY MD , Ahmet ÖZTÜRK MD , Anılcan Tahsin KARAHAN MD , Mert BARINDIK MD , Seval KOMUT MD , Yavuz YİĞİT MD","doi":"10.1016/j.hrtlng.2025.08.007","DOIUrl":"10.1016/j.hrtlng.2025.08.007","url":null,"abstract":"<div><h3>Background</h3><div>DeepSeek is a recently launched large language model (LLM), whereas GPT-4o is an advanced ChatGPT version whose electrocardiography (ECG) interpretation capabilities have been previously studied. However, DeepSeek’s performance in this domain remains unexplored.</div></div><div><h3>Objectives</h3><div>This study aims to evaluate DeepSeek’s accuracy in ECG interpretation and compare it with GPT-4o, emergency medicine specialists, and cardiologists. A secondary aim is to assess any performance changes in GPT-4o over one year.</div></div><div><h3>Methods</h3><div>Between February 9 and March 1, 2025, 40 ECG images (20 daily routine, 20 more challenging) from the book 150 ECG Cases were evaluated by both GPT-4o and DeepSeek, each model tested 13 times. The accuracy of their responses was compared with previously collected answers from 12 cardiologists and 12 emergency medicine specialists. GPT-4o’s 2025 performance was compared to its 2024 results on identical ECGs.</div></div><div><h3>Results</h3><div>GPT-4o outperformed DeepSeek with higher median correct answers on daily routine (14 vs. 12), more challenging (13 vs. 10), and total ECGs (27 vs. 22) with statistically significant differences (<em>p</em>=0.048, p<0.001, p<0.001). A moderate agreement was observed between the responses provided by GPT-4o (p<0.001, Fleiss Kappa=0.473), while a substantial agreement was observed in the responses provided by DeepSeek (p<0.001, Fleiss Kappa=0.712). No significant year-over-year improvement was observed in GPT-4o’s performance.</div></div><div><h3>Conclusion</h3><div>This first evaluation of DeepSeek in ECG interpretation reveals its performance is lower than that of GPT-4o and human experts. While GPT-4o demonstrates greater accuracy, both models fall short of expert-level performance, underscoring the need for caution and further validation before clinical integration.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 366-371"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066170","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 : 2026-01-01Epub Date: 2025-10-29DOI: 10.1016/j.hrtlng.2025.10.024
Lauren East , Joanna Joly , Preston Nicely , Laura Kukuc , Marie Wilson , Margaret Blood , Elizabeth Baker , Lucia Juarez , Jose Tallaj , William Holman , Nicole Lohr , Yolanda Hall , Stephen Clarkson
Background
As longevity with left ventricular assist devices (LVAD) and their potential to improve health-related quality of life (HRQOL) increase, it is important to examine factors that may limit HRQOL in patients receiving LVADs.
Objectives
This study explores the relationship between adverse social determinants of heath (SDOH) and HRQOL post-LVAD, contextualizing individual and community-level characteristics associated with HRQOL outcomes.
Methods
This was a retrospective cohort study utilizing EHR based chart review. All HM3 LVAD recipients at an academic center in the Southeast United States were included. HRQOL was estimated by EuroQol-5D visual analog scale (VAS) and Kansas City Cardiomyopathy Questionnaire-12 (KCCQ) score. Impact of adverse SDOH on HRQOL and self-reported satisfaction with LVAD was evaluated using linear mixed models at 6 months, 1 year, 1.5 years, and 2 years.
Results
A total of 111 patients with HM3 LVAD (mean age 50, SD 13) were included. VAS and KCCQ scores significantly increased compared to pre-implant. Community-level characteristics showed no relationship with VAS or KCCQ score, but education attainment was associated with higher absolute KCCQ scores at 2 years post LVAD (college- n = 11, mean 62.9, SD 20.3; no college- n = 11, mean 39.2, SD 21.5; p-value 0.018). Satisfaction results demonstrated that those with more education had higher satisfaction (chi square= 8, p = 0.018).
Conclusions
In this Southern cohort, adverse community SDOH factors are not associated with HRQOL following LVAD, and post-LVAD, HRQOL improves. These data support the beneficial nature of this therapy for all. Education attainment, a potential surrogate for health literacy, may be a source for future intervention.
背景：随着左心室辅助装置（LVAD）的使用寿命及其改善健康相关生活质量（HRQOL）的潜力的增加，检查可能限制左心室辅助装置患者HRQOL的因素是很重要的。目的：本研究探讨了lvad后健康不良社会决定因素（SDOH）与HRQOL之间的关系，以及与HRQOL结果相关的个人和社区水平特征。方法：这是一项基于电子病历的回顾性队列研究。美国东南部一个学术中心的所有HM3 LVAD受者均被纳入研究。HRQOL采用EuroQol-5D视觉模拟量表（VAS）和Kansas City Cardiomyopathy Questionnaire-12 （KCCQ）评分进行评估。使用线性混合模型在6个月、1年、1.5年和2年评估不良SDOH对HRQOL和LVAD自我报告满意度的影响。结果：共纳入111例HM3 LVAD患者（平均年龄50岁，SD 13）。与植入前相比，VAS和KCCQ评分明显升高。社区水平特征与VAS或KCCQ评分没有关系，但教育程度与LVAD后2年较高的KCCQ绝对评分相关（大学- n = 11，平均62.9,SD 20.3；非大学- n = 11，平均39.2,SD 21.5； p值0.018）。满意度结果显示，受教育程度越高，满意度越高（卡方= 8,p = 0.018）。结论：在这个南方队列中，不良社区SDOH因素与LVAD后的HRQOL无关，LVAD后HRQOL有所改善。这些数据支持这种疗法对所有人都有益。教育程度作为健康素养的潜在替代指标，可能是未来干预的一个来源。
{"title":"Impact of adverse social determinants on quality of life and satisfaction after left ventricular assist device: A Southern single-center pilot experience","authors":"Lauren East , Joanna Joly , Preston Nicely , Laura Kukuc , Marie Wilson , Margaret Blood , Elizabeth Baker , Lucia Juarez , Jose Tallaj , William Holman , Nicole Lohr , Yolanda Hall , Stephen Clarkson","doi":"10.1016/j.hrtlng.2025.10.024","DOIUrl":"10.1016/j.hrtlng.2025.10.024","url":null,"abstract":"<div><h3>Background</h3><div>As longevity with left ventricular assist devices (LVAD) and their potential to improve health-related quality of life (HRQOL) increase, it is important to examine factors that may limit HRQOL in patients receiving LVADs.</div></div><div><h3>Objectives</h3><div>This study explores the relationship between adverse social determinants of heath (SDOH) and HRQOL post-LVAD, contextualizing individual and community-level characteristics associated with HRQOL outcomes.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study utilizing EHR based chart review. All HM3 LVAD recipients at an academic center in the Southeast United States were included. HRQOL was estimated by EuroQol-5D visual analog scale (VAS) and Kansas City Cardiomyopathy Questionnaire-12 (KCCQ) score. Impact of adverse SDOH on HRQOL and self-reported satisfaction with LVAD was evaluated using linear mixed models at 6 months, 1 year, 1.5 years, and 2 years.</div></div><div><h3>Results</h3><div>A total of 111 patients with HM3 LVAD (mean age 50, SD 13) were included. VAS and KCCQ scores significantly increased compared to pre-implant. Community-level characteristics showed no relationship with VAS or KCCQ score, but education attainment was associated with higher absolute KCCQ scores at 2 years post LVAD (college- <em>n</em> = 11, mean 62.9, SD 20.3; no college- <em>n</em> = 11, mean 39.2, SD 21.5; p-value 0.018). Satisfaction results demonstrated that those with more education had higher satisfaction (chi square= 8, <em>p</em> = 0.018).</div></div><div><h3>Conclusions</h3><div>In this Southern cohort, adverse community SDOH factors are not associated with HRQOL following LVAD, and post-LVAD, HRQOL improves. These data support the beneficial nature of this therapy for all. Education attainment, a potential surrogate for health literacy, may be a source for future intervention.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 321-328"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410884","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 : 2026-01-01Epub Date: 2025-10-31DOI: 10.1016/j.hrtlng.2025.10.023
Aubree Bussa-Carlson , Timothy Joseph Sowicz
Background
Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease marked by progressive lung scarring of unknown cause. Diagnosis is complex, with an average delay of 2.1 years. While reasons for this delay are documented, less is known about the patient’s lived experience during the diagnostic process.
Objective
This qualitative descriptive study aimed to explore how individuals with IPF describe their diagnostic journey.
Methods
Individual interviews were conducted with people living with IPF. Transcripts were analyzed using qualitative content analysis, identifying meaning units, condensing them, and developing codes. Codes were defined in a codebook and organized into subcategories, which were then grouped into categories to develop a unifying theme.
Results
The sample included 11 individuals with IPF. Analysis generated 119 codes, organized into four categories: 1) Symptom recognition; 2) Explanation of diagnosis from providers; 3) Recognizing and reacting to ignorance about diagnosis; and 4) Deciding to disclose or not. These categories supported a central theme: being diagnosed with IPF is a nuanced, extended, and multifaceted experience. The process begins with symptom recognition and continues through obtaining diagnostic clarity, often requiring self-advocacy and persistence. This journey marks the transition into life with IPF. Diagnosis should thus be understood not as a discrete event, but as a dynamic, ongoing process.
Conclusion
Findings suggest that receiving an IPF diagnosis is not a singular event, but a dynamic and evolving journey, highlighting the need for greater awareness of the patient experience during diagnosis.
{"title":"A journey without a map: Qualitative insights into the diagnosis of idiopathic pulmonary fibrosis","authors":"Aubree Bussa-Carlson , Timothy Joseph Sowicz","doi":"10.1016/j.hrtlng.2025.10.023","DOIUrl":"10.1016/j.hrtlng.2025.10.023","url":null,"abstract":"<div><h3>Background</h3><div>Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease marked by progressive lung scarring of unknown cause. Diagnosis is complex, with an average delay of 2.1 years. While reasons for this delay are documented, less is known about the patient’s lived experience during the diagnostic process.</div></div><div><h3>Objective</h3><div>This qualitative descriptive study aimed to explore how individuals with IPF describe their diagnostic journey.</div></div><div><h3>Methods</h3><div>Individual interviews were conducted with people living with IPF. Transcripts were analyzed using qualitative content analysis, identifying meaning units, condensing them, and developing codes. Codes were defined in a codebook and organized into subcategories, which were then grouped into categories to develop a unifying theme.</div></div><div><h3>Results</h3><div>The sample included 11 individuals with IPF. Analysis generated 119 codes, organized into four categories: 1) Symptom recognition; 2) Explanation of diagnosis from providers; 3) Recognizing and reacting to ignorance about diagnosis; and 4) Deciding to disclose or not. These categories supported a central theme: being diagnosed with IPF is a nuanced, extended, and multifaceted experience. The process begins with symptom recognition and continues through obtaining diagnostic clarity, often requiring self-advocacy and persistence. This journey marks the transition into life with IPF. Diagnosis should thus be understood not as a discrete event, but as a dynamic, ongoing process.</div></div><div><h3>Conclusion</h3><div>Findings suggest that receiving an IPF diagnosis is not a singular event, but a dynamic and evolving journey, highlighting the need for greater awareness of the patient experience during diagnosis.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 347-351"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416334","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}
The impact of smoking on the prognosis of subjects with preserved ratio impaired spirometry (PRISm) remains unclear.
Objective
This study aimed to evaluate the impact of smoking on all-cause mortality in individuals with PRISm.
Methods
Data from the National Health and Nutrition Examination Survey 2007–2012 were analyzed. Survey-weighted Cox proportional hazards models were used to calculate hazard ratios (HRs) with 95 % confidence intervals (CIs) for all-cause mortality.
Results
A total of 741 participants with PRISm (weighted n = 7741,021) were included in the study, comprising 354 never smokers (weighted n = 3798,528), 219 former smokers (weighted n = 2383,778), and 168 current smokers (weighted n = 1558,715). Multivariable Cox regression analysis indicated that current smokers had a significantly increased risk of all-cause mortality compared to never smokers (HR: 2.57; 95 % CI: 2.48–2.67). In contrast, former smokers showed no significant difference in mortality risk compared to never smokers (HR: 1.00; 95 % CI: 0.64–1.57). When compared with current smokers, the HRs for those who had quit smoking ≤10 years, 10–20 years, and >20 years prior to personal interviews were 0.48 (95 % CI: 0.30–0.77), 0.29 (95 % CI: 0.28–0.30), and 0.40 (95 % CI: 0.23–0.92), respectively.
Conclusion
Among individuals with PRISm, current smoking was significantly associated with increased all-cause mortality, whereas former smoking was not linked to an elevated risk.
{"title":"Impact of smoking on all-cause mortality in individuals with preserved ratio impaired spirometry: A population-based cohort study","authors":"Ping Lin, Mingjing Yu, Faming Jiang , Zongan Liang","doi":"10.1016/j.hrtlng.2025.09.010","DOIUrl":"10.1016/j.hrtlng.2025.09.010","url":null,"abstract":"<div><h3>Background</h3><div>The impact of smoking on the prognosis of subjects with preserved ratio impaired spirometry (PRISm) remains unclear.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the impact of smoking on all-cause mortality in individuals with PRISm.</div></div><div><h3>Methods</h3><div>Data from the National Health and Nutrition Examination Survey 2007–2012 were analyzed. Survey-weighted Cox proportional hazards models were used to calculate hazard ratios (HRs) with 95 % confidence intervals (CIs) for all-cause mortality.</div></div><div><h3>Results</h3><div>A total of 741 participants with PRISm (weighted <em>n</em> = 7741,021) were included in the study, comprising 354 never smokers (weighted <em>n</em> = 3798,528), 219 former smokers (weighted <em>n</em> = 2383,778), and 168 current smokers (weighted <em>n</em> = 1558,715). Multivariable Cox regression analysis indicated that current smokers had a significantly increased risk of all-cause mortality compared to never smokers (HR: 2.57; 95 % CI: 2.48–2.67). In contrast, former smokers showed no significant difference in mortality risk compared to never smokers (HR: 1.00; 95 % CI: 0.64–1.57). When compared with current smokers, the HRs for those who had quit smoking ≤10 years, 10–20 years, and >20 years prior to personal interviews were 0.48 (95 % CI: 0.30–0.77), 0.29 (95 % CI: 0.28–0.30), and 0.40 (95 % CI: 0.23–0.92), respectively.</div></div><div><h3>Conclusion</h3><div>Among individuals with PRISm, current smoking was significantly associated with increased all-cause mortality, whereas former smoking was not linked to an elevated risk.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 65-70"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087933","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 : 2026-01-01Epub Date: 2025-10-04DOI: 10.1016/j.hrtlng.2025.09.019
Serdar Özdemir, İbrahim Altunok
Background
Non-ST-elevation myocardial infarction (NSTEMI) accounts for the majority of acute coronary syndromes, and accurate early risk stratification is essential for guiding clinical management. Traditional scoring systems are complex and may not be feasible in emergency settings. The blood urea nitrogen-to-left ventricular ejection fraction ratio (BUN/LVEF) has recently been proposed as a simple biomarker reflecting the interaction between cardiac and renal function.
Objectives
This study aimed to evaluate the prognostic value of BUN/LVEF in predicting 30-day all-cause mortality in patients with NSTEMI.
Methods
We conducted a retrospective observational study including 222 patients diagnosed with NSTEMI who presented to the emergency department of a tertiary university hospital between April 2024 and April 2025. Demographic, clinical, laboratory, and echocardiographic data were collected from hospital records. BUN/LVEF was calculated as BUN (mg/dL)/LVEF (%). Receiver operating characteristic (ROC) analysis was used to assess predictive performance.
Results
The median age was 61 years, and 70.3 % were male. The 30-day mortality rate was 13 %. Non-survivors had significantly higher BUN/LVEF compared with survivors (1.48 vs 0.64, p < 0.001). ROC analysis revealed that BUN/LVEF had an AUC of 0.802 for predicting mortality. A cutoff value of 1.465 provided 93.3 % sensitivity, 51.7 % specificity, and 87.8 % overall diagnostic accuracy.
Conclusion
BUN/LVEF is a simple, accessible, and independent predictor of short-term mortality in NSTEMI patients. Its ease of calculation and strong prognostic performance suggest potential clinical utility as a rapid risk stratification tool in emergency practice.
背景：非st段抬高型心肌梗死（NSTEMI）在急性冠状动脉综合征中占多数，准确的早期风险分层对指导临床治疗至关重要。传统的评分系统很复杂，在紧急情况下可能不可行。血液尿素氮与左心室射血分数比（BUN/LVEF）最近被提出作为反映心脏和肾脏功能相互作用的简单生物标志物。目的：本研究旨在评估BUN/LVEF在预测NSTEMI患者30天全因死亡率中的预后价值。方法：我们进行了一项回顾性观察研究，纳入了2024年4月至2025年4月在某三级大学医院急诊科就诊的222例确诊为NSTEMI的患者。从医院记录中收集人口统计、临床、实验室和超声心动图数据。BUN/LVEF计算为BUN (mg/dL)/LVEF（%）。采用受试者工作特征（ROC）分析评估预测效果。结果：中位年龄61岁，男性占70.3%。30天死亡率为13%。与幸存者相比，非幸存者的BUN/LVEF明显更高（1.48 vs 0.64, p < 0.001）。ROC分析显示，BUN/LVEF预测死亡率的AUC为0.802。截断值为1.465，灵敏度为93.3%，特异性为51.7%，总体诊断准确率为87.8%。结论：BUN/LVEF是NSTEMI患者短期死亡率的一个简单、可及且独立的预测指标。其易于计算和强大的预后性能表明潜在的临床应用，作为一个快速的风险分层工具在急诊实践。
{"title":"Blood urea nitrogen-to-left ventricular ejection fraction ratio as a prognostic indicator in non-ST-elevation myocardial infarction: Clinical utility as a mortality marker","authors":"Serdar Özdemir, İbrahim Altunok","doi":"10.1016/j.hrtlng.2025.09.019","DOIUrl":"10.1016/j.hrtlng.2025.09.019","url":null,"abstract":"<div><h3>Background</h3><div>Non-ST-elevation myocardial infarction (NSTEMI) accounts for the majority of acute coronary syndromes, and accurate early risk stratification is essential for guiding clinical management. Traditional scoring systems are complex and may not be feasible in emergency settings. The blood urea nitrogen-to-left ventricular ejection fraction ratio (BUN/LVEF) has recently been proposed as a simple biomarker reflecting the interaction between cardiac and renal function.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the prognostic value of BUN/LVEF in predicting 30-day all-cause mortality in patients with NSTEMI.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational study including 222 patients diagnosed with NSTEMI who presented to the emergency department of a tertiary university hospital between April 2024 and April 2025. Demographic, clinical, laboratory, and echocardiographic data were collected from hospital records. BUN/LVEF was calculated as BUN (mg/dL)/LVEF (%). Receiver operating characteristic (ROC) analysis was used to assess predictive performance.</div></div><div><h3>Results</h3><div>The median age was 61 years, and 70.3 % were male. The 30-day mortality rate was 13 %. Non-survivors had significantly higher BUN/LVEF compared with survivors (1.48 vs 0.64, <em>p</em> < 0.001). ROC analysis revealed that BUN/LVEF had an AUC of 0.802 for predicting mortality. A cutoff value of 1.465 provided 93.3 % sensitivity, 51.7 % specificity, and 87.8 % overall diagnostic accuracy.</div></div><div><h3>Conclusion</h3><div>BUN/LVEF is a simple, accessible, and independent predictor of short-term mortality in NSTEMI patients. Its ease of calculation and strong prognostic performance suggest potential clinical utility as a rapid risk stratification tool in emergency practice.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 171-177"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234254","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 : 2026-01-01Epub Date: 2025-09-18DOI: 10.1016/j.hrtlng.2025.09.015
Sachin Singh MD , Adil Sarvar Mohammed MD , Joel DeJonge , Anoop Venkat Puskoor MD , Rupak Desai MBBS , Muhammad Usman Ghani MD , Paritharsh Ghantasala MD FACP , Peter G. Fattal MD FACC , Nishtha Sareen MD MPH FACC FSCAI
Introduction
Tricuspid regurgitation (TR) may have detrimental effects on heart failure (HF) patients clinically. We aimed to study the impact of severity of TR on the long-term outcomes in patients with HF.
Objectives
To understand the association between moderate-to-severe TR and long-term clinical outcomes, including mortality and HF-related hospitalizations, in adults with HF.
Methods
We screened PubMed, SCOPUS, and Google Scholar databases up to May 2024 using appropriate keywords. Pooled odds ratios (OR) and confidence intervals (95 % CI) were estimated using a binary random effects model. Heterogeneity was assessed using I2 statistics, and a leave-one-out analysis was performed.
Results
Ten studies with 456,353 HF patients were included. The mean age was 71.2 years. Severe TR showed a significant association with higher odds of 1-year mortality (OR=1.25 [1.02–1.52], p = 0.03; I2=78.15 %), 2-year mortality (OR=1.63 [1.28–2.09], p < 0.01; I2=0 %), HF hospitalization (OR=1.39 [1.14–1.71], p < 0.01; I2=61.58 %), and composite events (OR=1.44 [1.10–1.88], p < 0.01; I2=73.46 %). However, it showed no association with cardiovascular deaths (OR=1.35 [0.82–2.24], p = 0.24; I2=78.31 %). Upon performing a leave-one-out sensitivity analysis, we found that excluding Adamo et al.’s 2024 study changed the overall OR to 1.34 (95 % CI: 1.29, 1.39), indicating its influence on the estimate.
Conclusion
Severe TR is associated with a higher risk of 1-year and 2-year mortality, HF hospitalizations, and composite events among HF patients. Therefore, HF patients with comorbid TR should be promptly screened and managed [Figure 1]
三尖瓣反流（TR）可能对心力衰竭（HF）患者有不利的临床影响。我们的目的是研究TR严重程度对HF患者长期预后的影响。目的：了解成人HF患者中重度TR与长期临床结果（包括死亡率和HF相关住院）之间的关系。方法：筛选截至2024年5月的PubMed、SCOPUS和谷歌Scholar数据库，使用合适的关键词。使用二元随机效应模型估计合并优势比（OR）和置信区间（95% CI）。采用I2统计量评估异质性，并进行留一分析。结果：纳入10项研究，456,353例HF患者。平均年龄为71.2岁。严重TR与1年死亡率（OR=1.25 [1.02-1.52], p = 0.03; I2= 78.15%）、2年死亡率（OR=1.63 [1.28-2.09], p < 0.01; I2= 0%）、HF住院率（OR=1.39 [1.14-1.71], p < 0.01; I2= 61.58%）和复合事件（OR=1.44 [1.10-1.88], p < 0.01; I2= 73.46%）相关。但与心血管死亡无相关性（OR=1.35 [0.82-2.24], p = 0.24; I2= 78.31%）。在进行留一敏感性分析后，我们发现，排除Adamo等人的2024年研究将总体OR改变为1.34 (95% CI: 1.29, 1.39)，表明其对估计的影响。结论：严重TR与HF患者1年和2年死亡率、HF住院和复合事件的高风险相关。因此，合并合并TR的HF患者应及时筛查和管理[图1]。
{"title":"Impact of moderate to severe tricuspid regurgitation on long-term clinical outcomes in heart failure: A systematic review and meta-analysis of 456,353 patients","authors":"Sachin Singh MD , Adil Sarvar Mohammed MD , Joel DeJonge , Anoop Venkat Puskoor MD , Rupak Desai MBBS , Muhammad Usman Ghani MD , Paritharsh Ghantasala MD FACP , Peter G. Fattal MD FACC , Nishtha Sareen MD MPH FACC FSCAI","doi":"10.1016/j.hrtlng.2025.09.015","DOIUrl":"10.1016/j.hrtlng.2025.09.015","url":null,"abstract":"<div><h3>Introduction</h3><div>Tricuspid regurgitation (TR) may have detrimental effects on heart failure (HF) patients clinically. We aimed to study the impact of severity of TR on the long-term outcomes in patients with HF.</div></div><div><h3>Objectives</h3><div>To understand the association between moderate-to-severe TR and long-term clinical outcomes, including mortality and HF-related hospitalizations, in adults with HF.</div></div><div><h3>Methods</h3><div>We screened PubMed, SCOPUS, and Google Scholar databases up to May 2024 using appropriate keywords. Pooled odds ratios (OR) and confidence intervals (95 % CI) were estimated using a binary random effects model. Heterogeneity was assessed using I2 statistics, and a leave-one-out analysis was performed.</div></div><div><h3>Results</h3><div>Ten studies with 456,353 HF patients were included. The mean age was 71.2 years. Severe TR showed a significant association with higher odds of 1-year mortality (OR=1.25 [1.02–1.52], <em>p</em> = 0.03; I2=78.15 %), 2-year mortality (OR=1.63 [1.28–2.09], <em>p</em> < 0.01; I2=0 %), HF hospitalization (OR=1.39 [1.14–1.71], <em>p</em> < 0.01; I2=61.58 %), and composite events (OR=1.44 [1.10–1.88], <em>p</em> < 0.01; I2=73.46 %). However, it showed no association with cardiovascular deaths (OR=1.35 [0.82–2.24], <em>p</em> = 0.24; I2=78.31 %). Upon performing a leave-one-out sensitivity analysis, we found that excluding Adamo et al.’s 2024 study changed the overall OR to 1.34 (95 % CI: 1.29, 1.39), indicating its influence on the estimate.</div></div><div><h3>Conclusion</h3><div>Severe TR is associated with a higher risk of 1-year and 2-year mortality, HF hospitalizations, and composite events among HF patients. Therefore, HF patients with comorbid TR should be promptly screened and managed [Figure 1]</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 90-97"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093089","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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