Heart & Lung最新文献

{"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}

{"title":"Supplemental oxygen prescriptions after hospitalization for coronavirus disease 2019","authors":"Zaidan MF ,&nbsp;Puebla Neira DA ,&nbsp;Lau C ,&nbsp;Nishi SP ,&nbsp;Duarte AD ,&nbsp;Wang J ,&nbsp;Kuo YF ,&nbsp;Sharma G","doi":"10.1016/j.hrtlng.2024.10.015","DOIUrl":"10.1016/j.hrtlng.2024.10.015","url":null,"abstract":"<div><h3>Background</h3><div>The role of home oxygen therapy for patients recovering from Coronavirus Disease 2019 (COVID-19) pneumonia, characterized by impaired gas exchange, is not well-defined.</div></div><div><h3>Objectives</h3><div>To compare the characteristics, duration, odds of receiving, and continuing to receive home oxygen prescriptions between patients discharged home after COVID-19 pneumonia hospitalization and those discharged after non-COVID-19 pneumonia.</div></div><div><h3>Methods</h3><div>From April 2020 to March 2021, 52,951 patients with COVID-19 pneumonia (53.6 % women, 64 % White) were identified, and from January 2019 to December 2019, 26,701 patients with non-COVID pneumonia (53.9 % women, 76.7 % White) were identified, using the Optum Clinformatics Data Mart Database. New oxygen prescriptions were identified through Healthcare Common Procedure Coding Systems codes. Propensity score matching adjusted for confounders, and Cox regression analysis was conducted to compare post-discharge oxygen use.</div></div><div><h3>Results</h3><div>Following hospitalization, oxygen was prescribed to 52,951 patients with COVID-19 pneumonia and 26,701 patients with non-COVID pneumonia in the United States. The COVID-19 pneumonia group were four times more likely to be prescribed supplemental oxygen compared to the non-COVID-19 pneumonia group (OR 4.22; 95 % confidence interval [CI] 3.76–4.74). This trend persisted in sensitivity analyses: ICU patients (OR 4.05; 95 % CI 3.36–4.88) and those who received both ICU admission and mechanical ventilation (OR 3.84; 95 % CI 2.32–6.37). Hispanic patients had the highest likelihood of receiving a supplemental oxygen prescription after discharge (OR 6.75; 95 % CI 5.03–9.05).</div></div><div><h3>Conclusions</h3><div>Post-hospitalization, one in five patients with COVID-19 received prescriptions for supplemental oxygen, which was significantly higher than the proportion of patients with non-COVID-19 pneumonia.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Pages 208-216"},"PeriodicalIF":2.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577749","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":"Inpatient mortality and outcomes of COVID-19 among patients with non-ischemic cardiomyopathy: A propensity matched analysis.","authors":"Mirza Faris Ali Baig, Kalyan Chaliki","doi":"10.1016/j.hrtlng.2024.06.018","DOIUrl":"10.1016/j.hrtlng.2024.06.018","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic medical conditions, particularly cardiovascular diseases, are at a greater risk of adverse outcomes due to COVID-19. The effect of COVID-19 on patients with non-ischemic cardiomyopathy (NICM) is not known well.</p><p><strong>Objectives: </strong>To study the impact of COVID-19 infection on NICM hospital mortality and other outcomes.</p><p><strong>Methods: </strong>This study included a cohort of patients from the 2020 and 2021 National Inpatient Sample databases. Patients hospitalized for COVID-19 with and without NICM were matched using a 1:1 propensity score-matching ratio. Outcomes analyzed were in-hospital mortality, rates of acute kidney injury (AKI), acute myocardial infarction (AMI), cardiogenic shock, cardiac arrest, mechanical ventilation, tracheal intubation, pulmonary embolism (PE), ventricular tachycardia (VT), ventricular fibrillation (VF), length of stay (LOS), and total hospitalization charges.</p><p><strong>Results: </strong>A total of 2,532,652 patients met the inclusion criteria (1,199,008 females [47.3 %], predominantly white 1,456,203 (57.5 %); mean [SD] age 63 [5.4] years), including 64,155 (2.5 %) patients with a history of NICM. Following propensity matching, 10,258 COVID-19 patients with and without NICM were matched. Patients with NICM had higher rates of AMI (11.1 vs. 7.1 %, p < 0.001), cardiogenic shock (2 vs. 0.6 %, p < 0.001), cardiac arrest (4.4 vs. 3.2 %, p < 0.01), mechanical ventilation (13.7 vs 12 %, p < 0.01), VT (8.5 vs. 2.2 %, p < 0.001), and VF (1.0 vs 0.25 %, p < 0.001). The odds ratios for in-hospital mortality, AKI, and PE did not differ significantly.</p><p><strong>Conclusion: </strong>A History of NICM does not affect COVID-19 mortality but increases the risk of cardiovascular complications.</p>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"160-165"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617687","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":"Accelerated biological age mediates the associations between sleep patterns and chronic respiratory diseases: Findings from the UK Biobank Cohort","authors":"Dongze Chen ,&nbsp;Zekang Su ,&nbsp;Yali Zhang ,&nbsp;Yi Bai ,&nbsp;Guiping Hu ,&nbsp;Yi Zhou ,&nbsp;Zhisheng Liang","doi":"10.1016/j.hrtlng.2024.10.012","DOIUrl":"10.1016/j.hrtlng.2024.10.012","url":null,"abstract":"<div><h3>Background</h3><div>Unhealthy sleep patterns and accelerated biological age are frequently associated with multiple chronic respiratory diseases (CRDs), including COPD, asthma, and interstitial lung disease (ILD). However, few studies have explored the role of biological age in the relationship between sleep patterns and CRDs.</div></div><div><h3>Objectives</h3><div>To explore the association between sleep patterns and CRD, and the extent to which biological age mediates the relationship between sleep patterns and CRD.</div></div><div><h3>Methods</h3><div>This was a prospective cohort study based on UK Biobank. The sleep score was derived from five self-reported sleep traits: sleep duration, daytime sleepiness, chronotype, snoring, and insomnia. The score ranged from 0 (least healthy) to 5 (healthiest). Biological age was represented by PhenoAgeAccel.</div></div><div><h3>Results</h3><div>Among 303,588 participants, 11,105 (3.7 %), 9,380 (3.1 %), and 1,667 (0.5 %) were diagnosed with asthma, COPD, and ILD, respectively. Each 1-point increase in the sleep score was associated with a 0.156-year reduction in PhenoAgeAccel, and 14.3 %, 12.4 %, and 6.7 % reduction in asthma, COPD, and ILD, respectively. For each 1-year increase in PhenoAgeAccel, the risk of asthma, COPD, and ILD increased by 2.8 %, 4.3 %, and 5.7 %, respectively. PhenoAgeAccel mediated the associations between the sleep score and asthma, COPD, and ILD, with a mediated proportion (95 % CI) of 2.81 % (2.35 % to 3.27 %), 4.94 % (4.23 % to 5.66 %), and 12.48 % (10.43 % to 14.53 %), respectively.</div></div><div><h3>Conclusion</h3><div>A better sleep score was significantly associated with younger biological age and decreased risk of CRDs, with biological age playing a mediating role in the association between sleep score and CRDs.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Pages 192-201"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564655","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":"Inflammatory and cardiac biomarkers in pulmonary arterial hypertension: The prognostic role of IL-34","authors":"Hasan Ata Bolayır ,&nbsp;Mehdi Karasu MD ,&nbsp;Mehmet Ali Gelen MD ,&nbsp;Yusuf Akın MD ,&nbsp;Erkan Çeçen MD ,&nbsp;Uğur Küçük MD ,&nbsp;Aykut Bulu MD","doi":"10.1016/j.hrtlng.2024.10.010","DOIUrl":"10.1016/j.hrtlng.2024.10.010","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary arterial hypertension (PAH) is characterized by increased pulmonary artery pressure with significant morbidity and mortality. Inflammatory processes are crucial in PAH pathogenesis, with inflammatory cells and mediators present early in disease progression. IL-34 involvement in inflammatory pathways suggests that IL-34 could be an important player in the progression of PAH, influencing both pulmonary pressures and vascular changes.</div></div><div><h3>Objective</h3><div>The purpose of this study was to investigate the correlation between IL-34 levels and pulmonary arterial hypertension (PAH), aiming to enhance the understanding of the molecular mechanisms underlying PAH and explore IL-34′s potential as a biomarker.</div></div><div><h3>Methods</h3><div>Consecutive PAH patients diagnosed via right-heart catheterization at Malatya Turgut Ozal Eğitim ve Araştırma Hastanesi (Dec 2022 - Apr 2024) were enrolled. Patients were classified into low-risk and high-risk groups based on comprehensive risk assessments that included clinical parameters, hemodynamic measurements and biomarkers, in-line with ESC/ERS guidelines. Serum IL-34, hs-CRP, and NT-proBNP levels were measured and compared with those of healthy controls. Echocardiographic assessments and statistical analyses, including ROC analysis, were conducted to evaluate biomarker significance and predictive capabilities.</div></div><div><h3>Results</h3><div>The mean age of low-risk and high-risk PAH patients was 42 ± 7.2 years and 45 ± 5.5 years, respectively. The mean age of the control group was 40 ± 6.4 years. Males comprised 54.29 % of the low-risk group, 56 % of the high-risk group, and 53.3 % of the control group. IL-34 and hs-CRP levels were significantly elevated in PAH patients compared to controls. IL-34 correlated positively with systolic pulmonary artery pressure, RA area, and NT-proBNP levels. Multivariate analysis revealed that IL-34 and hs-CRP were independent predictors of PAH. IL-34 levels&gt;29.8 pg/mL predicted PAH with 78 % sensitivity and 69 % specificity, while levels &gt;44.4 pg/mL predicted high-risk PAH with 84 % sensitivity and 77 % specificity.</div></div><div><h3>Conclusion</h3><div>Elevated IL-34 and hs-CRP levels are associated with PAH severity and right ventricular dysfunction, suggesting IL-34′s potential as a diagnostic and prognostic biomarker. Further research is needed to validate these findings and explore IL-34-targeted therapies in pH management.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Pages 202-207"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564668","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":"Time to death after compassionate extubation in medical and neuroscience intensive care units","authors":"Elaine Chen MD ,&nbsp;Nicholas Kosinski BA ,&nbsp;Ramandeep Kaur PhD","doi":"10.1016/j.hrtlng.2024.10.005","DOIUrl":"10.1016/j.hrtlng.2024.10.005","url":null,"abstract":"<div><h3>Background</h3><div>Medical ICU (MICU) and neuroscience ICU (NSICU) populations undergoing compassionate extubation (CE) may have different characteristics that affect post-procedure outcomes.</div></div><div><h3>Objectives</h3><div>To contrast clinical characteristics and evaluate time to death (TTD) following CE in MICU and NSICU populations.</div></div><div><h3>Methods</h3><div>Single-center retrospective cohort study of patients who completed CE in a MICU or NSICU in 2021. Data were obtained by manual chart abstraction. A Mann-Whitney U test was used to compare characteristics between the clinical units.</div></div><div><h3>Results</h3><div>Fifty patients were included in the study, 27 were in the MICU and 23 in the NSICU. Median age was 68 years. Patients in the MICU had a longer LOS before CE than those in the NSICU (10.0 vs. 3.0 days, p=0.001). Patients in the MICU experienced a shorter median TTD after CE than those in the NSICU (25 vs. 195 mins, p=0.004). MICU patients had a higher pre-hospital burden of illness (median CCI 6 vs 3, p=0.003), and a higher degree of organ failure at CE (median SOFA 12 vs 6, p&lt;0.001), with more severe hypoxemia (PaO2/FiO2 ratio of 149 vs 360, p&lt;0.001). Most MICU patients died of infection or cancer, compared with NSICU patients who had intracranial hemorrhage or ischemic stroke.</div></div><div><h3>Conclusion</h3><div>Patients in the NSICU underwent CE after shorter time in the ICU and survived longer afterwards than MICU patients. Patients in the MICU have a higher pre-hospital severity of illness and a higher level of organ failure at the time of CE compared with NSICU patients.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Pages 185-191"},"PeriodicalIF":2.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142561378","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}