Pub Date : 2026-01-09DOI: 10.1016/j.hrtlng.2025.102723
Alicia Bill PharmD , Bruce E. Blaine PhD, PStat® , Anuradha Godishala MD , John Martens MPH , Amanda Lloji MD , YeeAnn Chen PharmD
Background
Early aspirin initiation after orthotopic heart transplant (OHT) has been associated with delayed progression of cardiac allograft vasculopathy (CAV). There is limited guidance on whether aspirin for CAV prophylaxis should be continued in the setting of therapeutic anticoagulation.
Objectives
The purpose of this study is to compare the safety and efficacy of two antithrombotic strategies, anticoagulation alone (AC) versus combined anticoagulation and aspirin (AC+ASA), for patients with indications for therapeutic anticoagulation.
Methods
This was a single-center, retrospective, and observational cohort study of adult OHT recipients. The primary outcome was major bleeding within the first month of starting anticoagulation. Secondary outcomes included clinically relevant non-major bleeding, major bleeding within the first three months and first year of anticoagulation therapy, incidence of CAV, and death.
Results
Among the 126 patients included in the primary analysis, there were five and 19 major bleeding events in the AC group and AC+ASA group, respectively (p = 0.649). The AC group had 14.3 times higher odds of death than the AC+ASA group (OR 0.07, 95 % CI 0.01–0.32). There were no differences in other secondary outcomes.
Conclusion
In our cohort, there was no evidence of a difference between groups for major bleeding within one month of anticoagulation initiation. Future research focusing on appropriateness of therapeutic anticoagulation in the acute period after transplant where patients are at an increased risk of bleeding may be beneficial.
背景：原位心脏移植（OHT）后服用阿司匹林与心脏移植血管病变（CAV）的延迟进展有关。在治疗性抗凝的情况下，是否继续使用阿司匹林预防CAV的指导有限。目的本研究的目的是比较两种抗血栓策略，抗凝单独（AC）与抗凝联合阿司匹林（AC+ASA），对于有治疗性抗凝指征的患者的安全性和有效性。方法本研究为单中心、回顾性、观察性队列研究，对象为成人OHT受者。主要结局是在开始抗凝治疗的第一个月内出现大出血。次要结局包括临床相关的非大出血、抗凝治疗前三个月和第一年的大出血、CAV发生率和死亡。结果初步分析纳入的126例患者中，AC组和AC+ASA组分别有5例和19例大出血事件（p = 0.649）。AC组的死亡几率是AC+ASA组的14.3倍（OR 0.07, 95% CI 0.01 ~ 0.32）。其他次要结局无差异。在我们的队列中，没有证据表明抗凝治疗开始一个月内大出血在两组之间有差异。未来的研究重点是移植后急性期治疗抗凝的适宜性，此时患者出血风险增加，这可能是有益的。
{"title":"DisCONtinuing aspirin for Cardiac Allograft Vasculopathy prophylaxis in heart transplant patients on concurrEnt anticoagulation (CONCAVE)","authors":"Alicia Bill PharmD , Bruce E. Blaine PhD, PStat® , Anuradha Godishala MD , John Martens MPH , Amanda Lloji MD , YeeAnn Chen PharmD","doi":"10.1016/j.hrtlng.2025.102723","DOIUrl":"10.1016/j.hrtlng.2025.102723","url":null,"abstract":"<div><h3>Background</h3><div>Early aspirin initiation after orthotopic heart transplant (OHT) has been associated with delayed progression of cardiac allograft vasculopathy (CAV). There is limited guidance on whether aspirin for CAV prophylaxis should be continued in the setting of therapeutic anticoagulation.</div></div><div><h3>Objectives</h3><div>The purpose of this study is to compare the safety and efficacy of two antithrombotic strategies, anticoagulation alone (AC) versus combined anticoagulation and aspirin (AC+ASA), for patients with indications for therapeutic anticoagulation.</div></div><div><h3>Methods</h3><div>This was a single-center, retrospective, and observational cohort study of adult OHT recipients. The primary outcome was major bleeding within the first month of starting anticoagulation. Secondary outcomes included clinically relevant non-major bleeding, major bleeding within the first three months and first year of anticoagulation therapy, incidence of CAV, and death.</div></div><div><h3>Results</h3><div>Among the 126 patients included in the primary analysis, there were five and 19 major bleeding events in the AC group and AC+ASA group, respectively (<em>p</em> = 0.649). The AC group had 14.3 times higher odds of death than the AC+ASA group (OR 0.07, 95 % CI 0.01–0.32). There were no differences in other secondary outcomes.</div></div><div><h3>Conclusion</h3><div>In our cohort, there was no evidence of a difference between groups for major bleeding within one month of anticoagulation initiation. Future research focusing on appropriateness of therapeutic anticoagulation in the acute period after transplant where patients are at an increased risk of bleeding may be beneficial.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"77 ","pages":"Article 102723"},"PeriodicalIF":2.6,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926020","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 : 2026-01-08DOI: 10.1016/j.hrtlng.2025.102715
Valentina Scheggi , Pier Luigi Stefàno
Background
Despite advancements in diagnostic and therapeutic strategies, infective endocarditis (IE) remains associated with high morbidity and mortality rates. Recent studies have highlighted significant sex-related differences in the clinical presentation, management, and outcomes of IE, reporting conflicting results.
Objectives
identifying the sex-related differences of patients with IE in clinical presentation and predictors of all-cause mortality.
Methods
We conducted a retrospective study at a high-volume surgical centre, examining 687 new cases of non-device-related IE admitted between January 2013 and November 2023. Data were collected from anonymized electronic hospital records, including demographic, clinical, echocardiographic, and microbiologic characteristics. Statistical analyses were performed to identify sex-related differences in clinical presentation and predictors of all-cause mortality.
Results
Female patients represented 34% of the cohort and were significantly older than males (69.6 vs. 63.9 years, p < 0.001). Females had higher prevalence of diabetes (24.8% vs. 18.1%, p = 0.039) and hypertension (65.8% vs. 57%, p = 0.025). Mitral valve IE was more common in females (46.6% vs. 36%, p = 0.023), while males had higher incidence of spondylodiscitis (10.2% vs. 3.4%, p = 0.002). Overall mortality was higher in females, but sex was not an independent predictor of mortality at multivariable analysis.
Conclusion
Our study highlights important sex-based differences in IE, emphasizing the need for sex-specific approaches to diagnosis, treatment, and management. Recognizing and addressing these differences can improve outcomes for both male and female patients with IE.
{"title":"Sex-related differences in infective endocarditis. A retrospective study in a high-volume surgical centre","authors":"Valentina Scheggi , Pier Luigi Stefàno","doi":"10.1016/j.hrtlng.2025.102715","DOIUrl":"10.1016/j.hrtlng.2025.102715","url":null,"abstract":"<div><h3>Background</h3><div>Despite advancements in diagnostic and therapeutic strategies, infective endocarditis (IE) remains associated with high morbidity and mortality rates. Recent studies have highlighted significant sex-related differences in the clinical presentation, management, and outcomes of IE, reporting conflicting results.</div></div><div><h3>Objectives</h3><div>identifying the sex-related differences of patients with IE in clinical presentation and predictors of all-cause mortality.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study at a high-volume surgical centre, examining 687 new cases of non-device-related IE admitted between January 2013 and November 2023. Data were collected from anonymized electronic hospital records, including demographic, clinical, echocardiographic, and microbiologic characteristics. Statistical analyses were performed to identify sex-related differences in clinical presentation and predictors of all-cause mortality.</div></div><div><h3>Results</h3><div>Female patients represented 34% of the cohort and were significantly older than males (69.6 vs. 63.9 years, <em>p</em> < 0.001). Females had higher prevalence of diabetes (24.8% vs. 18.1%, <em>p</em> = 0.039) and hypertension (65.8% vs. 57%, <em>p</em> = 0.025). Mitral valve IE was more common in females (46.6% vs. 36%, <em>p</em> = 0.023), while males had higher incidence of spondylodiscitis (10.2% vs. 3.4%, <em>p</em> = 0.002). Overall mortality was higher in females, but sex was not an independent predictor of mortality at multivariable analysis.</div></div><div><h3>Conclusion</h3><div>Our study highlights important sex-based differences in IE, emphasizing the need for sex-specific approaches to diagnosis, treatment, and management. Recognizing and addressing these differences can improve outcomes for both male and female patients with IE.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102715"},"PeriodicalIF":2.6,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145908902","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 : 2026-01-08DOI: 10.1016/j.hrtlng.2025.102708
Burak Günay, Ömer Kostak, Atakan Küskün, Halis Harun Öztürk, Fatma Öztora, Muzaffer Savaş Tepe
Background
Extracardiac lung parenchymal findings (ECLF) are frequently identified during coronary computed tomography angiography (CCTA), although their relationship to coronary artery stenosis severity and plaque features is uncertain.
Objectives
To evaluate the relationship between the frequency and distribution of ECLF, observed in patients with normal coronary arteries and those with stenosed coronary arteries, the degree of coronary artery stenosis, and plaque types.
Methods
The examination of 335 patients who underwent CCTA for stable angina analyzed at the existence and types of ECLF, as well as the features of stenosis and plaque types in the coronary arteries. Stenosis severity was defined as mild, moderate, or severe, and plaque type as calcified, soft, or mixed. ECLF such as emphysema, atelectasis, nodule, bronchiectasis, consolidation were systematically investigated.
Results
Patients with calcified and mixed-type plaques were significantly older than those without plaques (p < 0.001). The prevalence of ECLF was significantly higher in patients with soft and mixed plaques compared to those with calcified plaques (p = 0.031). A significant association was observed between coronary artery stenosis severity and presence of ECFL (p = 0.0288), with emphysema being significantly more common in patients with severe stenosis (p < 0.001). Pulmonary nodules were more frequently detected in cases with soft plaques, whereas atelectasis and emphysema were more commonly associated with calcified plaques.
Conclusion
The frequency of ECLF increased with the severity of coronary stenosis. These findings highlight the importance of systematic assessment of extracardiac structures during CCTA.
{"title":"Is there a relationship between extracardiac pulmonary findings and coronary artery stenosis severity and plaque types?","authors":"Burak Günay, Ömer Kostak, Atakan Küskün, Halis Harun Öztürk, Fatma Öztora, Muzaffer Savaş Tepe","doi":"10.1016/j.hrtlng.2025.102708","DOIUrl":"10.1016/j.hrtlng.2025.102708","url":null,"abstract":"<div><h3>Background</h3><div>Extracardiac lung parenchymal findings (ECLF) are frequently identified during coronary computed tomography angiography (CCTA), although their relationship to coronary artery stenosis severity and plaque features is uncertain.</div></div><div><h3>Objectives</h3><div>To evaluate the relationship between the frequency and distribution of ECLF, observed in patients with normal coronary arteries and those with stenosed coronary arteries, the degree of coronary artery stenosis, and plaque types.</div></div><div><h3>Methods</h3><div>The examination of 335 patients who underwent CCTA for stable angina analyzed at the existence and types of ECLF, as well as the features of stenosis and plaque types in the coronary arteries. Stenosis severity was defined as mild, moderate, or severe, and plaque type as calcified, soft, or mixed. ECLF such as emphysema, atelectasis, nodule, bronchiectasis, consolidation were systematically investigated.</div></div><div><h3>Results</h3><div>Patients with calcified and mixed-type plaques were significantly older than those without plaques (<em>p</em> < 0.001). The prevalence of ECLF was significantly higher in patients with soft and mixed plaques compared to those with calcified plaques (<em>p</em> = 0.031). A significant association was observed between coronary artery stenosis severity and presence of ECFL (<em>p</em> = 0.0288), with emphysema being significantly more common in patients with severe stenosis (<em>p</em> < 0.001). Pulmonary nodules were more frequently detected in cases with soft plaques, whereas atelectasis and emphysema were more commonly associated with calcified plaques.</div></div><div><h3>Conclusion</h3><div>The frequency of ECLF increased with the severity of coronary stenosis. These findings highlight the importance of systematic assessment of extracardiac structures during CCTA.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"77 ","pages":"Article 102708"},"PeriodicalIF":2.6,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926110","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 : 2026-01-08DOI: 10.1016/j.hrtlng.2025.102701
Adnan Bhat , Anchit Chauhan , Maulinkumar Patel , Mariam Shahabi , Umar Iqbal , Mohammed Elzeneini , Waseem Nabi , Muzamil Khan , Nouman Aziz , Cesar A. Trillo , Jorge E. Lascano
Background
As survival improves for people with cystic fibrosis (PwCF) in the era of CFTR modulators, cardiovascular (CV) diseases are emerging as clinically important comorbidities. Beyond age-related risks, mechanistic pathways such as systemic inflammation, chronic hypoxia, CF-related diabetes, and CFTR-related endothelial dysfunction may contribute to CV injury. However, national-level data on CV outcomes in PwCF remain limited.
Objectives
We hypothesized that primary cardiac admissions in PwCF are increasing over time and associated with worse in-hospital outcomes compared to non-cardiac admissions.
Methods
We retrospectively analyzed adult (≥18 years) PwCF hospitalizations in the U.S. National Inpatient Sample (2016–2022). Primary cardiac admissions were defined by a principal diagnosis of atrial fibrillation (AF), heart failure (HF), or myocardial infarction (MI) using ICD-10 codes. Outcomes included in-hospital mortality, length of stay (LOS), charges, and discharge disposition. Temporal trends in cardiac admissions were modeled using negative binomial regression with an offset for total CF hospitalizations; Joinpoint regression was performed as a complementary method. Descriptive statistics and multivariable regression models adjusted for age, sex, and race were used. A p-value <0.05 was considered statistically significant.
Results
Among 121,290 PwCF hospitalizations, 520 (0.43%) were for cardiac causes. PwCF with cardiac admissions were older (median 62 vs. 29 years, p < 0.001) and had more traditional CV comorbidities. Cardiac admission rates increased by 16.4% per year from 2016 to 2022 (IRR 1.16 [1.04–1.29], p = 0.009) in negative binomial regression. Joinpoint regression detected no significant inflection points and estimated a non-significant APC of 16.4% per year (95% CI 10.9–57.4, p = 0.214). Unadjusted mortality was higher for cardiac vs. non-cardiac admissions (OR 3.70, 95% CI 1.61–8.53, p = 0.002), but not significant after adjustment (OR 1.36, 95% CI 0.55–3.34, p = 0.468).
Conclusion
Our findings indicated higher in-hospital mortality among PwCF admitted for cardiac causes, and more discharge to nursing facilities among PwCF admitted for cardiac causes. There is a need for greater CV screening, and geriatric care in PwCF.
在CFTR调节剂时代，随着囊性纤维化（PwCF）患者生存率的提高，心血管（CV）疾病正在成为临床重要的合并症。除了年龄相关的风险外，系统性炎症、慢性缺氧、cf相关糖尿病和cftr相关内皮功能障碍等机制途径也可能导致CV损伤。然而，关于PwCF的CV结果的国家级数据仍然有限。目的：我们假设PwCF的原发性心脏住院随着时间的推移而增加，并且与非心脏住院相比，住院结果更差。方法回顾性分析2016-2022年美国全国住院患者样本中成人（≥18岁）PwCF住院情况。根据ICD-10编码，以心房颤动（AF）、心力衰竭（HF）或心肌梗死（MI）为主要诊断来定义原发性心脏入院。结果包括住院死亡率、住院时间（LOS）、收费和出院处理。心脏住院的时间趋势采用负二项回归模型，并对CF总住院率进行偏移；结合点回归作为补充方法。使用描述性统计和多变量回归模型调整年龄、性别和种族。p值<；0.05被认为具有统计学意义。结果121290例PwCF患者中，520例（0.43%）因心脏原因住院。心脏入院的PwCF患者年龄较大（中位62岁vs. 29岁，p < 0.001），并且有更多传统的心血管合并症。在负二项回归中，2016 - 2022年心脏住院率每年增加16.4% （IRR 1.16 [1.04-1.29], p = 0.009）。联合点回归未检测到显著拐点，估计无显著APC为每年16.4% （95% CI 10.9-57.4, p = 0.214）。未经调整的心脏病死亡率高于非心脏病死亡率（OR 3.70, 95% CI 1.61-8.53, p = 0.002），但调整后的死亡率不显著（OR 1.36, 95% CI 0.55-3.34, p = 0.468）。结论因心脏原因住院的PwCF患者住院死亡率较高，因心脏原因住院的PwCF患者出院率较高。有必要加强心血管筛查和老年护理的PwCF。
{"title":"Cardiovascular disease-associated admissions in patients with Cystic Fibrosis: A 7-Year U.S. National Inpatient Sample Analysis","authors":"Adnan Bhat , Anchit Chauhan , Maulinkumar Patel , Mariam Shahabi , Umar Iqbal , Mohammed Elzeneini , Waseem Nabi , Muzamil Khan , Nouman Aziz , Cesar A. Trillo , Jorge E. Lascano","doi":"10.1016/j.hrtlng.2025.102701","DOIUrl":"10.1016/j.hrtlng.2025.102701","url":null,"abstract":"<div><h3>Background</h3><div>As survival improves for people with cystic fibrosis (PwCF) in the era of CFTR modulators, cardiovascular (CV) diseases are emerging as clinically important comorbidities. Beyond age-related risks, mechanistic pathways such as systemic inflammation, chronic hypoxia, CF-related diabetes, and CFTR-related endothelial dysfunction may contribute to CV injury. However, national-level data on CV outcomes in PwCF remain limited.</div></div><div><h3>Objectives</h3><div>We hypothesized that primary cardiac admissions in PwCF are increasing over time and associated with worse in-hospital outcomes compared to non-cardiac admissions.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed adult (≥18 years) PwCF hospitalizations in the U.S. National Inpatient Sample (2016–2022). Primary cardiac admissions were defined by a principal diagnosis of atrial fibrillation (AF), heart failure (HF), or myocardial infarction (MI) using ICD-10 codes. Outcomes included in-hospital mortality, length of stay (LOS), charges, and discharge disposition. Temporal trends in cardiac admissions were modeled using negative binomial regression with an offset for total CF hospitalizations; Joinpoint regression was performed as a complementary method. Descriptive statistics and multivariable regression models adjusted for age, sex, and race were used. A p-value <0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Among 121,290 PwCF hospitalizations, 520 (0.43%) were for cardiac causes. PwCF with cardiac admissions were older (median 62 vs. 29 years, <em>p</em> < 0.001) and had more traditional CV comorbidities. Cardiac admission rates increased by 16.4% per year from 2016 to 2022 (IRR 1.16 [1.04–1.29], <em>p</em> = 0.009) in negative binomial regression. Joinpoint regression detected no significant inflection points and estimated a non-significant APC of 16.4% per year (95% CI 10.9–57.4, <em>p</em> = 0.214). Unadjusted mortality was higher for cardiac vs. non-cardiac admissions (OR 3.70, 95% CI 1.61–8.53, <em>p</em> = 0.002), but not significant after adjustment (OR 1.36, 95% CI 0.55–3.34, <em>p</em> = 0.468).</div></div><div><h3>Conclusion</h3><div>Our findings indicated higher in-hospital mortality among PwCF admitted for cardiac causes, and more discharge to nursing facilities among PwCF admitted for cardiac causes. There is a need for greater CV screening, and geriatric care in PwCF.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102701"},"PeriodicalIF":2.6,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145908903","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 increase in patients with heart failure is a global issue, and various symptoms of heart failure, such as fatigue and shortness of breath, are associated with a decline in quality of life and high readmission rates. Many patients experience difficulties in managing heart failure at home. Readiness before discharge, including physical, psychological status, knowledge and ability to care, and expected support, is important.
Objectives
To determine the level of and factors associated with readiness for hospital discharge among inpatients with heart failure
Methods
A cross-sectional study design was used. We included adult patients admitted to a tertiary referral hospital in Tokyo, Japan, for heart failure treatment. The Readiness for Hospital Discharge Scale-Japanese version was used to measure the patients’ readiness before hospital discharge. Hierarchical multiple regression analysis was used to assess the impact of independent variables such as patient and clinical characteristics on the Readiness for Hospital Discharge Scale.
Results
The readiness score for one of the subscales, ‘expected support’, was below 7 in the pre-discharge readiness scale. Younger age, living with someone, higher ‘self-care maintenance’ scores, and absence of history of hospitalisation for heart failure were associated with good pre-discharge readiness in patients with heart failure.
Conclusion
This study revealed that hospitalised patients with heart failure generally had low readiness before discharge and identified its relevant factors. The results can be used to identify at-risk patients at an early stage for additional and continuous support.
{"title":"Pre-discharge readiness of hospitalised patients with heart failure and associated factors: A cross-sectional study","authors":"Mina Nozawa , Soichiro Hotta , Miki Arahata , Kaoru Kizawa , Tetsuo Sasano , Makoto Tanaka","doi":"10.1016/j.hrtlng.2025.102722","DOIUrl":"10.1016/j.hrtlng.2025.102722","url":null,"abstract":"<div><h3>Background</h3><div>The increase in patients with heart failure is a global issue, and various symptoms of heart failure, such as fatigue and shortness of breath, are associated with a decline in quality of life and high readmission rates. Many patients experience difficulties in managing heart failure at home. Readiness before discharge, including physical, psychological status, knowledge and ability to care, and expected support, is important.</div></div><div><h3>Objectives</h3><div>To determine the level of and factors associated with readiness for hospital discharge among inpatients with heart failure</div></div><div><h3>Methods</h3><div>A cross-sectional study design was used. We included adult patients admitted to a tertiary referral hospital in Tokyo, Japan, for heart failure treatment. The Readiness for Hospital Discharge Scale-Japanese version was used to measure the patients’ readiness before hospital discharge. Hierarchical multiple regression analysis was used to assess the impact of independent variables such as patient and clinical characteristics on the Readiness for Hospital Discharge Scale.</div></div><div><h3>Results</h3><div>The readiness score for one of the subscales, ‘expected support’, was below 7 in the pre-discharge readiness scale. Younger age, living with someone, higher ‘self-care maintenance’ scores, and absence of history of hospitalisation for heart failure were associated with good pre-discharge readiness in patients with heart failure.</div></div><div><h3>Conclusion</h3><div>This study revealed that hospitalised patients with heart failure generally had low readiness before discharge and identified its relevant factors. The results can be used to identify at-risk patients at an early stage for additional and continuous support.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102722"},"PeriodicalIF":2.6,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145908714","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 : 2026-01-06DOI: 10.1016/j.hrtlng.2025.102711
Pablo Álvarez-Maldonado , Grisel Hernández-Ríos , Alejandro Hernández-Solís , Arturo Reding-Bernal , José Guillermo Espinosa-Ramírez , Francisco Navarro-Reynoso
Background
Acute-on-chronic hypercapnic respiratory failure (AHRF) is among the most common causes of hospitalization in patients with obesity hypoventilation syndrome (OHS), and is associated with high mortality rates
Objectives
To characterize the clinical features and identify mortality risk factors in patients with confirmed or suspected OHS admitted to the ICU for AHRF.
Methods
Retrospective analysis of patients admitted to the respiratory-ICU of a tertiary academic hospital. Data was extracted from a prospective database covering from January 2010 to June 2025. Bivariate analyses and multivariable logistic regression were used to identify factors independently associated with in-hospital mortality.
Results
Among 5025 ICU admissions, 333 patients met inclusion criteria: 266 (79.8 %) with confirmed OHS and 67 (20.2 %) classified as suspected OHS. The mean age was 50.6±14.0 years; 56.5 % were male. Overall mortality was 48 % (n=160). Noninvasive mechanical ventilation prevented intubation in 44 % of subjects. In bivariate analysis, age, Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology Score-3 (SAPS-3), and hypertension were associated with increased mortality. Multivariable regression identified age (OR 1.02 per year; p=0.039) and SOFA (OR 1.69 per point; p<0.001) as independent predictors of mortality. Conversely, tracheostomy was associated with a lower risk of death (OR 0.26; p=0.007).
Conclusions
OHS-related AHRF is a common cause of ICU admission in obese patients and is associated with high mortality. Age and SOFA score are independent predictors of poor outcomes, while tracheostomy appears to confer a survival benefit. These findings highlight the need for early identification and tailored management in this understudied population.
{"title":"Outcomes of critically ill patients with obesity hypoventilation syndrome presenting with acute hypercapnic respiratory failure","authors":"Pablo Álvarez-Maldonado , Grisel Hernández-Ríos , Alejandro Hernández-Solís , Arturo Reding-Bernal , José Guillermo Espinosa-Ramírez , Francisco Navarro-Reynoso","doi":"10.1016/j.hrtlng.2025.102711","DOIUrl":"10.1016/j.hrtlng.2025.102711","url":null,"abstract":"<div><h3>Background</h3><div>Acute-on-chronic hypercapnic respiratory failure (AHRF) is among the most common causes of hospitalization in patients with obesity hypoventilation syndrome (OHS), and is associated with high mortality rates</div></div><div><h3>Objectives</h3><div>To characterize the clinical features and identify mortality risk factors in patients with confirmed or suspected OHS admitted to the ICU for AHRF.</div></div><div><h3>Methods</h3><div>Retrospective analysis of patients admitted to the respiratory-ICU of a tertiary academic hospital. Data was extracted from a prospective database covering from January 2010 to June 2025. Bivariate analyses and multivariable logistic regression were used to identify factors independently associated with in-hospital mortality.</div></div><div><h3>Results</h3><div>Among 5025 ICU admissions, 333 patients met inclusion criteria: 266 (79.8 %) with confirmed OHS and 67 (20.2 %) classified as suspected OHS. The mean age was 50.6±14.0 years; 56.5 % were male. Overall mortality was 48 % (n=160). Noninvasive mechanical ventilation prevented intubation in 44 % of subjects. In bivariate analysis, age, Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology Score-3 (SAPS-3), and hypertension were associated with increased mortality. Multivariable regression identified age (OR 1.02 per year; p=0.039) and SOFA (OR 1.69 per point; p<0.001) as independent predictors of mortality. Conversely, tracheostomy was associated with a lower risk of death (OR 0.26; p=0.007).</div></div><div><h3>Conclusions</h3><div>OHS-related AHRF is a common cause of ICU admission in obese patients and is associated with high mortality. Age and SOFA score are independent predictors of poor outcomes, while tracheostomy appears to confer a survival benefit. These findings highlight the need for early identification and tailored management in this understudied population.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"77 ","pages":"Article 102711"},"PeriodicalIF":2.6,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919065","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 incidence of Acute Myocardial Infarction (AMI) is rising among younger populations. Despite advancements in treatment protocols, improvements in morbidity and mortality remain limited.
Objective
To identify risk factors for cardiogenic death and stroke within one year in prematureAMI patients (≤55 years) and to develop a prognostic risk prediction model and scoring scale for comprehensive risk assessment.
Methods
Utilizing clinical study NCT03297164 and the follow-up center database, we included 3630 participants enrolled from January 2017 to August 2022 to create training and testing sets. An external set (n = 472) was then selected. Cox proportional hazards and LASSO regression were employed to identify predictive factors, and β coefficients from multivariable Cox regression were utilized to develop the scoring scale.
Results
Seven predictors were selected. The scoring scale achieved an AUC of 0.75 (0.66–0.84) in the test set and 0.77 (0.63–0.91) in the external set, outperforming the GRACE score (0.61 and 0.50, respectively). Based on event rate distributions, patients were stratified into three risk groups, with significant differences in event rates observed across subsets (log-rank test, P < 0.05). Further optimization of binning strategies, guided by the correlation between predictors and outcomes, resulted in a model with an AUC of 0.83 (0.72–0.93) in the external set. A corresponding web application was developed for supplementary risk assessment.
Conclusions
This study developed and validated a practical scoring scale and a prediction model based on optimized binning strategies for premature AMI patients, offering a comprehensive risk assessment to support clinical decision-making.
{"title":"Risk factors and assessment system for cardiogenic death and stroke in patients with premature acute myocardial infarction","authors":"Xinyu Hou , Jiatong Liu , Jinling Zhang, Xingyi Wang, Qi Liu, Shiyu Wang, Xinyu Yang, Yanqi Zhang, Wenjie Zhang, Shiliang Chen, Yong Sun, Jian Wu","doi":"10.1016/j.hrtlng.2025.102716","DOIUrl":"10.1016/j.hrtlng.2025.102716","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of Acute Myocardial Infarction (AMI) is rising among younger populations. Despite advancements in treatment protocols, improvements in morbidity and mortality remain limited.</div></div><div><h3>Objective</h3><div>To identify risk factors for cardiogenic death and stroke within one year in prematureAMI patients (≤55 years) and to develop a prognostic risk prediction model and scoring scale for comprehensive risk assessment.</div></div><div><h3>Methods</h3><div>Utilizing clinical study NCT03297164 and the follow-up center database, we included 3630 participants enrolled from January 2017 to August 2022 to create training and testing sets. An external set (<em>n</em> = 472) was then selected. Cox proportional hazards and LASSO regression were employed to identify predictive factors, and β coefficients from multivariable Cox regression were utilized to develop the scoring scale.</div></div><div><h3>Results</h3><div>Seven predictors were selected. The scoring scale achieved an AUC of 0.75 (0.66–0.84) in the test set and 0.77 (0.63–0.91) in the external set, outperforming the GRACE score (0.61 and 0.50, respectively). Based on event rate distributions, patients were stratified into three risk groups, with significant differences in event rates observed across subsets (log-rank test, <em>P</em> < 0.05). Further optimization of binning strategies, guided by the correlation between predictors and outcomes, resulted in a model with an AUC of 0.83 (0.72–0.93) in the external set. A corresponding web application was developed for supplementary risk assessment.</div></div><div><h3>Conclusions</h3><div>This study developed and validated a practical scoring scale and a prediction model based on optimized binning strategies for premature AMI patients, offering a comprehensive risk assessment to support clinical decision-making.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"77 ","pages":"Article 102716"},"PeriodicalIF":2.6,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919045","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 : 2026-01-06DOI: 10.1016/j.hrtlng.2025.102703
Yan Cheng , Qingqing Liu , Xumeng Zhu , Jing Wei , Wanling Li
Background
Dyspnea in elderly COPD patients may contribute to social frailty by limiting social engagement and increasing emotional distress, therefore clarifying the underlying mechanisms is crucial for developing effective interventions.
Objectives
To investigate the prevalence of social frailty in elderly COPD patients and assess the mediating effects of social support and depressive symptoms on the relationship between dyspnea and social frailty.
Methods
Between November 2024 and May 2025, 245 older patients with COPD in Taiyuan City participated in this study. A self-reported questionnaire was used to evaluate dyspnea, social support, depressive symptoms, and social frailty. Structural equation modeling was employed for data analysis.
Results
Dyspnea in elder patients with COPD were directly related to social frailty. Social support and depressive symptoms jointly mediate the relationship between dyspnea and social frailty, accounting for a total indirect effect of 0.211 and a total effect of 0.580, resulting in a mediation effect of 36.42%.
Conclusions
The study reveals that social support and depressive symptoms serve as multiple mediators in the relationship between dyspnea and social frailty. Dyspnea can exacerbate social frailty in COPD patients via the effect of social support and depressive symptoms.
{"title":"The influence of dyspnea on social frailty in elderly patients with chronic obstructive pulmonary disease: The mediating effects of social support and depression symptoms","authors":"Yan Cheng , Qingqing Liu , Xumeng Zhu , Jing Wei , Wanling Li","doi":"10.1016/j.hrtlng.2025.102703","DOIUrl":"10.1016/j.hrtlng.2025.102703","url":null,"abstract":"<div><h3>Background</h3><div>Dyspnea in elderly COPD patients may contribute to social frailty by limiting social engagement and increasing emotional distress, therefore clarifying the underlying mechanisms is crucial for developing effective interventions.</div></div><div><h3>Objectives</h3><div>To investigate the prevalence of social frailty in elderly COPD patients and assess the mediating effects of social support and depressive symptoms on the relationship between dyspnea and social frailty.</div></div><div><h3>Methods</h3><div>Between November 2024 and May 2025, 245 older patients with COPD in Taiyuan City participated in this study. A self-reported questionnaire was used to evaluate dyspnea, social support, depressive symptoms, and social frailty. Structural equation modeling was employed for data analysis.</div></div><div><h3>Results</h3><div>Dyspnea in elder patients with COPD were directly related to social frailty. Social support and depressive symptoms jointly mediate the relationship between dyspnea and social frailty, accounting for a total indirect effect of 0.211 and a total effect of 0.580, resulting in a mediation effect of 36.42%.</div></div><div><h3>Conclusions</h3><div>The study reveals that social support and depressive symptoms serve as multiple mediators in the relationship between dyspnea and social frailty. Dyspnea can exacerbate social frailty in COPD patients via the effect of social support and depressive symptoms.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"77 ","pages":"Article 102703"},"PeriodicalIF":2.6,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919084","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}
This study evaluated the ability of intraprocedural intracardiac echocardiography (ICE)-measured left atrial appendage (LAA) flow characteristics to predict the long-term risk of recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation.
Methods
The study included 105 patients who underwent radiofrequency catheter ablation for AF at our institution between October 2020 and December 2021. Eighty-seven of these patients completed 12 months of follow-up. The anteroposterior left atrial diameter to LAA emptying velocity (LAD/LAAEV) ratio was calculated. The patients were stratified into a recurrence group (n=18) and a non-recurrence group (n=69) based on the 12-month outcome. Predictive performance was evaluated by Cox regression and by receiver-operating characteristic curve and Kaplan–Meier survival analyses.
Results
The LAD/LAAEV ratio (P<0.001) was significantly higher in the recurrence group than in the non-recurrence group. Multivariate Cox analysis identified the LAD/LAAEV ratio (hazard ratio 1.36, 95 % confidence interval [CI] 1.02–1.83) and New York Heart Association functional class (hazard ratio 2.75, 95 % CI 1.19–6.35) as independent predictors of recurrence by one year. Receiver-operating characteristic curve analysis confirmed that the LAD/LAAEV ratio predicted recurrence with an area under the curve of 0.806 (95 % CI 0.707–0.906); the optimal cutoff was 1.42 (sensitivity 70.4 %, specificity 87.5 %). Kaplan–Meier analysis showed that the cumulative recurrence rate was significantly higher in the group with an LAD/LAAEV ratio of ≥1.42 (P<0.001, log-rank test).
Conclusions
The ICE-measured LAD/LAAEV ratio may predict recurrence of AF post-ablation, providing a basis for intensified post-procedural management in high-risk patients.
{"title":"Left atrial diameter to left atrial appendage emptying velocity ratio predicts risk of recurrence of atrial fibrillation after all-zero fluoroscopy ablation","authors":"Xiaoran Cui, Yichen Li, Ruibin Li, Wenli Zhou, Jidong Zhang","doi":"10.1016/j.hrtlng.2025.102721","DOIUrl":"10.1016/j.hrtlng.2025.102721","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>This study evaluated the ability of intraprocedural intracardiac echocardiography (ICE)-measured left atrial appendage (LAA) flow characteristics to predict the long-term risk of recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation.</div></div><div><h3>Methods</h3><div>The study included 105 patients who underwent radiofrequency catheter ablation for AF at our institution between October 2020 and December 2021. Eighty-seven of these patients completed 12 months of follow-up. The anteroposterior left atrial diameter to LAA emptying velocity (LAD/LAAEV) ratio was calculated. The patients were stratified into a recurrence group (n=18) and a non-recurrence group (n=69) based on the 12-month outcome. Predictive performance was evaluated by Cox regression and by receiver-operating characteristic curve and Kaplan–Meier survival analyses.</div></div><div><h3>Results</h3><div>The LAD/LAAEV ratio (<em>P</em><0.001) was significantly higher in the recurrence group than in the non-recurrence group. Multivariate Cox analysis identified the LAD/LAAEV ratio (hazard ratio 1.36, 95 % confidence interval [CI] 1.02–1.83) and New York Heart Association functional class (hazard ratio 2.75, 95 % CI 1.19–6.35) as independent predictors of recurrence by one year. Receiver-operating characteristic curve analysis confirmed that the LAD/LAAEV ratio predicted recurrence with an area under the curve of 0.806 (95 % CI 0.707–0.906); the optimal cutoff was 1.42 (sensitivity 70.4 %, specificity 87.5 %). Kaplan–Meier analysis showed that the cumulative recurrence rate was significantly higher in the group with an LAD/LAAEV ratio of ≥1.42 (<em>P</em><0.001, log-rank test).</div></div><div><h3>Conclusions</h3><div>The ICE-measured LAD/LAAEV ratio may predict recurrence of AF post-ablation, providing a basis for intensified post-procedural management in high-risk patients.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"77 ","pages":"Article 102721"},"PeriodicalIF":2.6,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913957","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 : 2026-01-05DOI: 10.1016/j.hrtlng.2025.102706
Adriano Rossi MD , Frederik J. Mooi MD , Eda Aydeniz MD , Teun Timmermans , Serge J.H. Heines , Frank van Rosmalen PhD , Jip de Kok MSc , Iwan C.C. van der Horst MD, PhD , Jan-Willem E.M. Sels MD, PhD , Dennis C.J.J. Bergmans MD, PhD , Marco Giani MD , Giuseppe Citerio MD, Prof , Bas C.T. van Bussel MD, PhD , Rob G.H. Driessen MD, PhD
Background
Mechanical ventilation is essential in critical care but can cause lung injury and hemodynamic compromise, particularly in patients with right ventricular dysfunction (RVD). Electrical impedance tomography (EIT) is increasingly used to guide ventilation, but its role in patients with RVD is not well defined.
Objectives
To evaluate how electrocardiographic (ECG) signs of RVD influence the application and effects of EIT-guided ventilation management.
Methods
This retrospective cohort study (2013–2023) included mechanically ventilated patients who underwent both ECG and EIT. Patients were grouped according to the presence of ECG signs of RVD. Demographic, clinical, and respiratory characteristics were compared. Airway pressures during EIT-guided recruitment maneuvers (RMs) and decremental positive end-expiratory pressure (PEEP) trials were analyzed using linear regression. Repeated ECG and EIT data were assessed using linear mixed-effects models.
Results
Of 285 patients, 38 (13 %) had ECG signs of RVD. They were more often male (89.5 % vs. 74.1 %, p = 0.04), older (68.2 vs. 63.5 years, p = 0.02), and had higher mortality (65.8 % vs. 48.6 %, p < 0.05). During EIT-guided RMs, they received lower maximum PEEP (–2.2 to –0.4 cmH₂O) and a narrower decremental PEEP range (–2.5 to –0.9 cmH₂O, both p < 0.01). After EIT-guided optimization, dynamic compliance was higher in patients with ECG signs of RVD (43.6 vs. 38.4 mL/cmH₂O, p = 0.04).
Conclusion
ECG signs of RVD identified a high-risk group that appeared less tolerant of, yet more responsive to, EIT-guided PEEP titration. By integrating respiratory and cardiac monitoring, EIT may facilitate safer ventilation strategies.
背景：机械通气在重症监护中是必不可少的，但可能导致肺损伤和血流动力学损害，特别是在右心室功能障碍（RVD）患者中。电阻抗断层扫描（EIT）越来越多地用于指导通气，但其在RVD患者中的作用尚未明确。目的：评价RVD的心电图征象对eit引导下通气管理的应用和效果的影响。方法：本回顾性队列研究（2013-2023）纳入了同时进行ECG和EIT检查的机械通气患者。根据有无RVD的心电图征象对患者进行分组。比较人口学、临床和呼吸特征。采用线性回归分析eit引导下气道压力恢复演习（RMs）和呼气末正压减少（PEEP）试验中的气道压力。使用线性混合效应模型评估重复ECG和EIT数据。结果：285例患者中，38例（13%）有RVD的心电图征象。男性居多（89.5%比74.1%,p = 0.04），年龄较大（68.2比63.5岁，p = 0.02），死亡率较高（65.8%比48.6%,p < 0.05）。在eit引导的RMs中，他们的最大PEEP较低（-2.2至-0.4 cmH₂O），而递减PEEP范围较窄（-2.5至-0.9 cmH₂O， p均< 0.01）。经eit引导优化后，有RVD心电图体征患者的动态依从性更高（43.6 vs 38.4 mL/cmH₂O, p = 0.04）。结论：RVD的心电图征象确定了一个高危组，他们对eit引导的PEEP滴定的耐受性较低，但对其反应更积极。通过整合呼吸和心脏监测，EIT可以促进更安全的通气策略。
{"title":"Association of right ventricular dysfunction on electrocardiogram with outcomes and ventilatory response in patients monitored by electrical impedance tomography: A cohort study","authors":"Adriano Rossi MD , Frederik J. Mooi MD , Eda Aydeniz MD , Teun Timmermans , Serge J.H. Heines , Frank van Rosmalen PhD , Jip de Kok MSc , Iwan C.C. van der Horst MD, PhD , Jan-Willem E.M. Sels MD, PhD , Dennis C.J.J. Bergmans MD, PhD , Marco Giani MD , Giuseppe Citerio MD, Prof , Bas C.T. van Bussel MD, PhD , Rob G.H. Driessen MD, PhD","doi":"10.1016/j.hrtlng.2025.102706","DOIUrl":"10.1016/j.hrtlng.2025.102706","url":null,"abstract":"<div><h3>Background</h3><div>Mechanical ventilation is essential in critical care but can cause lung injury and hemodynamic compromise, particularly in patients with right ventricular dysfunction (RVD). Electrical impedance tomography (EIT) is increasingly used to guide ventilation, but its role in patients with RVD is not well defined.</div></div><div><h3>Objectives</h3><div>To evaluate how electrocardiographic (ECG) signs of RVD influence the application and effects of EIT-guided ventilation management.</div></div><div><h3>Methods</h3><div>This retrospective cohort study (2013–2023) included mechanically ventilated patients who underwent both ECG and EIT. Patients were grouped according to the presence of ECG signs of RVD. Demographic, clinical, and respiratory characteristics were compared. Airway pressures during EIT-guided recruitment maneuvers (RMs) and decremental positive end-expiratory pressure (PEEP) trials were analyzed using linear regression. Repeated ECG and EIT data were assessed using linear mixed-effects models.</div></div><div><h3>Results</h3><div>Of 285 patients, 38 (13 %) had ECG signs of RVD. They were more often male (89.5 % vs. 74.1 %, <em>p</em> = 0.04), older (68.2 vs. 63.5 years, <em>p</em> = 0.02), and had higher mortality (65.8 % vs. 48.6 %, <em>p</em> < 0.05). During EIT-guided RMs, they received lower maximum PEEP (–2.2 to –0.4 cmH₂O) and a narrower decremental PEEP range (–2.5 to –0.9 cmH₂O, both <em>p</em> < 0.01). After EIT-guided optimization, dynamic compliance was higher in patients with ECG signs of RVD (43.6 vs. 38.4 mL/cmH₂O, <em>p</em> = 0.04).</div></div><div><h3>Conclusion</h3><div>ECG signs of RVD identified a high-risk group that appeared less tolerant of, yet more responsive to, EIT-guided PEEP titration. By integrating respiratory and cardiac monitoring, EIT may facilitate safer ventilation strategies.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"77 ","pages":"Article 102706"},"PeriodicalIF":2.6,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913899","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号