HEART & LUNG心脏与肺
HEART & LUNG(英文缩写 HEART LUNG),ISSN 0147-9563,eISSN 1527-3288,中文译名:心脏与肺 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 3.149 | Q1 |
| 2022 | 2.800 | Q1 |
| 2023 | 2.400 | Q1 |
| 2024 | 2.600 | Q1 |
| 2025 | 2.500 | Q2 |
HEART & LUNG 最新收录文献
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1. Global practice patterns, determinants, and perceived impact of humidification during non-invasive ventilation in hospitalized adults: A cross-sectional survey from 70 countries.
PMID:日期:2026-09-21Although a strong physiological rationale exists for humidification during non-invasive ventilation (NIV), its clinical relevance remains uncertain, and guideline recommendations are sparse and inconsistent. To understand the humidification use during NIV; factors influencing decisions to use or not use; disinfection practices; and beliefs about the impact on outcomes. We conducted a cross-sectional, web-based, international survey of clinicians who manage hospitalized adults receiving NIV for acute respiratory failure. Survey domains reflected device selection, decision-making factors, and the perceived impact on tolerance, compliance, and clinical outcomes. Descriptive statistics and Multiple Correspondence Analysis (MCA) were performed. 516 clinicians from 70 countries participated in this international survey; 70% reported using humidification during NIV, but only 33.5% reported having a written protocol. Use varied significantly by geographic region (p = 0.035). Among users, 46% always used humidification, 34.3% most often, and 19.7% sometimes. Devices included heat-and-moisture exchangers (HME; 22.2%), heated humidifiers (HH; 18%), or both (60%). Key drivers were equipment availability (80.6%), device type (80.9%), and NIV duration (70.9%), rather than evidence. Although most clinicians perceived benefits for tolerance (85.0%) and compliance (72.6%), few believed it affected length of stay (42.9%), infection rates (40.7%), or mortality (29.9%). MCA identified three distinct clinician profiles: "trouble-free responders" (low complication reporting), "high-issue responders" (frequent adverse events), and an "undecided/neutral group." Among clinicians participating in this survey, humidification during NIV was commonly reported, but practices varied considerably across regions and institutions. These findings highlight important evidence gaps and support the need for well-designed trials.
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2. Key elements of left ventricular assist device adjustment: A qualitative exploratory study.
PMID:日期:2026-09-21Advanced heart failure affects over six million Americans annually. For patients who are ineligible for a heart transplant, left ventricular assist devices (LVADs) offer life-sustaining therapy but require complex adjustment due to external components and lifestyle restrictions. This study aimed to explore how bridge-to-transplant and destination therapy recipients perceive and adjust to LVAD-supported life. Using general qualitative methods, 20 LVAD recipients (mean age 57; 65% male) from two high-volume urban centers participated in semi-structured interviews guided by the Roy Adaptation Model. Data were analyzed iteratively using ATLAS.ti, achieving thematic saturation. Participants described key elements of LVAD adjustment: physical ability, caregiver dependence, self-care, roles, public perception, and emotional connection. Most reported improved physical function but faced challenges with hygiene, clothing, sleep, travel, and employment. Public misperceptions and visibility of the device affected self-image, particularly among women. Peer and provider relationships were central to emotional adaptation. Despite the inconveniences, participants expressed gratitude for the LVAD as a life-sustaining device. The findings highlight the importance of connection, role restoration, and public perception-factors that are often underrepresented in clinical care. Participants emphasized the need for expanded education on recovery, hygiene, equipment, travel, and complication management, as well as tailored support for patients without caregivers. Addressing these psychosocial and practical challenges may improve patient satisfaction, safety, and long-term outcomes.
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3. Insulin resistance mediates the relationship between cardiovascular-kidney-metabolic syndrome and depression: A cross-sectional analysis.
PMID:日期:2026-09-19To date, no studies have examined the role of insulin resistance (IR) in the relationship between depression and cardiovascular-kidney-metabolic (CKM) syndrome. This study aims to explore the association between CKM and depression, and to determine whether IR mediates this relationship. A total of 8584 participants were included in the analysis. CKM was categorized according to the 2023 American Heart Association guidelines. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), with a score ≥10 indicating the presence of depressive symptoms. Multivariable linear and logistic regression models were used to examine the associations, and mediation analysis was performed to evaluate the potential mediating effect of IR biomarkers. Of the participants, 675 exhibited clinically significant depressive symptoms. After adjusting for confounders, compared with participants in CKM stage 0, those in CKM stages 1, 2, and advanced CKM exhibited increases in PHQ-9 scores of 0.41, 0.68, and 1.82, respectively (all p < 0.05). Among the core depressive symptoms, fatigue showed the strongest association with advanced CKM (β = 0.45, 95% CI: 0.32-0.57, p < 0.001). Additionally, all IR biomarkers demonstrated significant partial mediation effects (p < 0.05), with the estimated glucose disposal rate (eGDR) showing the largest mediation effect (7.04%). Advanced CKM is positively associated with depressive symptoms, and IR partially mediates this relationship. These findings highlight the importance of enhanced mental health screening in patients with advanced CKM and suggest that improving IR may be a potential therapeutic target for future interventions.
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4. Comparison of analgesic efficacy of dexamethasone and dexmedetomidine as an adjuvant to local anaesthetic in transversus thoracic muscle plane block in adult patients undergoing median sternotomy: A randomised controlled trial.
PMID:日期:2026-09-18Post-sternotomy pain contributes significantly to delayed recovery following cardiac surgery. The transversus thoracic muscle plane block (TTPB) is a recently described regional anaesthetic technique that provides analgesia to the anterior chest wall. The addition of adjuvants such as dexamethasone and dexmedetomidine may enhance the analgesic efficacy of TTPB. This study compared the analgesic efficacy of dexamethasone and dexmedetomidine as adjuvants to bupivacaine for TTPB in patients undergoing median sternotomy. 66 adult patients (ASA I-III) scheduled for cardiac surgery via median sternotomy were recruited for this randomised trial. Following induction of anaesthesia, all patients received bilateral TTPB and were allocated to three groups: dexamethasone (0.25 % bupivacaine + 8 mg dexamethasone), dexmedetomidine (0.25 % bupivacaine + 1 µg/kg dexmedetomidine), and a control group (0.25 % bupivacaine alone). The primary outcome was the time to first rescue analgesia following extubation. Secondary outcomes included 24-hour postoperative fentanyl consumption, intraoperative fentanyl requirement, pain scores, extubation time, patient satisfaction, and adverse events. Time to first rescue analgesia was significantly longer in the dexmedetomidine group than in the dexamethasone and control groups (P 0.001). Twenty-four-hour postoperative fentanyl consumption was significantly lower in both adjuvant groups than in the control group (P < 0.001). Pain scores were consistently lower with dexmedetomidine and dexamethasone groups. Extubation time and intraoperative fentanyl consumption were comparable among the three groups (P > 0.05). Both dexamethasone and dexmedetomidine improved TTPB analgesia. Dexmedetomidine significantly prolonged the duration of analgesia, whereas 24-hour postoperative opioid consumption was comparable between the adjuvant groups.
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5. Troponin elevation reflects disease severity rather than cardiac injury or dysfunction in mechanically ventilated COVID-19 ARDS patients.
PMID:日期:2026-09-16Cardiac troponin elevation is common in severe COVID-19 and acute respiratory distress syndrome (ARDS). To examine the association of elevated troponin I (TnI) with cardiac function, disease severity, and survival in mechanically ventilated (MV) COVID-19 ARDS patients. We retrospectively analyzed MV patients with COVID-19 ARDS and elevated TnI (>0.04 ng/mL) who underwent transthoracic echocardiography within 48 h of ICU admission for a previous study. Left ventricular function was assessed by left ventricular ejection fraction (LVEF), global longitudinal strain (LVGLS), and lateral mitral annular systolic velocity (LV S'). Right ventricular function and afterload were evaluated using tricuspid annular plane systolic excursion (TAPSE) and pulmonary artery systolic pressure (PASP). Disease severity was assessed using APACHE II and SOFA scores. Associations of TnI with echocardiographic indices, severity scores, and survival were analyzed. Ninety-four patients were included. Troponin correlated positively with APACHE II (r = 0.415, p < 0.0001) and SOFA (r = 0.232, p = 0.046), and inversely with ICU survival (r = -0.506, p < 0.0001), but not with LVEF, LVGLS, LV S', TAPSE, or PASP. ICU and 28-day survival did not differ between patients with LVEF <40% and those with LVEF ≥40%. Severity scores and troponin levels were similar between groups. In patients with LVEF <40%, LVGLS showed a moderate inverse correlation with troponin (r = -0.553, p = 0.032). In MV COVID-19 ARDS patients, elevated troponin is associated disease severity and poorer ICU survival rather than global systolic dysfunction. In patients with severe LV impairment, troponin may remain a marker of myocardial injury.
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6. Large language models fail to reliably predict emergent catheterization laboratory activation from prehospital electrocardiograms.
PMID:日期:2026-09-16Rapid and accurate electrocardiogram (ECG) interpretation is essential for timely identification of ST-elevation myocardial infarction (STEMI) and activation of reperfusion pathways in emergency care. To evaluate the diagnostic performance of multimodal LLMs in identifying prehospital ECGs warranting emergent catheterization laboratory activation. We performed a retrospective analysis of 615 ECGs from 270 emergency medical service patient encounters (EMS) with concern for acute myocardial infarction. The reference standard was cardiology activation of the STEMI pathway for emergent angiography. LLM-based image interpretation (three models) and ECG machine algorithm interpretations were compared. Sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy were calculated. Gemini demonstrated the highest sensitivity (95.3%; 95% CI 91.7-97.3) but extremely poor specificity (9.4%), indicating a high false-positive rate. ChatGPT and Claude showed moderate sensitivity (68.1% and 67.2%) with limited specificity (42.3% and 46.5%). The ECG machine algorithm demonstrated more balanced performance, with sensitivity of 67.7% (95% CI 61.4-73.4) and higher specificity (64.2%) than all LLMs. Multimodal LLM interpretation of prehospital ECGs demonstrated clinically unreliable performance for identifying ECGs warranting emergent cardiac catheterization laboratory activation when benchmarked against real-world cardiology activation decisions. Although some models achieved high sensitivity, poor specificity resulted in excessive false-positive activation recommendations. These findings suggest that general-purpose LLMs are not appropriate for ECG-based catheterization laboratory activation decisions in time-sensitive cardiopulmonary care workflows.
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8. Prognostic value of the Day-21 SOFA-2 score in patients requiring prolonged mechanical ventilation: A 10-year retrospective experience in a university-affiliated tertiary hospital.
PMID:日期:2026-09-14Patients requiring prolonged mechanical ventilation (PMV, ≥21 days) face poor long-term outcomes. The widely used ProVent 21 score relies on categorical variables that may not capture continuous multi-organ dysfunction. The updated SOFA-2 score simplifies neurological assessment, but its prognostic value at Day-21 in PMV patients is unknown. To assess the non-inferiority of the Day-21 SOFA-2 score relative to SOFA-1 and to develop an improved predictive model incorporating baseline clinical markers. This retrospective cohort study included 419 adult PMV patients in a South Korean intensive care unit (2015-2024). SOFA-1 and SOFA-2 were calculated on days 1 and 21 to predict 90-day and 1-year mortality, with non-inferiority defined by a 0.05 AUROC margin. Using multivariable Cox regression, we derived the "SOFA-2 PLUS" score and compared it against ProVent 21 using AUROC. Mortality rates were 52.0% (90-day) and 66.8% (1-year). Day-21 SOFA-2 was non-inferior to SOFA-1 for 1-year mortality; for 90-day mortality, the two scores performed comparably (no significant difference), though the prespecified margin was not formally met. Combining Day-21 SOFA-2 with age ≥70 years, BMI ≤22.1 kg/m², and hemato-oncologic malignancy, the SOFA-2 PLUS score yielded a higher 1-year AUROC (0.759) than SOFA-2 alone (0.700) or ProVent 21 (0.705). Day-21 SOFA-2 is non-inferior to SOFA-1 for 1-year mortality, with comparable 90-day performance. The SOFA-2 PLUS score showed modestly improved discrimination over ProVent 21, offering potential value for risk stratification, though its incremental benefit relative to its added complexity warrants external validation.
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9. Hematocrit-corrected pulmonary vascular resistance: a prognostic marker in left ventricular assist device candidates.
PMID:日期:2026-09-14Despite being a significant clinical marker in heart failure, pulmonary vascular resistance (PVR) is not an important predictor of outcome in left ventricular assist device (LVAD) candidates. Based on the Hagen-Poiseuille law, PVR is also influenced by blood viscosity which is mostly determined by hematocrit (HCT); however, it is not taken into account in the clinical practice. We aimed to examine HCT-adjusted PVR (aPVR) in a single center cohort of patients before LVAD implantation. Of the 101 LVAD implants, 96 patients prior to surgery (53 ± 10 years old, 84% male) were enrolled. We collected clinical characteristics, preprocedural and early postoperative laboratory and right heart catheterization data. The aPVR was calculated using previous experimental data and PVR was adjusted to a reference HCT of 0.45. Our outcome was 365-day mortality, reached by 20 patients (21%). Adjustment to HCT resulted in a mean 35% relative change of aPVR compared to PVR, with more pronounced relative difference in patients with clinically relevant HCT-abnormality (62% change). PVR was not a predictor of outcome, while aPVR was significantly associated with poor prognosis (HR: 1.183 [1.014-1.379], p = 0.03). The prognostic value of aPVR remained significant even when other clinically and statistically significant predictors, such as RVAD support or the HM3 Survival Risk Score were added to the model. Corresponding blood viscosity should not be neglected in the assessment of PVR: aPVR significantly differs from uncorrected PVR in LVAD candidates, moreover, aPVR is associated with 365-day mortality.
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10. Optimizing daily spontaneous breathing trial timing to expedite extubation.
PMID:日期:2026-09-13Spontaneous breathing trials (SBTs) are a crucial tool used to assess patients who are being mechanically ventilated for extubation readiness. As a quality improvement initiative, we have conducted a pre-post implementation study to evaluate whether changing the daytime scheduling of an SBT results in a reduction in SBT completion to extubation timing. We conducted a retrospective chart review of randomly selected general medical intensive care unit patients before and after an SBT timing change from 0500-0600 to 0800-0900 over a 13-month period. We reviewed 220 subjects in the pre-intervention group and 226 in the post-intervention group, and data analysis was performed using scipy.stats in Python. There was a significant reduction in the time from SBT to extubation in the 0800-0900 group compared to the 0500-0600 group (1.13 [0.48, 2.67] vs 3.63 [1.32, 6.32] h, p = <0.001). Therefore, we concluded that among this sample of intubated MICU subjects, changing SBT timing from 0500-0600 to 0800-0900 resulted in a significant decrease in SBT to extubation time. Reducing the SBT to extubation time minimizes the need to re-sedate a patient to promote continued ventilator tolerance. Thus, our results show that evaluating daily SBT timing can be a valuable quality improvement intervention that impacts patient centered outcomes.