Chest
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Randomized Controlled Trial Multicenter Study
Nocturnal Cardiac Arrhythmias in Heart Failure with Obstructive and Central Sleep Apnea.
Both obstructive and central sleep apnea (CSA) may contribute to nocturnal cardiac arrhythmias (NCAs). Data are scarce regarding the prevalence of clinically important nocturnal atrial and ventricular arrythmias in patients with heart failure with reduced ejection fraction (HFrEF) and OSA or CSA. ⋯ gov.
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Multicenter Study
Association of Cardiopulmonary Hemodynamics and Outcomes in Pulmonary Hypertension Following Kidney Transplant: A Multicenter Retrospective Cohort Study.
Pulmonary hypertension (PH) frequently complicates the evaluation of kidney transplantation (KT) candidates, and is associated with increased adverse outcomes (mortality, delayed graft function [DGF], and major adverse cardiovascular event) following KT. ⋯ Precapillary pulmonary hypertension and an mPAP of ≥ 30 mm Hg on RHC, but not echocardiographic evidence of PH, was associated with mortality and major adverse cardiovascular event following KT. These data suggest that RHC hemodynamics are superior to echocardiographic measures of PH in association with outcomes following KT, and RHC-derived mPAP in particular may have value in predicting major adverse cardiovascular event and mortality post-KT.
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Multiple listing (ML) is a practice used to increase the potential for transplant but is controversial due to concerns that it disproportionately benefits patients with greater access to health care resources. ⋯ ML is an uncommon practice with disparities existing between ML and SL patients based on several factors including social deprivation. ML patients are more likely to be transplanted, but only if they have ML status early in their transplant candidacy. With changing allocation guidelines, it is yet to be seen how ML will change with the implementation of continuous distribution.
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Combined pulmonary fibrosis and emphysema (CPFE) is an underdiagnosed syndrome in which individuals have variable degrees of pulmonary fibrosis and emphysema. Patients with CPFE have high morbidity, including poor exercise tolerance and increased development of comorbidities. CPFE mortality also seems to outpace that of lone emphysema and pulmonary fibrosis. A major limitation to rigorous, large-scale studies of CPFE has been the lack of a precise definition for this syndrome. A 2022 American Thoracic Society/European Respiratory Society/Japanese Respiratory Society/Latin American Thoracic Association research statement called attention to fundamental gaps in our understanding of CPFE and highlighted the potential use of quantitative imaging techniques to better define CPFE. ⋯ This review is structured into three primary themes, starting with early imaging studies, then evaluating the use of quantitative methods and imaging-based thresholds, both in large population studies and single-center cohorts to define CPFE and assess patient outcomes. It concludes by discussing current challenges and how to focus our efforts so that quantitative imaging methods can effectively address the most pressing clinical dilemmas in CPFE.