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Impact of SGLT2 inhibitors on major clinical events and safety outcomes in heart failure patients:a meta-analysis of randomized clinical trials

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Journal of Geriatric Cardiology 2021年第10期18卷 783-795页

作者： george bazoukis Stamatis S.Papadatos Costas Thomopoulos Gary Tse Stefanos Cheilidis Konstantinos Tsioufis Dimitrios Farmakis Department of Cardiology Larnaca General HospitalLarnacaCyprus Department of Anatomy Histology and EmbryologyMedical SchoolUniversity of IoanninaIoanninaGreece Department of Cardiology Helena Venizelou HospitalAthensGreece Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease Department of CardiologyTianjin Institute of CardiologySecond Hospital of Tianjin Medical UniversityTianjinChina University of Cyprus Medical School NicosiaCyprus First Cardiology Clinic Hippokration HospitalAthens UniversityAthensGreece

BACKGROUND Sodium-glucose co-transporter-2 inhibitors(SGLT2i)significantly reduce the risk of cardiovascular(CV)and renal adverse events in patients with diabetes mellitus,heart failure(HF)and/or chronic kidney *** performed a meta-analysis to explore the impact of several different SGLT2i on all-cause mortality,CV mortality,HF hospitalizations and the combined outcome CV death/HF hospitalization in HF patients across the spectrum of left ventricular ejection fraction(LVEF)*** A systematic search in MEDLINE database and Cochrane library through March 2021 was performed without *** clinical trials that provided data about the impact of SGLT2i on all-cause mortality,CV mortality,HF hospitalizations or the combined outcome of CV death/HF hospitalization in HF patients were included.A random effects model was used for calculating the effect *** Nine studies(n=16,723 patients,mean age:65.9 years,males:70.7%)were included in the quantitative *** to placebo,SGLT2i use was associated with 14%lower risk of all-cause mortality[hazard ratio(HR)=0.86,95%CI:0.78−0.94,I^(2)=0,P=0.0008],32%lower risk of HF hospitalizations(HR=0.68,95%CI:0.62−0.74,I^(2)=0,P<0.001),14%lower risk of CV mortality(HR=0.86,95%CI:0.77−0.95,I^(2)=0,P=0.003)and 26%lower risk of CV death/HF hospitalization(HR=0.74,95%CI:0.68−0.80,I^(2)=0,P<0.001).Regarding the safety outcomes,our data revealed no significant differences between SGLT2i and placebo groups in drug related discontinuations,amputations,severe hypoglycemia,hypotension,volume depletion,ketoacidosis and genital *** contrast,a protective role of SGLT2i against placebo was found for serious adverse events and acute kidney *** In patients with HF,regardless of LVEF phenotype,all SGLT2i had an excellent safety profile and significantly reduced the risk of all-cause mortality,CV mortality,HF hospitalizations and CV deaths/HF hospitalizations compared to placeb

关键词： patients clinical protective

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Simple hematological predictors of AF recurrence in patients undergoing atrial fibrillation ablation

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Journal of Geriatric Cardiology 2019年第9期16卷 671-675页

作者： george bazoukis Konstantinos P Letsas Konstantinos Vlachos Athanasios Saplaouras Dimitrios Asvestas Konstantinos Tyrovolas Aikaterini Rokiza Eirini Pagkalidou Gary Tse Stavros Stavrakis Antonios Sideris Michael Efremidis Department of Cardiology Electrophysiology Laboratory Evangelismos General Hospital of Athens Athens Greece Department of Hygiene and Epidemiology School of Medicine Aristotle University of Thessaloniki Thessaloniki Greece Department of Medicine and Therapeutics Faculty of Medicine Chinese University of Hong Kong Hong Kong China Li Ka Shing Institute of Health Sciences Faculty of Medicine Chinese University of Hong Kong Hong Kong SAR China Department of Medicine Cardiovascular Section Heart Rhythm Institute University of Oklahoma Health Sciences Center Oklahoma City Oklahoma USA

Backgound Red cell distribution width(RDW) and neutrophil-to-lymphocyte ratio(NLR) are simple hematologic indices that have been used to predict adverse outcomes in different clinical settings. The aim of our study is to determine whether RDW and NLR can predict atrial fibrillation(AF) recurrence in patients undergoing AF ablation. Methods Consecutive patients, without known hematological disorders, who underwent AF catheter ablation between January 2014 and April 2017 were enrolled into this study. Blood samples were taken one day before and five hours after the ablation procedure. Results A total of 346 patients(224 males(65%), mean age: 59 ± 11 years old) were included. After a mean follow up of 26.2 ± 12.1 months, 80(23.1%) patients experienced late AF recurrence(defined as any recurrence after the blanking period of three months), while 97(28%) patients experienced early AF recurrence during the blanking period. Univariate analysis showed that early arrhythmia recurrence, type of AF and NLR after the procedure were significantly associated with late AF recurrence, while early arrhythmia recurrence and NLR remained significant in multivariate analysis. RDW was not associated with late AF recurrence. None of the parameters above predicted early arrhythmia recurrence. Conclusions Simple and inexpensive hematological indices such as NLR should be evaluated for their ability to predict AF recurrence in patients undergoing catheter ablation in larger prospective studies.

关键词： Atrial fibrillation Neutrophils Radiofrequency ablation

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Spontaneous type 1 pattern, ventricular arrhythmias and sudden cardiac death in Brugada Syndrome： an updated systematic review and meta-analysis

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Journal of Geriatric Cardiology 2017年第10期14卷 639-643页

作者： Ahmed Bayoumy Meng-Qi GONG Ka Hou Christien Li Sunny Hei Wong William KK Wu Guang-Ping LI george bazoukis Konstantinos P Letsas Wing Tak Wong Yun-Long XIA Tong LIU Gary Tse Department of Medicine and Therapeutics Faculty of Medicine Chinese University of Hong Kong Hong Kong China Li Ka Shing Institute of Health Sciences Faculty of Medicine Chinese University of Hong Kong Hong Kong China Faculty of Medicine University of Amsterdam The Netherlands Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease Department of Cardiology Tianjin Institute of Cardiology Second Hospitalof Tianjin Medical University Tianjin China Faculty of Medicine Newcastle University United Kingdom Department of Anaesthesia and Intensive Care Faculty of Medicine Chinese University of Hong Kong Hong Kong China Second Department of Cardiology Evangelismos General Hospital of Athens Athens Greece School of Life Sciences Chinese University of Hong Kong Hong Kong China Department of Cardiology First Affiliated Hospital of Dalian Medical University Dalian China

Brugada syndrome （BrS） is primary electrical disorder characterized by ST segment elevation with right bundle branch block morphology in patients with apparent structurally normal hearts, It predisposes affected individuals to ventricular tachycardia/fibrillation （VT/VF） and sudden cardiac death （SCD）.A number of studies have identified risk factors that are associated with a more malignant course of disease. These include male gender, syncope, a spontaneous type 1 ECG pattern, family history of SCD, family history of Brugada syndrome,

关键词： Brugada syndrome Risk stratification Spontaneous type 1 Sudden cardiac death Ventricular arrhythmia

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Telemonitoring and hemodynamic monitoring to reduce hospitalization rates in heart failure： a systematic review and meta-analysis of randomized controlled trials and real-world studies

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Journal of Geriatric Cardiology 2018年第4期15卷 298-309页

作者： Gary Tse Cynthia Chan Mengqi Gong Lei MENG Jian ZHANG Xiao-Ling SU Sadeq Ali-Hasan-Al-Saegh Abhishek C Sawant george bazoukis Yun-Long XIA Ji-Chao Zhao Alex Pui Wai Lee Leonardo Roever Martin CS Wong Adrian Baranchuk Tong Liu Department of Medicine and Therapeutics Faculty of Medicine Chinese University of Hong Kong Hong Kong China Li Ka Shing Institute of Health Sciences Faculty of Medicine Chinese University of Hong Kong Hong Kong China Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease Department of Cardiology Tianjin Institute of Cardiology the Second Hospital of Tianjin Medical University Tianjin China State Key Laboratory of Cardiovascular Disease Heart Failure Center Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences Peking Union Medical College Beijing China Department of Cardiology Qinghai Provincial People's Hospital Xining China Cardiovascular Research Center Shahid Sadoughi University of Medical Sciences Yazd Iran Division of Cardiology State University of New York at Buffalo Buffalo NY USA The Second Department of Cardiology Laboratory of Cardiac Electrophystology Evangehsmos General Hospital of Athens Athens Greece Department of Cardiovascular Medicine the First Affiliated Hospital of Dalian Medical University Dalian China Auckland Bioengineering Institute the University of Auckland Auckland New Zealand Department of Clinical Research Federal University of Uberlandia Uberlandia MG Brazil JC School of Public Health and Primary Care Faculty of Medicine the Chinese University of Hong Kong Hong Kong China Division of Cardiology Kingston General Hospital Queen 's University Kingston Ontario Canada

Background Heart failure is a significant problem leading to repeated hospitalizations. Telemonitoring and hemodynamic monitoring have demonstrated success in reducing hospitalization rates, but not all studies reported significant effects. The aim of this systematic review and meta-analysis is to examine the effectiveness of telemonitoring and wireless hemodynamic monitoring devices in reducing hospitalizations in heart failure. Methods ＆ Results PubMed and Cochrane Library were searched up to 1st May 2017 for articles that investigated the effects of telemonitoring or hemodynamic monitoring on hospitalization rates in heart failure. In 31,501 patients （mean age： 68 ± 12 years; 61% male; follow-up 11 ± 8 months）, telemonitoring reduced hospitalization rates with a HR of 0.73 （95% CI： 0.65-0.83; P 〈 0.0001） with significant heterogeneity （I2 = 94%）. These effects were observed in the short-term （≤ 6 months： HR = 0.77, 95% CI： 0.65-0.89; P 〈 0.01） and long-term （≥ 12 months： HR = 0.73, 95% CI： 0.62-0.87; P 〈 0.0001）. In 4831 patients （mean age 66 ± 18 years; 66% male; follow-up 13 ± 4 months）, wireless hemodynamic monitoring also reduced hospitalization rates with a HR of 0.60 （95% CI： 0.53-0.69; P 〈 0.001） with significant heterogeneity （I2 = 64%）.This reduction was observed both in the short-term （HR = 0.55, 95% CI： 0.45-0.68; P 〈 0.001; I2 = 72%） and long-term （HR = 0.64, 95% CI： 0.57-0.72; P 〈 0.001; I2 = 55%）. Conclusions Telemonitoring and hemodynamic monitoring reduce hospitalization in both short- and long-term in heart failure patients

关键词： Heart failure Hemodynamic monitoring Hospitalization Telemedicine Telemonitoring

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Association of electrocardiographic markers with myocardial fibrosis as assessed by cardiac magnetic resonance in different clinical settings

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World Journal of Cardiology 2022年第9期14卷 483-495页

作者： george bazoukis Sebastian Garcia-Zamora GökselÇinier Sharen Lee Enes Elvin Gul JesúsÁlvarez-García Gabi Miana Mertİlker Hayıroğlu Gary Tse Tong Liu Adrian Baranchuk Department of Cardiology Larnaca General HospitalLarnaca 6036Cyprus Department of Basic and Clinical Sciences University of Nicosia Medical SchoolNicosia 2414Cyprus Department of Cardiology Delta ClinicSanta Fe 341Argentina Department of Cardiology Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research CenterIstanbul 34668Turkey Cardiovascular Analytics Group Laboratory of Cardiovascular PhysiologyHong Kong 999077China Division of Cardiac Electrophysiology Madinah Cardiac CentreMadinah 42351Saudi Arabia Department of Cardiology Ramon y Cajal University HospitalMadrid 28034Spain Telehealth Center of Hospital das Clínicas Hong Kong 999077China Kent and Medway Medical School CanterburyCanterbury CT27FSUnited Kingdom Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease Department of CardiologyTianjin Institute of CardiologySecond Hospital of TianjinTianjin Medical UniversityTianjin 300211China Department of Cardiology The Second Hospital of Tianjin Medical UniversityTianjin 300211China Department of Cardiology Queen's UniversityOntario K7L 3N6Canada

BACKGROUND Cardiac magnetic resonance(CMR)is a unique tool for non-invasive tissue characterization,especially for identifying *** To present the existing data regarding the association of electrocardiographic(ECG)markers with myocardial fibrosis identified by CMR-late gadolinium enhancement(LGE).METHODS A systematic search was performed for identifying the relevant studies in Medline and Cochrane databases through February *** addition,we conducted a relevant search by Reference Citation Analysis(RCA)(https://***).RESULTS A total of 32 studies were *** hypertrophic cardiomyopathy(HCM),fragmented QRS(fQRS)is related to the presence and extent of myocardial *** and abnormal Q waves are associated with LGE in ischemic cardiomyopathy patients,while fQRS has also been related to fibrosis in *** score,abnormal Q waves,and notched QRS have also been associated with *** abnormalities as reflected by increased Tp-Te,negative Twaves,and higher QT dispersion are related to myocardial fibrosis in HCM *** patients with Duchenne muscular dystrophy,a significant correlation between fQRS and the amount of myocardial fibrosis as assessed by LGE-CMR was *** atrial fibrillation patients,advanced inter-atrial block is defined as P-wave duration≥120 ms,and biphasic morphology in inferior leads is related to left atrial *** Myocardial fibrosis,a reliable marker of prognosis in a broad spectrum of cardiovascular diseases,can be easily understood with an easily applicable ***,more data is needed on a specific disease basis to study the association of ECG markers and myocardial fibrosis as depicted by CMR.

关键词： Myocardial fibrosis Late gadolinium enhancement Electrocardiogram Cardiac magnetic resonance

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Does Minimizing Ventricular Pacing Reduce the Incidence of Atrial Fibrillation ? A Systematic Review and Meta-analysis of Randomized Controlled Trials

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Cardiovascular Innovations and Applications 2020年第3期5卷 1-7页

作者： Ishan Lakhani Mengqi Gong Cheuk Wai Wong george bazoukis Konstantinos PLetsas Guangping Li Khalid bin Wahleed Yunlong Xia Adrian Baranchuk Gary Tse Keith Sai Kit Leung Tong Liu Dong Chang Laboratory of Cardiovascular Physiology Li Ka Shing Institute of Health SciencesHong Kong Special Administrative RegionPeople’s Republic of China Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease Department of CardiologyTianjin Institute of CardiologySecond Hospital of Tianjin Medical UniversityTianjin 300211People’s Republic of China Li Ka Shing Faculty of Medicine The University of Hong KongHong KongSpecial Administrative RegionPeople’s Republic of China Second Department of Cardiology Laboratory of Cardiac ElectrophysiologyEvangelismos General Hospital of AthensAthensGreece Department of Cardiology First Affi liated Hospital of Dalian Medical UniversityDalianChina Division of Cardiology Kingston General HospitalQueen’s UniversityKingstonOntarioCanada Xiamen Cardiovascular Hospital Xiamen UniversityXiamenFujianPeople’s Republic of China Aston Medical School Aston UniversityBirminghamUnited Kingdom

Background:Right ventricular pacing disrupts atrioventricular synchrony and increases the risk of atrial fi brillation(AF).However,whether algorithms for minimizing ventricular pacing reduce the incidence of AF remains ***,we conducted a systematic review and meta-analysis to compare the incidence of AF between minimizing ventricular pacing and conventional pacing protocols in patients with pacemakers ***:The PubMed,Embase,and Cochrane Library databases were searched up to August 1,2017,for randomized controlled trials that reported the incidence of AF in patients with and without the use of algorithms for minimizing ventricular ***:Eleven studies comprising 5705 participants(61%males,mean age 71 years[standard deviation 11 years])were fi nally included in the *** mean follow-up duration was 24 *** of algorithms for minimizing ventricular pacing signifi cantly reduced the incidence of AF,with an odds ratio of 0.74(95%confi dence interval 0.55–1.00;P<0.05).There was moderate heterogeneity among studies(I 2=63%).Conclusions:The incidence of AF was reduced by 26%with use of algorithms for minimizing ventricular *** incorporation of such algorithms in routine clinical practice should in theory lead to a decrease in AF-related morbidity and mortality.

关键词： Atrial fibrillation minimizing ventricular pacing pacemaker

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Flexible ultra-thin super-resolution endoscopy

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Science China(Physics,Mechanics & Astronomy) 2024年第3期67卷 171-172页

作者： george S.D.Gordon Department of Electrical and Electronic Engineering University of NottinghamNottingham NG7 2RDUK

In recent years, multimode fiber(MMF) has become an important tool for high-resolution endoscopic imaging in narrow channels(e.g., in the brain via needles or inside blood vessels) due to its high mode density and fine diameter, typically <0.125 mm [1-6]. However, a major obstacle to widespread deployment in applications is that realistic perturbations, including bending, twisting and changes in temperature, cause unacceptable image degradation.

关键词： fiber resolution typically

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Unique Genetic Features of Lean NAFLD: A Review of Mechanisms and Clinical Implications

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Journal of Clinical and Translational Hepatology 2024年第1期12卷 70-78页

作者： Jasmine Tidwell george Y.Wu Department of Medicine University of Connecticut Health CenterFarmingtonCTUSA Division of Gastroenterology-Hepatology University of Connecticut Health CenterFarmingtonCTUSA

Non-alcoholic fatty liver disease(NAFLD)affects 25%of the global *** 20%have a normal body mass index(BMI)and a variant known as lean *** typical NAFLD cases associated with obesity and diabetes,lean NAFLD causes liver disease by mechanisms not related to excess weight or insulin *** disorders are among the major factors in developing lean NAFLD,and genome-wide association studies have identified several genes associated with the *** review aims to increase awareness by describing the genetic markers linked to NAFLD and the defects involved in developing lean NAFLD.

关键词： Lean nonalcoholic fatty liver disease Palatine-like phospholipase domain-containing-3 Transmembrane 6 superfamily member 2 Familial hypobetalipoproteinemia Abetalipoproteinemia

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Heritable Chronic Cholestatic Liver Diseases:A Review

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Journal of Clinical and Translational Hepatology 2024年第8期12卷 726-738页

Chronic cholestasis due to heritable causes is usually diagnosedin ***,many cases can present andsurvive into *** time course varies considerablydepending on the underlying *** data usuallyreveal elevated conjugated hyperbilirubinemia,alkalinephosphatase,and gamma-glutamyl *** be asymptomatic;however,when present,the typicalsymptoms are pruritus,jaundice,fatigue,and *** diagnostic methods and management requireddepend on the underlying *** development of genome-wide associated studies has allowed the identificationof specific genetic mutations related to the pathophysiologyof cholestatic liver *** aim of this review was tohighlight the genetics,clinical pathophysiology,presentation,diagnosis,and treatment of heritable etiologies of chroniccholestatic liver disease.

关键词： Chronic cholestasis Cholestatic liver disease Congenital hepatic fibrosis Caroli disease Caroli syndrome Alagille syndrome Biliary atresia

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Effects of interlayer spacing and applied pressure on the lanthanide transport in MoS2-based two-dimensional channels

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International Journal of Smart and Nano Materials 2024年第3期15卷 579-592页

作者： Qinsi Xiong Chong Liu george C.Schatz Department of Chemistry Northwestern UniversityEvanstonILUSA Pritzker School of Molecular Engineering University of ChicagoChicagoILUSA

Rare-earth elements(REEs)are critical to modern industry but difficult to separate due to their subtle and monotonic changes in physico-chemical ***2-based two-dimensional(2D)materials offer novel opportunities for enhancing REE separation,exhibiting a distinct volcano-shaped transport performance distribution that peaks at Sm3+.However,the specific contributions of thermodynamic and kinetic factors to ion transport within 2D confinement remain *** this study,we conducted a series of non-equilibrium all-atom molecular dynamics(MD)simulations to explore the effects of interlayer spacing and external pressure on the transport of lanthanide ions inÅ-scale acetate functionalized 2D MoS2(MoS2-COOH)*** examined ion entry and permeation rates,water flux,dehydration,and binding *** simulation results reveal that the transport trends of lanthanide ions are jointly driven by the dehydration degree and the relative-binding strengths of ions to water and to the acetate within the 2D ***,the dehydration pattern of lanthanide ions during permeation is closely linked to kinetic ***,this study provides a detailed atomistic understanding of the mechanisms under-lying lanthanide ion transport under *** findings point to the significant potential for tuning confinement and chemical functionalization withinÅ-scale channels for more efficient REE separation.

关键词： MoS_(2) 2D channels Lanthanide ions ion transport nanofluidics

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