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Predictors of new-onset atrial fibrillation in elderly patients with coronary artery disease after coronary artery bypass graft

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Journal of Geriatric cardiology 2016年第5期13卷 444-449页

作者： Rubanenko O Anatol'evna Fatenkov O Veniaminovic Khokhlunov S Mikhaylovich Department of Faculty Therapy Samara State Medical Universtty Samara Russia Samara Regional cardiology centre Samara Russia

Objective To identify the factors associated with the development of postoperative atrial fibrillation （POAF） after coronary artery bypass graft （CABG） in elderly patients with coronary artery disease （CAD）. Methods A total of 81 patients with CAD who underwent CABG were enrolled in the study. Patients were divided into two groups： Group 1, without postoperative atrial fibrillation （59 patients, 74.6% men, mean age 65.8 ~ 4.0 years）; Group 2, with early new-onset atrial fibrillation after CABG （22 patients, 90.9% men, mean age 67.7 ＋ 5.4 years）. Interleukin （IL）-6, IL-8, IL-10, C-reactive protein （CRP）, fibrinogen, superoxide dismutase （SOD）, N-terminal pro-B-type natriuretic peptide （NT-proBNP）, and troponin I were studied. Results During the observation period, atrial fibrillation occurred in 27.2% cases, an average of 4.9 ±3.8 days after surgery. In group 2, the left atrium （LA） dimension was larger than in group 1 （43.9 ± 3.4 mm vs. 37.6 ±3.9 rnm, P 〈 0.001）. Patients with POAF had significantly higher IL-6 （72.7 ±60.8 pg/mL vs. 38.0 ± 34.6 pg/mL, P = 0.04）, IL-8 （11.9 ± 6.0 pg/mL vs. 7.7± 5.4 pg/mL, P = 0.01） and SOD （2462.0 ± 2029.3 units/g vs. 1515.0 ± 1292.9 units/g, P = 0.04） compared with group without POAF. The multivariate analysis showed that the odds ratio （OR） for POAF development in patients with left atrium more than 39 mm was 2.1 [95% confidence interval （CI）： 1.2-3.8, P = 0.0004], IL-6 levels more than 65.18 pg/mL-1.4 （95% Ch 1.1-2.7, P = 0.009）, IL-8 levels more than 9.67 pg/mL-1.2 （95% CI： 1.1-3.7, P ： 0.009）, SOD more than 2948 units/g-1.1 （95% Ch 1.01-2.9, P = 0.04）. Conclusions In our study, the independent predictors of postoperative atrial fibrillation after CABG in elderly patients were left atrium dimension and the increased postoperative concentration of IL-6, IL-8 and superoxide dismutase.

关键词： Antioxidant Atrial fibrillation Coronary artery bypass graft Interleukins Troponin

Role of microRNAs in endothelial function

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Chinese Medical Journal 2013年第9期126卷 1779-1786页

作者： CHEN Xian-bing ZHENG Si-dao WU Hong-jin Clinical Trials centre Department of Cardiology Beijing Hospital of Integrated Traditional Chinese and Western Medicine Beijing 100039 China

MicroRNAs （miRNAs） are a class of short, single-stranded, noncoding RNAs that modulate avariety of biological functions as negative regulators gene expression. Post-transcriptional regulation of by miRNAs is crucial in many aspects including cell proliferation and death. They play important regulatory roles in endothelial cell function, which are significant for the treatment of endothelial dysfunction and related metabolic disorders. This review summarizes current insights into the functions of miRNAs, focusing specifically on the regulation of endothelial function.

关键词： microRNA endothelial cell gene regulation

The Temporal Relation between Cardiomyopathy and LBBB and Response to Cardiac Resynchronization Therapy:Case Series and Literature Review

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Cardiovascular Innovations and Applications 2020年第1期4卷 163-172页

作者： Sanshuai Chang Yi He Hui Wang Fei Guo Qiang Lv Junping Kang Rong Bai Xiaohui Liu Xin Du Changsheng Ma Jianzeng Dong Department of cardiology Beijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina Department of Radiology Beijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina

Background:Left bundle branch block(LBBB)-induced cardiomyopathy has been proposed,but the association between LBBB and cardiac resynchronization therapy(CRT)response remains unclear and practical criteria for selecting CRT candidates are ***:One hundred and seventeen consecutive heart failure patients were reviewed,24 of whom received *** two patients had a clear temporal relation between cardiomyopathy and ***:Compared with the patient with“cardiomyopathy-induced LBBB,”the patient with“LBBB-induced cardiomyopathy”had higher left ventricular(LV)wall thickness,higher LV wall thickening rate,higher peak circumferential strain,and longer peak circumferential strain *** LV deformation patterns in the two patients were obviously distinct on cardiovascular magnetic resonance tissue *** follow-up,the patient with LBBB-induced cardiomyopathy had a good response to CRT(LV ejection fraction 23 before CRT vs.30%at 6 months vs.29 at 12 months vs.32%at 18 months;LV end-diastolic diameter 77 mm before CRT vs.66 mm at 6 months vs.62 mm at 12 months vs.63 mm at 18 months),and the other patient had no response to CRT(LV ejection fraction 29 before CRT vs.29%at 6 months vs.26 at 12 months vs.22%at 24 months;LV end-diastolic diameter 85 mm before CRT vs.88 mm at 6 months vs.85 mm at 12 months vs.84 mm at 24 months).Conclusion:The temporal relation between cardiomyopathy and LBBB could be a determinant for CRT *** magnetic resonance tissue tracking may be a useful tool to identify the chronological order and a principal consideration for selecting candidates for *** prospective clinical trials are needed to study the prevalence of,time course of,and risk factors for LBBB-induced cardiomyopathy.

关键词： left bundle branch block cardiomyopathy heart failure cardiovascular magnetic resonance cardiac resynchronization therapy

Can We Change a Look at Atherosclerotic Aortic Aneurism Treatment?

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Health 2014年第12期6卷 1345-1351页

作者： Vladimir Petrovich Krylov Аlexander Gennadyevich Mrochek Leonid Petrovich Titov Valentina Nikolaevna Gaiduk Leonid Ivanovich Reut Аleksey Leonidovich Smaliakou Republican Scientific and Practical centre “cardiology” Ministry of Health of Belarus Minsk Belarus Republican Scientific and Practical centre “cardiology” Ministry of Health of Belarus Minsk Belarus Republican Scientific and Practical centre “Epidemiology and Microbiology” Ministry of Health of Belarus Minsk Belarus

In recent years, the increasing number of cardiologists and cardiac surgeons tend to think that surgical treatment of patients with atherosclerotic aneurisms does not fully comply with contemporary ideas of what the disease is. Some data show that early operations in the presence of this pathology are associated with an unreasonably high mortality. Additionally, the use of intra-aortic stents and grafts cannot principally affect the therapeutic efficacy. Therefore, more attention is paid to the development of conservative therapeutic approaches leaving surgery defeated without surgical treatment. Two groups of patients with similar descending thoracic aortic atherosclerotic aneurisms (DTAAA) and abdominal aortic aneurisms (AAA) were retro- and prospectively studied over a 2-year period. Control group (Comparison group), (63 patients) received common surgical treatment from 2009 to 2010 whereas Main group (121 subjects) received multifaceted medical treatment to remove inflammatory reactions, strengthen aortic wall and control its dilation from 2011 to 2012. Operative treatment was used only in case of potential aneurism rupture. The comparison of the two groups of subjects showed that 2-year all-cause mortality in control group was 20.6% while in the main group it amounted to 9.1% due to the similar incidence of aneurism ruptures and deaths associated with concomitant diseases. It suggests that the odds ratio (OR) of survival when using attenuated therapeutic approach to treating atherosclerotic aneurisms is 2.6-fold higher compared to conventional surgical approach. One of the principal factors contributing to a higher mortality when using traditional surgical approach was the presence of polyorgan pathology that required constant medical correction irrespective of therapeutic option (surgical or medical) used. Another important factor is aortic aneurism wall frailty. The development of mechanisms that would allow its strengthening is considered a principal challen

关键词： Atherosclerotic Aortic Aneurisms Surgical and Conservative Treatment

Sex modification of the association of the radial augmentation index and incident hypertension in a Chinese community-based population

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Journal of Geriatric cardiology 2021年第1期18卷 39-46页

作者： Qiao QIN Fang-Fang FAN Meng-Yuan LIU Bo LIU Jia JIA Long ZHANG Yu-Xi LI Yi-Meng JIANG Peng-Fei SUN Dan-Mei HE Jian-Ping LI Ming CHEN Bo ZHENG Yan ZHANG Department of cardiology Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina

BACKGROUND Arterial stiffness,as assessed by aortic ultrasound and pulse wave velocity,is associated with incident ***,there is still no consensus on whether the augmentation index(AI)affects new onset of *** study investigated the relationship of radial AI(r AI)and incident hypertension in a Chinese community-based population without hypertension at *** A total of 1,615 Chinese non-hypertensive participants from an atherosclerosis cohort in Beijing,China were included in our *** r AI normalized to heart rate of 75 beats/min(r AIp75)was obtained using HEM-9000 ***-onset hypertension was defined as blood pressure≥140/90 mm Hg or self-reported hypertension or taking anti-hypertensive medications at the follow up *** regression models were used to evaluate the impact of r AIp75 on the risk of new-onset *** After a mean 2.35-year follow-up,213(13.19%)participants developed incident *** significant relation between r AIp75 and incident hypertension was observed in the whole population after adjustment for possible confounders(adjusted odds ratio(OR)and 95%confidence interval(CI):1.09[0.95-1.27];P=0.2260).However,r AIp75 was significantly associated with incident hypertension in women,but not in men(adjusted OR and 95%CI:1.29[1.06-1.56],P=0.0113 for women;0.91[0.72-1.15],P=0.4244 for men;P for interaction=0.0133).CONCLUSIONS Sex modified the effect of the r AI on incident hypertension in a Chinese,community-based,non-hypertensive *** of the r AI could be considered in women with a high risk of hypertension for the purpose of primary intervention.

关键词： Sex modification of the association of the radial augmentation index and incident hypertension in a Chinese community-based population

Three-year outcomes of patients with non-valvular atrial fibrillation: the COOL-AF registry

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Journal of Geriatric cardiology 2023年第3期20卷 163-173页

作者： Rungroj Krittayaphong Satchana Pumprueg Pontawee Kaewkumdee Ahthit Yindeengam Gregory YH Lip Division of cardiology Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand Liverpool centre for Cardiovascular Science University of Liverpool and Liverpool Heart&Chest HospitalLiverpoolUnited Kingdom Department of Clinical Medicine Aalborg UniversityAalborgDenmark

BACKGROUND Clinical outcomes of patients with non-valvular atrial fibrillation(AF)in Asian populations may be different from *** this study,we aimed to determine the incidence of ischemic stroke/systemic embolism(SSE),major bleeding,and death,and the predictors for clinical outcomes in a contemporary Asian cohort of newly diagnosed AF *** This is a prospective multicenter nationwide registry of patients with AF from 27 hospitals in *** data and follow-up data were collected every 6 months until 3 *** collections included demographic,medical history,laboratory,and medication *** outcomes were SSE,major bleeding,and all-cause *** rates for each clinical outcome were calculated and presented as rate per 100 *** and multivariate analysis was performed to determine the independent predictors for clinical *** There was a total of 3405 patients:mean age was 67.8±11.3 years,1981(58.2%)were *** 30.8±9.7 months follow-up,there was a total of 132 SSE(3.9%),191 major bleeding(5.6%),and 357 all-cause deaths(10.5%).The incidence rates of SSE,major bleeding,and death were 1.56(1.30-1.84),2.26(1.96-2.61),and 4.17(3.33-4.25),per 100 person-years *** predictors for clinical outcomes were age,type of AF,and the presence of comorbid *** The incidence rate of SSE,major bleeding,and death remains high reflecting the unmet needs in AF management。

关键词： patients fibrillation mortality

Age-dependent impact of the SYNTAX-score on longer-term mortality after percutaneous coronary intervention in an all-comer population

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Journal of Geriatric cardiology 2018年第9期15卷 559-566页

作者： Madeleine Eickhoff Stefanie Schupke Alexander Khandoga Julia Fabian Moritz Baquet David Jochheim David Grundmann Manuela Thienel Axel Bauer Hans Theiss Stefan Brunner Jorg Hausleiter Steffen Massberg Julinda Mehilli Department of cardiology Munich University Clinic Ludwig-Maximilians University Munich Germany German centre for Cardiovascular Research (DZHK) Partner Site Munich Heart Alliance Germany Deutsches Herzzentrum Miinchen Klinik fiir Herz- und Kreislauferkrankungen ISAResearch Center Munich Germany

Background The Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery （SYNTAX）-score is a validated tool for risk stratification and revascularization strategy selection in patients with complex coronary artery disease. The aim of this study was to analyse its age-related prognostic value. Methods SYNTAX-score was calculated in 1331 all-comer patients undergoing percutaneous coronary intervention （PCI）： 463 patients ≥ 75 years and 868 patients 〈 75 years. Outcomes of interest were all-cause mortality at one and two years. Results A significant interaction of age and SYNTAX-score for mortality was observed at two-year （Pinteraction= 0.019） but not at one-year follow-up （Pinteraction= 0.594）. In multivariable analysis, SYNTAX-score independently predicted 1-year mortality in both age groups （〈 75 years, hazard ratio （HR）： 1.43, 95% confidence intervals （CI）： 1.03-2.00, P = 0.034; and 〉 75 years, HR： 1.37, 95% CI： 1.01-1.85, P = 0.042）, but only two-year mortality among younger patients （〈 75 years, HR： 1.33, 95% CI： 1.01-1.76, P = 0.041; and ≥ 75 years, HR： 1.11, 95% CI： 0.87-1.41, P = 0.394）. SYNTAX-score tertiles were useful to stratify 1-year mortality in both, patients 〈 75 years （SYNTAX-score 〈 9, 3.8%; 9-20, 5.3%; 〉 20, 10.3%; P = 0.004） and 〉 75 years （SYNTAX-score 〈 11, 5.7%; 11-22.5, 16.1%; 〉 22.5, 18.7%; P = 0.003）, but two-year mortality only among patients 〈 75 years （SYNTAX-score 〈 9, 6.5%; 9-20, 7.6%; ≥ 20, 15%; P 〈 0.001） and not among ≥ 75 years old patients （SYNTAX-score 〈 11, 19.4%; 11-22.5, 26.3%; _〉 22.5, 27.9%; P = 0.138）. Conclusions Age modi- fies the impact of the SYNTAX-score on longer-term mortality after PCI. Among patients 〈 75 years, the SYNTAX-score independently predicts the risk of death at one and two years after PCI, while among patients 〉 75 years its predictive role is limited to the first year after PCI. Further studies are needed to evaluate the value of SYNTAX-score for selecting the most appropriate re

关键词： Age Mortality Percutaneous coronary intervention Syntax-score The elderly

Comparison of echocardiography and device based algorithm for atrio-ventricular delay optimization in heart block patients

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World Journal of cardiology 2015年第11期7卷 801-807页

作者： Rajesh Vijayvergiya Ankur Gupta Department of cardiology Advanced Cardiac CentrePost Graduate Institute of Medical Education and Research

AIM: To compare the atrio-ventricular(AV/PV) delay optimization by echocardiography and intra-cardiac electrocardiogram(IEGM) based Quick Opt algorithm in complete heart block(CHB) patients, implanted with a dual chamber pacemaker. METHODS: We prospectively enrolled 20 patients(age 59.45 ± 18.1 years; male: 65%) with CHB, who were implanted with a dual chamber pacemaker. The left ventricular outflow tract velocity time-integral was measured after AV/PV delay optimization by both echocardiography and Quick Opt algorithm method. Bland-Altman analysis was used for agreement between the two techniques. RESULTS: The optimal AV and PV delay determined by echocardiography was 155.5 ± 14.68 ms and 122.5 ± 17.73 ms(P < 0.0001), respectively and by Quick Opt method was 167.5 ± 16.73 and 117.5 ms ± 9.10 ms(P < 0.0001), respectively. A good agreement was observed between optimal AV and PV delay as measured by two methods. However, the correlation of the optimal AV(r = 0.0689, P = 0.77) and PV(r = 0.2689, P = 0.25) intervals measured by the two techniques was poor. The time required for AV/PV optimization was 45.26 ± 1.73 min by echocardiography and 0.44 ± 0.08 min by Quick Opt method(P < 0.0001).CONCLUSION: The programmer based IEGM method is an automated, quick, easier and reliable alternative to echocardiography for the optimization of AV/PV delay in CHB patients, implanted with a dual chamber pacemaker.

关键词： Atrio-ventricular delay optimization Complete hear

Role of Helicobacter pylori infection in pathogenesis of atherosclerosis

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World Journal of cardiology 2015年第3期7卷 134-143页

作者： Rajesh Vijayvergiya Ramalingam Vadivelu Department of cardiology Advanced Cardiac CentrePost Graduate Institute of Medical Education and Research

Though a century old hypothesis, infection as a cause for atherosclerosis is still a debatable issue. Epidemiological and clinical studies had shown a possible association but inhomogeneity in the study population and study methods along with potential confounders have yielded conflicting results. Infection triggers a chronic inflammatory state which along with other mechanisms such as dyslipidemia, hyper-homocysteinemia, hypercoagulability, impaired glucose metabolism and endothelial dysfunction, contribute in pathogenesis of atherosclerosis. Studies have shown a positive relations between Cytotoxic associated gene-A positive strains of Helicobacter pylori and vascular diseases such as coronary artery disease and stroke. Infection mediated genetic modulation is a new emerging theory in this regard. Further large scale studies on infection and atherosclerosis focusing on multiple pathogenetic mechanisms may help in refining our knowledge in this aspect.

关键词： Atherosclerosis Coronary artery disease Helicobacter pylori Infection Stroke