Clinical value of the HATCH score for predicting adverse outcomes in patients with heart failure

Factors predicting the recurrence of atrial fibrillation after catheter ablation: A review

Atrial fibrillation (AF) is the most common and clinically significant type of cardiac arrhythmia. Although catheter ablation (CA) can restore sinus rhythm in patients with AF, some patients experience recurrence after the procedure. This requires us to find a simple and effective way to identify patients at a high risk of recurrence and to intervene early in the high-risk population to improve patient prognosis. The mechanism of AF recurrence is unclear, but it involves several aspects including patient history, inflammation, myocardial fibrosis, and genes. This article summarizes the current predictors of AF recurrence after CA, including myocardial fibrosis markers, inflammatory markers, MicroRNAs, Circular RNAs, AF recurrence scores, and imaging indicators. Each predictor has its own scope of application, and the predictive capacity and joint application of multiple predictors may improve the predictive power. In addition, we summarize the mechanisms involved in AF recurrence. We hope that this review will assist researchers understand the current predictors of AF recurrence and help them conduct further related studies.

The Role of HATCH Score in the Prediction of Ischemic Cerebrovascular Events in Patients with Heart Failure and Atrial Fibrillation

The presence of both atrial fibrillation (AF) and heart failure (HF) increases the risk of an ischemic cerebrovascular event (CVE) by roughly fivefold. The HATCH score is a score used to predict new-onset AF. Although there are some differences, it contains risk factors similar to the CHA2DS2-VASc score. Our study aimed to investigate the relationship between the HATCH score and ischemic CVE. This retrospective study obtained data from 1719 HF patients between 2015 and 2022. About 673 patients with AF were included in the study. In the univariate and multivariate Cox regressions, we found that CHA2DS2-VASc and HATCH scores were independent predictors of ischemic CVE (p = 0.001 and < p = 0.001, respectively). The ROC analysis, AUC for the CHA2DS2-VASc score was 0.884 (95% CI 0.828-0.940, Collapse

Key Words

• CHA2DS2-VASc score
• HATCH score
• atrial fibrillation
• heart failure
• ischemic stroke

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MESH Headings

• Humans
• Atrial Fibrillation/complications
• Stroke/etiology
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Heart Failure/complications

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Affiliation(s)

Sidar Şiyar Aydın Department of Cardiology, University of Health Sciences, Erzurum Education and Research Hospital, Erzurum, Turkey
Emrah Aksakal Department of Cardiology, University of Health Sciences, Erzurum Education and Research Hospital, Erzurum, Turkey

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Genetic data visualization using literature text-based neural networks: Examples associated with myocardial infarction

Data visualization is critical to unraveling hidden information from complex and high-dimensional data. Interpretable visualization methods are critical, especially in the biology and medical fields, however, there are limited effective visualization methods for large genetic data. Current visualization methods are limited to lower-dimensional data and their performance suffers if there is missing data. In this study, we propose a literature-based visualization method to reduce high-dimensional data without compromising the dynamics of the single nucleotide polymorphisms (SNP) and textual interpretability. Our method is innovative because it is shown to (1) preserves both global and local structures of SNP while reducing the dimension of the data using literature text representations, and (2) enables interpretable visualizations using textual information. For performance evaluations, we examined the proposed approach to classify various classification categories including race, myocardial infarction event age groups, and sex using several machine learning models on the literature-derived SNP data. We used visualization approaches to examine clustering of data as well as quantitative performance metrics for the classification of the risk factors examined above. Our method outperformed all popular dimensionality reduction and visualization methods for both classification and visualization, and it is robust against missing and higher-dimensional data. Moreover, we found it feasible to incorporate both genetic and other risk information obtained from literature with our method.

Progression from paroxysmal to persistent atrial fibrillation in pacemaker patients with tachycardia-bradycardia syndrome: a multicenter study

Progression from paroxysmal to persistent atrial fibrillation (AF) is occasionally encountered in patients with previous pacemaker implantation (PMI) for the treatment of tachycardia-bradycardia syndrome (TBS). We aimed to determine the rate of its incidence occurring within the early years after PMI and the predictors. We studied TBS patients who received PMI at 5 core cardiovascular centers. The end point was a conversion from paroxysmal to persistent AF. We extracted 342 TBS patients out of 2579 undergoing PMI. During 5 ± 3.1 years of follow-up, 114 (33.3%) reached the end point. The time to the end point was 2.9 ± 2.7 years. The event rates within a year and 3 years after the PMI were 8.8% and 19.6%, respectively. In the multivariate hazard analyses, hypertension (hazard ratio [HR] 3.2, P = 0.03) and congestive heart failure (HR 2.1, P = 0.04) were found to be independent predictors of the end point occurring within a year after the PMI. Congestive heart failure (HR 1.82, P = 0.04), left atrial diameter of ≥ 40 mm (HR 4.55, P < 0.001), and the use of antiarrhythmic agents (HR 0.58, P = 0.04) were independently associated with the 3-year end point. Prediction models including combinations of those 4 parameters for the 1- and 3-year incidence both exhibited a modest risk discrimination (both c-statistics 0.71). In conclusion, early progression from paroxysmal to persistent AF was less frequent than expected in the TBS patients with PMI. Factors related to atrial remodeling and no use of antiarrhythmic drugs may facilitate the progression.

The cardiosplenic axis: the prognostic role of the spleen in heart failure

Despite the number of available methods to predict prognosis in patients with heart failure, prognosis remains poor, likely because of marked patient heterogeneity and varied heart failure etiologies. Thus, identification of novel prognostic indicators to stratify risk in patients with heart failure is of paramount importance. The spleen is emerging as a potential novel prognostic indicator for heart failure. In this article, we provide an overview of the current prognostic tools used for heart failure. We then introduce the spleen as a potential novel prognostic indicator, before outlining the structure and function of the spleen and introducing the concept of the cardiosplenic axis. This is followed by a focused discussion on the function of the spleen in the immune response and in hemodynamics, as well as a review of what is known about the usefulness of the spleen as an indicator of heart failure. Expert insight into the most effective spleen-related measurement indices for the prognostication of patients with heart failure is provided, and suggestions on how these could be measured in clinical practice are considered. In future, studies in humans will be required to draw definitive links between specific splenic measurements and different heart failure manifestations, as well as to determine whether splenic prognostic measurements differ between heart failure classes and etiologies. These contributions will provide a step forward in our understanding of the usefulness of the spleen as a prognostic predictor in heart failure.