1
|
Mehrabi Nasab E, Sadeghian S, Vasheghani Farahani A, Yamini Sharif A, Masoud Kabir F, Bavanpour Karvane H, Zahedi A, Bozorgi A. Determining the recurrence rate of premature ventricular complexes and idiopathic ventricular tachycardia after radiofrequency catheter ablation with the help of designing a machine-learning model. Regen Ther 2024; 27:32-38. [PMID: 38496010 PMCID: PMC10940794 DOI: 10.1016/j.reth.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 02/28/2024] [Accepted: 03/03/2024] [Indexed: 03/19/2024] Open
Abstract
Ventricular arrhythmias increase cardiovascular morbidity and mortality. Recurrent PVCs and IVT are generally considered benign in the absence of structural heart abnormalities. Artificial intelligence is a rapidly growing field. In recent years, medical professionals have shown great interest in the potential use of ML, an integral part of AI, in various disciplines, including diagnostic applications, decision-making, prognostic stratification, and solving complex pathophysiological aspects of diseases from these data at extraordinary complexity, scale, and acquisition rate. The aim of this study was to design an ML model to predict the probability of PVC and IVT recurrence after RF ablation. Data of patients were collected and manipulated using traditional analysis and various artificial intelligence models, namely MLP, Gradient Boosting Machines, Random Forest, and Logistic Regression. Hypertension, male sex, and the use of non-irrigate catheters were associated with less freedom from arrhythmia. All these results were obtained through traditional analytic methods, and according to AI, none of the variables had a clear effect on the recurrence of arrhythmia. Each AI model presents unique strengths and weaknesses, and further optimization and fine-tuning of these models are necessary to increase their clinical utility. By expanding the dataset, improved predictions can be fostered to ultimately increase the clinical utility of AI in predicting PVC erosion outcomes.
Collapse
Affiliation(s)
- Entezar Mehrabi Nasab
- Department of Cardiology, School of Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Cardiology, School of Medicine, Valiasr Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Saeed Sadeghian
- Department of Cardiology, School of Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Vasheghani Farahani
- Department of Cardiology, School of Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Yamini Sharif
- Department of Cardiology, School of Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Masoud Kabir
- Department of Cardiology, School of Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ahora Zahedi
- Department of Artificial Intelligence in Medical Sciences, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Bozorgi
- Department of Cardiology, School of Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
2
|
Al-Kasasbeh A, Alghzawi AA, Jarrah M, Ababneh M, Al-Makhamreh H, Shehadeh J, Migdadi A, Jum'ah M, Ahmad A, Ja'arah D, Al Omary AY, Hammoudeh A. Clinical Profiles and One-Year Outcome in Middle Eastern Patients With Atrial Fibrillation and Hypertension: Analysis From the Jordan Atrial Fibrillation Study. Angiology 2023:33197231206234. [PMID: 37849307 DOI: 10.1177/00033197231206234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Studies on the impact of hypertension (HTN) on the outcome of patients with atrial fibrillation (AF) in the Middle East are scarce. The aim of this contemporary multicenter study is to evaluate the effect of the coexisting HTN on the baseline clinical profiles and 1-year prognosis in a cohort of Middle Eastern patients with AF. Consecutive AF patients in 29 hospitals and cardiology clinics were enrolled in the Jordan AF study (May 2019-December 2020). Patients were prospectively followed up for 1 year, and the study had no influence on their treatment, which was at the discretion of the treating physician. We compared clinical features, use of medications, and 1-year prognosis in patients with AF/HTN compared with AF/no HTN. Among 1849 non-valvular AF patients, 76.4% had HTN, with higher prevalence of diabetes, dyslipidemia, coronary heart disease, stroke, and left ventricular hypertrophy in HTN patients. There was a higher thromboembolic and bleeding risk among HTN patients. At 1 year, HTN patients had significantly higher rates of stroke and systemic embolism (SSE) (4.5%), acute coronary syndrome (ACS) (2.4%), rehospitalization (27.9%), and major bleeding events (3.0%) compared with non-HTN patients. In this cohort, the coexistence of HTN was associated with worse baseline clinical profile and 1-year outcomes.
Collapse
Affiliation(s)
- Abdullah Al-Kasasbeh
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ahmad Abdalmajeed Alghzawi
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- Ministry of Health, Amman, Jordan
| | - Mohamad Jarrah
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Muhannad Ababneh
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Hanna Al-Makhamreh
- Department of Internal Medicine, Faculty of Medicine, University of Jordan, Amman, Jordan
| | - Joud Shehadeh
- Department of Internal Medicine, Istishari Hospital, Amman, Jordan
| | - Afnan Migdadi
- Department of Internal Medicine, Istishari Hospital, Amman, Jordan
| | - Mohammad Jum'ah
- Department of Internal Medicine, Istishari Hospital, Amman, Jordan
| | - Anas Ahmad
- Department of Internal Medicine, Istishari Hospital, Amman, Jordan
| | - Daria Ja'arah
- Department of Internal Medicine, Istishari Hospital, Amman, Jordan
| | - Anwar Y Al Omary
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | |
Collapse
|
3
|
Alkatib M, Alkotyfan ARN, Alshaghel MM, Shamiyeh M. Cardiac arrhythmias in STEMI patients in ICU: study on occurrence in first 48 h and correlation with age, sex, infarction site, and risk factors. Ann Med Surg (Lond) 2023; 85:4824-4829. [PMID: 37811071 PMCID: PMC10553150 DOI: 10.1097/ms9.0000000000001264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/23/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Acute myocardial infarction (AMI) is one of the leading causes of death in the developed world. The spread of the disease approaches three million people worldwide, with more than one million deaths in the United States annually. Myocardial ischemia and infarction can lead to electrophysiological and metabolic alterations that result in potentially fatal arrhythmias, some of which may be asymptomatic. About 90% of patients with AMI develop some form of arrhythmia during or immediately after the event, and in 25% of patients, these arrhythmias appear within the first 48 h. The most common cause of death in patients with AMI in pre-hospitalization is ventricular tachycardia/ventricular fibrillation (VT/VF). Methods A cross-sectional study targeting 150 patients with myocardial infarction attending tertiary hospital. According to certain acceptance and exclusion criteria. Results The sample consisted of 150 patients who suffered from heart infarction, the mean age of patients in the sample was 59.41 years with a standard deviation of 11.02 years and range of 28-90. Males constituted the largest portion of patients, with 112 males, that is 75%. The study identified that the anterior wall was the most frequent location for myocardial infarction among patients, with 64% of patients experiencing an infarction in this area. Additionally, ventricular fibrillation was the most commonly occurring arrhythmia, affecting 27% of myocardial infarction patients in the study. Recommendations One of the most important recommendations of our study is the necessity of keeping the patient under observation for at least 48 h after myocardial infarction within the hospital to monitor the ECG (Holter) in order to detect arrhythmias. Detection of arrhythmias in every patient with extensive anterior, lateral, or posterior myocardial infarction. And the need to know and take into account ventricular fibrillation and how to manage it in every patient with a heart infarction. And conducting future studies, including a larger number of patients, to study cardiac arrhythmias more precisely.
Collapse
Affiliation(s)
- Mahmoud Alkatib
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | | | | | - Marwan Shamiyeh
- Faculty of Medicine, Department of Internal Medicine, Syrian Private University, Damascus, Syria
| |
Collapse
|
4
|
Aminu AJ, Chen W, Yin Z, Kuniewicz M, Walocha J, Perde F, Molenaar P, Iaizzo PA, Dobrzynski H, Atkinson AJ. Novel micro-computed tomography contrast agents to visualise the human cardiac conduction system and surrounding structures in hearts from normal, aged, and obese individuals. TRANSLATIONAL RESEARCH IN ANATOMY 2022. [DOI: 10.1016/j.tria.2022.100175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
5
|
Ventrikuläre Arrhythmien bei obstruktiver und zentraler Schlafapnoe. SOMNOLOGIE 2021. [DOI: 10.1007/s11818-021-00319-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Zusammenfassung
Hintergrund
Ventrikuläre Arrhythmien treten mit einer hohen Prävalenz auf und sind mit einer hohen Morbidität und Mortalität assoziiert. Sowohl die obstruktive (OSA) als auch die zentrale (ZSA) Schlafapnoe können auf Grund ihrer Pathophysiologie zu vermehrten ventrikulären Arrhythmien beitragen.
Ziel
Dieser Artikel soll die komplexen Zusammenhänge und Erkenntnisse jüngster Forschungen bezüglich schlafbezogenen Atmungsstörungen (SBAS) und ventrikulärer Arrhythmien und deren Therapiemöglichkeiten beleuchten.
Material und Methoden
Es erfolgte eine Literaturrecherche basierend auf prospektiven, retrospektiven, klinischen und experimentellen Studien sowie Reviews, Metaanalysen und aktuellen Leitlinien, die seit 2014 in der Medline-Datenbank gelistet wurden.
Ergebnisse
Es besteht ein bidirektionaler Zusammenhang zwischen der SBAS und ventrikulären Arrhythmien. Intermittierende Hypoxie, oxidativer Stress, wiederkehrende Arousals, intrathorakale Druckschwankungen und kardiales Remodeling tragen im Rahmen der SBAS zu einer erhöhten ventrikulären Arrhythmieneigung bei. Der Schweregrad der OSA, gemessen mittels Apnoe-Hypopnoe-Index, ist mit der Prävalenz ventrikulärer Arrhythmien assoziiert. Ähnliche Ergebnisse liegen für Patienten mit ZSA und Herzinsuffizienz vor. Studien zu ventrikulären Arrhythmien bei ZSA-Patienten ohne Herzinsuffizienz fehlen. Eine Positivdrucktherapie (PAP) bei OSA- oder ZSA-Patienten führte in verschiedenen Studien zu einer reduzierten Anzahl an ventrikulären Arrhythmien. Dieser Zusammenhang konnte jedoch nicht in allen Studien bestätigt werden. Ventrikuläre Arrhythmien treten bei der OSA gehäuft nachts auf, bei der ZSA gleichmäßig über den Tag verteilt.
Diskussion
Bisherige Studien weisen einen Zusammenhang zwischen der OSA bzw. der ZSA und ventrikulären Arrhythmien trotz unterschiedlicher Pathophysiologie nach. Hinsichtlich des Effektes der PAP auf ventrikuläre Arrhythmien bei Patienten mit OSA und ZSA sind weitere Studien erforderlich.
Collapse
|
6
|
Gallego M, Zayas-Arrabal J, Alquiza A, Apellaniz B, Casis O. Electrical Features of the Diabetic Myocardium. Arrhythmic and Cardiovascular Safety Considerations in Diabetes. Front Pharmacol 2021; 12:687256. [PMID: 34305599 PMCID: PMC8295895 DOI: 10.3389/fphar.2021.687256] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/15/2021] [Indexed: 12/20/2022] Open
Abstract
Diabetes is a chronic metabolic disease characterized by hyperglycemia in the absence of treatment. Among the diabetes-associated complications, cardiovascular disease is the major cause of mortality and morbidity in diabetic patients. Diabetes causes a complex myocardial dysfunction, referred as diabetic cardiomyopathy, which even in the absence of other cardiac risk factors results in abnormal diastolic and systolic function. Besides mechanical abnormalities, altered electrical function is another major feature of the diabetic myocardium. Both type 1 and type 2 diabetic patients often show cardiac electrical remodeling, mainly a prolonged ventricular repolarization visible in the electrocardiogram as a lengthening of the QT interval duration. The underlying mechanisms at the cellular level involve alterations on the expression and activity of several cardiac ion channels and their associated regulatory proteins. Consequent changes in sodium, calcium and potassium currents collectively lead to a delay in repolarization that can increase the risk of developing life-threatening ventricular arrhythmias and sudden death. QT duration correlates strongly with the risk of developing torsade de pointes, a form of ventricular tachycardia that can degenerate into ventricular fibrillation. Therefore, QT prolongation is a qualitative marker of proarrhythmic risk, and analysis of ventricular repolarization is therefore required for the approval of new drugs. To that end, the Thorough QT/QTc analysis evaluates QT interval prolongation to assess potential proarrhythmic effects. In addition, since diabetic patients have a higher risk to die from cardiovascular causes than individuals without diabetes, cardiovascular safety of the new antidiabetic drugs must be carefully evaluated in type 2 diabetic patients. These cardiovascular outcome trials reveal that some glucose-lowering drugs actually reduce cardiovascular risk. The mechanism of cardioprotection might involve a reduction of the risk of developing arrhythmia.
Collapse
Affiliation(s)
- Mónica Gallego
- Department of Physiology, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Julián Zayas-Arrabal
- Department of Physiology, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Amaia Alquiza
- Department of Physiology, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Beatriz Apellaniz
- Department of Physiology, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Oscar Casis
- Department of Physiology, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| |
Collapse
|
7
|
Abstract
The population suffering from coronary heart disease (CHD) complicated by atrial fibrillation (AF) is rising rapidly. A strong correlation between the two diseases has been reported, and the many common risk factors they share may play prominent roles in their development. In addition, CHD can directly promote the progression of AF by affecting reentry formation, focal ectopic activity, and neural remodeling. At the same time, AF also affects CHD through three aspects: 1) atherosclerosis, 2) the mismatch of blood supply and oxygen consumption, and 3) thrombosis. In conclusion, CHD and AF can aggravate each other and seem to form a vicious cycle. For patients with CHD complicated by AF, principal studies and guidelines have focused on antithrombotic treatment and rhythm control, which are paramount for these patients. Of note, our review sheds light on the strategies to break the cycle of the two diseases, which may be fundamental to treat these patients and optimize the benefit.
Collapse
Affiliation(s)
- Feng Liang
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Wang
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
8
|
Dimos A, Xanthopoulos A, Papamichalis M, Bourazana A, Tavoularis D, Skoularigis J, Triposkiadis F. Sudden Arrhythmic Death at the Higher End of the Heart Failure Spectrum. Angiology 2019; 71:389-396. [DOI: 10.1177/0003319719896475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The risk of sudden cardiac death (SCD) is high in heart failure (HF) patients. Sudden arrhythmic death (SAD) is a frequent cause of exit in HF patients at the lower end of the HF spectrum, and implantable cardioverter–defibrillators have been recommended to prevent these life-threatening rhythm disturbances in select patients. However, less is known regarding the cause of SCD in patients at the upper end of the HF spectrum, despite the fact that the majority of out-of-hospital SCD victims have unknown or near-normal/normal left ventricular ejection fraction (LVEF). In this review, we report the epidemiology, summarize the mechanisms, discuss the diagnostic challenges, and propose a stepwise approach for the prevention of SAD in HF with near-normal/normal LVEF.
Collapse
Affiliation(s)
- Apostolos Dimos
- Department of Cardiology, University General Hospital of Larissa, Larisa, Greece
| | - Andrew Xanthopoulos
- Department of Cardiology, University General Hospital of Larissa, Larisa, Greece
| | - Michail Papamichalis
- Department of Cardiology, University General Hospital of Larissa, Larisa, Greece
| | - Angeliki Bourazana
- Department of Cardiology, University General Hospital of Larissa, Larisa, Greece
| | - Dimitrios Tavoularis
- Department of Cardiology, University General Hospital of Larissa, Larisa, Greece
| | - John Skoularigis
- Department of Cardiology, University General Hospital of Larissa, Larisa, Greece
| | | |
Collapse
|
9
|
Verdecchia P, Angeli F, Cavallini C, Aita A, Turturiello D, De Fano M, Reboldi G. Sudden Cardiac Death in Hypertensive Patients. Hypertension 2019; 73:1071-1078. [DOI: 10.1161/hypertensionaha.119.12684] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Paolo Verdecchia
- From the Fondazione Umbra Cuore e Ipertensione-ONLUS and Struttura Complessa di Cardiologia, Hospital S. Maria della Misericordia, Perugia, Italy (P.V., C.C., A.A.)
| | - Fabio Angeli
- Struttura Complessa di Cardiologia e Fisiopatologia Cardiovascolare, Hospital S. Maria della Misericordia, Perugia, Italy (F.A., D.T.)
| | - Claudio Cavallini
- From the Fondazione Umbra Cuore e Ipertensione-ONLUS and Struttura Complessa di Cardiologia, Hospital S. Maria della Misericordia, Perugia, Italy (P.V., C.C., A.A.)
| | - Adolfo Aita
- From the Fondazione Umbra Cuore e Ipertensione-ONLUS and Struttura Complessa di Cardiologia, Hospital S. Maria della Misericordia, Perugia, Italy (P.V., C.C., A.A.)
| | - Dario Turturiello
- Struttura Complessa di Cardiologia e Fisiopatologia Cardiovascolare, Hospital S. Maria della Misericordia, Perugia, Italy (F.A., D.T.)
| | | | | |
Collapse
|
10
|
Pala R, Mohieldin AM, Sherpa RT, Kathem SH, Shamloo K, Luan Z, Zhou J, Zheng JG, Ahsan A, Nauli SM. Ciliotherapy: Remote Control of Primary Cilia Movement and Function by Magnetic Nanoparticles. ACS NANO 2019; 13:3555-3572. [PMID: 30860808 PMCID: PMC7899146 DOI: 10.1021/acsnano.9b00033] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Patients with polycystic kidney disease (PKD) are characterized with uncontrolled hypertension. Hypertension in PKD is a ciliopathy, an abnormal function and/or structure of primary cilia. Primary cilia are cellular organelles with chemo and mechanosensory roles. In the present studies, we designed a cilia-targeted (CT) delivery system to deliver fenoldopam specifically to the primary cilia. We devised the iron oxide nanoparticle (NP)-based technology for ciliotherapy. Live imaging confirmed that the CT-Fe2O3-NPs specifically targeted primary cilia in cultured cells in vitro and vascular endothelia in vivo. Importantly, the CT-Fe2O3-NPs enabled the remote control of the movement and function of a cilium with an external magnetic field, making the nonmotile cilium exhibit passive movement. The ciliopathic hearts displayed hypertrophy with compromised functions in left ventricle pressure, stroke volume, ejection fraction, and overall cardiac output because of prolonged hypertension. The CT-Fe2O3-NPs significantly improved cardiac function in the ciliopathic hypertensive models, in which the hearts also exhibited arrhythmia, which was corrected with the CT-Fe2O3-NPs. Intraciliary and cytosolic Ca2+ were increased when cilia were induced with fluid flow or magnetic field, and this served as a cilia-dependent mechanism of the CT-Fe2O3-NPs. Fenoldopam-alone caused an immediate decrease in blood pressure, followed by reflex tachycardia. Pharmacological delivery profiles confirmed that the CT-Fe2O3-NPs were a superior delivery system for targeting cilia more specifically, efficiently, and effectively than fenoldopam-alone. The CT-Fe2O3-NPs altered the mechanical properties of nonmotile cilia, and these nano-biomaterials had enormous clinical potential for ciliotherapy. Our studies further indicated that ciliotherapy provides a possibility toward personalized medicine in ciliopathy patients.
Collapse
Affiliation(s)
- Rajasekharreddy Pala
- Department of Biomedical & Pharmaceutical Sciences, Chapman University School of Pharmacy (CUSP), Harry and Diane Rinker Health Science Campus, Chapman University, Irvine, California 92618, United States
- Department of Medicine, University of California Irvine, Irvine, California 92868, United States
| | - Ashraf M. Mohieldin
- Department of Biomedical & Pharmaceutical Sciences, Chapman University School of Pharmacy (CUSP), Harry and Diane Rinker Health Science Campus, Chapman University, Irvine, California 92618, United States
- Department of Medicine, University of California Irvine, Irvine, California 92868, United States
| | - Rinzhin T. Sherpa
- Department of Biomedical & Pharmaceutical Sciences, Chapman University School of Pharmacy (CUSP), Harry and Diane Rinker Health Science Campus, Chapman University, Irvine, California 92618, United States
- Department of Medicine, University of California Irvine, Irvine, California 92868, United States
| | - Sarmed H. Kathem
- Department of Biomedical & Pharmaceutical Sciences, Chapman University School of Pharmacy (CUSP), Harry and Diane Rinker Health Science Campus, Chapman University, Irvine, California 92618, United States
- Department of Medicine, University of California Irvine, Irvine, California 92868, United States
| | - Kiumars Shamloo
- Department of Biomedical & Pharmaceutical Sciences, Chapman University School of Pharmacy (CUSP), Harry and Diane Rinker Health Science Campus, Chapman University, Irvine, California 92618, United States
- Department of Medicine, University of California Irvine, Irvine, California 92868, United States
| | - Zhongyue Luan
- Chemical Engineering & Material Sciences, University of California Irvine, Irvine, California 92697, United States
| | - Jing Zhou
- Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Jian-Guo Zheng
- Irvine Materials Research Institute, University of California Irvine, Irvine, California 92697, United States
| | - Amir Ahsan
- Department of Physics, Computer Science & Engineering, Chapman University, Orange, California 92866, United States
| | - Surya M. Nauli
- Department of Biomedical & Pharmaceutical Sciences, Chapman University School of Pharmacy (CUSP), Harry and Diane Rinker Health Science Campus, Chapman University, Irvine, California 92618, United States
- Department of Medicine, University of California Irvine, Irvine, California 92868, United States
- Corresponding Author: ; . (S.M.N.)
| |
Collapse
|
11
|
Lip GYH, Coca A, Kahan T, Boriani G, Manolis AS, Olsen MH, Oto A, Potpara TS, Steffel J, Marín F, de Oliveira Figueiredo MJ, de Simone G, Tzou WS, Chiang CE, Williams B, Dan GA, Gorenek B, Fauchier L, Savelieva I, Hatala R, van Gelder I, Brguljan-Hitij J, Erdine S, Lovic D, Kim YH, Salinas-Arce J, Field M. Hypertension and cardiac arrhythmias: a consensus document from the European Heart Rhythm Association (EHRA) and ESC Council on Hypertension, endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS) and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE). Europace 2018; 19:891-911. [PMID: 28881872 DOI: 10.1093/europace/eux091] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 03/11/2017] [Indexed: 12/23/2022] Open
Abstract
Hypertension is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease, stroke, peripheral artery disease and chronic renal insufficiency. Hypertensive heart disease can manifest as many cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both supraventricular and ventricular arrhythmias may occur in hypertensive patients, especially in those with left ventricular hypertrophy (LVH) or HF. Also, some of the antihypertensive drugs commonly used to reduce blood pressure, such as thiazide diuretics, may result in electrolyte abnormalities (e.g. hypokalaemia, hypomagnesemia), further contributing to arrhythmias, whereas effective control of blood pressure may prevent the development of the arrhythmias such as AF. In recognizing this close relationship between hypertension and arrhythmias, the European Heart Rhythm Association (EHRA) and the European Society of Cardiology (ESC) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE), with the remit to comprehensively review the available evidence to publish a joint consensus document on hypertension and cardiac arrhythmias, and to provide up-to-date consensus recommendations for use in clinical practice. The ultimate judgment regarding care of a particular patient must be made by the healthcare provider and the patient in light of all of the circumstances presented by that patient.
Collapse
Affiliation(s)
- Gregory Y H Lip
- Institute of Cardiovascular Sciences, University of Birmingham, UK.,Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Antonio Coca
- Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clínic (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Thomas Kahan
- Karolinska Institutet Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden.,Department of Cardiology, Danderyd University Hospital Corp, Stockholm, Sweden
| | - Giuseppe Boriani
- Cardiology Department, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Antonis S Manolis
- Third Department of Cardiology, Athens University School of Medicine, Athens, Greece
| | - Michael Hecht Olsen
- Department of Internal Medicine, Holbaek Hospital and Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, University of Southern Denmark, Denmark
| | - Ali Oto
- Department of Cardiology, Memorial Ankara Hospital, Heart and Health Foundation of Turkey, Ankara, Turkey
| | - Tatjana S Potpara
- School of Medicine, Cardiology Clinic, Clinical Centre of Serbia, Belgrade University, Belgrade, Serbia
| | - Jan Steffel
- Electrophysiology and Cardiac Devices, Department of Cardiology, University Heart Center Zurich; Zurich, Switzerland
| | - Francisco Marín
- Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | | | - Giovanni de Simone
- Department of Translational Medical Sciences, Federico II University Hospital, via S. Pansini 5, bld # 1, Napoli 80131, Italy
| | - Wendy S Tzou
- Cardiac Electrophysiology, Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Chern-En Chiang
- Division of Cardiology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
| | - Bryan Williams
- Institute of Cardiovascular Science, University College London, UK
| | | | - Gheorghe-Andrei Dan
- Colentina University Hospital, Medicine Faculty, University of Medicine "Carol Davila"-Bucharest Romania
| | | | | | | | - Robert Hatala
- National Cardiovascular Institute, NUSCH, Bratislava, Slovak Republic
| | - Isabelle van Gelder
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jana Brguljan-Hitij
- University Medical Centre, Hypertension Department, Hospital Dr. Peter Drzaja, Ljubljana, Slovenia
| | - Serap Erdine
- Istanbul University Cerrahpasa Medical School, Head of Hypertension Department, Istanbul, Turkey
| | - Dragan Lovic
- Clinic for internal disease Intermedica, Cardiology department-Hypertension centere, Serbia
| | | | | | - Michael Field
- University of Wisconsin, Clinical Science Center, Madison, USA
| |
Collapse
|
12
|
Adeleye OE, Ale JM, Sogebi EOA, Durotoye LA, Adeleye AI, Adeyemi SO, Olukunle JO. Effects of Trypanosoma brucei brucei infection and diminazene aceturate administration on the blood pressure, heart rate, and temperature of Wistar albino rats. J Basic Clin Physiol Pharmacol 2018; 29:265-269. [PMID: 29570449 DOI: 10.1515/jbcpp-2017-0201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 12/16/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND This study was carried out to determine the blood pressure changes in experimentally Trypanosoma brucei brucei-infected Wistar albino rats and diminazene aceturate-treated rats. METHODS Twenty-four rats were purchased and divided into four groups consisting of six rats each. Control group (CON) received 0.5 mL of distilled water, i.m., infected but not treated group (INF) received 2×106 trypanosome/mL i.m., infected but diminazene aceturate-treated group (INFDIM) received 2×106 trypanosome/mL, 3.5 mg/kg, i.m.) and non-infected but diminazene aceturate-treated group (DIM) received 3.5 mg/kg, i.m. and served as negative control. The blood pressures were measured using a CODA 2® non-invasive blood pressure monitor (Kent Scientific, USA). The results were compiled and statistical analysis was done with significance set at p≥0.05. RESULTS The values of the blood pressure readings of the Trypanosoma-infected INF (137.0±2.0 mmHg) and diminazene-treated rats INFDIM (125.0±7.5 mmHg) when compared to the control group (168.0±3.0 mmHg) were significantly lower (p≤0.05) at the end of day 7. The heart rate was also significantly reduced in the INF (403.5±1.5 beats/min) and DIM (445.0±24 beats/min) groups of rats when compared with the control group (613.0±2.0 beats/min) at the end of day 8. CONCLUSION The findings indicate the significant reduction in blood pressure and heart rates during Trypanosoma brucei brucei infection and with diminazene aceturate administration. Hence, caution should be exercised when treating trypanosome-infected patients with diminazene aceturate.
Collapse
Affiliation(s)
- Olushola Emmanuel Adeleye
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Jude Makinde Ale
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Emmanuella Olubanke Amope Sogebi
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Ladoke A Durotoye
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Adenike Iyabo Adeleye
- Veterinary Teaching Hospital, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | | | - Johnny Olufemi Olukunle
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Ogun State, A234, Nigeria, Phone +2348101846078
| |
Collapse
|
13
|
Stephenson RS, Atkinson A, Kottas P, Perde F, Jafarzadeh F, Bateman M, Iaizzo PA, Zhao J, Zhang H, Anderson RH, Jarvis JC, Dobrzynski H. High resolution 3-Dimensional imaging of the human cardiac conduction system from microanatomy to mathematical modeling. Sci Rep 2017; 7:7188. [PMID: 28775383 PMCID: PMC5543124 DOI: 10.1038/s41598-017-07694-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 07/03/2017] [Indexed: 12/23/2022] Open
Abstract
Cardiac arrhythmias and conduction disturbances are accompanied by structural remodelling of the specialised cardiomyocytes known collectively as the cardiac conduction system. Here, using contrast enhanced micro-computed tomography, we present, in attitudinally appropriate fashion, the first 3-dimensional representations of the cardiac conduction system within the intact human heart. We show that cardiomyocyte orientation can be extracted from these datasets at spatial resolutions approaching the single cell. These data show that commonly accepted anatomical representations are oversimplified. We have incorporated the high-resolution anatomical data into mathematical simulations of cardiac electrical depolarisation. The data presented should have multidisciplinary impact. Since the rate of depolarisation is dictated by cardiac microstructure, and the precise orientation of the cardiomyocytes, our data should improve the fidelity of mathematical models. By showing the precise 3-dimensional relationships between the cardiac conduction system and surrounding structures, we provide new insights relevant to valvar replacement surgery and ablation therapies. We also offer a practical method for investigation of remodelling in disease, and thus, virtual pathology and archiving. Such data presented as 3D images or 3D printed models, will inform discussions between medical teams and their patients, and aid the education of medical and surgical trainees.
Collapse
Affiliation(s)
- Robert S Stephenson
- Comparative Medicine Lab, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Andrew Atkinson
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Petros Kottas
- School of Physics and Astronomy, University of Manchester, Manchester, UK
| | - Filip Perde
- National Institute of Legal Medicine, Bucharest, Romania
| | - Fatemeh Jafarzadeh
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Mike Bateman
- The Visible Heart Laboratory, University of Minnesota, Minneapolis, USA
| | - Paul A Iaizzo
- The Visible Heart Laboratory, University of Minnesota, Minneapolis, USA
| | - Jichao Zhao
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Henggui Zhang
- School of Physics and Astronomy, University of Manchester, Manchester, UK
| | - Robert H Anderson
- Institute of Genetic Medicine, University of Newcastle, Newcastle, UK
| | - Jonathan C Jarvis
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
| | - Halina Dobrzynski
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
| |
Collapse
|
14
|
Chiu HY, Chang WL, Huang WF, Wen YW, Tsai YW, Tsai TF. Increased risk of arrhythmia in patients with psoriatic disease: A nationwide population-based matched cohort study. J Am Acad Dermatol 2015; 73:429-38. [DOI: 10.1016/j.jaad.2015.06.023] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Revised: 06/07/2015] [Accepted: 06/10/2015] [Indexed: 12/13/2022]
|
15
|
Adebayo RA, Ikwu AN, Balogun MO, Akintomide AO, Ajayi OE, Adeyeye VO, Mene-Afejuku TO, Bamikole OJ, Ogunyemi SA, Ajibare AO, Oketona OA. Heart rate variability and arrhythmic patterns of 24-hour Holter electrocardiography among Nigerians with cardiovascular diseases. Vasc Health Risk Manag 2015; 11:353-9. [PMID: 26170685 PMCID: PMC4492626 DOI: 10.2147/vhrm.s81106] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Facilities for Holter electrocardiography (ECG) monitoring in many Nigerian hospitals are limited. There are few published works in Nigeria on the use of 24-hour Holter ECG in cardiac arrhythmic evaluation of patients with cardiovascular diseases. OBJECTIVE To study the clinical indications, arrhythmic pattern, and heart rate variability (HRV) among subjects referred for 24-hour Holter ECG at our Cardiac Care Unit. METHODS Three-hundred and ten patients (134 males and 176 females) were studied consecutively over a 48-month period using Schiller type (MT-101) Holter ECG machine. RESULTS Out of the 310 patients reviewed, 134 were males (43.2%) and 176 were females (56.8%). The commonest indication for Holter ECG was palpitation followed by syncope in 71 (23%) and 49 (15.8%) of subjects, respectively. Premature ventricular complex and premature atrial complex were the commonest types of arrhythmia in 51.5% and 15% subjects, respectively. Ventricular arrhythmia was more prevalent in dilated cardiomyopathy patients (85.7%). The HRV of subjects with palpitation, stroke, and diabetes mellitus with autonomic neuropathy, using standard deviation of normal to normal intervals average (milliseconds), were 107.32±49.61, 79.15±49.15, and 66.50±15.54, respectively. The HRV, using standard deviation of averages of normal to normal intervals average (milliseconds), of patients with palpitation, stroke, and diabetes mellitus with autonomic neuropathy were 77.39±62.34, 57.82±37.05, and 55.50±12.71, respectively. CONCLUSION Palpitation and syncope were the commonest indications for Holter ECG among our subjects. The commonest arrhythmic patterns were premature ventricular complex and premature atrial complex, with ventricular arrhythmia being more prevalent in dilated cardiomyopathy. There was a reduction in HRV in patients with stroke and diabetic autonomic neuropathy.
Collapse
Affiliation(s)
- Rasaaq Ayodele Adebayo
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Amanze Nkemjika Ikwu
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Michael Olabode Balogun
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Anthony Olubunmi Akintomide
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Olufemi Eyitayo Ajayi
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Victor Oladeji Adeyeye
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Tuoyo Omasan Mene-Afejuku
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Olaniyi James Bamikole
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Suraj Adefabi Ogunyemi
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Adeola Olubunmi Ajibare
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Omolola Abiodun Oketona
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| |
Collapse
|
16
|
Laukkanen JA, Khan H, Kurl S, Willeit P, Karppi J, Ronkainen K, Di Angelantonio E. Left ventricular mass and the risk of sudden cardiac death: a population-based study. J Am Heart Assoc 2014; 3:e001285. [PMID: 25376188 PMCID: PMC4338721 DOI: 10.1161/jaha.114.001285] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 08/28/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND Left ventricular (LV) mass ascertained using echocardiography may enhance risk stratification for sudden cardiac death. The objective of this study was to assess the association between left ventricular mass and the risk of sudden cardiac death in a population-based cohort and determine its incremental value beyond conventional risk predictors. METHODS AND RESULTS Assessment of LV mass was based on echocardiography in a sample of 905 middle-aged men representative of the general population (aged 42 to 61 years). During the follow-up period of 20 years, there were a total of 63 sudden cardiac deaths. In a comparison of the top versus the bottom quartile of LV mass adjusted by body surface area (>120 versus <89 g/m(2)), the multivariable adjusted hazard ratio was 2.57 (95% CI 1.24 to 5.31, P=0.010). Further adjustment for LV function only modestly attenuated the risk of sudden cardiac death among men with LV mass of >120 g/m(2) (hazard ratio 2.29, 95% CI 1.10 to 4.74, P=0.026). Addition of LV mass adjusted by body surface area to a conventional risk factor model for sudden cardiac death improved the integrated discrimination index by 0.033 (95% CI 0.009 to 0.057, P=0.007) and the category-free net reclassification index by 0.501 (95% CI 0.092 to 0.911, P=0.016). CONCLUSIONS Indexed LV mass by body surface area is an independent predictor of sudden cardiac death and may help improve the risk prediction of sudden cardiac death beyond conventional cardiovascular risk factors.
Collapse
Affiliation(s)
- Jari A. Laukkanen
- Department of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland (J.A.L., S.K., J.K., K.R.)
| | | | - Sudhir Kurl
- Department of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland (J.A.L., S.K., J.K., K.R.)
| | - Peter Willeit
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom (P.W., E.D.A.)
| | - Jouni Karppi
- Department of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland (J.A.L., S.K., J.K., K.R.)
| | - Kimmo Ronkainen
- Department of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland (J.A.L., S.K., J.K., K.R.)
| | - Emanuele Di Angelantonio
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom (P.W., E.D.A.)
| |
Collapse
|
17
|
Ferri C, Pasqualetti P, Tiberti S, Grassi D. Electrophysiological effects of short-term antihypertensive therapy. Expert Rev Cardiovasc Ther 2014; 6:1343-6. [DOI: 10.1586/14779072.6.10.1343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
18
|
Ajayi OE, Ajayi AAL. Valvular regurgitations may increase risk of arrhythmias in Nigerians with hypertensive heart failure. J Cardiovasc Med (Hagerstown) 2013; 14:453-60. [PMID: 23114272 DOI: 10.2459/jcm.0b013e32835936fd] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Hypertensive heart disease (HHD) is the commonest cause of sudden cardiac death among Nigerians. A high frequency and early onset of valvular regurgitations (VHD) in hypertensives, and greater concentric hypertrophy are also common in that population. AIMS AND METHODS To further investigate the relationship between VHD and cardiac arrhythmias and their correlates seen in the hypertensive spectrum and to test the hypothesis that VHD predisposes to cardiac arrhythmias in hypertensive heart failure (HHF). HHF patients (n = 14), HHD patients n = 23, and normotensive controls (n = 9) all underwent 24 h electrocardiogram Holter monitoring as well as two-dimensional and Doppler echocardiography. Participants in each patient category were classified according to the presence and severity of VHD or its absence (NVHD). RESULTS There were statistically significant differences in the mean supraventricular tachycardia (SVT) (P < 0.001 analysis of variance; ANOVA), the mean and median frequency of ventricular tachycardia episodes (P < 0.02 ANOVA), and couplets (P = 0.0002 ANOVA) between groups. HHF-VHD always had more SVT (81/24 versus 4.4/24 h; P = 0.016) and ventricular arrhythmias 69/24 versus 34/24 h (P < 0.02) than HHF-NVHD. Multivalvular regurgitations (three or more valves), higher left ventricular mass index (g/m2) [274 (24) versus 191(19); P < 0.001 ANOVA], and lower ejection fraction (EF; %) [29(3) versus 53(14)] in HHF-VHD were arrhythmogenic. Mean ventricular tachycardia/triplet frequency/24 h were HHF-VHD 69, HHF-NVHD 39, HHD-VHD 0.3, HHD-NVHD 6, and controls 0.2 (P < 0.02 ANOVA). Compared with 35% (10/27) of all VHD, 15.7% (3/19) of all NVHD participants had nonsustained ventricular tachycardia. The number of regurgitant valves was positively correlated with the frequency of the Lown class of the arrhythmias 0-IVB (r = 0.42, P = 0.003) and to ventricular tachycardia (r = 0.3, P = 0.04) (both n = 46). CONCLUSION Left ventricular hypertrophy (LVH) increased arrhythmias. But multivalvular regurgitations predisposes to greater SVT and complex ventricular arrhythmias, especially in HHF. Low EF and concentric LVH are correlates.
Collapse
Affiliation(s)
- Olufemi E Ajayi
- Division of Cardiology, Department of Medicine, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
| | | |
Collapse
|
19
|
Díez J. Hypertensive heart disease. Hypertension 2013. [DOI: 10.2217/ebo.12.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Javier Díez
- Javier Díez is Full Professor of Medicine at the University of Navarra (Pamplona, Spain). His group studies the mechanisms involved in myocardial remodeling associated with cardiac pressure overload, as well as noninvasive biomarkers and novel therapeutic targets for myocardial remodeling
| |
Collapse
|
20
|
Ely JJ, Zavaskis T, Lammey ML. Hypertension increases with aging and obesity in chimpanzees (Pan troglodytes). Zoo Biol 2013; 32:79-87. [PMID: 22968757 PMCID: PMC3537917 DOI: 10.1002/zoo.21044] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Revised: 08/10/2012] [Accepted: 08/10/2012] [Indexed: 12/17/2022]
Abstract
Cardiovascular disease is a primary cause of morbidity and mortality in captive chimpanzees. Four years of blood pressure (BP) data were analyzed from a captive former laboratory population of 201 healthy adult chimpanzees with assessment of age and obesity on elevated BP. Five different measures of obesity were compared: abdominal girth, basal metabolic rate, body-mass index (BMI), body weight, and surface area. Systolic BP varied by sex. Obesity did not influence male BP. For females, obesity was a significant determinant of BP. The best measure of female obesity was basal metabolic rate and the worst was BMI. Median systolic BP of healthy weight females (<54.5 kg) was significantly lower (128 mmHg) than overweight or obese females (140 mmHg), but both were lower than all males (147 mmHg). For diastolic BP, neither sex nor any of the five obesity measures was significant. But age was highly significant, with geriatric chimpanzees (>30 years) having higher median diastolic BP (74 mmHg) than young adults of 10-29 years of age (65 mmHg). By these criteria, 80% of this population is normotensive, 7% prehypertensive, and 13% hypertensive. In summary, systolic BP intervals required adjustment for obesity among females but not males. Diastolic BP required adjustment for advanced age (≥30 years). Use of these reference intervals can facilitate timely clinical care of captive chimpanzees.
Collapse
Affiliation(s)
- John J Ely
- Alamogordo Primate Facility, Holloman AFB, Alamogordo, New Mexico, USA.
| | | | | |
Collapse
|
21
|
Laukkanen JA, Jennings JR, Kauhanen J, Mäkikallio TH, Ronkainen K, Kurl S. Relation of systemic blood pressure to sudden cardiac death. Am J Cardiol 2012; 110:378-82. [PMID: 22521306 DOI: 10.1016/j.amjcard.2012.03.035] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 03/15/2012] [Accepted: 03/15/2012] [Indexed: 11/18/2022]
Abstract
The role of systolic blood pressure (SBP) as an independent risk factor for sudden cardiac death (SCD) is not well defined in a general population. Thus, we assessed the association between BP at rest and risk of SCD. BP and other risk factors were measured in a representative population-based sample of 2,666 Finnish men (42 to 61 years of age). During an average follow-up period of 18.9 years (interquartile range 17.9 to 22.6), 213 SCDs occurred. Each increment 10-mm Hg of SBP at rest was associated with an increased risk of SCD (relative hazard 1.15, 95% confidence interval 1.07 to 1.25, p <0.001) after adjustment for age, alcohol consumption, cigarette smoking, serum low-density lipoprotein cholesterol, type 2 diabetes, body mass index, left ventricular hypertrophy, previous myocardial infarction, family history of coronary heart disease, and use of antihypertensive medications. Men with increased SBP of >145 mm Hg had a 2.04-fold (95% confidence interval 1.23 to 2.52, p = 0.003) adjusted risk for SCD compared to those with SBP <123 mm Hg. In conclusion, this study emphasizes the importance of the definition of SBP at rest because it provides a valuable prognostic measurement for SCD.
Collapse
Affiliation(s)
- Jari Antero Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
| | | | | | | | | | | |
Collapse
|
22
|
Abstract
This review discusses cardiac consequences of pressure overload. In response to elevated pressure, the ventricular hypertrophy compensates for the increased wall stress. However, the ventricular hypertrophy involves numerous structural adaptations that may lead to ventricular dysfunction and, eventually, heart failure. Particular emphasis is placed on molecular mechanisms that govern the development of hypertrophy and that may lead to maladaptive structural changes resulting in adverse cardiac events.
Collapse
|
23
|
Bacharova L, Szathmary V, Mateasik A. Secondary and primary repolarization changes in left ventricular hypertrophy: a model study. J Electrocardiol 2010; 43:624-33. [DOI: 10.1016/j.jelectrocard.2010.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Indexed: 10/19/2022]
|
24
|
Guo D, Young L, Wu Y, Belardinelli L, Kowey PR, Yan GX. Increased late sodium current in left atrial myocytes of rabbits with left ventricular hypertrophy: its role in the genesis of atrial arrhythmias. Am J Physiol Heart Circ Physiol 2010; 298:H1375-81. [PMID: 20190097 DOI: 10.1152/ajpheart.01145.2009] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Left ventricular hypertrophy (LVH) is frequently associated with clinical atrial arrhythmias, but little is known about how it causes those arrhythmias. Our previous studies have shown that LVH increases the late sodium current (I(Na-L)) that plays an important role in the genesis of ventricular arrhythmias. We hypothesize that LVH may also induce an upregulation of the I(Na-L) in atrial myocytes, leading to atrial electrical abnormalities. The renovascular hypertension model was used to induce LVH in rabbits. Action potential and membrane current recordings were performed in single myocytes. At a pacing cycle length of 2,000 ms, spontaneous phase-2 early afterdepolarizations (EADs) could be recorded from the left atrial myocytes in 10 of 12 LVH rabbits, whereas no EADs could be elicited in right atrial myocytes of LVH rabbits or atrial myocytes from any of the 12 control rabbits. Spontaneous automaticity (SA) from left atrial myocytes was observed in 9 out of 12 LVH rabbits, but none in right atrial myocytes of LVH rabbits or control rabbits, at a pacing rate of 8,000 ms. The left atrial myocytes of LVH rabbits had a significantly higher density of the I(Na-L) compared with those of control rabbits (0.90 +/- 0.12 in LVH vs. 0.50 +/- 0.08 pA/pF in control, n = 8, P < 0.01). Tetrodotoxin, an I(Na-L) blocker, abolished all atrial EADs and SA at 10 microM. Our results demonstrate that LVH induction results in a significant increase of I(Na-L) in the left atrial myocytes that may render these cells susceptible to the genesis of EADs and SA. The I(Na-L) may serve as a potentially useful ionic target for antiarrhythmic drugs for the treatment of atrial arrhythmias in the setting of LVH.
Collapse
Affiliation(s)
- Donglin Guo
- Main Line Health Heart Center & Lankenau Inst., Medical Research, 100 Lancaster Ave., Wynnewood, PA 19096, USA.
| | | | | | | | | | | |
Collapse
|
25
|
Armario P, Hernández Del Rey R, Oliveras A. Papel actual de los antagonistas de los receptores de la angiotensina II y de sus combinaciones en el tratamiento de la hipertensión arterial. Med Clin (Barc) 2009; 132:792-6. [DOI: 10.1016/j.medcli.2009.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Accepted: 04/29/2009] [Indexed: 10/20/2022]
|
26
|
Pastor-Pérez F, Marín F. Hypertension, aortic sclerosis and the prothrombotic state: understanding the complex interaction. J Hum Hypertens 2008; 23:287-8. [DOI: 10.1038/jhh.2008.103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|