Association between serum albumin levels and paroxysmal atrial fibrillation by gender in a Chinese population: a case–control study

Clinical value of artificial intelligence 3D echocardiography in evaluating left atrial volume and pulmonary vein structure in patients with atrial fibrillation

OBJECTIVE

To explore the clinical value of 3D Echocardiography (3DE) in evaluating the changes of left atrial volume and pulmonary vein structure in patients with Atrial Fibrillation (AF).

METHODS

Clinical data were collected from 54 AF patients. Left Atrial Anteroposterior Diameter (LADap), Left Atrial left and right Diameter (LADml), and Left Atrial upper and lower Diameter (LADsi) were measured; the maximum Left Atrial Volume (LAVmax), minimum Left Atrial Volume (LAVmin), left atrial presystolic volume (LAVpre), and Cross-Sectional Area (CSA) of each pulmonary vein were analyzed. Passive Ejection Fraction (LAPEF) was calculated. The differences in left atrial volume and pulmonary vein structure between patients with AF and healthy people were compared, and the correlation between the indexes was analyzed. The diagnostic value of the above indicators for AF patients was analyzed.

RESULTS

LADap, LADml, LADsi, LAVmax, LAVmin, LAVpre, LAPEF, LSPV CSA, LIPV CSA, RSPV CSA, and RIPV CSA of AF patients were significantly higher. There was a significant positive correlation between left atrial diameter and pulmonary vein structure. There was a significant positive correlation between left atrial volume and pulmonary vein structure. There was a negative correlation between LAPEF and pulmonary vein structure. LADap, LADml, LADsi, LAVmax, LAVmin, LAVpre, LAPEF, LSPV CSA, LIPV CSA, RSPV CSA, and RIPV CSA had a diagnostic value for AF patients.

CONCLUSION

3DE is applicable for evaluating left atrial volume and pulmonary vein structure in patients with AF.

The association between antiphospholipid syndrome and atrial fibrillation: a single center retrospective case-control study

Antiphospholipid syndrome (APS) is a systemic autoimmune syndrome characterized by arterial or venous thrombosis, pregnancy complications and thrombocytopenia. The aim of this study is to investigate the association between APS and atrial fibrillation (AF) among patients in Peking University People's Hospital. A single center retrospective study was conducted. Cases were hospitalized patients diagnosed with AF by a cardiologist while the control group patients did not exhibit cardiac diseases. The results of the study revealed that in multivariable logistic regression, APS, anticardiolipin antibody (aCL) positivity and anti-beta-2-glycoprotein antibody (anti-β2GPI) positivity are independent risk factors of AF. APS, aCL positivity and anti-β 2GPI positivity are statistically different between AF patients and non-AF patients. Forthcoming studies are needed to clarify the potential link between APS and AF.

Prognostic value of serum albumin in heart failure patients with cardiac resynchronization therapy

Aim: There is a lack of data about the association between admission serum albumin levels and long-term mortality in heart failure (HF) patients with cardiac resynchronization therapy defibrillators (CRT-D). We aim to investigate this connection in HF patients with CRT-D. Methods: The study population consisted of 477 HF patients with CRT-D. The cohort was divided into three groups according to albumin values, and the relationship between these groups and long-term mortality were evaluated. Results: Long-term all-cause mortality (HR: 3.32, 95% CI: 2.12-6.84), appropriate (HR: 4.44, 95% CI: 2.44-8.06) and inappropriate (HR: 2.95, 95% CI: 1.88-6.02) shocks were higher in the low albumin group. Conclusion: Low albumin levels are associated with the long-term mortality and appropriate shock treatment in HF patients with CRT-D.

Evaluating Nutritional Risk Factors for Delirium in Intensive-Care-Unit Patients: Present Insights and Prospects for Future Research

Malnutrition, hypercatabolism, and metabolic changes are well-established risk factors for delirium in critically ill patients. Although the exact mechanisms are not fully understood, there is mounting evidence suggesting that malnutrition can cause a variety of changes that contribute to delirium, such as electrolyte imbalances, immune dysfunction, and alterations in drug metabolism. Therefore, a comprehensive metabolic and malnutrition assessment, along with appropriate nutritional support, may help to prevent or ameliorate malnutrition, reduce hypercatabolism, and improve overall physiological function, ultimately lowering the risk of delirium. For this aim, bioelectrical impedance analysis can represent a valuable strategy. Further research into the underlying mechanisms and nutritional risk factors for delirium is crucial to developing more effective prevention strategies. Understanding these processes will allow clinicians to personalize treatment plans for individual patients, leading to improved outcomes and quality of life in the intensive-care-unit survivors.

Predictive nomogram for postoperative atrial fibrillation in locally advanced esophageal squamous carcinoma cell with neoadjuvant treatment

Background

Neoadjuvant therapy following minimally invasive esophagectomy is recommended as the standard treatment for locally advanced esophageal squamous carcinoma cells (ESCC). Postoperative atrial fibrillation (POAF) after esophagectomy is common. We aimed to determine the risk factors and construct a nomogram model to predict the incidence of POAF among patients receiving neoadjuvant therapy.

Methods

We retrospectively included patients with ESCC receiving neoadjuvant chemotherapy (nCT), neoadjuvant chemoradiotherapy (nCRT), or neoadjuvant immunochemotherapy (nICT) following minimally invasive esophagectomy (MIE) for analysis. Patients without a history of AF who did not have any AF before surgery and who developed new AF after surgery, were defined as having POAF. We applied a LASSO regression analysis to avoid the collinearity of variables and screen the risk factors. We then applied a multivariate regression analysis to select independent risk factors and constructed a nomogram model to predict POAF. We used the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) curve to evaluate the nomogram model.

Results

A total of 202 patients were included for analysis, with 35 patients receiving nCRT, 88 patients receiving nCT, and 79 patients receiving nICT. POAF occurred in 34 (16.83%) patients. There was no significant difference in the distribution of neoadjuvant types between the POAF group and the no POAF group. There was a significant increase in postoperative hospital stay (p = 0.04), hospital expenses (p = 0.01), and comprehensive complication index (p < 0.001). The LASSO analysis screened the following as risk factors: blood loss; ejection fraction (EF); forced expiratory volume in 1 s; preoperative albumin (Alb); postoperative hemoglobin (Hb); preoperative Hb; hypertension; time to surgery; age; and left atrial (LA) diameter. Further, preoperative Alb ≤41.2 g/L (p < 0.001), preoperative Hb >149 g/L (p = 0.01), EF >67.61% (p = 0.008), and LA diameter >32.9 mm (p = 0.03) were determined as independent risk factors of POAF in the multivariate logistic analysis. The nomogram had an area under the curve (AUC) of 0.77. The Briser score of the calibration curve was 0.12. The DCA confirmed good clinical value.

Conclusions

Preoperative Alb ≤41.2 g/L, LA diameter >32.9 mm, preoperative Hb >149 g/L, and EF >67.61% were determined as the risk factors for POAF among patients with ESCC. A novel and valuable nomogram was constructed and validated to help clinicians evaluate the risk of POAF and take personalized treatment plans.