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Rafaqat S, Sharif S, Naz S, Gluscevic S, Mercantepe F, Ninic A, Klisic A. Cardiometabolic Risk Factors Related to Atrial Fibrillation and Metabolic Syndrome in the Pakistani Population. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1190. [PMID: 39202472 PMCID: PMC11356279 DOI: 10.3390/medicina60081190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 07/15/2024] [Accepted: 07/20/2024] [Indexed: 09/03/2024]
Abstract
Background and Objectives: This study aimed to examine the relationship between cardiometabolic risk factors and atrial fibrillation (AF) and the simultaneous presence of AF and metabolic syndrome (MetS) in the Pakistani population. Materials and Methods: A total of 690 subjects were enrolled (n = 230 patients with AF, n = 230 patients with AF and MetS, and n = 230 controls). The associations between cardiometabolic parameters and AF with and without MetS were analyzed by univariable and multivariable binary regression analyses. Results: Body mass index (BMI), fasting blood glucose (FBG), and triglycerides (TG) were independently positively correlated, but the glomerular filtration rate (GFR) and sodium were independently negatively correlated with AF. An increase in BMI, FBG, and TG levels by one unit measure increased the probability by 55.1%, 20.6%, and 1.3%, respectively, for the AF occurrence. A decrease in GFR and sodium levels increased the probability by 4.3% and 33.6%, respectively, for the AF occurrence. On the other hand, uric acid was independently negatively correlated, whereas sodium was independently positively correlated, with MetS and AF. A decrease in uric acid levels and an increase in sodium levels by 1 unit measure increased the probability for MetS and AF by 23.2% and 7.5%, respectively. Conclusions: Cost-effective and routinely measured parameters, i.e., BMI, FBG TG, GFR, and sodium levels, can be reliable indicators of AF, whereas serum uric acid and sodium levels are independently associated with AF and MetS in the Pakistani population. Timely recognition and the control of modifiable cardiometabolic risk factors are of great significance in the prevention of AF development.
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Affiliation(s)
- Saira Rafaqat
- Department of Zoology, Lahore College for Women University, Lahore 44444, Punjab, Pakistan
| | - Saima Sharif
- Department of Zoology, Lahore College for Women University, Lahore 44444, Punjab, Pakistan
| | - Shagufta Naz
- Department of Zoology, Lahore College for Women University, Lahore 44444, Punjab, Pakistan
| | - Sanja Gluscevic
- Department of Neurology, Clinical Center of Montenegro, 81000 Podgorica, Montenegro
| | - Filiz Mercantepe
- Department of Endocrinology and Metabolism, Faculty of Medicine, Recep Tayyip Erdogan University, 53100 Rize, Turkey
| | - Ana Ninic
- Department for Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, 11158 Belgrade, Serbia
| | - Aleksandra Klisic
- Faculty of Medicine, University of Montenegro, 81000 Podgorica, Montenegro
- Center for Laboratory Diagnostics, Primary Health Care Center, 81000 Podgorica, Montenegro
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Goliopoulou A, Oikonomou E, Theofilis P, Tsigkou V, Makavos G, Kourampi I, Katsioupa M, Antoniou VD, Ikonomidis I, Lambadiari V, Tsatsaragkou A, Sarantos S, Zakynthinos GE, Vavuranakis M, Siasos G. Impairment in Right Ventricular-Pulmonary Arterial Coupling in Overweight and Obesity. J Clin Med 2024; 13:3389. [PMID: 38929919 PMCID: PMC11203835 DOI: 10.3390/jcm13123389] [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: 04/18/2024] [Revised: 05/28/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
Background: The association of obesity with right ventricular function and the interplay between right heart and pulmonary circulation is incompletely understood. We evaluate the role of obesity as a determinant of right ventricular-pulmonary artery coupling (RVAC). Methods: We retrospectively studied consecutive subjects without overt cardiovascular or pulmonary disease. Subjects were stratified according to body mass index (BMI) as normal weight, overweight, or obese. A transthoracic echocardiographic study was used to assess left and right heart functional and structural parameters. RVAC was assessed using the ratio of peak systolic velocity of the tricuspid annulus to pulmonary artery systolic pressure (PASP). Results: A total of 145 subjects were enrolled with diabetes mellitus incidence higher in obese. There was no difference in left ventricular global longitudinal strain and in PASP or markers of right ventricular systolic function based on BMI. RVAC was significantly lower in the presence of obesity (normal weight: 0.52 (0.19) cm·(sec·mmHg)-1 vs. overweight: 0.47 (0.16) cm·(sec·mmHg)-1 vs. obese: 0.43 (0.14) cm·(sec·mmHg)-1, p = 0.03), even after adjustment for confounders (β: -0.085, 95% confidence interval: -0.163, -0.009, p = 0.029). Conclusions: Our findings highlight the relationship between metabolic impairment and RVAC, suggesting additional mechanisms for heart failure development observed in obese subjects.
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Affiliation(s)
- Athina Goliopoulou
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.G.); (V.T.); (G.M.); (M.K.); (V.-D.A.); (A.T.); (S.S.); (G.E.Z.); (M.V.); (G.S.)
| | - Evangelos Oikonomou
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.G.); (V.T.); (G.M.); (M.K.); (V.-D.A.); (A.T.); (S.S.); (G.E.Z.); (M.V.); (G.S.)
| | - Panagiotis Theofilis
- First Department of Cardiology, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Vasiliki Tsigkou
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.G.); (V.T.); (G.M.); (M.K.); (V.-D.A.); (A.T.); (S.S.); (G.E.Z.); (M.V.); (G.S.)
| | - George Makavos
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.G.); (V.T.); (G.M.); (M.K.); (V.-D.A.); (A.T.); (S.S.); (G.E.Z.); (M.V.); (G.S.)
| | - Islam Kourampi
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.G.); (V.T.); (G.M.); (M.K.); (V.-D.A.); (A.T.); (S.S.); (G.E.Z.); (M.V.); (G.S.)
| | - Maria Katsioupa
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.G.); (V.T.); (G.M.); (M.K.); (V.-D.A.); (A.T.); (S.S.); (G.E.Z.); (M.V.); (G.S.)
| | - Vaios-Dionysios Antoniou
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.G.); (V.T.); (G.M.); (M.K.); (V.-D.A.); (A.T.); (S.S.); (G.E.Z.); (M.V.); (G.S.)
| | - Ignatios Ikonomidis
- Second Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (I.I.); (V.L.)
| | - Vaia Lambadiari
- Second Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (I.I.); (V.L.)
| | - Aikaterini Tsatsaragkou
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.G.); (V.T.); (G.M.); (M.K.); (V.-D.A.); (A.T.); (S.S.); (G.E.Z.); (M.V.); (G.S.)
| | - Savvas Sarantos
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.G.); (V.T.); (G.M.); (M.K.); (V.-D.A.); (A.T.); (S.S.); (G.E.Z.); (M.V.); (G.S.)
| | - George E. Zakynthinos
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.G.); (V.T.); (G.M.); (M.K.); (V.-D.A.); (A.T.); (S.S.); (G.E.Z.); (M.V.); (G.S.)
| | - Manolis Vavuranakis
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.G.); (V.T.); (G.M.); (M.K.); (V.-D.A.); (A.T.); (S.S.); (G.E.Z.); (M.V.); (G.S.)
| | - Gerasimos Siasos
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.G.); (V.T.); (G.M.); (M.K.); (V.-D.A.); (A.T.); (S.S.); (G.E.Z.); (M.V.); (G.S.)
- Cardiovascular Division, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA 02115, USA
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Ligero C, Riera P, El-Amrani A, Bazan V, Guerra JM, Herraez S, Viñolas X, Alegret JM. Impact of Body Mass Index in the Cardioverter Efficacy of Amiodarone in Persistent Atrial Fibrillation. Pharmaceuticals (Basel) 2024; 17:693. [PMID: 38931360 PMCID: PMC11206555 DOI: 10.3390/ph17060693] [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: 04/08/2024] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Amiodarone is an anti-arrhythmic drug that has extensive tissue distribution and substantial storage in the fat tissue. Different studies have described some implications of body fat composition in its pharmacokinetics and pharmacodynamics. However, no clinical studies have described its implications for clinical efficacy. METHODS We studied 878 patients with persistent atrial fibrillation (AF) treated with a regimen of amiodarone and referred to electrical cardioversion (ECV), included prospectively in two Spanish registries. We analyzed the influence of body mass index (BMI), as well as overweight and obesity, in the efficacy of amiodarone for achieving pharmacologic cardioversion to sinus rhythm (SR) before ECV. RESULTS A total of 185 patients (21.1%) reverted to SR before ECV. Patients who reverted to SR had a lower BMI than those who did not revert (27.45 ± 4.36 kg/m2 vs. 29.11 ± 4.09 kg/m2; p < 0.001). We observed a progressively lower probability of reverting to SR in overweight and obese patients (normal weight 28.3%, overweight 21.3%, obesity 13.1%; p < 0.001). In the logistic regression, BMI (kg/m2) adjusted for other related variables remained as the main factor inversely related to reversion to SR (OR = 0.904 × kg/m2); CI 75% 0.864-0.946). CONCLUSIONS We observed a negative relationship between an increased BMI and the efficacy of amiodarone for reversion to SR, suggesting a negative clinical impact of excess body fat in its efficacy.
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Affiliation(s)
- Carmen Ligero
- Servei de Cardiología, Hospital Universitari de Sant Joan, Institut d’Investigació Sanitària Pere Virgili, Grup de Recerca Cardiovascular, Universitat Rovira i Virgili, 43204 Reus, Spain; (C.L.); (A.E.-A.)
| | - Pau Riera
- Servei de Farmacia, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain;
| | - Amine El-Amrani
- Servei de Cardiología, Hospital Universitari de Sant Joan, Institut d’Investigació Sanitària Pere Virgili, Grup de Recerca Cardiovascular, Universitat Rovira i Virgili, 43204 Reus, Spain; (C.L.); (A.E.-A.)
| | - Victor Bazan
- Servei de Cardiología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain;
| | - José M. Guerra
- Servei de Cardiología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain; (J.M.G.); (S.H.)
| | - Silvia Herraez
- Servei de Cardiología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain; (J.M.G.); (S.H.)
| | - Xavier Viñolas
- Servei de Cardiología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain; (J.M.G.); (S.H.)
| | - Josep M. Alegret
- Servei de Cardiología, Hospital Universitari de Sant Joan, Institut d’Investigació Sanitària Pere Virgili, Grup de Recerca Cardiovascular, Universitat Rovira i Virgili, 43204 Reus, Spain; (C.L.); (A.E.-A.)
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Zakynthinos GE, Tsolaki V, Oikonomou E, Pantelidis P, Gialamas I, Kalogeras K, Zakynthinos E, Vavuranakis M, Siasos G. Unveiling the Role of Endothelial Dysfunction: A Possible Key to Enhancing Catheter Ablation Success in Atrial Fibrillation. Int J Mol Sci 2024; 25:2317. [PMID: 38396990 PMCID: PMC10889579 DOI: 10.3390/ijms25042317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/10/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
Atrial fibrillation, a prevalent type of arrhythmia, is increasingly contributing to the economic burden on healthcare systems. The development of innovative treatments, notably catheter ablation, has demonstrated both impressive and promising outcomes. However, these treatments have not yet fully replaced pharmaceutical approaches, primarily due to the relatively high incidence of atrial fibrillation recurrence post-procedure. Recent insights into endothelial dysfunction have shed light on its role in both the onset and progression of atrial fibrillation. This emerging understanding suggests that endothelial function might significantly influence the effectiveness of catheter ablation. Consequently, a deeper exploration into endothelial dynamics could potentially elevate the status of catheter ablation, positioning it as a primary treatment option for atrial fibrillation.
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Affiliation(s)
- George E. Zakynthinos
- 3rd Department of Cardiology, “Sotiria” Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.O.); (P.P.); (I.G.); (K.K.); (M.V.); (G.S.)
| | - Vasiliki Tsolaki
- Critical Care Department, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, Mezourlo, 41335 Larissa, Greece; (V.T.); (E.Z.)
| | - Evangelos Oikonomou
- 3rd Department of Cardiology, “Sotiria” Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.O.); (P.P.); (I.G.); (K.K.); (M.V.); (G.S.)
| | - Panteleimon Pantelidis
- 3rd Department of Cardiology, “Sotiria” Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.O.); (P.P.); (I.G.); (K.K.); (M.V.); (G.S.)
| | - Ioannis Gialamas
- 3rd Department of Cardiology, “Sotiria” Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.O.); (P.P.); (I.G.); (K.K.); (M.V.); (G.S.)
| | - Konstantinos Kalogeras
- 3rd Department of Cardiology, “Sotiria” Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.O.); (P.P.); (I.G.); (K.K.); (M.V.); (G.S.)
| | - Epaminondas Zakynthinos
- Critical Care Department, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, Mezourlo, 41335 Larissa, Greece; (V.T.); (E.Z.)
| | - Manolis Vavuranakis
- 3rd Department of Cardiology, “Sotiria” Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.O.); (P.P.); (I.G.); (K.K.); (M.V.); (G.S.)
| | - Gerasimos Siasos
- 3rd Department of Cardiology, “Sotiria” Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.O.); (P.P.); (I.G.); (K.K.); (M.V.); (G.S.)
- Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
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