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Ukita K, Egami Y, Nohara H, Kawanami S, Kawamura A, Yasumoto K, Tsuda M, Okamoto N, Matsunaga-Lee Y, Yano M, Nishino M. Clinical Impact of Cryoballoon Ablation for Paroxysmal Atrial Fibrillation in Patients With Enlarged Left Atrium. Am J Cardiol 2023; 208:111-115. [PMID: 37832206 DOI: 10.1016/j.amjcard.2023.09.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 09/14/2023] [Indexed: 10/15/2023]
Abstract
The impact of cryoballoon ablation (CBA) for atrial fibrillation (AF) in patients with enlarged left atrium (E-LA) has not been sufficiently clarified. A total of 306 patients underwent an initial CBA for paroxysmal AF between February 2017 and March 2022 in our hospital. These patients were categorized into 2 groups according to the preprocedural left atrium (LA) diameter (LAD): E-LA group with LAD ≥40 mm and normal LA (N-LA) group with LAD <40 mm. We compared late recurrence (LR, defined as a recurrence of atrial tachyarrhythmia more than 3 months after the ablation) between the 2 groups. In addition, we made a further classification of the E-LA group into a severely E-LA (SE-LA) group with LAD ≥50 mm and mildly enlarged LA (ME-LA) group with LAD <50 mm and compared LR in the SE-LA, ME-LA, and N-LA groups. In the patients who experienced a second ablation procedure owing to LR, subsequent recurrences were also evaluated. After initial CBA, there was no significant difference in recurrence-free survival between E-LA and N-LA groups (p = 0.447). In contrast, the SE-LA group showed the lowest incidence of recurrence-free survival in the SE-LA, ME-LA, and N-LA groups (p = 0.012). However, when we analyzed recurrences after the ablation including second ablation procedure, there were no significant differences in recurrence-free survival among these 3 groups (p = 0.103). In conclusion, patients with paroxysmal AF with enlarged LA showed favorable outcomes compared with those with N-LA after CBA.
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Affiliation(s)
- Kohei Ukita
- Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan
| | - Yasuyuki Egami
- Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan
| | - Hiroaki Nohara
- Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan
| | | | - Akito Kawamura
- Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan
| | - Koji Yasumoto
- Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan
| | - Masaki Tsuda
- Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan
| | | | | | - Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan
| | - Masami Nishino
- Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.
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Lin J, Wu H, Zhang T. The correlation of left atrial diameter with preserved ejection fraction, reduced ejection fraction, and mid-range ejection fraction. Clin Cardiol 2023; 46:1588-1593. [PMID: 37622739 PMCID: PMC10716329 DOI: 10.1002/clc.24134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/02/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND In patients with heart failure, left atrial remodeling often occurs to varying degrees. Left atrial enlargement has been proved to be an important predictor of cardiovascular-related adverse events. However, the relationship between left atrial diameter (LAD) with heart failure (HF) with preserved ejection fraction (HFpEF), reduced ejection fraction (HFrEF) and mid-range ejection fraction (HFmrEF) remains unclear. HYPOTHESIS We want to explore the correlation between left atrial diameter and HFpEF, HFmrEF, and HFrEF. METHODS A total of 210 patients with heart failure who underwent hospitalization in Ningbo Medical Center Lihuili Hospital, Zhejiang, China, from January 1, 2020, to June 31, 2021, were reviewed. The basic demographic characteristics, blood test, and the related indexes of echocardiography of the subjects were collected and analyzed. RESULTS There is a significant difference between HFpEF and HFrEF group in LAD (p = .007), and LAD is negatively correlated with left ventricular ejection fraction (LVEF) (p = .002, r = -.209). CONCLUSION LAD is negatively correlated with LVEF, which may predict the prevalence of HFrEF.
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Affiliation(s)
- Jing Lin
- Department of CardiologyNingbo Medical Center Lihuili HospitalNingbo CityChina
| | - Huajui Wu
- Ningbo Aier Guangming Eye HospitalNingbo CityChina
| | - Tianwen Zhang
- Department of CardiologyNingbo Medical Center Lihuili HospitalNingbo CityChina
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Chen X, Lin G, Dai C, Xu K. Effect of estimated plasma volume status and left atrial diameter on prognosis of patients with acute heart failure. Front Cardiovasc Med 2023; 10:1069864. [PMID: 36760561 PMCID: PMC9905108 DOI: 10.3389/fcvm.2023.1069864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/06/2023] [Indexed: 01/26/2023] Open
Abstract
Objective Acute heart failure (AHF) is a frequent cardiovascular emergency presenting with high mortality as well as readmission rates. The aim was to investigate the predictive value of estimated plasma volume status (ePVs) and left atrial diameter (LAD) for the prognosis of patients with AHF. Methods Clinical profiles were collected from 259 cases of AHF patients at the Affiliated Hospital of Putian University between September 2019 and October 2021. Results Six patients lost follow-up, resulting in 253 patients enrolled. Cardiogenic death and heart failure readmission during follow-up were defined as major cardiovascular events (MACE) group, other patients were defined as Non-MACE group. Apart from age, no significant differences were found between the two groups in demographics and comorbidities. The comparison between the two groups was statistically significant in terms of ePVs, LAD, and N-terminal-pro B-type natriuretic peptide (Nt-pro-BNP). On binary logistic regression analysis, ePVs (OR = 2.061, 95% CI 1.322∼3.214, P = 0.001), LAD (OR = 1.054, 95% CI 1.012∼1.098, P = 0.011), and Nt-pro-bnp (OR = 1.006, 95% CI 1.003∼1.010, P = 0.036) as predicting factors for MACE. Kaplan-Meier analysis indicated that the risk for cardiogenic death increasing with ePVs (p < 0.05). Conclusion Estimated plasma volume status and LADs have some predictive value in assessing cardiogenic death and heart failure readmission in patients with AHF.
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Bai Y, Luo SQ, Liu ST, Gong L, Zhong P, Wang ZZ, Lip GYH, Zou YX, Guo WH. Clinical Features Associated with 'Normal Range' Fibrin D-Dimer Levels in Atrial Fibrillation Patients with Left Atrial Thrombus. Clin Appl Thromb Hemost 2022; 28:10760296221133380. [PMID: 36523145 PMCID: PMC9768829 DOI: 10.1177/10760296221133380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Left atrial thrombus (LAT) often complicates with atrial fibrillation (AF). The evidence whether fibrin D-dimer levels could be used as a predictive biomarker for LAT is contradictory. This study firstly investigated the relationship between 'normal range' D-dimer and prevalent LAT. Second, we explored factors contributing to normal D-dimer levels in the presence of LAT. METHODS We studied 244 AF patients with LAT (mean age: 59.9 years, SD:11.7; 53.3% female): of these, 103 (42.2%) had normal D-dimer, 25 (10.2%) had atrial thrombus exclusion score (ATE score) of 0 19 (16.7%) males had CHA2DS2-VASc score of 0, 21(16.2%) females had CHA2DS2-VASc score of 1 and 16 had overlapped ATE score of 0 and CHA2DS2-VASc score of 0 (N = 8 if male) or CHA2DS2-VASc score of 1(N = 8 if female). Using multivariate binary analysis, larger left atrial diameter (LAD; adjusted OR: 1.06, 1.03-1.10, p = 0.001) were associated with increased D-dimer. Patients with high body mass index (BMI), hypertension history and previous anticoagulation were more likely to show normal range D-dimer levels in the presence of LAT. CONCLUSIONS A high prevalence (42.2%) of 'normal range' D-dimer levels was found in AF patients with LAT, especially in those with hypertension, high BMI and prior anticoagulation. D-dimer levels of those patients with larger LAD were more likely to be increased.
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Affiliation(s)
- Ying Bai
- Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Si-Qing Luo
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Si-Tong Liu
- Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ling Gong
- Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Peng Zhong
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhen-Zhou Wang
- Trauma Medicine Center, Peking University People's Hospital, Beijing, China
| | - Gregory YH Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Yi-Xi Zou
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China,Yi-Xi Zou, Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
OR
| | - Wei-Hua Guo
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China,Wei-Hua Guo, Dongzhimen Hospital, Beijing University of Chinese Medicine, 101121, China.
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Xu W, Yang Y, Zhu J, Tan J, Wang J, Wang L. Left Atrial Diameter and the Risk of Thromboembolism in Patients with Left Ventricular Noncompaction. J Cardiovasc Dev Dis 2022; 9. [PMID: 36547423 DOI: 10.3390/jcdd9120426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/24/2022] [Accepted: 11/27/2022] [Indexed: 12/02/2022] Open
Abstract
Aims: Patients with left ventricular noncompaction (LVNC) are at risk of thromboembolism. The relationship between left atrial diameter (LAD), a robust predictor for thrombosis, and LVNC is unclear. The purpose of this study was to explore the effect of LAD on the thrombotic risk in LVNC. Methods: In this retrospective cohort study, 320 patients with imaging characteristics of LVNC were included for statistical analysis. The primary endpoint was a composite event of intracardiac thrombi and stroke or transient ischemic attack (TIA). The secondary endpoints were intracardiac thrombi and stroke/TIA. Results: The 320 included patients (211 [65.9%] men, median age: 45 years [interquartile range: 30−57]) were divided into LAD1 (<43 mm, n = 157) and LAD2 (≥43 mm, n = 163) groups based on the median LAD. Throughout the median follow-up of 34 months, the incidence of thromboembolism among them was 7.2%: 11 (3.4%) patients had stroke/TIA and 14 (4.4%) had intracardiac thrombi. The rate of thromboembolism in the LAD2 group was higher than that of patients in the LAD1 group (11.0% vs. 3.2%, p = 0.007). Kaplan−Meier survival curves suggested that a LAD ≥ 43 mm was associated with a higher risk of thromboembolism and intracardiac thrombi (log-rank test, all p < 0.05). After adjusting for potential risk factors, LAD ≥ 43 mm was found to be an independent risk factor for thromboembolism (p = 0.013) and stroke (p = 0.024). The area under the receiver operating characteristic curve of LAD for predicting thromboembolism reached 0.696 at 1 year, 0.635 at 2 years, and 0.660 at 3 years. Conclusions: A larger LAD was related to a higher risk of thromboembolism in patients with LVNC. The LAD may be a useful predictor for thrombotic risk stratification among such patients.
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Jurcevic R, Angelkov L, Tasic N, Tomovic M, Kojic D, Otasevic P, Bojic M. Pulmonary Vein Isolation Outcome Degree Is a New Score for Efficacy of Atrial Fibrillation Catheter Ablation. J Clin Med 2021; 10:jcm10245827. [PMID: 34945124 PMCID: PMC8708501 DOI: 10.3390/jcm10245827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/18/2021] [Accepted: 11/30/2021] [Indexed: 11/16/2022] Open
Abstract
This study introduces the pulmonary vein isolation outcome degree (PVIOD) as a new semiquantitative measure for the efficacy of atrial fibrillation (AF) catheter ablation and reports the determination of predictors associated with PVIOD. The median follow-up periods of 117 patients after the first and last ablation were, respectively, 82 (IQR 15) and 72 (IQR 30) months. PVIOD 1 included 32.5% of patients, those with successful single pulmonary vein isolation (PVI); PVIOD 2 included 29.1% of subjects, those with success after multiple procedures; PVIOD 3 comprised 14.5% of patients, those with clinical success; and PVIOD 4 included 23.9% of cases, those with procedural and clinical failure. In the multivariate ordinal logistic regression analysis, PVIOD 1-4 were independently associated with longstanding persistent AF with paroxysmal AF as the referent category (odds ratio (OR), 3.5; 95% confidence interval (95% CI), 1.1-10.7 (p = 0.031)), left atrial (LA) diameter (OR, 1.2; 95% CI, 1.1-1.3 (p = 0.001)) and left ventricular ejection fraction (LVEF) (OR, 0.9; 95% CI, 0.86-1.0 (p = 0.038)). LA size > 41 mm, LVEF ≤ 50% and longstanding persistent AF are strong predictors of AF recurrence. PVIOD 1-4 offer the most exact long-term prognosis of PVI. The purpose of the present article is to expand the quantitative measure of procedural success in the medical and biological fields.
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Peng Z, Wen-Heng L, Qing Z, Pin S, Shang-Lang C, Mao-Jing W, Ya-Qi P. Risk factors for late recurrence in patients with nonvalvular atrial fibrillation after radiofrequency catheter ablation. Ann Noninvasive Electrocardiol 2021; 27:e12924. [PMID: 34882911 PMCID: PMC8916568 DOI: 10.1111/anec.12924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 12/31/2022] Open
Abstract
Objective To identify the risk factors for postoperative atrial fibrillation (AF) recurrence in nonvalvular AF patients undergoing radiofrequency catheter ablation (CA). Methods We retrospectively reviewed the data from 426 of 450 AF patients who underwent CA. Patients were divided into two groups according to recurrence after the operation; the risk factors for AF recurrence were analyzed. A stratification system for lesions was created based on the cutoff of the risk factors; the associations among the subgroups and the AF recurrence rate were analyzed. Results AF recurrence occurred in 98 (23.0%) patients. Univariate analysis demonstrated that AF type, hypertrophic cardiomyopathy, left atrial diameter (LAD), left ventricular ejection fraction (LVEF), serum albumin, and D‐dimer concentrations were associated with AF recurrence. AF type (OR =2.907, p < .001), serum albumin concentration (OR =1.112, p < .05), and LAD (OR =1.115, p < .001) were independent risk factors for AF recurrence. The area under the ROC curve of LAD for the prediction of AF recurrence was 0.722 (95% CI: 0.664~0.779) and that of serum albumin for the prediction of AF recurrence was 0.608 (95% CI: 0.545~0.672). Further stratification revealed that patients with persistent or paroxysmal AF with LAD ≥43.5 mm and serum albumin concentration ≥42.2 g/L had a higher rate of AF recurrence than the reference group. Conclusion Atrial fibrillation type, LAD, and serum albumin concentration are risk factors for AF recurrence after CA in patients with nonvalvular AF. Patients with persistent AF with LAD ≥43.5 mm and serum albumin concentration ≥42.2 g/L have a higher risk of late AF recurrence after surgery.
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Affiliation(s)
- Zhang Peng
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Liu Wen-Heng
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhao Qing
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Sun Pin
- Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Cai Shang-Lang
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Wang Mao-Jing
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Pan Ya-Qi
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China
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8
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Zhou Y, Yu M, Cui J, Liu S, Yuan J, Qiao S. Impact of body mass index on left atrial dimension in HOCM patients. Open Med (Wars) 2021; 16:207-216. [PMID: 33585697 PMCID: PMC7863002 DOI: 10.1515/med-2021-0224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 12/11/2022] Open
Abstract
Background Substantial studies have demonstrated that left atrial (LA) enlargement was a robust predictor of atrial fibrillation (AF) and obesity was a modifiable risk factor for cardiovascular diseases. However, the role of body mass index (BMI) on LA dimension in hypertrophic obstructive cardiomyopathy (HOCM) remains unclear. Methods A total of 423 HOCM patients (average BMI 25.4 ± 3.4 kg/m2) were recruited for our study. Participants were stratified into three groups based on BMI: normal weight (BMI < 23 kg/m2), overweight (BMI 23–27.5 kg/m2), and obesity (BMI ≥ 27.5 kg/m2). Results Compared with normal weight, patients with obesity had significantly lower prevalence of syncope (p = 0.007) and moderate or severe mitral regurgitation (p = 0.014), and serum NT-proBNP (p = 0.004). Multiple linear regression analysis indicated that BMI (β = 0.328, p < 0.001), log NT-proBNP (β = 0.308, p < 0.001), presence of AF (β = 0.209, p = 0.001), and left ventricular diastolic diameter index (β = 0.142, p = 0.019) were independently related with LA diameter. However, BMI was not an independent predictor of the presence of AF on multivariable binary logistical regression analysis. Conclusions BMI was independently associated with LA diameter; however, it was not an independent predictor of prevalence of AF. These results suggest that BMI may promote incidence of AF through LA enlargement in HOCM.
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Affiliation(s)
- Yue Zhou
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing 100037, China.,Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Miao Yu
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing 100037, China.,Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jingang Cui
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing 100037, China
| | - Shengwen Liu
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing 100037, China
| | - Jiansong Yuan
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing 100037, China
| | - Shubin Qiao
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing 100037, China
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Bhopalwala H, Dewaswala N, Liu S, Scott CG, Welper JM, Akinnusotu O, Bos JM, Ommen SR, Ackerman MJ, Pellikka PA, Geske JB, Noseworthy P, Arruda-Olson AM. Conversion of left atrial volume to diameter for automated estimation of sudden cardiac death risk in hypertrophic cardiomyopathy. Echocardiography 2020; 38:183-188. [PMID: 33325582 PMCID: PMC7986336 DOI: 10.1111/echo.14943] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/12/2020] [Accepted: 11/15/2020] [Indexed: 12/16/2022] Open
Abstract
Background A subset of patients with hypertrophic cardiomyopathy (HCM) is at high risk of sudden cardiac death (SCD). Practice guidelines endorse use of a risk calculator, which requires entry of left atrial (LA) diameter. However, American Society of Echocardiography (ASE) guidelines recommend the use of LA volume index (LAVI) for routine quantification of LA size. The aims of this study were to (a) develop a model to estimate LA diameter from LAVI and (b) evaluate whether substitution of measured LA diameter by estimated LA diameter derived from LAVI reclassifies HCM‐SCD risk. Methods The study cohort was comprised of 500 randomly selected HCM patients who underwent transthoracic echocardiography (TTE). LA diameter and LAVI were measured offline using digital clips from TTE. Linear regression models were developed to estimate LA diameter from LAVI. A European Society of Cardiology endorsed equation estimated SCD risk, which was measured using LA diameter and estimated LA diameter derived from LAVI. Results The mean LAVI was 48.5 ± 18.8 mL/m2. The derived LA diameter was 45.1 mm (SD: 5.5 mm), similar to the measured LA diameter (45.1 mm, SD: 7.1 mm). Median SCD risk at 5 years estimated by measured LA diameter was 2.22% (interquartile range (IQR): 1.39, 3.56), while median risk calculated by estimated LA diameter was 2.18% (IQR: 1.44, 3.52). 476/500 (95%) patients maintained the same risk classification regardless of whether the measured or estimated LA diameter was used. Conclusions Substitution of measured LA diameter by estimated LA diameter in the HCM‐SCD calculator did not reclassify risk.
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Affiliation(s)
- Huzefa Bhopalwala
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Nakeya Dewaswala
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Sijia Liu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - James M Welper
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Johan Martijn Bos
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Steve R Ommen
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Michael J Ackerman
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
| | | | - Jeffrey B Geske
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Peter Noseworthy
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Adelaide M Arruda-Olson
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
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10
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Zhong L, Yin X, Xie Z. RETRACTED: Safety of radiofrequency ablation for reducing inflammatory cytokine levels and the left atrial diameter in patients with atrial fibrillation. J Int Med Res 2020; 48:300060520949760. [PMID: 38238979 PMCID: PMC7488899 DOI: 10.1177/0300060520949760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 07/23/2020] [Indexed: 11/15/2022] Open
Abstract
Objective To investigate the safety of radiofrequency ablation for reducing inflammatory cytokines and the left atrial diameter in patients with atrial fibrillation (AF). Methods A total of 200 patients with AF who were admitted to our hospital from December 2015 to April 2017 were included in this prospective analysis. Fifty patients were treated with conventional AF medication alone (AF medication group) and 50 patients received radiofrequency ablation (RFA) on the basis of conventional medication (RFA group). Results After treatment, the AF medication group showed significantly higher levels of high-sensitivity C-reactive protein, interleukin-6, carboxyterminal propeptide of type-I procollagen, procollagen type III N-terminal propeptide, and matrix metallopeptidase-9 than the RFA group. The AF medication group had a significantly lower activated partial thromboplastin time, thrombin time, and prothrombin time than the RFA group. A significantly smaller left atrial diameter was observed in both groups after treatment, but this decrease was more pronounced in the RFA group than in the AF medication group. The total treatment efficacy rate was significantly lower in the AF medication group than in the RFA group. Conclusions For patients with AF, RFA leads to a lower incidence of inflammatory responses, faster recovery of cardiac function, and good safety.
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Affiliation(s)
| | | | - Zhihong Xie
- Department of Cardiology, People’s Hospital of Ganzhou, Jiangxi, China
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11
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Chiu TH, Wu PY, Huang JC, Su HM, Chen SC, Chang JM, Chen HC. Hyperuricemia Is Associated with Left Ventricular Dysfunction and Inappropriate Left Ventricular Mass in Chronic Kidney Disease. Diagnostics (Basel) 2020; 10:diagnostics10080514. [PMID: 32722021 PMCID: PMC7460446 DOI: 10.3390/diagnostics10080514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/03/2020] [Accepted: 07/22/2020] [Indexed: 01/20/2023] Open
Abstract
Background. Hyperuricemia is common in patients with chronic kidney disease (CKD), and this may lead to poor cardiovascular (CV) outcomes. The aim of this cross-sectional study was to assess associations among serum uric acid (UA) and echocardiographic parameters, ankle-brachial index (ABI), and brachial-ankle pulse wave velocity (baPWV) in patients with CKD. Methods. A total of 418 patients with CKD were included. The echocardiographic measurements included left atrial diameter (LAD), left ventricular ejection fraction (LVEF) and the ratio of observed to predict left ventricular mass (LVM). ABI, baPWV and medical records were obtained. Results. Multivariable forward logistic regression analysis showed that a high UA level was significantly associated with LAD > 47 mm (odds ratio [OR], 1.329; p = 0.002), observed/predicted LVM > 128% (OR, 1.198; p = 0.008) and LVEF < 50% (OR, 1.316; p = 0.002). No significant associations were found between UA and ABI < 0.9 or baPWV > 1822 cm/s. Multivariate stepwise linear regression analysis showed that a high UA level correlated with high LAD (unstandardized coefficient β, 0.767; p < 0.001), high observed/predicted LVM (unstandardized coefficient β, 4.791; p < 0.001) and low LVEF (unstandardized coefficient β, −1.126; p = 0.001). No significant associations between UA and low ABI and high baPWV were found. Conclusion. A high serum UA level was associated with a high LAD, high observed/predicted LVM and low LVEF in the patients with CKD. A high serum UA level may be correlated with abnormal echocardiographic parameters in patients with stage 3–5 CKD.
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Affiliation(s)
- Tai-Hua Chiu
- Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan;
| | - Pei-Yu Wu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (P.-Y.W.); (J.-C.H.); (J.-M.C.)
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan;
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Jiun-Chi Huang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (P.-Y.W.); (J.-C.H.); (J.-M.C.)
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan;
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Ho-Ming Su
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan;
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Szu-Chia Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (P.-Y.W.); (J.-C.H.); (J.-M.C.)
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan;
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: (S.-C.C.); (H.-C.C.)
| | - Jer-Ming Chang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (P.-Y.W.); (J.-C.H.); (J.-M.C.)
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Hung-Chun Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (P.-Y.W.); (J.-C.H.); (J.-M.C.)
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: (S.-C.C.); (H.-C.C.)
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12
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Christou GA, O'Driscoll JM. The impact of demographic, anthropometric and athletic characteristics on left atrial size in athletes. Clin Cardiol 2020; 43:834-842. [PMID: 32271473 PMCID: PMC7403671 DOI: 10.1002/clc.23368] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 03/24/2020] [Indexed: 01/01/2023] Open
Abstract
The structural adaptations of the “athlete's heart” include left atrial (LA) enlargement. A literature search was performed based on PubMed listings up to November 2, 2019 using “athletes AND left atrium,” “athletes AND LA,” “sports AND left atrium,” “sports AND LA,” “exercise AND left atrium,” and “exercise AND LA” as the search terms. Eligible studies included those reporting the influence of demographic, anthropometric and athletic characteristics on LA size in athletes. A total of 58 studies were included in this review article. Although LA volume has been reported to be greater in males compared to females when indexed for body surface area (BSA), there was no difference between sexes. The positive association between LA size and age in athletes may reflect the increase in body size with maturation in nonadult athletes and the training age of endurance athletic activity in adult athletes. Caucasian and black athletes have been demonstrated to exhibit similar LA enlargement. The positive association of LA size with lean body mass (LBM) possibly accounts for the relationship of LA size with BSA. LA enlargement has been reported only in endurance‐trained, but not in strength‐trained athletes. LA size appears to increase with an increase in both the volume and intensity of endurance training. LA size correlates independently with the training age of endurance athletes. The athlete's characteristics that independently determine LA size include LBM, endurance training, and training age.
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Affiliation(s)
- Georgios A Christou
- Laboratory of Sports Medicine, Sports Medicine Division, Aristotle University of Thessaloniki, Thessaloniki, Greece.,MSc Sports Cardiology, St George's University of London, London, UK
| | - Jamie M O'Driscoll
- School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, UK.,Department of Cardiology, St George's Healthcare NHS Trust, London, UK
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13
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Abstract
Left atrial (LA) remodeling has been identified to predict atrial fibrillation (AF) and heart failure. However, the role of LA diameter (LAD) in patients with heart failure (HF) with preserved (HFpEF), mid-range (HFmrEF), and reduced ejection fraction (HFrEF) remains poorly understood.A total of 142 patients including 71 subjects with AF (21 of HFpEF, 22 of HFmrEF, and 28 of HFrEF) and 71 ejection fraction (EF)-matched subjects with sinus rhythm (SR) were included in the study. Baseline characteristics and echocardiographic parameters including LAD were compared between both groups as well as among HFpEF, HFmrEF, and HFrEF.In receiver-operating characteristic (ROC) analyses, LAD predicted AF in HFpEF, HFmrEF, and HFrEF [area under the curve (AUC): 0.646; P = .03]. LAD was negatively association with left ventricular ejection fraction while positively with Nt-proNP and left ventricular end-diastolic diameter (regression coefficient: -0.239, P = .004; regression coefficient: 0.191, P = .023; regression coefficient: 0.357, P < .001). In ROC analyses, LAD predicted HFrEF among the 3 categories (AUC: 0.629, P = .01).In the setting of HF, LAD was higher in AF than in and SR, and predicted AF. Furthermore, LAD was associated with severity of HF in HFpEF, HFmrEF, and HFrEF, and also predicted HFrEF.
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14
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Wang Y, Xu Y, Ling Z, Chen W, Su L, Du H, Xiao P, Liu Z, Yin Y. Radiofrequency catheter ablation for paroxysmal atrial fibrillation: outcomes during a 3-year follow-up period. J Int Med Res 2019; 47:1636-1648. [PMID: 30803295 PMCID: PMC6460609 DOI: 10.1177/0300060519828522] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Objective This study was performed to observe the effect of radiofrequency catheter ablation (RFCA) in patients with paroxysmal atrial fibrillation (PAF) and to explore the risk factors for late recurrence of atrial fibrillation (LRAF) after a single RFCA session. Methods In this retrospective study, 243 patients with PAF underwent RFCA and were followed up regularly. Results At a median follow-up of 37 months after a single procedure, 60.5% of patients maintained sinus rhythm (SR), and at a median follow-up of 42 months after multiple procedures, 74.9% of patients maintained SR. The statistically significant risk factors for LRAF after a single RFCA session were the left atrial diameter (LAD), left inferior pulmonary vein superior–inferior diameter (LIPV SID), PV number variation, circumferential pulmonary vein isolation (CPVI) combined with additional ablation, and early recurrence of atrial fibrillation (ERAF). The best cut-off value for LAD was 35.5 mm. Conclusions During a 3-year follow-up, about 70% of the patients with PAF maintained SR. LRAF after a single procedure was associated with the LAD, LIPV SID, PV number variation, CPVI combined with additional ablation, and ERAF.
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Affiliation(s)
- Yubing Wang
- 1 Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmia Service Center, Chongqing, China.,2 Affiliated Hospital of North Sichuan Medical College, Sichuan, China
| | - Yanping Xu
- 1 Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmia Service Center, Chongqing, China
| | - Zhiyu Ling
- 1 Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmia Service Center, Chongqing, China
| | - Weijie Chen
- 1 Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmia Service Center, Chongqing, China
| | - Li Su
- 1 Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmia Service Center, Chongqing, China
| | - Huaan Du
- 1 Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmia Service Center, Chongqing, China
| | - Peilin Xiao
- 1 Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmia Service Center, Chongqing, China
| | - Zengzhang Liu
- 1 Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmia Service Center, Chongqing, China
| | - Yuehui Yin
- 1 Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmia Service Center, Chongqing, China
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15
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Wang B, Xue Y, Shang F, Ni S, Liu X, Fan B, Wang H. Association of serum adropin with the presence of atrial fibrillation and atrial remodeling. J Clin Lab Anal 2018; 33:e22672. [PMID: 30239031 DOI: 10.1002/jcla.22672] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 08/18/2018] [Accepted: 08/20/2018] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE Adropin, a newly identified regulatory protein encoded by Enho gene, suppressed tumor necrosis factor α-induced THP1 monocyte adhesion to human umbilical vein endothelial cells. In addition, inflammation is demonstrated to be involved in the mechanism of atrial fibrillation (AF). Atrial remodeling is correlated with the persistence and progression of AF. Adropin is hypothesized to correlated with AF and atrial remodeling. This study aims to determine the correlation of serum adropin and the presence of AF and remodeling. METHODS This study consisted of 344 AF patients and 210 healthy controls. AF patients were then divided into three subgroups of paroxysmal AF, persistent AF, and permanent AF. Serum adropin concentrations were examined using enzyme-linked immunosorbent assay method. Left atrial diameter (LAD) was measured to evaluate atrial remodeling. RESULTS Decreased serum adropin concentrations were found in AF patients compared with healthy controls. Logistic regression analysis confirmed that serum adropin was inversely associated with the presence of AF (OR 0.218, 95% CI 0.15-0.316; P < 0.001). Permanent AF patients had significantly reduced serum adropin concentrations compared with persistent and paroxysmal AF patients. There were decreased serum adropin concentrations in persistent AF group than those in paroxysmal AF group. Simple linear regression analyses showed that serum adropin in AF patients were negatively correlated with BMI, SBP, and LAD. Multiple stepwise regression analysis showed that LAD remained to be inversely associated with serum adropin (β = 0.2, P = 0.010). CONCLUSION Serum adropin concentrations are inversely correlated with the presence of AF and atrial remodeling.
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Affiliation(s)
- Bin Wang
- Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shanxi, China
| | - Yusheng Xue
- Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shanxi, China
| | - Fujun Shang
- Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shanxi, China
| | - Sifeng Ni
- Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shanxi, China
| | - Xiongtao Liu
- Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shanxi, China
| | - Boyuan Fan
- Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shanxi, China
| | - Haichang Wang
- Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shanxi, China
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16
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Han B, Wang Q. Study on the clinical efficacy of specific phosphodiesterase inhibitor in patients with pulmonary hypertension due to left heart disease. Exp Ther Med 2018; 16:1175-1186. [PMID: 30112056 PMCID: PMC6090457 DOI: 10.3892/etm.2018.6310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 05/24/2018] [Indexed: 11/19/2022] Open
Abstract
Pulmonary hypertension due to left heart disease (PH-LHD) is caused by left ventricular (LV) systolic and/or diastolic dysfunction and left heart valve disease. LV diseases lead to left ventricular filling pressure increases, pulmonary venous obstruction and pulmonary venous pressure increases, and thus to secondary PH. Exercise tolerance is lower and fatality rates are higher in patients with PH-LHD than those in subjects with normal pulmonary arterial pressure. In spite of the progress in the study of the mechanisms of PH-LHD in recent years, no specific treatment is currently available. The efficacy and safety of targeted therapies for pulmonary arterial hypertension remain to be fully established. In the present study, PH-LHD patients were treated with milrinone injection. It was concluded that milrinone significantly reduces pulmonary artery systolic pressure (PASP) in patients with PH-LHD, and significantly improves the cardiac structure, cardiac function and biochemical indexes. PASP was significantly correlated with the left atrial diameter, LV end diastolic diameter, LV ejection fraction, tricuspid annular plane systolic excursion, right ventricular fractional area change, N-terminal pro-B-type natriuretic peptide and hypersensitive C-reactive protein.
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Affiliation(s)
- Bing Han
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, The State and Shandong Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China.,Intensive Care Unit, The Sixth People's Hospital of Jinan, Jinan, Shandong 250200, P.R. China
| | - Qingli Wang
- Internal Medicine Cardiovascular Department, The Sixth People's Hospital of Jinan, Jinan, Shandong 250200, P.R. China
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17
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Jin X, Pan J, Wu H, Xu D. Are left ventricular ejection fraction and left atrial diameter related to atrial fibrillation recurrence after catheter ablation?: A meta-analysis. Medicine (Baltimore) 2018; 97:e10822. [PMID: 29768386 PMCID: PMC5976293 DOI: 10.1097/md.0000000000010822] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 04/28/2018] [Indexed: 12/31/2022] Open
Abstract
Atrial fibrillation (AF), the most common form of arrhythmia, is associated with the prevalence of many common cardiovascular and cerebrovascular diseases. Catheter ablation is considered the first-line therapy for AF; however, AF recurrence is very common after catheter ablation. Studies have been performed to analyze the factors associated with AF recurrence, but none have reached a consistent conclusion on whether left ventricular ejection fraction (LVEF) and left atrial diameter (LA diameter) affect AF recurrence after catheter ablation.The databases PubMed, Embase, and the Cochrane Library were used to search for relevant studies up to September 2017. RevMan 5.3.5 software provided by the Cochrane Collaboration Network was used to conduct this meta-analysis.Thirteen studies involving 2825 patients were included in this meta-analysis. Overall, the results revealed that elevated LA diameter values were significantly associated with AF recurrence in patients after catheter ablation (MD = 2.19, 95% CI: 1.63-2.75, P < .001), while baseline LVEF levels were not significantly positively associated with AF recurrence in patients after catheter ablation (MD = -0.91, 95% CI: -1.18 to 1.67, P = .14).Overall, elevated LA diameter may be associated with AF recurrence after catheter ablation; however, there was no direct relationship between LVEF values and AF recurrence after catheter ablation when baseline LVEF values are normal or mildly decreased. Besides, because of publication bias, further studies should be performed to explore the mechanisms underlying AF recurrence.
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Affiliation(s)
- Xiao Jin
- Second School of Clinical Medicine, Guangzhou Univ Chinese Med
| | - Jianke Pan
- Department of Orthopedics, Second Affiliated Hospital of Guangzhou Univ Chinese Med (Guangdong Provincial Hospital of Chinese Medicine)
| | - Huanlin Wu
- Second School of Clinical Medicine, Guangzhou Univ Chinese Med
- Beijing University of Chinese Medicine, Beijing, China
| | - Danping Xu
- Department of Cardiology, Second Affiliated Hospital of Guangzhou Univ Chinese Med (Guangdong Provincial Hospital of Chinese Medicine)
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18
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Ogata T, Matsuo R, Kiyuna F, Hata J, Ago T, Tsuboi Y, Kitazono T, Kamouchi M. Left Atrial Size and Long-Term Risk of Recurrent Stroke After Acute Ischemic Stroke in Patients With Nonvalvular Atrial Fibrillation. J Am Heart Assoc 2017; 6:JAHA.117.006402. [PMID: 28862939 PMCID: PMC5586470 DOI: 10.1161/jaha.117.006402] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Among patients with ischemic stroke and atrial fibrillation, which ones are at high risk of recurrent stroke is unclear. This study aimed to determine whether left atrial size was associated with long-term risk of stroke recurrence in patients with nonvalvular atrial fibrillation. METHODS AND RESULTS In this multicenter prospective cohort study, nonvalvular atrial fibrillation patients hospitalized for acute ischemic stroke were enrolled and followed up after discharge. Indexed-left atrial diameter was obtained by dividing left atrial diameter by body surface area. Cause-specific and subdistribution hazard ratios of recurrent stroke were estimated by Cox proportional hazards and Fine-Gray models, respectively. Risk prediction was evaluated by integrated discrimination improvement and net reclassification improvement. In total, 1611 patients (77.8±10.2 [mean±SD] years, 44.5% female) were included. During follow-up for 2.40±1.63 (mean±SD) years, 251 patients had recurrent stroke and 514 patients died. An increased indexed-left atrial diameter (per 1 cm/m2) was significantly associated with elevated risk of stroke recurrence (hazard ratio 1.60, 95% CI 1.30-1.98). The association was maintained when death was regarded as the competing risk and in 1464 patients who were treated with anticoagulants (hazard ratio 1.59, 95% CI 1.27-2.00). Risk prediction for recurrent stroke was significantly improved by adding indexed-left atrial diameter to the baseline model composed of the factors in the CHADS2 score or those in the CHA2DS2-VASc score. CONCLUSION These findings suggest that left atrial enlargement is associated with an increased risk of recurrent stroke in nonvalvular atrial fibrillation patients with ischemic stroke.
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Affiliation(s)
- Toshiyasu Ogata
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Ryu Matsuo
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Fumi Kiyuna
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tetsuro Ago
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Nephrology, Hypertension, and Strokology, Kyushu University Hospital, Fukuoka, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Nephrology, Hypertension, and Strokology, Kyushu University Hospital, Fukuoka, Japan
| | - Masahiro Kamouchi
- Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan .,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Nephrology, Hypertension, and Strokology, Kyushu University Hospital, Fukuoka, Japan
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Möttönen MJ, Ukkola O, Lumme J, Kesäniemi YA, Huikuri HV, Perkiömäki JS. Cardiac Remodeling from Middle Age to Senescence. Front Physiol 2017; 8:341. [PMID: 28603501 PMCID: PMC5445175 DOI: 10.3389/fphys.2017.00341] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 05/09/2017] [Indexed: 01/19/2023] Open
Abstract
Background: The data on cardiac remodeling outside the scope of myocardial infarction and heart failure are limited. Methods: A cohort of middle-aged hypertensive subjects with age- and gender-matched control subjects without hypertension (n = 1,045, aged 51 ± 6 years) were randomly selected for the OPERA study (Oulu Project Elucidating Risk of Atherosclerosis study). The majority of those who were still alive after more than 20 years of follow-up underwent thorough re-examinations. Results: Left ventricular mass index (LVMI) increased significantly from 106.5 ± 27.1 (mean ± SD) to 114.6 ± 29.1 g/m2 (p < 0.001), the thickness of the left ventricular posterior wall (LVPW) from 10.0 ± 1.8 to 10.6 ± 1.7 mm (p < 0.001), fractional shortening (FS) from 35.0 ± 5.7 to 38.4 ± 7.2 % (p < 0.001), and left atrial diameter (LAD) from 38.8 ± 5.2 to 39.4 ± 6.7 mm (p = 0.028) during the 20-year follow-up. After multivariate adjustments, hypertension treated with antihypertensive medication and male gender predicted a smaller increase in the thickness of LVPW (p = 0.017 to <0.001). Baseline higher fasting plasma insulin level, larger intima media thickness of the carotid artery, greater height and antihypertensive medication (p = 0.046-0.002) predicted a smaller (less favorable) change of FS. The increase of LAD was associated with higher baseline diastolic blood pressure (p = 0.034) and greater height (p = 0.006). Conclusion: Aging from middle age to senescence increases the echocardiographic indexes of LVMI, LVPW thickness, FS and LAD. Several baseline factors are associated with these changes.
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Affiliation(s)
- Mikko J Möttönen
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of OuluOulu, Finland
| | - Olavi Ukkola
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of OuluOulu, Finland
| | - Jarmo Lumme
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of OuluOulu, Finland
| | - Y Antero Kesäniemi
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of OuluOulu, Finland
| | - Heikki V Huikuri
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of OuluOulu, Finland
| | - Juha S Perkiömäki
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of OuluOulu, Finland
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20
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Sun LY, Qu X, Chen LZ, Zheng GS, Wu XL, Chen XX, Huang WJ, Zhou H. Potential Roles of Serum Caveolin-3 Levels in Patients with Atrial Fibrillation. Front Aging Neurosci 2017; 9:90. [PMID: 28420984 PMCID: PMC5378709 DOI: 10.3389/fnagi.2017.00090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 03/20/2017] [Indexed: 12/01/2022] Open
Abstract
Objective: To explore serum caveolin-3 (Cav-3) levels in patients with atrial fibrillation (AF) and to evaluate the role of Cav-3 as a biomarker for AF and incident heart failure (HF). Methods: Three hundred and five patients were enrolled in the study and divided into three groups: sinus rhythm (Group SR), paroxysmal AF (Group paAF), and persistent AF (Group peAF). Serum Cav-3 concentrations were measured by enzyme-linked immunosorbent assay at baseline. Clinical characteristics, and laboratory data were collected during hospitalization, and a follow-up of 12-months was carried out. Results: Serum Cav-3 concentrations were significantly decreased on the Group SR and the highest concentrations of Cav-3 in patients were found on the Group peAF (516.7 ± 274.0 vs. 609.3 ± 287.0 vs. 688.3 ± 264.6 ng/L, P < 0.05). Left atrial diameter (LAD) in the Group peAF was significantly higher than in the Group paAF, and the Group SR had significantly lower LAD than the Group paAF and Group peAF. The risks of new-onset HF in the Group SR, Group paAF, and Group peAF were 8.1, 14.5, and 28.6%, respectively. There was a significant difference between the Group peAF and the other two groups. Serum Cav-3 concentrations were trisected in AF participants (lower tertile: ≤498, middle tertile: >498–703, upper tertile: ≥703). In further tertile studies, subjects in the lower tertile of Cav-3 concentrations were more likely to become paroxysmal AF and had much lower LAD (P < 0.05). And in the middle and upper tertiles, participants with AF tended to suffer from HF compared to the lower group (P < 0.05). Conclusion: We provide evidence that Cav-3 has a significant meaning in AF patients. The levels of Cav-3 may be related to the LAD and new-onset HF.
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Affiliation(s)
- Ling-Yue Sun
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical UniversityZhejiang, China
| | - Xiang Qu
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical UniversityZhejiang, China
| | - Ling-Zhi Chen
- Department of Clinical Laboratory, Wenzhou Central HospitalZhejiang, China
| | - Gao-Shu Zheng
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical UniversityZhejiang, China
| | - Xin-Lei Wu
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical UniversityZhejiang, China
| | - Xing-Xing Chen
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical UniversityZhejiang, China
| | - Wei-Jian Huang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical UniversityZhejiang, China
| | - Hao Zhou
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical UniversityZhejiang, China
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Wan C, Li Z. Serum macrophage migration inhibitory factor is correlated with atrial fibrillation. J Clin Lab Anal 2017; 32. [PMID: 28407372 DOI: 10.1002/jcla.22225] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 03/05/2017] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine secreted by macrophages. This study is performed to investigate whether serum MIF is correlated with atrial fibrillation (AF). METHODS Totally, 186 AF patients and 103 healthy controls were enrolled in this study. AF patients were then divided into paroxysmal AF, persistent AF, and permanent AF subgroups. RESULTS There were higher serum MIF concentrations in AF patients than in healthy subjects. Logistic regression analysis demonstrated that serum MIF was associated with AF. Permanent AF patients exhibited higher serum MIF concentrations than persistent and paroxysmal AF subgroups. Elevated serum MIF concentrations were found in persistent AF patients compared with paroxysmal AF patients. Moreover, serum MIF concentrations were associated with left atrial diameter after Spearman correlation analysis.
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Affiliation(s)
- Chunfu Wan
- Department of Pain and Rehabilitation, Forth Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Zhihua Li
- Department of Anaesthesia, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
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Abstract
Objective Chemerin, a newly discovered adipokine, is correlated with hypertension, diabetes and coronary heart disease. The aim of this study is to investigate the association of serum chemerin concentrations with the presence of atrial fibrillation. Methods Serum chemerin concentrations were determined in 256 patients with atrial fibrillation and 146 healthy subjects. Atrial fibrillation patients were then divided into paroxysmal, persistent and permanent atrial fibrillation. Results Serum chemerin concentrations were significantly higher in atrial fibrillation patients compared with healthy controls. In subgroup studies, patients with permanent atrial fibrillation had higher serum chemerin concentrations than those with persistent and paroxysmal atrial fibrillation. Furthermore, significant higher serum chemerin concentrations were observed in persistent atrial fibrillation patients compared with paroxysmal atrial fibrillation subjects. Serum chemerin concentrations were associated with the presence of atrial fibrillation after logistic regression analysis. Pearson correlation analysis revealed a positive relation of serum chemerin concentrations with body mass index, systolic blood pressure, diastolic blood pressure, triglycerides, low-density lipoprotein cholesterol, blood urea nitrogen, creatinine, C-reactive protein and left atrial diameter. Conclusion Serum chemerin concentrations are associated with the presence of atrial fibrillation and atrial remodelling.
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Affiliation(s)
- Guowei Zhang
- 1 Department of Cardiac Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Mochao Xiao
- 2 Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Lili Zhang
- 2 Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yue Zhao
- 2 Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Qinghui Yang
- 2 Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
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Abstract
Objective To explore the relationship between Helicobacter pylori (Hp) infection and atrial fibrillation (AF) in Chinese patients. Methods A total of 285 hospitalized patients with AF and 300 patients from Health Screening Center who matched age and sex with AF group were enrolled. AF patients were divided into two groups: the short-standing AF category (less than a year) and the long-standing AF category (more than a year). All patients had laboratory testing of 13C urea breath test, high-sensitive C-reactive protein (hs-CRP) and left atrial diameter (LAD). We analyzed the difference of these factors in all groups and explored the correlation between Hp infection and AF using logistic regression analysis. Results Both AF groups had more hypertension, diabetes, and Hp infection than the control group. The Hp value and the hs-CRP level in patients with long-standing AF were higher than those in the short-standing AF and the control groups (for Hp value: P<0.001 for both and for hs-CRP level: P=0.003, 0.002, respectively). The LAD of patients in the long-standing AF group was significantly larger than those in the short-standing AF group and control group (P=0.001 and P<0.001, respectively). The values of Hp, hs-CRP, and LAD in the long-standing AF category were significantly higher than those in the short-standing AF category (all P<0.05). After controlling the potential confounders, Hp value ≥4‰, hs-CRP >5 mg/L, and LAD >36 mm were significantly related to long-standing AF. Conclusion The values of Hp in patients with long-standing AF were significantly higher than those in short-standing AF and control groups. Hp δ value ≥4‰ is an independent predictor for long-standing AF.
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Affiliation(s)
- De-Zhao Wang
- Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Wei Chen
- Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Song Yang
- Department of Ultrasonography, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jun Wang
- Department of Cardiology, Beijing Mentougou District Hospital, Beijing, People's Republic of China
| | - Qun Li
- Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Qiang Fu
- Department of Ultrasonography, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Shi-Jing Li
- Department of Cardiology, Beijing Mentougou District Hospital, Beijing, People's Republic of China
| | - Bu-Xing Chen
- Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
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Alosco ML, Gunstad J, Jerskey BA, Clark US, Hassenstab JJ, Xu X, Poppas A, Cohen RA, Sweet LH. Left atrial size is independently associated with cognitive function. Int J Neurosci 2013; 123:544-52. [PMID: 23394115 PMCID: PMC4166650 DOI: 10.3109/00207454.2013.774396] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Left atrial (LA) diameter is easily attainable from echocardiograph and sensitive to underlying cardiovascular disease severity, although its association with neurocognitive outcomes is not well understood. Fifty older adults (64.50 ± 9.41 years), recruited from outpatient cardiology clinics and local papers who underwent magnetic resonance imaging, were administered the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and completed psychosocial self-report measures. LA diameter was quantified using echocardiogram. Hierarchical regression analyses revealed that greater LA size was independently associated with reduced performance on the following RBANS composites: language, delayed memory, and total index (p < 0.05 for all). Hierarchical regression analysis demonstrated no significant association between LA diameter and whole brain volume (p > 0.05). The current study suggests that greater LA size is associated with cognitive dysfunction in older adults and prospective studies are needed to validate these findings and elucidate underlying mechanisms.
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Affiliation(s)
- Michael L Alosco
- Department of Psychology, Kent State University, Kent, OH 44242, USA.
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Beeri MS, Schmeidler J, Haroutunian V, West R, Ostad D, Grossman HT, Rosendorff C, Silverman JM. Better cognitive performance associated with worse cardiac functioning suggests antagonistic pleiotropy in very elderly subjects. Am J Geriatr Psychiatry 2009; 17:911-2. [PMID: 19910880 DOI: 10.1097/JGP.0b013e3181ad4d2f] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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