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| 1 | Influences of blood lipids on the occurrence and prognosis of hemorrhagic transformation after acute cerebral infarction: a case-control study of 732 patients显示文摘Background: To study the influence of blood lipid levels on hemorrhagic transformation(HT) and prognosis after acute cerebral infarction(ACI).Methods: Patients with ACI within 72 h of symptoms onset between January 1 st, 2015, and December 31 st, 2016, were retrospectively analyzed. Patients were divided into group A(without HT) and group B(HT). The outcomes were assessed after 3 months of disease onset using the modified Rankin Scale(m RS). An m RS score of 0–2 points indicated excellent prognosis, and an m RS score of 3–6 points indicated poor prognosis.Results: A total of 732 patients conformed to the inclusion criteria, including 628 in group A and 104 in group B. The incidence of HT was 14.2%, and the median onset time was 2 d(interquartile range, 1–7 d). The percentages of patients with large infarct size and cortex involvement in group B were 80.8% and 79.8%, respectively, which were both significantly higher than those in group A(28.7 and 33.4%, respectively). The incidence rate of atrial fibrillation(AF) in group B was significantly higher than that in group A(39.4% vs. 13.9%, P<0.001). The adjusted multivariate analysis results showed that large infarct size, cortex involvement and AF were independent risk factors of HT, while total cholesterol(TC) was a protective factor of HT(OR=0.359, 95% CI 0.136–0.944, P=0.038). With every 1 mmol/L reduction in normal TC levels, the risk of HT increased by 64.1%. The mortality and morbidity at 3 months in group B(21.2% and 76.7%, respectively) were both significantly higher than those in group A(8.0% and 42.8%, respectively). The adjusted multivariate analysis results showed that large infarct size(OR=12.178, 95% CI 5.390–27.516, P<0.001) was an independent risk factor of long-term unfavorable outcomes, whereas low-density lipoprotein cholesterol(LDL-C) was a protective factor(OR=0.538, 95% CI 0.300–0.964, P=0.037). With every 1 mmol/L reduction in normal LDL-C levels, the risk of an unfavorable outcome increased by 46.2%. Major therapies, including intravenous recombinant human tissue plasminogen activator(r TPA), intensive lipid-lowering statins and anti-platelets, were not significantly related to either HT or long-term, post-ACI poor prognosis.Conclusions: For patients with large infarct sizes, especially those with cortex involvement, AF, or lower levels of TC, the risk of HT might increase after ACI. The risk of a long-term unfavorable outcome in these patients might increase with a reduction in LDL-C. | Gang Lv Guo-Qiang Wang Zhen-Xi Xia Hai-Xia Wang Nan Liu Wei Wei Yong-Hua Huang Wei-Wei Zhang | 2019 | Military Medical Research2019，6，3： | 60 |
| 2 | Cardiovascular risk factors for acute stroke: Risk profiles in the different subtypes of ischemic stroke显示文摘Timely diagnosis and control of cardiovascular risk factors is a priority objective for adequate primary and secondary prevention of acute stroke. Hypertension, atrial fibrillation and diabetes mellitus are the most common risk factors for acute cerebrovascular events, although novel risk factors, such as sleep-disordered breathing, inflammatory markers or carotid intima-media thickness have been identified. However, the cardiovascular risk factors profile differs according to the different subtypes of ischemic stroke. Atrial fibrillation and ischemic heart disease are more frequent in patients with cardioembolic infarction, hypertension and diabetes in patients with lacunar stroke, and vascular peripheral disease, hypertension, diabetes, previous transient ischemic attack and chronic obstructive pulmonary disease in patients with atherothrombotic infarction. This review aims to present updated data on risk factors for acute ischemic stroke as well as to describe the usefulness of new and emerging vascular risk factors in stroke patients. | Adrià Arboix | 2015 | World Journal of Clinical Cases2015，3，5： | 29 |
| 3 | Atrial fibrillation in obstructive sleep apnea显示文摘Atrial fibrillation(AF) is a common arrhythmia with rising incidence.Obstructive sleep apnea(OSA) is prevalent among patients with AF.This observation has prompted significant research in understanding the relationship between OSA and AF.Multiple studies support a role of OSA in the initiation and progression of AF.This association has been independent of obesity,body mass index and hypertension.Instability of autonomic tone and wide swings in intrathoracic pressure are seen in OSA.These have been mechanistically linked to initiation of AF in OSA patients by lowering atrial effective refractory period,promoting pulmonary vein discharges and atrial dilation.OSA not only promotes initiation of AF but also makes management of AF difficult.Drug therapy and electrical cardioversion for AF are less successful in presence of OSA.There has been higher rate of early and overall recurrence after catheter ablation of AF in patients with OSA.Treatment of OSA with continuous positive airway pressure has been shown to improve control of AF.However,additional studies are needed to establish a stronger relationship between OSA treatment and success ofAF therapies.There should be heightened suspicion of OSA in patients with AF.There is a need for guidelines to screen for OSA as a part of AF management. | Sandeep K Goyal Abhishek Sharma | 2013 | World Journal of Cardiology2013，5，6： | 16 |
| 4 | Prediction of atrial fibrillation development and progression:current perspectives显示文摘Atrial fibrillation(AF) is the most common arrhythmia in clinical practice. Several conventional and novel predictors of AF development and progression(from paroxysmal to persistent and permanent types) have been reported. The most important predictor of AF progression is possibly the arrhythmia itself. The electrical, mechanical and structural remodeling determines the perpetuation of AF and the progression from paroxysmal to persistent and permanent forms. Common clinical scores such as the hypertension, age ≥ 75 years, transient ischemic attack or stroke, chronic obstructive pulmonary disease, and heart failure and the congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category scores as well as biomarkers related to inflammation may also add important information on this topic. There is now increasing evidence that even in patients with so-called lone or idiopathic AF, the arrhythmia is the manifestation of a structural atrial disease which has recently been defined and described as fibrotic atrial cardiomyopathy. Fibrosis results from a broad range of factors related to AF inducing pathologies such as cell stretch, neurohumoral activation, and oxidative stress. The extent of fibrosis as detected either by late gadolinium enhancement-magnetic resonance imaging or electroanatomic voltage mapping may guide the therapeutic approach based on the arrhythmia substrate. The knowledge of these risk factors may not only delay arrhythmia progression, but also reduce the arrhythmia burden in patients with first detected AF. The present review highlights on the conventional and novel risk factors of development and progression of AF. | Konstantinos Vlachos Konstantinos P Letsas Panagiotis Korantzopoulos Tong Liu Stamatis Georgopoulos Athanasios Bakalakos Nikolaos Karamichalakis Sotirios Xydonas Michael Efremidis Antonios Sideris | 2016 | World Journal of Cardiology2016，8，3： | 16 |
| 5 | TGF-β1 signal pathway in the regulation of inflammation in patients with atrial fibrillation显示文摘Objective:To observe the expression changes of inflammatory markers TGF-β1,Smad3 and IL-6 in patients with atrial fibrillation(AF),and to explore the significance of TGF-β1 signaling pathway in the structural remodeling of AF.Methods:The expression of TGF-β1,Smad3 and IL-6 in 50 cases with AF and 30 normal cases were detected by RT-PCR and ELISA.Results:The TGF-β1,Smad3 and IL-6 mRNA and protein expression levels in patients with AF were significantly higher than that in the control group(P<0.05),but there was no significantly different between the paroxysmal AF group and the persistent AF group(P>0.05).The TGF-β1mRNA expression in the≥50 years subgroup was significantly higher than that in the<50years subgroups,and it was higher in the NYHAⅢsubgroup than in theⅠ/Ⅱgrade subgroup.It was also higher in the left ventricular ejection fraction(LVEF)<50%subgroup than in LVEF≥50%group,and it was significantly higher in the AF time≥36 months subgroup than that in<36months subgroup(P<0.05).The Smad3 and IL-6 expressions in the in the LVEF<50%subgroup were both high that than that in LVEF≥50%group,and higher in the AF time≥36 months subgroup than that in<36 months subgroup(P<0.05).There were a positive correlation between TGF-β1,Smad3 and IL-6(r=0.687,r=0.547).There were also a positive correlation between Smad3 and IL-6 mRNA(r=0.823).Conclusions:AF is associated with inflammation,and the inflammation is also involved in the fibrillation and sustain of AF.The TGF-β1 signal pathway may be involved in the process of atrial structural remodeling in patients with AF,and iss related with the occurrence and maintenance of AF. | Ye Erbo lati.Ali Mira Muhuyati Wu-Hong Lu Peng-Yi He Zhi-Qiang Liu Yu-Chun Yang | 2013 | Asian Pacific Journal of Tropical Medicine2013，6，12： | 14 |
| 6 | Postablation neutrophil/lymphocyte ratio correlates with arrhythmiarecurrence after catheter ablation of lone atrial fibrillation显示文摘Background Neutrophil/lymphocyte ratio (NLR) has been proposed as a novel marker of systemic inflammation andoxidative stress. The objective of this study was to ascertain the relationship between levels of NLR and recurrence of loneatrial fibrillation (AF) after catheter ablation. | | 2014 | Chinese Medical Journal2014，，6： | 14 |
| 7 | The Role of High-sensitivity C-reactive Protein, Interleukin-6 and Cystatin C in Ischemic Stroke Complicating Atrial Fibrillation显示文摘This study examined the role of high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6) and cystatin C in ischemic stroke complicating atrial fibrillation (AF) and the relationship of systemic inflammation with this disease in order to identify AF patients who are at high risk of stroke and need optimal anticoagulant therapy.A total of 103 AF patients, simple (n=75) or complicated by ischemic stroke (n=28), and 112 control subjects were recruited.IL-6 level was detected by using enzyme linked immunosorbent assay.Cystatin C and hsCRP levels were measured by means of a particle-enhanced immunonephelometric assay.The results showed that the AF patients had higher levels of hsCRP (P=0.004), IL-6 (P=0.000), and cystatin C (P=0.000) than control subjects.Plasma hsCRP level was increased in the AF patients with ischemic stroke as compared to the patients with simple AF (P=0.036).The AF patients who had the level of hsCRP exceeding 3.83 mg/L were at a higher risk than those with hsCRP level lower than 3.83 mg/L (P=0.030).After adjusting for other factors, cystatin C remained positively associated with IL-6 (r=0.613) and hsCRP (r=0.488).It was concluded that hsCRP is positively correlated with ischemic stroke complicating AF and may be a risk factor independent of other risk factors for AF.Elevated cystatin C level is also indicative of the increased risk of AF. | 尤玲 汪培华 吕家高 Katherine Cianflone 汪道文 赵春霞 | 2010 | Journal of Huazhong University of Science and Technology(Medical Sciences)2010，30，5： | 13 |
| 8 | Adverse reactions of Amiodarone显示文摘Adverse drug reaction is defined by the World Health Organization as any response to a drug that is noxious and unintended and occurs at a dose normally used in man.Older people are at elevated risk of adverse drug reactions—because of changes in pharmacodynamics,concurrent use of multiple medications and the related drug interactions.However,adverse drug reactions are significantly underestimated in the elderly population that is also exposed to inappropriate drugs.Amiodarone is an antiarrhythmic drug used commonly for the treatment of atrial fibrillation and is increasingly prescribed in older people.While amiodarone is an efficient drug for rhythm control,it’s a carrier of different adverse reactions,and pro and cons must be carefully evaluated before its use especially in older people. | Ruben ML Colunga Biancatelli Viviana Congedo Leonardo Calvosa Marco Ciacciarelli Alessandro Polidoro Luigi Iuliano | 2019 | Journal of Geriatric Cardiology2019，16，7： | 11 |
| 9 | Catheter ablation of atrial fibrillation in elderly population显示文摘Background Although elderly patients have been included in published series of catheter ablation for atrial fibrillation (AF), clinicalbenefit and safety remain still less defined in this population. A retrospective analysis of the results of catheter ablation for AF in a large volumecenter focused on comparison of elderly patients with the rest of the patient cohort was conducted in this study. Methods Consecutive patientswho underwent catheter ablation for AF between January 2001 and December 2016 were analysed. A total population of 3197 patients wasdichotomized by the age of 70 years (394 elderly vs. 2803 younger subjects). Patients were followed in terms of arrhythmia status and sur-vival for a median period of 18 vs. 21 and 35 vs. 57 months, respectively. Results Elderly patients were more frequently females (49% vs.29%, P 〈 0.0001), had a history of hypertension (79% vs. 57%, P 〈 0.0001), diabetes (16% vs. 11%, P 〈 0.01), stroke (9% vs. 6%, P 〈 0.01),coronary/peripheral artery disease (14% vs. 8%, P 〈 0.0001), and CHAzDS2-VASc score (3.1 ± 1.3 vs. 1.5 ± 1.2 s, P 〈 0.0001). Major com-plications were more frequent in elderly (5.3% vs. 3.2%, P = 0.03); however, this difference was driven by vascular complications (3.6% vs.1.9%, P = 0.04). There were comparable rates of cerebrovascular (0.3 vs. 0.3%) or nonvascular complications (1.8 vs. 1.2%). Good arrhyth-mia control was inferior in elderly patients as compared with the rest of the cohort, both without and with antiarrhythmic drugs: 44.2% vs.58.2% (P 〈 0.0001) and 78.2 vs. 83.2% (P 〈 0.01), respectively. Poor arrhythmia control was associated with relative risk of all-cause mor-tality of 2.7 (95% CI: 1.1-6.4) in elderly patients and 1.4 (95% CI: 0.9-2.0) in younger subjects. Conclusions Catheter ablation for AF inelderly patients is safe although somewhat less effective. Good arrhythmia control is associated with better survival, especially in elderly patients. | Josef Kautzner Petr Peichl Marek Sramko Robert Cihak Bashar Aldhoon Dan Wichterle | 2017 | Journal of Geriatric Cardiology2017，14，9： | 9 |
| 10 | Flecainide: Current status and perspectives in arrhythmia management显示文摘Flecainide acetate is a class IC antiarrhythmic agent and its clinical efficacy has been confirmed by the results of several clinical trials. Nowadays, flecainide is recommended as one of the first line therapies for pharmacological conversion as well as maintenance of sinus rhythm in patients with atrial fibrillation and/or supraventricular tachycardias. Based on the Cardiac Arrhythmia Suppression Trial study results, flecainide is not recommended in patients with structural heart disease due to high proarrhythmic risk. Recent data support the role of flecainide in preventing ventricular tachyarrhythmias in patients with catecholaminergic polymorphic ventricular tachycardia associated both with ryanodine receptor and calsequestrin mutations. We herein review the current clinical data related to flecainide use in clinical practice and some concerns about its role in the management of patients with coronary artery disease. | George K Andrikopoulos Sokratis Pastromas Stylianos Tzeis | 2015 | World Journal of Cardiology2015，7，2： | 8 |
| 11 | Left atrial enlargement and non-paroxysmal atrial fibrillation as risk factors for left atrial thrombus/spontaneous Echo contrast in patients with atrial fibrillation and low CHA2DS2-VASc score显示文摘Objective To determine the risk factors for thromboembolism in lower risk patients with non-valvular atrial fibrillation(AF)and low CHA2DS2-VASc scores,which remain undefined.Methods We retrospectively analyzed the baseline clinical characteristics,routine laboratory parameters,and echocardiographic measurements of 705 patients(71.1%male;mean age:52.10±9.64 years)with low CHA2DS2-VASc score(0 or 1;1 point for female sex)out of 1346 consecutive patients with non-valvular AF who underwent transesophageal echocardiography(TEE)at Guangdong Cardiovascular Institute between January 2013 and December 2015.Results Patients with left atrial thrombus(LAT)or spontaneous echo contrast(SEC)on TEE(24/705,4%)showed a higher incidence rate of vascular disease(54.2%vs.32.9%,P=0.045)and non-paroxysmal AF(79.2%vs.29.4%,P<0.001),larger left atrial diameter(43.08±4.59 vs.36.02±5.53 mm,P<0.001),and lower left ventricular ejection fraction(58.23±8.82%vs.64.15±7.14%,P<0.001)than those without.Multivariate logistic regression analysis identified left atrial diameter[odds ratio(OR)=1.171,95%confidence interval(CI):1.084–1.265,P<0.001]and non-paroxysmal AF(OR=3.766,95%CI:1.282–11.061,P=0.016)as independent risk factors for LAT/SEC.In ROC curve analysis,a left atrial dimeter cutoff of 37.5 mm yielded 95.0%sensitivity and 62.7%specificity(AUC:0.847,P<0.0001,95%CI:0.793–0.914).Conclusion In patients with non-valvular AF with low CHA2DS2-VASc score,the presence of LAT or SEC was associated with left atrial enlargement,which had moderate predictive value,and non-paroxysmal AF. | Wei-Dong LIN Yu-Mei XUE Fang-Zhou LIU Xian-Hong FANG Xian-Zhang ZHAN Hong-Tao LIAO Gary Tse Shu-Lin WU | 2020 | Journal of Geriatric Cardiology2020，17，3： | 8 |
| 12 | Correlations between low thyroid function and incidence of atrial fibrillation in hypertrophic obstructive cardiomyopathy显示文摘Background::Atrial fibrillation (AF) is the most common arrhythmia in patients with hypertrophic obstructive cardiomyopathy (HOCM). Data regarding the correlations of thyroid dysfunction and the incidence of AF in HOCM are quite limited. This study aimed to reveal the correlations between different thyroid status and the corresponding incidence of AF in a large HOCM cohort.Methods::A total of 806 HOCM patients with complete information on thyroid function tests and comprehensive cardiac evaluations were recruited. The participants were divided into the AF group (n = 159) and non-AF group (n = 647) according to established medical history and results of Holter monitoring. The thyroid status of the study population and the corresponding incidence of AF were assessed and analyzed.Results::Hypothyroidism accounted for the greatest proportion of thyroid dysfunction in HOCM patients. The incidence of AF significantly increased in individuals with both overt ( P = 0.022) and subclinical ( P = 0.007) hypothyroidism. Compared with participants in the non-AF group, those with positive AF episodes presented with lower free triiodothyronine (FT3) (2.86 ± 0.52 pg/mL vs. 3.01 ± 0.42 pg/mL, P = 0.001), higher free thyroxine (FT4) (1.24 ± 0.25 ng/dL vs. 1.15 ± 0.16 ng/dL, P < 0.001), and remarkably increased levels of thyrotropin (TSH) (12.6% vs. 5.3%, P = 0.001). Multivariable analyses demonstrated that the concentrations of FT3 (odds ratio [OR] = 0.470, 95% confidence interval [CI]: 0.272-0.813, P = 0.007) and FT4 (OR = 17.992, 95% CI: 5.750-56.296, P < 0.001), as well as TSH levels above normal ranges (OR = 2.276, 95% CI: 1.113-4.652, P = 0.024) were independently associated with the occurrence of AF in the large HOCM cohort. Conclusions::This study indicated a strong link between low thyroid function and the presence of AF in HOCM. Hypothyroidism (both overt and subclinical states) seems to be valuable for assessing the incidence of AF in patients with HOCM. | Liu Li-Min Shen Li-Shui Liu Shang-Yu Tu Bin Li Guo-Liang Hu Feng Hu Zhi-Cheng Wu Ling-Min Fan Xiao-Han Zheng Li-Hui Ding Li-Gang Yao Yan | 2020 | Chronic Diseases and Translational Medicine2020，6，1： | 8 |
| 13 | Comparison of cryoballoon ablation for atrial fibrillation guided by real-time three-dimensional transesophageal echocardiography vs. contrast agent injection显示文摘Background:Pulmonary vein (PV) occlusion generally depends on repetitive contrast agent injection when cryoballoon ablation for atrial fibrillation (AF). The present study was to compare the effect of cryoballoon ablation for AF guided by transesophageal echocardiography (TEE) vs. contrast agent injection.Methods:Eighty patients with paroxysmal AF (PAF) were enrolled in the study. About 40 patients underwent cryoballoon ablation without TEE (non-TEE group) and the other 40 underwent cryoballoon ablation with TEE for PV occlusion (TEE group). In the TEE group during the procedure, PVs were displayed in 3-dimensional images to guide the balloon to achieve PV occlusion. The patients were followed up at regularly scheduled visits every 2 months.Results:No differences were identified between the groups in regard to the procedure time and cryoablation time for each PV. The fluoroscopy time (6.7±4.2 min vs. 17.9±5.9 min, P<0.05) and the amount of contrast agent (3.0±5.1 mL vs.18.1±3.4 mL, P<0.05) in the TEE group were both less than the non-TEE group. At a mean of 13.0±3.3 mon follow-up, success rates were similar between the TEE group and non-TEE group (77.5% vs. 80.0%, P=0.88).Conclusions:Cryoballoon ablation with TEE for occlusion of the PV is both safe and effective. Less fluoroscopy time and a lower contrast agent load can be achieved with the help of TEE for PV occlusion during procedure. | Yuan-Jun Sun Xiao-Meng Yin Tao Cong Lian-Jun Gao Dong Chang Xian-Jie Xiao Qiao-Bing Sun Rong-Feng Zhang Xiao-Hong Yu Ying-Xue Dong Yan-Zong Yang Yun-Long Xia | 2019 | Chinese Medical Journal2019，，3： | 8 |
| 14 | Atrial fibrillation in the elderly显示文摘Atrial fibrillation(AF)is the most common arrhythmia in elderly population,with age being one of the most important factors involved in its pathogenesis.Conduction disturbances may be present on the surface electrocardiogram before AF onset in some patients.Once this arrhythmia is diagnosed,antithrombotic therapy is mandatory in most cases,as this is the only treatment that has demonstrated to improve survival.Age increases both the risk of thromboembolic and bleeding complications,while benefits from anticoagulant therapy outweigh that from bleeding in most scenarios,also in very elderly patients.However,elderly patients with AF are often undertreated.Non-vitamin K antagonist oral anticoagulants have emerged as an alternative to vitamin K antagonists,with significant less adverse events and better profile in terms of efficacy and safety.Other conditions related to age should be carefully evaluated in these patients(including frailty,comorbidity and polypharmacy)to ensure an individualized clinical and therapeutic approach. | Pablo Díez-Villanueva Fernando Alfonso | 2019 | Journal of Geriatric Cardiology2019，16，1： | 7 |
| 15 | Analysis of Incidence of Atrial Fibrillation after Implantation of VVI Pacemaker-Long-term Observation of 154 Patients显示文摘Incidence of occurrence of atrial fibrillation (Af) after implantation of VVI was examined and the possible mechanism was explored. Eighty cases of atriouentricular block (AVB) and 74 cases of sick sinus syhdrome (SSS) were studied and followed up for 1-14 years after implantation of VVI. The endpoint was the occurrence of permanent Af. The results showed that the incidence of Af among the 154 patients was 14.3 % (22/154). And the incidence was 2. 5 % among patients with AVB (2/80), and 27 % among patients with SSS (20/74). Significant significance was found between patients with AVB and those with SSS (P<0. 01). Among the patients with SSS, the incidence was 33. 3 % (9/27) in type I, 38.1 % (8/21) in type Ⅲ and 11. 5 % (3/26) in type Ⅱ. Significant differences were revealed among patients with Ⅱ, Ⅲ and Ⅱ type SSS (P<0. 05). It is concluded that retrograde conduction of pure ventricular pacing may play the chief role of occurrence of Af. | 李仁立 姚济华 | 2000 | Journal of Huazhong University of Science and Technology(Medical Sciences)2000，20，2： | 7 |
| 16 | Arrhythmia risk in liver cirrhosis显示文摘Interactions between the functioning of the heart and the liver have been described, with heart diseases affecting the liver, liver diseases affecting the heart, and conditions that simultaneously affect both. The heart is one of the most adversely affected organs in patients with liver cirrhosis. For example, arrhythmias and electrocardiographic changes are observed in patients with liver cirrhosis. The risk for arrhythmia is influenced by factors such as cirrhotic cardiomyopathy, cardiac ion channel remodeling, electrolyte imbalances,impaired autonomic function, hepatorenal syndrome, metabolic abnormalities, advanced age, inflammatory syndrome, stressful events, impaired drug metabolism and comorbidities. Close monitoring of cirrhotic patients is needed for arrhythmias, particularly when QT intervalprolonging drugs are given, or if electrolyte imbalances or hepatorenal syndrome appear. Arrhythmia risk may persist after liver transplantation due to possible QT interval prolongation, persistence of the parasympathetic impairment, post-transplant reperfusion and chronic immunosuppression, as well as consideration of the fact that the transplant itself is a stressful event for the cardiovascular system. The aims of the present article were to provide a review of the most important data regarding the epidemiology, pathophysiology, and biomarkers of arrhythmia risk in patients with liver cirrhosis, to elucidate the association with long-term outcome, and to propose future research directions. | Ioana Mozos | 2015 | World Journal of Hepatology2015，7，4： | 6 |
| 17 | Transcatheter Closure of Atrial Septal Defects Improves Cardiac Remodeling and Function of Adult Patients with Permanent Atrial Fibrillation显示文摘Background: Permanent atrial fibrillation (AF) is the most common form ofdysrhythmia associated with atrial septal defects (ASDs) in patients older than 40 years. However, little is known about cardiac remodeling after transcatheter closure in patients with permanent AF, This study was designed to compare cardiac events and remodeling effects after transcatheter closure in such patients. Methods: Clinical data of 289 adult patients older than 40 years who underwent ASD closure at our center were analyzed retrospectively, Of them, 63 patients with permanent AF were assigned to the case group, and the other 226 patients without permanent AF were assigned to the control group. Cardiac events and changes in left and right cardiac cavity dimensions before the procedure and 6 months after the procedure were compared between the two groups. Results: Patients in the case group were significantly older than those in the control group. The right ventricular (RV) volume and right atrial (RA) volume were decreased significantly in both the groups during a median follow-up period of 6 months after closure (P 〈 0.001 ). The left atrial dimensions, left ventricular end-systolic dimensions, left ventricular end-diastolic dimensions and left ventricular ejection fi'action showed no significant change before and after the procedure in both the groups. Changes of the RV volume and RA volume in the case group were significantly smaller than those in the control group (P = 0.005 and P 〈 0.001). The New York Heart Association cardiac function was improved in both the groups during the 6 months follow-up period. Conclusions: The transcatheter closure of ASD can improve the cardiac remodeling and cardiac function in patients with or without AF. | Liang Chen Yuan Bai Fei-Yu Wang Zhi-Gang Zhang Xing-Hua Shan Tao Chen Xian-Xian Zhao Yong-Wen Qin | 2015 | Chinese Medical Journal2015，，6： | 6 |
| 18 | Analyses of risk factors and prognosis for new-onset atrial fibrillation in elderly patients after dual-chamber pacemaker implantation显示文摘Objective To retrospectively identify risk factors and the prognosis for new-onset atrial fibrillation (AF)after implantation of dual-chamber pacemakers in elderly patients.Methods Consecutive patients aged >65years who underwent their first implantation of a dual-chamber permanent pacemaker in Beijing Anzhen Hospital from October 2013to May 2016were enrolled.Their complete program- ming and follow-up data were recorded.Follow-up end points included new-onset AF and major adverse cardiovascular and cerebrovascular events.Restdts Altogether,322patients were enrolled,with new-onset AF observed in 79(24.5%)during their follow-up.Multivariable analysis identified four independent predictors of new-onset AF in elderly patients after pacemaker implantation:hypertension (HR =3.040, 95%CI:1.09-3.05,P =0.00),age (HR =1.966,95%CI:1.57-3.68,P =0.01);left atrial enlargement (HR =1.645,95%CI:1.05-1.25,P = 0.03);high ventricular pacing rate (HR =1.137,95%CI:1.01-1.06,P =0.01).Univariable analysis indicated that the CHA2DS2-VASc score was also a risk factor for AF (HR =1.368,95%CI:1.178-1.589,P =0.002),whereas multivariable regression analysis did not. Kaplan-Meier survival analysis showed that the risk for ischemic stroke was significantly higher in the new-onset AF group than in the non-AF group (P <0.05).Conclusion Hypertension,age,left atrial enlargement,and high ventricular pacing rate were independent predictors of new-onset AF in elderly patients after implantation of a permanent pacemaker.New-onset AF increased the risk for ischemic stroke. | Xiao-Li CHEN Xue-Jun REN Zhuo LIANG Zhi-Hong HAN Tao ZHANG Zhi LUO | 2018 | Journal of Geriatric Cardiology2018，15，10： | 5 |
| 19 | Peripheral leukocyte count and risk of bleeding in patients with non-valvular atrial fibrillation taking dabigatran: a real-world study显示文摘Background: The association between peripheral leukocyte count and bleeding events in nonvalvular atrial fibrillation (NVAF) patients treated with dabigatran remains unclear. This study aimed to explore the association between leukocyte count and bleeding events after excluding other confounders in NVAF patients taking dabigatran. Methods: A total of 851 NVAF patients treated with dabigatran (110 mg bid) were recruited from 12 centers in China from February 2015 to December 2017. Follow-up was completed by May 2018. The exposure and outcome variables were leukocyte count measured at baseline and the number of bleeding events within the subsequent 6 months. Multivariate Cox proportional hazards models were constructed to analyze independent associations, and a Cox proportional hazards regression with cubic spline functions and smooth curve fitting (penalized spline method) was used to address nonlinearity between leukocyte count and bleeding. The inflection point was calculated using a recursive algorithm, and then a two-piecewise Cox proportional hazards model for both sides of the inflection point was constructed. Results: During 6-month follow-up, 87 participants occurred bleeding events. For every 1×10^9/L increase in leukocyte count, the risk of bleeding increased by 11%(hazard ratio [HR]: 1.11, 95% confidence interval [CI]: 0.99–1.25). The smooth curve showed nonlinear relationship between leukocyte count and bleeding events. The inflection point of the leukocyte count was 6.75×10^9/L. For leukocyte counts < 6.75×10^9/L, the HR (95% CI) was 0.88 (0.69–1.13), and for leukocyte counts ≥ 6.75×10^9/L, the HR (95% CI) was 1.28 (1.09–1.51). Conclusion: This study found a J-shaped association between baseline leukocyte count and risk of bleeding in NVAF patients treated with dabigatran. | Wei Zhou Tao Wang Ling-Juan Zhu Ming-Hua Wen Li-Hua Hu Xiao Huang Chun-Jiao You Ju-Xiang Li Yan-Qing Wu Qing-Hua Wu Hui-Hui Bao Xiao-Shu Cheng | 2019 | Chinese Medical Journal2019，，18： | 5 |
| 20 | Role of three-dimensional imaging integration in atrial fibrillation ablation显示文摘Atrial fibrillation is the most common arrhythmia and in symptomatic patients with a drug-refractory form,catheter ablation aimed at electrically disconnecting the pulmonary veins(PVs) has proved more effective than use of antiarrhythmic drugs in maintaining sinus rhythm during follow-up.On the other hand,this ablation procedure is complex,requires specific training and adequate clinical experience.A main challenge is represented by the need for accurate sequential positioning of the ablation catheter around each veno-atrial junction to deliver point-by-point radiofrequency energy applications in order to achieve complete and persistent electrical disconnection of the PVs.Imaging integration is a new technology that enables guidance during this procedure by showing a three-dimensional,pre-acquired computed tomography or magnetic resonance image and the relative real-time position of the ablation catheter on the screen of the electroanatomic system.Reports in the literature suggest that imaging integration provides accurate visual information with improvement in the procedure parameters and/or clinical outcomes of the procedure. | Roberto De Ponti Raffaella Marazzi Domenico Lumia Giuseppe Picciolo Roberto Biddau Carlo Fugazzola Jorge A Salerno-Uriarte | 2010 | World Journal of Cardiology2010，2，8： | 5 |
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