Dynamic exercise could be directly associated with the severity of the phenotype in relation to the precocity of major ventricular arrhythmic events and right ventricular systolic dysfunction in patients with high-risk definite ARVC/D.
Objectives: Sterol regulatory element-binding proteins (SREBP) genes are crucial in lipid biosynthesis and cardiovascular homeostasis. Their expression in epicardial adipose tissue (EAT) and their influence in the development of coronary artery disease (CAD) and type-2 diabetes mellitus remain to be determined. The aim of our study was to evaluate the expression of SREBP genes in EAT in patients with CAD according to diabetes status and its association with clinical and biochemical data.Methods: SREBP-1 and SREBP-2 mRNA expression levels were measured in EAT from 49 patients with CAD (26 with diabetes) and 23 controls without CAD or diabetes.Results: Both SREBPs mRNA expression were significantly higher in patients with CAD and diabetes (p<0.001) and were identified as independent cardiovascular risk factor for coronary artery disease in patients with type-2 diabetes (SREBP-1: OR 1.7, 95%CI 1.1-2.5, p=0.02; SREBP-2: OR 1.6, 95%CI 1.2-3, p=0.02) and were independently associated with the presence of multivessel CAD, left main and anterior descending artery stenosis, and higher total and LDL cholesterol levels, and lower HDL cholesterol levels, in patients with CAD and diabetes.Conclusions: SREBP genes are expressed in EAT and were higher in CAD patients with diabetes than those patients without CAD or diabetes. SREBP expression was associated as cardiovascular risk factor for the severity of CAD and the poor lipid control. In this preliminary study we suggest the importance of EAT in the lipid metabolism and cardiovascular homeostasis for coronary atherosclerosis of patients with diabetes and highlight a future novel therapeutic target.
During an average follow-up of 4 years, 16.67% presented appropriate events (4.16%/year). HCM Risk-SCD predicted the onset of events more suitably than classic risk factors.
BackgroundOxidized low-density lipoproteins and scavenger receptors (SRs) play an important role in the formation and development of atherosclerotic plaques. However, little is known about their presence in epicardial adipose tissue (EAT). The objective of the study was to evaluate the mRNA expression of different SRs in EAT of patients with ischemic heart disease (IHD), stratifying by diabetes status and its association with clinical and biochemical variables.MethodsWe analyzed the mRNA expression of SRs (LOX-1, MSR1, CXCL16, CD36 and CL-P1) and macrophage markers (CD68, CD11c and CD206) in EAT from 45 patients with IHD (23 with type 2 diabetes mellitus (T2DM) and 22 without T2DM) and 23 controls without IHD or T2DM.ResultsLOX-1, CL-P1, CD68 and CD11c mRNA expression were significantly higher in diabetic patients with IHD when compared with those without T2DM and control patients. MSR1, CXCL16, CD36 and CD206 showed no significant differences. In IHD patients, LOX-1 (OR 2.9; 95% CI 1.6–6.7; P = 0.019) and CD68 mRNA expression (OR 1.7; 95% CI 0.98–4.5; P = 0.049) were identified as independent risk factors associated with T2DM. Glucose and glycated hemoglobin were also shown to be risk factors.ConclusionsSRs mRNA expression is found in EAT. LOX-1 and CD68 and were higher in IHD patients with T2DM and were identified as a cardiovascular risk factor of T2DM. This study suggests the importance of EAT in coronary atherosclerosis among patients with T2DM.
Purpose: The QUARTO II study was an observational study that investigated the response to Cardiac Resynchronization Therapy (CRT) with the Quartetw Left Ventricular (LV) quadripolar lead. This sub-analysis evaluated the mortality and all-cause hospitalization (hosp) rate in patients programmed using the proximal pair of electrodes of this quadripolar lead (non-conventional vectors) versus the conventional bipolar vectors in real clinical practice. Methods: Patients !18 years underwent CRT Defibrillator device implantation with a Quartetw lead (St Jude Medical) and were programmed as per the investigators' criteria. Study data were collected at baseline and 6 months post-implant. CRT response was defined a priori as a reduction in Left Ventricular End Systolic Volume (LVESV) of .15% at 6 months post-implant. Summary of results: A total of 198 patients were enrolled in the study across 26 sites in Spain and Portugal. There were 5 (4.2%) deaths, 38 (31.7%) all-cause hosp and 41 (34.2%) patients with the combined endpoint (death and all-cause hosp) in patients with conventional programming; and 1 (1.3%), 8 (10.4%) and 9 (11.7%), respectively, in the non-conv group. Echocardiographic data at 6 months was collected in 87 (72.5%) patients with conv pacing vector and 59 (76.6 %) with non-conventional. Purpose: Recently, novel quadripolar coronary sinus leads (Acuity X4 family) have been introduced for cardiac resynchronization therapy (CRT). These leads potentially allow to overcome issues related to high thresholds and phrenic nerve stimulation. Three models (with different shapes and inter-electrode spacing) are currently available: the spiral long (Spiral L), spiral short (Spiral S) and Straight. The performance of these leads after implantation has not yet been reported. Our aim was to evaluate the electrical parameters and requirements for repositioning at 3 months follow-up. Methods: First consecutive 201 patients with a standard indication for CRT enrolled in the RALLY-X4 study following successful implantation of an Acuity X4 lead for standard CRT indications were followed-up prospectively. The protocol of this post-market follow up registry with . 800 enrolments specified an initial mandated analysis of a 200 patient dataset collected after at least 3 months post implant.Results: A total of 201 patients (169 males, mean age 67.1 + 9.6 years) were followed-up for a mean of 6.9+ 4.5months. No dislodgements were observed which required repositioning. Only 1/201 (0.5%) patient required reintervention due to phrenic nerve stimulation which could not be resolved by reprogramming. The electrical parameters (at the programmed configuration) are shown in the table below. Values are shown as mean + SD apart from the capture thresholds which are expressed as median (interquartile range):Threshold (V; n 5 198) 1.0 (0.7-1.5) 0.9 (0.7-1.2) 1.1 (0.7-1.5) Sensing (mV; n 5 186)17. Purpose of the study: Cardiac resynchronization therapy (CRT) is an established therapy to reduce morbidity and mortality in heart failure patients. ...
Pulmonary vein (PV) isolation is a well-established rhythm control therapy in atrial fibrillation (AF). Currently, there is no consensus on which ablation technique to use for the first procedure, cryoballoon (CB) or radiofrequency (RF). A retrospective cohort study was conducted on 1055 patients who underwent a first ablation, to assess both techniques based on the need for reablation. Patients with CB (n = 557) and RF (n = 498) ablations were clinically characterized and the need for reablation during a 30-month follow-up was used as the primary endpoint. Independent variables were analyzed to identify potential predictors. The need for reablation was significantly lower in the CB group than in the RF group (hazard ratio = 0.45 and 95% confident interval = 0.32–0.61; p < 0.001); in both paroxysmal and persistent AF, using a full-adjusted regression Cox model by age, sex, smoking, hypertension, diabetes mellitus, dyslipidemia, severe obstructive sleep apnea, dilated left atrium, persistent AF and early recurrence. RF ablation, dilated left atrium, persistent AF and early recurrence were identified as independent predictors of reablation. In addition, the CB-redo subgroup had a lower PV reconnection than the RF-redo subgroup. In conclusion, CB ablation suggests a reduction in the need for reablation and lower PV reconnection during the follow-up than RF ablation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.