Background
This study aimed to investigate the electrophysiological characteristics of idiopathic ventricular arrhythmias (VAs) originating from the left ventricular posterior papillary muscles (LPPM) and explore the efficiency of catheter ablation using three‐dimensional intracardiac ultrasound technology.
Methods
Twenty‐seven cases of premature ventricular contraction/ventricular tachycardia (PVC/VT) originating from the left ventricular posterior papillary muscles were recorded from July 2015 to June 2019 in the Central Hospital of Shengli Oil Field and the First Affiliated Hospital of Zhengzhou University. Electrophysiological mapping and radiofrequency catheter ablation (RFCA) were performed using three‐dimensional intracardiac ultrasound technology. The characteristics of the body surface and intracavity electrocardiogram were analyzed. All cases were followed up for 24 months after the operation.
Results
The VAs of all 27 cases were successfully eliminated by catheter ablation. QRS complexes were observed with a right bundle branch block (RBBB) pattern and a steep slope in the initial segment. Lead I appeared with an Rs pattern, and inferior leads (lead II, III, and aVF) were usually with an S wave. The lead aVR appeared with a qR pattern, while the R wave was commonly found in aVL. The main wave in leads V1‐V3 was positive but negative in V5 and V6.
Conclusion
Ventricular arrhythmias originating from the left ventricular posterior papillary muscles have similar electrophysiological characteristics. The origin site was accurately located using three‐dimensional intracardiac ultrasound technology. Catheter ablation effectively eliminated VAs.
BackgroundsAlthough Blood urea nitrogen (BUN) and serum creatinine concentration (Cr) has been widely measured in daily clinical practice, BUN-to-Cr ratio (BCR) for prognosis among patients admitted with cardiogenic shock (CS) remains unknown. The present study was conducted to assess the prognostic effectiveness of BCR on CS.Methods and resultsRecords of data for patients with CS were extracted from public database of the Medical Information Mart for Intensive Care-III (MIMIC-III). The primarily endpoint was in-hospital mortality. We incorporated multivariate Cox regression model and Kaplan–Meier curve to evaluate the relationship between BCR and in-hospital mortality, adjusting for potential confounders. Data of 1137 patients with CS were employed for the final cohort, with 556 in the low BCR (< 20) and 581 in the high BCR (≥ 20) group. In the multivariate Cox model and Kaplan–Meier curve, compared to low BCR, we found high BCR was independently associated with significantly improved in-hospital survival for CS (HR 0.66, 95% CI 0.51–0.84;P < 0.01). The benefit of high BCR on in-hospital survival for CS was remaining among subgroups of acute kidney injury (AKI) and non-AKI.ConclusionsOur analysis indicated that high BCR, as compared to low BCR, was correlated with improved in-hospital survival for participants with CS, with or without AKI. The results need to be proved in large prospective studies.
Background: DNA methylation is an important form of epigenetic regulation and is closely related to atherosclerosis (AS). The purpose of this study was to identify DNA methylation–related biomarkers and explore the immune-infiltrate characteristics of AS based on methylation data.Methods: DNA methylation data of 15 atherosclerotic and paired healthy tissues were obtained from Gene Expression Omnibus database. Differential methylation positions (DMPs) and differential methylation regions (DMRs) were screened by the ChAMP R package. The methylation levels of DMPs located on CpG islands of gene promoter regions were averaged. The limma R package was used to screen differentially methylated genes in the CpG islands of the promoter regions. The diagnostic values of the methylation levels were evaluated using the pROC R package. The EpiDISH algorithm was applied to quantify the infiltration levels of seven types of immune cells. Subsequently, three pairs of clinical specimens of coronary atherosclerosis with Stary’s pathological stage III were collected, and the methylation levels were detected by the methylation-specific PCR (MS-PCR) assay. Western blot was performed to detect the protein expression levels of monocyte markers.Results: A total of 110, 695 DMPs, and 918 DMRs were screened in the whole genome. Also, six genes with significant methylation differences in the CpG islands of the promoter regions were identified, including 49 DMPs. In total, three genes (GRIK2, HOXA2, and HOXA3) had delta beta greater than 0.2. The infiltration level of monocytes was significantly upregulated in AS tissues. MS-PCR assay confirmed the methylation status of the aforementioned three genes in AS samples. The Western blot results showed that the expression levels of the monocyte marker CD14 and M1-type macrophage marker CD86 were significantly increased in AS while M2-type macrophage marker protein CD206 was significantly decreased.Conclusion: This study identified potential DNA methylation–related biomarkers and revealed the role of monocytes in early AS.
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