Background: Narrow fragmented QRS (fQRS) has recently been recognized as a significant predictor of prognosis in various cardiovascular diseases. Hypothesis: We hypothesized that the presence of narrow fQRS on admission electrocardiogram (ECG) in patients with decompensated systolic heart failure (HF) of any cause would be associated with long-term prognosis. Methods: Patients hospitalized for decompensated HF due to ischemic or nonischemic dilated cardiomyopathy (left ventricular ejection fraction <35%) were retrospectively analyzed. The primary clinical end points were cardiovascular mortality, sudden cardiac death, and rehospitalization for HF. Results: The mean duration of follow-up was 3.73 ± 1.41 years. Patients were classified as fQRS(+) group (n = 114; mean age, 63.49 ± 12.04 years) and fQRS(−) group (n = 113 patients; mean age, 65.04 ± 11.95 years). fQRS on ECG was significantly correlated with New York Heart Association (NYHA) functional class (P = 0.001). In multivariate Cox proportional hazard analysis, narrow fQRS (odds ratio [OR]: 3.130, 95% confidence interval [CI]: 1.560-2.848, P = 0.001), chronic renal failure (OR: 2.455, 95% CI: 1.120-5.381, P = 0.025), NYHA class (OR: 8.305, 95% CI: 2.568-26.855, P < 0.0001), and hypoalbuminemia (OR: 2.099, 95% CI: 1.122-3.926, P = 0.020) were independent predictors of cardiovascular mortality. In Kaplan-Meier survival analysis, narrow fQRS on admission ECG predicted worse survival rate at 84 months; survival probability significantly decreased in the fQRS(+) group compared with fQRS(−) group (P < 0.0001). Conclusions: Presence of narrow fQRS is associated with worse NYHA functional class in patients hospitalized for decompensated HF. Narrow fQRS predicts cardiovascular mortality in a specific subgroup of systolic HF patients, namely those hospitalized for decompensated HF of both ischemic and nonischemic causes.
Orthorexia nervosa (ON) refers to an intense desire to consume healthy or biologically pure food that is free of artificial products. ON is not regarded as a separate eating disorder, but its clinical presentation shares common features with obsessive-compulsive disorder (OCD) and eating disorders. The current study examined 130 patients who were diagnosed with OCD (n = 49), panic disorder (n = 44), and generalized anxiety disorder (n = 37). Padua Inventory Washington State University Revision (PI-WSUR), The Eating Attitudes Test-40 (EAT-40), and the ORTO-11 test were given to the participants. There were no significant differences between patient groups in the mean scores of eating attitudes and orthorexia symptom severity. No significant association between ORTO-11 scores and body mass index was noted. Moderate correlations (r > 0.30) were obtained between orthorexia symptom severity and obsessive-compulsive symptom severity, EAT-40 total score, and checking and dressing/ grooming compulsions. These findings suggest that ON, a pathological inclination towards an obsession with healthy eating, is not specifically associated with any of the investigated illness groups. However, it has moderate correlations with the ritualistic signs of OCD. Underlying worry may predispose people to develop a compulsion to create the pure diet.
The VN level may be relevant as a clinical biomarker for adverse cardiovascular outcomes not only in patients with ischemic heart disease undergoing coronary interventions, as previously reported, but also in coronary artery disease patients presenting with acute MI.
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