Background
The CHA2DS2-VASc scoring system is correlated with left atrial (LA) reservoir function in patients with atrial fibrillation (AF) rhythm or paroxysmal AF. We assessed the ability of CHA2DS2-VASc to grade LA function in patients with sinus rhythm who were candidates for coronary artery bypass grafting (CABG).
Methods
This cross-sectional study recruited 340 consecutive candidates for CABG and categorized them according to their CHA2DS2-VASc scores as mild-, moderate-, and high-risk score groups with 34 (10%), 83 (24%), and 223 (66%) patients, respectively. LA function was evaluated via 2D speckle-tracking echocardiography in terms of global longitudinal strain and strain rate during the reservoir, conduit, and contraction phases. In-hospital mortality, postoperative AF, prolonged intensive care unit (ICU) stay, and prolonged mechanical ventilation were assessed.
Results
LA strain and strain rate during the reservoir phase was statistically significantly lower in the high-risk score group than the low- and moderate-risk score groups (27.8 ± 6.9% vs 31.0 ± 5.0% vs 29.8 ± 6.1%, respectively; P = 0.004 and 2.6 ± 0.7 s−1 vs 2.9 ± 0.6 s−1 vs 2.9 ± 0.6 s−1, correspondingly; P = 0.009) and regarding LA strain and strain rate during the conduit phase (9.7 [7.1–12.5]% vs 12.9 [9.4–15.1]% vs 11.5 [9.1–13.8]%, correspondingly; P < 0.001 and 2.1 [1.6–2.7] s−1 vs 2.8 [2.4–3.6] s−1 vs 2.6 [2.2–3.0] s−1, respectively; P < 0.001). In addition, LA strain rate during the conduit phase was lower in the moderate-risk score group than the low-risk score group. After adjustments for possible confounders, these differences remained statistically significant. The risk of postoperative AF and prolonged ICU stay was highest in the high-risk score group (relative risk = 9.67 (1.31–71.43) and 8.05 (1.08–60.16), respectively; P = 0.026 and P = 0.042, respectively).
Conclusions
LA reservoir and conduit functions decreased in the high-risk score group, which was accompanied by an increased risk of postoperative AF and prolonged ICU stay.
Alfalfa (Medicago sativa) is a plant with phytoestrogenic properties, which has been used as a major part of diets in husbandry. Since there are controversial reports related to the effects of alfalfa consumption on animal fertility, its effects on rat testicular tissue were assessed in the present study. Control (n=15) and alfalfa (n=15) groups were fed with ordinary rat chow and ordinary rat chow plus alfalfa, respectively. Testicles were removed after 30, 45, and 60 days of consumption, and tissue sections were prepared to assess histomorphometric changes related to alfalfa consumption.
Based on the results, there was no significant difference in length, width, and volume of testes of treated rats to control in all groups. But the number of testicular spermatogonia cells, primary spermatocyte cells, primary spermatid cells, testicular spermatozoid cells and Leydig cells significantly or insignificantly increased in rats that received alfalfa for 30 days but all of these parameters insignificantly decreased in rats that received alfalfa for 60 days. The cause of these changes may be due to estrogenic or anti-estrogenic, antioxidant and endocrine effects of alfalfa.
Conclusion: Consumption of alfalfa for short time had only a transient positive effects on testicular tissues but use of alfalfa for 60 days had little destructive effects on testicular tissue in rats. So longer durations of time could be suggested for further research on the effects of alfalfa on rat’s reproduction index.
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