The evolution of South China involved accretion-collision of multiple terranes from the Proterozoic to the Mesozoic. Zircon U-Pb ages, Hf data, and structural data indicate that the Cathaysia block consists of two terranes, West Cathaysia and East Cathaysia, separated by a newly recognized major strike-slip fault. We propose that West Cathaysia was part of a microcontinent that originated from a Grenvillian-aged orogen in the Rodinia supercontinent, East Cathaysia originated from an Indosinian-aged orogen in the Paleo-Tethyan regime to the south and was translated to the east of West Cathaysia through strike-slip motion, and the early Paleozoic Wuyi-Yunkai orogeny was a result of direct collision of West Cathaysia with a yet-unidentified terrane that rifted away after the collision. We conclude that a multiterrane Wilson cycle (multi-terrane accretion-collision, large-scale strike-slip motion, and separation of two terranes by post-collisional rifting along the suture zone) characterizes the history of South China and may be a common feature of orogens.*

Background Cardiac arrhythmias are associated with poorer outcomes in patients with heart failure (HF), diabetes mellitus (DM), and chronic kidney disease (CKD). Previous studies have shown inconsistent conclusions regarding the association between sodium-glucose cotransporter 2 inhibitors (SGLT2i) and the risk of developing arrhythmias. This study aims to investigate the association of SGLT2i treatment with arrhythmia outcomes in clinical trials of patients with HF, DM, or CKD. Methods MEDLINE, EMBASE, and ClinicalTrials.gov were searched from inception up to 27 August 2020. Randomized controlled trials that randomized patients with DM, CKD, or HF to SGLT2i or placebo were included. The outcomes of interest include atrial fibrillation (AF), embolic stroke, atrial flutter (AFL), AF/AFL, ventricular tachycardia (VT), and cardiac arrest. Relative risks (RRs) and 95% confidence intervals (CI) were pooled using a random-effects model. Results Out of 4,532 citations, 22 trials with altogether 52,115 patients were included (mean age 63.2 years; 33,747 [64.8%] of participants were men). SGLT2i were associated with a lower risk of AF (RR 0.82, 95% CI 0.70–0.96), embolic stroke (RR 0.32, 95% CI 0.12–0.85), AF/AFL (RR 0.82, 95% CI 0.71–0.95), and VT (RR 0.73, 95% CI 0.53–0.99), while the risk reductions in AFL (RR 0.83, 95% CI 0.58–1.17) and cardiac arrest (RR 0.83, 95% CI 0.61–1.14) did not reach statistical significance. The associations appeared to be consistent across different baseline conditions (DM vs CKD vs HF; atherosclerotic cardiovascular disease [ASCVD] vs no ASCVD) and the SGLT2i used. Conclusions SGLT2i reduced the risk of cardiac arrhythmias. Our study provides further evidence for recommending the use of SGLT2i in patients with DM, CKD, and HF. Further research is needed to fully elucidate the mechanism by which SGLT2i protect against arrhythmias.

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