Background: This study investigates the association between daily sitting time and subclinical atherosclerosis by using coronary computed tomography angiography (CCTA). Methods: The study enrolled 203 subjects (age 57.6 ± 8.8 years) who underwent CCTA at annual medical checkups. Sitting time was categorized as < 5 hours/day (short), 5 to 9 hours/day (moderate) and ≥10 hours/d (long). We analyzed the coronary calcium score, plaque characteristics, and severity of coronary artery stenosis, including the segment involvement score (SIS) and segment stenosis score (SSS). Results: Subjects with longer sitting times tended to be male gender and have lower levels of high-density lipoprotein cholesterol (p for trend < 0.05). In addition, those with longer sitting time had higher SIS (1.2 ± 1.5 vs. 1.6 ± 2.1 vs. 2.3 ± 2.0 for short, moderate, and long sitting time, respectively) (p for trend = 0.015) and SSS (1.4 ± 2.0 vs. 1.9 ± 2.7 vs. 2.7 ± 2.6) (p for trend = 0.015), suggesting longer sitting time-correlated with the severity of coronary atherosclerosis. When considering the coronary plaque patterns, subjects with shorter sitting time (<5 hours/d) tended to have more calcified plaque and subjects with longer sitting time (≥10 hours/d) had more mixed plaque (p for trend = 0.018). After adjusting for age, gender, comorbidities, body mass index, and lipid profiles, increased sitting time was independently associated with the presence of mixed plaque, suggesting longer sitting time may be associated with higher risk of the formation of vulnerable plaque. Conclusion: Longer sitting time was linked to the severity of subclinical atherosclerosis and the presence of high-risk vulnerable plaque in the general population.
Covid-19, also known as coronavirus disease 2019, is a highly contagious disease primarily transmitted through respiratory droplets. To mitigate the spread of the virus, the Malaysia government have implemented measures such as MySejahtera app for contact tracking purposes. The ‘Check-in’ feature is the core element in MySejahtera app where users will scan a QR code prior to entering a premise. However, it has some drawbacks in which a phone with internet connectivity and working camera are needed to scan the QR code. To overcome the limitations and ease the burden on the public, this paper proposes a RFID record tracker based on Atmel ATmega328P and NodeMCU ESP-12E technology as a complementary function to the ‘Check-in’ feature offered by MySejahtera. It has a RFID reader and built-in temperature sensor. It is ideally visualized to be sharing the same database with MySejahtera. This solution can be connected to the WiFi of the premise, thus the public just have to bring their Malaysian IC or relative RFID tag along with them. Once scanned, the system will crosscheck with the connected database to check their vaccination status and determine whether to grant access for them to enter the premise. At the same time, their record will be logged into associated database of the premise as well. All in all, this solution is designed in hopes to reduce the burden on public while easing the process of contact tracing.
Amyloidosis cardiomyopathy is a rare and underdiagnosed disease characterized by amyloid fibril deposition in the myocardium. The diagnosis of cardiac amyloidosis is often delayed due to a lack of awareness and the necessity of biopsy to confirm the diagnosis. Recent advances in cardiovascular imaging modalities have enhanced earlier recognition of this disease. A 66-year-old man experiences progressive shortness of breath for two weeks. Laboratory testing was significant for an elevation of cardiac biomarkers (creatine kinase: 522 U/L, troponin I: 0.10 ng/mL) and NT-pro-BNP (5074 pg/mL). He was diagnosed with acute coronary syndrome and received stent deployment. Nonetheless, progressive shortness of breath recurred in 2 months. Transthoracic echocardiography (TTE) demonstrated an increased left ventricular (LV) wall thickness with apical sparing. Cardiac magnetic resonance (CMR) imaging demonstrated high native T1 value, increased extracellular volume fraction as well as diffused subendocardial late gadolinium enhancement. Technetium-99m pyrophosphate (99mTc-PYP) scintigraphy, endomyocardial biopsy (EMB), and the genetic study confirmed the diagnosis of wild-type transthyretin amyloidosis (ATTRwt). The nonspecific clinical manifestations, lack of diagnostic biomarkers, and the rarity of systemic amyloidosis usually lead to delayed diagnosis and treatment. Our objective is to emphasize the role of multimodalities imaging in reducing delays to the diagnosis of cardiac amyloidosis.
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