scholarly journals Cardiac arrhythmias in COVID-19: Mechanisms, outcomes and the potential role of proarrhythmia

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
JL Merino ◽  
J Caro ◽  
JR Rey ◽  
S Castrejon ◽  
M Martinez-Cossiani
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ventricular Arrhythmias ◽  
Potential Role ◽  
Multivariable Analysis ◽  
Funding Sources ◽  
Kaplan Meier ◽  
Single Centre Study ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Cardiac arrhythmia seems to be a risk factor for mortality in coronavirus disease 2019 (COVID-19). However, the mechanisms, risk factors and outcomes of new arrhythmic events (NAEs) in this disease are unclear. Methods All patients with confirmed COVID-19 were retrospectively included in this single centre study. Patients who were alive and admitted <30 days before the database lock were excluded. Results 3416 consecutive patients were reviewed and 1476 finally enrolled (65.9 ± 20.9 years, 57.3% male). 76 (5.1%) patients had NAEs. Most of them were new atrial fibrillation episodes (48 patients, 3.2%), mostly seen in patients with no previous arrhythmia (38 patients, 79.2%). Atrial flutter (AFL) accounted for 20% of all NAEs. Ventricular arrhythmias were seen in 9 (0.6%) patients. Multivariable analysis showed that prior AFL, heart failure, dyslipidaemia, lopinavir/ritonavir, and combined hydroxychloroquine and azithromycin were independently associated with NAEs. 66 (86.8%) patients with NAEs died. The Kaplan-Meier analysis showed a lower survival of patients with NAEs (P < 0.001). Eight out of 9 (88.9%) and 41 out of 48 (85.4%) patients with ventricular arrhythmias and atrial fibrillation respectively died. Older age, male gender and NAEs were independently associated with death. NAEs and other outcomes, such as heart failure, thromboembolism, and bleeding independently predicted death. Conclusions NAEs are relatively uncommon in COVID-19 patients and mainly have an atrial mechanism. AFL is particularly frequent in this disease. The use of hydroxychloroquine, azithromycin and lopinavir/ritonavir, is associated with them, especially when used in combination. NAEs are independently and strongly associated with death. Abstract Figure.

scholarly journals Interleukin-6 Could Be a Potential Prognostic Factor in Ambulatory Elderly Patients with Stable Heart Failure: Results from a Pilot Study

2021 ◽  
Vol 10 (3) ◽  
pp. 504
Author(s):  
Marina Povar-Echeverría ◽  
Pablo Esteban Auquilla-Clavijo ◽  
Emmanuel Andrès ◽  
Francisco Javier Martin-Sánchez ◽  
María Victoria Laguna-Calle ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Renal Failure ◽  
Interleukin 6 ◽  
Kaplan Meier ◽  
Patients With Heart Failure ◽  
Potential Prognostic Factor ◽  
Fundamental Phenomenon ◽  
Group 2

Introduction: Inflammation is a fundamental phenomenon in heart failure, but the prognostic or therapeutic role of markers such as interleukin-6 (IL-6) has not yet been clarified. The objective of this study is to describe the clinical profile of patients with elevated IL-6 and determine if they have worse clinical outcomes. Methods: A retrospective c.ohort observational study including 78 patients with heart failure followed up at the Heart Failure Outpatient Clinic of the Internal Medicine Department. IL-6 was determined in all patients, who were then assigned into two groups according to IL-6 level (normal or high). Clinical and prognostic data were collected to determine the differences in both groups. Results: The average age was 79 years, 60% female. A total of 53.8% of the patients had elevated IL-6 (group 2). Patients with elevated IL-6 presented more frequently with anemia mellitus (64.3% vs. 41.7%; p = 0.046), atrial fibrillation (83.3% vs. 61.9% p = 0.036), dyslipidemia (76.2% vs. 58.2%; p = 0.03), higher creatinine levels (1.35 mg/dL vs. 1.08 mg/dL; p = 0.024), lower glomerular filtration rate (43.6 mL/min/m2 vs. 59.9 mL/min/m2; p = 0.007), and anemia 25% vs. 52.4% p = 0.014. The factors independently associated with the increase in IL-6 were anemia 3.513 (1.163–10.607) and renal failure 0.963 (0.936–0.991), p < 0.05. Mortality was higher in the group with elevated IL-6 levels (16% vs. 2%; p = 0.044) with a log-rank p = 0.027 in the Kaplan–Meier curve. Conclusion: Patients with heart failure and elevated IL-6 most often have atrial fibrillation, diabetes mellitus, dyslipidemia, anemia, and renal failure. In addition, mortality was higher and a tendency of higher hospital admission was observed in stable HF patients with elevated IL-6.

Potential role of statin therapy in heart failure, atrial fibrillation and aortic stenosis

2006 ◽  
Vol 2 (6) ◽  
pp. 687-693
Author(s):  
Sameer Nagamia ◽  
Martin Thoenes ◽  
Qamar A Khan ◽  
Anbu Pandian ◽  
Bobby V Khan
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Aortic Stenosis ◽  
Statin Therapy ◽  
Potential Role

scholarly journals The role of epicardial adipose tissue and autonomic nervous system in pathophysiology of cardiac arrhythmias

2021 ◽  
Vol 25 (3) ◽  
pp. 27
Author(s):  
D. V. Losik ◽  
N. A. Nikitin ◽  
S. M. Minin ◽  
E. V. Fisher ◽  
I. L. Mikheenko ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Nervous System ◽  
Adipose Tissue ◽  
Autonomic Nervous System ◽  
Cardiovascular Diseases ◽  
Cardiac Arrhythmias ◽  
Ventricular Arrhythmias ◽  
Epicardial Adipose Tissue

<p>The role of epicardial adipose tissue (EAT) in the pathogenesis and prognosis of cardiovascular diseases has been actively discussed. This review provides information regarding the main mechanisms by which EAT influences the pathophysiology of rhythm disturbances, such as atrial fibrillation and ventricular arrhythmias, as well as their relationship with chronic heart failure. The pathogenesis of cardiac arrhythmias is exceedingly complex. As such, the mechanism by which EAT influences arrhythmias and heart failure can vary according to the anatomy and type of arrhythmia, one of which involves the autonomic nervous system (ANS). Some studies have shown a good treatment effects by targeting EAT in atrial fibrillation, whereas others have found that EAT volume can be used to predict the efficacy of radiofrequency ablation, a method for treating atrial fibrillation and ventricular arrhythmias. However, no standards have yet been established for the use of EAT visualisation. Fundamental, translational and clinical research are needed to study the role of EAT and ANS in the pathogenesis of cardiovascular diseases.</p><p>Received 15 March 2021. Revised 25 April 2021. Accepted 26 April 2021.</p><p><strong>Funding:</strong> The work is supported by a grant of the Russian Science Foundation (project No. 17-75-20118).</p><p><strong>Conflict of interest:</strong> The authors declare no conflicts of interests.</p><p><strong>Contribution of the authors</strong><br />Conception and study design: D.V. Losik, N.A. Nikitin, S.M. Minin, A.B. Romanov, A.M. Chernyavskiy<br />Drafting the article: D.V. Losik, I.L. Mikheenko, E.V. Fisher, N.A. Nikitin<br />Critical revision of the article: D.V. Losik, I.L. Mikheenko, E.V. Fisher, N.A. Nikitin<br />Final approval of the version to be published: D.V. Losik, N.A. Nikitin, S.M. Minin, E.V. Fisher, I.L. Mikheenko, A.M. Chernyavskiy, A.B. Romanov</p>

Role of Metoprolol Succinate in the Treatment of Heart Failure and Atrial Fibrillation

2020 ◽  
Vol 27 (2) ◽  
pp. e183-e193
Author(s):  
Dragos Vinereanu ◽  
Jindrich Spinar ◽  
Atul Pathak ◽  
Dariusz Kozlowski
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Metoprolol Succinate

scholarly journals PROGNOSTIC ROLE OF ATRIAL FIBRILLATION AND HEART RATE CONTROL IN CHRONIC HEART FAILURE PATIENTS

2013 ◽  
Vol 61 (10) ◽  
pp. E735
Author(s):  
Savina Nodari ◽  
Marco Triggiani ◽  
Laura Lupi ◽  
Alessandra Manerba ◽  
Giuseppe Milesi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Rate ◽  
Chronic Heart Failure ◽  
Rate Control ◽  
Heart Rate Control ◽  
Prognostic Role ◽  
Heart Failure Patients

Evaluation of a multimarker panel in chronic heart failure: a 10-year follow-up

2021 ◽  
Author(s):  
Susanne Bauer ◽  
Christina Strack ◽  
Ekrem Ücer ◽  
Stefan Wallner ◽  
Ute Hubauer ◽  
...  
Keyword(s):  
Heart Failure ◽  
Prognostic Role ◽  
Blood Samples ◽  
Kaplan Meier ◽  
Risk Of Mortality ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
Long Time

Aim: We assessed the 10-year prognostic role of 11 biomarkers with different pathophysiological backgrounds. Materials & methods/results: Blood samples from 144 patients with heart failure were analyzed. After 10 years of follow-up (median follow-up was 104 months), data regarding all-cause mortality were acquired. Regarding Kaplan–Meier analysis, all markers, except TIMP-1 and GDF-15, were significant predictors for all-cause mortality. We created a multimarker model with nt-proBNP, hsTnT and IGF-BP7 and found that patients in whom all three markers were elevated had a significantly worse long-time-prognosis than patients without elevated markers. Conclusion: In a 10-year follow-up, a combination of three biomarkers (NT-proBNP, hs-TnT, IGF-BP7) identified patients with a high risk of mortality.

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