Abstract 15126: Cardiorespiratory Fitness and Atrial Fibrillation: A Population-based Follow-up Study

Background: Atrial fibrillation (AF) is the most common arrhythmia worldwide and has a complex association with exercise capacity. The relationship of atrial fibrillation with cardiorespiratory fitness (CRF) has not been previously investigated. Methods: Cardiorespiratory fitness, as assessed by maximal oxygen uptake (VO2max), was measured at baseline in 1,950 middle-aged men (mean 52.6 ± 5.1 years) from the Kuopio Ischaemic Heart Disease Study (KIHD). Results: During an average follow-up of 19.5 years, there were 305 incident AF cases (annual AF rate of 65.1/1000 person-years, 95% CI: 58.2 to 72.8). Overall a non-linear association was observed between CRF and incident atrial fibrillation. Rate of incident AF varied from 11.5 (95% CI: 9.4-14.0) for the first quartile of CRF, to 9.1 (95% CI: 7.4-11.2) for second quartile, 5.7 (95% CI: 4.4-7.4) for third quartile and 6.3 (95% CI: 5.0-8.0) for the fourth quartile respectively, Figure 1. Usual levels of CRF were non-linearly associated with AF risk, Figure 2. Age-adjusted HR comparing top versus bottom fourth of usual CRF levels was 0.67(95% CI: 0.48-0.95), which attenuated to 0.98 (95% CI: 0.66-1.43) upon further adjustment for several risk factors. These findings were comparable across age, body mass index, history of smoking, diabetes and cardiovascular disease status at baseline. Conclusions: Improved fitness as indicated by higher levels of CRF is protective of atrial fibrillation within an optimal range, beyond which the risk of atrial fibrillation rises again. Our findings are congruent with emerging data on the complex relationship between physical fitness and incident AF.

Download Full-text

Hypertension Burden and the Risk of New-Onset Atrial Fibrillation

Hypertension ◽

10.1161/hypertensionaha.120.16659 ◽

2021 ◽

Vol 77 (3) ◽

pp. 919-928

Author(s):

So-Ryoung Lee ◽

Chan Soon Park ◽

Eue-Keun Choi ◽

Hyo-Jeong Ahn ◽

Kyung-Do Han ◽

...

Keyword(s):

Atrial Fibrillation ◽

Total Study Population ◽

Increased Risk ◽

Burden Scale ◽

History Of ◽

Study Population ◽

Korean National Health Insurance ◽

Stage 1 ◽

The Relationship

The association between the cumulative hypertension burden and the development of atrial fibrillation (AF) is unclear. We aimed to investigate the relationship between hypertension burden and the development of incident AF. Using the Korean National Health Insurance Service database, we identified 3 726 172 subjects who underwent 4 consecutive annual health checkups between 2009 and 2013, with no history of AF. During the median follow-up of 5.2 years, AF was newly diagnosed in 22 012 patients (0.59% of the total study population; 1.168 per 1000 person-years). Using the blood pressure (BP) values at each health checkup, we determined the burden of hypertension (systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg), stratified as 0 to 4 per the hypertension criteria. The subjects were grouped according to hypertension burden scale 1 to 4: 20% (n=742 806), 19% (n=704 623), 19% (n=713 258), 21% (n=766 204), and 21% (n=799 281). Compared with normal people, subjects with hypertension burdens of 1, 2, 3, and 4 were associated with an 8%, 18%, 26%, and 27% increased risk of incident AF, respectively. On semiquantitative analyses with further stratification of stage 1 (systolic BP of 130–139 mm Hg or diastolic BP of 80–89 mm Hg) and stage 2 (systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg) hypertension, the risk of AF increased with the hypertension burden by up to 71%. In this study, both a sustained exposure and the degree of increased BP were associated with an increased risk of incident AF. Tailored BP management should be emphasized to reduce the risk of AF.

Download Full-text

A study of herpes zoster particularly in its relationship to chickenpox

Journal of Hygiene ◽

10.1017/s002217240001456x ◽

1949 ◽

Vol 47 (3) ◽

pp. 253-262 ◽

Cited By ~ 59

Author(s):

H. E. Seiler

Keyword(s):

Herpes Zoster ◽

Sex Differentiation ◽

Motor Paralysis ◽

Recurrent Herpes ◽

History Of ◽

The One ◽

Two Peaks ◽

Relationship Of ◽

The Relationship

The results of a field survey of herpes zoster over a period of 18 months are described and the difficulties of such a survey mentioned.A total of 246 patients with herpes zoster, only 16% of whom had attended hospital, is reported. It is calculated that the yearly incidence in the population was approximately 2 per 1000.Full investigation and ‘follow up’ was undertaken in 184 cases. These are classified according to the site of the zoster—the dorsal, supra-orbital and cervical regions being affected in almost 90%, the dorsal region alone accounting for 53·3%.Herpes generalisatus occurred in 7, or 38%, of the cases, recurrent herpes zoster in 6, or 3·3%, while there was one case of motor paralysis affecting lower limb.The majority of patients were apparently well at the onset of the zoster, but 27 had some associated disease; 5 gave a history of trauma prior to the onset and 2 were related to pregnancy.The seasonal and geographical distribution is given and, while the numbers are too small for statistical analysis, the disease in 1947 showed two peaks of higher incidence, the one in May and the other in October. Crowding or density of population did not appear to be important, and the disease occurred sporadically rather than in epidemic form.There was a higher proportion of female cases, but when related to the population as a whole no sex differentiation was observed. Of the patients 60% were over 45 years of age.There was no evidence that housing conditions or occupation were of aetiological significance or that the disease was more common among any particular section of the community.Eleven patients had been associated with other cases of herpes zoster before developing the disease, while 3 gave a suggestive history of prior contact with chickenpox.A condition indistinguishable from chickenpox occurred among the contacts of 10 patients, 12 individuals being affected, and there was one instance of concurrent herpes zoster and chickenpox. Other infections such as mumps, measles and rubella, while as common in association with the onset of herpes zoster, were not so frequently found as the chickenpox condition amongst contacts of the disease.The results of the survey as regards the relationship of chickenpox and herpes zoster are discussed. It is considered that the evidence does not favour a significant association with chickenpox prior to the onset of herpes zoster, but that the facts are consistent with the view that a condition indistinguishable from chickenpox may follow contact with herpes zoster. It is suggested, however, that this may be a generalized manifestation of the virus of zoster rather than true chickenpox.

Download Full-text

Abstract 5108: Microalbuminuria is Associated with Progression of Coronary Atherosclerosis in the Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽

10.1161/circ.118.suppl_18.s_1147-b ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Andrew P DeFilippis ◽

Holly J Kramer ◽

Ronit Katz ◽

Nathan Wong ◽

Alain Bertoni ◽

...

Keyword(s):

Lipid Lowering ◽

Albumin Creatinine Ratio ◽

Ethnic Study ◽

Median Increase ◽

Increased Risk ◽

History Of ◽

Relationship Of ◽

The Relationship ◽

Progression Of Atherosclerosis

Background: Microalbuminuria (MA) is associated with an increased risk of cardiovascular disease (CVD) but the mechanism by which microalbuminuria imparts this increased risk is not known. In this study we assessed the relationship between MA and the development and progression of atherosclerosis by measuring the incidence of new CAC and the progression of existing CAC in individuals free of clinical CVD. Methods : The Multi-Ethnic Study of Atherosclerosis (MESA) is a prospective cohort study of 6,814 participants free of clinical CVD at entry who underwent assessment of coronary artery calcification (CAC) by computerized tomography at baseline. Overall, 6,775 individuals had data available on urinary albumin creatinine ratio (UACR); 1,109 individuals were excluded for missing data or macroalbuminuria (UACR≥300 mg/g). Incident CAC was defined as detectable CAC at follow-up among those with CAC=0 at baseline, and absolute CAC score change among those with CAC>0 at baseline. Relative risk (RR) regression adjusted for covariates; and multivariable adjusted median regression was employed to assess the independent relationship of MA with CAC incidence and progression. Results : Of the 5,666 subjects (mean age 62±10 years, 48% males), baseline MA was seen in 424 (7%) participants, who were more likely to have CAC compared to those with normal UACR (62% vs. 48%, p<0.0001). During a mean follow-up of 2.4±0.8 years, those with MA were more likely to develop CAC (28% vs. 15%, p<0.0001) and they had a higher absolute median increase in CAC (47 vs. 29 Agatston Units, p<0.0001). After adjustment for age, gender, ethnicity, site, follow-up duration, diabetes, hypertension, smoking, family history of heart attack, total cholesterol, lipid lowering medications and body mass index; MA was associated with incident CAC (RR 1.65; 95%CI 1.41–2.48) among those with CAC=0 at baseline. Among those with CAC>0 at baseline, MA was associated with a median increase in CAC of 7.93 (95%CI 0.38 –15.47) Agatston Units in multivariable adjusted analyses (variables noted above). Conclusion : MA is independently associated with development of incident CAC and progression of CAC in an asymptomatic multi-ethnic population, and may in part explain its associated increased risk of CVD.

Download Full-text

Hydatid Cyst of the Adrenal Gland: A Clinical Study of Six Cases

The Scientific World JOURNAL ◽

10.1100/tsw.2006.375 ◽

2006 ◽

Vol 6 ◽

pp. 2420-2425 ◽

Cited By ~ 8

Author(s):

Ali Horchani ◽

Yassine Nouira ◽

Kais Nouira ◽

Haikel Bedioui ◽

Emna Menif ◽

...

Keyword(s):

Adrenal Gland ◽

Hydatid Cyst ◽

Ct Scan ◽

Preoperative Diagnosis ◽

Laparoscopic Approach ◽

Lumbar Pain ◽

History Of ◽

Relationship Of ◽

The Relationship

Hydatid cyst of the adrenal gland (HCAG) is an exceptional occurrence. We report our experience of six cases of HCAG and discuss the diagnosis and treatment of this hydatid localization. We retrospectively reviewed and analyzed the clinical files of six patients admitted to our institution from January 1990 to December 2000 for HCAG. Patients varied in age from 24—59 years. They were five males and one female. One patient had a history of pulmonary hydatidosis treated surgically 10 years previously. Five patients presented with lumbar pain and one patient had bouts of hypertension, headache, and palpitation. Physical examination was normal except in one patient who was hypertensive. Preoperative diagnosis was highly suggested by ultrasonography. CT scan performed in all cases clearly showed the relationship of the cyst with adjacent organs. Serology tests were positive in two cases. One patient had elevated urine VMA and was operated on with the diagnosis of cystic phaeochromocytoma. All six patients were operated on and had either an adrenalectomy (two cases) or partial pericystectomy (four cases). In one case, partial pericystectomy was conducted through a retroperitoneal laparoscopic approach. The hydatid nature of the cyst was confirmed pathologically. All patients had a smooth postoperative course with no cystic recurrence on follow-up. The diagnosis of HCAG is based mainly on ultrasonography and CT scan. Surgery with either partial or total excision of the cyst, with or without preservation of the adrenal gland, is the treatment of choice.

Download Full-text

Genetic epidemiology of binging and vomiting

The British Journal of Psychiatry ◽

10.1192/bjp.173.1.75 ◽

1998 ◽

Vol 173 (1) ◽

pp. 75-79 ◽

Cited By ~ 75

Author(s):

Patrick F. Sullivan ◽

Cynthia M. Bulik ◽

Kenneth S. Kendler

Keyword(s):

Environmental Factors ◽

Bulimia Nervosa ◽

Complex Traits ◽

Population Based ◽

History Of ◽

Best Fitting ◽

Sources Of Variation ◽

Using Data ◽

Relationship Of ◽

The Relationship

BackgroundBulimia nervosa is typically defined as the combination of the behaviours of binging and vomiting. We sought to clarify the relationship of these behaviours from a genetic epidemiological perspective.MethodUsing data on the lifetime history of binging and vomiting from a personally interviewed population-based sample of female twins (n = 1897), we applied bivariate twin modelling to estimate the sources of variation for these traits.ResultsThe association between having ever binged (23.6%) and having ever induced vomiting (4.8%) was very strong (odds ratio=8.78, P < 0.0001). The best-fitting model indicated that lifetime binging and vomiting were both heritable (46% and 72%) and influenced by individual-specific environmental factors (54% and 28%). The overlap between the genetic (ra = 0.74) and individual-specific environmental factors (re = 0.48) for the two traits was substantial. No violations of the equal environment assumption were evident.ConclusionsIncluding binging and vomiting under the rubric of bulimia nervosa appears to be appropriate. Our data are consistent with the identification of binging and vomiting as complex traits resulting from the interplay of multiple genes and individual-specific environmental influences. In contrast to ‘environmentalist’ theories, our results suggest that genetic influences may be of particular relevance to the aetiology of binging and vomiting.

Download Full-text

Risk factors for systemic thromboembolism after left chamber cardiac thrombi --- A retrospective multi-center study

10.21203/rs.2.14129/v1 ◽

2019 ◽

Author(s):

wei zhou ◽

Shun-yi Shi ◽

Yuan Ji ◽

Xin Chen ◽

Jun Huang ◽

...

Keyword(s):

Medical Records ◽

Heart Function ◽

Multivariate Logistic Regression ◽

Increased Risk ◽

All Cause Mortality ◽

History Of ◽

Multi Center Study ◽

Relationship Of ◽

The Relationship

Abstract Background : We aimed to characterize the independent predictors of systemic thromboembolism (ST) after left chamber thrombi. Methods: A retrospective analysis on the medical records of 175 patients diagnosed with left chamber thrombi by transthoracic echocardiography (TTE) at three centers were carried out. Multivariate logistic regression was performed to determine the relationship of each characteristic with ST. Multivariate Cox proportional survival analysis was conducted, with covariate adjustments, to identify predictors of all-cause mortality. Results: During a median 42 months of follow-up (25th–75th percentile: 20–62 months), 24 (13.7%) patients had ST, and 62 (35.4%) died. History of diabetes and thrombus mobility were independent predictors of ST (P = 0.003, P = 0.02, respectively). There was a significant association between abnormal ejection fraction (EF) and all-cause mortality (P = 0.003). Conclusions: The morbidity associated with ST and the increased risk for mortality associated with left chamber cardiac thrombi relates to medical history, thrombus state, and diminished heart function.

Download Full-text

Cardiorespiratory fitness and atrial fibrillation: A population-based follow-up study

Heart Rhythm ◽

10.1016/j.hrthm.2015.03.024 ◽

2015 ◽

Vol 12 (7) ◽

pp. 1424-1430 ◽

Cited By ~ 44

Author(s):

Hassan Khan ◽

Danesh Kella ◽

Rainer Rauramaa ◽

Kai Savonen ◽

Michael S. Lloyd ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cardiorespiratory Fitness ◽

Population Based ◽

Follow Up Study

Download Full-text

Antithrombotic therapy and the risk of new-onset dementia in elderly patients with atrial fibrillation

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2020-137916 ◽

2020 ◽

pp. postgradmedj-2020-137916

Author(s):

Chun Ka Wong ◽

Duo Huang ◽

Mi Zhou ◽

JoJo Hai ◽

Wen Sheng Yue ◽

...

Keyword(s):

Atrial Fibrillation ◽

Antithrombotic Therapy ◽

Lower Risk ◽

Female Gender ◽

Increased Risk ◽

The Mean ◽

Relationship Of ◽

The Relationship ◽

New Onset

BackgroundAtrial fibrillation (AF) is associated with an increased risk of dementia. Little is known about the relationship of antithrombotic therapy and the risk of dementia in patients with AF without clinical stroke.MethodThis was an observational study based on a hospital AF registry. Patients aged 65–85 years at the time of AF diagnosis were identified via the computerised database of the clinical management system. Patients with prior stroke or known cognitive dysfunction were excluded. The primary outcome was newly diagnosed dementia during the follow-up period.Results3284 patients (mean age 76.4±5.3 years, 51.6% male) were included for analysis. The mean CHA2DS2-VASc score was 3.94±1.44. 18.5% patients were prescribed warfarin, 39.8% were prescribed aspirin and 41.7% were prescribed no antithrombotic therapy. After a mean follow-up of 3.6 years, 71 patients (2.2%) developed dementia, giving rise to an incidence of 0.61%/year. The incidence of dementia were 1.04%/year, 0.69%/year and 0.14%/year for patients on no therapy, aspirin and warfarin, respectively. Both univariate and multivariate analyses showed that age ≥75 years, female gender and high CHA2DS2-VASc score were associated with significantly higher risk of dementia; warfarin use was associated with significantly lower risk of dementia (HR: 0.14%, 95% CI 0.05 to 0.36, p<0.001). Patients on warfarin with time in therapeutic range (TTR) ≥65% had a non-significant trend towards a lower risk of dementia compared with those with TTR <65%.ConclusionIn elderly AF patients, warfarin therapy was associated with a significantly lower risk of new-onset dementia compared those with no therapy or aspirin.

Download Full-text

The Relationship of Acute Bronchiolitis to Bronchial Asthma—A 4-to-14-year Follow-up

PEDIATRICS ◽

10.1542/peds.31.5.859 ◽

1963 ◽

Vol 31 (5) ◽

pp. 859-861

Author(s):

A. H. EISEN ◽

HARRY L. BACAL

Keyword(s):

Bronchial Asthma ◽

Respiratory Infections ◽

Acute Bronchiolitis ◽

Average Period ◽

Familial Incidence ◽

History Of ◽

Relationship Of ◽

The Relationship ◽

Allergic Manifestations

Of 63 patients suffering a single attack of acute bronchiolitis in infancy, 16 (25.4%) were found to have bronchial asthma on follow-up 4 to 14 years later. The familial incidence of allergic manifestations was high (62%) in this group. Thirteen patients (20.6%) continued to have attacks of wheezing associated with respiratory infections. This tendency to wheeze gradually subsided after an average period of five years. The ultimate prognosis of these children is not known. The presence of a positive immediate family history of allergy in an infant with bronchiolitis considerably alters the usually excellent prognosis. The first attack of bronchiolitis may be a form of respiratory allergic manifestation in an already potentially asthmatic infant.

Download Full-text

Associations of a healthy lifestyle score from childhood to adulthood with subclinical kidney damage in midlife: a population-based cohort study

BMC Nephrology ◽

10.1186/s12882-021-02627-0 ◽

2022 ◽

Vol 23 (1) ◽

Author(s):

Conghui Liu ◽

Jing Tian ◽

Matthew D. Jose ◽

Ye He ◽

Terence Dwyer ◽

...

Keyword(s):

Cohort Study ◽

Healthy Lifestyle ◽

Later Life ◽

Population Based ◽

Kidney Damage ◽

Urine Albumin ◽

Sum Scores ◽

Relationship Of ◽

The Relationship

Abstract Background The relationships of healthy lifestyle scores (HLS) of various kinds in adulthood with the risk of chronic kidney disease (CKD) have been reported, but little is known about the association of childhood lifestyle with later life CKD. This study examined the relationship of HLS from childhood to adulthood with subclinical kidney damage (SKD) in midlife, a surrogate measure for CKD. Methods Data were collected in an Australian population-based cohort study with 33 years follow-up. 750 participants with lifestyle information collected in childhood (ages 10–15 years) and midlife (ages 40–50 years), and measures of kidney function in midlife were included. The HLS was generated from the sum scores of five lifestyle factors (body mass index, smoking, alcohol consumption, physical activity, and diet). Each factor was scored as poor (0 point), intermediate (1 point), or ideal (2 points). Log-binomial regression was used to investigate the relationship of HLS in childhood and from childhood to adulthood with SKD defined as either 1) estimated glomerular filtration rate (eGFR) 30–60 mL/min/1.73m2 or 2) eGFR> 60 mL/min/1.73m2 with urine albumin-creatinine ratio ≥ 2.5 mg/mmol (males) or 3.5 mg/mmol (females), adjusting for socio-demographic factors and the duration of follow-up. Results The average HLS was 6.6 in childhood and 6.5 in midlife, and the prevalence of SKD was 4.9% (n = 36). Neither HLS in childhood nor HLS from childhood to adulthood were significantly associated with the risk of SKD in midlife. Conclusions A HLS from childhood to adulthood did not predict SKD in this middle-aged, population-based Australian cohort.

Download Full-text