Abstract 19811: Circulating Soluble ST2 Levels are Independent of Cardiac Production after Acute Myocardial Injury

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Vincent Y See ◽  
Jessica Fugate ◽  
Gagandeep Gurm ◽  
Dawn Ament ◽  
Timm-Michael Dickfeld ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Cardiac Disease ◽  
Myocardial Injury ◽  
Cardiac Injury ◽  
Acute Injury ◽  
Soluble St2 ◽  
Decoy Receptor ◽  
Before And After ◽  
Acute Myocardial Injury

Background: Soluble ST2 (sST2) is a decoy receptor that modulates the anti-hypertrophic and anti-fibrotic IL-33/ST2 pathway. sST2 is associated with adverse prognosis in HF and ACS; both states are associated with cardiac injury. However, sST2 levels are also increased in non-cardiac disease. To determine the extent of cardiac production of sST2 both chronically and after acute myocardial injury, we measured fractional cardiac production of sST2 compared to the cardiac specific injury marker high sensitive (hs) cTnT before and after elective cardiac ablation. Methods: Twenty-three patients undergoing ablation of atrial fibrillation were enrolled [Caucasian 22 (96%); Male 17 (74%); Age 57.7±10.4 years; eGFR 58.7 ± 0.6 mL/min/1.73m2). Of the 23, 15 (65%) had paroxysmal atrial fibrillation. At baseline, 14 (61%) were in sinus rhythm. Samples were obtained from the radial artery and coronary sinus (CS) pre- and post-ablation. sST2 was measured by the Presage assay. Post ablation samples were measured 201±44 minutes after the first ablation. Results: At baseline, in contrast to cTnT, there was no cardiac production of sST2. Both arterial and CS levels of sST2 increased after ablation but not nearly to the extent of cTnT. No net cardiac production of sST2 was noted (Table). Conclusion: Cardiac production of sST2 is not observed at baseline. Systemic sST2 levels modestly increase following acute myocardial injury. Despite direct myocardial injury, no cardiac production of sST2 is observed. The source of sST2 is extra-cardiac both chronically and after acute injury.

scholarly journals Acute myocardial injury in mdx hearts ameliorated by ARB but not ACE inhibitor treatment

2019 ◽  
Author(s):  
Tatyana A. Meyers ◽  
Jackie A. Heitzman ◽  
DeWayne Townsend
Keyword(s):  
Ace Inhibitors ◽  
Myocardial Injury ◽  
Angiotensin Receptor Blockers ◽  
Cardiac Injury ◽  
Muscle Disease ◽  
Acute Injury ◽  
Protective Actions ◽  
Acute Myocardial Injury ◽  
Receptor Blockers ◽  
Inhibitor Treatment

AbstractDuchenne muscular dystrophy (DMD) is a devastating muscle disease that afflicts males due to the loss of the protein dystrophin, resulting in muscle deterioration and cardiomyopathy. Dystrophin’s absence causes increased membrane fragility, myocyte death, and tissue remodeling. Inhibition of angiotensin signaling with ACE inhibitors or angiotensin receptor blockers (ARBs) is a mainstay of DMD therapy, with clinical guidelines recommending starting one of these therapies by the age of 10 to address cardiomyopathy.Using the mdx mouse model of DMD, we previously showed that isoproterenol causes extensive damage in dystrophic hearts, and treatment with the ARB losartan starting only 1 hour before isoproterenol dramatically reduced this myocardial injury. In the present study, we probed whether ACE inhibitors, which are more frequently prescribed, can deliver similar protection. Surprisingly, lisinopril treatment initiated 1 hour before isoproterenol failed to demonstrate any effect on injury in mdx hearts. Further, with a 2-week pretreatment, only losartan significantly lowered mdx cardiac injury, without any benefit associated with lisinopril treatment. These results confirm the ability of ARBs, but not ACE inhibitors, to prevent acute injury in mouse hearts, and prompt the question whether ARBs should be more frequently used for DMD cardiomyopathy because of these potential protective actions.

scholarly journals Are Three Weeks of Oral Anticoagulation Sufficient for Safe Cardioversion in Atrial Fibrillation?

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 554
Author(s):  
Stefan Naydenov ◽  
Nikolay Runev ◽  
Emil Manov
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Oral Anticoagulation ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Open Label ◽  
Before And After ◽  
Individualized Approach ◽  
Baseline Factors ◽  
And Function

Background and Objectives: Patients with atrial fibrillation (AF), lasting >48 h, considered for cardioversion, are recommended ≥3 weeks of oral anticoagulation before sinus rhythm restoration because of high risk of development of left atrial thrombosis (LAT) and stroke. However, the optimal duration of anticoagulation in the presence of overt LAT is unknown. Materials and Methods: An open-label study aimed to investigate the prevalence of spontaneous echo contrast (SEC) and LAT before and after 3 weeks of direct oral anticoagulant (DOAC) treatment. We included 51 consecutive patients (50.9% males), mean age 69.3 ± 7.4 years with paroxysmal/unknown duration of AF, considered for cardioversion, who agreed to have transesophageal echocardiography at enrollment and 3 weeks later. Results: At baseline SEC was present in 26 (50.9%) and LAT in 10 (19.6%) of 51 patients. After 3 weeks on DOAC, SEC persisted in 12 (25.0%) and LAT in 7 (14.5%) of 48 patients, p < 0.05 vs. baseline. Factors, associated most strongly with persistence of SEC/LAT, were left atrial appendage (LAA) emptying velocity <20 cm/s (OR = 2.82), LAA lobes >2 (OR = 1.84), and indexed left atrial volume ≥34 mL/m2 (OR = 1.37). Conclusions: In our study the incidence of SEC/LAT, particularly in AF with unknown duration, was not as low as we expected. The prevalence of SEC/LAT seemed to be dependent on factors not routinely evaluated in AF patients planned for cardioversion (indexed LA volume, LAA morphology and number of lobules, LAA emptying velocity, etc.). Our data suggested an individualized approach for DOAC duration in AF patients before an attempt for restoration of sinus rhythm is made, taking into consideration the LAA morphology and function.

scholarly journals Acute Myocardial Injury of Patients with Coronavirus Disease 2019

2020 ◽  
Author(s):  
Huayan Xu ◽  
Keke Hou ◽  
Hong Xu ◽  
Zhenlin Li ◽  
Huizhu Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Injury ◽  
Cardiac Injury ◽  
Cardiac Complications ◽  
Chronic Obstructive ◽  
C Reactive Protein ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
Acute Myocardial Injury ◽  
Novel Coronavirus

AbstractBackgroundSince the outbreak of the Coronavirus Disease 2019 (COVID-19) in China, respiratory manifestations of the disease have been observed. However, as a fatal comorbidity, acute myocardial injury (AMI) in COVID-19 patients has not been previously investigated in detail. We investigated the clinical characteristics of COVID-19 patients with AMI and determined the risk factors for AMI in them.MethodsWe analyzed data from 53 consecutive laboratory-confirmed and hospitalized COVID-19 patients (28 men, 25 women; age, 19–81 years). We collected information on epidemiological and demographic characteristics, clinical features, routine laboratory tests (including cardiac injury biomarkers), echocardiography, electrocardiography, imaging findings, management methods, and clinical outcomes.ResultsCardiac complications were found in 42 of the 53 (79.25%) patients: tachycardia (n=15), electrocardiography abnormities (n=11), diastolic dysfunction (n=20), elevated myocardial enzymes (n=30), and AMI (n=6). All the six AMI patients were aged >60 years; five of them had two or more underlying comorbidities (hypertension, diabetes, cardiovascular diseases, and chronic obstructive pulmonary disease). Novel coronavirus pneumonia (NCP) severity was higher in the AMI patients than in patients with non-definite AMI (p<0.001). All the AMI patients required care in intensive care unit; of them, three died, two remain hospitalized. Multivariate analyses showed that C-reactive protein (CRP) levels, NCP severity, and underlying comorbidities were the risk factors for cardiac abnormalities in COVID-19 patients.ConclusionsCardiac complications are common in COVID-19 patients. Elevated CRP levels, underlying comorbidities, and NCP severity are the main risk factors for cardiac complications in COVID-19 patients.

scholarly journals Device-detected atrial fibrillation before and after acute cardiac events: insights from ASSERT

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
WF Mcintyre ◽  
J Wang ◽  
EP Belley-Cote ◽  
JD Roberts ◽  
AP Benz ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Event ◽  
Hypertensive Crisis ◽  
Cardiac Injury ◽  
Coronary Intervention ◽  
Prior History ◽  
Cardiac Events ◽  
Funding Sources ◽  
Before And After ◽  
History Of

Abstract Funding Acknowledgements Type of funding sources: None. Background Atrial fibrillation (AF) that is first detected concurrently with or shortly after another cardiac event is often thought to be caused by acute cardiac injury, and therefore reversible. Methods ASSERT enrolled patients &gt;65 years old with hypertension and a pacemaker, but without known AF. We evaluated participants who had a cardiac event [angina/myocardial infarction (MI), cardiac catheterization/percutaneous coronary intervention (PCI), cardiac surgery or other (e.g. pericarditis, hypertensive crisis)] and compared the prevalence of device-detected AF before and after these events. Results Among 2580 participants, 178 (6.9%) had at least one cardiac event over a mean 2.5 years of follow-up. In the 30 days following a first cardiac event, the prevalence of device-detected AF &gt;6 min was 12.4% (95% confidence interval [CI] 7.9%-18.1%), which was higher than in the 30 days before the event (12.4% versus 4.5%, P = 0.004) (Figure 1). The prevalence of device-detected AF following the event was comparable across event subtypes (MI: 13.8%, 95%CI 7.9-18.1%; PCI: 6.9%, 95%CI 1.9-16.7%; Surgery: 20.0%, 95%CI 5.7-43.7%; Other: 18.5%, 95%CI 6.3-38.1%). There was a significant association between device-detected AF in the 6 months before a cardiac event and device-detected AF in the 30 days after a cardiac event: odds ratio (OR, adjusted for CHA2DS2-VASc score) for episodes &gt;6 min 7.07 (95%CI 2.07-24.19; P = 0.002); adjusted OR for episodes &gt;24 hours: 11.41 (95%CI 1.47-88.43; p = 0.020). Conclusions Acute cardiac events are associated with an increase in the prevalence of device-detected AF. These episodes are associated with a prior history of device-detected AF. Abstract Figure 1

scholarly journals Heartbeat Cycle Length Detection by a Ballistocardiographic Sensor in Atrial Fibrillation and Sinus Rhythm

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Matthias Daniel Zink ◽  
Christoph Brüser ◽  
Patrick Winnersbach ◽  
Andreas Napp ◽  
Steffen Leonhardt ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Sinus Rhythm ◽  
Quality Index ◽  
Cycle Length ◽  
Heart Rate Monitoring ◽  
Mechanical Vibrations ◽  
Before And After ◽  
Registration Number ◽  
Novel Algorithm

Background.Heart rate monitoring is especially interesting in patients with atrial fibrillation (AF) and is routinely performed by ECG. A ballistocardiography (BCG) foil is an unobtrusive sensor for mechanical vibrations. We tested the correlation of heartbeat cycle length detection by a novel algorithm for a BCG foil to an ECG in AF and sinus rhythm (SR).Methods.In 22 patients we obtained BCG and synchronized ECG recordings before and after cardioversion and examined the correlation between heartbeat characteristics.Results.We analyzed a total of 4317 heartbeats during AF and 2445 during SR with a correlation between ECG and BCG during AF ofr=0.70(95% CI 0.68–0.71,P<0.0001) andr=0.75(95% CI 0.73–0.77,P<0.0001) during SR. By adding a quality index, artifacts could be reduced and the correlation increased for AF to 0.76 (95% CI 0.74–0.77,P<0.0001,n=3468) and for SR to 0.85 (95% CI 0.83–0.86,P<0.0001,n=2176).Conclusion.Heartbeat cycle length measurement by our novel algorithm for BCG foil is feasible during SR and AF, offering new possibilities of unobtrusive heart rate monitoring. This trial is registered with IRB registration number EK205/11. This trial is registered with clinical trials registration numberNCT01779674.

scholarly journals An Echocardiographic Study of Atrial Fibrillation in Horses: Before and After Conversion to Sinus Rhythm

1995 ◽  
Vol 9 (5) ◽  
pp. 336-340 ◽  
Author(s):  
Celia M. Marr ◽  
Virginia B. Reef ◽  
Johanna M. Reimer ◽  
Raymond W. Sweeney ◽  
Stuart W.J. Reid
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Echocardiographic Study ◽  
Before And After

P179 Alterations of resting heart rate and heart rate viability after cryoballon ablation in the patients with paroxysmal atrial fibrillation

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
S Sakabe ◽  
K Maeno ◽  
H Yamagishi ◽  
K Unno ◽  
T Mori ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Sinus Rhythm ◽  
Vena Cava ◽  
Male Gender ◽  
Cryoballoon Ablation ◽  
Resting Heart Rate ◽  
Cardiac Autonomic Nervous System ◽  
Significant Difference ◽  
Before And After

Abstract Background While it is generally accepted that cardiac autonomic nervous system (CANS) plays an important role in atrial fibrillation (AF) and pulmonary vein isolation (PVI) by radiofrequency catheter ablation modifies the ganglionated plexi (GP), the alterations of CANS after PVI are not clarified. Purpose The objective of this study was to investigate the alteration of CANS after conventional cryoballoon ablation (CBA) by using a non-invasive examination method of measuring resting heart rate (R-HR) and coefficient of variation of R-R interval (CVR-R) which is a representative parameter of heart rate viability. CVR-R reflects R-R interval variation affected by respiration. It is calculated from the R-R interval of consecutive 100 heart beats of sinus rhythm recorded at rest. Declines of CVR-R indicate the parasympathetic dysfunction and the normal range of it varies depend on the age. As age increases from 30s to 70s, the average value of CVR-R decreases from 4.0% to 2.4%. Methods Consecutive patients of paroxysmal AF treated with initial CBA in our institute participated. Subjects were limited to the patients who maintained sinus rhythm through the study and whose prescription had not been changed after procedure. All patients recorded 12-lead electrocardiogram to measure R-HR and CVR-R before and the day after the procedure. We compared R-HR and CVR-R of all patients before and after CBA. And in addition, we compared them in each of two groups whose pre-procedural H-RH were under 50 bpm (Group-U50) and over 70 bpm (Group-O70). All procedures were performed with second generation 28mm cryoballoon (CB)s under the conscious sedation with Dexmedetomidine. CB temperature was down to a minimum of -60°C and target application time was 180 seconds. Results In the procedure of all 105 patients (male gender, 54%; age, 66.9 ± 10.4years; CHADS2score, 1.15 ± 1.04; diabetes mellitus,14%; beta-blocker therapy, 16%), 1 of touch-up for PVI, 6 of supra vena cava isolation and 21 of cavotricuspid isthmus linear ablations with radiofrequency catheter were added. In all patients, R-HR increased from 58.9 ± 9.2bpm to 72.4 ± 9.5bpm (P &lt; 0.01) and CVR-R decreased from 2.36 ± 1.08% to 1.24 ± 0.68% (P &lt; 0.01), respectively. In Group-U50 (n = 14; male gender 64%; age 67.6 ± 12.4 years), R-HR increased from 47.1 ± 2.1bpm to 64.4 ± 7.9bpm (P &lt; 0.01) and CVR-R decreased from 2.58 ± 1.59% to 1.34 ± 0.82% (P &lt; 0.01), respectively. In Group-O70 (n = 17; male gender 43%; age 67.4 ± 12.6 years), R-HR increased from 73.7 ± 2.8bpm to 81.8 ± 7.4bpm (P &lt; 0.01) and CVR-R decreased from 2.33 ± 0.94% to 1.14 ± 0.52% (P &lt; 0.01), respectively. Values of CVR-R before and after CBA showed no significant difference between the two groups. Conclusions After CBA, R-HR increment and CVR-R decrement were significantly observed. CVR-R was halved regardless of pre–procedural R-HR. Damages to GP by CBA would be reflected as denervation of vagus nerves in CANS. R-HR increase might be associated with parasympathetic suppression of CANS.

scholarly journals Exercise in Patients with Non-cardiac Myocardial Injury under Optical Microscope

2021 ◽  
Vol 271 ◽  
pp. 03024
Author(s):  
Hailian Zhang ◽  
Changlong Wang ◽  
Lijun Wang
Keyword(s):  
Therapeutic Effect ◽  
Myocardial Injury ◽  
Exercise Intervention ◽  
Cardiac Injury ◽  
Myocardial Damage ◽  
Optical Microscope ◽  
Good Effect ◽  
Before And After ◽  
Injury Treatment ◽  
Rehabilitation Exercise

In recent years, the incidence of cardiovascular disease has been increasing year by year, has gradually developed into a global health problem, in the world wide concern. Non - cardiac injury is one of the most common cardiovascular diseases. The rehabilitation of patients with non-cardiac myocardial injury is related to their life and quality of life. Rehabilitation exercise is helpful to improve the therapeutic effect of patients. The purpose of this paper is to explore the specific effects of rehabilitation exercise on non-cardiac myocardial injury and to promote the full play of the role of rehabilitation exercise in the treatment of noncardiac myocardial injury. First to illustrate the application of optical microscope, and then from the specific reflection of non cardiac myocardial damage and formation mechanism are introduced, based on the cases were retrospectively analyzed experiment, to explore the rehabilitation exercise in the cardiac effects of myocardial injury treatment, and on the basis of this puts forward the corresponding scientific rehabilitation exercise plan. Experimental results show that compared with the rehabilitation exercise intervention before and after rehabilitation exercise intervention, non cardiac myocardial injury in the therapeutic effect of 17% or so, in the treatment of speed increased by about 21%, in the recurrence rate was reduced by 17% or so, so sports in promoting the cardiac myocardial injury treatment has good effect.

scholarly journals Total NT-proBNP, a novel biomarker in atrial fibrillation. A mechanistic analysis of the GISSI-AF trial

2020 ◽  
Author(s):  
Lidia Staszewsky ◽  
Jennifer Meessen ◽  
Deborah Novelli ◽  
Ulla Wienhues-Thelen ◽  
Marcello Disertori ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Sinus Rhythm ◽  
Myocardial Injury ◽  
The Novel ◽  
Circulating Biomarkers ◽  
History Of ◽  
One Year ◽  
Af Recurrence

AbstractObjective(1) to test the association with prevalent and incident atrial fibrillation (AF), and prognosis of total N-terminal pro-B type natriuretic peptide (total NT-proBNP) and of a panel of biomarkers; (2) to assess iwhether the extent of glycosylation affects the relation of NT-proBNP with AF.MethodsIn a sub-study of the GISSI-AF trial on 382 patients in sinus rhythm with a history of AF, echocardiographic variables and eight circulating biomarkers were serially assayed over one year. The relations between circulating baseline biomarkers and AF and the risk of CV events, were assessed by Cox-analysis models adjusting the first by clinical variables, the second by clinical variables and the echocardiographic left-atrial-minimum-volume-index (LAVImin).ResultsOver a median follow-up of 365 days, 203/382 patients (53.1%) had at least one recurrence of AF and 16.3% were hospitalized for cardiovascular (CV) reasons. Total NT-proBNP, NT-proBNP, angiopoietin 2 (Ang2), myosin binding protein (MyBPC3) and bone morphogenic protein-10 (BMP-10) were strongly associated to ongoing AF. Natriuretic peptides and MyBPC3 predicted recurrent AF but this lost significance after adjustment for LAVImin. NT-proBNP and Ang2 predicted CV hospitalization even after adjustment for LAVImin, HR95%CI: 2.20 [1.02-4.80] and 5.26 [1.16-23.79].ConclusionsThe association of AF recurrence with the novel biomarker total NT-proBNP, is similar to that of NT-proBNP, suggesting no influence of glycosylation. Ang2, MyBPC3 and BMP10 were strongly associated with AF, indicating a possible role of extracellular matrix and myocardial injury. Abstract-words=233Key messagesWhat is already known on this subject?It is still complicated to predict the recurrence of AF in patients in sinus rhythm with a recent history of AF. Though several biomarkers have been associated with AF, few of them have proved to be independent predictors for recurrent AF or cardiovascular (CV) events. Their predictive sensitivity and specificity is modest at best. Previous studies showed that NT-proBNP was possibly the strongest predictor of recurrent AF and CV hospitalization. Natriuretic peptides circulate to a large extent as glycosylated molecules and a novel assay is now available to measure the glycosylated and non-glycosylated NT-proBNP in plasma, the total NT-proBNP. The extent of glycosylation varies in different diseases.What might this study add?No studies have assessed (a) the extent of NT-proBNP glycosylation in AF, or (b) the association and predictive value in patients with AF of total NT-proBNP. A multimarker approach, ratter than one based on a single biomarker, might predict AF better.The relation with AF of the novel biomarker, total NT-proBNP, is as strong as that of NT-proBNP, suggesting no-influence of glycosylation.Two biomarkers, MyBPC3, secreted few minutes after myocardial injury and Ang-2, involved in inflammation and coagulation, were strongly associated to AF.How might this impact on clinical practice?The identification of novel circulating biomarkers could have a direct impact on clinical practice when predicting the occurrence of AF, but unfortunately current data do not allow predictions based on biomarkers.The associations of different biomarkers with ongoing AF may cast light on the mechanisms of triggering and maintenance of AF.Strengths and limitations of this studyThe data came from to a multicenter randomized clinical trial with available concomitant serial echocardiographic and circulating biomarkers recorded and evaluated centrally, hence with minimal bias; AF recurrence during a 12-month follow up was checked weekly by trans-telephonic electrocardiographic monitoring, and with 12-lead ECG every six months.A comparative analysis of total NT-proBNP with other novel biomarkers and echocardiographic variables has never been done so far. The possible added value of total NT-proBNP to the benchmark biomarker NT-proBNP was assessed on the basis of different dimensions of performance, as recently proposed for new biomarkers. The main limitations are (1) the relatively small numbers of patients with AF during follow-up visits, (2) the very low prevalence of patients with other cardiac diseases such as coronary artery disease and heart failure, and (3) consequently, the low incidence of clinical events in one-year follow-up.

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