scholarly journals The preablation monocyte/ high density lipoprotein ratio predicts the late recurrence of paroxysmal atrial fibrillation after radiofrequency ablation

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
She-an Chen ◽  
Man-man Zhang ◽  
Meifang Zheng ◽  
Fei Liu ◽  
Lei Sun ◽  
...  

Abstract Background The monocyte/high-density lipoprotein ratio (MHR) has emerged as a promising alternative biomarker in the fields of cardiovascular disease and atrial fibrillation (AF). This retrospective study was aimed to explore the predictive value of the MHR for the late recurrence of AF after radiofrequency ablation. Methods From April 2015 to October 2018, patients with paroxysmal AF who had undergone radiofrequency catheter ablation at Subei People’s Hospital of Jiangsu Province were enrolled in our study. All the participants were observed until November 2019 after the procedure. During the postoperative follow up, the patients were categorized into the recurrence group and maintenance of sinus rhythm group based on who had experienced AF recurrence. Results One hundred twenty-five patients were diagnosed with paroxysmal AF, with an average age of 61.2 ± 9.3 years. Forty-seven patients had developed late recurrence during a mean follow up of 25.1 ± 12.0 months. The AF recurrence event rates were significantly increased in the highest MHR tertile compared with those in the lowest MHR tertile (22.0% vs. 57.1%; P < 0.05). On multivariate logistic regression analysis, the preablation MHR (OR = 1.34; 95% CI = 1.12 ~ 1.60; P = 0.001) and left atrial diameter (LAD) (OR = 1.21, 95% CI = 1.08 ~ 1.35; P = 0.001) were independent risk factors predicting the recurrence of AF after radiofrequency ablation. Furthermore, receiver operating characteristic (ROC) curve analysis revealed that the area under the curve (AUC) of the MHR was 0.712 (95% CI = 0.618 ~ 0.806; P = 0.000) and that of LAD was 0.739 (95% CI = 0.653 ~ 0.814; P = 0.000). Z-test found no significant difference between the MHR and LAD regarding the AUC (Z = 0.451; P = 0.652). Conclusion An elevated preablation MHR was associated with an increased risk of the postoperative recurrence of AF. Additionally, the MHR independently predicted the late recurrence of paroxysmal AF after radiofrequency ablation, with the same predictive value as LAD.

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Rafeal L Baker ◽  
Jean N Utumatwishima ◽  
Stephanie T Chung ◽  
Anne E Sumner

Introduction: For Africans living in the United States, the extent to which stress-induced physiologic dysfunction varies by reason for immigration is unknown. Allostatic load score (ALS) is used to assess physiologic stress. ALS has biomarkers in 3 domains: cardiovascular, metabolic and immune. However, there are many ALS equations and the number of biomarkers in each domain varies. In the cardiac domain of ALS, equations use either triglyceride (TG) or high density lipoprotein (HDL). A specific problem for African descent populations is that HDL may be superior to TG as a marker of insulin resistance and cardiac risk. Objective: Our primary goal in 95 African immigrants (71% male, age 42±10, (mean±SD), range 22-62y) was to determine if ALS varied by reason for immigration. Our secondary goal was to evaluate 4 different ALS equations to determine if there was a difference in ALS performance depending on whether HDL or TG was the included biomarker. Methods and Results: For all 4 equations, the reasons for immigration from lowest to highest ALS were: family reunification, lottery for self and immediate family, marriage, asylum, work and study (Figure 1). As the first 3 reasons for immigration promoted family unity, they were grouped together (Group 1). The Africans who came for other reasons were grouped together (Group 2). Equations 1 and 2 included HDL as a biomarker. For these equations, ALS in Group 1 vs. Group 2 were: 1.7±1.3 vs. 2.8±1.7, P <0.01 and 1.4±1.2 vs. 2.3±1.7, P <0.01 resp. Equations 3 and 4 used TG. For these two equations ALS in Group 1 vs. Group 2 were: 2.2±1.6 vs. 2.9±2.0, P =0.08 and 2.1±1.4 vs. 2.9±2.0, P =0.03 resp. In Equations 1 and 2, when HDL was replaced by TG, the significant difference in ALS between groups declined. In Equations 3 and 4, when TG was replaced by HDL, the significant difference in ALS between groups increased. Conclusions: ALS varies by reason for immigration and is easier to detect in ALS equations which use HDL rather than TG.


2021 ◽  
Vol 9 (4) ◽  
pp. 65-68
Author(s):  
Noor Muhammad Marwat ◽  
Shah Khalid ◽  
Pir Muhammad Abdul Aziz Shah ◽  
Fayaz ul Hasnain ◽  
Rashid Naeem Khan

Purpose: The purpose of this study to find out the impacts of a 6-weeks supervised aerobic exercise protocol on High-Density Lipoprotein among adults aged between 25-35 years was evaluated. Methodology: Researchers through a non-probability sampling procedure selected thirty (30) volunteers ranging from 25-35 untrained adults from Lakki Marwat. Researchers used a six-week aerobic exercise protocol to collect relevant information from the targeted dependent variables. The CHOD PAP method was used to measure the High-Density Lipoprotein (HDL) of adults. All the data collected from pre-and post- (HDL) tests were recorded in numerical form and analyzed by using a t-test. Main Findings: The results of the study indicate that the six-week aerobic exercise protocol program had no significant difference on pre-and post-intervention quantities of HDL of Experimental Group which is (P>0.05). The implication of the Study: The aerobic exercise programs used for this particular study may help adults to improve and maintain their health status, proper social stature, and lipid profile. An increase in the HLD is ideal as this increase in the HDL helps to prevent cardiovascular diseases particularly the heart valves from stroke and cardiac arrest and academic achievements of the participants. Novelty: So far, no particular research has been conducted on the social implications of exercise effects on adults. Future researchers may work on the social habits of physically fit adults and their input to society.


2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Ali H. Hachem ◽  
Joseph E. Marine ◽  
Housam A. Tahboub ◽  
Sana Kamdar ◽  
Shaffi Kanjwal ◽  
...  

Background. Pulmonary vein isolation is commonly performed using radiofrequency energy with cryoablation gaining acceptance. We performed a meta-analysis of randomized controlled trials which compared radiofrequency versus cryoablation for patients with atrial fibrillation. Methods. A systematic search strategy identified both published and unpublished articles from inception to November 10, 2016, in multiple databases. The primary outcomes for this meta-analysis were long-term freedom from atrial fibrillation at 12-month follow-up and overall postoperative complication rates. For all included studies, the methodological quality was assessed through the Cochrane Collaboration’s tool for risk of bias. Results. A total of 247 articles were identified with eight being included in this review as they satisfied the prespecified inclusion criteria. Overall, there was no significant difference in freedom from atrial fibrillation at ≥12-month follow-up between those receiving cryoballoon and radiofrequency ablation, respectively (OR = 0.98, CI = 0.67–1.43, I2 = 56%, p=0.90). Additionally, the secondary outcomes of duration of ablation, fluoroscopy time, and ablation time failed to reach significance. Cryoballoon ablation had significantly greater odds of postoperative phrenic nerve injury at 12-month follow-up. Conclusions. Our meta-analysis suggests that cryoballoon ablation provides comparable benefits with regard to freedom from atrial fibrillation at medium-term follow-up, fluoroscopy time, ablation time, operative duration, and overall complication rate in comparison to radiofrequency ablation.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Catherine Rahilly-Tierney ◽  
Howard D Sesso ◽  
J. Michael Gaziano ◽  
Luc Djousse

BACKGROUND: Few studies have examined prospectively the relationship between baseline high-density lipoprotein (HDL) cholesterol and longevity. OBJECTIVES: We sought to examine whether higher HDL levels were associated with lower risk of all-cause, cardiovascular (CVD), and non-CVD mortality prior to age 90 in the Physicians’ Health Study (PHS). METHODS: We considered a baseline cohort of 1351 PHS participants who provided bloods between 1997 and 2001 and were old enough to reach age 90 by March 4, 2009. Included subjects had complete baseline data on HDL and total cholesterol; lifestyle factors including smoking, exercise, alcohol consumption, and BMI; and comorbidities including hypertension, diabetes mellitus, congestive heart failure, cancer, and stroke. We used Cox proportional hazards to determine the HRs and 95% CIs for all-cause, CVD, and non-CVD mortality prior to age 90, adjusting for baseline age, co-morbidities, and non-HDL cholesterol. RESULTS: At baseline, the cohort had a mean (SD) age of 81.9 (2.9) years and a mean (SD) HDL cholesterol of 44.8(16.5) mg/dL. After a mean follow-up of 6.8 years (maximum 12.3 years), 501 (37.1%) of men died prior to age 90. In multi-variable adjusted analyses, men in the highest HDL-C quartile (≥54.1 mg/dL) had a 28% lower risk (HR 0.72, 95% CI 0.55-0.95) of all-cause mortality prior to age 90 compared to men in the lowest HDL-C quartile (<32.8 mg/dL). From the lowest to highest HDL quartile, age-adjusted HR(95%CI) for CVD mortality prior to age 90 were 0.66 (0.44-0.99), 0.58 (0.38-0.90), and 0.53 (0.34-0.82) (p for trend 0.004). There was no significant association between baseline HDL cholesterol and non-CVD death. CONCLUSION: In a cohort of older male physicians with long-term follow-up, baseline HDL cholesterol was inversely associated with the risk of dying prior to age 90, largely explained by an inverse association between HDL and CVD mortality.


1979 ◽  
Vol 25 (7) ◽  
pp. 1309-1313 ◽  
Author(s):  
C Mayfield ◽  
G R Warnick ◽  
J J Albers

Abstract Commercial heparin preparations (18 lots) from seven manufacturers were compared in the heparin-Mn2+ procedure for high-density-lipoprotein cholesterol quantitation. With normotriglyceridemic samples, 16 heparin lots, isolated from porcine intestinal mucosa, gave mean values for supernatant cholesterol that did not differ statistically; all were within 7 mg/L. Two heparin preparations from bovine lung gave results that were slightly (16 mg/L, average) but significantly (p less than 0.005) lower. With hypertriglyceridemic samples, we observed greater variation in supernatant cholesterol among the heparin preparations, which was ascribable to variable sedimentation by centrifugation of very-low-density and low-density lipoproteins precipitated by heparin-Mn2+ treatment. If the precipitated lipoproteins were completely removed by an ultrafiltration procedure, we saw no significant difference among the heparin preparations for results with hypertriglyceridemic samples.


1992 ◽  
Vol 285 (1) ◽  
pp. 105-112 ◽  
Author(s):  
Q Xu ◽  
G Jürgens ◽  
L A Huber ◽  
G Böck ◽  
H Wolf ◽  
...  

The nature and physiological importance of high-density lipoprotein (HDL) binding sites on unstimulated (resting) and mitogen-activated (blast) human peripheral blood lymphocytes were investigated. Specific HDL binding on resting and blast T-lymphocytes was saturable at 50 micrograms of 125I-HDL/ml and of high affinity, with Kd values of 8.1 x 10(-8) M and 6.5 x 10(-8) M, respectively, and Bmax. values of 79 ng and 180 ng/mg of cell protein respectively at 4 degrees C. Binding of HDL double-labelled with fluorescent dioctadecylindocarbocyanine (Dil) and isotope (125I) as well as of single fluorescence- or isotope-labelled HDL was inhibited competitively by HDL apoproteins. Studies of the cholesterol flux between the cells and HDL showed that HDL, low-density lipoprotein (LDL) or BSA at a concentration of 100 micrograms/ml in the tissue culture medium did not result in a significant difference in exogenous [3H]cholesterol efflux from the cell membrane at 37 degrees C. Proliferating T-blasts incorporated more cholesterol from HDL or LDL than did resting lymphocytes. When the cells were pulsed with 125I-HDL and chased in fresh lipid-free medium, up to 80% of the radioactivity released was not precipitable with trichloroacetic acid. This percentage decreased in a competitive manner when unlabelled HDL was present in the chase incubation medium. Finally, cultivation of lymphocytes with conditioned medium from macrophages increased Dil-HDL binding/uptake, while it was decreased by mevinolin-induced inhibition of hydroxymethylglutaryl-coA reductase. In conclusion, human lymphocytes possess a HDL binding site (receptor) responsible for lipid binding/uptake and concomitant internalization and degradation of apoproteins from HDL, but not for reverse cell membrane cholesterol transport. The activity of the binding site is up-regulated during cell proliferation and down-regulated during cell growth suppression.


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