scholarly journals Left Atrial Deformation And Risk of Transient Ischemic Attack And Stroke In Paroxysmal Atrial Fibrillation

2021 ◽  
Author(s):  
Jian Chen ◽  
Ying Zhao ◽  
Changsheng Ma ◽  
Xin Du ◽  
Yihua He
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Regression Analysis ◽  
Linear Regression ◽  
Body Mass ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Linear Regression Analysis ◽  
Volume Index ◽  
Chamber View

Abstract Left atrial (LA) remodeling is closely related to cerebral stroke, but the relationship between impaired deformability of LA in early stages and stroke/TIA is not clear. The aim of this study was to evaluate the changes of LA deformability and its relationship with stroke/TIA events by using Speckle Tracking echocardiography. In 365 patients with paroxysmal atrial fibrillation (AF) (318, Non stroke/TIA; 47, stroke/TIA), comprehensive echocardiography was performed by using speckle tracking imaging to calculate mean LA longitudinal strain and strain rate values from apical four chamber view, apical two chamber view and apical three cavity view. The patients in stroke/TIA group had greater ages, a greater proportion of men and lower LA strain rate during left ventricular (LV) early diastole (SRE), and the difference was statistically significant(p<0.05). In the univariate linear regression analysis, the following clinical and conventional echocardiographic parameters each had a significant linear correlation with SRE(p<0.001), they were E/A ratio, LA volume index, body mass index, mean E/e′, LV ejection fraction, age, proportion of hypertension. Through a multiple linear regression analysis, the results show that there is a linear dependence between SRE and E/A ratio, LA volume index and Body mass index. The regression equation is y=-1.430-0.394X1+0.012X2+0.019X3(p<0.001) (y,SRE; X1,E/A ratio; X2,LA volume index; X3,Body mass index).In the multivariate logistic regression analyses, SRE and Sex ratio were independently risk factors stroke/TIA. (SRE, OR 2.945, 95% CI 1.092-7.943, p= 0.033; Sex, OR 0.462, 95% CI 0.230-0.930, p = 0.031)In patients with paroxysmal AF, SRE could reflect the impaired deformability of LA in early stages, and it was associated with the risk of stroke/TIA.

scholarly journals P814 Independent association of body mass index and left atrial strain in patients with non valvular atrial fibrillation. The NeAfib-Echo registry

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
L Esposito ◽  
R Sorrentino ◽  
V Capone ◽  
C Santoro ◽  
M Lembo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Heart Rate ◽  
Body Mass ◽  
Left Atrial ◽  
Longitudinal Strain ◽  
Overweight And Obesity ◽  
Volume Index ◽  
The Third ◽  
Lv Mass

Abstract Background Overweight and obesity are related to the risk of new-onset atrial fibrillation (AF). Peak atrial longitudinal strain (PALS) is an advanced echocardiographic parameter of left atrial (LA) function with a recognized diagnostic and prognostic role in both the general population and AF. Purpose To investigate the impact of body mass index (BMI) on LA function by utilizing standard and advanced echocardiography in patients with non-valvular AF. Methods In the NeAfib-Echo registry, 395 consecutive adult patients with non-valvular AF (F/M: 175/220; mean age 70.6 ± 11 years, BMI: 27.8 ± 5.6 kg/m²) were enrolled. 215 patients (54.1%) had permanent/persistent AF (prAF) and 178 (45.9%) had paroxysmal AF (pxAF). Anthropometric parameters and blood pressure (BP) were recorded and CHA2DS2VASc score was calculated. Patients underwent a complete echo-Doppler exam, including determination of PALS and left ventricular (LV) global longitudinal strain (GLS) (both reported in absolute values). The overall population was divided according to BMI tertiles: first tertile &lt;25.3 Kg/m² (n = 127); second tertile 25.3-29 Kg/m² (n = 137); third tertile &gt; 29.3 Kg/m² (n = 130). Results No significant difference of sex prevalence, age, systolic BP and heart rate was found among the three BMI tertiles, whereas diastolic BP was higher in the third tertile (p &lt; 0.001). CHA2DS2VASc score did not significantly differ among tertiles. In the pooled population LV mass index (LVMi) (p = 0.001) progressively increased from the first to the third tertile (p &lt; 0.001), whereas LA volume index, LV ejection fraction (EF), GLS and E/e" ratio were not significantly different among the three groups. PALS was lower in third tertile (14.3 ± 8.2%) versus both the first (19.0 ± 11.5%) and the second tertile (17.7 ± 10.6%) (p &lt; 0.002). In separate sub-analyses according to AF type, PALS was significantly lower in the first than the third tertile in the PxAF group (p &lt; 0.01) but not in patients with PrAF (p = 0.158). In the pooled population PALS was significantly related with BMI (r= -0.17, p &lt; 0.001) (Figure) but also with age, heart rate, LVMi, LV EF, GLS, E/e’ ratio and pulmonary artery systolic pressure (PAPS). By a multilinear regression analysis, after adjusting for CHA2DS2VASc score, LV mass index, LV EF, E/e’ ratio and PAPs, BMI remained independently associated with PALS (standardized β coefficient = -0.127, p &lt; 0.02) (cumulative R² =0.41, SEE = 8.5%, p &lt; 0.0001). Conclusions In patients with non valvular AF, overweight and obesity exert a detrimental effect on LA function as testified by the gradual PALS reduction with the increase of BMI tertiles. BMI is associated with PALS independently of several confounders including CHA2DS2VASc. Besides CHA2DS2VASc score, BMI could be considered as an additional factor for evaluating cardiovascular risk in non valvular AF. Abstract P814 Figure. Relation between BMI and PALS

Serum myonectin is increased after laparoscopic sleeve gastrectomy

2020 ◽  
Vol 57 (5) ◽  
pp. 360-364
Author(s):  
Lei Li ◽  
Qianqian Wang ◽  
Chengkun Qin
Keyword(s):  
Body Mass Index ◽  
Regression Analysis ◽  
Sleeve Gastrectomy ◽  
Linear Regression ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Body Mass ◽  
Linear Regression Analysis ◽  
Acid Uptake ◽  
Model Assessment ◽  
Obese Patients

Objective Myonectin, a newly discovered myokine, enhances fatty acid uptake in cultured adipocytes and hepatocytes and suppresses circulating levels of free fatty acids in mice. Recent studies showed that serum myonectin concentration is negatively correlated with obesity. This study was undertaken to evaluate the change of serum myonectin in obese patients after laparoscopic sleeve gastrectomy. Methods This study was performed in a population of 42 obese and 58 control subjects from April of 2018 to December of 2019. All obese subjects underwent laparoscopic sleeve gastrectomy. Anthropometric measurements, lipid profiles, HbA1c and serum myonectin were assessed at baseline and six months after laparoscopic sleeve gastrectomy. Results Serum myonectin concentrations were significantly lower in the obese patients than in the controls. Serum myonectin concentrations were increased at six months after laparoscopic sleeve gastrectomy. Simple linear regression analysis indicated that serum myonectin was negatively correlated with weight, waist circumference, hip circumference, body mass index, fasting plasma glucose, homeostasis model assessment of insulin resistance and HbA1c. Only body mass index was still inversely correlated with serum myonectin after multiple linear regression analysis. Conclusion Serum myonectin is correlated with obesity and increased after laparoscopic sleeve gastrectomy.

Risk factors for development of obesity in an ethnically diverse CHD population

2019 ◽  
Vol 29 (2) ◽  
pp. 123-127
Author(s):  
Scott J. Weinreb ◽  
Abigail J. Pianelli ◽  
Sreyans R. Tanga ◽  
Ira A. Parness ◽  
Rajesh U. Shenoy
Keyword(s):  
Body Mass Index ◽  
Regression Analysis ◽  
Linear Regression ◽  
Longitudinal Data ◽  
Body Mass ◽  
Linear Regression Analysis ◽  
Paediatric Population ◽  
Post Surgery ◽  
Significant Difference ◽  
Age Cohort

AbstractObjectivesPrevious cross-sectional studies have demonstrated obesity rates in children with CHD and the general paediatric population. We reviewed longitudinal data to identify factors predisposing to the development of obesity in children, hypothesising that age may be an important risk factor for body mass index growth.Study designRetrospective electronic health records were reviewed in all 5–20-year-old CHD patients seen between 2011 and 2015, and in age-, sex-, and race/ethnicity-matched controls. Subjects were stratified into aged cohorts of 5–10, 11–15, and 15–20. Annualised change in body mass index percentile (BMI%) over this period was compared using paired Student’s t-test. Linear regression analysis was performed with the CHD population.ResultsA total of 223 CHD and 223 matched controls met the inclusion criteria for analysis. Prevalence of combined overweight/obesity did not differ significantly between the CHD cohort (24.6–25.8%) and matched controls (23.3–29.1%). Univariate analysis demonstrated a significant difference of BMI% change in the age cohort of 5–10 (CHD +4.1%/year, control +1.7%/year, p=0.04), in male sex (CHD +1.8%/year, control −0.3%/year, p=0.01), and status-post surgery (CHD 2.03%/year versus control 0.37%, p=0.02). Linear regression analysis within the CHD subgroup demonstrated that age 5–10 years (+4.80%/year, p<0.001) and status-post surgery (+3.11%/year, p=0.013) were associated with increased BMI% growth.ConclusionsPrevalence rates of overweight/obesity did not differ between children with CHD and general paediatric population over a 5-year period. Longitudinal data suggest that CHD patients in the age cohort 5–10 and status-post surgery may be at increased risk of BMI% growth relative to peers with structurally normal hearts.

scholarly journals Predictors of Hypertension among Nonpregnant Females Attending Health Promotion Clinic with Special Emphasis on Smokeless Tobacco: A Cross-Sectional Study

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Devika Bhatt ◽  
Shashi Sharma ◽  
Ruchika Gupta ◽  
Dhirendra N. Sinha ◽  
Ravi Mehrotra
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Health Promotion ◽  
Regression Analysis ◽  
Linear Regression ◽  
Body Mass ◽  
Smokeless Tobacco ◽  
Linear Regression Analysis ◽  
High Body Mass Index ◽  
Cross Sectional

Aim. To determine the predictors of hypertension among nonpregnant females attending a health promotion clinic. Design and Setting. A cross-sectional study was conducted during March to June 2016, at the National Institute of Cancer Prevention and Research, India. Methods. The study included 319 nonpregnant females of age 20–70 years. Demographics such as age, literacy, and income were noted. History regarding use, frequency, and quantity of smokeless tobacco was taken. Height, weight, and blood pressure were measured and body mass index was calculated. Statistical Analysis. Pearson’s product-moment correlation coefficient was calculated between each of the variables of age, smokeless tobacco consumption, and body mass index versus systolic and diastolic blood pressure, respectively. The linear as well as multiple linear regression analysis was employed to identify the risk factors for hypertension. Results. A univariate linear regression analysis showed that age, smokeless tobacco consumption, and body mass index were associated with systolic blood pressure (P value < 0.001 for each). For diastolic blood pressure, high body mass index was a predictor. Multiple linear regression analysis showed that both systolic and diastolic hypertension were associated with high body mass index and low level of education. Moreover, the systolic hypertension was associated with higher age and smokeless tobacco use. Conclusion. Health promotion requires control of body mass index and smokeless tobacco cessation for preventing hypertension and its complications.

scholarly journals Shortening of Leucocyte Telomerase Length Is Independently Correlated With High Body Mass Index and Subcutaneous Obesity (Predominantly Truncal), in Asian Indian Women With Prediabetes

2021 ◽  
Author(s):  
Surya Prakash Bhatt ◽  
Anoop Misra ◽  
Ravindra Mohan Pandey ◽  
Ashish Datt Upadhyay
Keyword(s):  
Body Mass Index ◽  
Regression Analysis ◽  
Linear Regression ◽  
Body Mass ◽  
Asian Indian ◽  
Quantitative Polymerase Chain Reaction ◽  
Linear Regression Analysis ◽  
Indian Women ◽  
Asian Indian Women ◽  
Multivariable Linear Regression Analysis

Abstract Introduction: Leucocyte telomerase length (LTL) are inked to accelerate aging and premature mortality. In this research, we aimed to explore the relations between biochemical and anthropometry markers and LTL in Asian Indian women with prediabetes.Methods: In this study, 797 prediabetic women (aged 20-60 years, obese, 492; non obese, 305) were recruited. Demographic and clinical profiles, medical history, skin exposure and duration of sunlight exposure were determined. Anthropometry, fasting blood glucose and serum 25-hydroxyvitamin D [25(OH) D] were evaluated. LTL was quantified by a quantitative polymerase chain reaction (qPCR). The study subjects were separated into quartiles groups according to the LTL.Results: The average telomerase length (T/S) ratio was significantly decreased with increasing age. The average telomerase length (T/S) ratio was significantly shorter in obese women with prediabetes (p<0.05). Univariate and multivariable linear regression analysis after adjustment for age, family income, education and hypertension showed that LTL was inversely correlated with body mass index (BMI), waist and hip circumference, waist-hip and waist-to-height ratio, and truncal skinfolds (subscapular, lateral thoracic, and subscapular/triceps ratio, central and total). Multivariable linear regression analysis identified BMI (93%, p<0.0001), central (92%, p<0.0001) and total skinfolds (90%, p<0.0001) as independent predictors of LTL. Conclusions: Besides age, obesity, and subcutaneous adiposity (predominantly truncal) are major contributors to telomerase shortening in Asian Indian women with prediabetes.

scholarly journals Impact of body mass index on left atrial dimension in HOCM patients

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 207-216
Author(s):  
Yue Zhou ◽  
Miao Yu ◽  
Jingang Cui ◽  
Shengwen Liu ◽  
Jiansong Yuan ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Regression Analysis ◽  
Body Mass ◽  
Left Atrial ◽  
Independent Predictor ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Left Ventricular ◽  
Normal Weight

Abstract Background Substantial studies have demonstrated that left atrial (LA) enlargement was a robust predictor of atrial fibrillation (AF) and obesity was a modifiable risk factor for cardiovascular diseases. However, the role of body mass index (BMI) on LA dimension in hypertrophic obstructive cardiomyopathy (HOCM) remains unclear. Methods A total of 423 HOCM patients (average BMI 25.4 ± 3.4 kg/m2) were recruited for our study. Participants were stratified into three groups based on BMI: normal weight (BMI < 23 kg/m2), overweight (BMI 23–27.5 kg/m2), and obesity (BMI ≥ 27.5 kg/m2). Results Compared with normal weight, patients with obesity had significantly lower prevalence of syncope (p = 0.007) and moderate or severe mitral regurgitation (p = 0.014), and serum NT-proBNP (p = 0.004). Multiple linear regression analysis indicated that BMI (β = 0.328, p < 0.001), log NT-proBNP (β = 0.308, p < 0.001), presence of AF (β = 0.209, p = 0.001), and left ventricular diastolic diameter index (β = 0.142, p = 0.019) were independently related with LA diameter. However, BMI was not an independent predictor of the presence of AF on multivariable binary logistical regression analysis. Conclusions BMI was independently associated with LA diameter; however, it was not an independent predictor of prevalence of AF. These results suggest that BMI may promote incidence of AF through LA enlargement in HOCM.

Identification of new factors associated to walking impairment in patients with vascular-type claudication

Vascular ◽  
2018 ◽  
Vol 27 (3) ◽  
pp. 260-269
Author(s):  
Tinhinan Mezdad ◽  
Samir Henni ◽  
Mathieu Feuilloy ◽  
Pierre Chauvet ◽  
Daniel Schang ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Heart Rate ◽  
Regression Analysis ◽  
Linear Regression ◽  
Body Mass ◽  
Linear Regression Analysis ◽  
Linear Analysis ◽  
Non Linear ◽  
New Variables ◽  
Walking Time

Objectives Mechanisms of walking limitation in arterial claudication are incompletely elucidated. We aimed to identify new variables associated to walking limitation in patients with claudication. Methods We retrospectively analyzed data of 1120 patients referred for transcutaneous exercise oxygen pressure recordings (TcpO2). The outcome measurement was the absolute walking time on treadmill (3.2 km/h, 10% slope). We used both: linear regression analysis and a non-linear analysis, combining support vector machines and genetic explanatory in 800 patients with the following resting variables: age, gender, body mass index, the presence of diabetes, minimal ankle to brachial index at rest, usual walking speed over 10 m (usual-pace), number of comorbid conditions, active smoking, resting heart rate, pre-test glycaemia and hemoglobin, beta-blocker use, and exercise-derived variables: minimal value of pulse oximetry, resting chest-TcpO2, decrease in chest TcpO2 during exercise, presence of buttock ischemia defined as a decrease from rest of oxygen pressure index ≤15 mmHg. We tested the models over 320 other patients. Results Independent variables associated to walking time, by decreasing importance in the models, were: age, ankle to brachial index, usual-pace; resting TcpO2, body mass index, smoking, buttock ischemia, heart rate and beta-blockers for the linear regression analysis, and were ankle to brachial index, age, body mass index, usual-pace, decrease in chest TcpO2, smoking, buttock ischemia, glycaemia, heart rate for the non-linear analysis. Testing of models over 320 new patients gave r = 0.509 for linear and 0.575 for non-linear analysis (both p < 0.05). Conclusion Buttock ischemia, heart rate and usual-pace are new variables associated to walking time.

Consideration of non-valvular atrial fibrillation with left atrial appendage thrombus formation despite under appropriate oral anticoagulation therapy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Shiraki ◽  
H Tanaka ◽  
K Yamashita ◽  
Y Tanaka ◽  
K Sumimoto ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Oral Anticoagulation ◽  
Left Atrial ◽  
Thrombus Formation ◽  
Anticoagulation Therapy ◽  
Left Ventricular ◽  
Volume Index ◽  
Oral Anticoagulation Therapy

Abstract Background Atrial fibrillation (AF) is the most frequently sustained cardiac arrhythmia, with a prevalence of about 2–3% in the general population. In accordance with CHADS2 or CHA2DS2-VASc score, appropriate oral anticoagulation therapy such as warfarin or direct oral anticoagulants (DOAC) significantly reduced the risk of thromboembolic events. However, left atrial (LA) thrombus can be detected in the LA appendage (LAA) in AF patients despite appropriate oral anticoagulation therapy. Purpose Our purpose was to investigate the associated factors of LAA thrombus formation in non-valvular atrial fibrillation (NVAF) patients despite under appropriate oral anticoagulation therapy. Methods We retrospectively studied consecutive 286 NVAF patients for scheduled catheter ablation or electrical cardioversion for AF in our institution between February 2017 and September 2019. Mean age was 67.1±9.4 years, 79 patients (29.5%) were female, and 140 (52.2%) were paroxysmal AF. All patients underwent transthoracic and transesophageal echocardiography before catheter ablation or electrical cardioversion. All patients received appropriate oral anticoagulation therapy including warfarin or DOAC for at least 3 weeks prior to transesophageal echocardiography based on the current guidelines. LAA thrombus was defined as an echodense intracavitary mass distinct from the underlying endocardium and not caused by pectinate muscles by at least three senior echocardiologists. Results Of 286 NVAF patients with under appropriate oral anticoagulation therapy, LAA thrombus was observed in 9 patients (3.3%). Univariate logistic regression analysis showed that age, paroxysmal AF, CHADS2 score ≥3, left ventricular end-diastolic volume index (LVEDVI), left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), LA volume index (LAVI), mitral inflow E and mitral e' annular velocities ratio (E/e'), and LAA flow were associated with LAA thrombus formation. It was noteworthy that multivariate logistic regression analysis showed that LAA flow was independent predictor of LAA thrombus (OR: 0.72, 95% CI: 0.59–0.89, p&lt;0.005) as well as LVEF. Furthermore, receiver operating characteristic (ROC) curve analysis identified the optimal cutoff value of LAA flow for predicting LAA thrombus as ≤15cm/s, with a sensitivity of 88%, specificity of 93%, and area under the curve (AUC) of 0.95. Conclusions LAA flow was strongly associated with LAA thrombus formation even in NVAF patients with appropriate oral anticoagulation therapy. According to our findings, further strengthen of oral anticoagulation therapy or percutaneous transcatheter closure of the LAA may be considered in NVAF patients with appropriate oral anticoagulation therapy but low LAA flow, especially &lt;15cm/s. Funding Acknowledgement Type of funding source: None

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