scholarly journals Distribution of Mean Cycle Length in Cavo-Tricuspid Isthmus Dependent Atrial Flutter

2012 ◽  
pp. 43-51 ◽  
Author(s):  
Š. HAVRÁNEK ◽  
J. ŠIMEK ◽  
P. ŠŤOVÍČEK ◽  
D. WICHTERLE
Keyword(s):  
Regression Analysis ◽  
Cardiac Surgery ◽  
Atrial Flutter ◽  
Multivariate Regression ◽  
Cycle Length ◽  
Antiarrhythmic Drugs ◽  
Multivariate Regression Analysis ◽  
History Of ◽  
Mean Cycle ◽  
Rule Out

Although cycle length (CL) constitutes a fundamental descriptor of any arrhythmia, there is not larger study describing mean CL in electrophysiologically confirmed cavo-tricuspid isthmus (CTI)-dependent atrial flutter (AFL). We analyzed retrospectively digital recordings of 121 patients (98 men; age 64±11 years) referred for radiofrequency ablation of persistent CTI-dependent AFL. Median of mean AFL CL was 240 ms (interquartile range (IQR) of 222-258 ms, overall range of 178-399 ms). The distribution of CL was not normal (Shapiro Wilk test, p<0.001). Both counterclockwise and clockwise (14.9 % of all cases) AFLs were comparable in their CL; 240 (IQR 222-258) ms vs. 234 (217-253) ms, respectively. AFL CL<200 ms and AFL CL<190 ms was noticed in 5 (4.1 %) and 3 cases (2.5 %), respectively. In multivariate regression analysis, age (increase by 6±3 ms per decade of age, p=0.036), treatment with specific antiarrhythmic drugs (increase by 11±6 ms, p=0.052) and the history of cardiac surgery (increase by 26±9 ms, p=0.004) were independently associated with AFL CL. In conclusions, the distribution of AFL CL is not normal. The prevalence of AFL with short CL is low. Short CL<200 ms does not rule out the CTI-dependent AFL, especially in young and otherwise healthy patients.

scholarly journals Platelet Count Increase Seen with Ledipasvir-Sofosbuvir Combination Treatment of Chronic Hepatitis C in Patients with Thrombocytopenia

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5967-5967
Author(s):  
Hind Rafei ◽  
Joao L. Ascensao ◽  
Anita Aggarwal
Keyword(s):  
Regression Analysis ◽  
Chronic Hepatitis ◽  
Multivariate Regression ◽  
Treatment Duration ◽  
Multivariate Regression Analysis ◽  
Fixed Dose ◽  
History Of ◽  
Pre Treatment ◽  
Chronic Hcv

Abstract Background: Thrombocytopenia (TCP) is commonly seen in chronic Hepatitis C (HCV). Ledipasvir-sofosbuvir (LDV/SOF) is a novel, fixed-dose anti-HCV combination that has shown high sustained virologic response (SVR) rates. However, since much remains to be learned about the natural history of TCP following LDV/SOF treatment, we set out to examine platelet (PLT) counts in thrombocytopenic patients with chronic HCV before, during, and after treatment with LDV/SOF. Methods: This is an IRB-approved, retrospective study of patients diagnosed with chronic HCV who received LDV/SOF between November 2014 and April 2016 at the Washington DC Veterans Affairs Medical Center. Patients who had PLT counts less than or equal to 150 x 109/L for at least 6 months prior to treatment andcompleted therapy with LDV/SOF were included. Patients diagnosed with heparin-induced TCP; disseminated intravascular coagulation; medication-induced TCP; sepsis; as well as those who received PLT transfusion or thrombopoietic agents were excluded. PLT counts were collected at baseline (within 6 months prior to the start of therapy), during treatment, and throughout the follow-up period until the last follow-up, initiation of a new HCV medication, liver transplant, or death. Patients were categorized into 3 groups: mild TCP (100-150 x 109/L), moderate (50-99 x 109/L), and severe (<50 x 109/L). Paired t-test was used to compare pre-treatment, on-treatment (week 4), and the last measured PLT counts. Multivariate regression analysis was used to determine the baseline variables associated with improvement in PLT counts. All registered PLT counts from the start of therapy were included in repeated measurement analyses to assess the evolution of PLTs over time. Results: Inclusion criteria were met in 244 patients (median age 64, 98% male, 88.9% African American). HCV genotypes were 1a (77.4%) and 1b (22.6%). The median follow-up from treatment start was 13 months. Treatment duration was 8 weeks (13.9%), 12 weeks (69.7%), or 24 weeks (16.4%), all at the fixed dose of LDV 90 mg and SOF 400 mg once daily. SVR at 12 weeks (SVR12) was attained in 159 patients (65.2%) while 67 patients (27.5%) had a documented undetectable viral load earlier than 12 weeks from treatment completion with no further testing. Eight patients (3.3%) failed treatment and 10 (4.1%) were lost-to-follow-up. The mean pre-treatment PLT count was 114 x 109/L (22-150). The on-treatment and last measured PLT counts were significantly higher than the baseline PLT count (129 x 109/L, p<0.001 and 144 x 109/L, p<0.001 respectively). The increase from the on-treatment to the last measured PLT count was also statistically significant (p=0.008). The last measured PLT counts were on average 32.8 ± 66.7% higher than the baseline and 31.6% of patients had normal last measured PLT counts. The increase in PLT count was observed for all three TCP groups: mild (73.4%): from 129 x 109/L at baseline to 149 x 109/L during treatment (p<0.001) to 160 x 109/L after (p=0.045); moderate (24.2%): from 75 x 109/L before to 89 x 109/L during (p=0.004) to 112 x 109/L after (p=0.027); severe (2.5%): from 38 x 109/L before to 64 x 109/L during (p=0.003) to 97 x 109/L after (p=0.234). Multivariate regression analysis was performed including the following variables: age; gender; HCV genotype; baseline PLT count, albumin, bilirubin, and AST/ALT; history of severe alcohol abuse; HIV coinfection; Hepatitis B coinfection; presence of splenomegaly; presence of cirrhosis; treatment duration and reaching SVR12. It showed that reaching SVR12 is associated with a faster increase in PLT count (p=0.022). Repeated measurement analyses showed a gradual and linear increase in PLT counts from the start of therapy for the entire cohort (p<0.001) as well as in every TCP group: mild (p<0.001), moderate (p=0.001) and severe (p=0.015). Conclusion: LDV/SOF is associated with an increase in PLT counts in chronic HCV patients with TCP. This desired effect becomes apparent even before the conclusion of therapy. It is thus tempting to correlate the increase in PLT count with LDV/SOF-associated quick eradication of HCV soon after treatment initiation. Whether that is due to elimination of HCV-associated bone marrow suppression and autoimmune TCP or other not yet known mechanisms, these results are tantalizing but would require longer follow-up. Larger prospective studies are needed to ascertain these results and uncover potential mechanisms. Disclosures No relevant conflicts of interest to declare.

Extracorporeal Life Support in Postcardiotomy Cardiogenic Shock: A View on Scenario, Outcome, and Risk Factors in 261 Patients

2020 ◽  
Author(s):  
Zdenek Provaznik ◽  
Alois Philipp ◽  
Florian Zeman ◽  
Daniele Camboni ◽  
Christof Schmid ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Multivariate Regression ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Multivariate Regression Analysis ◽  
Weaning Failure

Abstract Background Weaning failure from cardiopulmonary bypass, postoperative low cardiac output (LCO), and cardiopulmonary resuscitation (CPR) are common scenarios preceding extracorporeal life support (ECLS) implantation after cardiac surgery. The impact of these scenarios on short- and long-term outcome are not well described. Methods Between March 2006 and December 2018, 261 patients received ECLS support after cardiac surgery. Data of patients with weaning failure (NW), postoperative LCO, and CPR leading to ECLS implantation were retrospectively analyzed regarding outcome. Risk factors for outcome after postcardiotomy ECLS were assessed by uni- or multivariate regression analysis. Results Median duration of extracorporeal support was 5.5 ± 8.5 days. Overall mortality on ECLS was 39.1%. Scenario analysis revealed weaning failure from cardiopulmonary bypass in 40.6%, postoperative LCO in 24.5%, and postoperative CPR in 34.9% leading to initiation of ECLS. Most common cause of death was refractory LCO (25.3%). Overall follow-up survival was 23.7%. Survival after weaning and during follow-up in all subgroups was 9.2% (CPR), 5.0% (LCO), and 9.6% (NW), respectively. Uni- or multivariate regression analysis revealed age, aortic surgery, and vasopressor medication level on day 1 as risk for death on support, as well as postoperative renal failure, and body mass index (BMI) as risk factors for death during follow-up. Conclusion Mortality after postcardiotomy ECLS is high. Overall, outcome after CPR, NW, weaning failure and LCO is comparable. Postoperative resuscitation does not negatively affect outcome after postcardiotomy ECLS. Neurological status of ECLS survivors is good.

31P nuclear magnetic resonance measurement of free erythrocyte magnesium concentration in man and its relation to blood pressure

1988 ◽  
Vol 74 (5) ◽  
pp. 513-517 ◽  
Author(s):  
K. L. Woods ◽  
D. Walmsley ◽  
A. M. Heagerty ◽  
D. L. Turner ◽  
Lu-Yun Lian
Keyword(s):  
Blood Pressure ◽  
Regression Analysis ◽  
Multivariate Regression ◽  
Oral Contraceptive Pill ◽  
Positive Association ◽  
Multivariate Regression Analysis ◽  
Magnesium Concentration ◽  
History Of ◽  
Free Magnesium ◽  
Age And Sex

1. 31P n.m.r. spectroscopy was used to measure the dissociation constant of MgATP under simulated intracellular conditions and to measure erythrocyte free magnesium concentration. 2. In a group of 40 subjects, the relationship between erythrocyte free magnesium and blood pressure, age and sex was examined by univariate and multivariate regression analysis. 3. A weak positive association was found between erythrocyte free magnesium and mean blood pressure. This association was lost in a multivariate regression analysis including both age and sex. 4. No significant relationship was found between erythrocyte free magnesium and age, sex, family history of hypertension or use of the combined oral contraceptive pill in the sample studied.

PREVALENCE AND RELATED FACTORS OF POSTNATAL DEPRESSION IN HIV INFECTED WOMEN

2014 ◽  
pp. 140-152
Author(s):  
Manh Hoan Nguyen ◽  
Ngoc Thanh Cao
Keyword(s):  
Regression Analysis ◽  
Postpartum Depression ◽  
Hiv Infection ◽  
Postnatal Depression ◽  
Past History ◽  
Depression Scale ◽  
Multivariate Regression Analysis ◽  
Related Factors ◽  
History Of ◽  
History Of Depression

Background and Objective: HIV infection is also a cause of postpartum depression, however, in Vietnam, there has not yet the prevalence of postpartum depression in HIV infected women. The objective is to determine prevalence and related factors of postpartum depression in HIV infected women. Materials and Methods: From November 30th, 2012 to March 30th, 2014, a prospective cohort study is done at Dong Nai and Binh Duong province. The sample includes135 HIV infected women and 405 non infected women (ratio 1/3) who accepted to participate to the research. We used “Edinburgh Postnatal Depression Scale (EPDS) as a screening test when women hospitalized for delivery and 1 week, 6weeks postpartum. Mother who score EPDS ≥ 13 are likely to be suffering from depression. We exclude women who have EPDS ≥ 13 since just hospitalize. Data are collected by a structural questionaire. Results: At 6 weeks postpartum, prevalence of depression in HIV infected women is 61%, in the HIV non infected women is 8.7% (p < 0.001). There are statistical significant differences (p<0.05) between two groups for some factors: education, profession, income, past history of depression, child’s health, breast feeding. Logistical regression analysis determine these factors are related with depression: late diagnosis of HIV infection, child infected of HIV, feeling guilty of HIV infected and feeling guilty with their family. Multivariate regression analysis showed 4 factors are related with depression: HIV infection, living in the province, child’s health, past history of depression. Conclusion: Prevalence of postpartum depression in HIV infected women is 61.2%; risk of depression of postnatal HIV infected women is 6.4 times the risk of postnatal HIV non infected women, RR=6.4 (95% CI:4.3 – 9.4). Domestic women have lower risk than immigrant women from other province, RR=0.72 (95% CI:0.5 – 0.9). Past history of depression is a risk factor with RR=1.7 (95% CI:1.02 – 0.9. Women whose child is weak or die, RR=1.7(95% CI:0.9 – 3.1). Keywords: Postpartum depression, HIV-positive postpartum women

scholarly journals 1574. Multivariate Regression Analysis to Determine Independent Predictors of Treatment Outcomes in the RESTORE-IMI 2 Trial

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S785-S786
Author(s):  
Robert Tipping ◽  
Jiejun Du ◽  
Maria C Losada ◽  
Michelle L Brown ◽  
Katherine Young ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Clinical Response ◽  
Treatment Outcomes ◽  
Multivariate Regression ◽  
Multivariate Regression Analysis ◽  
Apache Ii Score ◽  
Double Blind ◽  
Mitt Population ◽  
Study Results ◽  
All Cause Mortality

Abstract Background In the RESTORE-IMI 2 trial, imipenem/cilastatin/relebactam (IMI/REL) was non-inferior to PIP/TAZ for treating hospital-acquired/ventilator-associated bacterial pneumonia (HABP/VABP) in the primary endpoint of Day 28 all-cause mortality (D28 ACM) and the key secondary endpoint of clinical response (CR) at early follow-up (EFU; 7-14 d after end of therapy). We performed a multivariate regression analysis to determine independent predictors of treatment outcomes in this trial. Methods Randomized, controlled, double-blind, phase 3, non-inferiority trial comparing IMI/REL 500 mg/250 mg vs PIP/TAZ 4 g/500 mg, every 6 h for 7-14 d, in adult patients (pts) with HABP/VABP. Stepwise-selection logistic regression modeling was used to determine independent predictors of D28 ACM and favorable CR at EFU, in the MITT population (randomized pts with ≥1 dose of study drug, except pts with only gram-positive cocci at baseline). Baseline variables (n=19) were pre-selected as candidates for inclusion (Table 1), based on clinical relevance. Variables were added to the model if significant (p &lt; 0.05) and removed if their significance was reduced (p &gt; 0.1) by addition of other variables. Results Baseline variables that met criteria for significant independent predictors of D28 ACM and CR at EFU in the final selected regression model are in Fig 1 and Fig 2, respectively. As expected, APACHE II score, renal impairment, elderly age, and mechanical ventilation were significant predictors for both outcomes. Bacteremia and P. aeruginosa as a causative pathogen were predictors of unfavorable CR, but not of D28 ACM. Geographic region and the hospital service unit a patient was admitted to were found to be significant predictors, likely explained by their collinearity with other variables. Treatment allocation (IMI/REL vs PIP/TAZ) was not a significant predictor for ACM or CR; this was not unexpected, since the trial showed non-inferiority of the two HABP/VABP therapies. No interactions between the significant predictors and treatment arm were observed. Conclusion This analysis validated known predictors for mortality and clinical outcomes in pts with HABP/VABP and supports the main study results by showing no interactions between predictors and treatment arm. Table 1. Candidate baseline variables pre-selected for inclusion Figure 1. Independent predictors of greater Day 28 all-cause mortality (MITT population; N=531) Figure 2. Independent predictors of favorable clinical response at EFU (MITT population; N=531) Disclosures Robert Tipping, MS, Merck & Co., Inc. (Employee, Shareholder) Jiejun Du, PhD, Merck & Co., Inc. (Employee, Shareholder) Maria C. Losada, BA, Merck & Co., Inc. (Employee, Shareholder) Michelle L. Brown, BS, Merck & Co., Inc. (Employee, Shareholder) Katherine Young, MS, Merck & Co., Inc. (Employee, Shareholder)Merck & Co., Inc. (Employee, Shareholder) Joan R. Butterton, MD, Merck & Co., Inc. (Employee, Shareholder) Amanda Paschke, MD MSCE, Merck & Co., Inc. (Employee, Shareholder) Luke F. Chen, MBBS MPH MBA FRACP FSHEA FIDSA, Merck & Co., Inc. (Employee, Shareholder)Merck & Co., Inc. (Employee, Shareholder)

Epicardial fat thickness as arterial hypertension predictor in normotensive patients with abdominal obesity

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Kuznetsova ◽  
M Druzhilov
Keyword(s):  
Blood Pressure ◽  
Regression Analysis ◽  
Blood Glucose ◽  
Waist Circumference ◽  
Arterial Hypertension ◽  
Multivariate Regression ◽  
Fasting Blood Glucose ◽  
Multivariate Regression Analysis ◽  
Epicardial Fat Thickness ◽  
Fat Thickness

Abstract Objective Arterial hypertension (HTN) is one of the most common diseases associated with obesity. Visceral obesity (VO) with dysfunctional visceral adipose tissue plays the main role in obesity induced HTN. Direct criteria of VO including echocardiographic epicardial fat thickness (EFT) may become an additional predictor of HTN. Purpose The aim was to assess the role of echocardiographic EFT (EEFT) as a predictor of HTN in normotensive patients with abdominal obesity (AO). Methods 526 normotensive men (according to ambulatory blood pressure monitoring (ABPM) without therapy) with AO (waist circumference (WC) &gt;94 cm) and SCORE &lt;5%, without cardiovascular diseases and diabetes mellitus were examined (age 45.1±5.0 years). The lipid and glucose profiles, creatinine, uric acid and C-reactive protein blood levels, albuminuria evaluation, echocardiography, carotid ultrasound, bifunctional ABPM were performed. The values of EEFT ≥75 percentile for persons 35–45 years and 46–55 years were 4.8 mm and 5.8 mm respectively. These values used as epicardial VO criteria. Patients with subclinical carotid atherosclerosis due to the lipid-lowering therapy administration (n=98) were excluded from the follow-up. Re-examination with ABPM was conducted on average through 46.3±5.1 months. Data were summarized as mean ± standard error, statistical analysis conducted with paired two-tailed t-tests, Pearson χ2 criterion and multivariate regression analysis. Results Data of 406 persons were available for analysis. HTN as average daily blood pressure ≥130/80 mm Hg was detected in 157 (38.7%) patients. These patients were characterized by initially higher values of age (45.9±4.6 years vs 44.3±4.9 years, p&lt;0.001), waist circumference (106.9±7.3 cm vs 104.2±7.3 cm, p&lt;0.001), body mass index (BMI) (32.0±3.3 kg/m2 vs 30.9±3.2 kg/m2, p&lt;0.001), average daily systolic and diastolic blood pressure (120.7/74.5±4.6/3.4 mm Hg vs 118.2/73.2±5.5/3.9 mm Hg, p&lt;0.001), EEFT (5.2±0.7 mm vs 4.4±1.0 mm, p&lt;0.001). The epicardial VO was initially detected in 95 (23.3%) patients. In patients with HTN the initial prevalence of epicardial VO was greater (58.0% vs 23.3%, p&lt;0.001). As predictors for the multivariate regression analysis the clinical and laboratory examinations data and EEFT were evaluated. According to the results a mathematical model for estimating the probability HTN was obtained: 0.696*fasting blood glucose + 0.198*systolic BP + 2.844*EFT – 40.166 (constant). Among these predictors EEFT was characterized by the highest standardized regression coefficient (0.302, p&lt;0.001) (0.295, p&lt;0.01 for fasting blood glucose, 0.035, p&lt;0.001 for systolic BP). The Hosmer-Lemeshow test value was 0.863, the total percentage of correct classifications was 86%, the area under the ROC-curve was 0.913. Conclusions EEFT (4.8 mm for persons 35–45 years and 5.8 mm for persons 46–55 years) may be an additional predictor of HTN in normotensive patients with AO. Funding Acknowledgement Type of funding source: None

Arterial stiffness could reflect increased cardiac load and reduced pulmonary function in the general population

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Murai ◽  
T Sugiura ◽  
Y Dohi ◽  
H Takase ◽  
T Mizoguchi ◽  
...  
Keyword(s):  
Regression Analysis ◽  
General Population ◽  
Arterial Stiffness ◽  
Pulmonary Function ◽  
Multivariate Regression ◽  
Troponin I ◽  
Augmentation Index ◽  
Smoking Status ◽  
Multivariate Regression Analysis ◽  
The Other

Abstract Background Pulmonary function is known to decrease with age and reduced pulmonary function has been reported to be associated with all-cause mortality and cardiovascular death. The association between pulmonary impairment and atherosclerosis was reported previously but has not been investigated sufficiently in the general population. Purpose We hypothesized that arterial stiffness could reflect increase of cardiac load and reduced pulmonary function. The present study aimed to investigate whether increased cardiac load and reduced pulmonary function could affect arterial stiffness in the general population. Methods Subjects undergoing their health check-up were enrolled. Plasma B-type natriuretic peptide (BNP) levels and serum high-sensitivity cardiac troponin I (hs-cTnI) levels were measured to evaluate cardiac load and myocardial damage. Radial augmentation index (rAI) was measured to investigate arterial stiffness using HEM-9000AI device. Subjects with an ST-T segment abnormality on the electrocardiogram, renal insufficiency, cancer, active inflammatory disease, or a history of cardiovascular events and pulmonary disease were excluded. Pulmonary function was assessed using spirometry by calculating forced vital capacity (FVC) as a percentage of predicted value (FVC%-predicted), forced expiratory volume in 1 second (FEV1) as a percentage of predicted value (FEV1%-predicted), and the ratio of FEV1 to FVC (FEV1/FVC). Results A total of 1100 subjects aged 57 years were enrolled and their median values of BNP and hs-cTnI were 15.5 and 2.3 pg/ml. The levels of rAI were significantly associated with the levels of BNP after adjustment for possible confounders in multivariate regression analysis, but were not with the levels of hs-TnI. While the parameters of pulmonary function were inversely associated with the levels of rAI and hs-cTnI after adjustment for possible confounders in the multivariate regression analysis, but not with the levels of BNP. The other multivariate regression analyses where BNP, hs-cTnI, parameters of pulmonary function, and the other possible factors were simultaneously included as independent variables revealed that the BNP levels and the FVC%-predicted or FEV1%-predicted, besides age, gender, smoking status, body mass index, blood pressure, heart rate, creatinine, fasting plasma glucose, and triglyceride, were significantly associated with the levels of rAI. Conclusions The significant associations of rAI with BNP and pulmonary function were revealed in the general population. These findings support that arterial stiffness could reflect increased cardiac load and reduced pulmonary function, in apparently healthy individuals. Funding Acknowledgement Type of funding source: None

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