scholarly journals New Strategies for the Treatment of Atrial Fibrillation

2021 ◽  
Vol 14 (9) ◽  
pp. 926
Author(s):  
Norbert Jost ◽  
Torsten Christ ◽  
János Magyar
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Arrhythmia ◽  
Pulmonary Veins ◽  
Basic Research ◽  
The Elderly ◽  
Pharmacological Targets ◽  
Atrial Remodelling ◽  
Ectopic Firing ◽  
The Relationship

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in the clinical practice. It significantly contributes to the morbidity and mortality of the elderly population. Over the past 25–30 years intense effort in basic research has advanced the understanding of the relationship between the pathophysiology of AF and atrial remodelling. Nowadays it is clear that the various forms of atrial remodelling (electrical, contractile and structural) play crucial role in initiating and maintaining the persistent and permanent types of AF. Unlike in ventricular fibrillation, in AF rapid ectopic firing originating from pulmonary veins and re-entry mechanism may induce and maintain (due to atrial remodelling) this complex cardiac arrhythmia. The present review presents and discusses in detail the latest knowledge on the role of remodelling in AF. Special attention is paid to novel concepts and pharmacological targets presumably relevant to the drug treatment of atrial fibrillation.

scholarly journals The Road More Travelled: The Differential Effects of Spatial Experience in Young and Elderly Participants

2021 ◽  
Vol 18 (2) ◽  
pp. 709
Author(s):  
Antonella Lopez ◽  
Alessandro Germani ◽  
Luigi Tinella ◽  
Alessandro Oronzo Caffò ◽  
Albert Postma ◽  
...  
Keyword(s):  
Mental Representations ◽  
Spatial Relations ◽  
The Elderly ◽  
The Road ◽  
Socio Demographic Factors ◽  
Effects Of Aging ◽  
Coordinate Spatial Relations ◽  
Categorical Spatial Relations ◽  
The Relationship

Our spatial mental representations allow us to give refined descriptions of the environment in terms of the relative locations and distances between objects and landmarks. In this study, we investigated the effects of familiarity with the everyday environment, in terms of frequency of exploration and mode of transportation, on categorical and coordinate spatial relations, on young and elderly participants, controlling for socio-demographic factors. Participants were tested with a general anamnesis, a neuropsychological assessment, measures of explorations and the Landmark Positioning on a Map task. The results showed: (a) a modest difference in performance with categorical spatial relations; (b) a larger difference in coordinate spatial relations; (c) a significant moderating effect of age on the relationship between familiarity and spatial relations, with a stronger relation among the elderly than the young. Ceteris paribus, the role of direct experience with exploring their hometown on spatial mental representations appeared to be more important in the elderly than in the young. This advantage appears to make the elderly wiser and likely protects them from the detrimental effects of aging on spatial mental representations.

scholarly journals Persistent Atrial Fibrillation: The Role of Left Atrial Posterior Wall Isolation and Ablation Strategies

2021 ◽  
Vol 10 (14) ◽  
pp. 3129
Author(s):  
Riyaz A. Kaba ◽  
Aziz Momin ◽  
John Camm
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Pulmonary Veins ◽  
Treatment Strategies ◽  
Persistent Atrial Fibrillation ◽  
Posterior Wall ◽  
Cardiovascular Death ◽  
Good Effect ◽  
Complex Forms

Atrial fibrillation (AF) is a global disease with rapidly rising incidence and prevalence. It is associated with a higher risk of stroke, dementia, cognitive decline, sudden and cardiovascular death, heart failure and impairment in quality of life. The disease is a major burden on the healthcare system. Paroxysmal AF is typically managed with medications or endocardial catheter ablation to good effect. However, a large proportion of patients with AF have persistent or long-standing persistent AF, which are more complex forms of the condition and thus more difficult to treat. This is in part due to the progressive electro-anatomical changes that occur with AF persistence and the spread of arrhythmogenic triggers and substrates outside of the pulmonary veins. The posterior wall of the left atrium is a common site for these changes and has become a target of ablation strategies to treat these more resistant forms of AF. In this review, we discuss the role of the posterior left atrial wall in persistent and long-standing persistent AF, the limitations of current endocardial-focused treatment strategies, and future perspectives on hybrid epicardial–endocardial approaches to posterior wall isolation or ablation.

scholarly journals DIAPH2, PTPRD and HIC1 Gene Polymorphisms and Laryngeal Cancer Risk

2021 ◽  
Vol 18 (14) ◽  
pp. 7486
Author(s):  
Mirosław Śnit ◽  
Maciej Misiołek ◽  
Wojciech Ścierski ◽  
Anna Koniewska ◽  
Grażyna Stryjewska-Makuch ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Laryngeal Cancer ◽  
Basic Research ◽  
Control Groups ◽  
Allele Distribution ◽  
Study Results ◽  
Risk Patients ◽  
And Control ◽  
The Relationship

AIM, DIAPH2, PTPRD and HIC1 are the cell glycoprotein, which play an important role in the occurrence and development of tumors. This study was designed to assess the association between DIAPH2, PTPRD and HIC1 SNPs and laryngeal cancer risk. PATIENTS AND METHODS: This study including 267 patients with histologically confirmed laryngeal cancer and 157 controls. The relationship between genetic variations DIAPH2 (rs6620138), PTPRD (rs3765142) and HIC1 (rs9901806) and the onset of laryngeal cancer were investigated. Statistical analysis to calculate the relationship between DIAPH2, PTPRD and HIC1 genes polymorphism and pathogenesis of laryngeal cancer. RESULTS: The results showed that rs6620138 DIAPH2 polymorphism could increase the onset risk of laryngeal cancer. Statistically significant differences in allele distribution of rs6620138 DIAPH2 and rs9901806 HIC1 in the case and control groups subgroups. CONCLUSIONS: This study results suggested that genetic variation of rs6620138 DIAPH2 polymorphism is related to the susceptibility to laryngeal cancer. Our results provide a basis to begin basic research on the role of DIAPH2 gene in the pathogenesis of laryngeal cancer.

Abstract 2753: The Relationship Between Pulmonary Vein Antrum Scarring Following Atrial Fibrillation Ablation and Procedural Success: Does Pulmonary Vein Isolation Matter?

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Troy J Badger ◽  
Robert S Oakes ◽  
Akram Shabaan ◽  
Nazem W Akoum ◽  
Nathan M Segerson ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Veins ◽  
Posterior Wall ◽  
Kaplan Meier ◽  
Number Of Patients ◽  
Procedural Success ◽  
The Relationship ◽  
Af Recurrence

Background. A mechanism of atrial fibrillation (AF) recurrence following ablation may be incomplete pulmonary vein antrum (PVA) scarring that allows for conduction between the pulmonary veins (PV) and the left atrium (LA). We report the relationship between circumferential PV scarring detected by delayed enhancement MRI (DE-MRI) and AF recurrence following PVAI. Methods. Eighty-six patients presenting for PVAI underwent DE-MRI 3 months post ablation. Circumferential ablation with posterior wall debulking was performed in all patients. PV ostia were marked on 3D images generated from the MRI data and assessed by consensus of two independent reviewers for the extent of scarring. Complete PVA scarring was defined as a continuous ring of enhancement surrounding the PVA. For patients with incomplete scarring, the degree of scarring was estimated. Results. The figure shows two patients from the cohort, Patient 1 exhibits successful scarring of all PVA. Patient 2 shows scarring of 1 PVA. At three months post ablation, complete circumferential lesion was seen on 131/335 PVA (39.1%). Complete scarring of 4 PVA was seen in 9 patients (10.5%), scarring of 3 PVA in 11 patients (12.8%) and scarring of 2 PVA was seen in 17 patients (19.8). Twenty-nine patients (33.7%) exhibited complete scarring in 1 PVA while 20 patients (23.3%) exhibited scarring in 0 PVA. Kaplan Meier analysis (Figure [E] ), suggests that PVA isolation may be important for long-term procedural success. Conclusion: Complete pulmonary vein antrum scarring exists in a very limited number of patients, despite its apparent importance for long-term procedural success.

scholarly journals Relationship between triglyceride glucose index and the incidence of non-alcoholic fatty liver disease in the elderly: a retrospective cohort study in China

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039804
Author(s):  
Chen Huanan ◽  
Li Sangsang ◽  
Adwoa Nyantakyiwaa Amoah ◽  
Bo Yacong ◽  
Chen Xuejiao ◽  
...  
Keyword(s):  
Cohort Study ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
The Elderly ◽  
Alcoholic Fatty Liver ◽  
Tyg Index ◽  
The Relationship ◽  
Alcoholic Fatty Liver Disease

ObjectiveNon-alcoholic fatty liver disease (NAFLD) is one of the major causes of liver-related diseases but relationship between triglyceride glucose (TyG) and NAFLD in the elderly is not reported yet. In this study, we investigated the role of TyG index for predicting the incidence of NAFLD in the elderly.Design and settingThis is a prospective cohort study in Henan, China, from 2011 to 2018.Participants and methodsIn total, 46 693 elderly who participated in a routine physical examination programme from 2011 to 2018 were included in this study. TyG index was calculated as ln (fasting triglyceride (mg/dL)×fasting plasma glucose (mg/dL)/2), while NAFLD was defined as hepatic steatosis after excluding other causes based on the results of abdominal ultrasonography; Cox regression model was performed to explore the relationship between TyG index and NAFLD. Also, mediation effect was used to analyse the role of the TyG index in WHtR (waist-to-height ratio) and NAFLD.ResultsDuring the 149 041 person-years follow-up, a total of 5660 NAFLD events occurred (3.80/100 person-years). After adjusting for potential confounding factors, quartiles 4 of TyG index significantly increased the incidence of NAFLD compared with quartile 1, the HRs and 95% CI were 1.314 (1.234 to 1.457). In addition, TyG index played a partial mediating role in the relationship between WHtR and NAFLD and indirect effect was 1.009 (1.006 to 1.011).ConclusionHigher TyG index was associated with higher risk of NAFLD in the aged, and therefore, TyG index may be a novel predictor for incidence of NAFLD. Further, regular examination and evaluation of the TyG index might be useful for controlling the occurrence of NAFLD.

scholarly journals The role of perceived stress and cognitive function on the relationship between neuroticism and depression among the elderly: a structural equation model approach

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mukda Banjongrewadee ◽  
Nahathai Wongpakaran ◽  
Tinakon Wongpakaran ◽  
Tanyong Pipanmekaporn ◽  
Yodying Punjasawadwong ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Structural Equation Model ◽  
Perceived Stress ◽  
Structural Equation ◽  
The Elderly ◽  
Equation Model ◽  
The Relationship ◽  
Model Approach

scholarly journals Lack of Evidence for Age Differences in Pain Beliefs

1997 ◽  
Vol 2 (1) ◽  
pp. 19-28 ◽  
Author(s):  
Lucy Gagliese ◽  
Ronald Melzack
Keyword(s):  
Chronic Pain ◽  
Age Differences ◽  
Self Efficacy ◽  
The Elderly ◽  
Pain Experience ◽  
Pain Beliefs ◽  
Self Assessments ◽  
Normal Ageing ◽  
The Relationship

OBJECTIVE: To assess, in two studies, whether there are any age differences in beliefs about the role of psychological, organic and ageing factors in the experience of chronic pain.SUBJECTS: Healthy adults free from chronic pain ranging in age from 18 to 86 years (first study); adults with chronic pain due to arthritis, fibromyalgia or other rheumatological disorders ranging in age from 27 to 79 years (second study).MATERIALS: In both studies, subjects completed the Pain Beliefs Questionnaire which was modified to measure beliefs about the relationship between pain and ageing. In addition, subjects completed various self-assessments of health, pain intensity and depression. Those with chronic pain also completed the Arthritis Self-Efficacy Scale.RESULTS: There was no evidence of any age differences in beliefs about pain in either the pain-free or chronic pain samples. There was some evidence that elderly patients may report less pain, but there were no age differences found on measures of depression or self-efficacy.CONCLUSIONS: The elderly were no more likely than younger persons to associate pain with the normal ageing process than with organic factors such as tissue damage, nor were they more likely to deny the importance of psychological factors to the pain experience.

Role of Triggering Pulmonary Veins in the Maintenance of Sustained Paroxysmal Atrial Fibrillation

2013 ◽  
Vol 36 (7) ◽  
pp. 845-854 ◽  
Author(s):  
VASSIL B. TRAYKOV ◽  
RÓBERT PAP ◽  
ZOLTÁN GINGL ◽  
SZAMI CHADAIDE ◽  
HARIS M. HAQQANI ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Pulmonary Veins
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