Background Information on the relationship between red blood cell distribution width(RDW)and atrial fibrillation(AF)in patients with essential hypertension are scarce.The study aimed to assess the relationship between...Background Information on the relationship between red blood cell distribution width(RDW)and atrial fibrillation(AF)in patients with essential hypertension are scarce.The study aimed to assess the relationship between AF and RDW in hypertensive patients.Methods We enrolled 432 hypertensive patients,including 350 AF patients and 82 patients as controls.Patients'demographic,clinical,laboratory and echocardiographic characteristics were recorded.The AF patients were further divided into the persistent and paroxysmal AF subgroups.Electrocardiograms were monitored to identify the cardiac rhythm during blood sampling,and based on the rhythm,the paroxysmal AF group was categorized into the presence(with AF rhythm during blood sampling)and absence(with sinus rhythm during blood sampling)groups.Results The AF group had elevated RDW levels than the controls(12.7%±0.8%vs.12.4%±0.7%,P=0.002),and the persistent AF subgroup had higher RDW levels than the paroxysmal AF subgroup(12.9%±0.8%vs.12.6%±0.8%,P=0.007).Furthermore,in the paroxysmal AF group,the presence group had higher RDW levels than the absence group(13.0%±0.6%vs.12.5%±0.9%,P=0.001).There was no significant difference in RDW levels between the persistent AF subgroup and presence group of the paroxysmal AF subgroup(P=0.533)and between the absence group of the paroxysmal AF subgroup and control group(P=0.262).In multivariate regression analysis,in hypertensive patients,the presence of AF rhythm is an independent predictor for increased RDW concentration(P=0.001).Conclusions The RDW may be associated with the presence of AF rhythm,which implies the importance of maintaining the sinus rhythm in hypertensive patients.展开更多
Background Endothelial function,as measured by big endothelin-1(ET-1),has been demonstrated to be useful in predicting adverse long-term events in patients with cardiovascular disease.Nevertheless,there are little dat...Background Endothelial function,as measured by big endothelin-1(ET-1),has been demonstrated to be useful in predicting adverse long-term events in patients with cardiovascular disease.Nevertheless,there are little data about the association between big ET-1 and thromboembolism risk in atrial fibrillation(AF).We aimed to investigate the relationship between big ET-1 and CHADS2/CHA2DS2-VASc scores used for evaluating thromboembolic risk in patients with non-valvular AF.Methods The study population consisted of 238 consecutive AF patients(67.6%with paroxysmal AF and 32.4%with persistent AF).The patients were divided into two groups(high-or low-intermediate risk group)based on CHADS2 and CHA2 DS2-VASc scores(score≥2 or<2,respectively).Clinical,laboratory,and echocardiographic parameters were evaluated,and the CHADS2/CHA2DS2-VASc scores were compared between groups.The association between big ET-1 levels and CHADS2/CHA2DS2-VASc score was assessed.Multivariate logistic regression analysis was performed to identify independent predictors of CHADS2/CHA2DS2-VASc scores.Results The high CHADS2/CHA2DS2-VASc score group had older age,higher big ET-1 levels,and enlarged left atrial diameter than the low CHADS2/CHA2DS2-VASc score group(P<0.05).Multiple logistic regression analysis revealed that big ET-1 level was an independent determinant of high CHADS2/CHA2DS2-VASc scores[odds ratio(OR)=2.545 and OR=3.816;both P<0.05].Conclusions Our study indicates that in non-valvular AF,big ET-1 was significantly correlated with CHADS2/CHA2DS2-VASc scores and an independent predictor of high CHADS2/CHA2DS2-VASc scores.Big ET-1 may serve as a useful marker for risk stratification in this setting.展开更多
Background One of the major challenges in arrhythmogenic right ventricular cardiomyopathy （ARVC） ablation is ventricular tachy-cardia （VT） non-inducibility. The study aimed to assess whether fast rate （≥ 250 bea...Background One of the major challenges in arrhythmogenic right ventricular cardiomyopathy （ARVC） ablation is ventricular tachy-cardia （VT） non-inducibility. The study aimed to assess whether fast rate （≥ 250 beats/min） right ventricular burst stimulation was useful for VT induction in patients with ARVC.Methods Ninety-one consecutive ARVC patients with clinical sustained VT that underwent electro-physiological study were enrolled. The stimulation protocol was implemented at both right ventricular apex and outflow tract as follows： Step A, up to double extra-stimuli; Step B, incremental stimulation with low rate （＆lt; 250 beats/min）; Step C, burst stimulation with fast rate （≥ 250 beats/min）; Step D, repeated all steps above with intravenous infusion of isoproterenol.Results A total of 76 patients had inducible VT （83.5%）, among which 49 were induced by Step C, 15 were induced by Step B, 8 and 4 by Step A and D, respectively. Clinical VTs were induced in 60 patients （65.9%）. Only two spontaneously ceased ventricular fibrillations were induced by Step C. Multivariate analysis showed that a narrower baseline QRS duration under sinus rhythm was independently associated with VT non-inducibility （OR： 1.1; 95% CI： 1.0-1.1;P = 0.019）.ConclusionFast rate （≥ 250 beats/min） right ventricular burst stimulation provides a useful supplemental method for VT induction in ARVC patients.展开更多
Anticoagulants are routinely prescribed in the first several weeks after atrial fibrillation(AF)catheter ablation.Nonvitamin K antagonist oral anticoagulants(NOACs)have been recommended over warfarin for their superio...Anticoagulants are routinely prescribed in the first several weeks after atrial fibrillation(AF)catheter ablation.Nonvitamin K antagonist oral anticoagulants(NOACs)have been recommended over warfarin for their superiority.Unlike warfarin need regular clinical visit to perform blood test,NOACs are more patient friendly.But the lack of routine medical contact may lead to poor adherence.Strict adherence to anticoagulant treatment is essential for both efficacy and safety.Considering NOACs are increasingly commonly used in China,it is therefore necessary to evaluate the adherence of NOACs after AF catheter ablation.The purpose of this research was to investigate the treatment adherence and identify factors that could improve the quality of anticoagulation.展开更多
基金supported by the National Natural Scientific Foundation of China(No.81600275)。
文摘Background Information on the relationship between red blood cell distribution width(RDW)and atrial fibrillation(AF)in patients with essential hypertension are scarce.The study aimed to assess the relationship between AF and RDW in hypertensive patients.Methods We enrolled 432 hypertensive patients,including 350 AF patients and 82 patients as controls.Patients'demographic,clinical,laboratory and echocardiographic characteristics were recorded.The AF patients were further divided into the persistent and paroxysmal AF subgroups.Electrocardiograms were monitored to identify the cardiac rhythm during blood sampling,and based on the rhythm,the paroxysmal AF group was categorized into the presence(with AF rhythm during blood sampling)and absence(with sinus rhythm during blood sampling)groups.Results The AF group had elevated RDW levels than the controls(12.7%±0.8%vs.12.4%±0.7%,P=0.002),and the persistent AF subgroup had higher RDW levels than the paroxysmal AF subgroup(12.9%±0.8%vs.12.6%±0.8%,P=0.007).Furthermore,in the paroxysmal AF group,the presence group had higher RDW levels than the absence group(13.0%±0.6%vs.12.5%±0.9%,P=0.001).There was no significant difference in RDW levels between the persistent AF subgroup and presence group of the paroxysmal AF subgroup(P=0.533)and between the absence group of the paroxysmal AF subgroup and control group(P=0.262).In multivariate regression analysis,in hypertensive patients,the presence of AF rhythm is an independent predictor for increased RDW concentration(P=0.001).Conclusions The RDW may be associated with the presence of AF rhythm,which implies the importance of maintaining the sinus rhythm in hypertensive patients.
基金supported by the National Natural Science Foundation of China(No.81600275)
文摘Background Endothelial function,as measured by big endothelin-1(ET-1),has been demonstrated to be useful in predicting adverse long-term events in patients with cardiovascular disease.Nevertheless,there are little data about the association between big ET-1 and thromboembolism risk in atrial fibrillation(AF).We aimed to investigate the relationship between big ET-1 and CHADS2/CHA2DS2-VASc scores used for evaluating thromboembolic risk in patients with non-valvular AF.Methods The study population consisted of 238 consecutive AF patients(67.6%with paroxysmal AF and 32.4%with persistent AF).The patients were divided into two groups(high-or low-intermediate risk group)based on CHADS2 and CHA2 DS2-VASc scores(score≥2 or<2,respectively).Clinical,laboratory,and echocardiographic parameters were evaluated,and the CHADS2/CHA2DS2-VASc scores were compared between groups.The association between big ET-1 levels and CHADS2/CHA2DS2-VASc score was assessed.Multivariate logistic regression analysis was performed to identify independent predictors of CHADS2/CHA2DS2-VASc scores.Results The high CHADS2/CHA2DS2-VASc score group had older age,higher big ET-1 levels,and enlarged left atrial diameter than the low CHADS2/CHA2DS2-VASc score group(P<0.05).Multiple logistic regression analysis revealed that big ET-1 level was an independent determinant of high CHADS2/CHA2DS2-VASc scores[odds ratio(OR)=2.545 and OR=3.816;both P<0.05].Conclusions Our study indicates that in non-valvular AF,big ET-1 was significantly correlated with CHADS2/CHA2DS2-VASc scores and an independent predictor of high CHADS2/CHA2DS2-VASc scores.Big ET-1 may serve as a useful marker for risk stratification in this setting.
文摘Background One of the major challenges in arrhythmogenic right ventricular cardiomyopathy （ARVC） ablation is ventricular tachy-cardia （VT） non-inducibility. The study aimed to assess whether fast rate （≥ 250 beats/min） right ventricular burst stimulation was useful for VT induction in patients with ARVC.Methods Ninety-one consecutive ARVC patients with clinical sustained VT that underwent electro-physiological study were enrolled. The stimulation protocol was implemented at both right ventricular apex and outflow tract as follows： Step A, up to double extra-stimuli; Step B, incremental stimulation with low rate （＆lt; 250 beats/min）; Step C, burst stimulation with fast rate （≥ 250 beats/min）; Step D, repeated all steps above with intravenous infusion of isoproterenol.Results A total of 76 patients had inducible VT （83.5%）, among which 49 were induced by Step C, 15 were induced by Step B, 8 and 4 by Step A and D, respectively. Clinical VTs were induced in 60 patients （65.9%）. Only two spontaneously ceased ventricular fibrillations were induced by Step C. Multivariate analysis showed that a narrower baseline QRS duration under sinus rhythm was independently associated with VT non-inducibility （OR： 1.1; 95% CI： 1.0-1.1;P = 0.019）.ConclusionFast rate （≥ 250 beats/min） right ventricular burst stimulation provides a useful supplemental method for VT induction in ARVC patients.
基金Supported by grants of the National Natural Science Foundation of China(No.81970285 and No.81600275).
文摘Anticoagulants are routinely prescribed in the first several weeks after atrial fibrillation(AF)catheter ablation.Nonvitamin K antagonist oral anticoagulants(NOACs)have been recommended over warfarin for their superiority.Unlike warfarin need regular clinical visit to perform blood test,NOACs are more patient friendly.But the lack of routine medical contact may lead to poor adherence.Strict adherence to anticoagulant treatment is essential for both efficacy and safety.Considering NOACs are increasingly commonly used in China,it is therefore necessary to evaluate the adherence of NOACs after AF catheter ablation.The purpose of this research was to investigate the treatment adherence and identify factors that could improve the quality of anticoagulation.
