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Atrial fibrillation and obesity

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https://www.readbyqxmd.com/read/27909521/recurrent-atrial-fibrillation-after-catheter-ablation-considerations-for-repeat-ablation-and-strategies-to-optimize-success
#1
REVIEW
Andrew E Darby Md Fhrs
Recurrent AF after catheter ablation occurs in at least 20 to 40% of patients. Repeat ablation is primarily considered for those with symptomatic AF recurrences (often drug-refactory) occurring at least 3 months or more post-ablation. Pulmonary vein reconnection is almost universally encountered, and repeat isolation of electrically connected pulmonary veins should be the primary ablation strategy. Beyond repeat PVI and possible ablation of non-PV triggers, there is little to no evidence that additional substrate modification improves outcomes...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909488/atrial-fibrillation-and-sleep-apnea-considerations-for-a-dual-epidemic
#2
REVIEW
Patricia Tung Md, Elad Anter Md
Atrial fibrillation (AF) is the most common cardiac arrhythmia and shares many of the same risk factors as another common clinical condition, sleep apnea. The estimated prevalence of sleep apnea has increased over the past decade, and reflects a parallel increase in the most prominent risk factors of obesity and overweight. Both obstructive and central sleep apnea have been associated with AF in multiple studies, with the risk of AF increasing 2-4-fold compared to those without sleep breathing disorder. Continuous positive airway pressure (CPAP) has been shown to reduce the rate of AF recurrence following catheter ablation in patients with sleep apnea...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27886982/impact-of-norepinephrine-weight-based-dosing-compared-with-non-weight-based-dosing-in-achieving-time-to-goal-mean-arterial-pressure-in-obese-patients-with-septic-shock
#3
Nina Vadiei, Mitchell J Daley, Manasa S Murthy, Carrie S Shuman
BACKGROUND: Currently, a lack of standardization exists in norepinephrine dosing units, the first-line vasopressor for septic shock. Timely achievement of goal mean arterial pressure (MAP) is dependent on optimal vasopressor dosing. OBJECTIVE: To determine if weight-based dosing (WBD) of norepinephrine leads to earlier time to goal MAP compared with non-WBD in obese patients with septic shock. METHODS: This was a retrospective, multicenter cohort study...
November 24, 2016: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/27870410/sex-differences-in-neuroinflammation-and-neuroprotection-in-ischemic-stroke
#4
REVIEW
Monica S Spychala, Pedram Honarpisheh, Louise D McCullough
Stroke is not only a leading cause of mortality and morbidity worldwide it also disproportionally affects women. There are currently over 500,000 more women stroke survivors in the US than men, and elderly women bear the brunt of stroke-related disability. Stroke has dropped to the fifth leading cause of death in men, but remains the third in women. This review discusses sex differences in common stroke risk factors, the efficacy of stroke prevention therapies, acute treatment responses, and post-stroke recovery in clinical populations...
January 2, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/27847152/endurance-exercise-induced-changes-in-bnp-concentrations-in-cardiovascular-patients-versus-healthy-controls
#5
Vincent L Aengevaeren, Maria T E Hopman, Dick H J Thijssen, Roland R van Kimmenade, Menko-Jan de Boer, Thijs M H Eijsvogels
BACKGROUND: Healthy athletes demonstrated increased B-type natriuretic peptide (BNP) concentrations following exercise, but it is unknown whether these responses are exaggerated in individuals with cardiovascular risk factors (CVRF) or disease (CVD). We compared exercise-induced increases in BNP between healthy controls (CON) and individuals with CVRF or CVD. Furthermore, we aimed to identify predictors for BNP responses. METHODS: Serum BNP concentrations were measured in 191 participants (60±12yrs) of the Nijmegen Marches before (baseline) and immediately after 4 consecutive days of walking exercise (30-50km/day)...
November 8, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27813300/echocardiographic-screening-for-non-ischaemic-stage-b-heart-failure-in-the-community
#6
Hong Yang, Kazuaki Negishi, Ying Wang, Mark Nolan, Makoto Saito, Thomas H Marwick
AIMS: Incident heart failure (HF) continues to pose a common and serious problem. We sought to examine the value of echocardiographic predictors of new HF in a community-based elderly population at risk for HF, independent of and incremental to clinical evaluation. METHODS AND RESULTS: Asymptomatic patients ≥65 years old, with ≥1 HF risk factor (hypertension, type 2 diabetes, or obesity) were recruited from the community; patients with valve disease, reduced ejection fraction (EF), and atrial fibrillation (AF) were excluded...
November 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27809772/the-burden-of-cardiovascular-morbidity-in-a-european-mediterranean-population-with-multimorbidity-a-cross-sectional-study
#7
Concepción Violán, Néker Bejarano-Rivera, Quintí Foguet-Boreu, Albert Roso Llorach, Mariona Pons-Vigués, Miguel Martin Mateo, Enriqueta Pujol-Ribera
BACKGROUND: Cardiovascular diseases are highly represented in multimorbidity patterns. Nevertheless, few studies have analysed the burden of these diseases in the population with multimorbidity. The objective of this study was to identify and describe the cardiovascular diseases among the patients with multimorbidity. METHODS: We designed a cross-sectional study in patients ≥19 years old assigned to 251 primary health care centres in Catalonia, Spain. The main outcome was cardiovascular morbidity burden, defined as the presence of one or more of 24 chronic cardiovascular diseases in multimorbid patients (≥2 chronic conditions)...
November 3, 2016: BMC Family Practice
https://www.readbyqxmd.com/read/27798703/risk-of-atrial-fibrillation-or-flutter-associated-with-periodontitis-a-nationwide-population-based-cohort-study
#8
Der-Yuan Chen, Ching-Heng Lin, Yi-Ming Chen, Hsin-Hua Chen
OBJECTIVE: To investigate the risk of atrial fibrillation or atrial flutter in patients with periodontitis (PD) in comparison with individuals without PD. METHODS: We used the 1999-2010 Taiwanese National Health Insurance Research Database to identify cases of PD in the year 2000 matching (1:1) with persons without PD during 1999-2000 according to sex and individual age as the control group. Using Cox proportional regression analysis adjusting for potential confounders, including age, sex, and comorbidities at baseline, and average annual number of ambulatory visits and dental scaling frequency during the follow-up period, we estimated hazard ratios (HRs) with 95% confidence intervals (CIs) to examine the risk of atrial fibrillation or flutter in PD patients in comparison with the control group...
2016: PloS One
https://www.readbyqxmd.com/read/27795488/traditional-cardiovascular-risk-factors-for-incident-atrial-fibrillation
#9
Yoshihiro Kokubo, Chisa Matsumoto
To prevent atrial fibrillation (AF), it is essential to reduce its risk factors and extend healthy life expectancy as a result. There are few reviews on the AF risk factors. We discuss them and approach the prevention of AF. We briefly review traditional risk factors for incident AF, especially focusing on high blood pressure, overweight/obesity, dyslipidemia, diabetes, tobacco smoking, and excessive drinking. When trying to prevent AF by modifying lifestyle, it is important to comprehensively utilize the risk factors for AF to predict the 10-year as an AF risk score...
October 29, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27784526/abdominal-elephantiasis-nostras-verrucosa-an-underrecognized-disorder
#10
Derek Ho, Eve J Lowenstein
Case 1 A 60-year-old African American man presented with a medical history of morbid obesity (weighing more than 550 lb), benign prostatic hyperplasia, hyperlipidemia, gynecomastia, atrial fibrillation, hypertension, chronic obstructive pulmonary disease, psoriasis, sleep apnea, and cardiomegaly. His size has limited his ability to clean himself properly. He experiences chronic and recurrent skin irritation and cellulitis possibly secondary to intertriginous superinfection, lymphedema, and venous stasis. On examination, his abdomen showed heavy skinfolding with hyperpigmentation, cobblestone and velvety changes, thickening and fibrotic induration of the skin, focal areas of redness, and tenderness on palpation (Figure 1A and 1B)...
2016: Skinmed
https://www.readbyqxmd.com/read/27783474/sulfonylurea-and-the-heart-theoretically-a-compounded-question-from-a-pathophysiological-perspective
#11
Pendar Farahani
Evidence from literature illustrates that from a pathophysiological perspective, sulfonylureas (SU) may impact the heart three ways: directly by intrinsic properties from a pharmacological receptor perspective, indirectly by adverse effects related to hypoglycemia, and obesity. From a pharmacologlogical receptor perspective, SU can bind to ATP-sensitive potassium channels in cardiomyocytes. Channel binding by SU in cardiac tissue may prevent ischemia myocardial protective mechanisms. From a pathophysiological perspective, obesity is associated with cardiac issues such as pulmonary hypertension, left ventricular hypertrophy, arrhythmia, and atrial fibrillation...
September 13, 2016: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/27777519/incidence-predictors-and-impact-of-postoperative-atrial-fibrillation-after-coronary-artery-bypass-grafting-in-military-veterans
#12
Shuab Omer, Lorraine D Cornwell, Ankur Bakshi, Eric Rachlin, Ourania Preventza, Todd K Rosengart, Joseph S Coselli, Scott A LeMaire, Nancy J Petersen, Greg Pattakos, Faisal G Bakaeen
Little is known about the frequency and clinical implications of postoperative atrial fibrillation in military veterans who undergo coronary artery bypass grafting (CABG). We examined long-term survival data, clinical outcomes, and associated risk factors in this population. We retrospectively reviewed baseline, intraoperative, and postoperative data from 1,248 consecutive patients with similar baseline risk profiles who underwent primary isolated CABG at a Veterans Affairs hospital from October 2006 through March 2013...
October 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/27776716/assessment-of-apelin-serum-levels-in-persistent-atrial-fibrillation-and-coronary-artery-disease
#13
Mehrnaz Riazian, Elnaz Khorrami, Elham Alipoor, Sina Moradmand, Mehdi Yaseri, Mohammad Javad Hosseinzadeh-Attar
BACKGROUND: Apelin, the endogenous ligand of orphan receptor APJ (gene symbol APLNR), is an adipokine that was suggested to have a direct correlation with obesity. This peptide might play a role in obesity-related disorders, especially in the cardiovascular system. Currently, few data are available on levels and potential metabolic functions of apelin in different cardiac diseases including atrial fibrillation (AF) and coronary artery disease (CAD), which have common underlying pathophysiological mechanisms...
October 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27771002/effectiveness-and-safety-of-an-independently-run-nurse-practitioner-outpatient-cardioversion-program-2009-to-2014
#14
Linda Norton, Angela Tsiperfal, Kelly Cook, Ani Bagdasarian, John Varady, Manali Shah, Paul Wang
Sustained growth in the arrhythmia population at Stanford Health Care led to an independent nurse practitioner-run outpatient direct current cardioversion (DCCV) program in 2012. DCCVs performed by a medical doctor, a nurse practitioner under supervision, or nurse practitioners from 2009 to 2014 were compared for safety and efficacy. A retrospective review of the electronic medical records system (Epic) was performed on biodemographic data, cardiovascular risk factors, medication history, procedural data, and DCCV outcomes...
September 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27753234/atrial-electrocardiography-in-obesity-and-hypertension-clinical-insights-from-the-polish-norwegian-study-pons
#15
Georgeta D Vaidean, Marta Manczuk, Jared W Magnani
OBJECTIVE: Obesity and hypertension often coexist and represent risk factors for atrial fibrillation. This study hypothesized that their single and joint effects on atrial remodeling would be reflected in the PR interval and P-wave durations on electrocardiogram (ECG). METHODS: This cross-sectional analysis of a community-based study included 11,308 men and women age 45-64. Atrial indices were obtained from digital standard 12-lead resting ECG. Analyses were adjusted for traditional cardiovascular risk factors...
October 18, 2016: Obesity
https://www.readbyqxmd.com/read/27735919/-atrial-fibrillation-and-prolonged-nocturnal-cardiac-arrests-in-a-patient-with-obstructive-sleep-apnea-syndrome-successful-correction-of-disorders-by-cpap-therapy
#16
E Sh Bairambekov, A V Pevzner, A Yu Litvin, O A Fomicheva
The case history of a 46-year-old patient with obstructive sleep apnea syndrome was analyzed. The examination revealed fourth-degree obesity, prior myocardial infarction, persistent atrial fibrillation with nocturnal asystoles lasting as long as 14.3 sec. During selected drug therapy and regular application of secondary ventilation (continuous positive airway pressure (CPAP) therapy) used to correct breathing problems, there was a reduction in the signs of circulatory deficiency, cessation of cardiac pauses, and recovery of sinus rhythm...
2016: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/27694532/heart-rate-at-admission-is-a-predictor-of-in-hospital-mortality-in-patients-with-acute-coronary-syndromes-results-from-58-european-hospitals-the-european-hospital-benchmarking-by-outcomes-in-acute-coronary-syndrome-processes-study
#17
Magnus T Jensen, Marta Pereira, Carla Araujo, Anti Malmivaara, Jean Ferrieres, Irene R Degano, Inge Kirchberger, Dimitrios Farmakis, Pascal Garel, Marina Torre, Jaume Marrugat, Ana Azevedo
AIMS: The purpose of this study was to investigate the relationship between heart rate at admission and in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS). METHODS: Consecutive ACS patients admitted in 2008-2010 across 58 hospitals in six participant countries of the European Hospital Benchmarking by Outcomes in ACS Processes (EURHOBOP) project (Finland, France, Germany, Greece, Portugal and Spain)...
September 30, 2016: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/27688858/is-it-possible-to-delay-or-prevent-age-related-cognitive-decline
#18
REVIEW
Jean-Pierre Michel
Already in the 90s, Khachaturian stated that postponing dementia onset by five years would decrease the prevalence of the late onset dementia by 50%. After two decades of lack of success in dementia drug discovery and development, and knowing that worldwide, currently 36 million patients have been diagnosed with Alzheimer's disease, a number that will double by 2030 and triple by 2050, the World Health Organization and the Alzheimer's Disease International declared that prevention of cognitive decline was a 'public health priority...
September 2016: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/27682440/risk-factors-for-incident-hospitalized-heart-failure-with-preserved-versus-reduced-ejection-fraction-in-a-multiracial-cohort-of-postmenopausal-women
#19
Charles B Eaton, Mary Pettinger, Jacques Rossouw, Lisa Warsinger Martin, Randi Foraker, Abdullah Quddus, Simin Liu, Nina S Wampler, Wen-Chih Hank Wu, JoAnn E Manson, Karen Margolis, Karen C Johnson, Matthew Allison, Giselle Corbie-Smith, Wayne Rosamond, Khadijah Breathett, Liviu Klein
BACKGROUND: Heart failure is an important and growing public health problem in women. Risk factors for incident hospitalized heart failure with preserved ejection fraction (HFpEF) compared with heart failure with reduced ejection fraction (HFrEF) in women and differences by race/ethnicity are not well characterized. METHODS AND RESULTS: We prospectively evaluated the risk factors for incident hospitalized HFpEF and HFrEF in a multiracial cohort of 42 170 postmenopausal women followed up for a mean of 13...
October 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27666172/relation-of-pericardial-fat-intrathoracic-fat-and-abdominal-visceral-fat-with-incident-atrial-fibrillation-from-the-framingham-heart-study
#20
Jane J Lee, Xiaoyan Yin, Udo Hoffmann, Caroline S Fox, Emelia J Benjamin
Obesity is associated with increased risk of developing atrial fibrillation (AF). Different fat depots may have differential associations with cardiac pathology. We examined the longitudinal associations between pericardial, intrathoracic, and visceral fat with incident AF. We studied Framingham Heart Study Offspring and Third-Generation Cohorts who participated in the multidetector computed tomography substudy examination 1. We constructed multivariable-adjusted Cox proportional hazard models for risk of incident AF...
November 15, 2016: American Journal of Cardiology
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