Objective To investigate whether plasma big endothelin-1(ET-1) predicts ventricular arrythmias(VAs) and end-stage events in primary prevention implantable cardioverter-defibrillator(ICD) indication patigents. Methods ...Objective To investigate whether plasma big endothelin-1(ET-1) predicts ventricular arrythmias(VAs) and end-stage events in primary prevention implantable cardioverter-defibrillator(ICD) indication patigents. Methods In total, 207 patients fulfilling the inclusion criteria from Fuwai Hospital between January 2013 and December 2015 were retrospectively analyzed. The cohort was divided into three groups according to baseline plasma big ET-1 tertiles: tertile 1(< 0.38 pmol/L, n = 68), tertile 2(0.38–0.7 pmol/L, n = 69), and tertile 3(> 0.7 pmol/L, n = 70). The primary endpoints were VAs. The secondary endpoints were end-stage events comprising all-cause mortality and heart transplantation. Results During a mean follow-up period of 25.6 ± 13.9 months, 38(18.4%) VAs and 78(37.7%) end-stage events occurred. Big ET-1 was positively correlated with NYHA class(r = 0.165, P = 0.018), serum creatinine concentration(Scr;r = 0.147, P = 0.034), high-sensitivity C-reactive protein(hs-CRP;r = 0.217, P = 0.002), Lg NT-pro BNP(r = 0.463, P < 0.001), left ventricular end diastolic diameter(LVEDD;r = 0.234, P = 0.039) and negatively correlated with left ventricular ejection fraction(LVEF;r =-0.181, P = 0.032). Kaplan-Meier analysis showed that elevated big ET-1 was associated with increased risk of VAs and end-stage events(P < 0.05). In multivariate Cox regression models, big ET-1 was an independent risk factor for VAs(hazard ratio(HR) = 3.477, 95% confidence interval(CI): 1.352–8.940, P = 0.010, tertile 2 vs. tertile 1;HR = 4.112, 95% CI: 1.604–10.540, P = 0.003, tertile 3 vs. tertile 1) and end-stage events(HR = 2.804, 95% CI: 1.354–5.806, P = 0.005, tertile 2 vs. tertile 1;HR = 4.652, 95% CI: 2.288–9.459, P < 0.001, tertile 3 vs. tertile 1). Conclusions In primary prevention ICD indication patients, plasma big ET-1 levels can predict VAs and end-stage events and may facilitate ICD-implantation risk stratification.展开更多
The integration of wearable technology and remote monitoring (RM) has significantlytransformed the early detection, continuous monitoring, and managementof cardiac arrhythmias. These conditions, characterized by irreg...The integration of wearable technology and remote monitoring (RM) has significantlytransformed the early detection, continuous monitoring, and managementof cardiac arrhythmias. These conditions, characterized by irregular heart rhythms,arise from various etiological factors, including congenital, structural, immunological,metabolic, and infectious diseases, with atrial fibrillation being themost prevalent type. Diagnosing arrhythmias remains challenging due to variableclinical presentations and episodic symptom manifestations, necessitating individualizedmanagement strategies. Recent advances in wearable technology offerscalable, cost-effective solutions for real-time arrhythmia monitoring. These devicesare equipped with sophisticated sensors and data analytics that enable earlydetection and personalized interventions, while empowering patients to activelyengage in their healthcare. Integrating RM systems enhances diagnostic accuracyand facilitates timely medical interventions. Despite their potential, regulatory,legal, privacy, security, and infrastructural challenges hinder the widespreadadoption of wearable technology and RM. Addressing these barriers requirescollaboration among stakeholders and rigorous clinical trials to assess theirefficacy and feasibility. Future research should focus on refining wearable technology,improving user experience, and integrating these innovations into existinghealthcare frameworks. Overcoming these challenges will maximize the potentialof wearable technology and RM, ultimately enhancing the management of cardiacarrhythmias and improving patient outcomes.展开更多
BACKGROUND Cardiovascular disease(CVD)and associated sequalae remain the leading cause of disability worldwide.Ischemic heart disease(IHD)and heart failure are the most common etiologies of morbidity and mortality wor...BACKGROUND Cardiovascular disease(CVD)and associated sequalae remain the leading cause of disability worldwide.Ischemic heart disease(IHD)and heart failure are the most common etiologies of morbidity and mortality worldwide.This is due to the poor diagnostic and management methods for heart failure and IHD.Early detection of related risk factors through modern strategies is underestimated and requires further research.AIM To interpret data from the published literature on volatile organic compounds(VOC),including all the methods used to analyze exhaled breath in patients with IHD and heart failure.METHODS Searches for specific keywords were performed on Scopus and PubMed.A total of 20 studies were identified in breath analysis and IHD and heart failure.The study is registered in PROSPERO(Registration No.CRD42023470556).RESULTS Considering the articles found,more research is required to gain a full understanding of the role of VOCs in IHD and heart failure.However,the existing literature demonstrates that cardiac metabolic changes can be expressed in exhaled air.The number of papers found is extremely low,making interpretation extremely difficult.CONCLUSION Exhaled breath analysis can be a novel biomarker for the diagnosis and prevention of heart failure and IHD.Exhaled breath analysis can be used as a mirror to reflect the metabolic changes related to IHD and heart failure.展开更多
基金supported by Natural Science Foundation of China(81470466)。
文摘Objective To investigate whether plasma big endothelin-1(ET-1) predicts ventricular arrythmias(VAs) and end-stage events in primary prevention implantable cardioverter-defibrillator(ICD) indication patigents. Methods In total, 207 patients fulfilling the inclusion criteria from Fuwai Hospital between January 2013 and December 2015 were retrospectively analyzed. The cohort was divided into three groups according to baseline plasma big ET-1 tertiles: tertile 1(< 0.38 pmol/L, n = 68), tertile 2(0.38–0.7 pmol/L, n = 69), and tertile 3(> 0.7 pmol/L, n = 70). The primary endpoints were VAs. The secondary endpoints were end-stage events comprising all-cause mortality and heart transplantation. Results During a mean follow-up period of 25.6 ± 13.9 months, 38(18.4%) VAs and 78(37.7%) end-stage events occurred. Big ET-1 was positively correlated with NYHA class(r = 0.165, P = 0.018), serum creatinine concentration(Scr;r = 0.147, P = 0.034), high-sensitivity C-reactive protein(hs-CRP;r = 0.217, P = 0.002), Lg NT-pro BNP(r = 0.463, P < 0.001), left ventricular end diastolic diameter(LVEDD;r = 0.234, P = 0.039) and negatively correlated with left ventricular ejection fraction(LVEF;r =-0.181, P = 0.032). Kaplan-Meier analysis showed that elevated big ET-1 was associated with increased risk of VAs and end-stage events(P < 0.05). In multivariate Cox regression models, big ET-1 was an independent risk factor for VAs(hazard ratio(HR) = 3.477, 95% confidence interval(CI): 1.352–8.940, P = 0.010, tertile 2 vs. tertile 1;HR = 4.112, 95% CI: 1.604–10.540, P = 0.003, tertile 3 vs. tertile 1) and end-stage events(HR = 2.804, 95% CI: 1.354–5.806, P = 0.005, tertile 2 vs. tertile 1;HR = 4.652, 95% CI: 2.288–9.459, P < 0.001, tertile 3 vs. tertile 1). Conclusions In primary prevention ICD indication patients, plasma big ET-1 levels can predict VAs and end-stage events and may facilitate ICD-implantation risk stratification.
文摘The integration of wearable technology and remote monitoring (RM) has significantlytransformed the early detection, continuous monitoring, and managementof cardiac arrhythmias. These conditions, characterized by irregular heart rhythms,arise from various etiological factors, including congenital, structural, immunological,metabolic, and infectious diseases, with atrial fibrillation being themost prevalent type. Diagnosing arrhythmias remains challenging due to variableclinical presentations and episodic symptom manifestations, necessitating individualizedmanagement strategies. Recent advances in wearable technology offerscalable, cost-effective solutions for real-time arrhythmia monitoring. These devicesare equipped with sophisticated sensors and data analytics that enable earlydetection and personalized interventions, while empowering patients to activelyengage in their healthcare. Integrating RM systems enhances diagnostic accuracyand facilitates timely medical interventions. Despite their potential, regulatory,legal, privacy, security, and infrastructural challenges hinder the widespreadadoption of wearable technology and RM. Addressing these barriers requirescollaboration among stakeholders and rigorous clinical trials to assess theirefficacy and feasibility. Future research should focus on refining wearable technology,improving user experience, and integrating these innovations into existinghealthcare frameworks. Overcoming these challenges will maximize the potentialof wearable technology and RM, ultimately enhancing the management of cardiacarrhythmias and improving patient outcomes.
基金Supported by the Government Assignment to Philipp Kopylov,No.1023022600020-6Russian Science Foundation Grant to Philipp Kopylov,No.24-15-00549the Ministry of Science and Higher Education of the Russian Federation within the Framework of State Support for the Creation and Development of World-Class Research Center to Basheer Marzoog and Peter Chomakhidze,No.075-15-2022-304.
文摘BACKGROUND Cardiovascular disease(CVD)and associated sequalae remain the leading cause of disability worldwide.Ischemic heart disease(IHD)and heart failure are the most common etiologies of morbidity and mortality worldwide.This is due to the poor diagnostic and management methods for heart failure and IHD.Early detection of related risk factors through modern strategies is underestimated and requires further research.AIM To interpret data from the published literature on volatile organic compounds(VOC),including all the methods used to analyze exhaled breath in patients with IHD and heart failure.METHODS Searches for specific keywords were performed on Scopus and PubMed.A total of 20 studies were identified in breath analysis and IHD and heart failure.The study is registered in PROSPERO(Registration No.CRD42023470556).RESULTS Considering the articles found,more research is required to gain a full understanding of the role of VOCs in IHD and heart failure.However,the existing literature demonstrates that cardiac metabolic changes can be expressed in exhaled air.The number of papers found is extremely low,making interpretation extremely difficult.CONCLUSION Exhaled breath analysis can be a novel biomarker for the diagnosis and prevention of heart failure and IHD.Exhaled breath analysis can be used as a mirror to reflect the metabolic changes related to IHD and heart failure.
