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Cardiovascular Pathology : the Official... May 2024Constrictive pericarditis (CP) is characterised by scarring fibrosis and a loss of pericardial elasticity, which causes heart failure. IgG4 (immunoglobulin G4)-related...
AIM
Constrictive pericarditis (CP) is characterised by scarring fibrosis and a loss of pericardial elasticity, which causes heart failure. IgG4 (immunoglobulin G4)-related disease (IgG4-RD) is a systemic fibro-inflammatory disease characterised by the infiltration of IgG4-immunopositive plasmacytes and high serum IgG4 levels that frequently shape tumorous lesions. Although pericardial involvement of IgG4-RD is rare, with indications of CP, pericardial effusion and irregular masses, the clinical and pathological features remain unclear. In this study, we examined the relationship between CP and IgG4-RD.
METHODS
Among 35 thick-walled CP cases (histologically pericardial thickening ≥2 mm), eight cases were aetiology identified. Using the diagnostic criteria for IgG4-RD, 11 cases were classified as IgG4-CP, whereas the remainder were considered true idiopathic CP (16 cases) and the clinical pathological features were evaluated.
RESULTS
Compared with the other groups, the IgG4-CP group was more common in men and associated with low-grade fever and massive pericardial effusion with frequent recurrence. Deaths resulting from heart failure occurred in a few cases of the IgG4-CP group, but not in other groups. An increase in C-reactive protein and a high positivity rate of anti-nuclear antibodies frequently occurred in the IgG4-CP group. Histologically, the IgG4-CP group included lymphoid follicle, eosinophil infiltration and few calcifications.
CONCLUSIONS
Pericardial IgG4-RD occurs not only as nodular lesions, but also as thick-walled CP, and accounts for approximately 40% of thick-walled CP cases of unknown cause. The predominant clinical characteristic was refractory and recurrent pericardial effusion. Recognising IgG4-RD as a cause of CP is important to initiate appropriate therapy.
PubMed: 38825060
DOI: 10.1016/j.carpath.2024.107665 -
International Journal of Cardiology Aug 2023Photoplethysmography (PPG) is an established technology for detecting pulse rate and pulse wave irregularities. However, whether temporal variations in pulse wave...
OBJECTIVES
Photoplethysmography (PPG) is an established technology for detecting pulse rate and pulse wave irregularities. However, whether temporal variations in pulse wave amplitudes, reflecting a combination of acute hemodynamic or autonomic responses to changes in overall vascular function, carry prognostic information remains unclear. To quantify nocturnal temporal pulse wave amplitude (PWA) attenuations and evaluate its association with long-term cardiovascular (CV) events in a large, racially diverse sample of men and women.
METHODS
Temporal PWA attenuations were determined based on the slopes between the upper and lower envelopes of PPGs derived from overnight polysomnography of 1957 participants (899 men, 1058 women, mean age 68.2 ± 9.1 years) of the Multi-Ethnic Study of Atherosclerosis. The nocturnal PWA attenuation index was defined as the cumulative duration of all PWA attenuation events relative to total sleep duration.
RESULTS
Nocturnal PWA attenuation index was greater in men than in women by almost 13% (16.3 ± 8.9% vs. 14.4 ± 7.9%, p < 0.001). The nocturnal PWA attenuation index was highest in Chinese-American participants (17.9 ± 9.2%) and lowest in African-Americans (13.5 ± 8.1%). During a median follow-up of 4.9 years, 94 CV events occurred. In multivariable Cox proportional hazard analysis adjusted for typical confounders, the nocturnal PWA attenuation index <15.2% was associated with CV events (HR = 1.58 [1.02-2.45], p = 0.042).
CONCLUSIONS
Nocturnal PWA attenuation index is inversely associated with the risk of CV events, particularly in men and African-Americans. The PPG-derived nocturnal PWA attenuation index could be simply obtained from smart wearable consumer devices and may provide a low-cost, accessible and scalable CV risk marker.
Topics: Male; Humans; Female; Middle Aged; Aged; Heart Rate; Polysomnography; Autonomic Nervous System; Heart Disease Risk Factors; Cardiovascular Diseases; Pulse Wave Analysis
PubMed: 37257516
DOI: 10.1016/j.ijcard.2023.05.047 -
International Journal of Molecular... Aug 2023Atrial fibrillation (AF) is a prevalent cardiac condition predominantly affecting older adults, characterized by irregular heartbeat rhythm. The condition often leads to... (Review)
Review
Atrial fibrillation (AF) is a prevalent cardiac condition predominantly affecting older adults, characterized by irregular heartbeat rhythm. The condition often leads to significant disability and increased mortality rates. Traditionally, two therapeutic strategies have been employed for its treatment: heart rate control and rhythm control. Recent clinical studies have emphasized the critical role of early restoration of sinus rhythm in improving patient outcomes. The persistence of the irregular rhythm allows for the progression and structural remodeling of the atria, eventually leading to irreversible stages, as observed clinically when AF becomes permanent. Cardioversion to sinus rhythm alters this progression pattern through mechanisms that are still being studied. In this review, we provide an in-depth analysis of the pathophysiological mechanisms responsible for maintaining AF and how they are modified during sinus rhythm restoration using existing therapeutic strategies at different stages of clinical investigation. Moreover, we explore potential future therapeutic approaches, including the promising prospect of gene therapy.
Topics: Humans; Aged; Atrial Fibrillation; Heart Rate; Tics; Heart Diseases; Heart Atria
PubMed: 37629037
DOI: 10.3390/ijms241612859 -
Frontiers in Endocrinology 2023Childhood obesity leads to early subclinical atherosclerosis and arterial stiffness. Studying biomarkers like trimethylamine N-oxide (TMAO), linked to cardio-metabolic...
Connections between serum Trimethylamine N-Oxide (TMAO), a gut-derived metabolite, and vascular biomarkers evaluating arterial stiffness and subclinical atherosclerosis in children with obesity.
INTRODUCTION
Childhood obesity leads to early subclinical atherosclerosis and arterial stiffness. Studying biomarkers like trimethylamine N-oxide (TMAO), linked to cardio-metabolic disorders in adults, is crucial to prevent long-term cardiovascular issues.
METHODS
The study involved 70 children aged 4 to 18 (50 obese, 20 normal-weight). Clinical examination included BMI, waist measurements, puberty stage, the presence of acanthosis nigricans, and irregular menstrual cycles. Subclinical atherosclerosis was assessed by measuring the carotid intima-media thickness (CIMT), and the arterial stiffness was evaluated through surrogate markers like the pulse wave velocity (PWV), augmentation index (AIx), and peripheral and central blood pressures. The blood biomarkers included determining the values of TMAO, HOMA-IR, and other usual biomarkers investigating metabolism.
RESULTS
The study detected significantly elevated levels of TMAO in obese children compared to controls. TMAO presented positive correlations to BMI, waist circumference and waist-to-height ratio and was also observed as an independent predictor of all three parameters. Significant correlations were observed between TMAO and vascular markers such as CIMT, PWV, and peripheral BP levels. TMAO independently predicts CIMT, PWV, peripheral BP, and central SBP levels, even after adding BMI, waist circumference, waist-to-height ratio, puberty development and age in the regression model. Obese children with high HOMA-IR presented a greater weight excess and significantly higher vascular markers, but TMAO levels did not differ significantly from the obese with HOMA-IR
CONCLUSION
Our study provides compelling evidence supporting the link between serum TMAO, obesity, and vascular damage in children. These findings highlight the importance of further research to unravel the underlying mechanisms of this connection.
Topics: Adult; Female; Humans; Child; Pediatric Obesity; Carotid Intima-Media Thickness; Vascular Stiffness; Pulse Wave Analysis; Acanthosis Nigricans; Atherosclerosis; Biomarkers
PubMed: 37850094
DOI: 10.3389/fendo.2023.1253584 -
Scientific Reports Nov 2023A medical check-up during driving enables the early detection of diseases. Heartbeat irregularities indicate possible cardiovascular diseases, which can be determined...
A medical check-up during driving enables the early detection of diseases. Heartbeat irregularities indicate possible cardiovascular diseases, which can be determined with continuous health monitoring. Therefore, we develop a redundant sensor system based on electrocardiography (ECG) and photoplethysmography (PPG) sensors attached to the steering wheel, a red, green, and blue (RGB) camera behind the steering wheel. For the video, we integrate the face recognition engine SeetaFace to detect landmarks of face segments continuously. Based on the green channel, we derive colour changes and, subsequently, the heartbeat. We record the ECG, PPG, video, and reference ECG with body electrodes of 19 volunteers during different driving scenarios, each lasting 15 min: city, highway, and countryside. We combine early, signal-based late, and sensor-based late fusion with a hybrid convolutional neural network (CNN) and integrated majority voting to deliver the final heartbeats that we compare to the reference ECG. Based on the measured and the reference heartbeat positions, the usable time was 51.75%, 58.62%, and 55.96% for the driving scenarios city, highway, and countryside, respectively, with the hybrid algorithm and combination of ECG and PPG. In conclusion, the findings suggest that approximately half the driving time can be utilised for in-vehicle heartbeat monitoring.
Topics: Humans; Heart Rate; Signal Processing, Computer-Assisted; Electrocardiography; Algorithms; Neural Networks, Computer; Photoplethysmography
PubMed: 38012195
DOI: 10.1038/s41598-023-47484-z -
Materials (Basel, Switzerland) Jul 2023Biofoams are a challenge for scientists in terms of innovation. Incorporation of cellulose fibrils (CF), might help improve the microstructure of foams, thus this study...
Biofoams are a challenge for scientists in terms of innovation. Incorporation of cellulose fibrils (CF), might help improve the microstructure of foams, thus this study focuses on studying the impact of CF on the foaming properties and rheology of lentil protein (LP) foams at various pH and CF concentrations. Additionally, LP-CF mixtures were transformed into solid foams, and their microstructure, physical properties, and morphology were evaluated. CF concentration significantly impacted on LP-CF foam properties, primarily due to high viscosity values. Increased CF concentration resulted in improved FS values (up to 77 min) at all pH values. This is likely attributed to associative interactions and coacervates formation. Also, foam microstructure could be related to apparent viscosity, suggesting the role of viscosity in preserving the integrity of the wet foam structure during freezing and lyophilization processes. However, elevated viscosity values might negatively impact properties such as foaming capacity and produce denser microstructures. The microstructure and morphology analysis revealed that certain foams exhibited a sponge-like structure with open pores and semi-spherical shapes, supported by CF fibers extending and forming layers. However, the structure itself was irregular. While others exhibited non-uniform, irregular pore size, and shape, along with a denser structure. These findings contribute to understanding the behavior of LP-CF mixtures, although additional investigations on mechanical properties, biodegradability, and hydrophobicity are necessary to reach their full potential for various applications.
PubMed: 37512240
DOI: 10.3390/ma16144965 -
Journal of Stomatology, Oral and... Jun 2024Laser application for the treatment of peri‑implantitis provides a variety of advantages; however, depending on the laser type and parameters, it may also have adverse...
The effects of diode and Er:YAG laser applications on the surface topography of titanium grade 4 and titanium zirconium discs with sand-blasted and acid-etched (SLA) surfaces.
BACKGROUND
Laser application for the treatment of peri‑implantitis provides a variety of advantages; however, depending on the laser type and parameters, it may also have adverse effects on the implant surface qualities. This study's objective is to assess the effects of laser type and parameters on the surface properties of two different titanium-based implant materials: titanium Grade 4 (Ti-Grade 4) and titanium zirconium (Ti-Zr) discs with sand-blasted and acid-etched (SLA) surfaces under in vitro conditions.
MATERIAL & METHOD
Sand-blasted and acid-etched discs made of titanium grade 4 (Ti-Grade 4) and titanium zirconium (Ti-Zr) were treated using 808 nm AlGaAs (diode) and 2940 nm Er:YAG lasers with varying parameters (i.e., diode laser in continuous wave mode, Er:YAG in short pulse mode, and Er:YAG in variable square pulse mode with four different doses). Then, the surface morphology and topography of the treated discs were characterized using scanning electron microscopy and optical profilometry.
RESULTS
The 3D surface topographies of discs treated with a high power Er:YAG laser displayed irregular peaks and deep valleys, indicating surface deterioration. The average surface roughness values (Sa) of both discs varied with laser type and parameters (3.55-4.80 µm for Ti-Grade 4 versus 3.25-4.5 µm for Ti-Zr). With diode laser applications, the topography features of the discs were preserved despite a small number of irregular valleys and peaks. However, the surface morphologies of the discs were dramatically altered by erosion and local melting because of the Er:YAG laser treatment.
CONCLUSION
Diode laser application appears to be the most reliable method for treating peri‑implantitis, as diode laser-treated implants retained their overall surface quality despite a small number of irregular peaks and valleys.
Topics: Titanium; Surface Properties; Zirconium; Lasers, Solid-State; Microscopy, Electron, Scanning; Acid Etching, Dental; Lasers, Semiconductor; Dental Implants; Materials Testing; Dental Etching
PubMed: 37951501
DOI: 10.1016/j.jormas.2023.101680 -
American Journal of Kidney Diseases :... Mar 2024Atrial fibrillation (AF) and chronic kidney disease (CKD) often coexist. However, it is not known whether CKD is an independent risk factor for incident AF. Therefore,... (Meta-Analysis)
Meta-Analysis
RATIONALE & OBJECTIVE
Atrial fibrillation (AF) and chronic kidney disease (CKD) often coexist. However, it is not known whether CKD is an independent risk factor for incident AF. Therefore, we evaluated the association between markers of CKD-estimated glomerular filtration rate (eGFR) and albuminuria-and incident AF.
STUDY DESIGN
Systematic review and meta-analysis of cohort studies and randomized controlled trials.
SETTING & STUDY POPULATIONS
Participants with measurement of eGFR and/or albuminuria who were not receiving dialysis.
SELECTION CRITERIA FOR STUDIES
Cohort studies and randomized controlled trials were included that reported incident AF risk in adults according to eGFR and/or albuminuria.
ANALYTICAL APPROACH
Age- or multivariate-adjusted risk ratios (RRs) for incident AF were extracted from cohort studies, and RRs for each trial were derived from event data. RRs for incident AF were pooled using random-effects models.
RESULTS
38 studies involving 28,470,249 participants with 530,041 incident AF cases were included. Adjusted risk of incident AF was greater among participants with lower eGFR than those with higher eGFR (eGFR<60 vs≥60mL/min/1.73m: RR, 1.43; 95% CI, 1.30-1.57; and eGFR<90 vs≥90mL/min/1.73m: RR, 1.42; 95% CI, 1.26-1.60). Adjusted incident AF risk was greater among participants with albuminuria (any albuminuria vs no albuminuria: RR, 1.43; 95% CI, 1.25-1.63; and moderately to severely increased albuminuria vs normal to mildly increased albuminuria: RR, 1.64; 95% CI, 1.31-2.06). Subgroup analyses showed an exposure-dependent association between CKD and incident AF, with the risk increasing progressively at lower eGFR and higher albuminuria categories.
LIMITATIONS
Lack of patient-level data, interaction between eGFR and albuminuria could not be evaluated, possible ascertainment bias due to variation in the methods of AF detection.
CONCLUSIONS
Lower eGFR and greater albuminuria were independently associated with increased risk of incident AF. CKD should be regarded as an independent risk factor for incident AF.
PLAIN-LANGUAGE SUMMARY
Irregular heartbeat, or atrial fibrillation (AF), is the commonest abnormal heart rhythm. AF occurs commonly in people with chronic kidney disease (CKD), and CKD is also common in people with AF. However, CKD in not widely recognized as a risk factor for new-onset or incident AF. In this research, we combined data on more than 28 million participants in 38 studies to determine whether CKD itself increases the chances of incident AF. We found that both commonly used markers of kidney disease (estimated glomerular filtration rate and albuminuria, ie, protein in the urine) were independently associated with a greater risk of incident AF. This finding suggests that CKD should be recognized as an independent risk factor for incident AF.
Topics: Adult; Humans; Atrial Fibrillation; Albuminuria; Renal Insufficiency, Chronic; Glomerular Filtration Rate; Risk Factors; Kidney
PubMed: 37777059
DOI: 10.1053/j.ajkd.2023.07.023 -
Diagnostics (Basel, Switzerland) Sep 2023Arrhythmia is a cardiac condition characterized by an irregular heart rhythm that hinders the proper circulation of blood, posing a severe risk to individuals' lives....
Arrhythmia is a cardiac condition characterized by an irregular heart rhythm that hinders the proper circulation of blood, posing a severe risk to individuals' lives. Globally, arrhythmias are recognized as a significant health concern, accounting for nearly 12 percent of all deaths. As a result, there has been a growing focus on utilizing artificial intelligence for the detection and classification of abnormal heartbeats. In recent years, self-operated heartbeat detection research has gained popularity due to its cost-effectiveness and potential for expediting therapy for individuals at risk of arrhythmias. However, building an efficient automatic heartbeat monitoring approach for arrhythmia identification and classification comes with several significant challenges. These challenges include addressing issues related to data quality, determining the range for heart rate segmentation, managing data imbalance difficulties, handling intra- and inter-patient variations, distinguishing supraventricular irregular heartbeats from regular heartbeats, and ensuring model interpretability. In this study, we propose the Reseek-Arrhythmia model, which leverages deep learning techniques to automatically detect and classify heart arrhythmia diseases. The model combines different convolutional blocks and identity blocks, along with essential components such as convolution layers, batch normalization layers, and activation layers. To train and evaluate the model, we utilized the MIT-BIH and PTB datasets. Remarkably, the proposed model achieves outstanding performance with an accuracy of 99.35% and 93.50% and an acceptable loss of 0.688 and 0.2564, respectively.
PubMed: 37761234
DOI: 10.3390/diagnostics13182867 -
Physiology & Behavior May 2024The pathophysiology of atrial fibrillation and ventricular tachycardia that result in cardiac arrhythmias is related to the sustained complicated mechanisms of the... (Review)
Review
The pathophysiology of atrial fibrillation and ventricular tachycardia that result in cardiac arrhythmias is related to the sustained complicated mechanisms of the autonomic nervous system. Atrial fibrillation is when the heart beats irregularly, and ventricular arrhythmias are rapid and inconsistent heart rhythms, which involves many factors including the autonomic nervous system. It's a complex topic that requires careful exploration. Cultivation of speculative knowledge on atrial fibrillation; the irregular rhythm of the heart and ventricular arrhythmias; rapid oscillating waves resulting from mistakenly inconsistent P waves, and the inclusion of an autonomic nervous system is an inconceivable approach toward clinical intricacies. Autonomic modulation, therefore, acquires new expansions and conceptions of appealing therapeutic intelligence to prevent cardiac arrhythmia. Notably, autonomic modulation uses the neural tissue's flexibility to cause remodeling and, hence, provide therapeutic effects. In addition, autonomic modulation techniques included stimulation of the vagus nerve and tragus, renal denervation, cardiac sympathetic denervation, and baroreceptor activation treatment. Strong preclinical evidence and early human studies support the annihilation of cardiac arrhythmias by sympathetic and parasympathetic systems to transmigrate the cardiac myocytes and myocardium as efficient determinants at the cellular and physiological levels. However, the goal of this study is to draw attention to these promising early pre-clinical and clinical arrhythmia treatment options that use autonomic modulation as a therapeutic modality to conquer the troublesome process of irregular heart movements. Additionally, we provide a summary of the numerous techniques for measuring autonomic tone such as heart rate oscillations and its association with cutaneous sympathetic nerve activity appear to be substitute indicators and predictors of the outcome of treatment.
Topics: Humans; Atrial Fibrillation; Heart; Autonomic Nervous System; Sympathetic Nervous System; Heart Rate
PubMed: 38527577
DOI: 10.1016/j.physbeh.2024.114527