scholarly journals Left ventricular ejection fraction and left atrium diameter related to new-onset atrial fibrillation following acute myocardial infarction: a systematic review and meta-analysis

Oncotarget ◽  
2017 ◽  
Vol 8 (46) ◽  
pp. 81137-81144 ◽  
Author(s):  
Rui-Xiang Zeng ◽  
Mao-Sheng Chen ◽  
Bao-Tao Lian ◽  
Peng-Da Liao ◽  
Min-Zhou Zhang
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Systematic Review ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Onset Atrial Fibrillation ◽  
Left Atrium Diameter ◽  
New Onset

scholarly journals Comprehensive Use of Routine Clinical Parameters to Identify Patients at Risk of New-Onset Atrial Fibrillation in Acute Myocardial Infarction

2021 ◽  
Vol 10 (16) ◽  
pp. 3622
Author(s):  
Monika Raczkowska-Golanko ◽  
Grzegorz Raczak ◽  
Marcin Gruchała ◽  
Ludmiła Daniłowicz-Szymanowicz
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Clinical Parameters ◽  
Ventricular Ejection Fraction ◽  
Significant Complication ◽  
Onset Atrial Fibrillation ◽  
New Onset

(1) Background: New-onset atrial fibrillation (NOAF) is a significant complication of acute myocardial infarction (AMI). Our study aimed to investigate whether routinely checked clinical parameters aid in NOAF identification in modernly treated AMI patients. (2) Patients and methods: Patients admitted consecutively within 2017 and 2018 to the University Clinical Centre in Gdańsk (Poland) with AMI diagnosis (necrosis evidence in a clinical setting consistent with acute myocardial ischemia) were enrolled. Medical history and clinical parameters were checked during NOAF prediction. (3) Results: NOAF was diagnosed in 106 (11%) of 954 patients and was significantly associated with in-hospital mortality (OR 4.54, 95% CI 2.50–8.33, p < 0.001). Age, B-type natriuretic peptide (BNP), C-reactive protein (CRP), high-sensitivity troponin I, total cholesterol, low-density lipoprotein cholesterol, potassium, hemoglobin, leucocytes, neutrophil/lymphocyte ratio, left atrium size, and left ventricular ejection fraction (LVEF) were associated with NOAF in the univariate logistic analysis, whereas age ≥ 66 yo, BNP ≥ 340 pg/mL, CRP ≥ 7.7 mg/L, and LVEF ≤ 44% were associated with NOAF in the multivariate analysis. (4) Conclusions: NOAF is a multifactorial, significant complication of AMI, leading to a worse prognosis. Simple, routinely checked clinical parameters could be helpful indices of this arrhythmia in current invasively treated patients with AMI.

scholarly journals COVID-19-associated myocarditis presenting as new-onset heart failure and atrial fibrillation

2021 ◽  
Vol 14 (7) ◽  
pp. e244027
Author(s):  
Sean Gaine ◽  
Patrick Devitt ◽  
John Joseph Coughlan ◽  
Ian Pearson
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Recent Onset ◽  
Onset Atrial Fibrillation ◽  
New Onset

A 58-year-old man presented to the emergency department with recent-onset palpitations and progressive exertional dyspnoea. ECG demonstrated new-onset atrial fibrillation. Transthoracic echocardiogram showed global impairment in left ventricular systolic function with left ventricular ejection fraction of 20%. Cardiac MRI (CMRI) demonstrated generalised severe myocarditis. A SARS-CoV-2 PCR was positive for SARS-CoV-2 RNA. As such, we diagnosed our patient with COVID-19-associated myocarditis based on CMRI appearances and positive SARS-CoV-2 swab. This case highlights that COVID-19-associated myocarditis can present as new atrial fibrillation and heart failure without the classic COVID-19-associated symptoms.

scholarly journals Simple clinical parameters could help to identify the patients with a high probability of new-onset atrial fibrillation in acute myocardial infarction

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
M Raczkowska-Golanko ◽  
W Puchalski ◽  
M Gruchala ◽  
G Raczak ◽  
L Danilowicz-Szymanowicz
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Significant Complication ◽  
Detailed Medical History ◽  
Onset Atrial Fibrillation ◽  
New Onset

Abstract Funding Acknowledgements Type of funding sources: None. Background New-onset atrial fibrillation (NOAF) is a significant complication of acute myocardial infarction (AMI) associated with a poor prognosis. The knowledge and understanding of risk factors of this arrhythmia are still the subjects of interest. Purpose: We aimed to investigate which clinical, routinely checked parameters could have the most predictive power on NOAF occurrence in AMI patients. Patients and methods This single-center, retrospective study was conducted on 954 consecutive patients admitted to our university clinical center with AMI diagnosis from January 2017 to December 2018. Patients underwent routine clinical assessment and laboratory investigations. AF detected at the time of admission or during a hospital stay, without a prior history of persistent or paroxysmal AF, was diagnosed as NOAF. Detailed medical history, routinely checked laboratory and echocardiography parameters, invasive and pharmacological treatment, as well as complications and in-hospital mortality, were taken into consideration. Results   NOAF was documented in 106 (11%) AMI patients at median age 74 (66 - 84) years old, and was significantly associated with in-hospital mortality [OR 4.53, p &lt; 0.001). There were some clinical factors significantly predicted NOAF in univariate logistic regression analysis: age ≥ 66 years old (odds ratio [OR] 3.09, p &lt; 0.001), B-type natriuretic peptide (BNP) ≥ 340 pg/ml (OR 5.28, p &lt; 0.001), C- reactive protein (CRP) ≥ 7.7 mg/l (OR 3.53, p &lt; 0.001), high-sensitivity troponin ≥ 1.85 ng/ml (OR 2.4, p &lt; 0.001), total cholesterol  ≤  195 mg/dl (OR 2.17, p &lt; 0.002), low-density lipoprotein ≤ 128.5 mg/dl (OR 2.03, p &lt; 0.007), potassium level ≤ 4.2 mmol/l (OR 1.92, p &lt; 0.002), hemoglobin ≤ 14 g/dl (OR 1.71, p &lt; 0.020), leucocytes ≥ 10.2 x10^9/l (OR 1.76, p &lt; 0.009), neutrophil to lymphocyte ratio ≥ 4.6 (OR 1.85, p &lt; 0.004), left atrium size ≥ 41 mm (OR 2.14, p &lt; 0.001), and left ventricular ejection fraction (LVEF) ≤ 44% (OR 2.99, p &lt; 0.001). Age, BNP, CRP, and LVEF at mentioned above pre-specified cut-off values turned out to be the most important independent predictors of NOAF development in multivariate analysis. Conclusions NOAF is a multifactorial, significant complication of AMI, leading to a worse prognosis. Older age, higher BNP and CRP level, and lower LVEF are independently associated with the probability of NOAF.

scholarly journals Statins to mitigate cardiotoxicity in cancer patients treated with anthracyclines and/or trastuzumab: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Mary Obasi ◽  
Arielle Abovich ◽  
Jacqueline B. Vo ◽  
Yawen Gao ◽  
Stefania I. Papatheodorou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Weighted Mean ◽  
Ventricular Ejection Fraction

Abstract Purpose Cardiotoxicity affects 5–16% of cancer patients who receive anthracyclines and/or trastuzumab. Limited research has examined interventions to mitigate cardiotoxicity. We examined the role of statins in mitigating cardiotoxicity by performing a systematic review and meta-analysis of published studies. Methods A literature search was conducted using PubMed, Embase, Web of Science, ClinicalTrials.gov, and Cochrane Central. A random-effect model was used to assess summary relative risks (RR), weighted mean differences (WMD), and corresponding 95% confidence intervals. Testing for heterogeneity between the studies was performed using Cochran’s Q test and the I2 test. Results Two randomized controlled trials (RCTs) with a total of 117 patients and four observational cohort studies with a total of 813 patients contributed to the analysis. Pooled results indicate significant mitigation of cardiotoxicity after anthracycline and/or trastuzumab exposure among statin users in cohort studies [RR = 0.46, 95% CI (0.27–0.78), p = 0.004, $${ }I^{2}$$ I 2  = 0.0%] and a non-significant decrease in cardiotoxicity risk among statin users in RCTs [RR = 0.49, 95% CI (0.17–1.45), p = 0.20, $$I^{2}$$ I 2  = 5.6%]. Those who used statins were also significantly more likely to maintain left ventricular ejection fraction compared to baseline after anthracycline and/or trastuzumab therapy in both cohort studies [weighted mean difference (WMD) = 6.14%, 95% CI (2.75–9.52), p < 0.001, $$I^{2}$$ I 2  = 74.7%] and RCTs [WMD = 6.25%, 95% CI (0.82–11.68, p = 0.024, $$I^{2}$$ I 2  = 80.9%]. We were unable to explore publication bias due to the small number of studies. Conclusion This meta-analysis suggests that there is an association between statin use and decreased risk of cardiotoxicity after anthracycline and/or trastuzumab exposure. Larger well-conducted RCTs are needed to determine whether statins decrease risk of cardiotoxicity from anthracyclines and/or trastuzumab. Trial Registration Number and Date of Registration PROSPERO: CRD42020140352 on 7/6/2020.

scholarly journals New onset of atrial fibrillation in cardiogenic shock

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
H Santos ◽  
T Vieira ◽  
J Fernandes ◽  
AR Ferreira ◽  
M Rios ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiogenic Shock ◽  
Linear Regression Analysis ◽  
Clinical Signs ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome ◽  
The Impact ◽  
New Onset

Abstract Funding Acknowledgements Type of funding sources: None. Introduction The development of cardiogenic shock (CS) is associated with worse prognosis, and can produce several hemodynamic manifestations. Then, is not surprised the manifestation of new-onset atrial fibrillation (AF) in these patients. Purpose Evaluate the impact of cardiovascular previous history, clinical signs and diagnosis procedures at admission as predictors of new-onset of AF in CS. Methods Single-centre retrospective study, engaging patients hospitalized for CS between 1/01/2014-30/10/2018. 222 patients with CS are included, 40 of them presented new onset of AF. Chi-square test, T-student test and Mann-Whitney U test were used to compare categorical and continuous variables. Multiple linear regression analysis was performed to evaluate predictors of new-onset AF in CS patients. Results CS patients without AF had a mean age of 61.08 ± 13.77 years old, on the other hand new-onset of AF patients in the setting of CS had a mean age of 67.02 ± 14.21 years old (p = 0.016). Nevertheless, no differences between the two groups was detected regarding the sex cardiovascular history (namely arterial hypertension, diabetes, dyslipidemia, obesity, smoker status, alcohol intake, previous acute coronary syndrome, history of angina, previous cardiomyopathy), neoplasia history, cardiac arrest during the CS, clinical signs at admission (like heart rate, blood pressure, respiratory rate), blood results (hemoglobin, leukocytes, troponin, creatinine, C-Reactive protein), left ventricular ejection fraction and the culprit lesion. New-onset of AF in CS patient had not impact in mortality rates. Multiple logistic regression reveals that only age was a predictor of new onset of AF in CS patients (odds ratio 1.032, confident interval 1.004-1.060, p = 0.024). Conclusions Age was the best predictor of new-onset AF in CS patients. The presence of this arrhythmia can have a hemodynamic impact, however, seems not influenced the final outcome.

scholarly journals Effects of Exercise on Cardiac Function Outcomes in Women Receiving Anthracycline or Trastuzumab Treatment for Breast Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (18) ◽  
pp. 8336
Author(s):  
Pedro Antunes ◽  
Dulce Esteves ◽  
Célia Nunes ◽  
Anabela Amarelo ◽  
José Fonseca-Moutinho ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Cardiac Function ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Cochrane Library ◽  
Circulating Biomarkers ◽  
Ventricular Ejection Fraction ◽  
Secondary Outcomes

Background: we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of exercise training on cardiac function and circulating biomarkers outcomes among women with breast cancer (BC) receiving anthracycline or trastuzumab-containing therapy. Methods: PubMed, EMBASE, Cochrane Library, Web of Science and Scopus were searched. The primary outcome was change on left ventricular ejection fraction (LVEF). Secondary outcomes included diastolic function, strain imaging and circulating biomarkers. Results: Four RCTs were included, of those three were conducted during anthracycline and one during trastuzumab, involving 161 patients. All trials provided absolute change in LVEF (%) after a short to medium-term of treatment exposure (≤6 months). Pooled data revealed no differences in LVEF in the exercise group versus control [mean difference (MD): 2.07%; 95% CI: −0.17 to 4.34]. Similar results were observed by pooling data from the three RCTs conducted during anthracycline. Data from trials that implemented interventions with ≥36 exercise sessions (n = 3) showed a significant effect in preventing LVEF decline favoring the exercise (MD: 3.25%; 95% CI: 1.20 to 5.31). No significant changes were observed on secondary outcomes. Conclusions: exercise appears to have a beneficial effect in mitigating LVEF decline and this effect was significant for interventions with ≥36 exercise sessions.

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