Dmitry Neymark, Christopher Lee, William F. McIntyre, Maria Higgins, James W. Tam, Colette Seifer
Background
Frailty predisposes individuals to morbidity and mortality. Increasing numbers of elderly and comorbid individuals are undergoing primary prevention implantable cardioverter defibrillator (ICD) device placement. Little is known about the association of frailty with post-device implantation outcomes.
Methods
We conducted a single-center, prospective cohort study of 71 patients who underwent primary prevention ICD insertion and who had their baseline frailty status assessed using the Fried index. Participants were followed for a median period of 7.8 years.
Results
The mean age (± SD) was 70.6 ± 4.5 years. 12 (17%) patients met the criteria for frailty. 23 (33%) patients received cardiac resynchronization therapy. Frailty was associated with a significantly higher incidence of mortality (HR [95% CI]; 3.9 [1.2–12.1]), ED visits (2.7 [1.1–6.7]), and hospitalizations (2.8 [1.1–7.6]). Within the non-frail cohort, there was no association between Fried frailty scores and adverse outcomes. None of the frail patients received appropriate shock therapy.
Conclusion
Among primary prevention ICD recipients, frailty is associated with worse mortality and morbidity. Clinicians should consider frailty when discussing risks and benefits with this patient population.
{"title":"Association of Frailty With Clinical Outcomes in Patients Receiving Primary Prevention Implantable Cardioverter Defibrillators: A Prospective Cohort Study","authors":"Dmitry Neymark, Christopher Lee, William F. McIntyre, Maria Higgins, James W. Tam, Colette Seifer","doi":"10.1111/anec.70061","DOIUrl":"https://doi.org/10.1111/anec.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Frailty predisposes individuals to morbidity and mortality. Increasing numbers of elderly and comorbid individuals are undergoing primary prevention implantable cardioverter defibrillator (ICD) device placement. Little is known about the association of frailty with post-device implantation outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a single-center, prospective cohort study of 71 patients who underwent primary prevention ICD insertion and who had their baseline frailty status assessed using the Fried index. Participants were followed for a median period of 7.8 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age (± SD) was 70.6 ± 4.5 years. 12 (17%) patients met the criteria for frailty. 23 (33%) patients received cardiac resynchronization therapy. Frailty was associated with a significantly higher incidence of mortality (HR [95% CI]; 3.9 [1.2–12.1]), ED visits (2.7 [1.1–6.7]), and hospitalizations (2.8 [1.1–7.6]). Within the non-frail cohort, there was no association between Fried frailty scores and adverse outcomes. None of the frail patients received appropriate shock therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among primary prevention ICD recipients, frailty is associated with worse mortality and morbidity. Clinicians should consider frailty when discussing risks and benefits with this patient population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pheochromocytoma, a type of neuroendocrine tumor, can cause numerous symptoms and signs similar to those of other clinical conditions, with the classic triad being palpitations, headache, and diaphoresis. Patients with pheochromocytoma can present with various cardiac complications, including myocarditis, acute coronary syndromes, cardiomyopathy, heart failure, and arrhythmias. Here we report a case of pheochromocytoma that first presented with bidirectional ventricular tachycardia. The patient was initially diagnosed with acute viral myocarditis and was treated accordingly. A pheochromocytoma crisis with severe blood pressure fluctuation occurred after glucocorticoid administration, leading to further diagnostic work-up, which eventually revealed the adrenal pheochromocytoma.
{"title":"Bidirectional Ventricular Tachycardia due to Pheochromocytoma: A Case Report","authors":"Gui-yang Li, Man-Xin Lin, Fa-Guang Zhou, Qiang Li","doi":"10.1111/anec.70063","DOIUrl":"https://doi.org/10.1111/anec.70063","url":null,"abstract":"<p>Pheochromocytoma, a type of neuroendocrine tumor, can cause numerous symptoms and signs similar to those of other clinical conditions, with the classic triad being palpitations, headache, and diaphoresis. Patients with pheochromocytoma can present with various cardiac complications, including myocarditis, acute coronary syndromes, cardiomyopathy, heart failure, and arrhythmias. Here we report a case of pheochromocytoma that first presented with bidirectional ventricular tachycardia. The patient was initially diagnosed with acute viral myocarditis and was treated accordingly. A pheochromocytoma crisis with severe blood pressure fluctuation occurred after glucocorticoid administration, leading to further diagnostic work-up, which eventually revealed the adrenal pheochromocytoma.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Various ventricular repolarization parameters are known to predict ventricular arrhythmias and mortality in various diseases. Although mortality in patients with heart failure with preserved ejection fraction (HFpEF) is similar to that in heart failure with reduced ejection fraction patients, studies on this subject are more limited. Therefore, it is important to evaluate the relationship between ventricular arrhythmias and mortality and ventricular repolarization parameters, especially the frontal plane QRS–T angle, in patients with HFpEF.
Methods
Electrocardiographic, echocardiographic, and laboratory data of 811 patients were evaluated, and the fQRST angle was calculated on ECG. The occurrence of ventricular tachycardia, ventricular fibrillation, or sudden death within a mean of 48 ± 12 months was recorded. Statistical significance was determined as p < 0.05.
Results
A total of 811 patients were evaluated, 180 patients in the cardiac event group and 631 patients in the no cardiac event group. NT-proBNP, La size, La volume index, Tp-e time, Tp-e/QTc ratio, and fQRS-T angle were statistically significantly higher in the cardiac event group. NT-proBNP level and fQRS-T angle were found to be independent predictors of mortality in multivariate cox analysis. According to ROC analysis, when QRS-T angle has a cut-off value of 58.63, its sensitivity is 81.2, and its specificity is 79.3. Kaplan-Meier analysis also found that when the fQRS-T angle was > 58.63, mortality was higher than at narrower angles.
Conclusions
According to our study, the fQRS-T angle, which can be easily and inexpensively calculated on ECG, predicts long-term ventricular arrhythmias in patients with HFpEF.
{"title":"Frontal Plane QRS – T Angle Is a Predictor of Ventricular Arrhythmia in Heart Failure With Preserved Ejection Fraction","authors":"Çağrı Zorlu, Barış Açıkel, Sefa Erdi Ömür","doi":"10.1111/anec.70062","DOIUrl":"https://doi.org/10.1111/anec.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Various ventricular repolarization parameters are known to predict ventricular arrhythmias and mortality in various diseases. Although mortality in patients with heart failure with preserved ejection fraction (HFpEF) is similar to that in heart failure with reduced ejection fraction patients, studies on this subject are more limited. Therefore, it is important to evaluate the relationship between ventricular arrhythmias and mortality and ventricular repolarization parameters, especially the frontal plane QRS–T angle, in patients with HFpEF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Electrocardiographic, echocardiographic, and laboratory data of 811 patients were evaluated, and the fQRST angle was calculated on ECG. The occurrence of ventricular tachycardia, ventricular fibrillation, or sudden death within a mean of 48 ± 12 months was recorded. Statistical significance was determined as <i>p</i> < 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 811 patients were evaluated, 180 patients in the cardiac event group and 631 patients in the no cardiac event group. NT-proBNP, La size, La volume index, Tp-e time, Tp-e/QTc ratio, and fQRS-T angle were statistically significantly higher in the cardiac event group. NT-proBNP level and fQRS-T angle were found to be independent predictors of mortality in multivariate cox analysis. According to ROC analysis, when QRS-T angle has a cut-off value of 58.63, its sensitivity is 81.2, and its specificity is 79.3. Kaplan-Meier analysis also found that when the fQRS-T angle was > 58.63, mortality was higher than at narrower angles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>According to our study, the fQRS-T angle, which can be easily and inexpensively calculated on ECG, predicts long-term ventricular arrhythmias in patients with HFpEF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Songcui Shen, Xiaolu Wang, Jingjuan Huang, Wenzhao Li
Background
Brugada syndrome (BrS) is associated with an electrocardiogram (ECG), but the causal relationship remains unclear. This study aimed to assess the bidirectional causal relationship between ECG parameters and BrS using Mendelian randomization (MR) analysis.
Methods
A bidirectional MR analysis using data from the OpenGWAS database. Six ECG parameters, including PR interval, PP interval, ST duration, QRS duration, T wave duration, and QT interval, were included in the forward MR analysis with BrS as the outcome. In the reverse MR analysis, BrS was the exposure and the aforementioned ECG parameters were the outcomes. The inverse-variance weighted (IVW) method was the primary analytical approach, complemented by four other methods to account for potential pleiotropy. Sensitivity analyses were performed using Cochran's Q test, MR-Egger intercept, and leave-one-out analysis to evaluate heterogeneity and pleiotropy.
Results
In the forward MR, genetically predicted ST duration (OR = 1.3478, 95% CI: 1.0611–1.7118, p = 0.014) and QRS duration (OR = 0.9582, 95% CI: 0.9208–0.9972, p = 0.036) showed significant associations with BrS. The reverse MR indicated that BrS was significantly associated with PR interval, QRS duration, P wave duration, and QT interval (all p < 0.05). Sensitivity analyses confirmed the robustness of the results in both forward and reverse MR analyses. However, there were significant horizontal pleiotropy and heterogeneity in reverse MR analysis.
Conclusions
This MR study supported a causal effect of ECG parameters, including ST duration and QRS duration, on BrS development.
{"title":"Causal Relationship Between Electrocardiogram Parameters and Brugada Syndrome: A Bidirectional Mendelian Randomization Study","authors":"Songcui Shen, Xiaolu Wang, Jingjuan Huang, Wenzhao Li","doi":"10.1111/anec.70060","DOIUrl":"https://doi.org/10.1111/anec.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Brugada syndrome (BrS) is associated with an electrocardiogram (ECG), but the causal relationship remains unclear. This study aimed to assess the bidirectional causal relationship between ECG parameters and BrS using Mendelian randomization (MR) analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A bidirectional MR analysis using data from the OpenGWAS database. Six ECG parameters, including PR interval, PP interval, ST duration, QRS duration, T wave duration, and QT interval, were included in the forward MR analysis with BrS as the outcome. In the reverse MR analysis, BrS was the exposure and the aforementioned ECG parameters were the outcomes. The inverse-variance weighted (IVW) method was the primary analytical approach, complemented by four other methods to account for potential pleiotropy. Sensitivity analyses were performed using Cochran's Q test, MR-Egger intercept, and leave-one-out analysis to evaluate heterogeneity and pleiotropy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the forward MR, genetically predicted ST duration (OR = 1.3478, 95% CI: 1.0611–1.7118, <i>p</i> = 0.014) and QRS duration (OR = 0.9582, 95% CI: 0.9208–0.9972, <i>p</i> = 0.036) showed significant associations with BrS. The reverse MR indicated that BrS was significantly associated with PR interval, QRS duration, P wave duration, and QT interval (all <i>p</i> < 0.05). Sensitivity analyses confirmed the robustness of the results in both forward and reverse MR analyses. However, there were significant horizontal pleiotropy and heterogeneity in reverse MR analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This MR study supported a causal effect of ECG parameters, including ST duration and QRS duration, on BrS development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To investigate the correlation between non-invasive cardiac function monitoring indexes and recent adverse prognosis in patients with STEMI. The hemodynamic indexes with high diagnostic value were selected to construct a new risk prediction model combined with GRACE scores, and the efficiency of the new prediction model was evaluated.
Methods
STEMI patients who met the inclusion and exclusion criteria were selected. All patients were followed for 6 months of major adverse cardiovascular events (MACE). The non-invasive cardiac function monitoring indexes were analyzed by univariate and multivariate logistic regression. The ROC curve was used to evaluate the accuracy of non-invasive cardiac function indexes predicting MACE. Then, a new risk prediction model was established and its prediction efficiency was evaluated by ROC curve.
Results
Patients were divided into MACE group (N = 69) and non-MACE group (N = 173), stroke volume (SV), cardiac output (CO), cardiac index (CI), cardiac time intervals (CTI), early diastolic filling rate (EDFR), end-diastolic volume (EDV), and systemic vascular resistance (SVR) were found to be significant predictors of recent MACE events in STEMI patients. Multivariate logistic regression analysis confirmed that indicators of noninvasive cardiac function were independent predictors. In addition, the combination of SV and CTI with the GRACE score has the potential to enhance the predictive accuracy for MACE.
Conclusion
Non-invasive hemodynamic indicators SV, CO, CI, CTI, EDFR, EDV and SVR can not only independently predict the risk of recent MACE in patients with STEMI, but can also be used as joint indicators to significantly improve the predictive ability of GRACE score.
{"title":"Predictive Value of Noninvasive Cardiac Function Monitoring Combined With GRACE Score for Short-Term Outcomes in Patients With ST-Segment Elevation Myocardial Infarction","authors":"Jiayan Xin, Yingwu Liu, Meng Ning, Chong Zhang","doi":"10.1111/anec.70056","DOIUrl":"https://doi.org/10.1111/anec.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the correlation between non-invasive cardiac function monitoring indexes and recent adverse prognosis in patients with STEMI. The hemodynamic indexes with high diagnostic value were selected to construct a new risk prediction model combined with GRACE scores, and the efficiency of the new prediction model was evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>STEMI patients who met the inclusion and exclusion criteria were selected. All patients were followed for 6 months of major adverse cardiovascular events (MACE). The non-invasive cardiac function monitoring indexes were analyzed by univariate and multivariate logistic regression. The ROC curve was used to evaluate the accuracy of non-invasive cardiac function indexes predicting MACE. Then, a new risk prediction model was established and its prediction efficiency was evaluated by ROC curve.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients were divided into MACE group (<i>N</i> = 69) and non-MACE group (<i>N</i> = 173), stroke volume (SV), cardiac output (CO), cardiac index (CI), cardiac time intervals (CTI), early diastolic filling rate (EDFR), end-diastolic volume (EDV), and systemic vascular resistance (SVR) were found to be significant predictors of recent MACE events in STEMI patients. Multivariate logistic regression analysis confirmed that indicators of noninvasive cardiac function were independent predictors. In addition, the combination of SV and CTI with the GRACE score has the potential to enhance the predictive accuracy for MACE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Non-invasive hemodynamic indicators SV, CO, CI, CTI, EDFR, EDV and SVR can not only independently predict the risk of recent MACE in patients with STEMI, but can also be used as joint indicators to significantly improve the predictive ability of GRACE score.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143489981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lei Song, Xiao-Ping Shen, Jian-Rong Cai, Hong-Lei Zhang, Gui-Ru Li, Jing Shi
Objective
To evaluate the association and predictive value of midregional pro-atrial natriuretic peptide (MR-proANP), bone morphogenetic protein (BMP-7), and left atrial diameter (LAD) with nonvalvular atrial fibrillation (NVAF) in postmenopausal women.
Methods
This retrospective study included 288 postmenopausal women treated at Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences from January 2022 to October 2024. Patients were categorized into the NVAF and control groups based on electrocardiogram findings. Observation indicators were LAD, MR-proANP, BMP-7, homocysteine (Hcy), and free thyroxine (FT4). Echocardiography excluded valvular disease and measured LAD. Serum biomarkers were quantified using ELISA. Logistic regression identified independent risk factors, and ROC curves assessed predictive value.
Results
Of the 288 participants, 175 (61%) had NVAF. MR-proANP (425.8 vs. 289.4 nmol/L, p < 0.001), and LAD (38.4 vs. 32.5 mm, p < 0.001) were significantly higher in the NVAF group, whereas BMP-7 levels were lower (2.22 vs. 2.67 pg/L, p < 0.001). Additionally, Hcy (13.59 vs. 11.64 nmol/L, p = 0.023) and FT4 (16.91 vs. 15.85 nmol/L, p = 0.014) levels were also significantly elevated in the NVAF group. Multivariate logistic regression showed MR-proANP (OR 1.005, 95% CI 1.001–1.008), BMP-7 (OR 0.338, 95% CI 0.226–0.504), and LAD (OR 1.291, 95% CI 1.205–1.383) as independent risk factors for NVAF. Combined ROC analysis for MR-proANP, BMP-7, and LAD demonstrated an area under the curve (AUC) of 0.803, indicating superior predictive sensitivity and specificity than one indicator alone.
Conclusion
MR-proANP, BMP-7, and LAD are independent risk factors for NVAF in postmenopausal women. Their combined measurement provides valuable predictive insights, aiding in clinical decision-making.
{"title":"Predictive Value of Blood and Echocardiographic Indicators for Nonvalvular Atrial Fibrillation in Postmenopausal Women","authors":"Lei Song, Xiao-Ping Shen, Jian-Rong Cai, Hong-Lei Zhang, Gui-Ru Li, Jing Shi","doi":"10.1111/anec.70053","DOIUrl":"https://doi.org/10.1111/anec.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the association and predictive value of midregional pro-atrial natriuretic peptide (MR-proANP), bone morphogenetic protein (BMP-7), and left atrial diameter (LAD) with nonvalvular atrial fibrillation (NVAF) in postmenopausal women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 288 postmenopausal women treated at Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences from January 2022 to October 2024. Patients were categorized into the NVAF and control groups based on electrocardiogram findings. Observation indicators were LAD, MR-proANP, BMP-7, homocysteine (Hcy), and free thyroxine (FT4). Echocardiography excluded valvular disease and measured LAD. Serum biomarkers were quantified using ELISA. Logistic regression identified independent risk factors, and ROC curves assessed predictive value.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 288 participants, 175 (61%) had NVAF. MR-proANP (425.8 vs. 289.4 nmol/L, <i>p</i> < 0.001), and LAD (38.4 vs. 32.5 mm, <i>p</i> < 0.001) were significantly higher in the NVAF group, whereas BMP-7 levels were lower (2.22 vs. 2.67 pg/L, <i>p</i> < 0.001). Additionally, Hcy (13.59 vs. 11.64 nmol/L, <i>p</i> = 0.023) and FT4 (16.91 vs. 15.85 nmol/L, <i>p</i> = 0.014) levels were also significantly elevated in the NVAF group. Multivariate logistic regression showed MR-proANP (OR 1.005, 95% CI 1.001–1.008), BMP-7 (OR 0.338, 95% CI 0.226–0.504), and LAD (OR 1.291, 95% CI 1.205–1.383) as independent risk factors for NVAF. Combined ROC analysis for MR-proANP, BMP-7, and LAD demonstrated an area under the curve (AUC) of 0.803, indicating superior predictive sensitivity and specificity than one indicator alone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>MR-proANP, BMP-7, and LAD are independent risk factors for NVAF in postmenopausal women. Their combined measurement provides valuable predictive insights, aiding in clinical decision-making.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143489902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xue-Yan Zhang, Jing-Xiu Li, Min Gao, Xue-Qi Li, Ming-Yu Zhang
The incidence and mortality rates of acute pulmonary embolism (APE) are high in clinical emergencies, making early diagnosis and risk stratification crucial. Electrocardiogram (ECG) plays a significant role in guiding the diagnosis and differential diagnosis of pulmonary embolism. Acute pulmonary embolism can present with various ECG manifestations. The presence of pulmonary hypertension and increased right ventricular load in pulmonary embolism can lead to T wave inversion in the right cardiac lead. Additionally, some patients may exhibit a prolonged QT interval, which is associated with the pathophysiological processes resulting from both pulmonary hypertension and myocardial ischemia.
{"title":"Syncope Linked to QT-Interval Prolongation and Global T-Wave Inversion: A Clinical Case of Acute Pulmonary Embolism","authors":"Xue-Yan Zhang, Jing-Xiu Li, Min Gao, Xue-Qi Li, Ming-Yu Zhang","doi":"10.1111/anec.70049","DOIUrl":"10.1111/anec.70049","url":null,"abstract":"<p>The incidence and mortality rates of acute pulmonary embolism (APE) are high in clinical emergencies, making early diagnosis and risk stratification crucial. Electrocardiogram (ECG) plays a significant role in guiding the diagnosis and differential diagnosis of pulmonary embolism. Acute pulmonary embolism can present with various ECG manifestations. The presence of pulmonary hypertension and increased right ventricular load in pulmonary embolism can lead to T wave inversion in the right cardiac lead. Additionally, some patients may exhibit a prolonged QT interval, which is associated with the pathophysiological processes resulting from both pulmonary hypertension and myocardial ischemia.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper presents a unique case of successful implementation of left bundle branch pacing (LBBP) in a pediatric patient with third-degree atrioventricular block following tricuspid valve replacement for a complex Ebstein anomaly. The procedure was performed under real-time recording technique, and resulted in the resolution of the patient's symptoms. This case underscores the feasibility and potential benefits of LBBP in pediatric patients, particularly in those with complex congenital heart conditions and following valve replacement surgery. The successful implementation of LBBP in this case provides valuable insights and a reference for similar cases in the future.
{"title":"Left Bundle Branch Pacing in a Pediatric Patient With Tricuspid Valve Replacement for a Complex Ebstein Anomaly","authors":"Di Tian, Longfu Jiang, Jiabo Shen","doi":"10.1111/anec.70057","DOIUrl":"https://doi.org/10.1111/anec.70057","url":null,"abstract":"<p>This paper presents a unique case of successful implementation of left bundle branch pacing (LBBP) in a pediatric patient with third-degree atrioventricular block following tricuspid valve replacement for a complex Ebstein anomaly. The procedure was performed under real-time recording technique, and resulted in the resolution of the patient's symptoms. This case underscores the feasibility and potential benefits of LBBP in pediatric patients, particularly in those with complex congenital heart conditions and following valve replacement surgery. The successful implementation of LBBP in this case provides valuable insights and a reference for similar cases in the future.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 40-year-old man, after accidentally ingesting aconitine in a herbal remedy, suffered severe poisoning symptoms and was diagnosed with multiple arrhythmias. He quickly received veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and hemoperfusion in the ICU, along with continuous renal replacement therapy (CRRT) to stabilize his internal environment. The treatment controlled the arrhythmias, restored heart function, and alleviated acidosis. The patient was discharged feeling well after 9 days. This combined therapy is valuable for severe aconitine poisoning, especially when specific antidotes are lacking, as it provides critical life support and effectively removes toxins.
{"title":"Application of Veno-Arterial ECMO Combined With Hemoperfusion in the Treatment of a Patient With Yunaconitine Poisoning: A Case Report","authors":"Zhuo Jiang, Yue Zhuang, Xueting Hu, Wei Chen, Fei Xia, Xiaoxia Hu, Aixiang Yang, Weiyi Tao","doi":"10.1111/anec.70051","DOIUrl":"https://doi.org/10.1111/anec.70051","url":null,"abstract":"<p>A 40-year-old man, after accidentally ingesting aconitine in a herbal remedy, suffered severe poisoning symptoms and was diagnosed with multiple arrhythmias. He quickly received veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and hemoperfusion in the ICU, along with continuous renal replacement therapy (CRRT) to stabilize his internal environment. The treatment controlled the arrhythmias, restored heart function, and alleviated acidosis. The patient was discharged feeling well after 9 days. This combined therapy is valuable for severe aconitine poisoning, especially when specific antidotes are lacking, as it provides critical life support and effectively removes toxins.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jing-Xiu Li, Xin-Xin Di, Min Gao, Xue-Qi Li, Yan-Lin Wang, Jie Zheng
This article describes a 44-year-old female with Fabry disease presenting with a 7-year history of chest discomfort, extremity pain, and hypohidrosis. ECG revealed sinus bradycardia (52 bpm), a short PR interval (100 ms) with a delta wave, and a QRS complex (126 ms) showing a complete right bundle branch block. T-wave inversion and ST-segment depression were observed in leads I, AVL, II, aVF, and V2–V6. Genetic testing confirmed Fabry disease (GLA: c.700_702del). Short PR interval with left ventricular hypertrophy (LVH) poses a diagnostic challenge, requiring advanced imaging and genetic testing to differentiate Fabry disease from other cardiomyopathies.
{"title":"Chest Discomfort, Left Ventricular Hypertrophy, Global T-Wave Inversion, and Short PR Interval Points to a Particular Cardiac Condition. What Could Be the Diagnosis?","authors":"Jing-Xiu Li, Xin-Xin Di, Min Gao, Xue-Qi Li, Yan-Lin Wang, Jie Zheng","doi":"10.1111/anec.70048","DOIUrl":"https://doi.org/10.1111/anec.70048","url":null,"abstract":"<p>This article describes a 44-year-old female with Fabry disease presenting with a 7-year history of chest discomfort, extremity pain, and hypohidrosis. ECG revealed sinus bradycardia (52 bpm), a short PR interval (100 ms) with a delta wave, and a QRS complex (126 ms) showing a complete right bundle branch block. T-wave inversion and ST-segment depression were observed in leads I, AVL, II, aVF, and V2–V6. Genetic testing confirmed Fabry disease (GLA: c.700_702del). Short PR interval with left ventricular hypertrophy (LVH) poses a diagnostic challenge, requiring advanced imaging and genetic testing to differentiate Fabry disease from other cardiomyopathies.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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