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BACKGROUND@#China bears the biggest atrial fibrillation (AF) burden in the world. However, little is known about the incidence and predictors of AF. This study aimed to investigate the current incidence of AF and its electrocardiographic (ECG) predictors in general community individuals aged over 60 years in China.@*METHODS@#This was a prospective cohort study, recruiting subjects who were aged over 60 years and underwent annual health checkups from April to July 2015 in four community health centers in Songjiang District, Shanghai, China. The subjects were then followed up from 2015 to 2019 annually. Data on sociodemographic characteristics, medical history, and the resting 12-lead ECG were collected. Kaplan-Meier curve was used for showing the trends in AF incidence and calculating the predictors of AF. Associations of ECG abnormalities and AF incidence were examined using Cox proportional hazard models.@*RESULTS@#This study recruited 18,738 subjects, and 351 (1.87%) developed AF. The overall incidence rate of AF was 5.2/1000 person-years during an observation period of 67,704 person-years. Multivariable Cox regression analysis indicated age (hazard ratio [HR], 1.07; 95% confidence interval [CI]: 1.06-1.09; P < 0.001), male (HR, 1.30; 95% CI: 1.05-1.62; P = 0.018), a history of hypertension (HR, 1.55; 95% CI: 1.23-1.95; P < 0.001), a history of cardiac diseases (HR, 3.23; 95% CI: 2.34-4.45; P < 0.001), atrial premature complex (APC) (HR, 2.82; 95% CI: 2.17-3.68; P < 0.001), atrial flutter (HR, 18.68; 95% CI: 7.37-47.31; P < 0.001), junctional premature complex (JPC) (HR, 3.57; 95% CI: 1.59-8.02; P = 0.002), junctional rhythm (HR, 18.24; 95% CI: 5.83-57.07; P < 0.001), ventricular premature complex (VPC) (HR, 1.76; 95% CI: 1.13-2.75, P = 0.012), short PR interval (HR, 5.49; 95% CI: 1.36-22.19; P = 0.017), right atrial enlargement (HR, 6.22; 95% CI: 1.54-25.14; P = 0.010), and pacing rhythm (HR, 3.99; 95% CI: 1.57-10.14; P = 0.004) were independently associated with the incidence of AF.@*CONCLUSIONS@#The present incidence of AF was 5.2/1000 person-years in the studied population aged over 60 years in China. Among various ECG abnormalities, only APC, atrial flutter, JPC, junctional rhythm, short PR interval, VPC, right atrial enlargement, and pacing rhythm were independently associated with AF incidence.
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Humans , Male , Middle Aged , Aged , Atrial Fibrillation/epidemiology , Prospective Studies , Incidence , Atrial Flutter/complications , Risk Factors , China/epidemiology , ElectrocardiographyABSTRACT
@#Objective To investigate the changes of functional brain connectivity over multiple frequency bands in resting-state electroencephalography (EEG) for lower limb amputation patients. Methods Resting-state EEG was collected from 18 lower limb amputees and 22 healthy controls from November, 2020 to June, 2021. Functional connectivity matrix was constructed with phase-locked values (PLV), and compared between groups. Results The functional connectivity was weaker in the amputees than in the controls on α band (t = 3.433, P = 0.001) and β band (t = 3.806, P = 0.001), and there was no significant difference on δ band (t = 1.429, P = 0.161) and θ band (t = 1.211, P = 0.233). Conclusion EEG functional connectivity weakens in lower limb amputees in on the α and β band, which results in neuroplasticity of multiple brain regions, not only for limb-respond cortex, but also for frontal, temporal and occipital cortices.
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Objective: To conduct a preliminary evaluation for the usability of Carelink remote monitoring system by clinical physician. Methods: A total of 215 patients received cardiovascular implantable electronic devices (CIED) with Carelink remote monitoring function from 12 hospitals in China between 2012-01 and 2013-10 were prospectively enrolled. The patient's mean age was (62.3±14.3) years including 108 male and 107 female. There were 54 physicians completed questionnaire survey. Based on the type of CIED, the patients were divided into3 groups: PM (pace maker) group,n=110, ICD (implantable cardioverter defibrillator) group,n=54 and CRT (cardiac resynchronization therapy) group,n=51. The patients received routine hospital visit at 3 months of CIED implantation and meanwhile, they performed device data transmission at 3 and 6 months of Carelink remote monitoring. The time physician spent to evaluate data was collected at 3 months and the questionnaire survey was completed by physician at 6 months after CIED implantation. Results: All 54 physicians felt that Carelink remote monitoring system was simple to operate and easy to use. There were 147 patients ifnished hospital visit at 3 months after CIED implantation, the mean time for physician to evaluate data was (14.8±8.4) min; 150 patients ifnished Carelink remote monitor at 3 months after CIED implantation, the mean time for physician to evaluate data was (8.2 ±4.6) min,P<0.0001.Conclusion: Carelink remote monitoring system was easy to use, it may save time in follow-up study which with high satisfaction in clinical practice.
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Objective: To explore clinical features of acute myocardial infarction (AMI) caused by left main (LM) coronary artery lesions and to study the effect of percutaneous coronary intervention (PCI) in relevant patients. Methods: A total of 3514 AMI patients received coronary angiography (CAG) in our hospital from 2000-01 to 2015-12 were studied, those including 36 of infarct-related artery (IRA) as LM. There were 28/36 patients received PCI and 8 received CABG. The clinical features and outcomes in 28 LM disease patients were investigated. Results: The patients included 5 female and 23 male at the mean age of (66.5±8.32) years. There were 16 patients with ST-segment elevation myocardial infarction (STEMI) and 12 with NSTEMI; 21 received primary PCI and 7 had elective PCI; there were 16 patients suffered from cardiac shock at admission. The procedural success rate was 82.1% and the in-hospital mortality was 35.7% (10/28). During (66.1±35.2) months follow-up period, 3 patients had re-NSTEMI and 1 of them received PCI again, 3 patients died. No event survival rate was 66.7%. Conclusion: PCI is feasible for treating AMI patients caused by LM lesions, the in-hospital survival rate was 64.3%; while the MACE occurrence rate during long-term follow-up period has been high.
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Objective: To analyze the electrocardiographic (ECG) characteristics for the ifrst diagonal branch of infarction related artery (IRA) in patients with acute ST-segment elevation myocardial infarction (STEMI) in order to ifnd the rule for physician to make quick diagnosis. Methods: A total of 28 STEMI patients with coronary angiography (CAG) confirmed first diagonal branch of IRA were retrospectively analyzed. The patients were treated in our hospital from 2005-01 to 2014-06 and their ECG changes at admission were studied for ST-segment elevation/depression and q wave, Q wave changes during the period of evolution at different leads in all patients. Results: CAG presented that there were 19/28 (67.9%) patients with single vessel disease, 13 (46.4%) with isolated diagonal lesion. From onset of chest pain to AMI graph shown on ECG was about 240 (252 ± 71) min in all patients. All 28 (100%) patients were with ST-segment elevation in lead aVL, 27 (96.4%) in lead I, and 15 (55.6%) patients with ST-segment elevation by (0.5-1.0) mm. The incidence of ST-segment elevation in the chest lead was, in turn as 21 (75.0%) patients in lead V2, 16 (57.1%) in lead V3 and 12 (42.9%) in lead V1respectively; while ST-segment depression was as 28 (100%) patients in lead III, 27 (96.4%) in lead aVF and 22 (78.6%) in lead II respectively. During the period of evolution, the most q wave or Q wave formation were, in turn as 22 (88.0%) patients in lead aVL, 10 (40.0%) in lead V2, 9 (36.0%) in lead V3 and 7 (28.0%) in lead I respectively. Conclusion: The ECG changes in STEMI patients with diagonal branch of IRA have the high prevalence of ST-segment elevation in lead aVL and lead I, while there is an important feature that the ST-segment elevation < 1 mm in about half amount of relevant patients.
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To assess the safety and efficacy of the StarClose device following intra-aortic balloon pump [IABP] counterpulsation using 8-Fr femoral sheaths. From June 2008 to August 2012, 42 consecutive patients who received IABP implantation via common femoral artery [CFA] punctures with an 8-Fr sheath [which were then sealed with the StarClose Vascular Closure System at the bedside] were included in this retrospective single-arm study. All the patients underwent duplex control of the puncture site 24 h after deployment of the device, in order to determine the presence or absence of vascular complications including hematoma, pseudoaneurysm, arteriovenous fistula and arterial/venous thrombosis or stenosis. The safety end points were the vascular complications during the hospital stay, and the efficacy end points included device and procedure success. The procedure success rate was 92.9% [39/42] and the device success rate was 88.1% [37/42]. Major vascular complications occurred in 3 [7.1%] patients; 1 developed a massive hematoma >10 cm which was managed by blood transfusion and surgical reconstruction, and the other 2 developed pseudoaneurysm which was cured by ultrasound-guided thrombin injection or manual compression. Minor vascular complications occurred in 5 [11.9%] patients, including blood oozing in 2, hematoma <5 cm in 2 and severe pain in the remaining patient. CFA closure with the StarClose device was safe, feasible and effective in patients undergoing IABP support using 8-Fr sheath sizes
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Objective To investigate the variation of lipid profile in patients with acute myocardial infarction (AMI) of different age groups.Methods Total 1214 patients of AMI were admitted to our hospital from May 2007 to July 2011.The age of patients ranged 40-89 years,and patients were divided into 5 age groups with 10-years step.Differences in lipid levels were observed by using pair-wise comparison among different age groups.Results Pair-wise comparisons among different age groups indicated that TC levels were higher in 40-69 years age groups [(4.71 ± 1.08),(4.80 ± 1.30),(4.69 ± 1.03) mmol/L,respectively] than those in the 70-89 age groups [(4.41 ± 0.96),(4.38 ± 1.03) mmol/L],all P ＜ 0.05(t values were 2.381,2.323,4.382,3.965,3.317,3.096).TG levels among three age groups ＜ 59 years had no significant difference,which were higher than those in groups over 60 years.Among 50-89 years age groups,TG gradually reduced with increase of age.HDL levels were lower in 40-59 years age groups [(1.03 ± 0.23),(1.05 ± 0.26) mmol/L,respectively] than those in 60-89 years age groups [(1.11 ±0.28),(1.11±0.28),(1.16±0.34) mmol/L,respectively],allP＜0.05 (t values were-2.777,-2.789,-3.731,-2.543,-2.566,-3.644).Total cholesterol (TC) (r =-0.123,P ＜0.01),lowdensity lipoprotein cholesterol (LDL) (r =-0.139,P ＜ 0.01) and triglyceride (TG) (r =-0.287,P ＜0.01) were negatively but high-density lipoprotein cholesterol (HDL) (r =0.125,P ＜ 0.01) was positively correlated with age of patients.TC levels in female patients were higher than those in male patients in 50-89 years age groups; LDL levels in female patients were higher than those in male patients in 50-69 years age groups and HDL levels in female patients were higher than those in male patients in 40-79 years age groups (all P ＜ 0.05,t values were-2.878,-3.007,-3.352,-3.333).Conclusions Results show that the non-elderly AMI patients (＜60 years) have higher levels of TC,LDL and TG,and lower level of HDL than the elderly patients; the TC,LDL and HDL levels are higher in female AMI patients than those in male patients at the same age groups.
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Objective To evaluate the delivery of recombinant adeno-associated virus(rAAV)-mediated CD151 gene in promoting neovascularization and coronary collateralization in swines after myocardial infarction.Method Twenty-six chinese minipigs(clean,provided by breeding pig farm of Huazhong Agricultural University) were randomly divided into four groups:(1)normal control group(n=4):swines without surgery.(2)rAAV-GFP group(n=7):The acute myocardial infarction models were produced in swines by ligating the left anterior descending coronary artery(LAD).The success criteria of the models was that ST-segment elevations in leatds I and aVL maintained for 20 minutes.The rAAV-GFP was injected into the left ventricular anterior wall(divided into 10 points,1×10 11 pfu/point).(3)rAAV-CD151 group(n=7):The operation method was the same as rAAV-GFP group.The rAAV-CD151 was injected into the left ventrieular anterior wall(divided into 10 points).(4) rAAV-antiCD151 group(n=8):The operation method was the same as rAAV-GFP group.The rAAV-antiCD151 was injected into the left ventricular anterior wall(divided into 10 points).Eight weeks after coronary artery liga-tion,the expression of CD151 was measured by western blot.Coronary angiography was done to evaluate collateral circulation of the infarct zone of myocardium.The infurct size was determined by staining with triphenyl-tetrazolium chloride(TTC).Statistical analysis wan carried out by using one-way analysis of variances.Results High level of CD151 protein expression was detected.Coronary angiography showed better collateral circulation in the rAAV-CD151 group.The percentage of infarct size was sinificanly lower in the rAAV-CD151 group (12.82±2.26)% than that in the other two groups,and that was higber in rAAV-anti-CD151 group(32.52±3.47)% than that in the rAAV-GFP group(23.14%±2.83%,both P＜0.05).Conelusions CD151 in vivo gene transferred to swines with acute myocardial infarction promotes neovascularization and thereby improves collateral circulation.
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Objective To evaluate the effects of different right ventricular pacing sites on left ventricular systolic synchrony using tissue Doppler imaging(TDI).Methods A tota[of sixty-nine patients with indications for permanent pacemaker implantation were enrolled sequentially by Pace-ROAD study(Pacemaker-right ventricular outflow tract and apex study,a randomized control study).They were randomized to RVOT pacing group(group A)or RVA pacing group(group B).Echocardiographic study with TDl was performed before and after 3 month follow up,and the data were analysed off-line.The peak velocity(Vs),the time to the peak of S wave(Ts)of all 12 basal and middle segments of left ventricle were measured,and then the standard deviation of Ts(Ts-SD),the average of Vs(Vs-M)were calculated.Results Thirty-six patients were randomized to group A,while the other 33 patients to group B.In each group,one patient was rejected due to non-pacing rhythm during follow-up.After 3 month pacing,the Ts-SD of group A was significantly shorter than that of group B[(23.63±2.32)ms vs(31.54±2.93)ms.P=0.0387-].In the patients with the basal Ts-SD longer than 32.6 ms(group A2 and group B2),the Ts-SD was significantly shortened than the baseline in group A2 during follow-up,while no significant difference was found in group B2.And the follow-up Ts-SD of group B2 was significantly longer than that of group A2 r(38.19±18.34)ms vs(28.55±16.93)ms,P=0.0290].Conclusions RVOT pacing is associated with favorable left ventricular systolic synchrony than RVA pacing,especially in patients with worsened baseline systolic synchrony.
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Objective To evaluate the relationship between early recurrences and long-term success in patients with paroxysmal atrial fibrillation (PAF) after electrical isolation of myocardial sleeves, and the mechanism of the delayed effects for early recurrences of paroxysmal atrial fibrillation after pulmonary vein ablation. Methods Guided by circular mapping catheter, 131 paroxysmal atrial fibrillation patients underwent the electrical isolation of muscle sleeves around the circumference of the targeted veins at the ostia until the achievement of electrical disconnection between the atria and veins. Results One hundred and four patients were followed up 112?37 days after ablation, of whom 59 (56.7%) were in sinus rhythm and PAF free, whereas 7 experienced remarkable reduction of PAF episodes. However, after the mean 380?226 days of follow-up, 81 cases (78%) were in sinus rhythm and PAF free, whereas 4 experienced remarkable reduction of PAF episodes. Conclusion Early recurrence of PAF did not mean the failure of the ablation of AF. Some patients may experience delayed success after a long-term follow-up.
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Aim To investigate changes of MAP2 expression level in rat hippocampal pyramidal cells induced by chronic stress, and to explore effects of tianeptine on them. Methods 25 rats were divided randomly into three groups:Control group,Stress group and Stree-tianeptine group. The forced-swimming was performed to rats in stress group and stress-tianeptine. Using the immunohistochemistry and the computerized image technique, expression levels of phosphorated MAP2 and the number the Positive cells were assayed quantitatively in each group. Results Compared with control group (149.34?1.81), the phosphorated MAP2 average gray degree in pyramidal cells of stress group (144.99?4.40) was significantly lower, that of the stress-tianeptine group (148.84?2.73) was significantly higher than that of stress group; The number of phosphorated MAP2 positive cells in stress group (40.36?1.35) was significantly less compared withthat of control group (42.73?1.56); that of stress-tianeptine group (42.14?1.62) was significantly more than that of stress group. Conclusion It is suggested that tianeptine could inhibit the enhancement of phosphorated MAP2 expression in hippocampal pyramidal cells induced by chronic stress.