Heart failure in older patients with atrial fibrillation: incidence and risk factors.

INTRODUCTION AND OBJECTIVES: Atrial fibrillation (AF) is linked to heart failure (HF). However, little has been published on the factors that may precipitate the onset of HF in AF patients. We aimed to determine the incidence, predictors, and prognosis of incident HF in older patients with AF with no prior history of HF. METHODS: Patients with AF older than 80 years and without prior HF were identified between 2014 and 2018. RESULTS: A total of 5794 patients (mean age, 85.2±3.8 years; 63.2% women) were followed up for 3.7 years. Incident HF, predominantly with preserved left ventricular ejection fraction, developed in 33.3% (incidence rate, 11.5-100 people-year). Multivariate analysis identified 11 clinical risk factors for incident HF, irrespective of HF subtype: significant valvular heart disease (HR, 1.99; 95%CI, 1.73-2.28), reduced baseline left ventricular ejection fraction (HR, 1.92; 95%CI, 1.68-2.19), chronic pulmonary obstructive disease (HR, 1.59; 95%CI, 1.40-1.82), enlarged left atrium (HR 1.47, 95%CI 1.33-1.62), renal dysfunction (HR 1.36, 95%CI 1.24-1.49), malnutrition (HR, 1.33; 95%CI, 1.21-1.46), anemia (HR, 1.30; 95%CI, 1.17-1.44), permanent AF (HR, 1.15; 95%CI, 1.03-1.28), diabetes mellitus (HR, 1.13; 95%CI, 1.01-1.27), age per year (HR, 1.04; 95%CI, 1.02-1.05), and high body mass index for each kg/m2 (HR, 1.03; 95%CI, 1.02-1.04). The presence of incident HF nearly doubled the mortality risk (HR, 1.67; 95%CI, 1.53-1.81). CONCLUSIONS: The presence of HF in this cohort was relatively frequent and nearly doubled the mortality risk. Eleven risk factors for HF were identified, expanding the scope for primary prevention among elderly patients with AF.

Don't catch me if you can - Using cabled observatories as multidisciplinary platforms for marine fish community monitoring: An in situ case study combining Underwater Video and environmental DNA data.

Cabled observatories are marine infrastructures equipped with biogeochemical and oceanographic sensors as well as High-Definition video and audio equipment, hence providing unprecedented opportunities to study marine biotic and abiotic components. Additionally, non-invasive monitoring approaches such as environmental DNA (eDNA) metabarcoding have further enhanced the ability to characterize marine life. Although the use of non-invasive tools beholds great potential for the sustainable monitoring of biodiversity and declining natural resources, such techniques are rarely used in parallel and understanding their limitations is challenging. Thus, this study combined Underwater Video (UV) with eDNA metabarcoding data to produce marine fish community profiles over a 2 months period in situ at a cabled observatory in the northeast Atlantic (SmartBay Ireland). By combining both approaches, an increased number of fish could be identified to the species level (total of 22 species), including ecologically and economically important species such as Atlantic cod, whiting, mackerel and monkfish. The eDNA approach alone successfully identified a higher number of species (59%) compared to the UV approach (18%), whereby 23% of species were detected by both methods. The parallel implementation of point collection eDNA and time series UV data not only confirmed expectations of the corroborative effect of using multiple disciplines in fish community composition, but also enabled the assessment of limitations intrinsic to each technique including the identification of false-negative detections in one sampling technology relative to the other. This work showcased the usefulness of cabled observatories as key platforms for in situ empirical assessment of both challenges and prospects of novel technologies in aid to future monitoring of marine life.