Abstract Objective To evaluate the role of bioelectrical impedance vector analysis (BIVA) and brain natriuretic peptide (BNP) in detecting peripheral congestion in heart failure (HF). Background ...BIVA/BNP are biomarkers for congestion in acute (ADHF) and chronic HF. Methods 487 ADHF and 413 chronic HF patients underwent BIVA and BNP tests. Results BIVA was more accurate than BNP in detecting peripheral congestion both in ADHF (AUC 0.88 vs 0.57 respectively; p < 0.001) and chronic HF patients (AUC 0.89 vs 0.68, respectively; p < 0.001). In ADHF patients, the optimal BNP cut-off for discriminating presence or absence of edema was >870 pg/mL (PPV = 48% and NPV = 58%) whereas in chronic HF it was >216 pg/mL (PPV = 18% and NPV = 95%). The BIVA detected edema when the vector fell into the lower pole of 75th percentile tolerance ellipse (PPV = 84% and NPV = 78%) in ADHF, the lower pole of 50% (PPV = 68% and NPV = 95%) in chronic HF. Conclusions In HF patients, BIVA is an easy, fast technique to assess peripheral congestion, and is even more accurate than BNP.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
The relevance of the temporal relationship between a unipolar electrogram (UEGM) and a bipolar electrogram (BEGM) in determining the site of origin (SOO) of focal arrhythmias has been largely ...demonstrated.
We sought to demonstrate that a negative concordance in the initial forces of these EGMs is also helpful in predicting the SOO of premature ventricular contractions (PVCs).
Mapping and radiofrequency (RF) ablation were performed in 41 patients with symptomatic PVCs in the absence of structural heart disease. Simultaneous recordings of the minimally filtered (0.5-500 Hz) UEGM and filtered BEGM (30-500 Hz) were analyzed at 247 mapping sites, where RF was attempted. EGMs of 63 mechanically induced PVCs were separately analyzed as a validation group. All ablation sites had a QS pattern in the UEGM. Acute PVC suppression was defined as a complete disappearance of ventricular ectopic beats after a 60-second pulse of RF.
RF ablation obtained PVC suppression (RF+) in 33 of 247 sites (13.3%). A negative concordance pattern (NCP) during the initial 20 ms of both UEGM and BEGM was observed in 31 of 33 (94%) RF+ sites compared with 10 of 214 (4%)RF- sites (P < .0001). The NCP criterion demonstrated to be an additional powerful predictor of acute RF success with sensitivity, specificity, positive predictive value, and negative predictive value of 94%, 95%, 76%, and 99%, respectively. Similarly to RF+ sites, the NCP was observed in 60 of 63 sites (95.2%) in the mechanical PVC group.
An NCP in both UEGM and BEGM may be an additional criterion that helps to localize the SOO of focal ventricular arrhythmias.
Abstract Objectives The goal of our study was to determine the prevalence of metabolic syndrome (MetS) and all its components, in a population of postmenopausal women aged over 45 years, ...consecutively accessed to our Heart Station, during 2014, for their first cardiac examination,furthermore to estimate their cardiovascular risk and the achievement of target blood values of main risk factors, according to current Guidelines. Methods We screened 1257 postmenopausal women. MetS was assessed according to the National-Cholesterol-Education-Program-Adult-Treatment-Panel III definition. Cardiovascular risk was calculated by the Systematic Coronary Risk Evaluation (<65 years). Results MetS was assessed on 834 women (66.4%). Prevalence of each component was: hypertension on 767 women (91.9%), central obesity 758 women (90.9%), low high-density lipoproteins cholesterol (HDLc) increased levels 612 women (73.3%), high triglyceride levels 428 women (51.3%), glucose levels higher than 110 mg/dl or diabetes 404 women (48.5%). Cardiovascular risk was moderate until 65 years, but it increases after. Metabolic control in postmenopausal women was poor for glucose, only 82 women (9.8%) presented glucose levels lower than 110 mg/dl, it was better for systolic blood pressure, that was normal in 564 women (67.6%) and worse for lipid levels. Conclusion The prevalence of metabolic syndrome in our population of postmenopausal women is high. Hypertension and central obesity are the more common components. The cardiovascular risk is moderate-high, the achievement of target values for glycemic and lipid levels is unsatisfactory, while systolic blood pressure is enough well controlled but however it is mandatory to improve this goal. An early MetS diagnosis and an early educational intervention are useful to decrease cardiovascular risk of postmenopausal women affected by metabolic syndrome.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
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