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- Cadrin-Tourigny, Julia, et al.
(författare)
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Sudden Cardiac Death Prediction in Arrhythmogenic Right Ventricular Cardiomyopathy : A Multinational Collaboration
- 2021
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Ingår i: Circulation: Arrhythmia and Electrophysiology. - : Lippincott Williams & Wilkins. - 1941-3149 .- 1941-3084. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is associated with ventricular arrhythmias (VA) and sudden cardiac death (SCD). A model was recently developed to predict incident sustained VA in patients with ARVC. However, since this outcome may overestimate the risk for SCD, we aimed to specifically predict life-threatening VA (LTVA) as a closer surrogate for SCD. Methods: We assembled a retrospective cohort of definite ARVC cases from 15 centers in North America and Europe. Association of 8 prespecified clinical predictors with LTVA (SCD, aborted SCD, sustained, or implantable cardioverter-defibrillator treated ventricular tachycardia >250 beats per minute) in follow-up was assessed by Cox regression with backward selection. Candidate variables included age, sex, prior sustained VA (≥30s, hemodynamically unstable, or implantable cardioverter-defibrillator treated ventricular tachycardia; or aborted SCD), syncope, 24-hour premature ventricular complexes count, the number of anterior and inferior leads with T-wave inversion, left and right ventricular ejection fraction. The resulting model was internally validated using bootstrapping. Results: A total of 864 patients with definite ARVC (40±16 years; 53% male) were included. Over 5.75 years (interquartile range, 2.77-10.58) of follow-up, 93 (10.8%) patients experienced LTVA including 15 with SCD/aborted SCD (1.7%). Of the 8 prespecified clinical predictors, only 4 (younger age, male sex, premature ventricular complex count, and number of leads with T-wave inversion) were associated with LTVA. Notably, prior sustained VA did not predict subsequent LTVA (P=0.850). A model including only these 4 predictors had an optimism-corrected C-index of 0.74 (95% CI, 0.69-0.80) and calibration slope of 0.95 (95% CI, 0.94-0.98) indicating minimal over-optimism. Conclusions: LTVA events in patients with ARVC can be predicted by a novel simple prediction model using only 4 clinical predictors. Prior sustained VA and the extent of functional heart disease are not associated with subsequent LTVA events.
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| 2. |
- Khairy, M., et al.
(författare)
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Bioaccumulation of PCBs, OCPs and PBDEs in Marine Mammals From West Antarctica
- 2021
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Ingår i: Frontiers in Marine Science. - : Frontiers Media SA. - 2296-7745. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- To understand the bioaccumulation and food web dynamics of persistent organic pollutants (POPs) as a function of species, age and sex in Antarctic mammals, blubber samples of 3 killer whales (Type C) and 77 pinnipeds (Weddell, Ross and crabeater seals) were collected from the Southern Ocean, Antarctica. They were analyzed for polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs) and polybrominated diphenyl ethers (PBDEs). sigma DDTs, sigma(29)PCBs and chlordanes (12 - 4,600, 13 - 1,600, and < 1.5 - 1,700 ng/g lipid, respectively) were the most abundant POPs. Killer whales typically displayed several times greater concentrations of POPs compared to seals, except for PBDEs. PCBs and PBDEs were consistently higher in adult crabeater and Weddell seal males, and in adult female Ross seals than in other sex and age groups reflecting an age accumulation and possible influence of segregated diet, foraging areas, and metabolic transformation rates. POPs concentrations significantly correlated with gene transcription of nuclear receptors involved in detoxification of contaminants and immune relevant cell mediators in the crabeater seals, indicating possible immunotoxic and deleterious health effects. This represents one of the largest studies on POPs in Antarctic marine predators and highlights the complexity of POPs bioaccumulation.
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