| 11. |
- Bytyci, I. Ibadete, et al.
(author)
-
Left atrial size as predictor of recurrences after catheter ablation in paroxysmal atrial fibrillation : a systematic review and meta-analysis
- 2017
-
In: European Journal of Heart Failure. - : European Society of Cardiology. - 1388-9842 .- 1879-0844. ; 19:S1, s. 80-80
-
Journal article (peer-reviewed)abstract
- Background and Aim: Left atrial (LA) enlargement is associated with paroxysmal atrial fibrillation (PAF) incidence and outcome. The predictive role of the LA size in AF treatment with catheter ablation is still controversial. The aim of this meta-analysis was to analyze the potential association between LA diameter in patients with PAF undergoing ablation and AF recurrence after ablation.Methods: We systematically searched PubMed-Medline, EMBASE, Scopus, Google Scholar and the Cochrane Central Registry, up to December 2016 in order to select clinical trial and observational studies, which assessed the predictive role of LA diameter in AF recurrence after catheter-ablation. 2962 patients from 16 studies with paroxysmal AF (PAF) were included.Results: The pooled analysis showed that after a follow-up period of 19. 66± 8.31 months, patients with AF recurrence had larger LA size compared with those without AF recurrence, with a weighted mean difference (WMD) 2.31 ([95% CI 1.27 to 3.34], P < 0.0001). LA diameter ≥40 mm predicted AF recurrence HR:1.04 [95% CI 1.00 to 1.08], P=0.04), but the best cut-off value, in all included patients, was ≥50mm HR:3.08 [95% CI 1.47 to 6.49], P=0.003).Conclusions: Enlarged left atrium in patients with PAF undergoing catheter ablation predicts recurrences. The diameter more than 50 mm is the best cut-off of the recurrences of AF, but diameter of 40 mm also can predict recurrences in these patients.
|
|
| 12. |
|
|
| 13. |
|
|
| 14. |
- Bytyci, Ibadete, et al.
(author)
-
Left atrial strain increases in CRT responders : a systematic review and meta-analysis
- 2018
-
In: European Heart Journal. - : OXFORD UNIV PRESS. - 0195-668X .- 1522-9645. ; 39, s. 422-422
-
Journal article (other academic/artistic)abstract
- Background and aim: Impaired left atrial (LA) strain is associated with myocardial fibrosis and carries poor prognosis, especially arrhythmia. Cardiac resynchronization therapy (CRT) is associated with reserved LA remodeling and reduced arrhythmia. The aim of this meta-analysis was to assess the relationship between CRT and LA function improvement.Methods: We systematically searched PubMed-Medline, EMBASE, Scopus, Google Scholar and the Cochrane Central Registry, up to February 2018 in order to select clinical trials and observational studies, which assessed the predictive value of LA strain of CRT response. The left ventricular end-systolic volume (LVESV) reduction ≥15 ml and/or LV ejection fraction (EF) increase ≥10% were the documented criteria for assessment of CRT response.Results: A total of 299 patients (181 responders and 118 non-responders to CRT) from 5 observational studies, with mean follow-up period of 6 months were included in this meta-analysis. The pooled analysis showed no difference between baseline LA strain in the two groups with weighted mean difference (WMD) 1.07% [95% CI -2.37 to 4.51, P=0.54, Figure 1]. After the follow-up period, LA strain in the CRT responders significantly increased, WMD 27.7% [95% CI 23.1 to 32.6, P<0.001, Figure 2, a)], but not in the non-responders, WMD -34.5 [95% CI -38.4 to -30.6, p<0.001, Figure 2, b)].Conclusions: Improvement of LA strain in CRT responders reflects LA reserve remodeling. These results support the importance of LA function in patients treated by CRT for heart failure.
|
|
| 15. |
- Ibrahimi, P., et al.
(author)
-
Enlarged left atrium and increased basal heart rate predict exercise capacity in heart failure patients
- 2017
-
In: European Journal of Heart Failure. - : European Society of Cardiology. - 1388-9842 .- 1879-0844. ; 19:S1, s. 582-583
-
Journal article (peer-reviewed)abstract
- Background and aim: Heart failure (HF) is a major and growing health problem characterized by high mortality, frequent hospitalization, reduced quality of life and a complex therapeutic regimen. Six minute walking test (6-MWT) may serve as a reproducible test for assessing exercise capacity in HF patients and can be clinically predicted. The aim of this study was to assess clinical, biochemical and echocardiographical predictors of limited exercise capacity in HF patients.Methods: The study subjects were 135 consecutive clinically stable HF patients (64±11 years, 66 [47%] female, classified as NYHA I-III). Echocardiography, including tissue Doppler measurements, was performed in all patients. A six minute walk test (6-MWT) distance was performed in all patients, who were divided into two groups based on the 6-MWT distance (Group I: ≤ 300 m and Group II: >300 m).Results: Patients with limited exercise performance (≤ 300 m) were older (p<001), more frequent female (p=0.007) and diabetics (p=0.003), had lower level of hemoglobin (p=0.02), larger left atrium (LA, p=0.003), higher basal heart rate (p=0.009), higher E/e’ ratio (p=0.01) and lower septal systolic myocardial velocity (p=0.03) compared with good performance patients. Enlarged LA [2.856 (1.439-5.666), p=0.003], older age [1.110 (1.036-1.188), p=0.003], increased basal heart rate [1.055 (1.012-1.099), p=0.012] and the presence of diabetes [3.321 (1.022-10.796), p=0.046] independently predicted poor 6-MWT performance.Conclusions: In patients with HF, the limited exercise capacity assessed by 6-MWT, is related mostly to the enlarged left atrium as e reflection of longstanding increased left ventricular filling pressure, increased basal heart rate, in addition to the older age and the presence of diabetes. These findings highlights the need of the optimal medical treatment of HF patients towards the decreasing LV filling pressure and heart rate.
|
|
| 16. |
- Katsiki, Niki, et al.
(author)
-
Statin therapy in athletes and patients performing regular intense exercise - Position paper from the International Lipid Expert Panel (ILEP)
- 2020
-
In: Pharmacological Research. - : Elsevier. - 1043-6618 .- 1096-1186. ; 155
-
Journal article (peer-reviewed)abstract
- Acute and chronic physical exercises may enhance the development of statin-related myopathy. In this context, the recent (2019) guidelines of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS) for the management of dyslipidemias recommend that, although individuals with dyslipidemia should be advised to engage in regular moderate physical exercise (for at least 30 min daily), physicians should be alerted with regard to myopathy and creatine kinase (CK) elevation in statin-treated sport athletes. However it is worth emphasizing that abovementioned guidelines, previous and recent ESC/EAS consensus papers on adverse effects of statin therapy as well as other previous attempts on this issue, including the ones from the International Lipid Expert Panel (ILEP), give only general recommendations on how to manage patients requiring statin therapy on regular exercises. Therefore, these guidelines in the form of the Position Paper are the first such an attempt to summary existing, often scarce knowledge, and to present this important issue in the form of step-by-step practical recommendations. It is critically important as we might observe more and more individuals on regular exercises/athletes requiring statin therapy due to their cardiovascular risk.
|
|
| 17. |
- Penson, Peter E., et al.
(author)
-
Step-by-step diagnosis and management of the nocebo/drucebo effect in statin-associated muscle symptoms patients : a position paper from the International Lipid Expert Panel (ILEP)
- 2022
-
In: Journal of Cachexia, Sarcopenia and Muscle. - : John Wiley & Sons. - 2190-5991 .- 2190-6009. ; 13:3, s. 1596-1622
-
Research review (peer-reviewed)abstract
- Statin intolerance is a clinical syndrome whereby adverse effects (AEs) associated with statin therapy [most commonly statin-associated muscle symptoms (SAMS)] result in the discontinuation of therapy and consequently increase the risk of adverse cardiovascular outcomes. However, complete statin intolerance occurs in only a small minority of treated patients (estimated prevalence of only 3–5%). Many perceived AEs are misattributed (e.g. physical musculoskeletal injury and inflammatory myopathies), and subjective symptoms occur as a result of the fact that patients expect them to do so when taking medicines (the nocebo/drucebo effect)—what might be truth even for over 50% of all patients with muscle weakness/pain. Clear guidance is necessary to enable the optimal management of plasma in real-world clinical practice in patients who experience subjective AEs. In this Position Paper of the International Lipid Expert Panel (ILEP), we present a step-by-step patient-centred approach to the identification and management of SAMS with a particular focus on strategies to prevent and manage the nocebo/drucebo effect and to improve long-term compliance with lipid-lowering therapy.
|
|
