Pulse最新文献

{"title":"Large Artery Stiffness: A Companion to the 2015 AHA Science Statement on Arterial Stiffness.","authors":"Jimena Rey-García,&nbsp;Raymond R Townsend","doi":"10.1159/000518613","DOIUrl":"https://doi.org/10.1159/000518613","url":null,"abstract":"<p><p>Large artery stiffness (LAS) has proven to be an independent risk factor for cardiovascular disease and mortality. Nevertheless, the position of current hypertension guidelines regarding the usefulness of assessing LAS differs across different continents. In general, European Guidelines recognize pulse wave velocity (PWV) as a marker of target organ damage but do not recommend its systematic use in general population. Asian guidelines consider PWV as a recommended test at diagnosis of hypertension, in contrast to North American guidelines that do not state any position about its usefulness. However, PWV predicts cardiovascular events, and several studies have shown that it improves risk classification adjusting for established risk factors especially for intermediate-risk patients. Finally, some advances have been made related to treatments affecting LAS. Dietary interventions such as sodium restriction and exercise-based interventions have a modest effect in reducing LAS. Pharmacological interventions, such as statins, or more recent advances with mineralocorticoid blocker seem to have a beneficial effect. Last, controversial effects of renal denervation on LAS have been found. Our goal here is to update the reader on LAS on these areas since the 2015 American Heart Association Scientific Statement.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"9 1-2","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8527919/pdf/pls-0009-0001.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39580050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Converting and Standardizing Various Measures of Arterial Stiffness to Pulse Wave Velocity.","authors":"Taha Alhalimi,&nbsp;Jisok Lim,&nbsp;Drew Gourley,&nbsp;Hirofumi Tanaka","doi":"10.1159/000517872","DOIUrl":"https://doi.org/10.1159/000517872","url":null,"abstract":"<p><strong>Background: </strong>A variety of arterial stiffness measures have been used to assess the impacts of disease states and various interventions without clear consensus among them. One of the primary problems faced by investigators conducting systematic reviews and meta-analyses is the lack of standardized methodology with a same unit to evaluate and compare investigations using different arterial stiffness measures. Therefore, the purpose of this study was to derive and summarize standardized equations to convert commonly used image-based measures of arterial stiffness to local pulse wave velocity (PWV).</p><p><strong>Methods: </strong>We first conducted a literature search to obtain and summarize conversion equations in the published literature such that these equations can be found in one convenient location. Then, we generated regression equations using the data collected in a well-controlled laboratory-based study, in which all measures of arterial stiffness were obtained in 49 apparently healthy participants.</p><p><strong>Results: </strong>All literature-based conversion equations produced similar local PWV values and were moderately and significantly correlated with directly measured carotid-femoral PWV (cfPWV) with a Pearson's <i>r</i> ranging from 0.41 to 0.50. The local PWV using laboratory-based equations were modestly associated with cfPWV (<i>r</i> = 0.39-0.49) with an exception of incremental elastic modulus (<i>r</i> = 0.15, <i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>Commonly used measures of ultrasound-based arterial stiffness can be converted to local PWV and compared with a reference standard measure of arterial stiffness.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"9 3-4","pages":"72-82"},"PeriodicalIF":2.2,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8740287/pdf/pls-0009-0072.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39739615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cold Pressor Test Influences the Cardio-Ankle Vascular Index in Healthy Overweight Young Adults.","authors":"Supaporn Kulthinee,&nbsp;Nitirut Nernpermpisooth,&nbsp;Montatip Poomvanicha,&nbsp;Jidapa Satiphop,&nbsp;Thizanamadee Chuang-Ngu,&nbsp;Napaporn Kaleeluan,&nbsp;Kittisak Thawnashom,&nbsp;Anuchit Manin,&nbsp;Rosarin Kongchan,&nbsp;Kingkarn Yinmaroeng,&nbsp;Peerapong Kitipawong,&nbsp;Phatiwat Chotimol","doi":"10.1159/000517617","DOIUrl":"https://doi.org/10.1159/000517617","url":null,"abstract":"<p><strong>Objective: </strong>The cold pressor test (CPT) has been shown a potential sympathoexcitatory stimulus which increases aortic pulse wave velocity and the aortic augmentation index, suggesting that noninvasively, arterial stiffness parameters are altered by the CPT. The cardio-ankle vascular index (CAVI) is widely used for reflecting arterial stiffness, and the ankle-brachial index (ABI) for evaluating peripheral artery disease in obesity. We aimed to assess CAVI and ABI in overweight young adults in the context of sympathetic activation by using the CPT.</p><p><strong>Methods: </strong>160 participants were divided into 2 groups: 86 normal-weight (body mass index [BMI] 18.50-22.99 kg/m²) and 74 overweight (BMI ≥23 kg/m²). The CPT was performed by immersing a participant's left hand into cold water (3-5°C) for 3 min, and CAVI and ABI assessment.</p><p><strong>Results: </strong>At baseline, the CAVI in the overweight group was significantly less than that in the normal-weight group (5.79 ± 0.85 vs. 6.10 ± 0.85; <i>p</i> < 0.05). The mean arterial pressure (MAP) for overweight was significantly greater than that for normal-weight subjects (93.89 ± 7.31 vs. 91.10 ± 6.72; <i>p</i> < 0.05). During the CPT, the CAVI increased in both normal-weight and overweight subjects, the CAVI value was greater during the CPT in overweight subjects by 14.36% (6.62 ± 0.95 vs. 5.79 ± 0.85, <i>p</i> < 0.05) and in normal-weight subjects by 8.03% (6.59 ± 1.20 vs. 6.10 ± 0.85, <i>p</i> < 0.05) than those baseline values. The CPT evoked an increase in systolic blood pressure (SBP), diastolic BP (DBP), heart rate (HR,) and pulse pressure (PP) in both groups. After a 4-min CPT period, the CAVI returned values similar to the baseline values in both groups, and the SBP, DBP, MAP, and PP in overweight participants were significantly higher than those in normal-weight participants. However, there was no significant difference in the ABI at baseline, during CPT, and post-CPT in either group.</p><p><strong>Conclusions: </strong>Our results indicated that the CAVI was influenced by sympathetic activation response to the CPT in both normal-weight and overweight young adults. Specifically, during the CPT, the percentage change of the CAVI in overweight response was greater in normal-weight participants than baseline values in each group. The ABI was not found significantly associated with CPT. These findings suggesting that sympathoexcitatory stimulus by CPT influence CAVI results.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"9 1-2","pages":"30-37"},"PeriodicalIF":2.2,"publicationDate":"2021-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000517617","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39580053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-Related Differences in Hypertrophic Cardiomyopathy: A Systematic Review and Meta-Analysis.","authors":"Angkawipa Trongtorsak,&nbsp;Natchaya Polpichai,&nbsp;Sittinun Thangjui,&nbsp;Jakrin Kewcharoen,&nbsp;Ratdanai Yodsuwan,&nbsp;Amrit Devkota,&nbsp;Harvey J Friedman,&nbsp;Alfonso Q Estrada","doi":"10.1159/000517618","DOIUrl":"https://doi.org/10.1159/000517618","url":null,"abstract":"<p><strong>Background: </strong>Gender-related differences in phenotypic expression and outcomes have been established in many cardiac conditions; however, the impact of gender in hypertrophic cardiomyopathy (HCM) remains unclear. We conducted a systematic review and meta-analysis to assess the differences in clinical outcomes between female and male HCM patients.</p><p><strong>Methods: </strong>We searched MEDLINE and EMBASE from inception to October 2020. Included were cohort studies that compared outcomes of interest including all-cause mortality, HCM-related mortality, and worsening heart failure (HF) or HF hospitalization between male and female. Data from each study were combined using the random effects model to calculate pooled odds ratio (OR) with 95% confidence interval (CI).</p><p><strong>Results: </strong>Eleven retrospective cohort studies with a total of 9,427 patients (3,719 females) were included. Female gender was significantly associated with an increased risk of all-cause mortality (pooled OR = 1.63, 95% CI: 1.26-2.10, <i>p</i> ≤ 0.001), HCM-related mortality (pooled OR = 1.47, 95% CI: 1.08-2.01, <i>p</i> = 0.015), and worsening HF or HF hospitalization (pooled OR = 2.05, 95% CI: 1.76-2.39, <i>p</i> ≤ 0.001).</p><p><strong>Conclusions: </strong>Female gender was associated with a worse prognosis in HCM. These findings suggest the need for improved care in women including early identification of disease and more possible aggressive management. Moreover, gender-based strategy may benefit in HCM patients.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"9 1-2","pages":"38-46"},"PeriodicalIF":2.2,"publicationDate":"2021-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8527921/pdf/pls-0009-0038.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39579977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Cardio-Ankle Vascular Index and Ankle-Brachial Index in Patients with Peripheral Arterial Disease.","authors":"Taichiro Hayase","doi":"10.1159/000515357","DOIUrl":"https://doi.org/10.1159/000515357","url":null,"abstract":"<p><strong>Introduction: </strong>The cardio-ankle vascular index (CAVI) is a well-known index to evaluate arterial stiffness and predict cardiovascular risk.</p><p><strong>Methods: </strong>We investigated whether CAVI can predict severity and extent of peripheral arterial disease. This study was a single-center, retrospective, observational study approved by the Ethics Committee of Yokohama Shintoshi Neurosurgical Hospital. A total of 96 patients (males, 63) with an abnormal ankle-brachial blood pressure index (ABI) of <0.9 and who underwent extremity arteriography at our hospital from 2015 to 2018 were enrolled in this study. We defined that CAVI with a range of <8.0 was normal.</p><p><strong>Results: </strong>Coronary angiography and extremity arteriography were performed for patients who had intermittent claudication and abnormal ABI. We divided the affected limbs into 3 categories: above-the-knee artery stenosis, above-the-knee artery chronic total occlusion, and only below-the-knee artery stenosis/occlusion groups. CAVI pseudonormalization was seen in 28, 76, and 19%, respectively. The above-the-knee artery stenosis and the only below-the-knee artery stenosis/occlusion groups had a high odds ratio of abnormalization of CAVI (3.1, 95% confidence interval [CI]: 1.39-7.22; <i>p</i> = 0.05, 4.56, 95% CI: 1.64-14.7).</p><p><strong>Discussion/conclusion: </strong>In the presence of the above-the-knee artery chronic total occlusion, CAVI pseudonormalization was likely to be seen. The presence of CTO in the above-the-knee artery is one cause of pseudonormalized CAVI. In the range of ABI, in which stenotic lesions and obstructive lesions coexist, it may be possible to detect the existence of CTO by a combination of both ABI and CAVI.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"9 1-2","pages":"11-16"},"PeriodicalIF":2.2,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000515357","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39580051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of Stress-Derived E/e' Ratio in Asymptomatic Hypertensive Patients.","authors":"Ragab A Mahfouz,&nbsp;Mohammed Abdelhamed,&nbsp;Islam Galal,&nbsp;Moataz Elsanan","doi":"10.1159/000511217","DOIUrl":"https://doi.org/10.1159/000511217","url":null,"abstract":"<p><strong>Purpose: </strong>We sought to investigate the usefulness of stress echocardiography-derived E/e' in predicting subclinical atherosclerosis in asymptomatic hypertensive patients.</p><p><strong>Materials and methods: </strong>71 newly diagnosed untreated hypertensive patients (48 ± 13 years, 65% males) and 30 age- and sex-matched healthy controls were recruited. Resting and exercise echocardiography was performed to assess resting diastolic blood pressure and the diastolic stress parameters. Coronary flow reserve (CFR) was evaluated as well.</p><p><strong>Results: </strong>Based on CFR values, newly diagnosed, untreated hypertensives were stratified into hypertensives with microvascular dysfunction (MVD; 34 patients had CFR <2.0) and those without MVD (37 patients had CFR ≥2.0). Patients with MVD had a significantly higher C-reactive protein level (<i>p</i> < 0.05) and lower metabolic equivalent values (<i>p</i> < 0.05). With resting echocardiography, only the left atrial volume index (LAVI) was significantly increased in those with MVD compared with those without MVD and controls (<i>p</i> < 0.05). With exercise echo, the E/e' was significantly increased in MVD patients compared with those without MVD and controls (<i>p</i> < 0.001). Importantly, the percentage of subjects with exercise E/e' ≥15 was 76.5% (26 patients in the group with MVD), 4.1% (3 patients in the group without MVD), and 0% in controls. At univariate analysis, high-sensitivity C-reactive protein (<i>p</i> < 0.05), LAVI (<i>p</i> < 0.05), and exercise E/e' (<i>p</i> < 0.001) were independently associated with reduced CFR. On the other hand, at multivariate analysis, only exercise E/e' was the independent predictor of reduced CFR in newly diagnosed hypertensives.</p><p><strong>Conclusion: </strong>We have demonstrated significant associations between exercise-derived raised left ventricular pressure and coronary MVD in newly diagnosed untreated hypertensive patients. Herein, we supposed that exercise-derived E/e' could predict subclinical atherosclerosis and might be a risk parameter for newly diagnosed untreated hypertensive patients.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"8 3-4","pages":"92-98"},"PeriodicalIF":2.2,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000511217","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39220871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating Serum Magnesium and the Risk of Venous Thromboembolism in Men: A Long-Term Prospective Cohort Study.","authors":"Setor K Kunutsor,&nbsp;Jari A Laukkanen","doi":"10.1159/000515409","DOIUrl":"https://doi.org/10.1159/000515409","url":null,"abstract":"<p><strong>Background and objective: </strong>Serum magnesium, an essential trace element involved in processes that regulate cardiovascular function, has been linked to the risk of atherosclerotic cardiovascular disease. However, the potential association between serum magnesium and venous thromboembolism (VTE) has not been previously investigated. We aimed to assess the prospective association of serum magnesium with the risk of VTE.</p><p><strong>Methods: </strong>Serum magnesium was measured using atomic absorption spectrometry in 2,361 men aged 42-61 years with no history of VTE at baseline in the Kuopio Ischemic Heart Disease prospective cohort. Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for VTE.</p><p><strong>Results: </strong>A total of 159 incident VTE events were recorded during a median follow-up of 27.1 years. The risk of VTE per 1 SD increase in serum magnesium in the age-adjusted analysis was (HR 1.30; 95% CI 0.46-3.69). The association remained consistent in analyses adjusted for systolic blood pressure, body mass index, total cholesterol, triglycerides, smoking status, a history of type 2 diabetes, a history of coronary heart disease, medication for dyslipidemia, alcohol consumption, physical activity, socioeconomic status, serum active calcium, high-sensitivity C-reactive protein, and a history of cancer (HR 1.38; 95% CI 0.48-3.96). Comparing the extreme tertiles of serum magnesium, the corresponding adjusted HRs were 1.17 (95% CI 0.81-1.70) and 1.17 (95% CI 0.81-1.70), respectively.</p><p><strong>Conclusion: </strong>In a middle-aged Caucasian male population, serum-circulating magnesium was not associated with a future risk of VTE. Further studies in women, other age groups, and other populations are required to generalize these findings.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"8 3-4","pages":"108-113"},"PeriodicalIF":2.2,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000515409","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39222232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Heartbreak to Heart Disease: A Narrative Review on Depression as an Adjunct to Cardiovascular Disease.","authors":"Jahanzeb Malik,&nbsp;Hamid Sharif Khan,&nbsp;Faizan Younus,&nbsp;Muhammad Shoaib","doi":"10.1159/000516415","DOIUrl":"https://doi.org/10.1159/000516415","url":null,"abstract":"<p><p>Patients with cardiovascular disease (CVD) commonly have subclinical depression and are often delayed in their diagnosis. Literature suggests an increased association of depression and adverse cardiovascular events like myocardial infarction and heart failure. Prevalence of depression in developed countries is approximately 16.6%, and it confers higher cardiovascular mortality even after attrition bias and confounding factors are eliminated. Pharmacological and cognitive-behavioral therapy have been extensively studied, and are generally safe and effective in alleviating depressive symptoms in patients with CVD. However, their impact on cardiovascular outcomes is still unclear. Results of randomized controlled trials have shown antidepressants, especially selective serotonin reuptake inhibitors, to be safe and effective for healing a \"broken heart.\" This review outlines the prevalence of depression in patients with CVD, the pathophysiological mechanism causing cardiovascular events with depression, and a link between depression and CVD. There is a wealth of literature explaining the precursor of CVD in depression, and like all chronic diseases, inflammation seems to be the culprit in this case as well.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"8 3-4","pages":"86-91"},"PeriodicalIF":2.2,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000516415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39220870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of a Diagnostic Methodology of Cardiac Systems Based on the Proportions of Entropy in Normal Patients and with Different Pathologies.","authors":"Javier Rodríguez,&nbsp;Signed Prieto,&nbsp;Elveny Laguado,&nbsp;Frank Pernett,&nbsp;Magda Villamizar,&nbsp;Edinson Olivella,&nbsp;Fredy Angarita,&nbsp;Giovanni de la Cruz,&nbsp;Carlos Morales,&nbsp;Mónica Castro","doi":"10.1159/000515699","DOIUrl":"https://doi.org/10.1159/000515699","url":null,"abstract":"<p><strong>Introduction: </strong>Dynamical systems theory, probability, and entropy were the substrate for the development of the diagnostic and predictive methodology of adult heart dynamics.</p><p><strong>Objective: </strong>To apply a previously developed methodology from dynamical systems, probability, and entropy in both normal and pathological subjects.</p><p><strong>Methods: </strong>Electrocardiographic records were selected from 30 healthy subjects and 200 with different pathologies, with a length of least 18 h. Numerical attractors from dynamical attractors and the probability of occurrence of ordered pairs of consecutive heart rates were built. A calculation of entropy and its proportions was performed and statistical analysis was conducted.</p><p><strong>Results: </strong>The normal patients' heart dynamics were evaluated according to the methodology of entropy proportions, highlighting that there are differences in normal patients with different pathologies. There was maximal level of sensitivity, specificity, and diagnostic agreement.</p><p><strong>Conclusion: </strong>Proportional entropy constitutes a diagnostic and predictive method of heart systems, and may be useful as a tool to objectively diagnose and perform the follow-up of normal and pathological cases.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"8 3-4","pages":"114-119"},"PeriodicalIF":2.2,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000515699","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39222233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Heart Rate Variability and Fragmented QRS for Determination of Subclinical Cardiac Involvement in Beta-Thalassemia Major.","authors":"Mozhgan Parsaee,&nbsp;Amir Farjam Fazelifar,&nbsp;Elham Ansaripour,&nbsp;Azita Azarkeyvan,&nbsp;Behshid Ghadrdoost,&nbsp;Ashraf Charmizadeh,&nbsp;Mohaddeseh Behjati","doi":"10.1159/000505556","DOIUrl":"https://doi.org/10.1159/000505556","url":null,"abstract":"<p><strong>Background: </strong>Iron accumulation leads to increased susceptibility to cardiovascular diseases in thalassemia major (TM) patients. Depressed heart rate variability (HRV) and development of arrhythmia are among the manifestations of subclinical cardiac involvement in TM cases. Determination of subclinical cardiac involvement is essential for preventive measures. Thus, we aimed to evaluate the best method for identification of subclinical cardiac dysfunction in TM cases.</p><p><strong>Materials and methods: </strong>In this prospective study, 45 TM and 45 non-TM cases, who were referred for cardiac evaluation, were enrolled. Exclusion criteria included non-sinus rhythm and overt cardiac disease. TM cases underwent cardiac MRI, electrocardiography (ECG), and Holter monitoring. TM cases were divided into two groups of normal versus iron overload with a cardiac T2* of more or less than 20 ms, respectively. The non-TM cases underwent only ECG and Holter monitoring.</p><p><strong>Results: </strong>We observed no significant difference regarding HRV between normal versus iron overload TM and non-TM cases. Higher rates of premature atrial complex, low limb voltage, low atrial rhythm, as well as minimum and average HR with lower QRS duration and PR interval were detected in TM versus non-TM cases (<i>p</i> value <0.05).</p><p><strong>Conclusions: </strong>We observed a higher prevalence of low limb voltage and low atrial rhythm in TM cases versus non-TM cases. Indeed, the role of fragmented QRS (fQRS) for subclinical detection of cardiac disease in TM cases is still so controversial and needs more evaluation. Application of HRV and fQRS in this regard may need to be performed at the right time point after initiation of blood transfusion, but this needs to be determined.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"8 1-2","pages":"15-20"},"PeriodicalIF":2.2,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000505556","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38439389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}