British journal of hospital medicine最新文献

{"title":"Efficacy of General Magnetic Therapy and Motor-Evoked Potential-Guided Precision Magnetic Therapy in Patients with Overactive Bladder: A Randomized Controlled Trial.","authors":"Hongzhe Xu, Zhangji Zhu, Yinan Lv, Jiawei Gong, Yue Duan","doi":"10.12968/hmed.2024.0532","DOIUrl":"https://doi.org/10.12968/hmed.2024.0532","url":null,"abstract":"<p><p><b>Aims/Background</b> Overactive bladder (OAB) is a prevalent chronic condition affecting approximately 12% of adults, with incidence increasing with age. While pharmacological and behavioural therapies are standard treatments, their efficacy is often limited by side effects and poor adherence. This study aimed to compare the therapeutic effects of precision magnetic stimulation guided by motor-evoked potential with general magnetic therapy in patients with OAB. <b>Methods</b> This randomized controlled trial included 45 patients diagnosed with OAB at The Second Affiliated Hospital of Zhejiang Chinese Medicine University between January 2022 and September 2022. Participants were randomly divided into Group 1 (n = 15) which received bladder training (BT) alone, Group 2 (n = 15) received BT combined with general magnetic therapy, and Group 3 (n = 15) received BT combined with precision magnetic therapy. Clinical efficacy was evaluated using the Overactive Bladder Symptom Score (OABSS), urination diaries, initial bladder volume, and maximum bladder volume before and after treatment. <b>Results</b> At the end of the intervention, Groups 2 and 3 demonstrated significant improvements in OABSS scores, urgency of urination, initial bladder volume, and maximum bladder volume compared to Group 1 (<i>p</i> < 0.05). Group 3 exhibited superior urination frequency and initial bladder volume improvements compared to Group 2 (<i>p</i> < 0.05). <b>Conclusion</b> General magnetic therapy combined with BT and precision magnetic therapy combined with BT were more effective than BT alone in treating OAB. While there were no significant differences between the two magnetic stimulation methods in terms of OABSS scores, urgent urination, nocturnal urination, or maximum bladder volume, precision magnetic therapy showed greater efficacy in reducing urination frequency and improving initial bladder volume. These findings suggest that precision magnetic therapy offers an enhanced therapeutic benefit. <b>Clinical Trial Registration</b> Chinese Clinical Trial Registry (ChiCTR2400087888).</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed Diagnosis of Dysphagia: Consider \"FOSMN\".","authors":"Lauren Fratalia, Andrew J Larner","doi":"10.12968/hmed.2024.0499","DOIUrl":"https://doi.org/10.12968/hmed.2024.0499","url":null,"abstract":"<p><p>An 80-year-old lady had a history of progressive swallowing difficulty over several years with significant weight loss, but prior investigations in several medical departments proved negative. Neurological assessment noted her complaint of impaired feeling for food in her mouth and examination showed impaired corneal reflexes and facial sensory function. Blink reflex electrodiagnostic testing was consistent with a diagnosis of facial onset sensory and motor neuronopathy (FOSMN). This article raises awareness of the diagnosis, investigation and treatment of FOSMN.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-6"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a GULP-Based Predictive Model for Dehydration in Elderly Patients with Post-Stroke Dysphagia.","authors":"Yan Liang, Xin Dai, Bing Wei, Haiyan Jia, Jinxiu Zhang, Zi Qiu, Qian Zhang","doi":"10.12968/hmed.2024.0366","DOIUrl":"https://doi.org/10.12968/hmed.2024.0366","url":null,"abstract":"<p><p><b>Aims/Background</b> The background for establishing and verifying a dehydration prediction model for elderly patients with post-stroke dysphagia (PSD) based on General Utility for Latent Process (GULP) is as follows: For elderly patients with PSD, GULP technology is utilized to build a dehydration prediction model. This aims to improve the accuracy of dehydration risk assessment and provide clinical intervention, thereby offering a scientific basis and enhancing patient prognosis. This research highlights the innovative application of GULP technology in constructing complex medical prediction models and addresses the special health needs of elderly stroke patients. Based on GULP criteria, the study aims to establish and validate a dehydration prediction model for elderly patients with dysphagia following a stroke. <b>Methods</b> Two hundred patients with post-stroke dysphagia treated at Beijing Rehabilitation Hospital Affiliated with Capital Medical University, from January 2020 to December 2023, were selected retrospectively. The patients were randomly matched at a ratio of 1:4 to establish a verification group (n = 40) and a modelling group (n = 160). Based on the occurrence of dehydration, the modelling group patients were divided into two groups: the dehydration group (n = 55) and the non-dehydration group (n = 105). Univariate and multivariate logistic regression analyses were used to identify the influencing factors of dehydration in elderly patients with dysphagia after a stroke, and to establish a predictive model based on GULP. The predictive value of the model was evaluated using receiver operating characteristic (ROC) curve analysis. <b>Results</b> The results of univariate and multivariate logistic regression analyses showed significant differences in age, lesion location, muscle strength grade, homocysteine (Hcy), and swallowing function score (<i>p</i> < 0.05). When these influencing factors were included in the model, the slope of the calibration curve in both the training set and the validation set was close to 1, indicating that the predicted dehydration risk was consistent with the actual risk. ROC analysis results revealed that in the training set, the model predicted dehydration in elderly post-stroke patients with dysphagia with an area under the curve (AUC) of 0.934, a standard error of 0.034, and a 95% confidence interval (CI) of 0.916 to 0.981. The optimal cutoff value was 0.78, yielding a sensitivity of 88.84% and a specificity of 90.00%. In the validation set, the AUC was 0.867 with a standard error of 0.025 and a 95% CI of 0.694 to 0.934. The optimal cutoff value here was 0.66, with a sensitivity of 80.16% and a specificity of 85.94%. <b>Conclusion</b> This study successfully established and validated a GULP-based dehydration prediction model for elderly patients with dysphagia following a stroke, demonstrating high application value.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-16"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Once-Weekly Insulin: A Breakthrough in Diabetes Management or an Unresolved Challenge?","authors":"Raheel Ahmed, Aimen Shafiq, Mushood Ahmed","doi":"10.12968/hmed.2024.0712","DOIUrl":"https://doi.org/10.12968/hmed.2024.0712","url":null,"abstract":"<p><p>The advent of once-weekly insulin icodec is a promising development in the care of individuals with diabetes. These once-weekly formulations aimed to improve patient adherence and quality of life for patients who find daily injection administration challenging. Insulin icodec has demonstrated comparable glycemic control to conventionally used daily basal insulins, such as insulin glargine and degludec, in the ONWARDS clinical trials. This approach is aligned with patient-centred guidelines, offers better convenience, and can potentially improve adherence, particularly among older adults with type 2 diabetes and those experiencing distress related to frequent injection administration. However, several challenges persist before widespread adoption is feasible. One main concern is ensuring consistent insulin levels over a full week as fluctuations can lead to an increased risk of hypo- or hyperglycemia. Education, precise dosing, and further research are required to ensure long-term efficacy and safety. Moreover, logistical hurdles, including production costs and supply chain complexities need to be addressed especially in low-resource settings. Future studies should evaluate the broader health impacts of weekly insulin, including cardiovascular outcomes, quality of life, and personalized dosing strategies. Making weekly insulin safe, affordable, and widely available is important to fully realize its potential in diabetes management.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-6"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Assessment Prior to Cardiotoxic Anticancer Therapies in 7 Steps.","authors":"Jieli Tong, Isabelle Senechal, Sivatharshini Ramalingam, Alexander R Lyon","doi":"10.12968/hmed.2024.0632","DOIUrl":"https://doi.org/10.12968/hmed.2024.0632","url":null,"abstract":"<p><p>The burdens of cardiovascular (CV) diseases and cardiotoxic side effects of cancer treatment in oncology patients are increasing in parallel. The European Society of Cardiology (ESC) 2022 Cardio-Oncology guidelines recommend the use of standardized risk stratification tools to determine the risk of cardiotoxicity associated with different anticancer treatment modalities and the severity of their complications. The use of the Heart Failure Association-International Cardio-Oncology Society (HFA-ICOS) is essential for assessing risk prior to starting cancer treatment, and validation of these methods has been performed in patients receiving anthracyclines, human epidermal receptor 2 (HER2)-targeted therapies and breakpoint cluster region-abelson oncogene locus (BCR-ABL) inhibitors. The benefits of performing baseline CV risk assessment and stratification include early recognition of cardiotoxicities, personalisation of cancer treatment and monitoring strategies, and allocation of cardioprotection to those at the highest risk. This review summarizes the key points of risk stratification in these patients. The steps include identifying the target population, assessing nonmodifiable and modifiable CV risk factors, reviewing previous oncologic therapies and CV histories, and performing baseline investigations. In summary, this review aims to provide general physicians with a simple 7-step guide that will help steer and navigate them through cardiac risk evaluation of potentially cardiotoxic oncologic treatment strategies.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-21"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Manage an Individual Living with Parkinson's Disease Who Acutely Cannot Swallow.","authors":"Mayu Teranaka, Wakana Teranaka, Howell T Jones","doi":"10.12968/hmed.2024.0518","DOIUrl":"https://doi.org/10.12968/hmed.2024.0518","url":null,"abstract":"<p><p>Parkinson's disease (PD) is a common neurodegenerative condition that can lead to problems swallowing. Individuals living with PD may be unable to take medications orally for various reasons including acute or chronic dysphagia, non-PD related causes and being placed nil-by-mouth for elective reasons. This article outlines a five-step approach to managing an individual living with PD who is unable to take oral medication acutely. This includes assessment for the appropriateness of nasogastric tube insertion and the conversion of an individual's usual medication regimen to either a dispersible one or to a topical patch if a nasogastric tube is not possible. A patient-centred multidisciplinary approach is important, with shared decision-making involving the individual and their next of kin with key members including the Speech and Language Therapy and dietetic teams. The patient should be reviewed daily with their medication titrated according to clinical response, aiming to restart their usual regimen as soon as possible.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-10"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune Cell Characteristics and Infections Associated with Chronic Obstructive Pulmonary Disease (COPD), Asthma, and Interstitial Lung Disease (ILD): A Mendelian Randomization Studies.","authors":"Yunhai Liao, Lei Gu, Lanhua Chen, Jing Lin","doi":"10.12968/hmed.2024.0572","DOIUrl":"https://doi.org/10.12968/hmed.2024.0572","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Aims/Background&lt;/b&gt; Epidemiological studies indicate that the involvement of the immune system in the pathogenesis of infections associated with chronic obstructive pulmonary disease (COPD), asthma, and interstitial lung disease (ILD) remains unclear. This study aims to assess the potential causal link between infections associated with COPD, asthma, or ILD and immune system function. &lt;b&gt;Methods&lt;/b&gt; We conducted a two-sample Mendelian randomization analysis using publicly available genome-wide association study (GWAS) datasets. The causal relationship between immune cell signaling and susceptibility to infections related to COPD, asthma, and ILD was evaluated using inverse variance weighting (IVW), Mendelian randomization (MR)-Egger regression, weighted median, weighted mode, and simple mode approaches. To concurrently assess the causal impact of immune cell signaling on infection susceptibility associated with COPD, asthma, and ILD, a reverse Mendelian randomization analysis was also conducted. &lt;b&gt;Results&lt;/b&gt; Genetic predisposition to elevated counts of circulating blood cells and their subpopulations demonstrated significant causal associations with a higher risk of COPD/asthma/ILD-related infections, as determined by IVW analysis. Specifically, genetically predicted increases in white blood cell count (odds ratio (OR) 1.08 [95% confidence interval (CI): 1.04-1.11], &lt;i&gt;p&lt;/i&gt; &lt; 0.00001), neutrophil count (OR: 1.06 [95% CI: 1.02-1.10], &lt;i&gt;p&lt;/i&gt; = 0.00190), lymphocyte count (OR: 1.04 [95% CI: 1.01-1.07], &lt;i&gt;p&lt;/i&gt; = 0.01515), monocyte count (OR: 1.03 [95% CI: 1.01-1.06], &lt;i&gt;p&lt;/i&gt; = 0.00440), and eosinophil count (OR: 1.07 [95% CI: 1.04-1.10], &lt;i&gt;p&lt;/i&gt; = 0.00001) were causally correlated with an increased risk of these respiratory infections. Notably, four immunophenotypes were significantly associated with the risk of COPD/asthma/ILD-related infections: Human Leukocyte Antigen (HLA) DR&lt;sup&gt;+&lt;/sup&gt; NK% NK (OR: 0.98 [95% CI: 0.97-0.99], &lt;i&gt;p&lt;/i&gt; = 0.0004), CD66b on CD66b&lt;sup&gt;++&lt;/sup&gt; myeloid cell (OR: 0.98 [95% CI: 0.97-0.99], &lt;i&gt;p&lt;/i&gt; = 0.0007), HLA DR on CD14&lt;sup&gt;+&lt;/sup&gt; monocyte (OR: 1.03 [95% CI: 1.01-1.04], &lt;i&gt;p&lt;/i&gt; = 0.0002), and HLA DR on CD33&lt;sup&gt;-&lt;/sup&gt; HLA DR&lt;sup&gt;+&lt;/sup&gt; (OR: 1.03 [95% CI: 1.02-1.05], &lt;i&gt;p&lt;/i&gt; &lt; 0.00001). The causal effect of COPD/asthma/ILD-related infections on Immunoglobulin D (IgD) expression in IgD&lt;sup&gt;+&lt;/sup&gt; CD38&lt;sup&gt;br&lt;/sup&gt; and transitional B cells was estimated to be 0.64 (95% CI: 0.49-0.83, &lt;i&gt;p&lt;/i&gt; = 0.00091) and 0.70 (95% CI: 0.54-0.91, &lt;i&gt;p&lt;/i&gt; = 0.00727), respectively. Additionally, COPD/asthma/ILD-related infections demonstrated a significant causal effect on several B cell and T cell subpopulations: IgD&lt;sup&gt;+&lt;/sup&gt; CD38&lt;sup&gt;-&lt;/sup&gt; % B cells, IgD&lt;sup&gt;+&lt;/sup&gt; CD38&lt;sup&gt;-&lt;/sup&gt; AC, CD4&lt;sup&gt;+&lt;/sup&gt; CD8&lt;sup&gt;dim&lt;/sup&gt; AC, IgD&lt;sup&gt;+&lt;/sup&gt; CD38&lt;sup&gt;-&lt;/sup&gt; % lymphocyte, and TD CD4&lt;sup&gt;+&lt;/sup&gt; AC, with the OR 1.54 (95% CI: 1.19-2.00, &lt;i&gt;p&lt;/i&gt; = 0.00113), 1.56 (95% CI: 1.16-2.10, &lt;i&gt;p&lt;/i&gt; = 0.00340), 1.60 (9","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-17"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the Environmental Impact of Pharmaceuticals: A Call to Action.","authors":"Amy Booth, Sara Elizabeth Shaw","doi":"10.12968/hmed.2024.0841","DOIUrl":"https://doi.org/10.12968/hmed.2024.0841","url":null,"abstract":"<p><p>The contribution of health care to environmental and climate crises is significant, under-addressed, and with consequences for human health. This editorial is a call to action. Focusing on pharmaceuticals as a major environmental threat, we examine pharmaceutical impacts across their lifecycle, summarising greenhouse gas emissions, pollution, and biodiversity loss, and outlining challenges and opportunities to reduce this impact. We urge health care decision-makers and providers to urgently consider environmental factors in their decision-making relating to both policy, and practice, promoting actions such as rational prescribing, non-pharmaceutical interventions, and research and advocacy for sustainable production, procurement, and use.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-8"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Brain Volume and Thickness between Shammah (Smokeless Tobacco) Users and Non-Users: A Cross-Sectional Study.","authors":"Naif A Majrashi, Ali S Alyami, Mohammed Ali Almansour, Mohmmed Hussain Alyami, Mohmmed Hamad Almansour, Essa Alhashlan, Nasser Shubayr, Ali M Hendi, Wael A Ageeli, Yahia Madkhali, Bandar Alwadani, Turkey A Refaee, Gordon D Waiter","doi":"10.12968/hmed.2024.0480","DOIUrl":"https://doi.org/10.12968/hmed.2024.0480","url":null,"abstract":"<p><p><b>Aims/Background</b> Previous research has shown that smoking tobacco is associated with changes or differences in brain volume and cortical thickness, resulting in a smaller brain volume and decreased cortical thickness in smokers compared with non-smokers. However, the effects of smokeless tobacco on brain volume and cortical thickness remain unclear. This study aimed to investigate whether the use of shammah, a nicotine-containing smokeless tobacco popular in Middle Eastern countries, is associated with differences in brain volume and thickness compared with non-users and to assess the influence of shammah quantity and type on these effects. <b>Methods</b> Male shammah users (aged 20 to 47 years, n = 30) and non-users (n = 39) underwent 1.5T magnetic resonance imaging (MRI) scans, and cortical brain volumes and thicknesses were measured using FreeSurfer. <b>Results</b> Significant differences were found in the volume of the right pallidum (<i>p</i> = 0.02), total pallidum (<i>p</i> = 0.02), total ventricle (<i>p</i> = 0.02), middle posterior corpus callosum (<i>p</i> = 0.04), and brainstem (<i>p</i> = 0.02) between shammah users and non-users. Furthermore, yellow shammah users exhibited smaller volumes in the right lateral ventricle (<i>p</i> = 0.02), total lateral ventricle (<i>p</i> = 0.03), and right putamen (<i>p</i> = 0.02) compared with users of other types of shammah. Regarding cortical thickness, significant differences were observed in the right medial orbito-frontal thickness (<i>p</i> = 0.03), left rostral middle frontal thickness (<i>p</i> = 0.03), and right rostral anterior cingulate thickness (<i>p</i> = 0.04). <b>Conclusion</b> These findings shed light on the potential neurobiological effects of shammah use, particularly the yellow shammah, and highlighting the need for further research to fully understand its implications for brain structure and function.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-18"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mendelian Randomization Study Reveals Causal Pathways for Hypertrophic Cardiomyopathy, Cardiovascular Proteins, and Atrial Fibrillation.","authors":"Yifei Zhang, Chenyuan Guo, Lanxin Wang, Lei Wu, Jia Lv, Xia Huang, Wuxiao Yang","doi":"10.12968/hmed.2024.0504","DOIUrl":"https://doi.org/10.12968/hmed.2024.0504","url":null,"abstract":"<p><p><b>Aims/Background</b> Research evidence has demonstrated a significant association between hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF), but the causality and pattern of this link remain unexplored. Therefore, this study investigated the causal relationship between HCM and AF using a two-sample and bidirectional Mendelian randomization (MR) approach. Additionally, this assessed the role of cardiovascular proteins (CPs) associated with cardiovascular diseases between HCM and AF by applying a two-step MR analysis. <b>Methods</b> Data for HCM, AF, and 90 CPs were obtained from the Finn Gen and IEU Open GWAS Project databases. MR-Egger, inverse variance weighting (IVW), weighted median estimator (WME), weighted mode, and simple mode were used to estimate causal inferences. Furthermore, Cochran's Q test, MR-Egger's intercept terms, and Leave-one-out methods determined the heterogeneity, horizontal pleiotropy, and sensitivity. Additionally, mediation effects were used to assess the role of CPs in the relationship between HCM and AF. <b>Results</b> Two-sample and bidirectional MR analysis revealed HCM as a risk factor for AF (odds ratio (OR) = 1.008, 95% confidence interval (CI): 1.001-1.016, <i>p</i> = 0.029) and AF was found to increase the risk of developing HCM (OR = 1.145, 95% CI: 0.963-1.361, <i>p</i> = 0.126). Moreover, Two-step MR analyses indicated that 5 CPs were causally associated with HCM; 12 CPs with AF and 1 CP (Melusin) with both HCM and AF. Additionally, Melusin was observed as a protective factor for both HCM and AF and may serve as a mediator variable for these two conditions (mediation effect 0.0004, mediation ratio 5.5178%, 95% CI: 5.4624-5.5731). <b>Conclusion</b> HCM may increase the risk of developing AF, with Melusin serving as a mediator for this risk.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-19"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}