Changes in Serum Lipids and Blood Glucose in Non Diabetic Patients with Metabolic Syndrome after Mixed Meals of Different Composition

Aims. To investigate the postprandial changes in serum lipoproteins and blood glucose and to verify whether different nutrient composition of the meal elicits different response in patients with (MetS+) and without (MetS−) metabolic syndrome. Research Design and Methods. 50 MetS+ patients and 50 age- and sex-matched MetS− consumed a regular lunch chosen among those more similar to their usual diet. Blood was drawn in the morning after 12-hour fasting and 2 and 4:30 hours after the meal. Results. Serum triglycerides increased more in MetS+ (35%, 4:30 hours after the meal) than in MetS− (29%), HDL-cholesterol decreased 2 hours after the meal in both groups (−4% and −5%, resp.). Blood sugar similarly increased in both groups (19%, 2 hours after the meal in MetS+ and 17% in MetS−) and plasma insulin increased more and remained high longer in MetS+ (73.5 and 52.3 μU/mL, 2 and 4:30 hours after the meal) than in MetS− (46.7 and 21.6 μU/mL). Difference in nutrient composition of the meal (carbohydrate 57%, fat 28% versus carbohydrate 45%, fat 35%) was not associated with differences in postprandial levels of triglycerides, HDL-cholesterol, glucose, and insulin within each group. Conclusions. As compared with MetS−, MetS+ patients show a greater hypertriglyceridemic and hyperinsulinemic response to a regular lunch whatever the carbohydrate or fat content of the meal

Diagnostic Yield of Electroanatomic Voltage Mapping in Guiding Endomyocardial Biopsies

Background: Electroanatomic voltage mapping (EVM) is a promising modality for guiding endomyocardial biopsies (EMB). However, few data support its feasibility and safety. We now report the largest cohort of patients undergoing EVM-guided EMB in order to show its diagnostic yield and to compare it with a cardiac magnetic resonance (CMR) guided approach. Methods: One-hundred and sixty-two consecutive patients undergoing EMB at our Institution from 2010 to 2019 were included. EMB was performed in pathological areas identified at EVM and CMR. According to EMB results, CMR and EVM sensitivity and specificity regarding the identification of pathological substrates of myocardium were evaluated. Results: Pre-operative CMR showed late gadolinium enhancement (LGE) in 70% of the patients, while EVM identified areas of low voltages in 61%. Right (73%), left (19%) or both ventricles (8%) underwent sampling. EVM proved to have similar sensitivity to CMR (74% vs. 77%), with specificity being respectively 70% and 47%. In 12 patients with EMB-proven cardiomyopathy, EVM identified pathological areas, which had been undetected at CMR evaluation. Sensitivity of pooled EVM and CMR was as high as 95%. EMB analysis allowed to reach a new diagnosis, different from the suspected clinical diagnosis, in 39% of patients. Complications rate was low, mostly vascular access related, with no patients requiring urgent management. Conclusions: EVM proved to be a promising tool for targeted-EMB due to its sensitivity and specificity for identification of myocardial pathological substrates. EVM demonstrated to have an accuracy similar to CMR. EVM and CMR together conferred EMB a positive predictive value of 89%

J-Wave syndromes expert consensus conference report: Emerging concepts and gaps in knowledge

Buchang Pharmaceuticals; NHLBI [HL47678]; Wistar and Martha Morris; Sharpe-Strumia Research Foundation; National Natural Science Foundation of China [NSFC-81370289]; Mayo Clinic Windland Smith Rice Comprehensive Sudden Cardiac Death Program; Ministry of Health, Labor and Welfare of Japan for Clinical Research on Intractable Diseases [H24-033, H26-040, H27-032]; Finnish Academy of Science and Sigrid Juselius Foundation, Helsinki, Finland; SPS KAKENHI [24591051, 15K09082]; Ministry of Science and Technology of China [2013BAI09B02, 2013DFB30310]; University of Padua, Italy; Netherlands Cardio-Vascular Research Initiative; Dutch Heart Foundation; Dutch Federation of University Medical Centres; Netherlands Organization for Health Research and Development; Royal Netherlands Academy of Sciences; Agence National de la Recherche, French Government [ANR-10-IAHU-04,]; Gilead Sciences; Gilead Sciences and Buchang Pharma; GlaxoSmithKline; Johnson Johnson; Novartis; Astellas; Pfizer; Medtronic Bakken Research CenterSCI(E)[email protected]