African American Race and Prevalence of Atrial Fibrillation:A Meta-Analysis

Background. It has been observed that African American race is associated with a lower prevalence of atrial fibrillation (AF) compared to Caucasian race. To better quantify the association between African American race and AF, we performed a meta-analysis of published studies among different patient populations which reported the presence of AF by race. Methods. A literature search was conducted using electronic databases between January 1999 and January 2011. The search was limited to published studies in English conducted in the United States, which clearly defined the presence of AF in African American and Caucasian subjects. A meta-analysis was performed with prevalence of AF as the primary endpoint. Results. In total, 10 studies involving 1,031,351 subjects were included. According to a random effects analysis, African American race was associated with a protective effect with regard to AF as compared to Caucasian race (odds ratio 0.51, 95% CI 0.44 to 0.59, P < 0.001). In subgroup analyses, African American race was significantly associated with a lower prevalence of AF in the general population, those hospitalized or greater than 60 years old, postcoronary artery bypass surgery patients, and subjects with heart failure. Conclusions. In a broad sweep of subjects in the general population and hospitalized patients, the prevalence of AF in African Americans is consistently lower than in Caucasians

Utility of 18-Fluorodeoxyglucose positron emission tomography in the prediction of ventricular tachycardia and advanced conduction disease in patients with cardiac sarcoidosis

BackgroundThe diagnosis and management of cardiac sarcoidosis (CS) along with the recognition of high risk features remains a significant challenge. Failing to identify reliable disease prognosticators often results in fatal ventricular arrhythmia or heart failure.AimsThis study sought to determine the association of regional fluorodeoxyglucose positron emission tomography (18FDG PET) patterns and the presence of ventricular tachycardia (VT) storm and conduction disease in patients with CS.Methods In an observational cohort analysis, patients with a working diagnosis of CS who underwent 18FDG PET imaging were included. Baseline clinical data and 18FDG PET data were collected and analysed.Results A total of 57 patients with CS were studied. All had abnormal 18FDG PET imaging consisting of inflammation, scar or combination of both. VT storm was present in 33 per cent of the cohort, while 63 per cent had high grade conduction disease. Mean inflammatory burden noted on 18FDG PET in those with VT storm was 12 per cent. Inflammation involving ≥2 basal septal or mid septal segments (> 15 per cent myocardium) was an independent predictor of VT storm (OR: 9.62, 95 per cent CI 1.97–46.9, p=0.005). The degree of inflammatory burden and regional inflammation pattern on 18FDG PET demonstrated significant concordance with the presentation of VT storm. Inflammation in the anteroseptal segment was associated with high grade conduction disease (OR: 8.00, 95 per cent CI 0.94–68, p=0.029).ConclusionThe presence of > 15 per cent myocardial inflammation on 18FDG PET imaging and regional inflammation ≥2 basal or mid septal segment significantly correlated with risk of ventricular arrhythmia specifically VT storm regardless of scar burden

Is there a role of statins in the prevention of aortic biological prostheses degeneration

It has been recently observed that statins might slow the progression of aortic stenosis or sclerosis. Preliminary reports suggested a similar positive effect in reducing the degeneration of aortic valve bioprostheses even though this hypothesis should be further proven and supported by new data. In this review the present evidences of the possible effects of statins in this field are discussed

Identificación de riesgos en organizaciones de aviación a través de modelos analíticos: análisis y propuesta de mitigación de riesgos mediante técnicas de mejora continua

70 páginasCuando una organización se enfrenta al desarrollo de identificación de riesgos, usualmente emplea métodos tradicionales como lo es el DOFA y el sector aeronáutico no es la excepción. Para esto, normalmente se escuchan las apreciaciones de expertos de diferentes áreas o consultores, pero estos pueden llegar a tener limitaciones. En el presente documento se plantea una aproximación a la identificación de los riesgos operacionales en la industria de la aviación latinoamericana, empleando algoritmos de aprendizaje automático. Adicionalmente , se presenta un análisis y propuesta de mitigación de riesgos mediante técnicas de mejora continua, para la identificación de consecuencias potenciales que puedan materializar el riesgo en las operaciones de atención de aeronaves en tierra, más específicamente en los procesos de cargue y descargue.Maestría en Analítica AplicadaMagíster en Analítica Aplicad

Repeat recurrence of takotsubo cardiomyopathy related to inhaled beta-2-adrenoceptor agonists

Takotsubo cardiomyopathy (also referred to as transient apical ballooning syndrome, broken heart syndrome or stress cardiomyopathy) is an increasingly recognized entity in the western world typically characterized by reversible left ventricular dysfunction that develops in the setting of acute severe emotional or physical stress. Increased catecholamine levels have been proposed to play a central role in the pathogenesis of the disease, although the specific pathophysiology of this condition remains elusive at the present moment. In recent times, there have been reports of takotsubo cardiomyopathy (TC) following medical interventions such as invasive or surgical procedures or specific medical regimens. In the current report, we present a patient with multiple recurrences of TC triggered by the same medical therapeutic intervention; in our particular case, repetitive exposure to inhaled beta-2-adrenoceptor agonist