Retinal microvascular abnormalities predict clinical outcomes in patients with heart failure

Background: Narrower retinal arterioles and wider retinal venules have been associated with the incidence of heart failure (HF). However, whether they are predictive of the prognosis of heart failure (HF) is unclear. We aimed to explore the role of retinal vessel calibers in predicting long-term clinical outcomes of HF. Methods: This is a prospective, single-center, observational study that surveyed patients in a tertiary referral hospital for the treatment of HF. Retinal vessel caliber was graded using retinal photography. The primary endpoint was the composite endpoint of HF rehospitalization and mortality at 12 months. Results: There were 55 patients with chronic HF included in the final analysis. At 12 months, the cumulative incidence of the primary endpoint, HF rehospitalization, and mortality tended to be higher with the widening of the central retinal venular equivalent (CRVE) (p for non-linearity = 0.059) and was significantly increased when CRVE reached a cut-off value (283 μm) (p = 0.011) following adjustment for age, sex, etiology of HF, and diabetes. No association between the central retinal arteriolar equivalent (CRAE) and arteriolar-to-venular caliber ratio (AVR) was found with the clinical outcome in both univariable and multivariable Cox regression. CRAE, CRVE, and AVR had no relationship with the concentration of the N-terminal pro-B-type natriuretic peptide. In addition, CRVE was not associated with cardiac diastolic and systolic function. Conclusions: When the retinal venular caliber widens to a certain point, the composite incidence of HF rehospitalization and mortality significantly increase, suggesting retinal vessel caliber imaging may provide insight into the development of HF

Serum autoantibodies against human oxidized low-density lipoproteins are inversely associated with severity of coronary stenotic lesions calculated by Gensini score

Background: The relationship between autoantibodies against human oxidized low-density lipoprotein (anti-oxLDL) and the progression of atherosclerotic diseases is unclear. This study aimed to investigate the association between serum anti-oxLDL titers and the severity and extent of coronary stenotic lesions. Methods: We measured the titers of IgG anti-oxLDL by enzyme-linked immunosorbent assay (ELISA) in 154 consecutive patients undergoing coronary angiography for suspected coronary heart disease (CHD). The severity and extent of coronary stenotic lesions were evaluated on coronary angiography findings by Gensini score. Results: The anti-oxLDL titers were significantly lower in 117 patients with CHD than those in 37 controls (p < 0.01). The serum anti-oxLDL titers were significantly correlated to serum levels of globulin (r = 0.405), conjugated bilirubin (r = 0.280), high-density lipoprotein (HDL) cholesterol (r = 0.238), homeostatic model assessment for insulin resistance (HOMA-IR) (r = &#8211;0.267), high sensitivity C-reactive protein (hs-CRP) (r = &#8211;0.230), triglyceride (r = &#8211;0.207), advanced glycation end products (AGEs) (r = &#8211;0.200), and malondialdehyde (r = &#8211;0.165). However, only HDL cholesterol and AGEs remained independent predictors of the anti-oxLDL titers after adjusting for confounders. Multivariate regression analysis showed that the anti-oxLDL titers, as well as serum levels of hs-CRP, fasting glucose, and albumin, were significantly associated with Gensini scores. Conclusions: Titers of anti-oxLDL are inversely associated with complicated proatherogenic metabolic risk factors, and the severity of coronary stenotic lesions calculated by Gensini scores, supporting a protective role for anti-oxLDL against the progression of atherosclerosis. (Cardiol J 2011; 18, 4: 364&#8211;370

Expert Consensus on ECG Identification Applied in the Insurance Industry

Electrocardiograms (ECGs) have the potential to be used as a reliable source of information for human identity recognition due to their universality, portability, and unique and stable biological identification features. This method enriches and refines existing biometric identification techniques, and is suitable for customer identity identification in the insurance industry. This article has the following objectives: 1) to introduce biometric identification techniques commonly used in the insurance industry, including ECG biometric identification techniques, and their advantages; 2) to discuss major aspects of ECG biometric identification techniques; 3) to systematically review the most recent advances in ECG identification and extraction characteristics from research in China and other countries; 4) to outline the technical aspects of using ECGs for recognizing client identity in the insurance industry; and 5) to discuss the future of ECGs in identity recognition. This article is aimed at further promoting the application of living personal ECG identification techniques in the insurance industry, and extending it to areas including medical insurance, banking, justice, public security, military, government, enterprises, and other departments and areas in which identification is needed to promote social stability and national security

Biomarkers for Predicting Left Atrial or Left Atrial Appendage Thrombus in Anticoagulated Patients with Nonvalvular Atrial Fibrillation

Purpose. Although atrial fibrillation (AF) is often associated with thromboembolic complications, there is no definite biomarker for detecting the presence of thrombi in the left atrial (LA) or left atrial appendage (LAA) in patients with nonvalvular atrial fibrillation (NVAF). Methods. NVAF patients who underwent transesophageal echocardiography (TEE) to evaluate LA/LAA thrombus and spontaneous echo contrast (SEC) before AF ablation were included. Multivariate logistic regression and receiver operating characteristic curve (ROC) analyses were performed to explore the independent risk factors of LA/LAA thrombus and indicate the best cutoff point. Results. Of the 260 consecutive subjects (mean age: 63.67 ± 9.39 years; 42% women), 45 (17.3%) patients were with LA/LAA thrombus, 131 (50.4%) were with SEC, and 84 (32.3%) were with neither thrombus nor SEC. The results of multivariate logistic regression analysis showed that N-terminal pro-B-type natriuretic peptide (NT-proBNP) (OR, 2.179; 95% CI: 1.191–3.987; p=0.012) and red cell distribution width (RDW) (OR, 2.398; 95% CI: 1.075–5.349; p=0.033) were independently correlated with the presence of LA/LAA thrombus but not D-dimer (OR, 0.999; 95% CI: 0.998–1.000; p=0.210). When all patients were divided into four groups based on the combination between RDW (cutoff value: 12.95%) and NT-proBNP levels (cutoff value: 368.9 ng/L), the rate of LA/LAA thrombus was the highest in the high RDW and NT-proBNP group. Conclusion. In anticoagulation patients with NVAF, elevated NT-proBNP and RDW are related to LA/LAA thrombus. Therefore, these might be considered as useful prognostic markers in the management and treatment of NVAF patients

Retinal Microvascular Abnormalities Predict Clinical Outcomes in Patients with Heart Failure

Background: Narrower retinal arterioles and wider retinal venules have been associated with the incidence of heart failure (HF). However, whether they are predictive of the prognosis of heart failure (HF) is unclear. We aimed to explore the role of retinal vessel calibers in predicting long-term clinical outcomes of HF. Methods: This is a prospective, single-center, observational study that surveyed patients in a tertiary referral hospital for the treatment of HF. Retinal vessel caliber was graded using retinal photography. The primary endpoint was the composite endpoint of HF rehospitalization and mortality at 12 months. Results: There were 55 patients with chronic HF included in the final analysis. At 12 months, the cumulative incidence of the primary endpoint, HF rehospitalization, and mortality tended to be higher with the widening of the central retinal venular equivalent (CRVE) (p for non-linearity = 0.059) and was significantly increased when CRVE reached a cut-off value (283 &mu;m) (p = 0.011) following adjustment for age, sex, etiology of HF, and diabetes. No association between the central retinal arteriolar equivalent (CRAE) and arteriolar-to-venular caliber ratio (AVR) was found with the clinical outcome in both univariable and multivariable Cox regression. CRAE, CRVE, and AVR had no relationship with the concentration of the N-terminal pro-B-type natriuretic peptide. In addition, CRVE was not associated with cardiac diastolic and systolic function. Conclusions: When the retinal venular caliber widens to a certain point, the composite incidence of HF rehospitalization and mortality significantly increase, suggesting retinal vessel caliber imaging may provide insight into the development of HF

Temporal lung changes on thin-section CT in patients with COVID-19 pneumonia

We examined characteristics of chest CT across different time periods for patients with COVID-19 pneumonia in Huizhou, China. This study included 56 COVID-19 patients with abnormal CT acquired between January 22 and March 3, 2020. The 141 scans of 56 patients were classified into four groups (Groups 1–4) based on dates on which scans were obtained at the 1st, 2nd, 3rd week or longer than three weeks after illness onset. Forty-five patients with follow-up scans were categorized into four groups (Groups A–D) according to extent that lesions reduced (≥ 75%, 50–75%, 25–50% and &lt; 25%). Ground-glass opacities (GGO) was prevalent in Groups 1–4 (58.1–82.6%), while percentages of consolidation ranged between 9.7% in Group 4 and 26.2% in Group 2. The highest frequency of fibrous stripes occurred in Group 3 (46.7%). Total CT scores were on average higher in Groups 2–3. Among 45 follow-up patients, 11 (24.4%) of them recovered with lesions reducing ≥ 75%, with the lowest median age and total CT scores on admission. There are temporal patterns of lung abnormalities in COVID-19 patients, with higher extent of lesion involvement occurring in the 2nd and 3rd week. Persisting lung changes indicate some patients may need isolation after discharge from hospital