Galectin-3 as a Predictor of Post Cardiac Surgery Atrial Fibrillation: A Scoping Review

Galectin-3 is associated with myocardial fibrosis, a known risk factor for developing re-entrant circuits associated with atrial fibrillation (AF). Previous studies have demonstrated increased galectin levels in AF patients. Whether preoperative galectin-3 levels can predict the incidence of postoperative atrial fibrillation (POAF) remains unknown.This scoping review was conducted in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Electronic searches were conducted in Medline, EMBASE, Cochrane, and Google Scholar databases using a predetermined strategy. Methodological variables, demographics and operative data were extracted. Data extraction was performed manually by 3 reviewers.The search yielded 620 citations, of which 74 underwent full text review, and 3 citations with 3 independent samples (n=1812) met full inclusion/exclusion criteria and were included. Of the 3 studies that reported on the association between preoperative galectin-3 levels and POAF, 2 studies compared median galectin levels in patients who developed POAF and those who did not. While Alexandre et al. reported a significant difference (P=0.002), Bening et al did not find a significant difference between POAF and non-POAF groups (P=0.3). A third study reporting on the association between galectin-3 and atrial fibrillation comparing third and first tercile galectin-3 levels found a significant association between preoperative galectin levels and POAF on univariate analysis (OR 1.54; 95% CI 1.14-2.09).Galectin-3 is an emerging biomarker that has been associated with the development of AF. However, there is currently not enough evidence to establish its prognostic role in postcardiac surgery atrial fibrillation.Fil: King, Morgan. Queens University; CanadáFil: Stambulic, Thomas. Queens University; CanadáFil: Kirupaharan, Sawmmiya. Queens University; CanadáFil: Baranchuk, Adrian. Queens University; CanadáFil: Rabinovich, Gabriel Adrián. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; ArgentinaFil: Payne, Darrin. Queens University; CanadáFil: El Diasty, Mohammad. Queens University; Canad

Changes in pain following bilateral intermittent theta-burst, transcranial magnetic stimulation for depression: A retrospective chart review

ABSTRACTIntroduction Pain management in patients with chronic pain and comorbid depression is challenging and understudied. There is interest in intermittent theta-burst stimulation (iTBS), a new modality of repetitive transcranial magnetic stimulation (rTMS). This retrospective review describes changes in pain, anxiety and depression throughout iTBS treatment at the dorsolateral prefrontal cortex (DLPFC).Methods A retrospective chart review was conducted of patients who underwent their first acute series of iTBS treatments at the DLPFC for depression at a single institution between 2020 and 2023. Data on depression, anxiety, and pain were collected throughout iTBS treatment using the Beck Depression Inventory–II (BDI-II; higher scores indicate worse depression) and visual analogue scale (VAS; 0–100, higher scores indicate worse pain, anxiety, and depression). Nonparametric tests were used for all analyses.Results Of 104 patients, 52 reported moderate pain at baseline (50.0%). Median BDI-II scores decreased from 38.0 (interquartile range [IQR] = 29.0–44.0) to 24.0 (IQR = 9.0–36.0) from pre- to posttreatment (P < 0.001). Of the 32 patients with both pre- and posttreatment pain scores, there was a significant decrease from 40.0 (IQR = 5.5–71.8) to 15.0 (IQR = 3.5–53.8; P = 0.037). In patients with at least moderate pain at baseline, pain scores decreased from 71.0 (IQR = 55.0–80.0) to 20.0 (IQR = 11.0–71.0; P = 0.004). Ten of 32 patients with available pre- and posttreatment scores reported ≥30% reduction in pain scores (31.2%).Conclusion These preliminary results, suggesting decreases in pain following iTBS treatment, provide a rationale for future rigorous investigations to evaluate this intervention for depression and comorbid chronic pain