Fan Bai

Succinylation as a novel mode of energy metabolism regulation during atrial fibrillation

Atrial fibrillation (AF) is the most common arrhythmia, resulting in significant morbidity and mortality. AF is associated with a higher demand of energy and impaired energy synthesis in cardiomyocytes. The succinate group is far bulkier cause it to have a larger impact on the structure and function of the proteins. So far, the study of the maximum fluence of the healthy heart sample proteome has mapped the cardiac proteomics map and builded a model of the heart proteome at the subcellular level. Compared with the normal sample, the most significantly downregulated proteins in the AF group were enriched for mitochondrion. Succinylation of proteins appears to be prevalent in mechanisms involving cellular metabolism within the mitochondria. Experiment has show that heart has a much higher concentration of succinyl-CoA than any other organ. This supports the knowledge that the heart would need to prioritize energy production through the tricarboxylic acid cycle. So, we put forward this hypothesis: Succinylation is a new potential regulation model of cardiac energy metabolism during atrial fibrillation.

Percutaneous coronary intervention versus optimal medical therapy for patients with chronic total occlusion: a meta-analysis and systematic review

BackgroundnIt was under debate whether chronic total occlusion (CTO) patients could benefit from percutaneous coronary intervention (PCI). We sought to compare clinical outcomes of PCI and optimal medical therapy (OMT) in these patients.nnnMethodsnPubMed, Embase and Cochrane Library were searched for studies enrolling patients with CTO who accepted PCI or OMT. The meta-analysis was performed by using a random-effect model. In addition, subgroup analyses were performed, including patients after propensity-matching and patients with CTO in infarct-related artery (IRA), respectively.nnnResultsnWe identified 5 studies enrolling 4,761 participants in this meta-analysis. In the main analysis, when compared with OMT, PCI was associated with significant improvement in all-cause death [risk ratio (RR) 0.41, 95% CI: 0.35-0.48], cardiac death (RR 0.44, 95% CI: 0.35-0.55) and major adverse cardiac events (MACE) (RR 0.64, 95% CI: 0.43-0.97). But there were no differences in myocardial infarction (MI) and stroke. The results of the propensity-matched subgroup were somewhat consistent with those of the main analysis (all-cause death: RR 0.57, 95% CI: 0.26-0.89; MI: RR 0.54, 95% CI: 0.32-0.77; and MACE: RR 0.76, 95% CI: 0.33-1.18). In IRA subgroup, PCI reduced risks of mortality (all-cause death: RR 0.41, 95% CI: 0.34-0.49; cardiac death: RR 0.44, 95% CI: 0.35-0.56) and MACE (RR 0.71, 95% CI: 0.46-1.10). But no difference was observed in MI.nnnConclusionsnPCI was associated with improved survival and reduced MACE relative to OMT.

Coupling interval variability: A new diagnostic method for distinguishing left from right ventricular outflow tract origin in idiopathic outflow tract premature ventricular contractions patients with precordial R/S transition at lead V3

BACKGROUNDnTo distinguish left ventricular outflow tract (LVOT) from right ventricular outflow tract (RVOT) origin in idiopathic outflow tract premature ventricular contractions (IOT-PVCs) patients with precordial R/S transition at lead V3 is still a challenge. We sought to develop a new electrocardiography (ECG) method for distinguishing LVOT from RVOT origin in IOT-PVCs patients with precordial R/S transition at lead V3.nnnMETHODSnWe analyzed the surface 12-lead ECG characteristics and the difference of coupling interval variability (CIV) of PVCs between distinct origin sites in a retrospective cohort of IOT-PVCs patients with precordial R/S transition at lead V3 who underwent successful radiofrequency catheter ablation (RFCA) to develop a new diagnostic method, then validated it in a prospective cohort.nnnRESULTSnA total of 196 consecutive patients (41u202f±u202f15u202fyears, 36.7% male) underwent RFCA of IOT-PVCs between January 2014 and August 2016. Among them, 68 patients (34.7%, 23 male) with precordial R/S transition at lead V3 constituted the retrospective cohort. Based on the areas under the receiver operating characteristic curves (AUCs), a CIVu202f>u202f100u202fms with the largest value of AUC was selected to develop a new diagnostic method with a specificity of 93.9% and an accuracy of 92.6%. It correctly identified the origin site of 38 from 41 patients in the prospective cohort, demonstrating a 96.8% specificity and 92.7% accuracy.nnnCONCLUSIONSnWe presented a new simple method, a CIVu202f>u202f100u202fms which could reliably distinguish LVOT from RVOT origin in IOT-PVCs patients with precordial R/S transition at lead V3.

Catheter ablation for treatment of patients with atrial fibrillation and heart failure: a meta-analysis of randomized controlled trials

BackgroundThere is a little evidence for the effects of catheter ablation (CA) on hard endpoints in patients with atrial fibrillation (AF) and heart failure (HF).MethodsPubMed, Embase and Cochrane Library were searched for randomized controlled trials (RCTs) enrolling patients with AF and HF who were assigned to CA, rate control or medical rhythm control groups. This meta-analysis was performed by using random-effect models.ResultsSeven RCTs enrolling 856 participants were included in this meta-analysis. CA reduced the risks of all-cause mortality (risk ratio [RR] 0.52, 95% CI 0.35 to 0.76), HF readmission (RR 0.58, 95% CI 0.46 to 0.66) and the composite of all-cause mortality and HF readmission (RR 0.55, 95% CI 0.47 to 0.66) when compared with control. But there was no significant difference in cerebrovascular accident (RR 0.56, 95% CI 0.23 to 1.36) between two groups. Compared with control, CA was associated with improvement in left ventricular ejection fraction (mean difference [MD] 7.57, 95% CI 3.72 to 11.41), left ventricular end systolic volume (MD -14.51, 95% CI -26.84 to −u20092.07), and left ventricular end diastolic volume (MD -3.78, 95% CI -18.51 to 10.96). Patients undergoing CA exhibited increased peak oxygen consumption (MD 3.16, 95% CI 1.09 to 5.23), longer 6-min walk test distance (MD 26.67, 95% CI 12.07 to 41.27), and reduced Minnesota Living with Heart Failure Questionnaire scores (MD -9.49, 95% CI -14.64 to −u20094.34) than those in control group. Compared with control, CA was associated with improved New York Heart Association class (MD -0.74, 95% CI -0.83 to −u20090.64) and lower B-type natriuretic peptide levels (MD -105.96, 95% CI -230.56 to 19.64).ConclusionsCA was associated with improved survival, morphologic changes, functional capacity and quality of life relative to control. CA should be considered in patients with AF and HF.