Heightened Risk of Intensive Rate Control in Patients With Atrial Fibrillation Who Are Obese or Have Type 2 Diabetes: A Critical Review and Re ‐Evaluation

AbstractAtrial fibrillation (AF) is common in patients with obesity and diabetes; the arrhythmia (if long ‐standing) is typically managed by rate‐control and anticoagulation. However, the coexistence of these two metabolic disorders complicates therapeutic options for rate‐control. The likely pathogenesis of AF in these patients is an expansion of epicardial adipose tissue, whose inflammation is t ransmitted to the left atrium causing electromechanical remodeling. However, this same process is also transmitted to the left ventricle, impairing its distensibility and its ability to tolerate volume, leading to heart failure with preserved ejection fraction. Unfortunately, the latter diagnosis (a lthough commonly present in patients with AF and a coexistent metabolic disorder) is often ignored. To achieve rate control, physicians prescribe intensive treatment with atrioventricular (AV)‐nodal blocking drugs, often at doses that are titrated to blunt exercise as well as resting heart rate re sponses. However, strict rate control (target rate
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: COMPREHENSIVE REVIEWS Source Type: research

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CONCLUSION: Thus, diabetes mellitus itself was not an independent factor associated with IAD. A larger IAD was preferentially associated with the presence of PAD, and this association was modified by age. PMID: 31813900 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Abstract The close connection and interaction between the cardiac and the liver functions are well-known, as cirrhotic cardiomyopathy is an important clinical entity which best describes the mutual pathogenical influence between these two organs. Due to the fact that cardiac dysfunction in patients with chronic hepatic disorders is oligosymptomatic or even asymptomatic, an early diagnosis represents a challenge for every physician. Syndecan-1-a transmembrane proteoglycan that exerts its functions mainly via its heparane sulfate chains-is a very promising biomarker, correlated not only with the degree of cardiac fi...
Source: Cardiology Research and Practice - Category: Cardiology Authors: Tags: Cardiol Res Pract Source Type: research
Publication date: Available online 10 December 2019Source: Canadian Journal of DiabetesAuthor(s): Antoine B.M. Clarke, Hanaa Ahsan, Jennifer Harrington, Farid H. MahmudAbstractBackgroundThe factors associated with allied healthcare professional (HCP) time spent face-to-face with patients in clinic have not been well described in type 1 diabetes (T1D) given the introduction of resource-intensive technologies and gaps in socioeconomic circumstances.ObjectiveTo evaluate clinical and social factors associated with non-physician HCP time in a pediatric T1D practice.MethodsNon-physician HCP workload data, including time spent in...
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research
Publication date: Available online 25 September 2019Source: Canadian Journal of DiabetesAuthor(s): Tyler B. Dubois, Scot H. Simpson, Dean T. EurichAbstractObjectivesOur aim in this study was to determine whether differences exist in time to treatment intensification in newly treated type 2 diabetes patients in Canada and the United States (US).MethodsTwo separate retrospective cohorts of diabetes patients were used from Canada and the US. Time to treatment intensification (i.e. addition of a second antihyperglycemic agent after initial metformin use) was determined using multivariate Cox proportional hazard models.ResultsA...
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research
DiabetesMine interviews David Walton, new CEO of the influential nonprofit diabetes research org T1D Exchange.
Source: Diabetes Mine - Category: Endocrinology Authors: Source Type: blogs
Authors: Suzuki S, Yokoyama A, Noro E, Aoki S, Shimizu K, Shimada H, Sugawara A Abstract Carbohydrate response element binding protein (ChREBP), a glucose responsive transcription factor, mainly regulates expression of genes involved in glucose metabolism and lipogenesis. Recently, ChREBP is speculated to be involved in the onset and progression of diabetic nephropathy (DN). However, there exists no report regarding the localization and function of ChREBP in the kidney. Therefore, we analyzed the localization of Chrebp mRNA expression in the wild type (WT) mice kidney using laser microdissection method, and observe...
Source: Endocrine Journal - Category: Endocrinology Tags: Endocr J Source Type: research
ConclusionsBy integrated serum metabolomic and network analysis, we found that LGZGD might retard the pathological process of HF by regulating the disturbed metabolic pathways and the relative enzymes, which may be potential mechanism for LGZGD in the treatment of HF.Graphical abstract
Source: Journal of Ethnopharmacology - Category: Drugs & Pharmacology Source Type: research
Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter, please visit: https://www.fightaging.org/newsletter/ Longevity Industry Consulting Services Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out m...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
In conclusion, T2D impairs vascular function by dysregulated autophagy. Therefore, autophagy could be a potential target for overcoming diabetic microvascular complications. To What Degree Does Loss of Skeletal Muscle with Age Contribute to Immunosenescence? https://www.fightaging.org/archives/2019/11/to-what-degree-does-loss-of-skeletal-muscle-with-age-contribute-to-immunosenescence/ Sarcopenia, the progressive loss of muscle mass and strength, is characteristic of aging. A perhaps surprisingly large fraction of the losses can be averted by strength training, but there are nonetheless inexorable process...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Conclusion: These findings limit the possible roles of gene transcriptional changes in previously reported age-dependent pro-arrhythmic electrophysiologial changes observed in Pgc-1β-/- atria to an altered Ca2+-ATPase (Atp2a2) expression. This directly parallels previously reported arrhythmic mechanism associated with p21-activated kinase type 1 deficiency. This could add to contributions from the direct physiological outcomes of mitochondrial dysfunction, whether through reactive oxygen species (ROS) production or altered Ca2+ homeostasis. Introduction Atrial arrhythmias constitute a major public health probl...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
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