Dofetilide use is not associated with increased mortality in patients with left ventricular hypertrophy and atrial fibrillation.

BACKGROUND: Left ventricular hypertrophy (LVH) is common in patients with atrial fibrillation (AF), however, many antiarrhythmic drugs (AADs) are contraindicated. US guidelines recommend avoiding pure class III antiarrhythmics such as dofetilide in patients with significant LVH due to concern for an increased risk of death, however, clinical data is lacking. We sought to determine if dofetilide use was associated with increased mortality in patients with LVH. METHODS: Patients ≥18 years of age with AF and LVH ≥ 1.4 cm were included. A group of patients treated with dofetilide and a control group of patients without a history of AAD use were propensity matched. The primary outcome was all-cause mortality at 3 years and secondary outcomes were total number of all-cause hospitalizations and hospitalizations related to AF. RESULTS: There were 359 patients in each of the groups. Baseline variables were well-matched. The primary outcome of all-cause mortality occurred in 7% of patients in the dofetilide group and 12% of patients in the control group (hazard ratio: 0.90, 95% confidence interval: 0.53-1.53). Total all-cause hospitalizations were higher in the control group but hospitalizations for AF were no different. CONCLUSIONS: In a propensity-matched cohort of 718 patients with AF and LVH, dofetilide was not associated with increased mortality at 3 years. Our study adds to prior data demonstrating the safety of dofetilide in this population despite guideline recommendations against its use. Given the limited options for AF management in LVH patients, dofetilide may be reasonable for symptomatic AF management.

γ-Tocotrienol induces apoptosis in pancreatic cancer cells by upregulation of ceramide synthesis and modulation of sphingolipid transport.

BACKGROUND: Ceramide synthesis and metabolism is a promising target in cancer drug development. γ-tocotrienol (GT3), a member of the vitamin E family, orchestrates multiple effects that ensure the induction of apoptosis in both, wild-type and RAS-mutated pancreatic cancer cells. Here, we investigated whether these effects involve changes in ceramide synthesis and transport. METHODS: The effects of GT3 on the synthesis of ceramide via the de novo pathway, and the hydrolysis of sphingomyelin were analyzed by the expression levels of the enzymes serine palmitoyl transferase, ceramide synthase-6, and dihydroceramide desaturase, and acid sphingomyelinase in wild-type RAS BxPC3, and RAS-mutated MIA PaCa-2 and Panc 1 pancreatic cancer cells. Quantitative changes in ceramides, dihydroceramides, and sphingomyelin at the cell membrane were detected by LCMS. Modulation of ceramide transport by GT3 was studied by immunochemistry of CERT and ARV-1, and the subsequent effects at the cell membrane was analyzed via immunofluorescence of ceramide, caveolin, and DR5. RESULTS: GT3 favors the upregulation of ceramide by stimulating synthesis at the ER and the plasma membrane. Additionally, the conversion of newly synthesized ceramide to sphingomyelin and glucosylceramide at the Golgi is prevented by the inhibition of CERT. Modulation ARV1 and previously observed inhibition of the HMG-CoA pathway, contribute to changes in membrane structure and signaling functions, allows the clustering of DR5, effectively initiating apoptosis. CONCLUSIONS: Our results suggest that GT3 targets ceramide synthesis and transport, and that the upregulation of ceramide and modulation of transporters CERT and ARV1 are important contributors to the apoptotic properties demonstrated by GT3 in pancreatic cancer cells.

Clinical and regulatory considerations for novel electrophysiology mapping systems: Lessons from FIRM.

Atrial fibrillation (AF) presents a growing clinical and public health burden for which better rhythm control therapies are needed. Focal impulse and rotor mapping (FIRM), currently marketed as a part of the Topera Rotor Mapping system (Abbott Laboratories, Austin, TX, USA), represents a potentially transformational approach to guide the invasive treatment of AF. However, many years after its initial marketing clearance, the clinical utility of this technology remains uncertain. In this article, we review the scientific rationale for this novel approach to AF ablation, evaluate the current clinical evidence for FIRM-guided ablation, and characterize its premarket regulatory assessment. Lessons for clinicians considering adoption of newly marketed mapping systems are presented.

Association of pre-left ventricular assist device defibrillator shocks for ventricular arrhythmia with clinical outcomes after left ventricular assist device implantation.

Background: Implantable cardioverter-defibrillation (ICD) shocks after left ventricular assist device therapy (LVAD) are associated with adverse clinical outcomes. Little is known about the association of pre-LVAD ICD shocks on post-LVAD clinical outcomes and whether LVAD therapy affects the prevalence of ICD shocks. Objectives: The purpose of this study was to determine whether pre-LVAD ICD shocks are associated with adverse clinical outcomes post-LVAD and to compare the prevalence of ICD shocks before and after LVAD therapy. Methods: Patients 18 years or older with continuous-flow LVADs and ICDs were retrospectively identified within the University of Pittsburgh Medical Center system from 2006-2020. We analyzed the association between appropriate ICD shocks within 1 year pre-LVAD with a primary composite outcome of death, stroke, and pump thrombosis and secondary outcomes of post-LVAD ICD shocks and ICD shock hospitalizations. Results: Among 309 individuals, average age was 57 ± 12 years, 87% were male, 80% had ischemic cardiomyopathy, and 42% were bridge to transplantation. Seventy-one patients (23%) experienced pre-LVAD shocks, and 69 (22%) experienced post-LVAD shocks. The overall prevalence of shocks pre-LVAD and post-LVAD were not different. Pre-LVAD ICD shocks were not associated with the composite outcome. Pre-LVAD ICD shocks were found to predict post-LVAD shocks (hazard ratio [HR] 5.7; 95% confidence interval [CI] 3.42-9.48; P <.0001) and hospitalizations related to ICD shocks from ventricular arrhythmia (HR 10.34; 95% CI 4.1-25.7; P <.0001). Conclusion: Pre-LVAD ICD shocks predicted post-LVAD ICD shocks and hospitalizations but were not associated with the composite outcome of death, pump thrombosis, or stroke at 1 year. The prevalence of appropriate ICD shocks was similar before and after LVAD implantation in the entire cohort.

Effects of Game Outcomes and Status Instability on Spectators' Status Consumption: The Moderating Role of Implicit Team Identification.

This study explores the interaction effects of game outcomes and status instability and the moderating role of implicit team identification on spectators' status-seeking behavior (the pursuit and preservation of social status). The current study seeks to contribute to the existing consumer behavior and spectatorship literature by examining the counterintuitive outcomes of winner-loser effects through the application of the biosocial theory of status. In an online experiment, NFL fans' retrospective spectating experiences were captured and manipulated. This experiment used a 2 (game outcome: victory vs. loss) × 2 (status instability: decisive vs. close) × 2 (iTeam ID: high vs. low) between-subjects design. The findings indicated that decisive victories and close losses positively influenced spectators' future attendance as well as their intention to purchase luxury suites and merchandise featuring images of the team mascot. Conversely, decisive losses and close victories had a negative influence. Additionally, the more spectators implicitly identified with a particular team, the more they exhibited status-seeking behavior; even close victories positively influenced the outcomes. By applying a nascent theoretical approach in the field of consumer behavior (the hormonal account), our results provide fresh insight into explaining spectators' status-seeking behavior. Also, the findings identify specific conditions in which spectators' status-seeking behavior is enhanced, thus suggesting ways for managers to strategically allocate their resources.

Sport team identification and social fear.

Previous research has explored the relationship between identifying with a sport team and psychological health. The current study focused on team identification and social fear. For 75 college undergraduates, these two variables were not significantly correlated.

Examining relations of entertainment with social interaction motives and team identification.

The goal was to investigate a potential causal pattern between the motives of sport spectators and team identification by using a cross-lagged panel design. Questionnaires were completed by 229 participants at the beginning and end of one NCAA (National Collegiate Athletic Association) college football season for 4 mo. in the USA. The questionnaire included three items for each motive (Social Interaction and Entertainment), three items measuring team identification, and demographic items. The relation of Entertainment at Time 1 to team identification at Time 2 was larger than the relation of team identification at Time 1 to Entertainment at Time 2. This suggests that the motivation of Entertainment may lead to the formation of team identification more than team identification leads to Entertainment. However, the motive of Social Interaction did not show the same pattern. As results of this study suggested some spectator sport motives might lead to identification with a team, the hypothesis that all motives would be the basis of team identification might not be correct.

Enhancing Older Adults' Sense of Belonging and Subjective Well-Being Through Sport Game Attendance, Team Identification, and Emotional Support.

Objective: We investigate how (a) attendance at sport games and (b) identification with a sport team as fans (i.e., team identification) influence older adults' perceptions of emotional support, belonging, and subjective well-being (SWB). Method: An experimental pilot study was conducted with 50 older adults, followed by a main survey study administered to 534 older adults from various communities across the United States. Results: Pilot study results indicated that game attendance and team identification had a positive and significant influence on older adults' perceptions of emotional support from fellow team fans. These results were replicated in the main study, which also showed that older adults' perceived emotional support from fellow fans was positively associated with their sense of belonging which predicted their SWB. Discussion: The findings provide insights into how older adults may be engaged in meaningful forms of social life to help them maintain and enhance mental health.

Does Time Heal all Wounds? A Case Study on Rival Perceptions Before and After Conference Realignment.

The current longitudinal case study investigated how conference realignment and beginning new annual competitions impacted fan rival perceptions for fans of the Texas A&M Aggies, Missouri Tigers, and Texas Christian University Horned Frogs. In particular, fan rival perceptions before and after conference realignment were compared to determine if significant differences were present. Findings indicate that history plays an important role in rivalry as fans of teams sharing longstanding rivalries with schools in their previous conference (i.e., Texas A&M/Texas and Missouri/Kansas) did not differ in their rival perceptions before or after conference realignment. On the other hand, rival perceptions of TCU fans significantly differed in their perceptions of Boise State (previous rival) and Baylor (current rival) before and after conference realignment. Implications for sport managers are discussed.

Relationship of dysfunctional sport fandom with dislike for rivals in a sample of college students.

The relationships among sport-fandom dysfunctionality (tendencies toward complaining and confrontation as assessed via the Dysfunctional Sport Fandom Scale) and items assessing team identification (assessed via the Sport Spectator Identification Scale) were examined with 87 college students (24 men, 63 women, M age=20.2 yr.). Although positive associations of dysfunction and identification were found, contrary to expectations, the relationship between dysfunction and dislike for rivals was not particularly strong.

Biased evaluations of in-group and out-group spectator behavior at sporting events: the importance of team identification and threats to social identity.

Previous researchers have demonstrated that sport fans often exhibit in-group bias by reporting more positive evaluations of fellow in-group fans than of rival out-group fans. The authors designed the present investigation to extend previous research by replicating past efforts in a field setting and to advance our understanding of the impact of social identity threat. The present authors hypothesized that, in addition to the base-level in-group bias effect, the bias effect would be most pronounced in situations involving a threat to one's social identity. The authors believed that fans of a losing team and fans of a home team would experience threats to their identity and, consequently, exhibit particularly high levels of in-group favoritism. Further, because past researchers had shown that one's level of group identification plays a vital role in social perception, the present authors predicted an interaction in which the greatest amount of bias would be exhibited by highly identified fans rooting for a home team that had lost. Data gathered from spectators (N = 148) at 2 North American college basketball games confirmed the authors' expectations, with the exception that the supporters of the winning team reported higher levels of bias. The authors discussed the factors underlying the unexpected game outcome effect and the use of in-group bias as a coping strategy.

Relationship between team identification and trait aggression: a replication.

Research yielded no significant relationship between sport fandom and trait aggression. The current study replicated previous efforts using the Buss-Perry Aggression Questionnaire, an updated version of the Buss-Durkee Hostility Inventory. In contrast to past work, the current study did yield a significant relationship between fandom and aggression for men.

Relations between sport team identification and optimism.

Previous research indicated a positive relation between identification with a local sport team and psychological well-being. The current study was done to extend this line of research by examining the relation between identification and optimism. However, contrary to the hypothesis, the two variables were not significantly correlated for these 137 undergraduates.

The Norelco Sport Fanatics Survey: examining behaviors of sport fans.

The Norelco Sport Fanatics Survey administered by Impulse Research to over 1,400 avid sport fans online assessed their support of and involvement with their teams, emotional responses prior to and subsequent to team performance, and the effect of their fandom on their family and social relations. Analysis yielded results which replicated past research and indicated that sport fandom was extremely important to the respondents, intensified affective reactions, and was perceived as a highly social activity with very few negative consequences for interpersonal relations.

Applying the Team Identification-Social Psychological Health Model to older sport fans.

According to the Team Identification-Social Psychological Health Model (Wann, 2006b), team identification and social psychological health should be positively correlated because identification leads to important social connections which, in turn, facilitate well-being. Although past research substantiates the hypothesized positive relationship between team identification and well-being, earlier studies focused solely on college student populations. The current study extended past work in this area by investigating the team identification/well-being relationship among older sport fans. A sample of older adults (N = 96; M age = 70.82) completed scales assessing demographics, identification with a local college basketball team, and measures of social psychological well-being. As hypothesized, team identification accounted for a significant proportion of unique variance in two measures of social psychological health (collective self-esteem and loneliness).