Preoperative QRS Duration Predicts the Responsiveness of Chronic Heart Failure Patients with Pacemaker Indications to Left Bundle Branch Area Pacing Treatment.

BACKGROUND: This study investigated the predictive value of preoperative QRS duration (QRSd) in responsiveness of chronic heart failure (CHF) patients with pacemaker indications to the left bundle branch area pacing (LBBAP). METHODS: Thirty-one CHF patients with cardiac function categorized as NYHA class II or above and indications for pacemaker therapy who successfully underwent LBBAP treatment were enrolled in this study. Based on the 12-month postoperative responsiveness to treatment, patients were divided into a responsiveness group (N = 16) and a no-responsiveness group (N = 15). Data from all patients were collected for analysis. Multivariate binary logistic regression analysis was used to determine the independent factors associated with the responsiveness to LBBAP treatment. RESULTS: Among the 31 patients with LBBAP, 16 patients (51.6%) responded to the treatment, and 15 patients (48.4%) had no response. There were significant differences between the two groups with regard to complete left bundle branch block (CLBBB), preoperative QRSd, and preoperative left ventricular peak time (LVAT). Univariate logistic regression analysis showed that CLBBB, preoperative QRSd, and preoperative LVAT all were significantly correlated with responsiveness to LBBAP. Multivariate binary logistic regression analysis showed that QRSd was an independent predictor of responsiveness to LBBAP. The maximum area under the ROC curve for QRSd was 0.827 (95%C.I.:0.663-0.991), the maximum Youden index was 0.679, with the optimal cutoff point of QRSd ≥ 153 ms, a sensitivity of 81.3%, and a specificity of 86.7%. CONCLUSION: Preoperative QRSd predicts the responsiveness of CHF patients with pacemaker indications to LBBAP.

Body Mass Index and Risk of Female Reproductive System Tumors Subtypes: A Meta-Analysis Using Mendelian Randomization.

Introduction: A strong association was previously established between body mass index (BMI) and female reproductive system tumors; however, the causal relationship is unclear. We conducted a Mendelian randomization (MR) study to further explore this association. Methods: Genetic information for BMI was retrieved from a published genome-wide association study involving 339,224 participants. Genetic associations with five common female reproductive system tumors were obtained from the FinnGen, UK Biobank studies, and other large consortia. Results: Genetic predisposition towards BMI exhibits a significant association with multiple tumors of the female reproductive system. Specifically, for every 1-unit increase in BMI log-transformed odds ratio (OR). The OR fluctuations overall for patients with breast cancer ranged from 0.661 to 0.996 (95% confidence interval [CI],0.544-1.000, P < 0.05). When stratified by estrogen receptor (ER) status, the OR for patients with ER (+) breast cancer ranged from 0.782 to 0.844 (95% CI, 0.616-0.994, P < 0.05) and that for those with ER (-) breast cancer ranged from 0.663 to 0.789 (95% CI, 0.498-0.991, P < 0.05). Additionally, ORs were as follows for cancer types: 1.577-1.908 (95% CI, 1.049-2.371, P < 0.05) for endometrial carcinoma; 1.216-1.303 (95% CI, 1.021-1.591, P < 0.05) for high-grade serous ovarian cancer; 1.217 (95% CI, 1.034-1.432, P < 0.05) for low-grade malignant serous ovarian cancer; and 1.502 (95% CI, 1.112-2.029, P < 0.05) for endometrioid ovarian carcinoma. Furthermore, our findings indicated that genetic predisposition towards BMI did not exhibit a causal association with uterine fibroids, cervical precancerous lesions, or cervical cancer itself. Conclusion: A genetic association was established between a high BMI and high risk of developing multiple tumors of the female reproductive system and their associated subtypes. This underscores the significance of taking measures to prevent reproductive system tumors in women who have a high BMI.