The relationship between ambulatory arterial stiffness index and incident atrial fibrillation.

BACKGROUND: The ambulatory arterial stiffness index (AASI) is an indirect measure of blood pressure variability and arterial stiffness which are atrial fibrillation (AF) risk factors. The relationship between AASI and AF development has not been previously investigated and was the primary aim of this study. METHODS: This was an observational cohort study of adults (aged 18-85 years) in sinus rhythm, who underwent 24-h ambulatory blood pressure monitoring (ABPM) for the diagnosis of hypertension or its control. RESULTS: Eight hundred and twenty-one patients (49% men) aged 58.7 ± 15.3 years were followed up for a median of 4.0 years (3317 patient-years). In total, 75 patients (9.1%) developed ≥1 AF episode during follow-up. The mean AASI was 0.46 ± 0.17 (median 0.46). AASI values (0.52 ± 0.16 vs. 0.45 ± 0.17; p < .001) and the proportion of AASI values above the median (65.3% vs. 48.4%; p = .005) were greater among the patients who developed AF versus those that did not respectively. AASI significantly correlated with age (r = .49; 95% confidence interval: 0.44-0.54: p < .001). On Kaplan-Meier analysis, higher baseline AASI by median, tertiles, and quartiles were all significantly associated with AF development (X2: 10.13; p < .001). On Cox regression analyses, both a 1-standard deviation increase and AASI > median were independent predictors of AF, but this relationship was no longer significant when age was included in the model. CONCLUSIONS: AASI is an independent predictor of AF development. However, this relationship becomes insignificant after adjustment for age which is higher correlated with AASI.

A Case Report of Native Coronary Artery Thrombosis With Heparin-Induced Thrombocytopenia.

Heparin is an anticoagulant which has been widely used in various clinical settings, from thromboprophylaxis to the treatment of thromboembolism. Heparin-induced thrombocytopenia (HIT) is a rare medical condition with severe complications if unrecognised, and it carries significant risks of co-morbidities and mortality. The incidence of HIT is relatively less common in low molecular weight heparin. HIT is more common in the venous system than the arterial circulatory system, and it is rare to see multi-vessel coronary artery thrombosis due to HIT. We hereby report a case of multi-vessel coronary thrombosis secondary to low molecular weight HIT, presenting as a case of ST-segment elevation myocardial infarction. We learned from the case that low molecular weight heparin can cause thrombosis secondary to HIT and HIT could be one of the differential diagnoses in those presenting with ST-elevation myocardial infarct and recent exposure to low molecular weight heparin.

Melatonin treatment reduces ethylene production and maintains fruit quality in apple during postharvest storage.

The effects of treatment with melatonin on ripening of 'Fuji' apples during storage at 1 °C for 56 d were investigated. The apples were harvested at the commercial ripening stage and treated with 1 mmol L-1 melatonin. Compared with the control, melatonin treated apples had significant reduced ethylene production (28 d-56 d) and weight loss (14 d-56 d) during storage (p < 0.05). Also, the melatonin treatment maintained better apple skin structure throughout storage. The reduced ethylene production was regulated by the decreased expressions of MdACO1, MdACS1, MdAP2.4 and MdERF109, based on RNA-Seq analysis, which was validated using qRT-PCR analysis. Moreover, the activity of 3 enzymes, including peroxidase (POD), superoxide dismutase (SOD) and catalase (CAT), were significantly increased in melatonin treated fruit (p < 0.05). Taken together, this study highlights the inhibitory effects of melatonin in ethylene biosynthesis and factors influencing postharvest quality in apple.

Transcription Factor MdWRKY32 Participates in Starch-Sugar Metabolism by Binding to the MdBam5 Promoter in Apples During Postharvest Storage.

Starch degradation with fruit ripening is closely related to the aging process and flavor formation in apples. In this study, ethylene, 1-methylcyclopropene (1-MCP), and apples treated at different temperatures were used to determine the key genes of starch-sugar metabolism during storage. Compared with 4 °C storage, 20 °C storage promoted starch degradation and sugar accumulation in apples. In addition, ethylene treatment promoted starch degradation and sugar accumulation in apples, while 1-MCP treatment showed the opposite effects. The expression of MdBams indicated the crucial role of MdBam5 in starch-sugar conversion. Transient overexpression of MdBam5 significantly reduced the starch content in apples. Furthermore, MdWRKY32 directly combined the MdBam5 promoter and activated the MdBam5 expression, which may promote the starch degradation in apples. Therefore, it was concluded that MdWRKY32 may be involved in the regulation of starch-sugar metabolism in postharvest apples by activating the MdBam5 expression.

Cuticular wax composition changes of 10 apple cultivars during postharvest storage.

Cuticular wax chemicals differ among fruit cultivars and contribute to storage ability. However, wax analysis in apple cultivars, particularly during storage, has not been described. In this work, the chemicals and crystal structures of cuticular wax in 10 apple cultivars were analyzed to observe wax functions in apple during storage. Results showed that alkanes and primary alcohols decreased while fatty acids increased in stored fruits of all cultivars compared with the fruits before storage. Terpenoids, aldehydes, and phenols were observed in stored fruits but not in the fruits before storage in all cultivars except 'Red Star' fruit. The weight loss rate was significantly correlated with six components including C13 alcohol, C14 alkanes, total alkanes, total wax, C13 alkanes and C54 alkanes in 10 cultivar apple fruits during storage. Our findings indicate that the total wax, particularly alkanes, in the peel of apple fruits is essential for storage and quality control.