The association between C-peptide and atrial cardiomyopathy in nondiabetic adults: results from NHANES III.

Serum C-peptide exhibits various biological activities. The relationship between C-peptide and atrial cardiomyopathy remains unknown. We aimed to investigate the association between C-peptide level and atrial cardiomyopathy in nondiabetic adults. Our study enrolled 4578 participants without diagnosed diabetes from the Third National Health and Nutrition Examination Survey (NHANES III). Atrial cardiomyopathy was defined as a deep terminal negative P wave in V1 below - 100 µV (more negative), according to the electrocardiogram. The participants were categorized into low C-peptide (≤ 1.46 nmol/L) and high C-peptide (> 1.46 nmol/L) groups, according to the receiver operating characteristic analysis. Odds ratio (OR) and 95% confidence interval (CI) for the association between C-peptide level and atrial cardiomyopathy were generated using multivariate logistic regression analysis. The prevalence of atrial cardiomyopathy was higher in the high C-peptide group than in the low C-peptide group (5.62% vs. 2.31%, P < 0.001, respectively). Multivariate logistic regression analysis showed that participants in the high C-peptide group had a 3.60-fold (95% CI 1.81-6.99) higher risk of atrial cardiomyopathy than those in the low C-peptide group. Per standard deviation increase in C-peptide was linked to a 1.20-fold (95% CI 1.00-1.41) higher risk in atrial cardiomyopathy. High C-peptide level might be an independent risk factor for atrial cardiomyopathy in nondiabetic adults.

[Thalamocortical Neural Mass Model Simulation and Study Based on Field Programmable Gate Array].

Using the computer to imitate the neural oscillations of the brain is of great significance for the analysis of brain functions.Thalamocortical neural mass model(TNMM)reflects the mechanisms of neural activities by establishing the relationships between the thalamus and the cortex,which contributes to the understanding of some specific cognitive functions of the brain and the neural oscillations of electroencephalogram(EEG)rhythms.With the increasing complexity and scale of neural mass model,the performance of conventional computer system can not achieve rapid and large-scale model simulation.In order to solve this problem,we proposed a computing method based on Field Programmable Gate Array(FPGA)hardware in this study.The Altera's DSP Builder module combined with MATLAB/Simulink was used to achieve the construction of complex neural mass model algorithm,which is transplanted to the FPGA hardware platform.This method takes full advantage of the ability of parallel computing of FPGA to realize fast simulation of large-scale and complex neural mass models,which provides new solutions and ideas for computer implementation of neural mass models.

Case report: Unusual cause of refractory hypoxemia after pacemaker lead extraction.

A 59-year-old woman with a history of a pacemaker implanted for III-degree atrioventricular block was admitted due to pocket infection. The atrial and ventricular leads were removed via the right femoral vein using a needle's eye snare. Hypoxemia was observed immediately after the removal of the lead. It was refractory to oxygen therapy. The pulse oxygen saturation (SpO2) showed 89% in the supine position and 77% in the upright position. However, the CTPA and pulmonary perfusion SPECT/CT imaging did not reveal any signs of pulmonary embolism. Pulmonary function tests and chest CT showed normal results. Transthoracic contrast echocardiography revealed a patent foramen ovale (PFO) and a right-to-left intracardiac shunt, no significant tricuspid regurgitation, without any signs of elevated right heart pressure or pulmonary hypertension. Hypoxemia was considered to be associated with the right-to-left shunt through PFO. The condition was relieved by percutaneous closure of the PFO. Refractory hypoxemia resulting from an intracardiac right-to-left shunt following pacemaker lead extraction is a rare but serious complication. Transthoracic contrast echocardiography helps in diagnosis. If the right-to-left intracardiac shunt through PFO persists irreversibly and the associated hypoxemic symptoms are significant, closure of the PFO is necessary. Transesophageal echocardiography also revealed the presence of a left-to-right shunt through PFO during cardiac systole. The closure of the PFO is also necessary to avoid long-term complications, such as chronic pulmonary hypertension and right heart failure.

Initial Experience in Transvenous Implantation of a Left Ventricular Lead With a Novel Venogram Balloon Catheter.

Aim: The most challenging and time-consuming stage of cardiac resynchronization therapy (CRT) device implantation is coronary sinus (CS) cannulation and left ventricular epicardial electrode implantation. This paper reports the initial clinical experience of CS cannulation and left ventricular lead implantation guided by a novel venogram balloon catheter (Lee's venogram balloon catheter). Methods and Results: Consecutive patients eligible for CRT were deemed suitable for this novel venogram balloon catheter. Parameters such as left ventricular lead implantation time, procedure time, and fluoroscopy time were recorded. CS cannulation with LV lead implantation guided by Lee's venogram balloon catheter was successful in all 5 patients, including 4 challenging cases. The total fluoroscopy and procedural durations were 5.0 ± 3.0 and 57.4 ± 12.5 min, respectively. No adverse catheter-related events occurred during the procedures. Conclusion: This initial study of an innovative venogram balloon catheter demonstrated that it greatly facilitated CS cannulation and successful LV lead placement in all patients undergoing CRT system implantation. This significantly shortened the learning curve and showed a decrease in left ventricular lead implantation time, procedure time, and fluoroscopy time.

The safety and efficiency of fluoroless site-specific transseptal puncture guided by three-dimensional intracardiac echocardiography.

BACKGROUND: Although fluoroless transseptal puncture (TSP) guided by intracardiac echocardiography (ICE) has been used for many years, there are no reports of an accurate site-specific method for TSP in detail, especially about the safety and efficiency of the method. This study aimed to compare the efficacy and safety of TSP guided by three-dimensional ICE using a fluoroless site-specific method with that of the conventional fluoroless method in patients with atrial fibrillation (AF). METHODS: This prospective study included 60 patients with AF scheduled for radiofrequency ablation who were assigned to undergo modified fluoroless site-specific TSP (SS-ICE group, n = 30) or conventional fluoroless TSP (C-ICE group, n = 30). TSP was guided by three-dimensional ICE in both study groups. RESULTS: All fluoroless TSP were performed successfully in both groups. There were no significant differences in patient characteristics, Pre-TSP time (11.3 ± 1.7 min vs. 11.1 ± 1.6 min, P = 0.822) and TSP time (3.4 ± 0.9 min vs. 3.5 ± 1.1 min, P = 0.772) between the SS-ICE group and the C-ICE group. The distance between the actual traversing point and the presetting point in the fossa ovalis was less than 5 mm in 87% of patients (26/30, 3.1 ± 1.2 mm) in the SS-ICE group. There were no TSP-related complications in either group. CONCLUSION: SS-ICE method is a simple, safe, and effective approach for fluoroless site-specific TSP.

Preliminary study on the application of near infrared spectroscopy and pattern recognition methods to classify different types of apple samples.

In this paper, near infrared (NIR) spectroscopy combined with pattern recognition methods was used in an attempt to classify different types of apple samples. Three pattern recognition methods such as K-nearest neighbour (KNN), partial least-squares discriminant analysis (PLSDA) and moving window partial least-squares discriminant analysis (MWPLSDA) were used to classify apple samples of different geographical origins, grades and varieties. The result indicates that MWPLSDA is superior to these two conventional pattern recognition methods. Because MWPLSDA method can select narrow but informative wavelength intervals to reconstruct an efficacious classification model with high predicting accuracy. In conclusion, MWPLSDA coupled with near-infrared fibre-optic technology is proved to be an effective method for fruit classification.