Left atrial functions in long term after catheter ablation of premature ventricular complexes.

OBJECTIVE: Premature ventricular complex (PVC) ablation has been shown to improve left ventricle (LV) diastolic function and left atrial (LA) reverse modeling, especially in the short term. In the present study, PVC ablation via radiofrequency catheter (RFCA) was evaluated with respect to its long-term effects on LA size and dynamic functions. PATIENTS AND METHODS: A total of 71 patients (age 43.49±12.8 years, 37 men [52%]) with high-burden (21% mean burden) PVCs who were treated with RFCA were included in this retrospective study. The effects of RFCA on three characteristics - LV systolic functions, LV diastolic dysfunctions and mechanical effects pertaining to the LA - were examined by echocardiography at baseline and at 3 months and 18 months after the procedure. RESULTS: Advancement in LV ejection fraction (LVEF) was seen on long-term follow-up (LVEF baseline 53.01; 3rd month 54.55; 18th month 58.02; p<0.001). LA function gradually improved after RFCA. The LA volume index was significantly decreased after RFCA (baseline 18.15±2.89; 3 months 17.11±2.71; 18 months 16.67±2.61; p<0.001). The LA passive emptying fraction was still increasing over long-term follow-up (baseline 33.33; 3rd month 37.11; 18th month 40.91; p<0.001). CONCLUSIONS: In the present study, in patients with or without apparent cardiomyopathy, RFCA was shown to successfully eliminate PVCs and improve LA functions in the long term.

Development and evaluation of a new pelvic floor muscle training Patient reported Outcome Measures (PROM) (PFMT-P).

OBJECTIVE: There are several Patient reported Outcome Measures (PROM) of knowledge, source of knowledge and practice of pelvic floor muscle training (PFMT), in different combinations but few integrating all three in one instrument. The objective of this study was the initial psychometric testing of a new PFMT PROM (PFMT-P), which aims to describe the knowledge, source of knowledge, and practices of PFMT for use by general female population, in order to contribute to preliminary validity and reliability. STUDY DESIGN: This study offered psychometric testing (validity and reliability) of a new assessment tool concerning PFMT (PFMT-P). The sample included 323 non-pregnant women, aged 20-50, who were heath care professionals and ancillary staff in one medical center in northern Israel. The PFMT-P was developed in Hebrew and composed of 3 sections: knowledge (score range 0-3), source of knowledge (initially scored), and practice (score range 3-35). A demographic and general health questionnaire was included. RESULTS: The face and content validity of the PFMT-P were evaluated by five experts with a factor analysis done on the practice component. Test-retest scores for internal consistency were reported for a group of 20 women, to whom the tool was administered 2 weeks apart. The results of the questionnaire components were knowledge, r= 0.538, p=0.014, and practice r=0.878, p<0.001. The component, source of knowledge on practice, showed non-significant results (p=0.796). Cronbach's alpha for the PFMT-P was 0.921 for the practice component. CONCLUSION: The PFMT-P was employed for the first time in a descriptive, correlational study, where its validity and reliability was tested and shows promise. The questionnaire is brief and easy to use. Continued research using this new PROM needs to be done to establish it as an assessment tool for PFMT programs.

Association of epicardial fat thickness with TIMI risk score in NSTEMI/USAP patients.

BACKGROUND: The association of epicardial adipose tissue (EAT) with coronary artery disease has been shown in previous studies. Furthermore, the relationship between EAT and acute coronary syndrome was studied recently. Herein, we investigated the relationship between EAT thickness and the thrombolysis in myocardial infarction (TIMI) risk score for non-ST-elevation myocardial infarction (NSTEMI) and unstable angina pectoris (USAP). PATIENTS AND METHODS: The study included 144 patients with NSTEMI/USAP. The study population was divided into two subgroups according to TIMI risk scores as group I (≤ 4, n = 86) and group II (> 4, n = 58). Stepwise multivariable logistic regression analysis was used to assess the independent association of clinical parameters with TIMI risk score. RESULTS: EAT thickness was higher in group II than in group I (8.2 ± 2.1 vs. 6.2 ± 2.2, p < 0.001). Moreover, patients in group II had higher rates of multivessel disease and Gensini score (p < 0.001). In univariate linear regression analysis, EAT was positively correlated with TIMI risk score and Gensini score. Multivariate regression analysis showed that EAT thickness (OR: 1.56, 95 % CI: 1.17-2.08, p = 0.003), LVEF (OR: 0.93, 95 % CI: 0.85-0.98, p = 0.03), and Gensini score (OR: 1.36, 95 % CI: 1.24-1.98, p = 0.002) were independently associated with a higher TIMI risk score. CONCLUSION: In conclusion, EAT thickness is independently associated with TIMI risk score and may be an emerging risk factor for adverse events in NSTEMI/USAP patients.