Proenkephalin as a Novel Prognostic Marker in Heart Failure Patients: A Systematic Review and Meta-Analysis.

Over the last several years, the use of biomarkers in the diagnosis of patients with heart failure (HF) has skyrocketed. Natriuretic peptides are currently the most widely used biomarker in the diagnosis and prognosis of individuals with HF. Proenkephalin (PENK) activates delta-opioid receptors in cardiac tissue, resulting in a decreased myocardial contractility and heart rate. However, the goal of this meta-analysis is to evaluate the association between the PENK level at the time of admission and prognosis in patients with HF, such as all-cause mortality, rehospitalization, and decreasing renal function. High PENK levels have been associated with a worsened prognosis in patients with HF.

Reverse of left ventricular remodeling in heart failure patients with left bundle branch area pacing: Systematic review and meta-analysis.

BACKGROUND: Left bundle branch area pacing (LBBAP) has recently become a promising option for the near-natural restoration of electrical activation. However, the clinical relevance of therapeutic effects in individuals with heart failure with reduced ejection fraction (HFrEF) and dyssynchrony remains unknown. METHODS: MEDLINE, EMBASE, and Cochrane databases were searched from inception until June 2022. Data from each study was combined using a random-effects model, the generic inverse variance method of DerSimonian and Laird, to calculate standard mean differences and pooled incidence ratio, with 95% confidence intervals (CIs). RESULTS: A total of 772 HFrEF patients were analyzed from 15 observational studies per protocol. The success rate of LBBAP implantation was 94.8% (95% CI 89.9-99.6, I2 = 79.4%), which was strongly correlated with shortening QRS duration after LBBAP implantation, with a mean difference of -48.10 ms (95% CI -60.16 to -36.05, I2 = 96.7%). Over a period of 6-12 months of follow-up, pacing parameters were stable over time. There were significant improvements in left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic diameter (LVEDD), and left ventricular end-diastolic volume (LVEDV) with mean difference of 16.38% (95% CI 13.13-19.63, I2 = 90.2%), -46.23 ml (95% CI -63.17 to -29.29, I2 = 86.82%), -7.21 mm (95% CI -9.71 to -4.71, I2 = 84.6%), and -44.52 ml (95% CI -64.40 to -24.64, I2 = 85.9%), respectively. CONCLUSIONS: LBBAP was associated with improvements in both cardiac function and electrical synchrony. The benefits of LBBAP in individuals with HFrEF and dyssynchrony should be further validated by randomized studies.

Validation of Uright model TD 3127AT wireless-portable ambulatory blood pressure monitoring device with timer trigger modification, standard cuff size, in normotensive and mild hypertensive patients of Thailand registry (Thai valid ambulatory blood pressure monitoring).

BACKGROUND: Nowadays, automated blood pressure (BP) monitoring devices are commonly used by patients as a part of standard medical care for hypertension. The timer trigger was modified into a wireless automated home BP monitoring (HBPM) device to expand its potential use as ambulatory BP monitoring. However, the BP measurement accuracy in this modified device remains unknown. OBJECTIVE: We aimed to assess the accuracy of Uright model TD 3127AT, which is an automated HBPM device with a timer trigger modification, following an International Organization for Standardization (ISO) 81060-2:2018 guidelines in the Thai population. METHODS: This cross-sectional study included normotensive and hypertensive Thai participants following the ISO 81060-2:2018 guidelines from August 2021 to February 2022. This study aimed to compare the BP readings from an automated sphygmomanometer, Uright model TD 3127AT, TaiDoc Technology Corporation, with a timer trigger to a standard manual BP measurement. RESULT: BPs were measured in 85 participants with a mean age ± SD of 38.39 ± 13.91 years, and 69% were females. The mean SBP ± SD (range) was 117.46 ± 18.63 (84-176) mmHg and the mean DBP ± SD (range) was 74.84 ± 10.70 (42-108) mmHg. The mean BP difference between observers and devices was 0.66 ± 6.81 mmHg for SBP and -0.96 ± 6.33 mmHg for DBP. The SD of the averaged pair determination per individual was ±4.45 mmHg for SBP and ±3.46 mmHg for DBP. The accuracy of the timer-triggered device was found to be acceptable when evaluated according to the ISO 81060-2: 2018 guidelines. CONCLUSION: An automated sphygmomanometer, Uright model TD 3127AT, TaiDoc Technology Corporation, with timer trigger modification passed the ISO 81060-2:2018 guidelines.