Publications by authors named "Brian Olshansky"
Aims: Recent evidence supports non-class cardioprotective effects of metoprolol against neutrophil-mediated ischemia-reperfusion injury during exacerbated inflammation. Whether metoprolol exerts direct anti-inflammatory effect on cardiomyocytes is unknown. Accordingly, we aimed to investigate the direct anti-inflammatory effects of metoprolol in a cellular model of human induced pluripotent stem cell-derived cardiomyocytes (hiCMs) and to explore the role of β-arrestin2 (β-ARR2) biased agonism signaling pathway.
View Article and Find Full Text PDFCardiac arrhythmias are commonly noted in patients during infections with and recovery from COVID-19. Arrhythmic manifestations span the spectrum of innocuous and benign to life-threatening and deadly. Various pathophysiological mechanisms have been proposed.
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- Clinical decision-making regarding syncope is complex due to its varied presentations and risk factors, which can lead to physician errors.
- AI technologies like machine learning, deep learning, and natural language processing can help identify patterns in syncope risk factors and clinical outcomes, improving diagnosis and predicting adverse events.
- The article discusses the potential advantages and challenges of using AI in syncope research and education, questioning whether AI can surpass human performance in these areas.
Article Synopsis
- A study explored the risk of thromboembolic events in patients with atrial fibrillation (AF) who were on oral anticoagulants (OACs) by analyzing different patient profiles.
- Researchers used data from over 22,000 patients in the GLORIA-AF registry and identified five distinct patient profiles, including factors like age, obesity, and hypertension.
- Among the profiles, "frailty" had the highest risk for thromboembolic events and death, while a profile classified as "young and obese" showed the lowest risk, highlighting the need for tailored risk assessment in AF patients.
Aims: Atrial fibrillation (AF) and diabetes mellitus (DM) are both associated with adverse clinical events, but the associations have not been fully elucidated, particularly with concomitant insulin use. This study aimed to analyse the associations between adverse events and DM, as well as adverse events and sole insulin use.
Materials And Methods: Our analysis included individuals with AF from the prospective Global Registry on Long-Term Oral Anti-Thrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) registry with 3-year follow-up.
Article Synopsis
- A study assessed whether the heart rate score (HRSc) after pacemaker (PM) implantation can predict new atrial high-rate episodes (AHREs) in patients with sinus node dysfunction (SND).
- Researchers evaluated 130 patients over nearly 49 months, finding that a higher HRSc (≥80%) was linked to an increased risk of AHREs compared to lower scores.
- The results suggest that HRSc ≥80% may serve as a useful predictor of AHREs, potentially influencing treatment decisions for patients with SND.
Article Synopsis
- * Data from over 14,000 AF patients were analyzed, revealing that after three years, there were significant rates of major cardiovascular events (MACE) and death among those on different treatment regimens.
- * Results showed that patients using combination therapy (beta-blockers and digoxin) had a higher risk of MACE and all-cause death compared to those using only beta-blockers.
Aims: The pathophysiology of orthostatic hypotension (OH), a common clinical condition, associated with adverse outcomes, is incompletely understood. We examined the relationship between OH and circulating endostatin, an endogenous angiogenesis inhibitor with antitumour effects proposed to be involved in blood pressure (BP) regulation.
Methods And Results: We compared endostatin levels in 146 patients with OH and 150 controls.
Article Synopsis
- Clinical complexity in patients with atrial fibrillation (AF) is associated with factors like aging and multiple health issues, which complicate treatment and outcomes.
- * A study of over 32,000 AF patients identified six distinct patient phenotypes based on comorbidities, finding that those with more complex health profiles received different treatments and had varied risks of major health events.
- *The results indicated that patients with high complexity and cardiometabolic issues had significantly higher risks of death and major cardiovascular events compared to those with fewer health issues.
Article Synopsis
- The study examined the relationship between chronic obstructive pulmonary disease (COPD) and atrial fibrillation (AF) using data from the global GLORIA-AF registry, focusing on how COPD affects treatment and outcomes.
- Out of 36,263 patients, 6.2% had COPD, with varying prevalence in different regions; factors like age, gender, and smoking were linked to COPD presence.
- COPD patients experienced different medication patterns and significantly worse health outcomes, including higher risks of death, major adverse cardiovascular events (MACEs), and major bleeding compared to patients without COPD.
Article Synopsis
- Cardioneuroablation (CNA) is a treatment that's becoming popular for people who faint often due to vasovagal syncope (VVS).
- It helps reduce the slowing down of the heart caused by too much activity from a part of the nervous system called the parasympathetic system.
- However, there are concerns that this treatment could cause an imbalance in how the heart regulates itself, possibly leading to other heart issues in the long run.
Cardiovascular dysautonomia in postacute sequelae of SARS-CoV-2 infection.
J Cardiovasc Electrophysiol
March 2024
Coronavirus disease 2019 (COVID-19) has led to a worldwide pandemic that continues to transform but will not go away. Cardiovascular dysautonomia in postacute sequelae of severe acute respiratory syndrome coronavirus 2 infection has led to persistent symptoms in a large number of patients. Here, we define the condition and its associated symptoms as well as potential mechanisms responsible.
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- * Data from the GLORIA-AF Registry included 34,421 patients, revealing that Asian patients had lower OAC prescriptions but higher discontinuation rates compared to non-Asian patients, with varying results among specific Asian subgroups.
- * Despite higher OAC discontinuation rates, Asian patients experienced a lower risk of adverse outcomes like all-cause death and major cardiovascular events, highlighting distinct ethnic factors affecting AF management.
Article Synopsis
- The study investigated the relationship between metabolic status, body mass index (BMI), and outcomes in patients with atrial fibrillation (AF) among over 24,000 participants.
- It found that higher BMI is linked with poorer metabolic health and a greater likelihood of receiving intensive treatments, like oral anticoagulants.
- Additionally, the risks of major adverse cardiovascular events varied among different BMI groups, with metabolically unhealthy individuals facing the highest risks of complications.
Aims: Heart rate score (HRSc), the per cent of atrial paced and sensed event in the largest 10 b.p.m.
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- The review investigates the mechanisms, electrocardiographic changes, and treatment methods related to cardiac arrhythmias that may occur after COVID-19 vaccination.
- A global survey indicates that 18.27% of hospitalized COVID-19 patients experience arrhythmias, with myocarditis being the most common cardiac adverse event post-vaccination.
- Potential causes of these arrhythmias include direct viral effects, inflammatory responses, electrolyte imbalances, and myocardial damage, prompting a need for standard treatment strategies for vaccination-induced arrhythmias.
Syncope is a form of transient loss of consciousness (TLOC) resulting from cerebral hypoperfusion and is characterized by rapid onset, short duration and spontaneous complete recovery [...
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- The study investigates whether vigorous exercise increases the risk of ventricular arrhythmias and mortality in individuals with hypertrophic cardiomyopathy (HCM).
- Researchers enrolled 1,660 participants aged 8 to 60 with HCM or its genetic markers, categorizing them by their exercise levels (sedentary, moderate, vigorous).
- The primary outcomes included serious events like death and arrhythmias, with findings analyzed by an unbiased committee to evaluate the effects of exercise intensity on these health risks.
Syncope, a form of transient loss of consciousness, remains a complex medical condition for which adverse cardiovascular outcomes, including death, are of major concern but rarely occur. Current risk stratification algorithms have not completely delineated which patients benefit from hospitalization and specific interventions. Patients are often admitted unnecessarily and at high cost.
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